Document Detail

Blood, bugs, and motion - what do we really know in regard to total joint arthroplasty?
MedLine Citation:
PMID:  21332442     Owner:  NLM     Status:  In-Data-Review    
In total joint arthroplasty, it is often necessary to formulate decisions that are not clearly evidence-based. This review presents some current controversial topics in total joint arthroplasty, including preoperative autologous blood donation versus erythropoietin (EPO) usage, preoperative screening and treatment for methicillin resistant Staphylococcus aureus (MRSA), and the use of continuous passive motion (CPM) following total knee arthroplasty, providing an evidence-based guide for the treating orthopaedic surgeon. Our review shows that preoperative autologous blood donation is over utilized, with EPO being under utilized. Surgeons are encouraged to develop patient-specifc strategies, which have been shown to decrease transfusion rates, reduce wasted autologous blood, and increase EPO use. Defnitive conclusions regarding MRSA screening for orthopaedic patients cannot be drawn; but due to the signifcant cost and morbidity associated with a postoperative MRSA infection, we believe a screen and treat protocol should be considered for all patients being admitted to the hospital for elective or emergent surgery. Short-term (3 to 5 days) inpatient use of CPM is recommended at this time. It is low-cost, has minimal risk, and may be a factor in decreasing the length of stay, potentially leading to signifcant cost savings. However, no long-term benefts of CPM use have been established.
Philip J Glassner; James D Slover; Joseph A Bosco; Joseph D Zuckerman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Bulletin of the NYU hospital for joint diseases     Volume:  69     ISSN:  1936-9727     ISO Abbreviation:  Bull NYU Hosp Jt Dis     Publication Date:  2011  
Date Detail:
Created Date:  2011-02-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101300541     Medline TA:  Bull NYU Hosp Jt Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-80     Citation Subset:  IM    
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