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Not all in your head (and neck): Stroke after blunt cerebrovascular injury is associated with systemic hypercoagulability
CONCLUSION Patients who suffer BCVI-related stroke are hypercoagulable compared with those with BCVI who remain asymptomatic. Increased angle or MA should be considered when assessing the risk of thrombosis and determining the optimal time to initiate antithrombotic therapy in patients with BCVI. LEVEL OF EVIDENCE Prognostic, Level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2019 Category: Orthopaedics Tags: 2019 WTA PODIUM PAPERS Source Type: research

A predictive model of complications after spine surgery: the National Surgical Quality Improvement Program (NSQIP) 2005–2010
Conclusions: Our model can provide individualized estimates of the risks of postoperative complications based on preoperative conditions, and can potentially be used as an adjunct in decision-making for spine surgery.
Source: The Spine Journal - November 8, 2013 Category: Orthopaedics Authors: Kimon Bekelis, Atman Desai, Samuel F. Bakhoum, Symeon Missios Tags: Clinical Studies Source Type: research

New strategies for osteoporosis patients previously managed with strontium ranelate
The aim of this article is to describe potential alternatives to patients no longer eligible for management with strontium ranelate for osteoporosis according to the recommendations by the European Medicines Agency. A systematic search of Pubmed was done for papers on fracture efficacy of various treatments for osteoporosis, and potential harms especially in terms of cardiovascular events and stroke. The results showed that drugs more efficacious in terms of relative risk reduction of fractures than strontium ranelate were alendronate, risedronate, zoledronate, and denosumab. Raloxifene, as for strontium, may be associated...
Source: Therapeutic Advances in Musculoskeletal Disease - November 19, 2014 Category: Orthopaedics Authors: Vestergaard, P. Tags: Reviews Source Type: research

Post-traumatic thrombo-embolic complications in polytrauma patients
Conclusion TE complications were associated with longer ICU and hospital stay as well as a higher mortality. Overall, age and repeated operations were the most important risk factors for the development of TE events.
Source: International Orthopaedics - February 18, 2015 Category: Orthopaedics Source Type: research

Impact of Patent Foramen Ovale on Total Knee Arthroplasty Cerebrovascular Accident Perioperative Management.
This study was undertaken to determine whether patients with a PFO would have a significantly increased risk of cerebrovascular accident (CVA) following TKA. The Humana national database was used to identify TKA patients who were stratified by the presence of a PFO from 2007 to 2016. Ninety-day follow-up was used for the primary outcome of CVA. Potential confounding comorbidities also were investigated, including age, sex, anticoagulation, insurance type, arrhythmia, valvular disease, peripheral vascular disease, chronic kidney disease, and diabetes mellitus. Of 153,245 TKAs, a total of 2272 patients had strokes; 479 of th...
Source: Orthopedics - February 19, 2020 Category: Orthopaedics Authors: Hong CS, Politzer C, Ryan SP, Wellman SS, Jiranek WA, Bolognesi MP, Seyler TM Tags: Orthopedics Source Type: research

Reduced short-term complications and mortality following Enhanced Recovery primary hip and knee arthroplasty: results from 6,000 consecutive procedures.
Abstract Background and purpose Enhanced Recovery (ER) is a well-established multidisciplinary strategy in lower limb arthroplasty and was introduced in our department in May 2008. This retrospective study reviews short-term outcomes in a consecutive unselected series of 3,000 procedures (the "ER" group), and compares them to a numerically comparable cohort that had been operated on previously using a traditional protocol (the "Trad" group). Methods Prospectively collected data on surgical endpoints (length of stay (LOS), return to theater (RTT), re-admission, and 30- and 90-day mortality) and medical complication...
Source: Acta Orthopaedica - December 20, 2013 Category: Orthopaedics Authors: Khan SK, Malviya A, Muller SD, Carluke I, Partington PF, Emmerson KP, Reed MR Tags: Acta Orthop Source Type: research

What Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty?
CONCLUSIONS: As lengths of hospital stay after TJA continue to decrease, our findings suggest that caution is in order because several acute and immediately life-threatening findings, including myocardial infarction and pulmonary embolism, might occur after discharge. Furthermore, the timing of surgical site infection and sepsis suggests that even the 30-day followup afforded by the ACS-NSQIP may not be sufficient to study the latest occurring adverse events. Additionally, both pulmonary embolism and deep vein thrombosis tend to occur earlier after TKA than THA, and this should guide clinical surveillance efforts in patien...
Source: Clinical Orthopaedics and Related Research - January 3, 2017 Category: Orthopaedics Authors: Bohl DD, Ondeck NT, Basques BA, Levine BR, Grauer JN Tags: Clin Orthop Relat Res Source Type: research

Are Cardiac Complications Associated With Other Adverse Events? A Look at 56,000 Orthopaedic Trauma Patients.
Authors: Yarlagadda M, Shen M, Abraham A, Mousavi I, Sethi MK Abstract The purpose of this study was to identify those complications for which patients with adverse cardiac events are at risk within the 30-day postoperative period following treatment oforthopaedic trauma cases. This was a retrospective cohort study of orthopaedic trauma patients in the United States between 2006 and 2013. A total of 56,336 patients meeting any one of 89 CPT codes in the American College of Surgeons National Surgical Quality Improvement Program database were used. The main outcome measure was myocardial infarction or cardiac arrest ...
Source: Journal of surgical orthopaedic advances - November 30, 2018 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients
CONCLUSION THC exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients. LEVEL OF EVIDENCE Prognostic study, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - June 23, 2020 Category: Orthopaedics Tags: 2020 EAST PODIUM PAPER Source Type: research

Hematomyelia after cervical facet infiltration mimicking brainstem stroke
An 84-year-old woman with a long-standing history of severe cervical facet syndrome was admitted to the emergency department with suspected acute basilar artery thrombosis.
Source: The Spine Journal - January 14, 2016 Category: Orthopaedics Authors: Valentin Taucher, Birgit Hoermanseder, Dierk Oel, Stefan Einsiedler, Herbert Lugmayr, Raffi Topakian Tags: Images of Spine Care Source Type: research

Effect of Smoking on Joint Replacement Outcomes: Opportunities for Improvement Through Preoperative Smoking Cessation.
Authors: Wright E, Tzeng TH, Ginnetti M, El-Othmani MM, Saleh JK, Saleh J, Lane JM, Mihalko WM, Saleh KJ Abstract Because orthopaedic surgeons focus on identifying serious potential complications, such as heart attack, stroke, and deep vein thrombosis, during the preoperative assessment, correctable factors, such as smoking, may be overlooked. Chronic exposure to nicotine has been correlated with perioperative complications that lead to worse outcomes, including decreased patient satisfaction, longer hospitalization periods, and an increased rate of hospital readmission. It has been proven that smoking is a negativ...
Source: Instructional Course Lectures - April 7, 2016 Category: Orthopaedics Tags: Instr Course Lect Source Type: research

Medial unicompartmental knee arthroplasty in the ACL-deficient knee
Abstract Symptomatic osteoarthritis (OA) of the knee develops often in association with anterior cruciate ligament (ACL) deficiency. Two distinct pathologies should be recognised while considering treatment options in patients with end-stage medial compartment OA and ACL deficiency. Patients with primary ACL deficiency (usually traumatic ACL rupture) can develop secondary OA (typically presenting with symptoms of instability and pain) and these patients are typically young and active. Patients with primary end stage medial compartment OA can develop secondary ACL deficiency (usually degenerate ACL rupture) and the...
Source: Journal of Orthopaedics and Traumatology - May 8, 2016 Category: Orthopaedics Source Type: research

Embedding a trauma hospitalist in the trauma service reduces mortality and 30-day trauma-related readmissions
CONCLUSION: Our study provides evidence that embedding a hospitalist on the trauma service reduces mortality and trauma-related readmissions. A reason for these improved outcomes may be related to THOSP “vigilance.” LEVEL OF EVIDENCE: Therapeutic/care management study, level IV.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - June 22, 2016 Category: Orthopaedics Tags: Original Articles Source Type: research

Effect of Antifibrinolytic Therapy on Complications, Thromboembolic Events, Blood Product Utilization, and Fusion in Adult Spinal Deformity Surgery
Conclusion. TXA or EACA use was associated with increased minor intraoperative complications. TXA was associated with decreased major perioperative complications. AF was associated with decreased utilization of blood products without an increased rate of thromboembolic events. Given the nature of this study, transfusion threshold was not standardized. Future studies with rigid criteria for transfusion should be prospectively performed to better evaluate the impact of AF during ASD surgery. Level of Evidence: 3
Source: Spine - July 9, 2016 Category: Orthopaedics Tags: Deformity Source Type: research

Hematomyelia after cervical facet infiltration mimicking brainstem stroke
An 84-year-old woman with a long-standing history of severe cervical facet syndrome was admitted to the emergency department with suspected acute basilar artery thrombosis.
Source: The Spine Journal - January 13, 2016 Category: Orthopaedics Authors: Valentin Taucher, Birgit Hoermanseder, Dierk Oel, Stefan Einsiedler, Herbert Lugmayr, Raffi Topakian Tags: Images of Spine Care Source Type: research

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