The Journal of arthroplasty
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The objective of this study is to assess preoperative patient expectations of medial opening wedge high tibial osteotomy (MOWHTO) and related postoperative fulfillment, to increase understanding of associated factors of postoperative satisfaction. ⋯ The small discrepancy between preoperative expectations and postoperative fulfillment of expectations was a major contributor to patients' satisfaction following MOWHTO.
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Randomized Controlled Trial
Efficacy of Adductor Canal Block Combined With Additional Analgesic Methods for Postoperative Analgesia in Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Study.
The aim of this study is to evaluate the efficacy of adductor canal block (ACB) combined with additional analgesic methods in total knee arthroplasty (TKA) and investigate whether blocking the sensory nerves that are distributed in the posterior and lateral aspect of knee could improve postoperative pain control. ⋯ Combining ACB with both iPACK and LFCNB is an effective method for decreasing early postoperative pain in TKA without increasing the complications or affecting the early rehabilitation.
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There is limited evidence on the survivorship of patients who undergo cementless stem implantation, beyond 20 years of the hip arthroplasty. We report implant survival and results of the CLS Spotorno femoral stem until 30 years from implantation. ⋯ The cementless CLS Spotorno stem displayed satisfactory results 24 years after implantation and high estimated survival until 30 years from surgery. However, patients below the age of 50 at the time of surgery have an increased risk of undergoing revision of their femoral stem.
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Persistent wound drainage (PWD) is one of the major risk factors for periprosthetic joint infections (PJI), arguably the most dreaded complications after a total hip and knee arthroplasty (THA and TKA). The aim of this study is to identify the rates of PWD among THA and TKA patients who received aspirin (ASA) or Coumadin for postoperative venous thromboembolism (VTE) prophylaxis. ⋯ Use of ASA is associated with significantly lower rates of PWD after THA and TKA when compared to Coumadin while being equally efficacious at preventing VTE. Coumadin was found to be an independent risk factor for PWD.
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There is paucity of data regarding opioid dispension in patients undergoing bilateral total knee arthroplasty (BTKA). Our aim is to compare in-hospital opioid dispension between BTKA and unilateral TKA (UTKA) and to identify other factors associated with opioid dispension in the BTKA and UTKA cohorts. ⋯ BTKA patients have increased odds for higher in-hospital opioid dispension compared to UTKA recipients. Utilization and prescribing habits should be examined to determine the optimal approach to opioid prescription in BTKA patients compared to UTKA.