Objective: The aim was to evaluate whether using novel anchored barded suture for capsular closure can further shorten the length of stay following primary total knee arthroplasty (TKA) within existed enhanced recovery after surgery (ERAS) protocol in osteoarthritis patients.
Methods: A retrospective cohort study was conducted among osteoarthritis patients aged 18 to 80 years without major comorbidities who underwent primary unilateral TKA between January 2018 and December 2019 was conducted. The capsular closure techniques, interventions for ERAS, operation time and length of stay were collected via hospital electronic information system. Propensity-score matching was used to compensate for the difference in interventions for ERAS and patient characteristics. Subgroup comparison of patients treated under normal ERAS protocol was performed.
Results: Included were 315 patients with capsular closure by barded suture and 397 patients with interrupted capsular closure by traditional suture. Patients' characteristics and interventions for ERAS were balanced after propensity-score matching. The average postoperative length of stay in barded suture group was shorter than the compared group (2.10 ± 0.57 vs. 2.33 ± 0.80 days, p = 0.004), and with a significantly higher proportion of patients discharging within 2 days post procedure (88.0% vs. 70.7%, p < 0.001). The operation time for patients with barded suture closure was shorter compared to interrupted closure technique (100.90 ± 16.59 vs. 105.52 ± 18.47 min, p = 0.004). Subgroup analysis of patients treated under different levels ERAS protocol showed comparable results.
Conclusion: The use of barded suture for capsular closure was associated with shorter length of stay after TKA compared to traditional suture, suggesting that barded suturing technique could be one effective intervention for ERAS.
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http://dx.doi.org/10.1186/s12891-022-05292-y | DOI Listing |
Arthroscopy
December 2024
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, U.S.A.. Electronic address:
Purpose: To assess whether capsular closure during hip arthroscopy with periportal capsulotomy affects 2-year postoperative outcomes for patients with femoroacetabular impingement syndrome (FAIS) without hypermobility.
Methods: A matched-cohort retrospective analysis of a single institutional database of patients who underwent hip arthroscopy with periportal capsulotomy for management of FAIS between 2014 and 2022 was performed. Study inclusion criteria consisted of patients with FAIS who exhibited no signs of generalized ligamentous laxity (GLL) (Beighton score 0).
In all aspects of orthopaedic surgery, restoring native patient anatomy has shown improved outcomes in comparison to nonanatomic reconstructions. Particular attention has been paid to the hip capsule, as the complex of the iliofemoral, pubofemoral, and ischiofemoral ligaments, as well as the zona orbicularis and iliocapsularis, all play an essential role in hip stability, mechanics, and maintenance of intra-articular pressures. An anatomic approach toward hip arthroscopy also includes labral repair or reconstruction with preservation of the chondrolabral junction and cam resection.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Orthopaedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, NC.
Purpose: To determine the optimal treatment decision for capsular management after primary hip arthroscopy for femoroacetabular impingement syndrome.
Methods: An expected-value decision analysis was performed, (1) Organizing the decision problem, (2) determining outcome probabilities, (3) determining outcome utilities, (4) performing fold-back analyses, (5) performing sensitivity analyses. A decision tree was constructed (complete capsule closure vs incomplete closure) and a meta-analysis was conducted.
Cureus
November 2024
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, JPN.
We report a case of acute angle closure secondary to pupillary block caused by a dislocated intraocular lens (IOL)-capsular tension ring (CTR) complex. A 68-year-old woman, who had undergone cataract surgery 28 months earlier, presented with acute right eye pain and blurred vision. Examination revealed elevated intraocular pressure (IOP) of 80 mmHg, corneal edema, and anterior chamber shallowing, with anterior displacement of the IOL-CTR complex observed on anterior-segment optical coherence tomography.
View Article and Find Full Text PDFArthroscopy
November 2024
Department of Orthopaedic Surgery, The University of Texas Health Center at Houston, Houston, Texas, U.S.A.. Electronic address:
Purpose: To report minimum 2-year follow-up patient-reported outcomes (PROs), clinical benefit, and survivorship in patients who underwent concomitant hip arthroscopy and periacetabular osteotomy (PAO) for the surgical treatment of the developmental dysplasia of the hip (DDH).
Methods: Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy with concomitant PAO between December 2015 and September 2022. Patients with baseline and minimum 2-year PROs were included.
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