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https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#1
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28647788/the-efficacy-and-safety-of-two-low-dose-peri-operative-dexamethasone-on-pain-and-recovery-following-total-hip-arthroplasty-a-randomized-controlled-trial
#2
Yi-Ting Lei, Bin Xu, Xiao-Wei Xie, Jin-Wei Xie, Qiang Huang, Fu-Xing Pei
PURPOSE: To evalute the efficacy and safety of two low-dose peri-operative dexamethasone on pain and recovery following total hip arthroplasty (THA). METHODS: One hundred ten patients received two-dose of 10 mg IV-dexamethasone (group dexa) or IV-isotonic saline (group placebo). The level of C-reactive protein (CRP) and interleukin-6 (IL-6), pain at rest and during mobilization, incidence of post-operative nausea and vomiting (PONV), intensity of nausea, post-operative fatigue, consumption of analgesic and antiemetic rescue, range of motion (ROM), post-operative length of stay (post-operative LOS), wound problems and complications were recorded and compared...
June 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28646420/composite-reverse-shoulder-arthroplasty-can-provide-good-function-and-quality-of-life-in-cases-of-malignant-tumour-of-the-proximal-humerus
#3
Cyril Lazerges, Louis Dagneaux, Benjamin Degeorge, Nicolas Tardy, Bertrand Coulet, Michel Chammas
PURPOSE: Management of proximal humeral tumours remains a surgical challenge. No study to date has assessed the quality of life scores following the composite reverse shoulder arthroplasty for this indication. We, therefore, evaluated function and quality of life following reconstruction with allograft for malignant tumour of the humerus. METHODS: A series of six cases of humeral tumour treated by a single surgeon in a single centre was reviewed after a mean follow-up of 5...
June 23, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28646129/microscope-enhanced-the-efficacy-and-safety-of-anterior-cervical-surgery-for-managing-cervical-ossification-of-the-posterior-longitudinal-ligament
#4
Mingxiao Sun, Lili Kong, Zhaofu Jiang, Liming Li, Bing Lu
BACKGROUND We aimed to compare microscope-assisted anterior cervical surgery with traditional open-base surgery for treating cervical ossification of the posterior longitudinal ligament (OPLL). MATERIAL AND METHODS Patients were grouped into microscope-assisted anterior cervical surgery group (case group, n=30) and conventional anterior cervical surgery group (control group, n=30). Baseline characteristics, intraoperative and post-operative indexes including operation time, blood loss amount, duration of hospitalization, visual analogue scale (VAS), and complication rate were recorded...
June 24, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28645672/percutaneous-pedicle-screw-placement-under-single-dimensional-fluoroscopy-with-a-designed-pedicle-finder-a-technical-note-and-case-series
#5
Fon-Yih Tsuang, Chia-Hsien Chen, Yi-Jie Kuo, Wei-Lung Tseng, Yuan-Shen Chen, Chin-Jung Lin, Chun-Jen Liao, Feng-Huei Lin, Chang-Jung Chiang
BACKGROUND CONTEXT: Minimally invasive spine surgery has become increasingly popular in clinical practice, and it offers patients the potential benefits of reduced blood loss, wound pain, and infection risk and also diminishes the loss of working time and length of hospital stay. However, surgeons require more intraoperative fluoroscopy and ionizing radiation exposure during minimally invasive spine surgery for localization, especially for guidance in instrumentation placement. In addition, computer navigation is not accessible in some facility-limited institutions...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28645301/the-sternal-management-accelerated-recovery-trial-s-m-a-r-t-standard-restrictive-versus-an-intervention-of-modified-sternal-precautions-following-cardiac-surgery-via-median-sternotomy-study-protocol-for-a-randomised-controlled-trial
#6
Md Ali Katijjahbe, Linda Denehy, Catherine L Granger, Alistair Royse, Colin Royse, Rebecca Bates, Sarah Logie, Sandy Clarke, Doa El-Ansary
BACKGROUND: The routine implementation of sternal precautions to prevent sternal complications that restrict the use of the upper limbs is currently worldwide practice following a median sternotomy. However, evidence is limited and drawn primarily from cadaver studies and orthopaedic research. Sternal precautions may delay recovery, prolong hospital discharge and be overly restrictive. Recent research has shown that upper limb exercise reduces post-operative sternal pain and results in minimal micromotion between the sternal edges as measured by ultrasound...
June 23, 2017: Trials
https://www.readbyqxmd.com/read/28642060/microsurgically-assisted-inguinal-hernia-repair-and-simultaneous-male-fertility-procedures-rationale-technique-and-outcomes
#7
Michael L Schulster, Matthew R Cohn, Bobby B Najari, Marc Goldstein
PURPOSE: Inguinal herniorrhaphy is the most common general surgical procedure. It is associated with frequent complications such as recurrence (1.9% with mesh), post-operative hematoma (4.5%), reduced sensation (0 - 42.8%), chronic post-operative pain (5.1%), vasal injury (0.1 - 0.53%) and infection (3 - 6%)(1-5). Drawing on our experience utilizing the operating microscope for varicocelectomy, vasectomy reversal and repair of iatrogenic vasal obstruction from hernia repair, we employed it for inguinal hernia repair...
June 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28638971/longer-duration-of-operative-time-enhances-healing-metabolites-and-improves-patient-outcome-after-achilles-tendon-rupture-surgery
#8
Simon Svedman, Olof Westin, Susanna Aufwerber, Gunnar Edman, Katarina Nilsson-Helander, Michael R Carmont, Jón Karlsson, Paul W Ackermann
PURPOSE: The relationship between the duration of operative time (DOT), healing response and patient outcome has not been previously investigated. An enhanced healing response related to DOT may potentiate repair processes, especially in hypovascular and sparsely metabolized musculoskeletal tissues such as tendons. This study aimed to investigate the association between DOT and the metabolic healing response, patient-reported outcome and the rate of post-operative complications after acute Achilles tendon injury...
June 21, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28638926/-mechanisms-and-applications-of-transcutaneous-electrical-nerve-stimulation-in-analgesia
#9
Zheng-Yu Tang, Hui-Quan Wang, Xiao-Lei Xia, Yi Tang, Wei-Wei Peng, Li Hu
Transcutaneous electrical nerve stimulation (TENS), as a non-pharmacological and non-invasive analgesic therapy with low-cost, has been widely used to relieve pain in various clinical applications, by delivering current pulses to the skin area to activate the peripheral nerve fibers. Nevertheless, analgesia induced by TENS varied in the clinical practice, which could be caused by the fact that TENS with different stimulus parameters has different biological mechanisms in relieving pain. Therefore, to advance our understanding of TENS in various basic and clinical studies, we discussed (1) neurophysiological and biochemical mechanisms of TENS-induced analgesia; (2) relevant factors that may influence analgesic effects of TENS from the perspectives of stimulus parameters, including stimulated position, pulse parameters (current intensity, frequency, and pulse width), stimulus duration and used times in each day; and (3) applications of TENS in relieving clinical pain, including post-operative pain, chronic low back pain and labor pain...
June 25, 2017: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/28638555/a-comparative-evaluation-oral-leukoplakia-surgical-management-using-diode-laser-co2-laser-and-cryosurgery
#10
Madhukar Natekar, Hosahallli-Puttaiah Raghuveer, Dilip-Kumar Rayapati, Eshwara-Singh Shobha, Nagesh-Tavane Prashanth, Vinod Rangan, Archana G Panicker
BACKGROUND: The comparatively evaluate the three surgical treatment modalities namely cryosurgery, diode and CO2 laser surgery in terms of healing outcomes on the day of surgery, first and second week post operatively and recurrence at the end of 18 months was assessed. MATERIAL AND METHODS: Thirty selected patients were divided randomly into three groups. Each group comprising of ten patients were subjected to one of the three modalities of treatment namely cryosurgery, diode laser or CO2 laser surgery for ablation of OL...
June 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28635352/a-randomized-controlled-trial-comparing-two-types-of-retractors-at-caesarean-delivery
#11
Abbey J Hardy-Fairbanks, Todd Mackenzie, Martin McCarthy, Marlene B Goldman, Michele R Lauria
The aim of this study was to determine if the use of a self-retaining, symmetrical retractor (OB/Mobius(®)) during caesarean delivery is associated with differences in post-operative pain experience. Consenting women undergoing caesarean delivery were randomly assigned to OB/Mobius(®) versus conventional retraction instruments. Women were blinded to retractor type and filled out surgical pain surveys each post-operative day. Additional outcome variables were collected through a provider survey and chart review...
June 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28632644/do-former-smokers-exhibit-a-distinct-profile-before-and-after-lumbar-spine-surgery
#12
Ehsan Jazini, Steven D Glassman, Erica F Bisson, Eric A Potts, Leah Y Carreon
STUDY DESIGN: Retrospective longitudinal cohort OBJECTIVES.: To determine if former smokers undergoing lumbar spine surgery have distinct baseline and post-operative Patient Reported Outcomes (PROs) compared to never smokers and current smokers SUMMARY OF BACKGROUND DATA.: Smoking has known deleterious effects on patients undergoing lumbar spine surgery. However, former smokers have not been extensively evaluated. There are few studies regarding the relationship between pack-years or duration of smoking cessation, and subsequent clinical outcome...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28630840/suspension-arthroplasty-combined-with-ligament-reconstruction-of-the-thumb-carpometacarpal-joint-to-salvage-two-failed-arthroplasties-a-case-report
#13
Ryosuke Kakinoki, Kazuhiko Hashimoto, Hiroki Tanaka, Masao Akagi
INTRODUCTION: Thumb basal joint arthroplasty with removal of the entire trapezium is often followed by proximal subsidence and impingement of the thumb metacarpal to the scaphoid, which is a common cause of post-operative thumb pain. Treatment of this impingement is a challenge among surgeons. We performed suspension arthroplasty combined with intercarpal ligament reconstruction using a strip of the extensor carpi radialis longus (ECRL) tendon on a patient suffering from pain caused by this type of the impingement and obtained a successful outcome...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#14
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630833/anti-inflammatory-prophylaxis-prevents-heterotopic-ossification-in-contralateral-side-hip-arthroscopy-a-case-report
#15
Yaniv Warschawski, Zachary T Sharfman, Eyal Amar, Ehud Rath
INTRODUCTION: Heterotopic ossification (HO) after hip surgery is the formation of bone in non-skeletal tissue, usually between the muscle and the joint capsule. HO after hip surgery may be associated with clinical sequelae such as pain, impingement and decreased range of motion, compromising surgical outcomes. CASE REPORT: A 20-year-old basketball player presented with a 2-year duration of the left groin pain after a basketball-related injury. Due to continued disability and failure of conservative management the patient underwent hip arthroscopy...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630755/advances-in-hip-arthroplasty-surgery-what-is-justified
#16
Luigi Zagra
Total hip arthroplasty (THA) surgery has shown dramatic changes in terms of increased number of procedures and of technical development in recent years. It has been described as "the operation of the 20(th) century" for the excellent results, the high satisfaction of the patients and the improvement of the quality of life.A lot of variations have been introduced over the last few decades in THA especially in terms of indications (both in younger and older patients), techniques and devices (approaches, tissue preservation, biomaterials and industrial finishing), per-operative management (blood loss and pain control) and post-operative protocols (the so called "fast track" surgery)...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28630735/arthroscopic-acetabuloplasty-without-labral-detachment-for-focal-pincer-type-impingement-a-minimum-2-year-follow-up
#17
Fernando M Comba, Pablo A Slullitel, Pedro Bronenberg, Gerardo Zanotti, Martin A Buttaro, Francisco Piccaluga
In order to access and resect the acetabular rim, arthroscopic acetabuloplasty was described with labral detachment. When the chondrolabral junction remains intact, acetabuloplasty and labral refixation can be performed maintaining an unharmed labrum. We aimed to evaluate the outcome of a group of patients treated with arthroscopic acetabuloplasty without labral detachment. During the study period, we retrospectively analysed 44 patients with pincer-type o combined impingement and an intact chondroblabral junction, with an average follow-up of 32 months (range: 27-38)...
July 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28629437/evaluation-of-a-low-cost-low-power-syringe-pump-to-deliver-magnesium-sulfate-intravenously-to-pre-eclamptic-women-in-a-malawian-referral-hospital
#18
Erica Skerrett, Edward Kommwa, Kelley Maynard, Alexa Juarez, Ronald Mataya, Rebecca Richards-Kortum, Z Maria Oden
BACKGROUND: Magnesium sulfate is an affordable and effective treatment for pre-eclampsia and eclampsia. In settings where infusion pumps are not available to regulate the flow rate of intravenous delivery, healthcare providers must administer magnesium sulfate (MgSO4) via time-consuming and painful, large-volume intramuscular injections. As an alternative to costly commercially available syringe pumps, we developed AutoSyp, an accurate, low-cost, and low-powered syringe pump designed to meet the needs and constraints these low-resource settings...
June 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28626981/post-discharge-nausea-and-vomiting-after-total-intravenous-anaesthesia-and-standardised-ponv-prophylaxis-for-ambulatory-surgery
#19
U Bruderer, A Fisler, M P Steurer, M Steurer, A Dullenkopf
BACKGROUND: The incidence of post-discharge nausea and vomiting (PDNV) after ambulatory anaesthesia using total intravenous anaesthesia with a risk-stratified anti-emetic approach is not well documented in the literature. In this study, we outline such an approach. The goal was to achieve an acceptably low rate of PDNV both immediately and the day after surgery. METHODS: With ethics committee approval, adult patients undergoing outpatient surgery received a Propofol-based general anaesthetic plus standardised PONV-prophylaxis corresponding to their Apfel risk-score (0-4); ondansetron (risk-score 2), additional dexamethasone (risk-score 3), and additional droperidol (risk-score 4)...
June 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28626819/comparison-of-bandage-contact-lens-removal-on-the-fourth-versus-seventh-postoperative-day-after-photorefractive-keratectomy-a-randomized-clinical-trial
#20
Mehrdad Mohammadpour, Delaram Shakoor, Hassan Hashemi, Mohamad Aghaie Meybodi, Fateme Rajabi, Pegah Hosseini
PURPOSE: To compare the outcomes of bandage contact lens (BCL) removal on the fourth versus seventh post-operative day following photorefractive keratectomy (PRK). METHODS: This study recruited eyes of patients who underwent PRK surgery. The patients were randomly assigned to 2 groups. In Group 1 BCL was removed on the 4th postoperative day, while in Group 2, BCL was removed on the 7th postoperative day. After BCL removal, patients were asked to express their pain score and eye discomfort...
June 2017: Journal of Current Ophthalmology
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