Topical vs Intravenous Tranexamic Acid in Primary Total Hip Arthroplasty: A Double-Blind, Randomized Controlled Trial.

Background: Tranexamic acid (TXA) reduces perioperative blood loss in total hip arthroplasty (THA).

Methods: In our randomized control trial, 139 patients were enrolled and received 2 g of either topical or intravenous (IV) TXA. Preoperative and postoperative protocols were standardized.

A prospective double-blind placebo controlled trial of topical tranexamic acid in total knee arthroplasty.

Tranexamic acid (TNA) reduces postoperative blood loss in general and obstetrical surgery but there is limited orthopaedic literature regarding its use in the topical setting. To study the effect of topical TNA after primary total knee arthroplasty (TKA), 101 patients were randomized to topical administration of 2.0g TNA in 75mL of normal saline (50 patients) or placebo (51 patients).

Failure of a modular hip implant at the stem-sleeve interface.

In the current era of total hip arthroplasty (THA), orthopedic surgeons have several fixation options at their disposal. The modern monoblock prosthesis, introduced by Dr. Sir John Charnley, has seen many modifications since its inception in the 1970s and continues to be the most commonly used prosthesis style for primary and revision THA.

Endogenous circadian rhythm in vasovagal response to head-up tilt.

Background: The incidence of syncope exhibits a daily pattern with more occurrences in the morning, possibly as a result of influences from the endogenous circadian system and/or the daily pattern of behavioral/emotional stimuli. This study tested the hypothesis that the circadian system modulates cardiovascular responses to postural stress, leading to increased susceptibility to syncope at specific times of day.

Methods And Results: Twelve subjects underwent a 13-day in-laboratory protocol in which subjects' sleep-wake cycles were adjusted to 20 hours for 12 cycles.

Cardiovascular disease prevention: the new Joint British Societies' guidelines.

The Joint British Societies' recommendations for coronary heart disease (CHD) prevention have been updated in the light of recent developments. Key features of the new guidelines include focusing on cardiovascular disease (CVD) prevention rather than CHD and adopting strategies that target high-risk groups, with equal priority being given to all those with established CVD or diabetes mellitus. Subjects without CVD but with a risk factor profile resulting in an absolute risk of developing CVD>or=20% over 10 years should be included in these strategies and CVD prevention should also be applied to subjects with particularly unfavourable single risk factors including familial dyslipidaemias, such as familial hypercholesterolaemia, hypercholesterolaemia when the total cholesterol:HDL cholesterol ratio is >or=7.

Articular cartilage changes in avascular necrosis: an arthroscopic evaluation.

Treatment methods for osteonecrosis (avascular necrosis) are wide and varied. When untreated, progression of the disease is common and may dictate femoral head replacement. However, before femoral head collapse, some patients have mechanical joint symptoms (locking, buckling, clicking) that are unaddressed by femoral head drilling alone.