Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Oct 1996
Multicenter Study Clinical Trial Controlled Clinical TrialRange of motion in total knee replacement.
This is a multicenter prospective clinical study using a modified Knee Society scoring system which evaluated the effect of age, gender, weight, preoperative range of motion and knee score, previous surgery, and modification of the posterior femoral condyle geometry on postoperative range of motion. The primary outcome variable was change in flexion. The data were collected from 5 surgeons using a single total knee system. ⋯ Analysis of delta range of motion and delta pain showed similar results. Age, weight, previous open surgical procedure, and altered femoral component contour, did not seem significantly correlated with changes in postoperative flexion. The best predictors of postoperative clinical results are the preoperative scores.
-
Clin. Orthop. Relat. Res. · Oct 1996
Randomized Controlled Trial Clinical TrialRandomized trial of epidural versus general anesthesia: outcomes after primary total knee replacement.
To compare the effects of epidural anesthesia and general anesthesia on early postoperative outcomes after unilateral primary total knee replacement, 262 patients were randomly assigned to receive either epidural or general anesthesia. All patients received a common rehabilitation protocol including a standardized assessment of progress. One hundred eighty-eight patients received a common thromboembolic prophylaxis protocol with postoperative aspirin, and had a standardized surveillance protocol to detect thromboembolic complications. ⋯ Epidural anesthesia is associated with more rapid achievement of postoperative in hospital rehabilitation goals after total knee replacement. A minor reduction in postoperative deep vein thrombosis rate was observed with epidural anesthesia, but this did not reach statistical significance. No difference in early postoperative pulmonary embolism was observed between the 2 types of anesthesia.