There have been multiple successful efforts to improve and shorten the recovery period after elective total joint arthroplasty. The development of rapid recovery protocols through a multidisciplinary approach has occurred in recent years to improve patient satisfaction as well as outcomes. Bundled care payment programs and the practice of outpatient total joint arthroplasty have provided additional pressure and incentives for surgeons to provide high-quality care with low cost and complications. In this review, the evidence for modern practices are reviewed regarding patient selection and education, anesthetic techniques, perioperative pain management, intraoperative factors, blood management, and postoperative rehabilitation.
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http://dx.doi.org/10.1016/j.ocl.2017.05.002 | DOI Listing |
Arthroplast Today
February 2025
Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL, USA.
Background: For reimbursement purposes, current coding fails to reflect the true complexity and resource utilization of hospital encounters for surgeries performed to treat periprosthetic total hip arthroplasty (THA) infection. Therefore, when compared to aseptic revisions, we sought to determine (1) Is length of stay (LOS) longer for septic surgeries? (2) Are septic procedures more expensive? and (3) How do different surgical procedures for infection compare with aseptic revisions on hospital LOS and charges?
Methods: Retrospective chart review of 596 unilateral THA reoperations (473 patients) performed at a single institution (January 2015 to November 2020). Demographics, professional (ie, physicians), and technical (ie, room, implants) hospital charges per case were compared between 6 different surgery types: (1) aseptic revision (control; n = 364); (2) debridement, antibiotics, and implant retention (n = 11); (3) explantation (n = 145); (4) spacer exchange (n = 7); (5) 2-stage reimplantation (n = 59); and (6) 1-stage reimplantation (n = 10).
Rheumatol Adv Pract
January 2025
Rheumatology Unit, ERN ReCONNET Center, IRCCS Meyer Children's Hospital, Firenze, Italy.
Objectives: Two different European Reference Networks cover CTDs with paediatric onset, the European Reference Network on Rare and Complex Connective Tissue Diseases (ERN ReCONNET) and the European Reference Network on Rare Immunological Disorders (ERN RITA). The transition of care is a significant focus, with ReCONNET centres actively addressing this through updated programs. Despite these efforts, challenges persist.
View Article and Find Full Text PDFJACC Asia
January 2025
Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Background: Elevated blood pressure (BP) in childhood is associated with adult hypertension and arterial stiffness. However, the effect of long-term time in target range (TTR) for BP since childhood on the risk of arterial stiffness in midlife remains unclear.
Objectives: The purpose of this study was to determine the independent association of TTR for systolic blood pressure (SBP) from childhood to midlife with arterial stiffness in adulthood.
Front Vet Sci
January 2025
VetAgro Sup (Campus Vétérinaire), Centre de Recherche et de Formation en Algologie Comparée (CREFAC), University of Lyon, Marcy l'Etoile, France.
Introduction: This study was designed to determine the prevalence of myofascial pain and the location of myofascial trigger points (MTPs) in dogs with osteoarthritis.
Methods: Thirty-five dogs were selected and examined for the presence of MTPs using palpation. Assessments were performed independently by two examiners.
J Orthop Surg Res
January 2025
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, 300072, China.
Background: Knee Osteoarthritis (KOA) is a prevalent condition worldwide, significantly diminishing quality of life and productivity. Except for the alignment change, muscle activation patterns (MAP) have garnered increasing attention as another crucial factor contributing to KOA.
Objective: This study explores the factors, characteristics, and effects of MAP changes caused by KOA, providing a neuromuscular-based causal analysis for the rehabilitation treatment of KOA.
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