The Journal of arthroplasty
-
Randomized Controlled Trial Comparative Study
Comparison of Local Infiltration Analgesia With Femoral Nerve Block for Total Knee Arthroplasty: A Prospective, Randomized Clinical Trial.
Total knee arthroplasty (TKA) is usually associated with severe postoperative pain, which can prevent rehabilitation of patients' knee function and influence the satisfaction of surgery. Local infiltration analgesia (LIA) as a new method to managing postoperative pain has been applied in clinical practice recently. However, the safety and efficacy of LIA compared with femoral nerve block (FNB) in postoperative pain management of TKA still remains controversial. Thus, we conducted an original clinical trial to compare LIA and FNB. ⋯ Our research showed that no significant differences were observed between the 2 treatment groups. LIA could provide a similar analgesic effect to FNBs with a low incidence of complications.
-
Randomized Controlled Trial
The Effect of Perioperative Corticosteroids in Total Hip Arthroplasty: A Prospective Double-Blind Placebo Controlled Pilot Study.
Surgery produces a rapid rise in interleukin 6 (IL-6) which may increase the risk of deep vein thrombosis and medical complications. Perioperative corticosteroids suppress IL-6 release in patients undergoing total knee arthroplasty. This study evaluates the effects of a perioperative corticosteroid regimen on IL-6 formation, thrombogenesis, fibrinolysis, and clinical outcomes in patients undergoing unilateral, uncemented, total hip arthroplasty. ⋯ The use of corticosteroids was associated with a statistically significant decrease in IL-6 at 6 and 24 hours postoperatively but did not affect thrombogenic markers. The study group had improved postoperative analgesia and a trend toward improved functional outcome at 3 months postoperatively.
-
This study aimed to compare risk of postdischarge adverse events in elective total joint arthroplasty (TJA) patients by discharge destination, identify risk factors for inpatient discharge placement and postdischarge adverse events, and stratify TJA patients based on these risk factors to identify the most appropriate discharge destination. ⋯ SNF or IRF discharge increases the risk of postdischarge adverse events compared to home. Modifiable risk factors for nonhome discharge and postdischarge adverse events should be addressed preoperatively to improve patient outcomes across discharge settings.