Pain control is necessary for successful rehabilitation and outcome after total knee arthroplasty. Our goal was to compare the clinical efficacy of periarticular injections consisting of a long-acting local anesthetic (ropivacaine) and epinephrine with and without combinations of an α2-adrenergic agonist (clonidine) and/or a nonsteroidal anti-inflammatory agent (ketorolac). In a double-blinded controlled study, we randomized 160 patients undergoing total knee arthroplasty to receive 1 of 4 intraoperative periarticular injections: Group A, ropivacaine, epinephrine, ketorolac, and clonidine; Group B, ropivacaine, epinephrine, and ketorolac; Group C, ropivacaine, epinephrine, and clonidine; Group D (control), ropivacaine and epinephrine.
View Article and Find Full Text PDFBackground: Proponents of minimally invasive total knee arthroplasty claim that patellar eversion and anterior tibial translation during total knee arthroplasty have a deleterious effect on early patient rehabilitation and the early clinical outcome. Our purpose was to identify differences in knee preference and clinical outcome measures in a series of patients who had undergone bilateral total knee arthroplasty with each knee randomized to one of two different surgical approaches: patellar eversion and anterior tibial translation, or patellar subluxation and no tibial translation.
Methods: The knees of forty patients were prospectively randomized to one of two treatment groups, patellar eversion or patellar subluxation, with each patient having one knee treated with each type of approach.
Objective: To determine whether extremely obese binge eating disorder (BED) subjects (BED defined by the Eating Disorder Examination) differ from their extremely obese non-BED counterparts in terms of their eating disturbances, psychiatric morbidity and health status.
Design: Prospective clinical comparison of BED and non-BED subjects undergoing gastric bypass surgery (GBP).
Subjects: Thirty seven extremely obese (defined as BMI > or = 40 kg/m(2)) subjects (31 women, six men), aged 22-58 y.
Background: This study compared the effectiveness of cognitive therapy (CT), nutritional therapy (NT), the combination of cognitive and nutritional therapy (CNT), against a control condition of support group (SG) in the treatment of bulimia nervosa.
Methods: One hundred female out-patients who fulfilled DSM-III-R criteria for bulimia nervosa were randomized to the four treatment groups. NT and CT were designed to cover different areas with minimal overlap, and CNT provided all of the features of both of these treatments.
A retrospective review of 770 consecutive primary total hip arthroplasties was conducted to determine the complications and utility of a modified direct lateral approach, which involves elevation of the anterior one-third of the gluteus medius and vastus lateralis in continuity. In 640 patients, 712 total hip arthroplasties were followed up for a minimum of 2 years (maximum 6.5 years, average 3.
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