Equivalent VTE rates after total joint arthroplasty using thromboprophylaxis with aspirin versus potent anticoagulants: retrospective analysis of 4562 cases across a diverse healthcare system.

Background: Guidelines support aspirin thromboprophylaxis for primary total hip and knee arthroplasty (THA and TKA) but supporting evidence has come from high volume centers and the practice remains controversial.

Methods: We studied 4562 Medicare patients who underwent elective primary THA (1736, 38.1%) or TKA (2826, 61.

The relative stress on the Achilles tendon during ambulation in an ankle immobiliser: implications for rehabilitation after Achilles tendon repair.

Background: After Achilles tendon repair, immediate weightbearing and immobilisation closer to neutral plantarflexion are thought to limit atrophy and stiffness, but may place deleterious stress on the repair.

Objectives: To estimate the relative stress on the Achilles tendon during weightbearing with immobilisation in varying degrees of plantarflexion.

Methods: Electromyographic (EMG) activity from the plantarflexors was recorded during walking in 10 subjects (six men, four women) without ankle pathology.

Arthroscopic surgery of the knee in the geriatric patient.

There remains some controversy and confusion regarding arthroscopic surgery of the knee in the elderly population, particularly for patients with osteoarthritis. A retrospective review was undertaken of 105 knees in patients 60 years or older who had arthroscopy during a 4-year period. The surgical outcomes were evaluated using a postoperative knee scoring system at a mean followup period of 11.

The plica syndrome.

The plica syndrome is an uncommon pathologic entity diagnosed far too often in the setting of concomitant pathology. Medial patellar pain is more likely to be related to patellofemoral maltracking than to plica syndrome. Likewise, anteromedial joint line tenderness is more likely to be related to a meniscal tear than to a pathological plica.

Acute Hemarthrosis of the Adolescent Knee.

In brief: A serious knee injury can result in dysfunction and can thwart the promising career of a gifted young athlete if not accurately diagnosed and properly treated. This article focuses on the bloody effusion (hemarthrosis) that usually signals the presence of a serious internal derangement. The most frequent causes of hemarthrosis are patellar dislocation/subluxation, epiphyseal injury, disruption of the anterior cruciate ligament, and chondral/osteochondral fracture.