Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyUnicompartmental versus total knee arthroplasty database analysis: is there a winner?
TKA and unicompartmental knee arthroplasty (UKA) are both utilized to treat unicompartmental knee arthrosis. While some surgeons assume UKA provides better function than TKA, this assumption is based on greater final outcome scores rather than on change in scores and many patients with UKA have higher preoperative scores. ⋯ While patients with UKA had higher pre- and postoperative scores than patients with TKA, the changes in scores were similar in both groups and survival appeared higher in patients with TKA.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyDecreased length of stay after TKA is not associated with increased readmission rates in a national Medicare sample.
There is a trend toward decreasing length of hospital stay (LOS) after TKA although it is unclear whether this trend is detrimental to the overall postoperative course. Such information is important for future decisions related to cost containment. ⋯ The most common causes for readmission were cardiac-related. A reduction in LOS was not associated with an increase in the readmission rate in this sample. Optimization of cardiac status before discharge and routine primary care physician followup may lead to lower readmission rates.
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Clin. Orthop. Relat. Res. · Jan 2012
Lateral unicompartmental knee arthroplasty relieves pain and improves function in posttraumatic osteoarthritis.
Posttraumatic arthritis secondary to lateral tibial plateau fracture malunion causes pain and limited function for patients. It is sometimes technically challenging to correct malalignment in these patients with advanced arthritis using osteotomies. Lateral unicompartmental knee arthroplasty (UKA) may be an option to treat such patients. ⋯ Despite the limited number of indications and technical considerations, our observations suggest lateral UKA is a reasonable option for treating lateral arthritis secondary to malunited fractures.
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Clin. Orthop. Relat. Res. · Jan 2012
Incidence of deep vein thrombosis and pulmonary embolism after Achilles tendon rupture.
The use of venous thromboembolism prophylaxis after an Achilles rupture is controversial. The rates of reported deep vein thrombosis (DVT) range from 6.3% to 34%. There is no agreement regarding prophylactic therapy after an Achilles tendon rupture. ⋯ We found the overall incidence of symptomatic DVT and PE to be low after an Achilles tendon rupture and believe routine use of anticoagulation might be unwarranted.
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Clin. Orthop. Relat. Res. · Jan 2012
Comparative StudyPatient-related risk factors for postoperative mortality and periprosthetic joint infection in medicare patients undergoing TKA.
The impact of specific baseline comorbid conditions on the relative risk of postoperative mortality and periprosthetic joint infection (PJI) in elderly patients undergoing TKA has not been well defined. ⋯ We believe this information important when counseling elderly patients regarding the risks of mortality and PJI after TKA and risk-adjusting publicly reported TKA patient outcomes.