The Journal of arthroplasty
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Randomized Controlled Trial
To use or not to use continuous passive motion post-total knee arthroplasty presenting functional assessment results in early recovery.
Continuous passive motion (CPM), though of doubtful value, is yet routinely practiced post-total knee arthroplasty (TKA). We prospectively distributed 84 patients with TKA to 1 of the 3 standard rehabilitation regimes: no-CPM, 1-day-CPM, and 3-day-CPM. ⋯ We concluded that CPM gives no benefit in immediate functional recovery post-TKA, and in fact, the postoperative knee swelling persisted longer. We have since then discontinued its use in our patients without any untoward effect.
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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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Randomized Controlled Trial
Is intra-articular multimodal drug injection effective in pain management after total knee arthroplasty? A randomized, double-blinded, prospective study.
We performed a prospective, double-blinded, randomized, and controlled study to assess the clinical efficacy and safety of intra-articular multimodal drug injection after total knee arthroplasty. Two hundred eighty-six patients undergoing simultaneous bilateral total knee arthroplasty were randomized to receive the injection of multimodal drugs in one knee and normal saline solution as a placebo in the contralateral knee. ⋯ The range of motion and blood loss were also recorded. Intraoperative intra-articular injection of multimodal drugs into the knee did not improve patient pain and satisfaction, range of motion, or blood loss compared with the placebo control.