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Tourniquet knee surgery

Ohannes F Plate, Andrew D Wohler, Matthew L Brown, Daniel Sun, Nora F Fino, Jason E Lang
INTRODUCTION: Stiffness and loss of motion following total knee arthroplasty (TKA) is a complex and multifactorial complication that may require manipulation under anesthesia (MUA). However, patient and surgical factors that potentially influence the development of knee stiffness following TKA are not fully understood. The purpose of this study was to identify patient and surgical factors that may influence range of motion loss following TKA by assessing a cohort of patients that underwent MUA and comparing them to a matched cohort of patients without complications...
October 6, 2016: Surgical Technology International
Gong Long, Chen Hao, Geng Li, Yu Yang, Zhou Hongzhong, Wang Zhenhu
BACKGROUND: B-type natriuretic peptide (BNP) is a well-known biomarker to predict cardiac events following orthopedic procedures. However, further information regarding BNP can be completed. The present study aims to determine which of preoperative, postoperative or the difference between them (DVPPB) can best predict adverse cardiac events following TKA procedure and detect possible risk factors of high level of BNP. METHODS: Between Jan. 2012 and Jan. 2014. 1120 included patients in 3 institutions have a minimum of 2-years follow-up...
September 9, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Satoshi Takayama, Takeshi Yamamoto, Chiduru Tsuchiya, Hideo Noguchi, Junko Sato, Yoshinori Ishii
BACKGROUND: Steri-Strips (3M, Two Harbors, MN, USA) have recently been employed for skin closures after orthopedic surgeries. Here we compare the performance of Steri-Strips and skin staples for wound closure after primary total knee arthroplasties (TKAs). METHODS: A total of 76 consecutive osteoarthritic knees (71 patients) that underwent a primary TKA at our facility were included in this study. Thirty-eight knees received Steri-Strips for wound closure and were evaluated prospectively...
September 6, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Qi Zhang, Jiyuan Dong, Ke Gong, Xiang Li, Shihao Zheng, Tao Wen
OBJECTIVE: To clarify the effects of tourniquet use on pain, early rehabilitation, blood loss, incidence rate of thrombosis in primary total knee arthroplasty (TKA) through a randomized controlled trial. METHODS: Between Janurary 2014 and August 2015, 168 patients with knee osteoarthritis undergoing primary TKA were randomly allocated to tourniquet group (n = 84) or non-tourniquet group (n = 82). There was no significant difference in gender, age, body mass index, affected side, osteoarthritis grading, disease duration, preoperative range of motion (ROM), visual analogue scale (VAS), Hospital for Special Surgery (HSS) score, and hemoglobin (Hb) between 2 groups (P > 0...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
Noriaki Mori, Shoichi Kimura, Tomohiro Onodera, Norimasa Iwasaki, Izumi Nakagawa, Takeshi Masuda
BACKGROUND: There has been controversy regarding the incidence of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) with or without the use of a tourniquet. The aim of this randomized, prospective study was to clarify the effects of tourniquet use on DVT in TKA. METHODS: The subjects were 109 patients scheduled to undergo TKA from April 2008 to March 2009 before the establishment of the American Association of Orthopedic Surgeons (AAOS) practice guidelines...
October 2016: Knee
Sergio Barroso Rosa, Dugal James, Brent David Matthews
PURPOSE: To determine that when the patient chooses their intervention, whether there is any difference in duration of surgery, effectiveness, patient satisfaction and recovery time between two methods of anaesthesia, local anaesthetic (LA) and general anaesthesia (GA) in knee arthroscopy (KA). METHODS: Inclusion criteria were medically fit, adults, undergoing unilateral KA, in a native knee as a day case. Exclusion criteria were requirement for ligament reconstruction or meniscal repair, pre-existing regional sensory impairment or active psychiatric condition...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Jinwei Xie, Jun Ma, Huan Yao, Chen Yue, Fuxing Pei
BACKGROUND: The optimal dosage and timing of tranexamic acid (TXA) in total knee arthroplasty (TKA) are undetermined. The purpose of this study was to explore the effect of multiple boluses of intravenous TXA on hidden blood loss (HBL), inflammatory response, and knee function after primary TKA without tourniquet. METHODS: A total of 151 patients were randomly divided into 3 groups to receive single bolus of 20 mg/kg IV-TXA before skin incision (group A), or another bolus of 10 mg/kg IV-TXA 3 hours later (group B), or another 2 boluses of 10 mg/kg IV-TXA 3 hours and 6 hours later (group C)...
May 6, 2016: Journal of Arthroplasty
Gangyong Huang, Jun Xia, Siqun Wang, Yibing Wei, Jianguo Wu, Feiyan Chen, Jie Chen, Jingsheng Shi
BACKGROUND: Apart from transepicondylar axis, the native femoral sulcus was also reported to be used as a guide for the femoral component position in total knee arthroplasty (TKA). However, it was not shown in patients with severe knee osteoarthritis. This study was conducted to compare the position of trochlear groove in patients with and without osteoarthritis, and to assess whether trochlear groove could be used as a guide for position of femoral component in TKA for severe knee osteoarthritis...
2016: BMC Surgery
Mark S Hsiao, Nicholas Kusnezov, Ryan N Sieg, Brett D Owens, Joshua P Herzog
Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-articular visualization, less pain in the immediate postoperative period, and faster recovery for patients. Pump systems used for arthroscopic surgery have evolved over the years to provide improved intraoperative visualization...
May 1, 2016: Orthopedics
Daniel Volquind, Remi Antônio Zardo, Bruno Costamilan Winkler, Bruno Bertagnolli Londero, Natália Zanelatto, Gisele Perondi Leichtweis
BACKGROUND AND OBJECTIVES: The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. METHOD: 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2...
May 2016: Brazilian Journal of Anesthesiology
Lúcio Honório de Carvalho Júnior, Luiz Fernando Machado Soares, Matheus Braga Jacques Gonçalves, Tiago Pinto de Oliveira Gomes, Juraci Rosa de Oliveira, Mauro Gualberto Coelho, Rogério Luciano Dos Santos, Marco Antônio Percope de Andrade, Guilherme de Lima E Silva, Eduardo Nilo Vasconcelos Novais
UNLABELLED: To evaluate whether, by using an arthropump (irrigation equipment with pressure sensor), pneumatic tourniquet use could interfere with the duration of surgery, recovery of movement and joint volume in patients who underwent knee videoarthroscopy for partial meniscectomy. METHODS: 103 patients divided randomly into two groups regarding use or nonuse of a pneumatic tourniquet were evaluated in five different centers by seven different surgeons. The variables were evaluated during the surgery and seven days after the operation...
September 2010: Revista Brasileira de Ortopedia
Sohail Hafeez, M Sohail Amin, Jahanzeb Ameen, Rana Adnan
OBJECTIVE: To compare the effects of duration and timing of tourniquet release on perioperative blood loss, transfusion requirement, duration of surgery, length of hospital stay and early complications in total knee arthroplastywith and without additional anti-fibrinolytic therapy. METHODS: The prospective quasi-experimental study was conducted at the Combined Military Hospital, Rawalpindi, from March to August 2014. The patients undergoing total knee arthroplasty were divided into two groups: in Group A tourniquet was released after closure of surgical wound and applying compressive dressing; and in Group-B tourniquet was deflated after cementation of implants following which closure was done...
November 2015: JPMA. the Journal of the Pakistan Medical Association
Hans C Dreyer
Muscle atrophy after total knee arthroplasty (TKA) occurs at a rate of 1% per day for the first 2 wk. Our hypothesis is that tourniquet-induced ischemia-reperfusion injury occurring during TKA influences metabolism and may contribute to atrophy. Identifying pathways that are upregulated during this critical "14-d window" after surgery may help us delineate therapeutic approaches to avoid muscle loss.
April 2016: Exercise and Sport Sciences Reviews
J Pertlíček, J Stehlík, P Sadovský, D Musil, V Mezera
PURPOSE OF THE STUDY: Tranexamic acid is an antifibrinolytic agent which blocks plasmin-mediated fibrin degradation. It is used in surgery to reduce intra-operative and post-operative blood loss. The aim of our study was to assess the effect of tranexamic acid administration on blood loss after elective primary unilateral total knee arthroplasty. MATERIAL AND METHODS: A total of 119 patients (50 men, 69 women) with an average age of 69.2 years were included. The patients were randomised into two groups: Group A received a single dose of tranexamic acid (Exacyl, 1...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Jonathan B Muyskens, Austin D Hocker, Douglas W Turnbull, Steven N Shah, Brick A Lantz, Brian A Jewett, Hans C Dreyer
Total knee arthroplasty (TKA) is the most common and cost-effective treatment for older adults with long-standing osteoarthritis. Projections indicate that nearly 3.5 million older adults will undergo this procedure annually by the year 2030. Thus, understanding the factors that lead to optimal outcomes is of great clinical interest. In the majority of cases, tourniquet is applied during surgery to maintain a clear surgical field, however, there is debate as to whether this intervention is completely benign...
January 2016: Physiological Reports
M Yaqub Noorzai, Nicole Carpp, Christian W Ertl
A 23-year-old Afghan National Policeman sustained a right popliteal artery injury secondary to a ground-based blast. Initial treatment was an application of a tourniquet, and after triage at a local civilian hospital a shunt was placed, 3 hours after the initial injury, and then was transferred to Kabul for definitive care, 24 hours after injury. Extensive trauma to both legs precluded use of greater saphenous vein as a graft. To avoid an above-the-knee amputation, a branch of the internal iliac artery was harvested for grafting...
December 2015: Military Medicine
Yu-Mei Zhang, Jie He, Chang Zhou, Yu Li, De-Kun Yi, Xia Zhang
OBJECTIVE: To determine the factors affecting postoperative acute hypotension after total knee arthroplasty (TKA) and provide a basis for guiding the clinical prevention. METHODS: Between May 2001 and May 2013, a total of 495 patients undergoing routine TKA were analyzed retrospectively. Independent risk factors related to postoperative acute hypotension after TKA were determined by univariate and multivariate analysis. RESULTS: Of the 495 patients undergoing TKA, 61 (12...
2015: International Journal of Clinical and Experimental Medicine
Ashir Ejaz, Anders C Laursen, Andreas Kappel, Thomas Jakobsen, Poul Torben Nielsen, Sten Rasmussen
BACKGROUND: Tourniquet use in total knee arthroplasty (TKA) surgery is applied to minimize blood loss thereby creating better overview of the surgical field. This induces ischemia in the skeletal muscle resulting in reperfusion injury. Our aim was to investigate the in vivo metabolic changes in the skeletal muscle during TKA surgery using microdialysis (MD). METHODS: Seventy patients were randomly allocated to tourniquet group (n = 35) or non-tourniquet group (n = 35)...
2015: BMC Musculoskeletal Disorders
Cheng Ni, Ting Xu, Nan Li, Yang Tian, Yongzheng Han, Qingsheng Xue, Min Li, Xiangyang Guo
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a frequent complication in elderly patients undergoing major non-cardiac surgery, but its etiology is still unclear. Cerebral oxygen saturation (ScO2) represents the balance of cerebral oxygen supply and demand. The aim of present study was to evaluate the relationship between perioperative ScO2 and POCD, and to verify the hypothesis that the value of ScO2 after multiple perioperative influential factors could predict POCD in elderly patients undergoing total knee arthroplasty (TKA)...
2015: BMC Anesthesiology
W D Harrison, B Narayan, A W Newton, J V Banks, G Cheung
INTRODUCTION: This study reviews the litigation costs of avoidable errors in orthopaedic operating theatres (OOTs) in England and Wales from 1995 to 2010 using the National Health Service Litigation Authority Database. MATERIALS AND METHODS: Litigation specifically against non-technical errors (NTEs) in OOTs and issues regarding obtaining adequate consent was identified and analysed for the year of incident, compensation fee, cost of legal defence, and likelihood of compensation...
November 2015: Annals of the Royal College of Surgeons of England
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