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Orthopedic Clinics of North America

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https://www.readbyqxmd.com/read/29145991/outpatient-surgery
#1
EDITORIAL
Frederick M Azar
No abstract text is available yet for this article.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145990/the-role-of-superior-capsule-reconstruction-in-rotator-cuff-tears
#2
REVIEW
Paul Sethi, Wm Grant Franco
Massive, irreparable rotator cuff disease is a challenging problem to treat, especially in the younger active patient. This condition allows the deltoid to generate anterosuperior translation and shoulder dysfunction. Ideally, this dysfunction may be improved with rotator cuff repair. However, in the setting of irreparable rotator cuff disease, normal function is challenging to restore. Superior capsule reconstruction theoretically improves function by recentering the humeral head and improving glenohumeral kinematics...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145989/pain-management-strategies-in-shoulder-arthroplasty
#3
REVIEW
Jason L Codding, Charles L Getz
Pain control in total shoulder arthroplasty demands a multidisciplinary approach with collaboration between patients, surgeon, and anesthetist. A multimodal approach with preemptive medication, regional blockade, local anesthetics, and a combination of acetaminophen, nonsteroidal antiinflammatory drugs, tramadol, and gabapentinoids postoperatively leads to pain control and patient satisfaction. Assessment of patients' expectations constitutes a vital aspect of the preoperative patient evaluation. Educating and psychologically preparing patients reduces postoperative pain...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145988/outpatient-shoulder-arthroplasty
#4
REVIEW
Tyler J Brolin, Thomas W Throckmorton
Health care policy makers have placed increased attention on the cost of health care making outpatient joint arthroplasty an attractive alternative to routine hospital admission. Recent studies have shown outpatient shoulder arthroplasty is a safe and cost-effective alternative to inpatient shoulder arthroplasty. Proper patient selection, patient education, effective pain management strategies, and attention to intraoperative blood loss are keys in the success of outpatient shoulder arthroplasty.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145987/outpatient-total-knee-arthroplasty-are-we-there-yet-part-2
#5
REVIEW
Andrew Krause, Zain Sayeed, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The method by which surgeons conduct outpatient total knee procedures has yet to be fully elucidated. Literature demonstrates different experiences from various care protocols in place across the nation. This article reviews current recommendations for implementing successful total knee arthroplasty (TKA) and unicompartmental knee arthroplasty outpatient protocols. Specifically, information regarding anesthesia and analgesia modalities, perioperative care, operative technique, and postoperative care within outpatient TKA pathways is discussed...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145986/hand-surgery-in-the-ambulatory-surgery-center
#6
REVIEW
Norfleet B Thompson, James H Calandruccio
Outpatient surgery, especially in free-standing ambulatory surgery centers (ASC), provides a safe, cost-effective option for a variety of surgical procedures and has become the preferred choice over inpatient and hospital-based outpatient surgery for most hand and wrist procedures. Complication rates after ASC hand surgery are low (0.2%-2.5%). Patient dissatisfaction with ASC surgery is primarily associated with postoperative nausea and vomiting and inadequate pain control.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145985/use-of-wide-awake-local-anesthesia-no-tourniquet-in-hand-and-wrist-surgery
#7
REVIEW
Murphy M Steiner, James H Calandruccio
WALANT (wide-awake local anesthesia no tourniquet) appears to be a safe and effective anesthesia technique for many hand and wrist surgeries. Patient satisfaction is high because of the avoidance of preoperative testing and hospital admission. Postoperative recovery is rapid, and procedures can be done in outpatient settings, resulting in substantial savings in time and money.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145984/outpatient-pediatric-orthopedic-surgery
#8
REVIEW
Daniel J Miller, Susan E Nelson, Apurva S Shah, Theodore J Ganley, John Jack M Flynn
Outpatient surgery refers to a surgical procedure that is performed without an overnight stay in a hospital. Outpatient surgery is associated with decreased individual and societal costs while achieving equivalent health outcomes and excellent patient satisfaction. Successful outpatient pediatric surgery is predicated on appropriate patient selection, adequate pain control, thorough preoperative education, and close clinical follow-up. Continuous research in quality, value, and patient safety are needed to ensure that this practice continues in as safe and efficient a manner as possible...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145983/the-role-of-implant-removal-in-orthopedic-trauma
#9
REVIEW
Eric A Barcak, Michael J Beebe, John C Weinlein
Although implant removal is common after orthopedic trauma, indications for removal remain controversial. There are few data in the literature to allow evidence-based decision-making. The risk of complications from implant removal must be weighed against the possible benefits and the likelihood of improving the patient's symptoms.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145982/impact-of-outpatient-total-joint-replacement-on-postoperative-outcomes
#10
REVIEW
Danielle Lovett-Carter, Zain Sayeed, Leila Abaab, Vinay Pallekonda, William Mihalko, Khaled J Saleh
Total joint arthroplasty (TJA) has demonstrated tremendous benefits to patients with osteoarthritis. Health care reform has influenced surgeons to optimize TJA care pathways as well as playing a role in the formation of outpatient TJA protocols. Understanding the outcomes of outpatient TJA is imperative to surgical predicate decision making. The aim of this review is to compare outcomes of outpatient TJA patients to standard-stay inpatients. Postoperative outcomes assessed include pain, complications, readmissions, reoperation, patient satisfaction, and cost...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145981/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-2
#11
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The intra- and postoperative phases of outpatient total hip arthroplasty (THA) vary by institution and surgeon. An understanding of an evidence-based approach to enhancing the intra- and postoperative phases of the care continuum is warranted to offer high-value care to outpatient candidates. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding anesthesia and analgesia modalities, intraoperative considerations, and postoperative rehabilitation amenable to outpatient THA...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145980/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-1
#12
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The method by which surgeons conduct outpatient total hip arthroplasty (THA) procedures has yet to be fully standardized. Careful examination of components involved in the preoperative phase of outpatient hip arthroplasty procedures may lead to improved outcomes. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding patient selection criteria, preoperative education, and preoperative medical optimization.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145979/current-ultrasound-application-in-the-foot-and-ankle
#13
REVIEW
Nahum Michael Beard, Robert Patrick Gousse
This article is a comprehensive review of the current utilizations of ultrasound in the treatment of orthopedic conditions of the foot and ankle. It reviews the diagnostic and interventional applications to commonly encountered lower-extremity ailments, including plantar fasciosis, tendinosis, and peripheral nerve disorders. It also outlines minimally invasive ultrasound-guided procedures and emerging therapies as alternatives to current treatments. These emerging therapies can be used to assist surgeons and provide options for patients needing intervention...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145978/outpatient-management-of-ankle-fractures
#14
REVIEW
Charles Qin, Robert G Dekker, Mia M Helfrich, Anish R Kadakia
Interest in outpatient orthopedic surgery has been fueled by provider desire to control costs and development of rapid recovery protocols. Open reduction and internal fixation (ORIF) is a commonly elected treatment strategy for ankle fracture that may be performed in an outpatient setting. Lessons on cost-savings of the outpatient model in orthopedics can be learned in total joint replacement and spine surgery. Moreover, in properly selected patients, outpatient ORIF has been shown to be comparably safe. Reasons for admission of the surgically managed patient with ankle fractures, including concern for surgical delay and additional social factors, warrant further investigation...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145977/outpatient-total-knee-arthroplasty-are-we-there-yet-part-1
#15
REVIEW
Andrew Krause, Zain Sayeed, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
Recent trends in total joint care have moved toward outpatient surgery. Total knee arthroplasty (TKA) remains a definitive management for end-stage osteoarthritis and has experienced increased utilization over the past several decades. The method by which surgeons conduct outpatient total knee procedures has yet to be fully elucidated as different institutions report different experiences from their pathways. This article will discuss current data and recommendations for implementing successful TKA and unicompartmental knee arthroplasty outpatient protocols...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870311/perioperative-pain-management
#16
EDITORIAL
Frederick M Azar
No abstract text is available yet for this article.
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870310/peripheral-nerve-blocks-in-foot-and-ankle-surgery
#17
REVIEW
Tyler W Fraser, Jesse F Doty
Postoperative pain is one of the most important factors in regard to patient outcomes. It has been linked with patient satisfaction, length of stay, and overall hospital costs. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe. Peripheral nerve blocks, whether used intraoperatively or postoperatively, provide an alternative or adjunct to conventional pain management methods for patients who may not tolerate heavy narcotics or general anesthesia, in particular the elderly and those with cardiopulmonary disease...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870309/multimodal-analgesia-in-foot-and-ankle-surgery
#18
REVIEW
Jessica M Kohring, Nathan G Orgain
Progress in surgical acute pain management has allowed most foot and ankle surgery to be performed in ambulatory outpatient surgical centers. Multimodal analgesia focuses on improving postoperative pain by combining pharmacologic and other modalities, addressing multiple pain mechanisms and receptor pathways while reducing adverse effects through lower doses of oral medications. Local anesthesia techniques provide excellent pain relief with few adverse events. Multimodal analgesia in foot and ankle surgery provides superior pain relief, and reduced opioid dependence and opioid-related side effects, improving patient satisfaction, safety, and timely return to function...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870308/perioperative-pain-management-for-upper-extremity-surgery
#19
REVIEW
Alexander C Coleman
Upper extremity surgeons are currently faced with a daunting array of anesthesia techniques, ranging from traditional general anesthesia to wide-awake surgery, during which patients can watch their surgeons operate in the morning and return to work as soon as that afternoon. This range of options means that surgeons must consider patient-related factors such as disease process and relevant comorbidities, as well as surgery-related factors such as anatomic location, complexity, length of procedure, and postoperative pain expectations...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870307/perioperative-pain-management-in-pediatric-spine-surgery
#20
REVIEW
Benjamin W Sheffer, Derek M Kelly, Leslie N Rhodes, Jeffrey R Sawyer
Pain management after spinal deformity correction surgery for scoliosis in the pediatric population can be difficult. Deformity correction with posterior spinal fusion causes significant tissue trauma. Historically, pain control has been achieved with intravenous opiates. Opiates provide excellent analgesic effect; however, they have serious consequences when used alone. In adult total joint arthroplasty, multimodal pain control has become an increasingly common method to achieve pain control without these sequelae...
October 2017: Orthopedic Clinics of North America
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