The Journal of arthroplasty
-
Randomized Controlled Trial
Multiple-Dose Intravenous Tranexamic Acid Further Reduces Hidden Blood Loss After Total Hip Arthroplasty: A Randomized Controlled Trial.
The most appropriate dose of tranexamic acid in total hip arthroplasty (THA) has not been decided. This study was conducted to evaluate the clinical effects of multiple-dose intravenous tranexamic acid (IV-TXA) in THA. ⋯ The 5-dose IV-TXA regimen can further diminish HBL, decrease maximum Hb drop, provide additional fibrinolysis control, and ameliorate postoperative inflammatory response following THA.
-
The prevalence of dialysis-dependent patients is growing, and an increasing number of these patients are being considered for total knee arthroplasty (TKA). Studies assessing the preoperative risk associated with TKA in this population are limited to institutional cohorts with small sample sizes or national inpatient databases that lack follow-up data. ⋯ 3.
-
Bundled payments are meant to reduce costs and improve quality of care. Without adequate risk adjustment, bundling may be inequitable to providers and restrict access for certain patients. This study examines patient factors that could improve risk stratification for the Comprehensive Care for Joint Replacement (CJR) bundled-payment program. ⋯ Large database analysis; Level III.
-
The incidence of and risk factors for kinesiophobia after total knee arthroplasty (TKA) have not been well characterized in the literature. Thus, the aim of this study was to investigate the incidence of postoperative kinesiophobia among patients undergoing TKA and to identify the associated risk factors. ⋯ A 24.4% incidence rate of postoperative kinesiophobia was noted in patients following TKA. Older age (most notably ≥76 years old), lower education levels, negative coping styles, greater pain intensity, lower self-efficacy, and less social support were associated with odds of developing postoperative kinesiophobia.
-
The use of narcotics has been found to be a modifiable risk factor for success of arthroplasty. We sought to determine the risk factors leading to increased narcotic use after total hip arthroplasty and total knee arthroplasty. ⋯ This study suggests that a patient's preoperative narcotic, tramadol, benzodiazepine, and tobacco use are correlated to the amount of postoperative narcotic prescriptions filled in the 3 months following surgery. Predisposition to substance abuse may be a characteristic which leads to increased postoperative narcotic use.