header advert
Results 1 - 2 of 2
Results per page:
Bone & Joint Research
Vol. 4, Issue 2 | Pages 11 - 16
1 Feb 2015
Femoral nerve infusion after primary total knee arthroplasty
C. Wyatt M Wright T Locker J Stout K Chapple C Theis JC
Full Access
View article Download PDF

Objectives

Effective analgesia after total knee arthroplasty (TKA) improves patient satisfaction, mobility and expedites discharge. This study assessed whether continuous femoral nerve infusion (CFNI) was superior to a single-shot femoral nerve block in primary TKA surgery completed under subarachnoid blockade including morphine.

Methods

We performed an adequately powered, prospective, randomised, placebo-controlled trial comparing CFNI of 0.125% bupivacaine versus normal saline following a single-shot femoral nerve block and subarachnoid anaesthesia with intrathecal morphine for primary TKA. Patients were randomised to either treatment (CFNI 0 ml to 10 ml/h 0.125% bupivacaine) or placebo (CFNI 0 ml to 10 ml/h normal saline). Both groups received a single-shot femoral nerve block (0.25% 20 ml bupivacaine) prior to placement of femoral nerve catheter and subarachnoid anaesthesia with intrathecal morphine. All patients had a standardised analgesic protocol. The primary end point was post-operative visual analogue scale (VAS) pain score over 72 hours post-surgery. Secondary outcomes were morphine equivalent dose, range of movement, side effects, and length of stay.

Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XLI | Pages 81 - 81
1 Sep 2012
WHAT IS THE BEST TREATMENT FOR INFECTED ARTHROPLASTY: DEBRIDEMENT VERSUS 2 STAGE REVISON?
Locker J Hooper G Chambers S
Full Access
View article

Determine if debridement, rather than staged revision is a more effective strategy in some patient subgroups with infected arthroplasty

We compiled a database comprising 154 proven infected knee replacements and 144 infected hip replacements in Christchurch over the last 10 years. This has given us the largest series in the literature. Cross referencing this database with the joint registry enabled us to compare the treatment of both acute and chronic infection in hip and knee arthroplasty with regard to both functional outcome and re-revision rate.

Patients treated with debridement had no statistically significant difference in re-revision rate or functional score when compared with patients undergoing staged revision.

Orthopaedic surgeons justifiably aim to eradicate infection in arthroplasty patients. A prosthesis retaining management strategy may be justifiable, especially in certain patient groups in whom multiple operations are best avoided.