Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 2015
Topical tranexamic Acid does not affect electrophysiologic or neurovascular sciatic nerve markers in an animal model.
Tranexamic acid is a safe and effective antifibrinolytic agent used systemically and topically to reduce blood loss and transfusion rate in patients having TKA or THA. As the hip does not have a defined capsule, topical application of tranexamic acid may entirely envelop the sciatic nerve during THA. Accidental application of tranexamic acid onto the spinal cord in spinal anesthesia has been shown to produce seizures; therefore, we sought to investigate if topical application of tranexamic acid on the sciatic nerve has a deleterious effect. ⋯ Topical tranexamic acid is effective in decreasing patient blood loss during THA, and results from our in vivo rat model study suggest there may be no electrophysiologic and histologic effects on the sciatic nerve, with the numbers available, up to 1 month.
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Clin. Orthop. Relat. Res. · Mar 2015
Diabetes confers little to no increased risk of postoperative complications after hip fracture surgery in geriatric patients.
Diabetes and hip fractures in geriatric patients are common, and many elderly patients have a history of diabetes. However, the influence of diabetes on surgical complications may vary based on which particular type of diabetes a patient has. To our knowledge, no prior study has stratified patients with diabetes to compare patients with noninsulin-dependent and insulin-dependent diabetes regarding rates of postoperative adverse events, length of hospitalization, and readmission rate after surgical stabilization of hip fractures in geriatric patients. ⋯ Level III, case-control study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2015
What are the 5-year survivorship outcomes of compressive endoprosthetic osseointegration fixation of the femur?
Aseptic complications such as stress shielding leading to bone loss are major problems associated with revision of cemented and uncemented long-stem tumor endoprostheses. Endoprosthetic reconstruction using compressive osseointegration fixation is a relatively new limb salvage technology designed to enhance osseointegration, prevent stress shielding, and provide fixation for short end-segments. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2015
Meta AnalysisDoes nonsurgical treatment improve longitudinal outcomes of lateral epicondylitis over no treatment? A meta-analysis.
Lateral epicondylitis is a painful tendinopathy for which several nonsurgical treatment strategies are used. Superiority of these nonsurgical treatments over nontreatment has not been definitively established. ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Mar 2015
What are the functional outcomes of endoprosthestic reconstructions after tumor resection?
The majority of published functional outcome data for tumor megaprostheses comes in the form of subjective functional outcome scores. Sparse objective data exist demonstrating functional results, activity levels, and efficiency of gait after endoprosthetic reconstruction in patients treated for orthopaedic tumors. Patients embarking on massive surgical operations, often in the setting of debilitating medical therapies, face mortality and a myriad of unknowns. Objective functional outcomes provide patients with reasonable expectations and a means to envision life after treatment. Objective outcomes also provide a means for surgeons to compare techniques, rehabilitation protocols, and implants. ⋯ Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.