The Journal of arthroplasty
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The purpose of our study is to examine post-operative opioid use in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients and describe factors associated with the need for refill prescriptions. ⋯ Compared to THA patients, TKA patients were twice as likely to require refill opioid prescriptions and were prescribed a greater total MED for a longer period of time post-operatively. Patients undergoing TKA who present with a comorbidity or are currently being treated for anxiety or depression are more likely to require a refill.
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Periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) is a devastating complication. The short-term morbidity profile of revision TKA performed for PJI relative to non-PJI revisions is poorly characterized. The purpose of this study is to determine 30-day postoperative outcomes after revision TKA for PJI, relative to primary TKA and aseptic revision TKA. ⋯ Utilizing a large, prospectively collected, national database, we found that revision TKA for PJI has a greater risk of short-term morbidity and mortality and requires a higher utilization of healthcare resources. These results have implications for patient counseling and alternative payment models that may eventually include revision TKA.
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Multicenter Study
Midterm Survivorship After Revision Total Hip Arthroplasty With a Custom Triflange Acetabular Component.
Custom triflange acetabular components are being increasingly used for the reconstruction of Paprosky type IIIB acetabular defects. However, midterm survivorship data are lacking. ⋯ Custom triflange reconstruction for severe acetabular deficiency is a viable option; however, complications are common and significant challenges remain for those that fail.
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Randomized Controlled Trial
Intraoperative Infiltration of Liposomal Bupivacaine vs Bupivacaine Hydrochloride for Pain Management in Primary Total Hip Arthroplasty: A Prospective Randomized Trial.
Pain management after total hip arthroplasty is well studied. Nevertheless, there is no consensus regarding the "cocktail" to use in periarticular infiltration (PAI). Liposomal bupivacaine (LB) is a slow release local anesthetic that can be infiltrated during surgery. In this study, we compared LB to bupivacaine hydrochloride (HCL). ⋯ Intraoperative PAI with LB did not result in significant differences in postoperative opioid consumption, pain scores, opioid-related side effects, time to first ambulation, and length of stay up to 72 hours following total hip arthroplasty compared to a control group.
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Lateral unicompartmental knee arthroplasty (UKA) has been shown to be an effective procedure to treat isolated lateral compartment osteoarthritis with excellent long-term survivorship. Whether a medial parapatellar approach or a lateral parapatellar approach is superior in lateral UKA is unknown. The purpose of this study was to determine if there is a difference in intermediate-term clinical outcomes in patients undergoing lateral UKA through a lateral vs medial parapatellar approach. ⋯ Although our sample size was small, we could not demonstrate a difference in revision rates or clinical outcome scores when comparing a lateral or a medial approach with lateral UKA at intermediate-term follow-up. A lateral approach did have greater postoperative flexion, but its clinical significance remains undetermined.