Comparison of the Unipolar Electrocautery and the Bipolar Sealer in Reducing Blood Loss in Total Knee Arthroplasty: A Prospective, Randomized, Noninferiority Study.

Background: This was a noninferiority trial to evaluate blood loss during total knee arthroplasty (TKA) when using the unipolar electrocautery system compared to the saline coupled bipolar sealer system in primary TKA.

Methods: One hundred sixty-four patients were randomly assigned by a 1:1 ratio to either the unipolar electrocautery system (N = 82) or bipolar sealer system (N = 82). Inclusion criteria included patients scheduled for primary unilateral TKA, preoperative hemoglobin ≥11 mg/dL, preoperative platelet count ≥150,000, age >18 years, and patient willing to complete all study-related procedures.

The Thresholds of Caprini Score Associated With Increased Risk of Venous Thromboembolism Across Different Specialties: A Systematic Review.

Objective: Estimation of the specific thresholds of the Caprini risk score (CRS) that are associated with the increased incidence of venous thromboembolism (VTE) across different specialties, including identifying the highest level of risk.

Background: Accurate risk assessment remains an important but often challenging aspect of VTE prophylaxis. One well-established risk assessment model is CRS, which has been validated in thousands of patients from many different medical and surgical specialties.

Resumption of Elective Orthopaedic Surgery in the US Epicenter of COVID-19: Overcoming the Continuous Challenges.

On 1 March 2020, New York State confirmed its first case of COVID-19. An explosive progression of hospitalizations ensued, and all elective surgeries were cancelled between 23 March and 13 May 2020 per federal and state mandate. Upon return to elective surgery in May, 2020, the hospital found itself navigating uncharted territory.

Utilization of the Caprini Score for Risk Stratification of the Arthroplasty Patient in the Prevention of Postoperative Venous Thrombosis.

Venous thromboembolism (VTE) is a serious and predictable complication following arthroplasty. It has been recognized that a strategy utilizing individualized anticoagulation choices based on patient risk stratification results in improved patient outcomes. A 2013 version of the Caprini Risk Score has previously been validated for use in total joint arthroplasty.

Resumption of Elective Orthopaedic Surgery in the US Epicenter of COVID-19.

On March 1, 2020, New York State confirmed its first case of COVID-19. This state has had the largest initial mortality in the United States with more than 479,000 confirmed cases and over 25,000 deaths as of October 10, 2020. All elective surgeries in New York State were suspended on March 23, 2020, due to the national state of emergency.

Lessons Learned: Using the Caprini Risk Assessment Model to Provide Safe and Efficacious Thromboprophylaxis Following Hip and Knee Arthroplasty.

Two of the more common potential complications after arthroplasty are venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolus (PE), and excess bleeding. Appropriate chemoprophylaxis choices are essential to prevent some of these adverse events and from exacerbating others. Risk stratification to prescribe safe and effective medications in the prevention of postoperative VTE has shown benefit in this regard.

Interaction Between Low-Dose Aspirin and Nonsteroidal Anti-Inflammatory Drugs Can Compromise Aspirin's Efficacy in Preventing Venous Thrombosis Following Total Joint Arthroplasty.

Total joint arthroplasty is a rapid recovery procedure with patients optimized quickly in preparation for discharge. Two significant postoperative goals are effective pain management and prevention of postoperative venous thromboembolism (VTE). Low-risk patients receive aspirin 81 mg twice daily for VTE prophylaxis; this dosing regimen has been reduced over the past few years from 325 mg to 162 mg to 81 mg twice daily.

Malignant peripheral nerve sheath tumor of the sciatic nerve presenting with leg pain in the setting of lumbar scoliosis and spinal stenosis.

Study Design: Case report.

Objective: We present a case of malignant peripheral nerve sheath tumor (MPNST) presenting as neuropathic pain in the setting of lumbar scoliosis and spinal stenosis. Most peripheral nerve sheath tumors are benign, and malignant cases are more commonly associated with neurofibromatosis type 1 or prior radiation exposure.

Completion of the Updated Caprini Risk Assessment Model (2013 Version).

The Caprini risk assessment model (RAM) has been validated in over 250 000 patients in more than 100 clinical trials worldwide. Ultimately, appropriate treatment options are dependent on precise completion of the Caprini RAM. As the numerical score increases, the clinical venous thromboembolism rate rises exponentially in every patient group where it has been properly tested.

Implementation and Validation of the 2013 Caprini Score for Risk Stratification of Arthroplasty Patients in the Prevention of Venous Thrombosis.

Appropriate chemoprophylaxis choice following arthroplasty requires accurate patient risk assessment. We compared the results of our prospective department protocol to the Caprini risk assessment model (RAM) retrospectively in this study group. Our goal was to determine whether the department protocol or the Caprini score would identify venous thromboembolism (VTE) events after total joint replacement.

The Effect of BMI and Gender on Bleeding Events when Rivaroxaban Is Administered for Thromboprophylaxis Following Total Hip and Total Knee Arthroplasty.

Rivaroxaban is approved in Europe and the United States for thromboprophylaxis following total joint arthroplasty. As the rate of obesity increases, confirming safety and efficacy in this patient population is paramount. This retrospective chart review assessed the efficacy and safety of rivaroxaban between two body mass index (BMI) groups: normal or overweight (< 30 kg/m) and obese or morbidly obese (≥30 kg/m).

Use of Intravenous Tranexamic Acid Improves Early Ambulation After Total Knee Arthroplasty and Anterior and Posterior Total Hip Arthroplasty.

We conducted a retrospective cohort study (N = 477) to determine if use of intravenous tranexamic acid (TXA) improves early ambulation and reduces blood loss after total knee arthroplasty and anterior and posterior total hip arthroplasty. Mean (SD) patient age was 66.5 (10.

Acute Renal Infarction After Lateral Lumbar Interbody Spinal Fusion for Kyphoscoliosis.

Study Design: Case report.

Objectives: Case report of acute renal infarction following lateral interbody fusion with posterior instrumentation for adult lumbar kyphoscoliosis.

Summary Of Background Data: This is the first reported renal infarction following minimally invasive lateral interbody fusion and posterior spinal instrumentation.

Implementation of a multidisciplinary, pharmacy-led, thromboprophylaxis program in total-joint arthroplasty patients.

Purpose: The implementation of a multidisciplinary, pharmacy-led, thromboprophylaxis program that reduced the rates of venous thromboembolism (VTE) in total-joint arthroplasty patients is discussed.

Summary: The results from a 2005 VTE review led to the formation of a thromboprophylaxis team at Glen Cove Hospital that consisted of representatives from the departments of general surgery, orthopedic surgery, anesthesia, hematology, rehabilitative medicine, internal medicine, pharmacy, nursing, and quality management. The team created a thromboprophylaxis risk factor assessment/prescriber order sheet that reflected the American College of Chest Physicians guidelines for venous thromboprophylaxis for all patients.