Acta Orthop Belg
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Comparative Study
Anticoagulant use and its effect on bleeding and complications in total knee arthroplasty.
Currently, there is very limited literature on the effect of long-term anticoagulants on total knee arthroplasty. The primary purpose of this study was to determine the effect of warfarin and clopidogrel on the transfusion rate, intra-operative blood loss, and postoperative blood loss for total knee arthroplasty. ⋯ Data was collected retrospectively from medical charts between 2003-2008 and case matched to a control group. The patients on warfarin had a higher rate of blood transfusion, blood loss, and length of hospital stay compared to the clopidogrel and control groups.
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Review Comparative Study
Higher incidence of new vertebral fractures following percutaneous vertebroplasty and kyphoplasty--fact or fiction?
New vertebral fractures after percutaneous vertebroplasty or kyphoplasty are said to result from biomechanical changes induced by cementation. Fact or fiction? The reported incidences for new vertebral fractures after cementation or after conservative therapy vary widely. This is mainly due to differences in their design, more specifically as to the duration of followup. ⋯ In other words, it was impossible to separate facts from fiction with the studies available to-day. The combined odds ratio of vertebroplasty and kyphoplasty versus conservative treatment, namely 0.96, gave a hint that there might be little difference. Large scale randomized studies will be necessary.
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The optimal form of post-operative analgesia in hip and knee arthroplasty is still debated. Traditionally, patient-controlled analgesia and epidural anaesthesia were used. Potential side-effects such as nausea, confusion, urinary retention, hypotension and immobility have resulted in the emergence of newer techniques that limit opioid use. ⋯ Local infiltrative analgesia (LIA) is an emerging technique that has shown to provide superior analgesia, higher patient satisfaction and earlier discharge from hospital when compared to some of the more traditional methods. This review article highlights the advantages of LIA in hip and knee arthroplasty surgery. We describe the technique used, including additional measures that aid early ambulation and discharge from hospital in this cohort of patients.