A Randomized Trial of Three Routes of Tranexamic Acid Administration in Total Knee Arthroplasty.

Tranexamic acid (TXA) has been shown to decrease blood loss and transfusion rates across a variety of routes of administration and doses in the setting of total knee arthroplasty (TKA). Oral TXA is less studied but has decreased cost and increased ease of administration. This prospective, randomized study compared the efficacy and cost of three routes of TXA administration in the setting of primary TKA.

Modifiable Patient Factors Demonstrate No Increased Risk for 30-Day Complication Rate for Elective 1-2 Level Posterior Lumbar Fusion Surgery: A Comparison Between a National Database and Local Registry.

Background: While national databases provide large datasets that can be used to understand trends over time, their correlation with prospectively collected data from local registries has not been established. The purpose of the study was to compare differences in patient demographics and adverse events for patients undergoing elective posterior spinal fusion (PSF) between a national database and institutional registry.

Methods: A retrospective chart review was performed.

Evaluating the Success of Perioperative Self-Guided Meditation in Reducing Sleep Disturbance After Total Knee Arthroplasty.

Background: Disruptions in sleep and pain are frequent complaints following total knee arthroplasty (TKA). Perioperative sleep disturbances may lead to decreased pain tolerance as well as other consequences. The purpose of this study is to evaluate the effectiveness of self-guided meditation for improving sleep quality following TKA.

Comparison of Dexamethasone 4mg vs 8mg Doses in Total Joint Arthroplasty Patients: A Retrospective Analysis.

Introduction Dexamethasone is commonly administered intraoperatively to control postoperative nausea and vomiting (PONV) and pain. There is limited evidence of the ideal dosage of dexamethasone during surgery. Dexamethasone administration may increase blood glucose levels, posing unique challenges in maintaining acceptable blood glucose levels in patients with diabetes.

Mobility Technicians: A Viable Solution to Early Ambulation of Total Joint Replacement Patients.

Background: Early ambulation of patients with total joint replacement (TJR) has been shown to improve outcomes while reducing length of stay and postoperative complications. Limited physical therapy (PT) resources and late-in-the-day cases may challenge day-of-surgery (POD0) ambulation. At our institution, a Mobility Technician (MT) program, composed of specially trained nurse's aides, was developed to address this issue.

Considering healthcare value and associated risk factors with postoperative urinary retention after elective laminectomy.

Background: Mitigating common complications such as postoperative urinary retention (POUR) following elective spine surgery is prudent. Identifying patients at risk for POUR and recognizing associated factors, to avoid a more complicated postoperative episode should be a priority and easily achievable. Understanding the financial burden of complications, such as POUR, is also important for value-based healthcare, not only for providers, but for employers and payors as well.