Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Randomized Controlled TrialNo difference in blood loss between posterior-cruciate-ligament-retaining and posterior-cruciate-ligament-stabilized total knee arthroplasties.
Posterior-cruciate-ligament-retaining (PCR) and posterior-cruciate-ligament-stabilized (PS) arthroplasties are two major common practices in total knee arthroplasty (TKA). The hypothesis of the present study was that compared with the PCR technique, the PS technique is associated with a higher amount of postoperative blood loss and greater need for blood transfusion in cemented TKA. ⋯ Use of the PS technique during cemented TKA does not appear to influence the amount of perioperative blood loss or the need for postoperative blood transfusion in general. The clinical relevance of this study is that the difference in blood loss between the PCR and PS techniques does not need to be considered by surgeons when performing TKA.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Randomized Controlled TrialClinical value of tranexamic acid in unilateral and simultaneous bilateral TKAs under a contemporary blood-saving protocol: a randomized controlled trial.
Despite the documented blood-saving effects of tranexamic acid (TNA) in total knee arthroplasty (TKA), the question whether clinical values of TNA are identical in unilateral and bilateral TKAs remains unclear. This study was undertaken to determine the clinical values of TNA in unilateral and simultaneous bilateral TKAs under a contemporary blood-saving protocol in terms of efficacy (total blood loss and transfusion rate) and safety (the incidences of symptomatic deep vein thrombosis and pulmonary embolism). ⋯ This study demonstrates that the use of TNA reduces total blood loss, but the effects on the transfusion rate can differ depending on the type of TKAs (unilateral vs. bilateral) and the blood-saving protocols.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Review Meta AnalysisPeriarticular multimodal drug injection in total knee arthroplasty.
A systematic review and meta-analysis based on randomized controlled trials (RCTs) were conducted to evaluate the efficiency and safety of periarticular multimodal drug injection in total knee arthroplasty (TKA). ⋯ The current evidence suggests that periarticular multimodal drug injection in TKA provides short-term advantages in pain relief, straight leg raise and postoperative complications.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Randomized Controlled Trial Comparative StudyBetter quadriceps recovery after minimally invasive total knee arthroplasty.
The proponents of minimally invasive total knee arthroplasty (TKA) have reported better functional recovery than conventional TKA. In most of the previous studies, the results were shown with the relatively subjective methods. We investigated the objective results with a dynamometry in this prospective randomized study. It was hypothesized that minimally invasive TKA would have a better and earlier recovery of quadriceps force in terms of the objective numeric data. ⋯ Minimally invasive TKA has benefit in quadriceps recovery at earlier rehabilitation period although catch-up recovery in conventional TKA was accelerated from the postoperative 6 weeks to 3 months. It may support the concept of early return to full activity after minimally invasive TKA, and patients might get back early to normal life.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
ReviewPain after knee arthroplasty: an unresolved issue.
Despite the recent advances in the understanding of pain mechanisms and the introduction of new drugs and new techniques in the postoperative management, pain after total knee arthroplasty (TKA) is still an unresolved issue. It affects the quality of life and rehabilitation of an important percentage of patients undergoing TKA. The aim of this narrative review was to give an overview on pain mechanisms and multimodal pain management. ⋯ This narrative review offers a clear overview of pain mechanism after knee arthroplasty and an understanding on how multimodal pain management can reduce the intensity and duration of pain after knee arthroplasty.