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Tourniquet knee surgery

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https://www.readbyqxmd.com/read/29159505/biochemical-stress-evaluation-after-medial-parapatellar-and-subvastus-approach-in-total-knee-replacement
#1
L Sabatini, G Nicolaci, F Atzori, A Oliva, A Aprato, M Terzolo, A Masse'
INTRODUCTION: Even if different surgical approaches for total knee arthroplasty are well known since decades, the standard medial parapatellar incision remains the most common one; general agreement about significant advantages with minimally invasive techniques is lacking. Furthermore, the surgical stress effect on the organism has always been analyzed through blood inflammatory parameters. This study aim was to compare the standard and subvastus approaches, using the salivary cortisol in particular as measure for systemic surgery-related stress...
November 20, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/29153864/changes-in-markers-of-thrombin-generation-and-interleukin-6-during-unicondylar-knee-and-total-knee-arthroplasty
#2
Edwin P Su, Lauren E Mount, Allina A Nocon, Thomas P Sculco, George Go, Nigel E Sharrock
BACKGROUND: Total knee arthroplasty (TKA) is associated with a risk of thromboembolism requiring routine thromboprophylaxis, but there is debate about the risk with unicondylar knee arthroplasty (UKA) as it is a more minor procedure. We sought to investigate the relative risk of thromboembolism with UKA compared to TKA and one-staged bilateral TKA (BTKA) by measuring the increase in circulating biochemical markers of thrombin generation during the procedures. Degree of surgical trauma was also assessed by measuring interleukin-6, a marker of metabolic injury...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29137681/influence-of-tourniquet-use-in-primary-total-knee-arthroplasty-with-drainage-a-prospective-randomised-controlled-trial
#3
Kai Zhou, Tingxian Ling, Haoyang Wang, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
BACKGROUND: We aimed to compare the effect of tourniquet use or lack of it on recovery following uncomplicated primary total knee arthroplasty (TKA). METHODS: In a prospective randomised double-blinded study, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group. At the early phase, 3 and 6 months after surgery, an independent observer assessed the primary outcome measure (i.e. total blood loss) and secondary outcome measures (i...
November 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29114639/knee-septic-arthritis-after-arthroscopy-incidence-risk-factors-functional-outcome-and-infection-eradication-rate
#4
REVIEW
G Balato, S L Di Donato, T Ascione, A D'Addona, F Smeraglia, G Di Vico, D Rosa
Purpose  Septic knee arthritis following arthroscopy is a rare but dreaded complication. Definition and management of knee deep infections are quite discussed in literature. In this review, literature regarding infections after knee arthroscopy is analyzed highlighting the incidence, causative bacteria, risk factors as well as clinical outcomes. Methods  We performed a review of the literature matching the following key words: "septic arthritis" OR "infection" AND "arthroscopy" AND "knee." Knee arthroscopic procedures, such as debridement, meniscectomy, meniscus repair, synovectomy, microfracture, and lateral release, were considered...
June 2017: Joints
https://www.readbyqxmd.com/read/29095191/determination-of-pneumatic-tourniquet-pressure-of-lower-limb-by-ultrasonic-doppler
#5
Jinyan Mu, Dan Liu, Daihong Ji, Borui Li, Zhigang Li, Feng Zhang, William C Lineaweaver
OBJECTIVE: The aim of this study was to investigate the clinical effect of tourniquet inflation pressure setting by ultrasonic Doppler on lower limb operation. METHODS: Ninety-six patients with total knee arthroplasty were selected in this study from January 2015 to December 2015. The patients were randomly divided into the study group and the control group with 48 cases in each group. In the control group, the tourniquet pressure is determined by the doctor's request for the patient's condition, but all the tourniquet pressure values should be 80 KPa or less...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29078996/ambulatory-unicompartmental-knee-arthroplasty-short-outcome-of-50-first-cases
#6
N Ruiz, X Buisson, G Filippi, M Roulet, H Robert
INTRODUCTION: The reduction in length of stay (LOS) in orthopaedic surgery has been steady for several years. For the past 3 or 4 years in France, the trend towards outpatient surgery has been growing up, as it is a goal for hospital administration. MATERIALS AND METHODS: This is a prospective, continuous,mono-centric, single operator study on 56 UKAs. Included were all UKAs carried out between January 2014 and December 2015, meeting the following criteria: voluntary patients, supportive family environment, absence of comorbidity (oral anticoagulants, diabetes, obesity), ASA score ≤ 3...
October 24, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29062824/comparative-study-of-topical-vs-intravenous-tranexamic-acid-regarding-blood-loss-in-total-knee-arthroplasty
#7
Ari Zekcer, Ricardo Del Priori, Clauber Tieppo, Ricardo Soares da Silva, Nilson Roberto Severino
OBJECTIVE: To compare topical vs. intravenous tranexamic acid (TA) in total knee arthroplasty regarding blood loss and transfusion. METHODS: Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV), topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group), or intravenous saline (100 mL with anesthesia; control group). The volume of drained blood in 48 h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated...
September 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28951649/experience-of-supracondylar-cheveron-osteotomy-for-genu-valgum-in-115-adolescent-knees
#8
Jatin Prakash, Tankeswar Boruah, Anil Mehtani, Suresh Chand, Hitesh Lal
PURPOSE: Medial close wedge Coventry type osteotomy is commonly performed procedure for adoloscent Genu valgum. However this osteotomy has some inherent problems, a wedge resection causes shortening of affected site. An additional plate for stabilization causes increase in soft tissue dissection and surgical time. A cheveron osteotomy is an alternative procedure, not requiring any internal fixation due to its inherent stability. We started this study with aim to analyze the results of Cheveron osteotomy, to see if the osteotomy was stable enough without implants, time required for healing of osteotomy, post-operative range of motion, limb length discrepancy and to evaluate any other complication...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28942397/catastrophic-cement-reaction-following-cementation-for-megaprosthesis-for-proximal-femoral-fracture
#9
Muhammad Nouman Baig, William Curtin, Michael Andrew Callaghan, Colin G Murphy
Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.Donaldson et alproposed the definition of BCIS as a syndrome "characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery"...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28899856/release-of-the-tourniquet-immediately-after-the-implantation-of-the-components-reduces-the-incidence-of-deep-vein-thrombosis-after-primary-total-knee-arthroplasty
#10
P Zan, M O Mol, J J Yao, L Fan, D Yang, K Liu, G Li
AIMS: The length of the tourniquet time during total knee arthroplasty (TKA) is related to the incidence of post-operative deep vein thrombosis (DVT). Our aim in this study was to investigate the effect of the early release of the tourniquet on the incidence of DVT in patients undergoing TKA. METHODS: A total of 200 patients who underwent TKA between November 2015 and November 2016 were prospectively enrolled. The tourniquet was inflated before surgery and released immediately after the introduction of the components (early release group)...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28853118/occlusion-training-pilot-study-for-postoperative-lower-extremity-rehabilitation-following-primary-total-knee-arthroplasty
#11
Christopher L Gaunder, Michael P Hawkinson, David J Tennent, Creighton C Tubb
With continued emphasis on the value of healthcare, factors such as quality of life and patient reported outcomes are critical in evaluating high-demand procedures such as knee replacement surgery. Equally important to the surgery itself is maximizing the effectiveness and efficiency of the treatment, both preoperatively and postoperatively, which can have a significant effect the final outcome. Technical outcomes of total knee replacement are generally considered excellent; however, many patients continue to have postoperative pain, functional limitations, and low treatment satisfaction...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28793978/patellofemoral-arthroplasty-conversion-to-total-knee-arthroplasty-retrieval-analysis-and-clinical-correlation
#12
Alexander B Christ, Elexis Baral, Chelsea Koch, Beth E Shubin Stein, Alejandro Gonzalez Della Valle, Sabrina M Strickland
BACKGROUND: Patellofemoral arthroplasty (PFA) can be a successful, bone-sparing treatment for isolated patellofemoral arthritis. However, progression of tibio-femoral arthritis or incorrect indications may predispose patients to early conversion to total knee arthroplasty (TKA). The purpose of this study was to review the clinical cases and perform retrieval analysis of PFA conversions to TKA at our institution. METHODS: Twenty one patellofemoral arthroplasties in 18 patients that were converted to TKA were identified through our implant retrieval registry...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#13
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28747231/different-patient-satisfaction-levels-between-the-first-and-second-knee-in-the-early-stage-after-simultaneous-bilateral-total-knee-arthroplasty-tka-a-comparison-between-subjective-and-objective-outcome-assessments
#14
Shuai Huang, Xing Li, Yubo Tang, Sunny Stiphan, Bin Yan, Peiheng He, Dongliang Xu
BACKGROUND: Simultaneous bilateral total knee arthroplasty (TKA) is an effective treatment option and safe for properly selected patients. The purpose of this study was to evaluate whether patients have different satisfaction levels between the first and second knee in the early stage after simultaneous bilateral TKA. METHODS: We retrospectively reviewed 46 patients who underwent simultaneous bilateral TKA by a single surgeon in our department between March 2013 and March 2015...
July 26, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#15
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28700413/venous-thromboembolism-after-major-venous-injuries-competing-priorities
#16
Brian Frank, Zoё Maher, Joshua P Hazelton, Shelby Resnick, Elizabeth Dauer, Anna Goldenberg, Andrea L Lubitz, Brian P Smith, Noelle N Saillant, Patrick M Reilly, Mark J Seamon
BACKGROUND: Venous thromboembolism (VTE) after major vascular injury (MVI) is particularly challenging as the competing risk of thrombosis and embolization after direct vessel injury must be balanced with risk of bleeding after surgical repair. We hypothesized that venous injuries, repair type and intraoperative anticoagulation would influence VTE formation after MVI. METHODS: A multi-institution, retrospective cohort study of consecutive MVI patients was conducted at 3 urban, level-I centers (2005-2013)...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28660135/perioperative-blood-management-strategies-for-patients-undergoing-total-knee-replacement-where-do-we-stand-now
#17
REVIEW
Tzatzairis Themistoklis, Vogiatzaki Theodosia, Kazakos Konstantinos, Drosos I Georgios
Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28598560/effects-of-unilateral-tourniquet-used-in-patients-undergoing-simultaneous-bilateral-total-knee-arthroplasty
#18
Pei-Lai Liu, De-Qiang Li, Yuan-Kai Zhang, Qun-Shan Lu, Liang Ma, Xue-Zhi Bao, Meng Zhang
OBJECTIVE: To assess the benefits of use of a tourniquet in one limb in patients undergoing simultaneous bilateral total knee arthroplasty (TKA). METHODS: A prospective randomized trial was designed to evaluate the outcomes of unilateral tourniquet use during simultaneous bilateral TKA. A total of 52 (36 women and 16 men) patients with osteoarthritis who underwent simultaneous bilateral primary TKA between January 2010 and January 2015 were assigned randomly to tourniquet (TG) or non-tourniquet (NG) groups prior to surgery...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28470576/a-comparative-analysis-of-the-role-of-tranexamic-acid-as-an-independent-variable-in-reducing-intraoperative-blood-loss-in-patients-undergoing-conventional-total-knee-arthroplasty-versus-computer-assisted-total-knee-arthroplasty
#19
K K Eachempati, A V Gurava Reddy, S Apsingi, S R Sankineani, J Shaheed, C Dannana
BACKGROUND: Blood loss in total knee arthroplasty (TKA) is an area of significant concern as it has an effect on patient morbidity and hospital stay. Among many different modalities to reduce blood loss, the use of Tranexamic acid has become a standard procedure nowadays. The aim of our study was to determine if Tranexamic acid alone decreases blood loss as an independent variable irrespective of other blood loss preserving measures. METHOD: This prospective non-randomized study included patients undergoing unilateral TKA by conventional method (Group 1) and computer-assisted TKA (Group 2)...
May 3, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28399633/value-of-tourniquet-use-in-anterior-ankle-arthroscopy-a-randomized-controlled-trial
#20
Damjan Dimnjaković, Pero Hrabač, Ivan Bojanić
BACKGROUND: A tourniquet is usually used during anterior ankle arthroscopy to allow for improved visibility and reduced operation time. However, this has not been demonstrated to be true in clinical studies on knee arthroscopy, while limited tourniquet time has been described as a possible factor to lower the complication rate of ankle arthroscopy. The purpose of this randomized controlled trial was to examine the effect of tourniquet use on arthroscopic visualization, operative time, postoperative intra-articular bleeding, postoperative pain scores, and outcome of anterior ankle arthroscopy...
July 2017: Foot & Ankle International
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