The use of tourniquet in total knee arthroplasty does not impact the functional outcome: a randomised controlled study.

Background: This study evaluates the clinical evidence for performing total knee arthroplasty (TKA) without a tourniquet, a shift from the near-universal use in 2009 to current trends towards tourniquet-less TKA in Norway and Sweden. This change is set against a backdrop of conflicting evidence regarding the positive and negative effects of tourniquet use.

Questions/purposes: The aims were to determine if the tourniquet has an impact on [1] Forgotten Joint Score-12 (FJS-12) at 8 weeks after surgery; [2] postoperative strength and function; [3] postoperative pain and opioid analgesic use; and [4] operative time, bleeding, and length of stay (LOS).

The tourniquet's effects on skeletal muscle during total knee arthroplasty.

This study investigates the impact of perioperative tourniquet on skeletal muscle cells during total knee arthroplasty (TKA) and its effects on the gene expression of apoptotic, inflammatory, and angiogenic pathways. The randomized controlled trial included 44 patients undergoing TKA. The patients were randomized to undergo surgery with (n = 23) or without (n = 21) tourniquet.

The anatomy of safe surgical teams: an interview-based qualitative study among members of surgical teams at tertiary referral hospitals in Norway.

Background: In spite of the global implementation of surgical safety checklists to improve patient safety, patients undergoing surgical procedures remain vulnerable to a high risk of potentially preventable complications and adverse outcomes. The present study was designed to explore the surgical teams' perceptions of patient safety culture, capture their perceptions of the risk for adverse events, and identify themes of interest for quality improvement within the surgical department.

Methods: This qualitative study had an explorative design with an abductive approach.

Surgical approach had minor association with femoral stem migration in total hip arthroplasty: radiostereometric analysis of 61 patients after 5-year follow-up.

Background And Purpose: Total hip arthroplasty (THA) is usually performed using 1 of 3 surgical approaches: direct lateral (DLA), posterior (PA), or anterior (AA). AA is different from DLA and PA owing to limited intraoperative visibility of the femoral canal. This could affect stem positioning and therefore migration.

Barriers to Organ Donation: A Qualitative Study of Intensive Care Nurses' Experiences.

Background: An increasing number of patients affected by organ failure can be treated with organ transplantation. The need for organs available for transplantation is critical and patients die while on the transplant list. Intensive care unit (ICU) nurses are essential in facilitating organ donation through their ceaseless bedside care for potential organ donors and their families.

Physical activity in the first postoperative week in 132 knee arthroplasty patients randomized to 3 different analgesic regimens.

Background: The aim of this study was to investigate whether objectively recorded physical activity in the first week after surgery in total knee arthroplasty patients differed between patients allocated to 3 different analgesic regimens.

Methods: A total of 132 total knee arthroplasty patients wore activity monitors 24 hours a day from day 1 after surgery for 6 consecutive days. The time mobilized (stepping/standing) and the number of steps were recorded.

Using welfare technology for individuals with intellectual disabilities. Expectations, experiences, and challenges of intellectual disability nursing students during clinical placement.

Purpose: Little is known about how welfare technology (WT) is used in welfare services for people with intellectual disabilities. This study aimed to explore expectations, experiences, and challenges concerning the use of WT for people with intellectual disabilities among bachelor-level intellectual disability nursing students during clinical placement.

Materials And Methods: A written reflection assignment (four open questions about using WT) was collected from 100 intellectual disability nursing students (30 males, 70 females).

Understanding the possibilities and limitations of assistive technology in health and welfare services for people with intellectual disabilities, staff perspectives.

Purpose: Little is known regarding what assistive technology (AT) exists and how it is used in welfare services for people with intellectual disabilities (ID). This study aimed to explore healthcare staff's perspectives and insights regarding AT in daily support and welfare services for people with ID. We also sought to explore the associations between the use of AT and workplace-related factors and background characteristics (e.

Tapentadol vs oxycodone for postoperative pain treatment the first 7 days after total knee arthroplasty: a randomized clinical trial.

Pain after total knee arthroplasty is a prevalent condition. This study compared the effectiveness of tapentadol extended-release (ER) 50 mg × 2, oxycodone controlled-release (CR) 10 mg × 2, and placebo, as added to a multimodal analgesic regime both in-hospital and at home the first week after total knee arthroplasty. The study was randomized and blinded for investigators, staff, outcome assessors, and patients.

Does the line-to-line cementing technique of the femoral stem create an adequate cement mantle?

Background: The line-to-line cementing technique is proposed to create a press-fit in the femoral canal, which is contrary to modern cementing techniques. The term 'French paradox' has been used to describe the acceptable results associated with this technique. It has been suggested that the quality of the mantle may not be satisfactory, predisposing to early failure and aseptic loosening.

Pain and load progression following an early maximal strength training program in total hip- and knee arthroplasty patients.

Purpose: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients significantly increase muscle strength after maximal strength training (MST) initiated soon after surgery. Owing to severe postoperative pain, knee patients are anticipated to be more limited in performing heavy load exercises than hip patients. The aim of the present study was to describe pain and load progression during early MST in THA and TKA patients.

Increased Muscle Strength Limits Postural Sway During Daily Living Activities in Total Hip Arthroplasty Patients.

Objective: The aim of the study was to investigate the effect of maximal strength training on postural sway after total hip arthroplasty, performed before and after a battery of physical performance tests that resemble daily living activities.

Design: This study is an exploratory study based on data from a 3-mo randomized controlled trial involving 54 total hip arthroplasty patients performing maximal strength training or conventional rehabilitation. At 3, 6, and 12 mos postoperatively, postural sway was evaluated in two gait tests; ie, one test before and one test after conducting a battery of physical performance tests.

Muscular strength and function after total hip arthroplasty performed with three different surgical approaches: one-year follow-up study.

Background: Surgical approach influences short-term muscular strength, and leg-strength asymmetry has been demonstrated after total hip arthroplasty (THA). We evaluated muscular strength, physical function and patient-reported outcome measures (PROMs) up to 12 months postoperatively, in patients operated on using 3 different surgical approaches.

Methods: 60 patients scheduled for primary THA were allocated to the direct lateral (DLA), posterior (PA) or anterior (AA) approach.

A randomized controlled trial on maximal strength training in 60 patients undergoing total hip arthroplasty.

Background and purpose - Total hip arthroplasty (THA) patients have reduced muscle strength after rehabilitation. In a previous efficacy trial, 4 weeks' early supervised maximal strength training (MST) increased muscle strength in unilateral THA patients <65 years. We have now evaluated muscle strength in an MST and in a conventional physiotherapy (CP) group after rehabilitation in regular clinical practice.

Randomized controlled trial of maximal strength training vs. standard rehabilitation following total knee arthroplasty.

Background: Total knee arthroplasty (TKA) alleviates pain, but muscle strength and function is reduced for a long period postoperatively.

Aim: To investigate whether maximal strength training (MST) is more effective in improving muscle strength than standard rehabilitation (SR) after TKA.

Design: A randomized, controlled study.

Patient experience with early discharge after total knee arthroplasty: a focus group study.

Background: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast-track pathway aims at improving patient outcome, and patients are now discharged 2-3 days after surgery.

Daily Physical Activity in Total Hip Arthroplasty Patients Undergoing Different Surgical Approaches: A Cohort Study.

Objective: Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches.

Design: A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach.

Muscular strength after total hip arthroplasty. A prospective comparison of 3 surgical approaches.

Background And Purpose: Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. PATIENTS AND METHODs: In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach.

Unilateral vs. bilateral total hip arthroplasty - the influence of medial femoral head offset and effects on strength and aerobic endurance capacity.

The purpose of the present study was to determine whether unilaterally operated total hip arthroplasty (THA) patients were superior to bilaterally operated THA patients with respect to aerobic endurance capacity, muscle strength and gait patterns 3-5 years after surgery, and to what extent medial femoral head offset (FO) influenced hip abductor strength. 10 unilaterally operated THA patients with normal FO (UNO), 10 bilaterally operated THA patients with normal FO (BNO) and 10 bilaterally operated THA patients with abnormal offset (BDO) participated in the study. Improved muscle strength in the healthy leg of the UNO did not result in differences compared to the BNO and the BDO in work efficiency, gait patterns or maximal oxygen consumption (VO2max ) A reduced FO in the BDO did not result in lower hip abduction strength compared to the BNO.

Early postoperative maximal strength training improves work efficiency 6-12 months after osteoarthritis-induced total hip arthroplasty in patients younger than 60 years.

Objective: To assess physical outcome of early maximal strength training after total hip arthroplasty.

Design: Six- and 12-mo follow-up of 24 (22) total hip arthroplasty patients randomly assigned to 4 wks of maximal strength training and conventional rehabilitation and to conventional rehabilitation only was conducted. After the intervention period, all patients attended conventional rehabilitation.

Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty.

Unlabelled: Husby VS, Helgerud J, Bjørgen S, Husby OS, Benum P, Hoff J. Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty.

Objective: To compare muscle strength, work efficiency, gait patterns, and quality of life in patients undergoing total hip arthroplasty (THA) randomly assigned to either maximal strength training or a conventional rehabilitation program.

Aerobic high intensity one and two legs interval cycling in chronic obstructive pulmonary disease: the sum of the parts is greater than the whole.

The purpose of this study was to investigate whether individual leg cycling could produce higher whole body peak oxygen uptake (VO(2peak)) than two legs cycling during aerobic high intensity interval training in chronic obstructive pulmonary disease (COPD) patients. Nineteen patients trained in 24 supervised cycling sessions either by one leg training (OLT) (n = 12) or by two legs training (TLT) (n = 7) at 4 x 4 min intervals at 85-95% of peak heart rate. Whole body VO(2peak) and peak work rate increased significantly by 12 and 23% in the OLT, and by 6 and 12% in the TLT from pre- to post-training, respectively, and were significantly greater in the OLT than the TLT (P < 0.