Clinical Experience of Dissolvable Calcium Sulfate (Stimulan) Carrier for Antibiotic Delivery in Orthopedic Surgery: A Study of 143 Patients.

Prosthetic bone and joint infections are difficult to treat with varying levels of success with standard therapy. Synthetic calcium sulfate carrier, to which specific antibiotics can be added, can be utilized as an alternative drug delivery system in these cases. We have reviewed clinical outcomes using commercially available pure synthetic calcium sulfate dissolvable beads (Stimulan) loaded with antibiotics in 143 patients undergoing orthopedic surgery for prevention and treatment of joint infection.

Adductor Catheter Insertion Through the Knee Arthrotomy: Can This Technique Be as Safe and Effective as Ultrasound-Guided Insertion?

Background: Early postoperative pain following total knee arthroplasty remains challenging. We devised a technique for inserting a continuous catheter intraoperatively in the adductor canal and aimed to compare its efficacy and safety with that of an ultrasound-guided anesthetist-administered continuous catheter.

Methods: This single-center, single-surgeon, prospective, interventional, randomized controlled trial included 330 patients, who were randomized into two groups with similar preoperative status and demographics.

Morbidity index: A score to assess immediate postoperative recovery in TKR patients.

Background: Every surgical procedure involves certain amount of postoperative morbidity which varies among different surgeries and the same surgery done by different techniques. Minimally invasive surgeries have evolved in all surgical branches and are believed to have a lesser morbidity than the traditional procedures; however there is no score or index to assess the immediate recovery after any surgical procedure in the literature. We tried to devise an immediate postoperative assessment method that takes into account the early recovery phase of patient post total knee arthroplasty (TKA) from day1 to day3.

Total knee arthroplasty using subvastus approach in stiff knee: A retrospective analysis of 110 cases.

Background: Subvastus approach used in total knee arthroplasty (TKA) is known to produce an earlier recovery but is not commonly utilized for TKA when the preoperative range of motion (ROM) of the knee is limited. Subvastus approach is known for its ability to give earlier recovery due to less postoperative pain and early mobilization (due to rapid quadriceps recovery). Subvastus approach is considered as a relative contraindication for TKA in knees with limited ROM due to difficulty in exposure which can increase risk of complications such as patellar tendon avulsion or medial collateral injury.

Total knee arthroplasty in valgus knees using minimally invasive medial-subvastus approach.

Background: An ideal approach for valgus knees must provide adequate exposure with minimal complications due to approach per se. Median parapatellar approach is most commonly used approach in TKA including valgus knees. A medial subvastus approach is seldom used for valgus knees and has definite advantages of maintaining extensor mechanism integrity and minimal effect on patellar tracking.

Combined Administration of Systemic and Topical Tranexamic Acid for Total Knee Arthroplasty: Can It Be a Better Regimen and Yet Safe? A Randomized Controlled Trial.

Background: Total knee arthroplasty (TKA) is associated with substantial blood loss in postoperative period. Tranexamic acid (TXA) is potent antifibrinolytic agent, routinely administered by intravenous (IV) and topical route, which can possibly interrupt cascade of events due to hemostatic irregularities close to source of bleeding. However, scientific evidence of combined administration of TXA in TKA is still meagre.

Adductor Canal Blockade Following Total Knee Arthroplasty-Continuous or Single Shot Technique? Role in Postoperative Analgesia, Ambulation Ability and Early Functional Recovery: A Randomized Controlled Trial.

Unlabelled: Total knee arthroplasty (TKA) can be associated with severe pain in early postoperative period. Adductor canal block may provide optimal analgesia following TKA. However, ideal regimen for administration whether continuous or single shot is yet undefined.

Limited femoral navigation versus conventional intramedullary femoral jig based instrumentation for achieving optimal restoration of mechanical axis post total knee arthroplasty: a prospective comparative study of 200 knees.

A prospective comparative study was conducted to compare the mechanical axis post total knee arthroplasty (TKA) between two groups: In the first group of 100 knees (ASM group) Articular Surface Mounted navigation system was used to guide the distal femoral cut. In the second group of 100 knees (JIG group) conventional intramedullary femoral jig was used. The postoperative mechanical axis of the leg was within 3° of neutral alignment in 90% of the TKA in the ASM group (mean 178.

Is continuous adductor canal block better than continuous femoral nerve block after total knee arthroplasty? Effect on ambulation ability, early functional recovery and pain control: a randomized controlled trial.

Unlabelled: Total knee arthroplasty is associated with intense, early post-operative pain. Femoral nerve block is known to provide optimal pain relief but reduces the strength of the quadriceps muscle and associated with the risk of falling. Adductor canal block is almost pure sensory blockade with minimal effect on quadriceps muscle strength.