scholarly journals The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention.

2020 ◽  
Author(s):  
Camilo Partezani Helito ◽  
Marcel Faraco Sobrado ◽  
Pedro Nogueira Giglio ◽  
Marcelo Batista Bonadio ◽  
Jose Ricardo Pecora ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Negative Pressure Wound Therapy ◽  
Wound Complications ◽  
Control Group ◽  
Surgical Wound ◽  
Wound Therapy ◽  
Total Knee ◽  
Group 1

Abstract Background: Wound healing complications are causal factors of prosthesis infection and poor postoperative evolution of patients after total knee arthroplasty (TKA). Negative-pressure wound therapy (NPWT) can be an option to minimize these complications. The aim of this study is to compare the complications of patients undergoing TKA who used a portable NPWT device in the immediate postoperative period with those of a control group.Methods: A total of 296 patients were evaluated. Patients were divided into two groups: those who used NPWT for seven days in the postoperative period (Group 1 – prospective evaluated) and those who used conventional dressings (Group 2 – historical control group). Epidemiological data, comorbidities, local parameters related to the surgical wound and complications were evaluated.Results: The groups did not differ in regard to sex, age and clinical comorbidities. Overall, 153 (51.7%) patients had at least one risk factor for wound complications. Patients who used NPWT had a lower rate of complications (28.5% vs. 45.7%, p = 0.001) and a lower rate of reintervention in the operating room (2% vs. 8.5%, p = 0.001). Patients in group 1 had a lower incidence of hyperaemia (14.7% vs. 40.2%, p = 0.01), skin necrosis (2.1% vs. 8.5%, p = 0.04) and wound dehiscence (3.1% vs 10.1%, p = 0.03). The use of NPWT was a protective factor for the presence of complications, with an odds ratio of 0.36 (95% CI 0.206-0.629).Conclusion: The number of complications related to the wound after TKA is high; however, most of them are minor and have no impact on the treatment and clinical evolution of patients. The use of NPWT decreased the number of surgical wound complications, especially hyperaemia, dehiscence and necrosis, and reduced the need for reintervention.

scholarly journals The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention.

2020 ◽  
Author(s):  
Camilo Partezani Helito ◽  
Marcel Faraco Sobrado ◽  
Pedro Nogueira Giglio ◽  
Marcelo Batista Bonadio ◽  
Jose Ricardo Pecora ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Complications ◽  
Surgical Wound ◽  
Wound Therapy ◽  
Total Knee ◽  
Group 1

Abstract Background: Compare the complications of patients undergoing total knee arthroplasty (TKA) who used a portable negative-pressure wound therapy (NPWT) device in the immediate postoperative period with those of a control group. Methods: A total of 296 patients were evaluated. Patients were divided into two groups: those who used NPWT for seven days in the postoperative period (Group 1) and those who used conventional dressings (Group 2). Demographic data, comorbidities, local parameters related to the surgical wound and complications were evaluated.Results: The groups did not differ in regard to sex, age and clinical comorbidities. Overall, 153 (51.7%) patients had at least one risk factor for wound complications. Patients who used NPWT had a lower rate of complications (28.5% vs. 45.7%, p = 0.001) and a lower rate of reintervention in the operating room (2% vs. 8.5%, p = 0.001). Patients in group 1 had a lower incidence of hyperaemia (14.7% vs. 40.2%, p = 0.01), skin necrosis (2.1% vs. 8.5%, p = 0.04) and wound dehiscence (3.1% vs 10.1%, p = 0.03). The use of NPWT was a protective factor for the presence of complications, with an odds ratio of 0.36 (95% CI 0.206-0.629).Conclusion: The number of complications related to the wound after TKA is high; however, most of them are minor and have no impact on the treatment and clinical evolution of patients. The use of NPWT decreased the number of surgical wound complications, especially hyperaemia, dehiscence and necrosis, and reduced the need for reintervention.

scholarly journals NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY

2017 ◽  
Vol 25 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Camilo Partezani Helito ◽  
Daniel Kamura Bueno ◽  
Pedro Nogueira Giglio ◽  
Marcelo Batista Bonadio ◽  
José Ricardo Pécora ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Case Series ◽  
Favorable Outcome ◽  
Wound Complications ◽  
Surgical Wound ◽  
Wound Therapy ◽  
Total Knee

ABSTRACT Objective: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. Methods: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico(r) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases. Results: We evaluated 10 patients who used Pico(r) in our service. All patients had a favorable outcome according to established criteria. No complications were identified regarding the use of the NPWT device. The mean follow-up of the patients after the use of the device was 10.5 months. Conclusion: The NPWT can be safely used in wound infections and complications following TKA with promising results. Long-term randomized prospective studies should be conducted to prove its effectiveness. Level of Evidence IV, Case Series.

scholarly journals The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Camilo Partezani Helito ◽  
Marcel Faraco Sobrado ◽  
Pedro Nogueira Giglio ◽  
Marcelo Batista Bonadio ◽  
José Ricardo Pécora ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Total Knee

scholarly journals Evaluation of the Clinical Efficacy of Using Thermal Camera for Cryotherapy in Patients with Total Knee Arthroplasty: A Prospective Study

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 661 ◽  
Author(s):  
Zekeriya Okan Karaduman ◽  
Ozan Turhal ◽  
Yalçın Turhan ◽  
Zafer Orhan ◽  
Mehmet Arican ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Thermal Camera ◽  
Prosthesis Infection ◽  
Total Knee ◽  
Group 3 ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

scholarly journals Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study

2021 ◽  
Author(s):  
Silvia J. Mrotzek ◽  
Shahir Ahmadi ◽  
Alexander von Glinski ◽  
Alexis Brinkemper ◽  
Mirko Aach ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Continuous Passive Motion ◽  
Control Group ◽  
New Therapy ◽  
Total Knee ◽  
Hybrid Assistive Limb

Abstract Introduction The first weeks after total knee arthroplasty (TKA) are crucial for the functional outcome. To improve knee mobility, a continuous passive motion (CPM) motor rail is commonly used during in-hospital rehabilitation. The single-joint hybrid assistive limb (HAL-SJ) is a new therapy device. The aim of the study was to improve patients’ range of motion (ROM), mobility, and satisfaction using the active-assistive support of the HAL-SJ. Materials and methods Between 09/2017 and 10/2020, 34 patients, who underwent TKA and matched the inclusion criteria, were randomized into study (HAL-SJ) and control (CPM) group. Treatment began after drain removal and was carried out until discharge. Primary outcome parameters were raised pre- and postoperatively and included the Oxford knee score (OKS), visual analog scale (VAS), and acquired range of motion. Furthermore complications caused by the device were recorded. Results OKS increased in both groups postoperatively, but only significantly in the HAL-SJ group. Postoperative pain improved in both groups without significant differences. Flexion improvement was significant in both groups between days 3/7 and 8 weeks postoperatively. We did not encounter any complications related to HAL-SJ. Conclusions In conclusion, use of the HAL-SJ during rehabilitation in the early postoperative period after TKA was safe without disadvantages compared to the control group and seems to have advantages in terms of daily life impairment.

Magnesium Sulfate Combined with a Levobupivacaine Periarticular Cocktail for Analgesia in the Early Postoperative Period after Total Knee Arthroplasty

2020 ◽  
Author(s):  
Zhenrui Zhao ◽  
Xiaozhou Zhang ◽  
Hao Peng ◽  
Wei Li ◽  
Hengzhong Liu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Magnesium Sulfate ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Normal Saline ◽  
Early Postoperative Period ◽  
Control Group ◽  
Vas Scores ◽  
Total Knee ◽  
Time Required

AbstractThis study aimed to evaluate the analgesic effect of magnesium sulfate combined with a levobupivacaine periarticular cocktail in the early postoperative period after total knee arthroplasty (TKA). A total of 60 patients who underwent primary unilateral TKA in our department from March 2018 to May 2019 were prospectively selected and randomly divided into the trial group (30 patients with 20 mL of magnesium sulfate 250 mg + levobupivacaine 50 mg + triamcinolone 25 mg + 0.9% normal saline) and the control group (30 patients with 20 mL of levobupivacaine 50 mg + triamcinolone 25 mg + 0.9% normal saline). Visual analog scale (VAS) scores at 6, 12, 24, 48, and 72 hours postoperatively during rest; VAS scores at 12, 24, 48, and 72 hours postoperatively during motion; the time required to reach 30 degrees straight leg elevation and 60 degrees active knee flexion; and the analgesia pump dosage at 6, 12, 24, and 48 hours postoperatively were recorded. Magnesium sulfate combined with levobupivacaine injection around the knee joint can significantly prolong the time of postoperative analgesia, significantly reduce the use of postoperative analgesics, and effectively alleviate early postoperative pain after TKA.

Negative pressure wound therapy in total hip and knee arthroplasty: a meta-analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 791-797 ◽  
Author(s):  
Lei Wang ◽  
Xin Xu ◽  
Jian-gang Cao ◽  
Jun Liu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Negative Pressure Wound Therapy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Site Infection ◽  
Wound Therapy ◽  
Randomized Controlled ◽  
Hip And Knee Arthroplasty ◽  
Total Knee

Aim: To assess the efficiency and safety of negative pressure wound therapy (NPWT) in the total hip and knee arthroplasty, we conducted a meta-analysis from randomized controlled trials. Methods: Potential academic articles were identified from the Cochrane Library, PubMed, Embase, Springer and ScienceDirect. Secondary sources were identified from the references of the included literature. RevMan 5.1 was used to analyze the pooled data. Results: Six randomized controlled trials met the inclusion criteria. Meta-analysis showed more superficial surgical site infection and blisters in patients with total knee arthroplasty. There were no significant differences between two groups in total infection and total complications. Conclusion: NPWT decreased the incidence of superficial surgical site infection. More blisters were noticed in patients with NPWT after total knee arthroplasty.

scholarly journals Efficacy and Safety of Bioabsorbable Bone Hemostatic Agent in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

2021 ◽  
Vol 27 ◽  
pp. 107602962110235
Author(s):  
Jong-Keun Kim ◽  
Du Hyun Ro ◽  
Sang-Min Han ◽  
Myung Chul Lee ◽  
Hyuk-Soo Han
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Controlled Trial ◽  
Hemostatic Agent ◽  
Control Group ◽  
Efficacy And Safety ◽  
Drainage Volume ◽  
Estimated Blood Loss ◽  
Total Knee

Although a bioabsorbable bone hemostatic agent (BBHA) was developed approximately 20 years ago to overcome the shortcomings of conventional bone wax, its bleeding control capacity has not yet been studied. This study was aimed at investigating the efficacy and safety of BBHA in total knee arthroplasty (TKA). Sixty-two patients who underwent unilateral primary TKA for knee osteoarthritis were included and randomized to the control or BBHA group. Before releasing the tourniquet, BBHA was applied on the bone-cut surface that was not covered by implants. The primary variable was the drainage volume during the postoperative period. The secondary outcomes were total estimated blood loss (EBL), hemoglobin level, hematocrit level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, range of motion (ROM), pain visual analog scale (VAS) score, and rate of complications. There were no significant differences in drainage volume or EBL between the 2 groups. Hemoglobin and hematocrit levels were higher in the BBHA group during the 4-week postoperative period; however, the intergroup differences were not significant. The ESR, CRP, ROM, and pain VAS scores in the BBHA group were not significantly different from the corresponding values in the control group. No specific complications were observed. Although BBHA was found to be safe without complications, it did not decrease bleeding after TKA in general cases. Further studies are necessary to evaluate the efficacy of BBHA in patients with coagulation problems.

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