The Journal of arthroplasty
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Tranexamic acid (TXA) has proven to be very advantageous to the total knee arthroplasty (TKA) population. With TXA, the need for allogeneic blood transfusion is reduced and thus hospital costs are reduced. ⋯ There were no transfusions when TXA was applied topically, and the facility cost was $39.14/TKA and no employee hours consumed. Topical TXA has the potential to significantly reduce blood transfusions and decrease hospital man-hours/TKA as well as achieve larger cost saving.
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Antibiotic-loaded cement spacers in first-stage revision hip arthroplasty for infection are associated with a high dislocation and fracture rate. This technical note describes a novel surgical technique, utilizing screws and cement, improving acetabular coverage and reducing the risk of mechanical failure. ⋯ No dislocations or fractures of the cement spacers were observed. This technique affords the potential to reduce the duration of time cement spacers remaining in situ, provides enhanced mechanical stability and improved antibiotic elution through cement-on-cement articulation.
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Randomized Controlled Trial Comparative Study
The use of exparel (liposomal bupivacaine) to manage postoperative pain in unilateral total knee arthroplasty patients.
Efforts continue to improve pain after total knee arthroplasty (TKA) in order to allow for accelerated rehabilitation. The purpose of this study was to evaluate pain control after TKA. A randomized prospective study of 80 consecutive patients was performed comparing Exparel versus femoral nerve block (FNB). ⋯ There were no statistically significant differences between the groups with regard to pain, nausea and vomiting, and narcotic consumption. The FNB group had greater flexion but the Exparel group had improved early ambulation and decreased LOS. Exparel provided similar pain relief to a FNB after TKA without compromising early rehabilitation.