Harato et al[ 9 ]. To evaluate the early migration, measured by RSA, of cemented knee prosthesis. Breeman et al[ 39 ]. When thesis the key topic drivers, students should look no further than the projected cost savings, which are responsible for the premium over the stand-alone estimate. No difference between the 2 groups in terms of anterior knee pain rate, knee pain score, knee society score and knee function score.
Beaupre et al[ 43 ] in , performed a randomized controlled trial, with a follow-up of years, in which they agreed that patellar resurfacing showed no difference with non-resurfacing regarding knee specific outcomes, like pain, stiffness, and function. A good use of time during the class is to explore other thesis drivers by conducting a sensitivity analysis. A meta-analysis of cases. Another interesting randomized controlled trial in , by Olivecrona et al[ 24 ], demonstrated that measuring the limb-occlusion pressure before surgery reduced cuff pressure during surgery without influencing the quality of the bloodless field. His [URL], easy pick-up on any subject matter and depth of understanding seemed limitless. More specifically, in , Postel et al[ 30 ] in their review of level I and II studies, noted that CPM offered short-term benefits concerning postoperative pain, swelling and knee motion, but claimed that long-term benefits were not established, and underlined the necessity for investigation of different CPM modalities and comparison with alternative intermittent mobilization techniques for safer conclusions. Weak evidence that CPM reduces the need for manipulation under anesthesia.
Open in a separate window. The knee component of the Knee Society Score was higher in the resurfacing group. Yagishita et al[ 13 topic performed a prospective randomized study inwith a minimum follow-up of 5 years, which indicated that posterior-stabilized prosthesis showed better results in postoperative knee motion, posterior knee pain at passive flexion and patient satisfaction, but no significant difference was found between the 2 types of TKA regarding Knee Society Score.
Patella resurfacing vs nonresurfacing in patients undergoing bilateral TKA No differences with regard to range of motion, Knee Score, satisfaction, revision rates, or anterior knee pain. Molt et al[ 27 ]. Thesiz effects of cyclooxygenase COX inhibitors on bone healing have previously been demonstrated in diaphyseal fracture models in animals. A concise follow-up of a randomized trial. Postoperative improvement in health-related quality of life: The effect of tourniquet use on fixation quality in cemented total knee arthroplasty a prospective randomized clinical controlled RSA trial.
A tourniquet was not tpoics because it caused significantly increased blood loss, lower free hemoglobin levels, more extensive postoperative swelling, and ecchymosis. Additionally, the tkrr of CPM was discouraged by the review of randomized controlled trials by Harvey et al[ 33 ] also inwho supported that, in the patients who participated, range of knee motion, pain, swelling, quadriceps strength, length of hospital stay, and incidence of manipulation under anesthesia, did not show significant improvement after the use of CPM[ 33 ].
No difference in the Oxford knee score or rate of recovery. Continuous passive motion following total knee replacement: However, tourniquet release after wound closure can increase the risk of early postoperative complications requiring another operation. Following this study, Leach et al[ 29 ] in published a prospective randomized trial, with a 1-year follow-up, in which they concluded that CPM does not offer significant benefits in range of knee motion and pain, after the application of a specific CPM protocol.
Moreover, on the same subject, a meta-analysis of randomized controlled trials by Rama et al[ 17 ] inindicated that early tourniquet release for hemostasis increases blood loss, but also decreases the risk of regional postoperative complications wound complications, symptomatic deep venous thrombosis and knee stiffness requiring manipulation and the risk of reoperation.
Recently published articles from Journal of Arthroplasty.
Recent Journal of Arthroplasty Articles – Elsevier
Yagishita et al[ 13 ]. More recently, the theory that topisc patella eversion results in better range of motion and earlier quadriceps recovery has gained popularity. Meta-analysis of randomized controlled trials. Continuous passive motion; VTE: Also, inTarwala et al[ 26 ] in a randomized trial, examined the outcomes of the use of a tourniquet only during topifs and found that it offered bloodless bone for fixation, and did not influence the surgical time, pain, range of knee motion and total blood loss.
Common controversies in total knee replacement surgery: Current evidence
Table 2 Studies investigating the usefulness of tourniquet use in total knee replacement. Support Center Support Center. To use a tourniquet during operation or not?
Recent Journal of Arthroplasty Articles. This effect is too ttkr to clinically justify the use of CPM. Furthermore, Arnout et al[ 51 ] inin a prospective randomized study, concluded that patellar dislocation without eversion improved the active and passive range of knee motion up to 1 year postoperatively and recommended this procedure as safe. Reid et al[ 53 ].
Thesis topics on tkr :: buy an essay online now
A strong debate is found in the literature about the usefulness of the tourniquet in TKA. Additionally, inMittal et al[ 23 ] performed a randomized controlled trial to investigate the possible advantages of tourniquet application only during cement fixation: Posterior cruciate-retaining versus posterior stabilized total knee arthroplasty: No significant difference was observed for the function component of the Knee Society Score or for any other reported knee score.
Retention versus removal of the posterior cruciate ligament in total knee replacement: Tourniquet release either before or after wound closure Tourniquet release before wound closure caused a significant increase in total blood loss.
Type of study Outcome Chen et al[ 48 ] Meta-analysis of randomized topcis trials Patellar resurfacing vs nonresurfacing in primary TKR Patellar resurfacing reduces the risk of reoperation after TKR.