The Journal of arthroplasty
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Randomized Controlled Trial
Risk of deep venous thrombosis in drain clamping with tranexamic acid and carbazochrome sodium sulfonate hydrate in total knee arthroplasty.
The aim of this randomized prospective study was to clarify risks associated with a drain-clamping method using tranexamic acid and carbazochrome sodium sulfonate hydrate after total knee arthroplasty (TKA). Subjects comprised 100 patients scheduled to undergo TKA, randomized into 2 groups: 50 patients received the drain-clamping method using tranexamic acid and carbazochrome sodium sulfonate hydrate and 50 patients received drain-clamping with saline. Although bleeding volume was significantly lower in the group with tranexamic acid and carbazochrome sodium sulfonate hydrate, risk of asymptomatic deep venous thrombosis as detected by ultrasonography was comparable between groups. Tranexamic acid and carbazochrome sodium sulfonate hydrate in the drain-clamping method help reduce bleeding after TKA without increasing the risk of deep venous thrombosis.
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Randomized Controlled Trial
Prewarming operating rooms for prevention of intraoperative hypothermia during total knee and hip arthroplasties.
Prewarming operating rooms has been shown to limit hypothermia in pediatric surgical patients but may be associated with extreme discomfort for surgeons. We examined the effect of prewarming operating rooms on core temperatures during knee and hip arthroplasties. Sixty-six patients were randomized to the prewarmed group at 24 °C or control group at 17 °C. ⋯ By the start of surgery, the difference was 36.01 °C prewarmed vs 35.83 °C control, P = .038. There was no significant difference in the last recorded mean temperatures between groups: 36.35°C (prewarmed) vs 36.16 °C (control). A prewarmed operating room for adults undergoing knee or hip arthroplasty had minimal effect on preventing intraoperative hypothermia.
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Randomized Controlled Trial
Anterolateral minimally invasive total hip arthroplasty: a prospective randomized controlled study with a follow-up of 1 year.
Anterolateral minimally invasive hip surgery (ALMIS) is a challenging procedure that is thought to offer a more expedient and a better functional outcome. Seventy-nine patients receiving primary hip arthroplasty were randomized. Röttinger ALMIS technique was used for 42 patients, whereas 41 received the standard lateral transgluteal Hardinge approach. ⋯ Computed tomographic analysis revealed no significant difference in implant position, heterotopic ossification, and loosening. Röttinger ALMIS is a valid approach for hip arthroplasty. However, it offers no advantages at 1 year.
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Failure on the femoral side after third-generation metal-on-metal hip resurfacing arthroplasty is suggested to be easily treated with conversion to conventional total hip arthroplasty. Clinical results of conversion for failed hip resurfacing arthroplasty with the use of primary femoral implants confirmed this for a short-term follow-up. We present a case of the occurrence of a stemmed femoral implant neck fracture in a patient who was earlier treated for a failed hip resurfacing. We advise to consider acetabular revision in case of (suspected) acetabular metal damage and to use a stem component with a relative large neck diameter.
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Comparative Study
Does a collar improve the immediate stability of uncemented femoral hip stems in total hip arthroplasty? A bilateral comparative cadaver study.
The aim of this study was to compare the immediate stability of collared vs collarless uncemented femoral stems in total hip arthroplasty. A bilateral comparative study of 20 cadavers (40 hips: 20 collarless, 20 collared) was performed. Forces in the vertical and horizontal planes required to initiate subsidence of femoral stem and subsequent femoral fracture were measured. ⋯ Fracture occurred at a significantly higher force for collared stems (P = .005). Collared uncemented stems have significantly greater immediate stability than collarless. They are able to withstand greater vertical and horizontal forces before the initiation of subsidence and subsequent fracture.