Medicine and Health Sciences Commons^™

Intraoperative Periprosthetic Hip Fractures, Ahmed E. E. Ahmed, Bahaa Z. M. Hassan, Bahaa Eldin M. Elserwi

Menoufia Medical Journal

Purpose The aim of this work was to study the risk factors, clinical results, particularly the functional outcome, and radiological results for intraoperative periprosthetic fractures (PPFs) around hip arthroplasties through a retrospective analysis. Materials and methods We conducted a retrospective study based on hospital records. Patients with intraoperative PPFs around hip arthroplasties who underwent follow-up for at least 9 months were enrolled in the study. For each patient, preoperative and intraoperative risk factors were analyzed; the functional outcome in terms of the Harris hip score was compared before fracture and at the last follow-up. Results Fifteen cases were enrolled in …

Blood Loss In Primary Total Knee Arthroplasty—Body Temperature Is Not A Significant Risk Factor—A Prospective, Consecutive, Observational Cohort Study, Michael Dan, Sarah Martinez Martos, Elaine Beller, Peter Jones, Ray Randle, David Liu

Elaine Beller

Background Hypothermia related to anaesthesia and operating theatre environment is associated with increased blood loss in a number of surgical disciplines, including total hip arthroplasty. The influence of patient temperature on blood loss in total knee arthroplasty (TKA) has not been previously studied. Methods We recorded patient axillary temperature in the peri-operative period, up to 24 h post-operatively, and analysed the effect on transfusion rate and blood loss from a consecutive cohort of 101 patients undergoing primary TKA. Results No relationship between peri-operative patient temperature and blood loss was found within the recorded patient temperature range of 34.7–37.8 °C. Multivariable …

The Fate Of Spacers In The Treatment Of Periprosthetic Joint Infection., Miguel M Gomez, Timothy L Tan, Jorge Manrique, Gregory K Deirmengian, Javad Parvizi Md

Rothman Institute Faculty Papers

BACKGROUND: Two-stage exchange arthroplasty remains the preferred method to treat periprosthetic joint infection. The aim of this study was to investigate the clinical course of periprosthetic joint infection following resection arthroplasty and insertion of a spacer.

METHODS: Our institutional database was used to identify 504 cases of periprosthetic joint infection (326 knees and 178 hips) treated with resection arthroplasty and spacer insertion as part of a two-stage exchange arthroplasty. A review of the patient charts was performed to extract information relevant to the objectives of this study that included the details of the clinical course following resection arthroplasty.

RESULTS: The …

Anesthesia Preoperative Clinic Referral For Elevated Hba1c Reduces Complication Rate In Diabetic Patients Undergoing Total Joint Arthroplasty, Peter J. Kallio, Jenea Nolan, Amy C. Olsen, Susan Breakwell, Richard Topp, Paul S. Pagel

College of Nursing Faculty Research and Publications

Background: Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery.

Objectives: We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA).

Patients and Methods: Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled). Those evaluated between in subsequent two-year intervals were referred to primary care for HbA1c ≥ 10% and ≥ 8%, respectively, to improve DM control before surgery. Complications …

Management Of Complications Of Wrist Arthroplasty And Wrist Fusion., Michael P. Gaspar, Patrick M Kane, Eon K. Shin

Department of Orthopaedic Surgery Faculty Papers

The human wrist joint is unique from functional and anatomic standpoints. Numerous articulations exist within the wrist that allow for many options for partial wrist fusion and arthroplasty. In cases of pancarpal disease, fusion or arthroplasty of the entire wrist joint can be performed. Because of the high functional demand of the wrist, many of these surgical options can fail, leading to devastating complications. This article addresses the types of fusions and arthroplasties available for the wrist and discusses the potential complications associated with each. Methods to prevent these complications are presented and those to treat them once they have …

Implementing A Tiered Pain Protocol In The Total Knee Arthroplasty Patient, Heidi Meyer, Kelen Sohre, Tamara Welle

Nursing Posters

Objective: Address the culture of pain management with physicians and nurses utilizing a tiered pain protocol in conjunction with non-pharmacological approaches to achieve improvement in pain satisfaction to a tolerable level.

Utilizing A Protocol To Reduce Post-Operative Urinary Retention In Total Joint Arthroplasty, Gina Anderson-Malum, Naomi Schneider

Nursing Posters

Foley catheters have not routinely been used for our total joint patients for many years, leading staff to bladder scan and straight catheterize patients postoperatively. Bladder scanning and catheterization were identified as an inconsistent practice. Patients were commonly straight catheterized when nurses determind bladder scan volume and time of last void; yet the amounts for both and decision to catheterize were inconsistent. Also, the clinical evaluation and treatment was inconsistent among physicians. Variations in practice included rationale for a urology consult, use of medications for urinary retention, and documentation. Baseline urinary retention condition codes ranged from 8-18%, which led our …