Does Total Intravenous Anesthesia With Short-acting Spinal Anesthetics in Primary Hip and Knee Arthroplasty Facilitate Early Hospital Discharge?

Introduction: Our study assessed the effect of total intravenous anesthesia (TIVA) with short-acting spinal anesthesia and aggressive day-of-surgery postoperative day 0 physical therapy (POD#0 PT) on hospital length of stay (LOS) in patients who underwent primary total joint arthroplasty.

Methods: A retrospective chart review compared the hospital LOS of 116 patients who underwent primary total hip arthroplasty and total knee arthroplasty with TIVA and short-acting spinal blockade ("Updated protocol group") with that of the control group of 228 patients who were under standard anesthesia ("Traditional protocol group").

Results: Both total hip arthroplasty and total knee arthroplasty patients in the Updated protocol group had markedly reduced LOS compared with those in the Traditional protocol group (1.

Novel therapeutic strategies for degenerative disc disease: Review of cell biology and intervertebral disc cell therapy.

Intervertebral disc degeneration is a disease of the discs connecting adjoining vertebrae in which structural damage leads to loss of disc integrity. Degeneration of the disc can be a normal process of ageing, but can also be precipitated by other factors. Literature has made substantial progress in understanding the biological basis of intervertebral disc, which is reviewed here.

Cross-linking of porcine acellular dermal matrices negatively affects induced neovessel formation using platelet-rich plasma in a rat model of hernia repair.

The degree of cross-linking within acellular dermal matrices (ADM) seems to correlate to neovascularization when used in ventral hernia repair (VHR). Platelet-rich plasma (PRP) enhances wound healing through several mechanisms including neovascularization, but research regarding its effect on soft tissue healing in VHR is lacking. We sought to study the effect of cross-linking on PRP-induced neovascularization in a rodent model of bridging VHR.

Does Accelerated Physical Therapy After Elective Primary Hip and Knee Arthroplasty Facilitate Early Discharge?

Accelerated physical therapy (PT) protocols are a potential mechanism for achieving early mobilization and safe discharge from hospital after elective primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). We compared 2 groups of patients who underwent elective unilateral THA or TKA-those who started PT the same day (Day 0) and those who started PT the next day (Non-Day 0). The difference in mean (SD) hospital length of stay between the Day 0 and Non-Day 0 groups was not statistically significant for THA patients, 2.

Decreased hernia recurrence using autologous platelet-rich plasma (PRP) with Strattice™ mesh in a rodent ventral hernia model.

Background: Recurrence after ventral hernia repair (VHR) remains a multifactorial problem still plaguing surgeons today. Some of the many contributing factors include mechanical strain, poor tissue-mesh integration, and degradation of matrices. The high recurrence rate witnessed with the use of acellular dermal matrices (ADM) for definitive hernia repair has reduced their use largely to bridging repair and breast reconstruction.

Does high knee flexion cause separation of meniscal repairs?

Background: Previous clinical studies comparing nonrestrictive and restrictive protocols after meniscal repair have shown no difference in outcomes; however, some surgeons still limit range of motion out of concern that it will place undue stress on the repair.

Hypothesis: Large acute medial meniscal tears will gap during simulated open chain exercises at high flexion angles, and a repaired construct with vertical mattress sutures will not gap.

Study Design: Controlled laboratory study.

Surgical Technique for Implantation of Articulating Spacers with Stem Extensions for Treatment of Infection Following Total Knee Arthroplasty.

Introduction: This article describes our technique of adding a custom-made antibiotic-coated stem to an articulating spacer to improve fixation and effectively deliver antibiotics to the medullary canal in the treatment of infection following total knee arthroplasty.

Step 1 Obtain Items Required For Intraoperative Assembly: Make sure all required items are ready prior to the start of the operation.

Step 2 Remove The Components And Perform Thorough Debridement: Remove the components and debride all cement and necrotic, devitalized, and infected tissue.

Preformed articulating knee spacers in 2-stage total knee revision arthroplasty: minimum 2-year follow-up.

Two-stage revision arthroplasty using articulating spacers for the treatment of infected total knee arthroplasty (TKA) is a successful management technique. Our purpose was to report our results using preformed, commercially available articulating spacers made of gentamicin-impregnated cement. Thirty-three patients with infected primary or revision TKAs were treated with these spacers using a 2-stage revision technique.

Anti-thrombotic effect of bivalirudin compared with eptifibatide and unfractionated heparin in diabetic patients: an ex vivo human study.

Patients with diabetes who undergo percutaneous coronary intervention (PCI) are at high risk for thrombotic complications following the procedure. We sought to compare the anti-thrombotic effect of bivalirudin to that of eptifibatide plus unfractionated heparin in diabetic patients undergoing elective PCI. Thirty diabetic patients were randomized to receive during PCI either bivalirudin (bivalirudin group, n=15) or eptifibatide plus heparin (eptifibatide group, n=15) at standard dosing regimens.