Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2014
Randomized Controlled Trial Comparative StudyIs L2 paravertebral block comparable to lumbar plexus block for postoperative analgesia after total hip arthroplasty?
Continuous lumbar plexus block (LPB) is a well-accepted technique for regional analgesia after THA. However, many patients experience considerable quadriceps motor weakness with this technique, thus impairing their ability to achieve their physical therapy goals. ⋯ Level I, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Observational StudyAssociation of obesity with inflammation and pain after total hip arthroplasty.
The prevalence of obesity is increasing, and obesity often leads to degenerative joint disease requiring total hip arthroplasty (THA). Obesity is a proinflammatory state associated with an increase in chronic, low-grade inflammatory response. As such, it may augment the postoperative inflammatory response, which has been associated with postoperative pain and complications. ⋯ Level II, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Observational StudyBurden incurred by patients and their caregivers after outpatient surgery: a prospective observational study.
The burden of patients and their caregivers after outpatient surgery has not been fully examined. The number of outpatient surgeries has dramatically increased in the last several years, particularly in the orthopaedic sector. Patients undergoing outpatient orthopaedic procedures may be expected to have more postdischarge pain than those undergoing nonorthopaedic outpatient procedures. In light of this, assessment of patient and caregiver expectations and actual burden after discharge is of importance. ⋯ Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Comparative StudyUnicompartmental knee arthroplasty survivorship is lower than TKA survivorship: a 27-year Finnish registry study.
Balancing the relative advantages and disadvantages of unicompartmental knee arthroplasties (UKAs) against those for TKAs can be challenging. Survivorship is one important end point; arthroplasty registers repeatedly report inferior midterm survival rates, but longer-term data are sparse. Comparing survival directly by using arthroplasty register survival reports also may be inadequate because of differences in indications, implant designs, and patient demographics in patients having UKAs and TKAs. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2014
Topical tranexamic acid reduces blood loss and transfusion rates associated with primary total hip arthroplasty.
Systemic tranexamic acid can decrease blood loss and rates of transfusion in patients undergoing total hip arthroplasty (THA). However, the efficacy of topical tranexamic acid in THA has only recently been characterized in a small number of studies. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.