Background: Perioperative tranexamic acid (TXA) use with total knee arthroplasty (TKA) is widely accepted today. Recently, a few international groups have published on the safety and outcomes of extending TXA use in the postoperative period. Through a double-blinded, randomized control trial (RCT), we aimed to investigate the safety and clinical efficacy of extended postoperative oral TXA use in TKA performed in an American, free-standing ambulatory surgery center (ASC).
View Article and Find Full Text PDFThe number of spinal operations performed in the United States has significantly increased in recent years. Along with these rising numbers, there has been a corresponding increase in the number of patient comorbidities. The focus of this article is to review comorbidities in Spine surgery patients and outline strategies to optimize patients and avoid complications.
View Article and Find Full Text PDFOrthop Clin North Am
April 2023
Current technologies for image guidance navigation and robotic assistance with spinal surgery are improving rapidly with several systems commercially available. Newer machine vision technology has several potential advantages. Limited studies have shown similar outcomes to traditional navigation platforms with decreased intraoperative radiation and time required for registration.
View Article and Find Full Text PDFIntroduction: This study evaluated the effect of bupivacaine versus mepivacaine spinal anesthesia and preoperative adductor canal block (ACB) on recovery, length of stay, pain, and complications of same-day discharge total knee arthroplasty (TKA) at a free-standing ambulatory surgery center.
Methods: We performed a retrospective review of patients who underwent TKA between March 2018 and September 2019. The patients were grouped based on the neuraxial anesthetic regimen: bupivacaine with ACB, bupivacaine without ACB, and mepivacaine without ACB.
Case: We report the case of a 27-year-old man who presented after a 30-foot fall with a hemopneumothorax, multiple rib fractures, and left shoulder dislocation with greater tuberosity fracture. During attempted arthroscopic repair, the patient developed pulseless electrical activity arrest as the result of intraoperative tension hydrothorax. We hypothesize that this was caused by a traumatic soft-tissue communication to his shoulder joint from the apex of his lung.
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