Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2013
Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty.
The use of antifibrinolytic medications in hip and knee arthroplasty reduces intraoperative blood loss and decreases transfusion rates postoperatively. Tranexamic acid (TXA) specifically has not been associated with increased thromboembolic (TE) complications, but concerns remain about the risk of symptomatic TE events, particularly when less aggressive chemical prophylaxis methods such as aspirin alone are chosen. ⋯ A low complication rate was seen when using TXA as a blood conservation modality during primary THA and TKA with less aggressive thromboprophylactic regimens such as aspirin alone and dose-adjusted warfarin.
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Clin. Orthop. Relat. Res. · Jan 2013
Which factors increase risk of malalignment of the hip-knee-ankle axis in TKA?
Computer navigation has improved accuracy and reduced the percentage of alignment outliers in TKA. However, the characteristics of outliers and the risk factors for limb malalignment after TKA are still unclear. ⋯ The presence of preoperative radiographic risk factors should alert the surgeon to increased chance of malalignment and every measure should be undertaken in such at-risk knees to ensure proper limb and component alignment and soft tissue balance.
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Clin. Orthop. Relat. Res. · Jan 2013
Postoperative alignment and ROM affect patient satisfaction after TKA.
Patient satisfaction has increasingly been recognized as an important measure after total knee arthroplasty (TKA). However, we do not know yet how and why the patients are satisfied or dissatisfied with TKA. ⋯ Most patients did not report symptoms, but they experienced difficulty with activities of daily living after TKA. Patient satisfaction is difficult to measure, but avoiding varus alignment and achieving better ROM appear to be important for increasing satisfaction and meeting expectations.
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Clin. Orthop. Relat. Res. · Jan 2013
Do fresh osteochondral allografts successfully treat femoral condyle lesions?
Fresh osteochondral allograft transplantation is an increasingly common treatment option for chondral and osteochondral lesions in the knee, but the long-term outcome is unknown. ⋯ Followup of femoral condyle osteochondral allografting demonstrated durable improvement in pain and function, with graft survivorship of 82% at 10 years.