Total Knee

Levy, O.L.. Martinowilz, U., Oran, A., Tauber, C. and Horoszowski, H., The use of fibrin tissue adhesive to reduce blood loss and the need for blood transfusion after total knee arthroplasty a prospective, randomized, mullicenter study. J. Bone Joint Surg.. 81A. 1580 (1999). 

Zohar E, EUis M, Ifrach N, Stern A, Sapir O, Eredman B. The postoperative blood-sparing efficacy of oral versus intravenous tranexamic acid after total knee replacement. Anesth Analg 2004 99 1679-83. 

Carbon Fibers. Indeed, carbon fiber reinforced PE and a heat pressed PE have shown relatively poor wear resistance when used as the tibial components of total knee prosthesis (23). 

Farag E, Dilger J, Brooks P, Tetzlaff JE. Epidural analgesia improves early rehabilitation after total knee replacement. J Clin Anesth. 2005 17 281-285. 

Francis CW, Berkowitz SD, Comp PC, et al, Comparison of ximelagatran with warfarin for the prevention of venous thromboembolism after total knee replacement. N EnglJ Med 2003 349 1703-1712. 

Two major clinical studies14 (621 patients who underwent elective total knee replacement, and 706 patients who underwent elective total hip replacement) have evaluated the efficacy and safety of rivaroxaban in the prophylaxis of thrombosis in patients undergoing orthopedic surgery. In these studies, rivaroxaban (2.5-10 mg b.i.d.) compared favorably with enoxaparin (40 mg once daily). 

In summary, rivaroxaban 1 is an oral direct factor Xa inhibitor and is the first approved factor Xa inhibitor on the European and Canadian market. This class of inhibitors is expected to expand, with new members currently in late-stage clinical development. Rivaroxaban is indicated for the prevention of venous thromboembolic events in patients who have undergone elective total hip or total knee replacement surgery. Rivarobaxan was underwent extensive clinical program that included three Phase III trials of rivaroxaban involving a total of nearly 12,000 patients. The results from these three studies demonstrated the superior efficacy of the factor Xa inhibitor, both in head-to-head comparisons with enoxaparin and when comparing extended-duration (5 weeks) rivaroxaban with short-duration (2 weeks) enoxaparin. In all three... 

Total knee 3.5 1 Staphylococcus epidermidis Staphylococcus aureus... 

Mr KT is a 58-year-old man who has been admitted to the surgical ward on which you work for a total knee replacement. He lives with his wife and two sons. He smokes 15 cigarettes a day and usually drinks about 35 units of alcohol a week. He is slightly overweight with a BMI of 27 kg/m2. His current medication includes... 

In a randomized, double-blind study, 64 patients undergoing total knee arthroplasty received either intrathecal morphine 0.3 mg or intrathecal diamorphine, 0.3 mg in 0.3 ml, with 2-2.5 ml of 0.5% heavy spinal bupivacaine (3). The patients given morphine had significantly greater analgesia at 4, 8, and 12 hours postoperatively. The incidence of opioid-related adverse effects was not significantly different between the groups. 

Jansen AJ, Andreica S, Claeys M, D Haese J, Camu F, Jochmans K. Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. Br J Anaesth 1999 83(4) 596-601. 

A 53-year-old woman received postoperative epidural analgesia by nurse-administered bolus doses after a total knee replacement (16). She received her first epidural bolus of 0.25% bupivacaine 6 ml with morphine 2 mg 2 hours after the operation, with good effect. Six hours later she was accidentally given a second top-up dose intravenously. She became distressed and complained of tinnitus, palpitation, and dizziness. She was able to cooperate and was in sinus rhythm with a tachycardia of 120/minute. She was observed overnight on ICU and made a full recovery. 

An 85-year-old woman undergoing elective right total knee replacement had prolonged motor blockade of her left leg when her epidural ropivacaine (0.2% at 8-10 ml/hour) infusion was discontinued on the third postoperative day normal motor function had returned by the sixth postoperative day (139). 

Silvasti M, Pitkanen M. Patient-controlled epidnral analgesia versus continuous epidural analgesia after total knee arthroplasty. Acta Anaesthesiol Scand 2001 45(4) 471-6. 

Worland, R.L. Arredondo, J. Angles, F. Lopez-Jimenez, F. Jessup, D.E. Home continous passive motion machine versus professional physical therapy following total knee replacement. J. Arthroplast. 1998, 13, 784-787. 

The decreased coagulation FVIII level occurred postoperatively in a patient receiving rAHF-PFM via continuous infusion for placement of total knee prosthesis. The clearance rate increased 10 days... 

She has osteoarthritis in her left knee, is under the care of an orthopaedic consultant, and is being considered for total knee replacement. 

Voigt, J.D. and Mosier, M. (2011) Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty. Acta Orthop., 82 (4), 448-459. 

Dixon MC et al (2005) Modular fixed-bearing total knee arthroplasty with retention of the posterior cruciate ligament. A study of patients followed for a minimum of fifteen years. J Bone Joint Surg Am 87(3) 598-603... 

The client who has had a total knee surgery returns to the room with an autotransfusion drainage system (cell saver) device inserted into the wound. Which interventions should the nurse implement Select all that apply. 

---