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Tourniquet knee surgery

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https://www.readbyqxmd.com/read/28330800/tourniquet-and-closed-suction-drains-in-total-knee-arthroplasty-no-beneficial-effects-on-bleeding-management-and-knee-function-at-a-higher-cost
#1
David Yin, JoséeDelisle, AndreeaBanica, Andrea Senay, Pierre Ranger, G Yves Laflamme, Jiang Jun, Julio Fernandes
BACKGROUND: Blood loss is a major concern in total knee arthroplasty (TKA) along with postoperative knee function. The present study explores the impact of tourniquet (T) and closed-suction drains (D) on these parameters in TKA. MATERIALS AND METHODS: A prospective study was conducted on 111 patients admitted for TKA. Subjects were divided into three groups: 36 in group T+D+, 42 in T-D+ and 33 in T-D- (where T+: prolonged tourniquet use, T-: cementation-only tourniquet, D+: closed-suction drain use, and D-: no drain)...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28260153/effects-of-different-methods-of-using-pneumatic-tourniquet-in-patients-undergoing-total-knee-arthroplasty-a-randomized-control-trial
#2
Y Zhang, D Li, P Liu, X Wang, M Li
BACKGROUND: The goal of this work was to investigate the effects of different methods of using pneumatic tourniquet on reducing blood loss in patients undergoing cemented total knee arthroplasty (TKA). METHODS: One hundred and fifty patients undergoing unilateral cemented TKA were randomly divided into three groups (50 patients per group). The tourniquet was used during the entire operation (Group A), used from the beginning of operation to the completion of joint replacement (Group B), and from the beginning of osteotomy to the completion of arthroplasty (Group C)...
March 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28217217/the-effect-of-air-tourniquet-on-interleukin-6-levels-in-total-knee-arthroplasty
#3
Kenji Tsunoda, Motoki Sonohata, Hajime Kugisaki, Shinsuke Someya, Hidefumi Honke, Mitsunori Komine, Masataka Izumi, Shuya Ide, Masaaki Mawatari
BACKGROUND: Air tourniquet-induced skeletal muscle injury increases the concentrations of some cytokines such as interleukin-6 (IL-6) in plasma. However, the effect of an air tourniquet on the IL-6 concentrations after total knee arthroplasty (TKA) is unclear. We therefore investigated the impact of tourniquet-induced ischemia and reperfusion injury in TKA using the IL-6 level as an index. METHODS: Ten patients with primary knee osteoarthrosis who underwent unilateral TKA without an air tourniquet were recruited (Non-tourniquet group)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#4
RANDOMIZED CONTROLLED TRIAL
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28144581/tourniquets-do-not-increase-the-total-blood-loss-or-re-amputation-risk-in-transtibial-amputations
#5
Christian Wied, Peter T Tengberg, Gitte Holm, Thomas Kallemose, Nicolai B Foss, Anders Troelsen, Morten T Kristensen
AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28139973/effects-of-five-treatment-regimens-on-blood-loss-and-blood-transfusion-in-total-knee-arthroplasty-a-preliminary-study-in-china%C3%A2
#6
Kong-Zu Hu, He-Yan Sun, Cong Sui
OBJECTIVE: Our study is aimed to explore effects of five treatment regimens on blood loss and blood transfusion rate in total knee arthroplasty (TKA) patients. METHODS: 191 TKA patients were divided into the rivaroxaban, nadroparin, and tranexamic acid groups (n = 37 each) as well as into the affected-limb-position and tourniquet group (n = 40 each). A 3-month follow-up after operation was needed for all patients. The total blood loss, hidden blood loss, and dominant blood loss were recorded, and hemoglobin and red blood cell changes, pain and knee swelling degrees, hospital for special surgery (HSS), and American knee society (KSS) knee scores were observed...
January 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28050539/comparative-analysis-of-pain-in-patients-who-underwent-total-knee-replacement-regarding-the-tourniquet-pressure
#7
Marcos George de Souza Leão, Gladys Pedrosa Martins Neta, Lucas Inoue Coutinho, Thiago Montenegro da Silva, Yacov Machado Costa Ferreira, Waryla Raissa Vasconcelos Dias
OBJECTIVES: To evaluate through the visual analog scale (VAS) the pain in patients undergoing total knee replacement (TKR) with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard) and the other with systolic blood pressure plus 100 mmHg (P + 100)...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27999958/use-of-patient-specific-cutting-blocks-reduces-blood-loss-after-total-knee-arthroplasty
#8
Vicente J León, María A Lengua, Víctor Calvo, Alonso J Lisón
Total knee arthroplasty (TKA) is associated with substantial blood loss. Sources of bleeding are the femoral and tibial intramedullary canals, which are violated during implantation using standard instrumentation. Patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) do not require violation of the intramedullary canals. Therefore, we sought to assess the impact of these methods on blood loss and transfusion requirement. A retrospective cohort study was conducted in a series of 107 consecutive primary TKAs...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27895370/lower-red-cell-transfusion-rates-with-use-of-tranexamic-acid-in-single-stage-bilateral-total-knee-arthroplasty-a-retrospective-audit
#9
Muhammad Aziz, Salman Bin Mahmood, Riaz Hussain Lakdawala, Tashfeen Ahmad
Bilateral total knee arthroplasty (BTKA) patients may require blood transfusion which has its risks. Anti-fibrinolytic drugs such as aprotinin, aminocaproic acid and tranexamic acid (TXA) have reduced transfusion requirements in major surgery. This retrospective audit was performed to assess effectiveness of TXA in reducing blood transfusion rate in single-stage sequential BTKA cases operated by a single surgeon. Records of 91 patients given TXA and 80 controls who were operated before 2012 and not given TXA were reviewed...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27861210/symptomatic-venous-thromboembolism-after-adolescent-knee-arthroscopy
#10
Robert F Murphy, Benton Heyworth, Dennis Kramer, Manahil Naqvi, Patricia E Miller, Yi-Meng Yen, Mininder S Kocher, Benjamin J Shore
BACKGROUND: The frequency of knee arthroscopy procedures is increasing in pediatric and adolescent patients. In general, complications after these procedures in adolescents are uncommon. The purposes of this study are to report the incidence of venous thromboembolism (VTE) in adolescent patients after knee arthroscopy procedures, as well identify risk factors in this patient population. METHODS: Medical records were reviewed in all pediatric and adolescent patients (≤19 y) who underwent an arthroscopic knee procedure from 2010 to 2014 and were diagnosed with a symptomatic VTE in the postoperative period...
November 17, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27848053/tourniquet-use-during-total-knee-arthroplasty-does-not-modulate-the-neutrophil-to-lymphocyte-ratio-pain-or-activity
#11
Tyler Barker, Victoria E Rogers, Kimberly B Brown, Vanessa T Henriksen, G Lynn Rasmussen
The purpose of our study was to identify the influence of tourniquet use during total knee arthroplasty (TKA) on the neutrophil-to-lymphocyte ratio (NLR) shortly after surgery and patient-reported outcomes (pain and physical activity) from outpatient physical therapy. This retrospective study consisted of 104 subjects who underwent primary unilateral TKA (51 subjects with and 53 subjects without tourniquet assistance) between 2010 and 2012. The NLR was calculated from the absolute neutrophil and lymphocyte counts obtained immediately before and after (1 and 2 days) knee arthroplasty...
November 15, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27842707/-tourniquet-induced-ischaemia-reperfusion-injury-the-comparison-of-antioxidative-effects-of-small-dose-propofol-and-ketamine
#12
Karaca Omer, Gogus Nermin, Ahiskalioglu Ali, Aksoy Mehmet, Dogus Unal, Kumas Solak Sezen, Kalafat Hakan
OBJECTIVES: The aim of the present study was to investigate the preventive effects of propofol and ketamine as small dose sedation during spinal anesthesia on tourniquet-induced ischemia-reperfusion injury. METHODS: Thirty patients were randomly assigned into two groups of fifteen patients. In the propofol group, sedation was performed with propofol 0.2mgkg(-1) followed by infusion at a rate of 2mgkg(-1)h(-1). In the ketamine group, a continuous infusion of ketamine 0...
November 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27728948/factors-associated-with-range-of-motion-recovery-following-manipulation-under-anesthesia
#13
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
https://www.readbyqxmd.com/read/27623045/predictive-value-of-b-type-natriuretic-peptide-bnp-for-adverse-cardiac-events-in-patients-undergoing-primary-total-knee-arthroplasty-tka
#14
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...
November 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27600333/comparing-steri-strip-and-surgical-staple-wound-closures-after-primary-total-knee-arthroplasties
#15
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
https://www.readbyqxmd.com/read/27411268/-effects-of-tourniquet-use-on-perioperative-outcome-in-total-knee-arthroplasty
#16
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/27372555/use-of-a-pneumatic-tourniquet-in-total-knee-arthroplasty-increases-the-risk-of-distal-deep-vein-thrombosis-a-prospective-randomized-study
#17
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
https://www.readbyqxmd.com/read/27324262/is-knee-arthroscopy-under-local-anaesthetic-a-patient-friendly-technique-a-prospective-controlled-trial
#18
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
https://www.readbyqxmd.com/read/27262419/multiple-boluses-of-intravenous-tranexamic-acid-to-reduce-hidden-blood-loss-after-primary-total-knee-arthroplasty-without-tourniquet-a-randomized-clinical-trial
#19
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)...
November 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27216144/total-knee-arthroplasty-using-trochlear-groove-as-guide-for-position-of-femoral-component-in-severe-knee-osteoarthritis
#20
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...
May 23, 2016: BMC Surgery
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