Early versus delayed postoperative adductor canal block in total knee arthroplasty.

Background: We hypothesized that patients who received an adductor canal block (ACB) in the operating room following unilateral total knee arthroplasty would have a lower oral morphine milligram equivalent (MME) consumption during the postanesthesia care unit (PACU) phase 1 recovery period compared to patients who received an ACB in the PACU.

Methods: This was a retrospective cohort study of patients who underwent robotic-assisted unilateral total knee arthroplasty under general anesthesia between March 1, 2020, and February 28, 2021, and received postoperative ACB either in the operating room or the PACU.

Results: A total of 36 and 178 patients received postoperative ACB in the operating room and PACU, respectively, and had median and interquartile range MME consumption in the PACU of 22.

Preoperative Activity Level an Indicator of Postoperative Functional Outcomes with a Contemporary Revision Total Knee System.

As the population requiring revision total knee arthroplasty (rTKA) grows, varying preoperative conditions may need to be considered when attempting to predict postoperative outcomes. Considering preoperative activity levels may help manage the expectations of patients. The purpose of this study was to analyze the outcomes of low- and high-activity subgroups of patients receiving a contemporary rTKA.

Efficacy of Liposomal Bupivacaine Compared with Multimodal Periarticular Injections for Postoperative Pain Control following Total Knee Arthroplasty.

Single-dose long-acting periarticular anesthetics have been shown to be an effective method of postoperative analgesia in total knee arthroplasty (TKA). This study retrospectively compares the efficacy of multimodal periarticular injection consisting of a combination of ropivacaine, duramorph, epinephrine, and toradol (HC) with liposomal bupivacaine (LB) periarticular injection in TKA. This study was a retrospective matched comparative chart review of two cohorts of patients who underwent TKA within a single health care system and cared for by one provider.

The Difficult Primary Total Knee Arthroplasty.

Primary total knee arthroplasty (TKA) for the treatment of knee arthritis has substantially increased over the past decade. Because of its success, the indications for primary TKA have expanded to include younger patients who are more active, elderly patients who have multiple comorbidities, and patients who have more complex issues, such as posttraumatic arthritis and severe deformity. TKA also has been used to salvage failed unicondylar arthroplasty and osteotomies about the knee.

Use of a Flexible Intramedullary Rod and its Influence on Patient Satisfaction and Femoral Size in Total Knee Arthroplasty.

Improper femoral component size remains a source of multiple postoperative complications following total knee arthroplasty (TKA). However, the use of a flexible intramedullary (IM) rod may help optimize femoral component size and therefore improve outcomes. The purpose of this study was to assess (1) patient-reported functional outcomes, (2) overall quality of life, and (3) changes in implant sizing associated with total knee arthroplasties performed with a flexible IM rod compared to a conventional, rigid rod.

A prospective, longitudinal study of patient satisfaction following total knee arthroplasty using the Short-Form 36 (SF-36) survey stratified by various demographic and comorbid factors.

The purpose of this study was to evaluate the longitudinal variations in SF-36 physical and mental scores and the effects of demographics and comorbidities after TKA. This prospective study evaluated 108 men and 173 women who had a mean age of 66 years. All patients were followed for a minimum of five years and SF-36 physical and mental component scores were evaluated longitudinally.

Clinical and patient-reported outcomes of primary TKA with a single-radius design.

Total knee arthroplasty (TKA) is a cost-effective procedure used to treat degenerative knee disease with excellent long-term outcomes. However, TKA has not always resulted in excellent functional and patient satisfaction outcomes, partly due to the use of prostheses that did not reproduce natural knee kinematics. Due to a paucity of reports on single-radius designs, the authors evaluated the clinical and patient-reported outcomes of primary TKA in patients who had received a single-radius prosthesis.

Revision total hip arthroplasty using a modular femoral implant in Paprosky type III and IV femoral bone loss.

The purpose of this study was to compare results of patients with Paprosky type I and II femoral defects vs type IIIA, IIIB, and IV defects in patients undergoing revision hip arthroplasty. There were 64 patients in the group with type I and II defects with an average age of 68 years. There were 52 patients with Paprosky type IIIA, IIIB, and IV defects with an average age of 67 years.

A proteomic study of protein variation between osteopenic and age-matched control bone tissue.

The focus of this study was to identify changes in protein expression within the bone tissue environment between osteopenic and control bone tissue of human femoral neck patients with osteoarthritis. Femoral necks were compared from osteopenic patients and age-matched controls. A new method of bone protein extraction was developed to provide a swift, clear view of the bone proteome.

Mechanical bone strength of the tibial resection surface at increasing distance from the joint line in total knee arthroplasty.

Few articles have addressed the bone strength of the proximal tibia. This study attempts to quantify the compressive strength of bone in the proximal tibia of human cadaveric knees at increasing distance from the joint surface. Sixteen fresh-frozen human cadaveric knees were tested.