The Journal of arthroplasty
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Multicenter Study Observational Study
Does Neuraxial Anesthesia Decrease Transfusion Rates Following Total Hip Arthroplasty?
Perioperative transfusions increase complications and cost following THA. Current series evaluating neuraxial anesthesia and blood loss following THA are small and utilize heterogeneous populations. Using the NSQIP database we compared transfusion rates following THA with neuraxial and general anesthesia. ⋯ Operative time and length of stay were shorter with neuraxial anesthesia as well. After adjusting for patient comorbidities, a multivariate regression model showed fewer transfusions with neuraxial anesthesia. The multivariate regression model showed additional independent risk factors for transfusion including gender, operative time, elevated INR, and a history of hypertension, metastatic cancer, and renal failure.
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The purpose of this study is to evaluate the effect of gender on functional outcomes in Asian patients undergoing conventional total knee arthroplasty (TKA). ⋯ Similar to several studies in the Western literature, gender does not seem to affect short-term outcomes in Asian patients undergoing TKA. Longer-term data on survivorship and outcomes are needed before routine use of gender-specific TKA can be recommended.
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127 patients with a height ≤ 150 cm (non metric ≤ 4 feet and 11 inches) who received hip arthroplasty surgery between July 1, 2006 and May 30, 2013 at our institution were enrolled. Retrospective data evaluation was performed for two different times of follow-up (1 year and 5 years respectively). 115 patients were evaluated for 1-year follow up. ⋯ Hip arthroplasty can be performed in patients with dwarfism with good clinical benefits. However, survival rates are worse compared to the general population.
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We undertook a systematic review of 11 randomised controlled trials comparing patient outcomes in total knee arthroplasty in those who had undergone pre-operative physiotherapy-based interventions against control groups. Results show that there is little evidence that pre-operative physiotherapy brings about significant improvements in patient outcome scores, lower limb strength, pain, range of movement and hospital length of stay following total knee arthroplasty. The overall quality of the studies was moderate to poor, mostly due to the small sample sizes.
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Randomized Controlled Trial
Adductor Canal Blockade Following Total Knee Arthroplasty-Continuous or Single Shot Technique? Role in Postoperative Analgesia, Ambulation Ability and Early Functional Recovery: A Randomized Controlled Trial.
Total knee arthroplasty (TKA) can be associated with severe pain in early postoperative period. Adductor canal block may provide optimal analgesia following TKA. However, ideal regimen for administration whether continuous or single shot is yet undefined. We prospectively randomized 90 patients in continuous and single shot adductor canal blockade groups. Postoperative VAS (visual analog scale for pain) score was significantly better at all times in continuous than single shot technique (P<0.001). However, ambulation ability (Timed Up & Go, 10m walk, 30s chair) and early functional recovery (active SLR, ambulation with walker, staircase competency, ambulation distance and maximal flexion at discharge) showed no statistical significant difference. Continuous adductor canal blockade was superior to single shot block in terms of pain control but was similar for early functional recovery. ⋯ Level III, therapeutic study.