The Journal of arthroplasty
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This study investigated the effects of dronabinol on pain, nausea, and length of stay following total joint arthroplasty (TJA). ⋯ These findings suggest that further investigation into the role of cannabinoid medications for non-opioid pain control in the post-arthroplasty patient may hold merit.
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We aimed at determining whether the coronal alignment of lower extremity was related to rotational geometry of distal femur, femoral anteversion, and tibial torsion in patients with knee osteoarthritis. ⋯ The change patterns of the rotational profiles of the lower extremity according to the coronal alignment should be considered in order to obtain satisfactory rotational alignment after TKA.
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Observational Study
The Role of Perioperative Statin Use in the Prevention of Delirium After Total Knee Replacement Under Spinal Anesthesia.
The relationship between statin use and incidence of postoperative delirium (POD) is controversial. We investigated the association between perioperative statin use and occurrence of delirium after total knee arthroplasty (TKA) under spinal anesthesia. ⋯ Continuous perioperative statin use may be associated with a significantly lower risk of delirium after TKA under spinal anesthesia; simvastatin was the most effective statin for POD prevention.
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Two-stage revision utilizing spacers loaded with high-dose antibiotic cement prior to reimplantation remains the gold standard for treatment of periprosthetic joint infections (PJI) in total hip arthroplasty (THA) in North America, but there is a paucity of data on mid-term outcomes. We sought to analyze the survivorship free of infection, clinical outcomes, and complications of a specific articulating spacer utilized during 2-stage revision. ⋯ Insertion of an articulating antibiotic spacer during a 2-stage revision THA for PJI demonstrates reliable infection eradication and improvement in clinical function, including the spacer phase. Patients with trochanteric deficiency and an articulating spacer dislocation are at high risk of post-reimplantation dislocation; judicial use of a dual-mobility or constrained device should be considered in these patients.
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Bone loss is a severe problem in septic revision total knee arthroplasty (RTKA). The use of porous coated metaphyseal sleeves is a promising treatment option for metaphyseal bone defects. The currently published midterm results remain limited and no study has been focused exclusively on septic cases. Our aim was to determine the implant survivorship (with special focus on osseointegration) and the clinical and radiological midterm outcome of metaphyseal sleeve fixation in septic RTKA surgery (minimum follow-up of 2 years). ⋯ Metaphyseal sleeves have shown very promising midterm results regarding clinical scores, osseointegration, and aseptic loosening. Our results are the first analyzing exclusively septic indications and indicate that they are a reliable fixation option in all bone defect types in septic RTKA patients.