The quality of immediate postoperative radiographs, performed after total hip replacement in the operating room versus in the post-anesthesia care unit: is there a difference?

Introduction: Currently, there are no clear guidelines regarding the optimal settings for immediate postoperative imaging following total hip arthroplasty (THA). Authors' primary aim was to determine the preferred setting for postoperative radiographs by comparing a technical quality of imaging performed in postanesthesia care unit (PACU) versus operating room (OR).

Materials And Methods: Our study is a retrospective comparison of quality of postoperative radiographs following THAs, performed in PACU versus OR.

Efficacy of single-shot adductor canal block before Versus after primary total knee arthroplasty - Does timing make a difference? A randomized controlled trial.

Background: Total knee arthroplasty (TKA) is associated with severe postoperative pain. Multimodal analgesia, including peripheral nerve block, is recommended for post-operative pain relief. Administration of some pain medications prior to surgery has shown to be more effective than after the operation.

Lateral Column Lengthening for Flexible Flat Foot: Was It Short to Begin With?

Background: Flexible flatfoot (FF) is a common foot deformity that can often consist of foot pain. Surgical treatment is designed to lengthen the lateral column.

Objectives: To resolve whether radiographic standing feet measurements of normo-plantigrade feet and FF, symptomatic or not, differ and to determine whether the lateral column is shorter.

Mild radiographic osteoarthritis is associated with increased pain and dissatisfaction following total knee arthroplasty when compared with severe osteoarthritis: a systematic review and meta-analysis.

Purpose: The association between severity of radiographic osteoarthritis with patient pain, function, and satisfaction following total knee arthroplasty has been disputed. The discrepancies in current literature prompt us to further examine this association in a systematic review and meta-analysis.

Methods: The OVID-Medline, Embase, and Web of Science databases were searched from their inception up to Mar 2020.

Earlier Initiation of Postoperative Physical Therapy Decreases Opioid Use after Total Knee Arthroplasty.

For patients with advanced osteoarthritis of the knee, total knee arthroplasty (TKA) has been shown to provide significant pain relief and improved function with consistent, reproducible results. Post-operative physical therapy (PT) plays an important role is restoring muscle strength and range of motion (ROM). Yet, the impact of earlier physical therapy initiation after TKA has not been well defined.

Biocompatibility of a Marine Collagen-Based Scaffold In Vitro and In Vivo.

Scaffold material is essential in providing mechanical support to tissue, allowing stem cells to improve their function in the healing and repair of trauma sites and tissue regeneration. The scaffold aids cell organization in the damaged tissue. It serves and allows bio mimicking the mechanical and biological properties of the target tissue and facilitates cell proliferation and differentiation at the regeneration site.

Increased Risk of Heterotopic Ossification Following Revision Hip Arthroplasty for Periprosthetic Joint Infection.

Background: To investigate whether surgery for Periprosthetic Joint Infection (PJI) of the hip, the number of procedures and their duration contribute to risk of Heterotopic Ossification formation.

Methods: 56 patients with hip PJI undergoing one-stage (10) or two-stage (46) exchange arthroplasty were matched to 112 patients undergoing revision arthroplasty for aseptic failure based on age, gender, body mass index (BMI), surgical approach (all direct lateral) and date of surgery (2006-2013). Patients with Paget's disease and ankylosing spondylitis, or preoperative HO were excluded.

The detached stump of the torn anterior cruciate ligament adheres to the femoral notch wall and then to the posterior cruciate ligament within 6 months from injury.

Purpose: To evaluate the progressive changes in the morphology of traumatic ruptures of the anterior cruciate ligament (ACL) over time. A secondary objective was evaluating their correlation with meniscal tears or chondral lesions.

Methods: The study included one hundred and one patients who underwent ACL reconstruction surgery of the knee after a definite date of injury.

Stability of extracapsular hip fracture: Does it affect rehabilitation outcome of post-acute patients?

Background: Various factors have been shown to affect rehabilitation outcome of hip fractured patients. The degree of extracapsular fracture stability may also affect functional recovery. The aim of our study was to assess the relationship between extracapsular hip fracture stability and rehabilitation outcome in a post-acute setting.

Medial forefoot fillet flap for primary closure of transmetatarsal amputation: A series of four cases.

Amputation of the forefoot is a salvage procedure for several forefoot acute or chronic infection. A good, sensate and durable skin cover is important for quicker and better rehabilitation. The use of filleted flaps (or "spare parts technique") has been published in the past as a creative technique.

A comparison of treatment setting for elderly patients with hip fracture, is the geriatric ward superior to conventional orthopedic hospitalization?

Introduction: Hip fractures in the elderly are a major cause of morbidity and mortality. The treatment settings of these patients may change their outcomes. The aim of this study is to compare the outcomes of patients with displaced femoral neck fractures who were admitted to the orthopedic vs.

Tritanium acetabular wedge augments: short-term results.

Background: Reconstruction of acetabular defects in total hip arthroplasty (THA) presents a great challenge to orthopaedic surgeons. Previous studies have reported on the use and outcomes of trabecular metal acetabular augments for the reconstruction of acetabular defects. However, no study has been conducted evaluating the short-term results of tritanium acetabular wedge augments for the reconstruction of acetabular defects in THA.

Aspirin Can Be Used as Prophylaxis for Prevention of Venous Thromboembolism After Revision Hip and Knee Arthroplasty.

Background: The optimal prophylaxis for prevention of venous thromboembolic events (VTEs) after revision total joint arthroplasty (TJA) remains unknown. The objective of this study was to evaluate whether aspirin, known to be effective for prevention of VTEs after primary arthroplasty, is also effective after revision TJA.

Methods: We studied 2997 consecutive patients who underwent revision TJA between 2005 and 2013 and were treated with intermittent pneumatic compression devices and either aspirin (534 patients) or warfarin (2463 patients) for VTE prophylaxis.

Tranexamic Acid Can Be Administered to Arthroplasty Patients Who Receive Aspirin for Venous Thromboembolic Prophylaxis.

Background: Venous thromboembolism (VTE) is not uncommon after total joint arthroplasty (TJA). Various prophylactic agents have been used to minimize this complication after TJA. Numerous studies have demonstrated that acetylsalicylic acid (ASA) has equivalent efficacy to other agents in preventing VTE after TJA.

The Sphygmomanometer Pain Test: A Simple Method for Identifying Patients at Risk of Excessive Pain after Total knee Arthroplasty.

Background: Despite the overall success of total knee arthroplasty (TKA), a relatively large proportion of patients remain dissatisfied with the outcome. We hypothesized that patients with a lower threshold for pain were more likely to have worse outcomes after TKA.

Methods: Forty-eight consecutive patients with primary knee osteoarthritis graded a standardized painful stimulus caused by inflating a sphygmomanometer placed on the forearm, on a visual analog scale (VAS) scale before their TKA.

Direct Anterior Hip Exposure for Total Hip Arthroplasty.

Total hip arthroplasty through the direct anterior approach provides the only true internervous access to the hip joint. The indications are the same as those for total hip replacement performed through any other approach. If necessary, the approach can be extended proximally or distally and can be used for complex primary cases as well as for revision cases.

Tourniquet Release Prior to Dressing Application Reduces Blistering Following Total Knee Arthroplasty.

Skin blisters occur in up to 20% of patients after total knee arthroplasty (TKA). Tourniquet release results in a limb volume increase of 10%. We hypothesized that releasing tourniquet before application of circumferential dressing will decrease blister formation.

Periprosthetic joint infection: the algorithmic approach and emerging evidence.

Periprosthetic joint infections (PJIs) continue to affect patients, result in accelerated mortality, and consume approximately $1 billion of annual healthcare resources. The future of otherwise successful total joint arthroplasties can be jeopardized by PJI. In recent years, the issue of hospital-acquired infections has gained increasing attention in the United States and the rest of the world, and numerous efforts are being made to address this problem.

Prosthetic joint infections.

Prosthetic joint infections (PJIs) are often managed by surgical treatment of irrigation and debridement (I&D) in acute infections, and 1-stage or 2-stage exchange arthroplasty in chronic infections. Patients who undergo I&D have had lower success rates compared with patients who undergo exchange arthroplasty, especially if resistant organisms are encountered. In patients who cannot undergo surgical reconstruction, resection arthroplasty, fusion, or amputation may be performed.

Direct anterior approach for revision total hip arthroplasty.

Revision total hip arthroplasty (THA) can be successfully performed through the direct anterior (DA) approach. Patient positioning, the surgical approach and specific instruments are important for obtaining adequate exposure. Acetabular exposure can be facilitated by capsular release and correct placement of retractors.

Adverse clinical outcomes in a primary modular neck/stem system.

We report our experience with 215 recalled neck modular stems due to corrosion. Among the 195 hips with 2 years follow-up, 56% had no clinical symptoms, 26% had groin pain (typical of corrosion), and 17% had other symptoms. Cobalt levels were comparable between asymptomatic (3.

Prevention of periprosthetic joint infection: what are the effective strategies?

Periprosthetic joint infection (PJI) following total knee arthroplasty is a major burden for patients and health systems. Prevention of this challenging complication through implementation of effective strategies should be a priority. These strategies should encompass various levels of patient care.