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- Cebatorius, Algimantas, et al.
(författare)
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Choice of approach, but not femoral head size, affects revision rate due to dislocations in THA after femoral neck fracture: results from the Lithuanian Arthroplasty Register
- 2015
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 39:6, s. 1073-1076
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Hip dislocation after arthroplasty for femoral neck fractures (FNF) remains a serious complication. The aim of our study was to investigate FNF patients treated with THA, with a special focus of comparing the effect of surgical approach and femoral head size on the risk of revision for dislocation. Methods Data were derived from the Lithuanian Arthroplasty Register, and we calculated the cumulative revision rates after surgery. For survival analysis, we used revision due to dislocation as an end-point. Cox proportional hazards models were used to analyse the influence of various covariates (age, gender, femoral head size, surgical approach). Results A total of 8,813 primary THAs were registered from 1 January 2011 to 31 December 2013, of which 1,412 were due to FNF: 899 involved 28-mm femoral heads and the remaining 513 received 32-mm heads. The posterior approach was used in 1,156 cases and the anterolateral approach in 256.. At the end of the follow-up period, 74 hips had been revised for recurrent dislocation. Cox regression adjusting for age, gender and head size showed that the posterior approach had 2.3-times [95% confidence interval (CI): 1.0-5.0, p = 0.04] greater risk of revision for dislocation Conclusions We conclude that in order to reduce the early dislocation rate in FNF patients treated with THA, it is more effective to use the anterolateral approach than it is to select a femoral head size of 32 mm instead of 28 mm.
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| 2. |
- Stucinskas, Justinas, et al.
(författare)
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Conventional drainage versus four hour clamping drainage after total knee arthroplasty in severe osteoarthritis: a prospective, randomised trial
- 2009
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 33:5, s. 1275-1278
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Tidskriftsartikel (refereegranskat)abstract
- Total knee replacement in severe osteoarthritis usually requires extensive soft tissue releases often associated with considerable bleeding. In a prospective, randomised trial we compared postoperative conventional suction drainage versus four hour clamping drainage in 60 patients undergoing total knee arthroplasty for severe osteoarthritis. We compared blood loss, number of transfusions, postoperative complications and knee function and found significantly less postoperative blood loss through the drains (p < 0.001), and fewer blood transfusions (p=0.09) were needed in the clamped group. We conclude that clamping drainage after total knee arthroplasty in severe osteoarthritis reduces blood loss through the drains and the need for blood transfusions.
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