Who Should Not Undergo Short Stay Hip and Knee Arthroplasty? Risk Factors Associated With Major Medical Complications Following Primary Total Joint Arthroplasty

2015 ◽  
Vol 30 (9) ◽  
pp. 1-4 ◽  
Author(s):  
P. Maxwell Courtney ◽  
Joshua C. Rozell ◽  
Christopher M. Melnic ◽  
Gwo-Chin Lee
Keyword(s):  
Risk Factors ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Medical Complications ◽  
Short Stay ◽  
Factors Associated ◽  
Hip And Knee Arthroplasty

scholarly journals The impact of enhanced recovery after surgery on total joint arthroplasty: A protocol for systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Siddharth Rele ◽  
Cade Shadbolt ◽  
Chris Schilling ◽  
Nicholas F Taylor ◽  
Michelle M Dowsey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Joint Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

BACKGROUND The number of total joint arthroplasty being performed is increasing worldwide. To match this increasing demand, there has been focus on hastening patients’ recovery of function. This effort has culminated in formulation of enhanced recovery for surgery (ERAS) strategies. However, with evolving ERAS programs and new recommendations, a review of current evidence is required to provide clinicians with up-to-date information about its effect on outcomes for total joint arthroplasty. OBJECTIVE This study outlines the protocol for a systematic review and meta-analysis that aims to assess the utility of enhanced recovery after surgery programs on patient, health services and economic outcomes for primary, elective total hip and knee arthroplasty. METHODS A systematic search will be conducted in Medline (OVID), EMCARE (OVID), Web of Science, CINAHL, National Health Service Economic Evaluations Database and the Cochrane Library. Analytical, observational and experimental designs will be included in this systematic review. Only studies including patients undergoing primary, total knee and hip arthroplasty comparing ERAS programs with conventional surgery and postoperative care will be included. Data related to patient outcomes, health service outcomes, safety and economic evaluation will be extracted. RESULTS The search terms have been finalized, and the final primary database search will be completed in November 2020. The results of this systematic review will be disseminated in a peer-reviewed journal. CONCLUSIONS This protocol will guide a systematic review assessing outcomes associated with ERAS surgery in primary, total hip and knee arthroplasty CLINICALTRIAL Open Science Framework. Doi: 10.17605/OSF.IO/Y4BHS

scholarly journals Comprehensive Operative Note Templates for Primary and Revision Total Hip and Knee Arthroplasty

2016 ◽  
Vol 10 (1) ◽  
pp. 725-731 ◽  
Author(s):  
Ali J. Electricwala ◽  
Derek F. Amanatullah ◽  
Rapeepat I. Narkbunnam ◽  
James I. Huddleston ◽  
William J. Maloney ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Revision Thas ◽  
Total Hip ◽  
Operative Note ◽  
Hip And Knee Arthroplasty ◽  
Operative Notes ◽  
Revision Total Joint Arthroplasty ◽  
Revision Tkas

Background: Adequate preoperative planning is the first and most crucial step in the successful completion of a revision total joint arthroplasty. The purpose of this study was to evaluate the availability, adequacy and accuracy of operative notes of primary surgeries in patients requiring subsequent revision and to construct comprehensive templates of minimum necessary information required in the operative notes to further simplify re-operations, if they should become necessary. Methods: The operative notes of 144 patients (80 revision THA’s and 64 revision TKA’s) who underwent revision total joint arthroplasty at Stanford Hospital and Clinics in the year 2013 were reviewed. We assessed the availability of operative notes and implant stickers prior to revision total joint arthroplasty. The availability of implant details within the operative notes was assessed against the available surgical stickers for adequacy and accuracy. Statistical comparisons were made using the Fischer-exact test and a P-value of less than 0.05 was considered statistically significant. Results: The primary operative note was available in 68 of 144 revisions (47%), 39 of 80 revision THAs (49%) and 29 of 66 revision TKAs (44%, p = 0.619). Primary implant stickers were available in 46 of 144 revisions (32%), 26 of 80 revision THAs (32%) and 20 of 66 revision TKAs (30%, p = 0.859). Utilizing the operative notes and implant stickers combined identified accurate primary implant details in only 40 of the 80 revision THAs (50%) and 34 of all 66 revision TKAs (52%, p = 0.870). Conclusion: Operative notes are often unavailable or fail to provide the necessary information required which makes planning and execution of revision hip and knee athroplasty difficult. This emphasizes the need for enhancing the quality of operative notes and records of patient information. Based on this information, we provide comprehensive operative note templates for primary and revision total hip and knee arthroplasty.

scholarly journals Management of von Willebrand disease in patients undergoing total hip and knee arthroplasty

2019 ◽  
Vol 29 (9) ◽  
pp. 266-269
Author(s):  
Khaled M. Yaghmour ◽  
Yuhan Peng ◽  
Emanuele Chisari ◽  
Wasim Khan ◽  
Stephen M. McDonnell
Keyword(s):  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Perioperative Management ◽  
Functional Limitation ◽  
Joint Arthroplasty ◽  
Von Willebrand Disease ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Surgical Field ◽  
Von Willebrand

Von Willebrand disease is the commonest bleeding disorder encountered in the medical and surgical field. As a result of the repetitive bleeding into the joints many patients suffer from arthropathy that can cause a significant amount of pain and functional limitation. Total joint arthroplasty is being utilised as the last resort in managing these patients; however, the presence of von Willebrand disease raises a number of dilemmas. In this review, we look at the effects of von Willebrand disease on joints and the perioperative management of von Willebrand disease patients undergoing total joint arthroplasty.

Impact of Weight-Band Dosing of Tinzaparin for Venous Thromboembolism Prophylaxis on Persistent Wound Drainage in Adult Patients Undergoing Hip and Knee Arthroplasty

2021 ◽  
pp. 106002802110242
Author(s):  
Cassandra Cooper ◽  
Ouida Antle ◽  
Jennifer Lowerison ◽  
Deonne Dersch-Mills ◽  
Ashley Kenny
Keyword(s):  
Body Weight ◽  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Thromboembolism Prophylaxis ◽  
Wound Drainage ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

Background: Persistent wound drainage and venous thromboembolism (VTE) are potential complications of total joint arthroplasty, and these risks can be challenging to balance in clinical practice. Anecdotal observation has suggested that following joint arthroplasty, persistent wound drainage occurs more frequently with higher body weight and higher doses of tinzaparin when compared with lower body weight and lower doses of tinzaparin. Objective: The overall purpose of this study was to describe the impact of a tinzaparin weight-band dosing table for VTE prophylaxis on wound healing, thrombosis, and bleeding outcomes in patients undergoing total joint arthroplasty. Methods: This retrospective chart review included patients who underwent total hip or knee arthroplasty and received tinzaparin for thromboprophylaxis per their weight-banding category. The primary outcome was the incidence of persistent wound drainage. Secondary outcomes include the occurrence of VTE and clinically important bleeding during hospital admission. Results: A total of 231 patients were included in the analysis. There was no significant difference in persistent wound drainage between the 3 weight categories, and there were no differences in rates of VTE or clinically important bleeding. Concurrent use of low-dose acetylsalicylic acid was associated with a 3-fold increased risk of persistent wound drainage (risk ratio = 3.35; 95% CI = 2.14-5.24; P = 0.00003). Conclusion and Relevance: In joint arthroplasty patients, we observed no significant difference in rates of persistent wound drainage between various weight categories receiving different weight-banded doses of tinzaparin. Our results do not suggest that the current weight-band dosing table for tinzaparin needs to be adjusted to optimize patient outcomes.

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