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https://www.readbyqxmd.com/read/29896560/single-dose-lidocaine-spinal-anesthesia-in-hip-and-knee-arthroplasty
#1
Nicholas B Frisch, Brian Darrith, Dane C Hansen, Adrienne Wells, Sheila Sanders, Richard A Berger
Background: With the increasing interest in fast recovery and outpatient joint arthroplasty, short-acting local anesthetic agents and minimal narcotic use are preferred. Lidocaine is a fast-onset, short-duration local anesthetic that has been used for many years in spinal anesthesia. However, lidocaine spinal anesthesia has been reported to have a risk of transient neurologic symptoms (TNSs). The purpose of this study is to determine the safety and efficacy of single-dose lidocaine spinal anesthesia in the setting of outpatient joint arthroplasty...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29881165/the-incidence-of-mild-hypothermia-after-total-knee-or-hip-arthroplasty-a-study-of-2600-patients
#2
Ruben Scholten, Borg Leijtens, Keetie Kremers, Marc Snoeck, Sander Ko√ęter
Hypothermia is associated with a higher risk of perioperative complications and occurs frequently after total joint arthroplasty (TJA). The incidence of hypothermia following total joint arthroplasty was assessed with its risk factors and its correlation with PJI. Correlation of hypothermia with age, gender, BMI, type of arthroplasty surgery, type of anesthesia, operation time, blood loss, date of surgery and PJI was evaluated in 2600 patients. Female gender and spinal anesthesia increased the risk for hypothermia whereas an increased BMI and surgery duration correlated decreased the risk of hypothermia...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29866097/endoscopic-resection-of-acetabular-screw-tip-to-decompress-sciatic-nerve-following-total-hip-arthroplasty
#3
Sun-Jung Yoon, Myung-Sik Park, Dean K Matsuda, Yun Ho Choi
BACKGROUND: Sciatic nerve injuries following total hip arthroplasty are disabling complications. Although degrees of injury are variable from neuropraxia to neurotmesis, mechanical irritation of sciatic nerve might be occurred by protruding hardware. This case shows endoscopic decompression for protruded acetabular screw irritating sciatic nerve, the techniques described herein may permit broader arthroscopic/endoscopic applications for management of complications after reconstructive hip surgery...
June 4, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29849332/ultrasound-guided-femoral-nerve-block-to-facilitate-the-closed-reduction-of-a-dislocated-hip-prosthesis
#4
Edward Carlin, Brendon Stankard, Ashley Voroba, Mathew Nelson
Prosthetic hip dislocation is a common but unfortunate complication in patients who have undergone total hip arthroplasty. Successful closed reduction in the emergency department leads to a reduced length of stay and rate of hospitalization.1,2 The use of regional anesthesia by femoral nerve block represents a novel approach for controlling pain in patients with hip pathologies.3 Ultrasound-guided approaches have been used with great success for controlling pain in patients with hip fractures.4,5 Here we report the case of a 90-year-old male who presented with a dislocated hip prosthesis, which was subsequently corrected with closed reduction following delivery of regional anesthesia to the femoral nerve under ultrasound guidance...
November 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29805106/the-efficacy-of-tranexamic-acid-in-total-knee-arthroplasty-a-network-meta-analysis
#5
Yale A Fillingham, Dipak B Ramkumar, David S Jevsevar, Adolph J Yates, Peter Shores, Kyle Mullen, Stefano A Bini, Henry D Clarke, Emil Schemitsch, Rebecca L Johnson, Stavros G Memtsoudis, Siraj A Sayeed, Alexander P Sah, Craig J Della Valle
BACKGROUND: A growing body of published research on tranexamic acid (TXA) suggests that it is effective in reducing blood loss and the risk for transfusion in total knee arthroplasty (TKA). The purpose of this network meta-analysis was to evaluate TXA in primary TKA as the basis for the efficacy recommendations of the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Medicine on the use of TXA in primary total joint arthroplasty...
May 5, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29758587/regional-vs-general-anesthesia-for-total-knee-and-hip-replacement-an-analysis-of-postoperative-pain-perception-from-the-international-pain-out-registry
#6
Katharina Donauer, Hagen Bomberg, Stefan Wagenpfeil, Thomas Volk, Winfried Meissner, Alexander Wolf
BACKGROUND: Total hip and knee replacements are common surgeries, and an optimal pain treatment is essential for early rehabilitation. Since data from randomized controlled trails on the use of regional anesthesia in joint replacements of the lower extremities are conflicting, we analyzed the international PAIN OUT registry for comparison of regional anesthesia vs. general anesthesia regarding pain and morphine consumption on the first postoperative day. METHODS: International Classification of Diseases-9 (ICD-9) codes were used to identify 2,346 cases for knee and 2,315 for hip arthroplasty between 2010 and 2016 from the PAIN OUT registry...
May 14, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29756695/stimulating-versus-non-stimulating-catheter-for-lumbar-plexus-continuous-infusion-after-total-hip-replacement
#7
Gianluca Cappelleri, Daniela Ghisi, Andrea L Ambrosoli, Alice Ascari, Elisa Compagnino, Marco Gemma, Giorgio Danelli
BACKGROUND: This study was aimed to investigate whether stimulating catheters for continuous lumbar plexus block reduce local anesthetic consumption after hip arthroplasty if compared with traditional non-stimulating catheters. METHODS: Seventy-two ASA I-III, 18-82 year-old, undergoing primary hip replacement (THA) for osteoarthritis with spinal anesthesia were randomized into two groups: Stim group (stimulating catheter, n=36) and Nonstim group (non-stimulating catheter, n=36)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29755607/risk-factors-for-the-development-of-nerve-palsy-following-primary-total-hip-arthroplasty
#8
Shunsuke Kawano, Motoki Sonohata, Masaru Kitajima, Masaaki Mawatari
Background: Nerve palsy following total hip arthroplasty (THA) is a complication that worsens the functional prognosis. The present study analyzed the risk factors of nerve palsy following THA. Methods: The subjects of this study included 6,123 cases in which primary THA was performed under spinal anesthesia with cementless implants used in the posterolateral approach. Results: Fourteen cases (0.22%) developed nerve palsy following THA, all of which involved palsy of the entire peroneal nerve region...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29752506/examination-of-intra-operative-core-temperature-in-joint-arthroplasty-a-single-institution-prospective-observational-study
#9
Jennifer R Matos, Julie R McSwain, Bethany J Wolf, J Wesley Doty, Sylvia H Wilson
PURPOSE: Peri-operative hypothermia is associated with increased blood loss, delayed wound healing, and surgical site infections. However, it is not known when or how rapidly hypothermia develops during arthroplasty. This study observed patients undergoing lower extremity arthroplasty to identify the times of greatest heat loss or gain. METHODS: This single-institution prospective observational study enrolled 120 patients undergoing elective knee or hip arthroplasty for peri-operative temporal temperature measurements at ten prespecified intervals...
May 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29730078/the-efficacy-and-safety-of-intravenous-glucocorticoids-in-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#10
REVIEW
Ning An, Kang Liu, Bao-Ying Fan, Dong-Hua Ma
OBJECTIVE: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the effect and safety of intravenous glucocorticoids for reducing pain scores, postoperative nausea and vomiting (PONV) and total morphine consumption for patients prepared for total hip arthroplasty (THA). METHODS: Electronic databases: PubMed (1950-September 2016), EMBASE(1974-September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL, September 2016 Issue 3) and Web of Science (1950-September 2016) were systematically searched...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29688961/does-total-intravenous-anesthesia-with-short-acting-spinal-anesthetics-in-primary-hip-and-knee-arthroplasty-facilitate-early-hospital-discharge
#11
Derek M Klavas, Azim Karim, Bradley S Lambert, Marley Sam Ferris, Domenica Delgado, Stephen J Incavo
INTRODUCTION: Our study assessed the effect of total intravenous anesthesia (TIVA) with short-acting spinal anesthesia and aggressive day-of-surgery postoperative day 0 physical therapy (POD#0 PT) on hospital length of stay (LOS) in patients who underwent primary total joint arthroplasty. METHODS: A retrospective chart review compared the hospital LOS of 116 patients who underwent primary total hip arthroplasty and total knee arthroplasty with TIVA and short-acting spinal blockade ("Updated protocol group") with that of the control group of 228 patients who were under standard anesthesia ("Traditional protocol group")...
May 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29685712/no-difference-in-major-complication-and-readmission-rates-following-simultaneous-bilateral-vs-unilateral-total-hip-arthroplasty
#12
Mina W Morcos, Adam Hart, John Antoniou, Olga L Huk, David J Zukor, Stephane G Bergeron
BACKGROUND: Simultaneous bilateral total hip arthroplasty (THA) is an attractive option for patients with osteoarthritis as it requires a single anesthetic and hospitalization. Nonetheless, serious concerns remain over the perioperative safety and rate of hospital readmission. The purpose of the present study was to compare the rate of 30-day major complications and hospital readmissions between patients undergoing simultaneous bilateral vs unilateral THA using the National Surgical Quality Improvement Program database...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29616915/refractory-hypoxemia-in-a-patient-with-submassive-pulmonary-embolism-and-an-intracardiac-shunt-a-case-report-and-review-of-the-literature
#13
REVIEW
Jean Liew, Janelle Stevens, Christopher Slatore
INTRODUCTION: Acute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. CASE PRESENTATION: A 46-year-old man experienced acute hypoxemic respiratory failure requiring mechanical ventilation after anesthesia induction for elective hip arthroplasty. He was found to have submassive bilateral pulmonary emboli with acute right ventricular dysfunction and a coexisting patent foramen ovale with right-to-left shunt...
March 2, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29615378/intraoperative-psoas-compartment-block-vs-preoperative-fascia-iliaca-block-for-pain-control-after-direct-anterior-total-hip-arthroplasty-a-randomized-controlled-trial
#14
Clayton R Perry, Adam M Fahs, Michael D Kurdziel, Denise M Koueiter, Randy J Fayne, James J Verner
BACKGROUND: Modern joint arthroplasty protocols place an emphasis on minimizing patient-reported postoperative pain while minimizing opioid consumption. The use of multimodal pain management protocols has been reported to improve patient outcomes and satisfaction after total hip arthroplasty. METHODS: In a prospective, single-surgeon trial, 50 patients undergoing primary direct anterior approach total hip arthroplasty were randomized to receive a preoperative fascia iliaca compartment block (FICB) or an intraoperative surgeon-delivered psoas compartment block (PCB)...
June 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29607863/total-hip-replacement-in-sickle-cell-disorder-a-preliminary-report-of-challenges-and-early-outcome-of-21-consecutive-patients
#15
A U Katchy, U E Anyaehie, C U Nwadinigwe, G O Eyichukwu
Objective: The aim of this study is to describe the pattern of presentation osteoarthritic patients with sickle cell disorder (SCD) in our environment, determine the implant sizes taking the peculiar nature of the pathology and our operating environment into consideration, highlight the challenges and technical difficulties encountered during the procedure, measure the functional outcome and observe complications of treatment, recommend ways of improving outcome. Patients and Methods: Between November 2008 and November 2012, 29 consecutive primary total hip replacements (THRs) were performed on 21 patients with avascular necrosis of the head of femur secondary to SCD...
April 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29555492/psoas-compartment-block-vs-periarticular-local-anesthetic-infiltration-for-pain-management-after-anterior-total-hip-arthroplasty-a-prospective-randomized-study
#16
Adam M Fahs, Denise M Koueiter, Michael D Kurdziel, Kristine A Huynh, Clayton R Perry, James J Verner
BACKGROUND: The psoas compartment block (PCB) or periarticular soft-tissue local anesthetic injection are forms of regional anesthesia often used as one of the components in multimodal anesthesia applied during total hip arthroplasty (THA). The most efficacious form of regional anesthesia for THA has yet to be determined. METHODS: In a single-surgeon, prospective, clinical trial, patients undergoing THA via direct anterior approach were randomized to receive an intraoperative periarticular local anesthetic infiltration (periarticular injection) or a PCB...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29541272/is-head-and-neck-resection-of-the-femur-girdlestone-s-procedure-still-relevant-indications-and-results-about-24-cases
#17
Mamoudou Sawadogo, Hamado Kafando, Salam Ouedraogo, Alexandre Stanislas Korsaga, Souleymane Ouedraogo, Sayouba Tinto, Anatole Jean Innocent Ouedraogo, Mohamed Tall, Songahir Christophe DA
Introduction: Head and neck resection of the femur was described by Girdlestone in 1928 in the treatment of coxalgia. Very invasive at the beginning, this intervention is much less so today, but the term of "Girdlestone's operation" or "Girdlestone's procedure" has remained in use. The reported results are controversial. In resource-limited countries, Girdlestone's procedure is often indicated for lack of a better one. In this context, we report the results of a series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso) with the aim of showing that this technique remains valid and can be benefit...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29523446/reasons-for-ninety-day-emergency-visits-and-readmissions-after-elective-total-joint-arthroplasty-results-from-a-us-integrated-healthcare-system
#18
Matthew P Kelly, Heather A Prentice, Wei Wang, Brian H Fasig, Dhiren S Sheth, Elizabeth W Paxton
BACKGROUND: Previous studies evaluating reasons for 30-day readmissions following total joint arthroplasty (TJA) may underestimate hospital-based utilization of healthcare resources during a patient's episode-of-care. We sought to identify common reasons for 90-day emergency department (ED) visits and hospital readmissions following primary elective unilateral TJA. METHODS: Patients from July 1, 2012 through June 30, 2015 having primary elective TJA and at least one 90-day postoperative ED-only visit and/or readmission for any reason were identified using the Kaiser Permanente Total Joint Replacement Registry...
February 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29493328/no-effect-of-double-nerve-block-of-the-lateral-cutaneous-nerve-and-subcostal-nerves-in-total-hip-arthroplasty
#19
Johannes L Bron, Jeanette Verhart, Inger N Sierevelt, Dirk De Vries, Hylke J Kingma, Maarten V Rademakers
Background and purpose - The use of local infiltration anesthesia (LIA) has become one of the cornerstones of rapid recovery protocols in total knee arthroplasty patients during the past decade. In total hip arthroplasty (THR), however, the study results are more variable and LIA has therefore not yet been generally accepted. There is no consensus on which structure should be infiltrated and the cutaneous nerves are generally neglected. Hence, we hypothesized a pain-reducing effect of specifically blocking these nerves...
June 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29468091/surgical-technical-evidence-review-for-elective-total-joint-replacement-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#20
REVIEW
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
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