Does Tourniquet Time in Primary Total Knee Arthroplasty Influence Clinical Recovery?

J Knee SurgDOI: 10.1055/s-0034-1388654There are limited data on the influence of a reduced tourniquet time strategy on the clinical outcome of primary total knee arthroplasty (TKA). The aim of our study was to prospectively compare clinical recovery in two groups of patients undergoing TKA based on differences in tourniquet strategy at the same institution. Group A (40 patients) consisted of TKAs performed by a surgeon using tourniquet from incision to arthrotomy closure, and group B (40 patients) consisted of TKAs performed by another surgeon using tourniquet only during cementation. The surgical technique, implants, perioperative management, and patient demographics were similar between groups. Average tourniquet time was significantly higher in group A (71.7 minutes) as compared with group B (36.8 minutes). The maximum hemoglobin (Hb)/hematocrit (Hct) drop was statistically higher in group B (Hb drop = 3.5 ± 0.9 g/dL; Hct drop = 11 ± 3) as compared with group A (Hb drop = 2.9 ± 0.9 g/dL; Hct drop = 9 ± 2; Hb drop p = 0.01; Hct drop p = 0.002). There were no significant differences in visual analogue scale pain scores, narcotic consumption, ability to straight leg raise during hospital stay, range of motion (ROM) at discharge, as well as isometric quadriceps strength, ROM, Short Form 36 scores, Knee Society s...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

Related Links:

We present the case of a 61-year-old woman with clinically significant venous and arterial thromboemboli in the setting of COVID-19 infection requiring tissue plasminogen activator (tPA).
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
ConclusionsThe clinical outcomes of 10 patients who underwent TES for spinal metastatic LMS were favorable without severe complications. Postoperative disability was significantly associated with short-term survival after TES.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
We present three cases in which EUS was decisive in establishing the correct diagnosis. Case 1: A 74-year-old female was hospitalized because of acute pancreatitis. Medical history, CT and MRI gave no clue to etiology, but EUS diagnosed a small pancreatic tumor. Case 2: A female patient was admitted because of abdominal pain and weight loss. While MRI suspected a pancreatic tumor, EUS showed typical features of autoimmune pancreatitis. Case 3: A 50-year-old patient was hospitalized with cachexia, ascites and pulmonary embolism. At first, a pancreatic tumor was suspected, but EUS showed a cystic lesion with a solid componen...
Source: Medical Ultrasonography - Category: Radiology Tags: Med Ultrason Source Type: research
We present a case of primary pulmonary arterial sarcoma (PPAS) treated with endostatin (endostar) injection and radiotherapy  discuss the diagnosis, clinical manifestations, and pathology of PPAS. The patient complained of cough with sputum, fever, and chest pain with hemoptysis. Numerous nodules were observed in the computed tomography (CT) scan. The patient was diagnosed with pulmonary embolism (PE) by computed tomography pulmonary angiography (CTPA). The pathology and immunohistochemistry results indicated soft tissue sarcomas, indicative of angiosarcoma. The nodules shrunk after 5 courses of endostatin and one cou...
Source: Saudi Medical Journal - Category: Middle East Health Tags: Saudi Med J Source Type: research
AbstractPurposeTo assess safety and efficacy of multi-level vertebroplasty, when treating 6 or more levels in the same procedural setting for the management of osteoporotic vertebral compression fractures (oVCF) in cancer patients.Materials and MethodsSingle institution retrospective review from 2015 to 2019 of patients treated for multi-level oVCF in a single session procedural setting by vertebroplasty of 6 or more levels. Procedure outcomes collected included procedural complications, pre- and 4  week post-procedure pain score by numeric rating scale, opioid usage, and vertebral height changes.ResultsIn total, 197 ...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
Authors: Ofori-Acquah SF Abstract Introduction: In sickle cell disease (SCD), hemoglobin S (HbS) red blood cells (RBCs) are characteristically deformed and inflexible. Often breaking down in the circulation, they exhibit increased adhesive properties with the endothelium and activated neutrophils and platelets, increasing the risk of occlusion of the microcirculation. SCD is categorized into two sub-phenotypes: hyperhemolytic, associated with priapism, leg ulcers, pulmonary hypertension, and stroke, and high hemoglobin/viscosity, which may promote vaso-occlusion-associated pain, acute chest syndrome, and osteonecro...
Source: Expert Review of Hematology - Category: Hematology Tags: Expert Rev Hematol Source Type: research
CONCLUSIONS: There is a small risk that healthy adult patients undergoing KA will develop venous thromboembolism (PE or DVT). There is moderate- to low-certainty evidence of no benefit from the use of LMWH, aspirin or rivaroxaban in reducing this small risk of PE or symptomatic DVT. There is very low-certainty evidence that LMWH use may reduce the risk of asymptomatic DVT when compared to no treatment but it is uncertain how this directly relates to incidence of DVT or PE in healthy patients. No evidence of differences in adverse events (including major and minor bleeding) was seen, but data relating to this were limited d...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSION: In cases where IMVM is located in one muscle in the leg, we demonstrated that surgery yielded improvement in pain, function, and quality of life. PMID: 32375603 [PubMed - as supplied by publisher]
Source: Phlebology - Category: Internal Medicine Authors: Tags: Phlebology Source Type: research
Conclusion: Pregnancy was the most common provoking factor for VTE in our study. Pregnant women should undergo formal, written assessments of risk factors for VTE at the first visit and delivery. Larger studies with a randomized design, and control groups are required to confirm the current findings. PMID: 32351991 [PubMed - in process]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
Rationale: Chilaiditi syndrome is a rare disorder characterized by a broad spectrum of (gastro-intestinal) symptoms caused by interposition of a segment of bowel between the liver and the diaphragm. Most cases present with abdominal symptoms and the morbidity tend to increase with age. Patient concerns: Here we present a rare case of Chilaiditi syndrome. An elderly postmenopausal woman developed unresolved postoperative respiratory symptoms and chest pain. Chest auscultation revealed considerable attenuation of respiratory sounds. She showed postoperative increase in D-dimer level and sudden onset of dyspnea. Diagnos...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
More News: Anesthesia | Anesthesiology | Hospital Management | Hospitals | Orthopaedics | Pain | Pain Management | Pulmonary Thromboembolism | Radiography | Statistics | Study