The coronavirus pandemic has reduced the capability of Canadian hospitals to offer elective orthopaedic surgery requiring admission, despite ongoing and increasing demands for elective total hip and total knee arthroplasty surgery (THA and TKA). We sought to determine if the coronavirus pandemic resulted in more
Percutaneous flexor tenotomy involves cutting the flexor digitorum tendons to correct claw toe deformity to treat apical pressure areas and prevent subsequent infection in patients with peripheral neuropathy. Performing this under ultrasound guidance provides reassurance of complete release of the tendon and increases procedural safety. This study is a retrospective case series evaluating the effectiveness, safety, and patient satisfaction of performing percutaneous ultrasound-guided flexor tenotomy in an
The response to the COVID-19 pandemic has raised the profile and level of interest in the use, acceptability, safety, and effectiveness of virtual
Introduction. External fixation (EF) devices are commonly used in the management of complex skeletal trauma, as well as in elective limb reconstruction surgery for the management of congenital and acquired pathology. The subsequent removal of an EF is commonly performed under a general anaesthetic in an operating theatre. This practice is resource intensive and limits the amount of operating theatre time available for other surgical cases. We aimed to assess the use of regional anaesthesia as an alternative method of analgesia to facilitate EF removal in an
The brief answer is no….I do not believe that
Aims. Currently, there is no single, comprehensive national guideline for analgesic strategies for total joint replacement. We compared inpatient and
The discussion of
Closed ankle fractures have been reported to account for 10% off all fractures presenting to the Emergency Department. Many of these injuries require acute surgical management either via direct admission or through defined
An
Length of hospital stay has been decreased to the point where the next logical progression in arthroplasty surgery is outpatient arthroplasty procedures. This trend has already happened for procedures formerly regarded as “inpatient” procedures such as upper extremity surgery, arthroscopy, anterior cruciate ligament reconstruction, foot and ankle procedures, and rotator cuff repair. Refinement of surgical techniques, anesthesia protocols, and patient selection has facilitated this transformation. Today, hip, knee and shoulder arthroplasty can be performed safely as
Introduction.
Introduction.
Significant advances in perioperative pain management, such as multimodal periarticular injection, and subtler advances in surgical technique have resulted in improved postoperative experiences for patients with less pain, earlier rehabilitation, and shorter stays in hospital. Concurrently, and by applying the learnings from above, significant advances have been made in unicompartmental knee arthroplasty care pathways leading to safe programs for
To progress to a same day surgery program for arthroplasty, it is important that we examine and resolve the issues of why patients stay in the hospital. The number one reason is fear and anxiety of the unknown and of surgical pain. The need for hospital stay is also related to risk arising from comorbidities and medical complications. Patients also need an extended stay to manage the side effects of our treatment, including after effects of narcotics and anaesthesia, blood loss, and surgical trauma. The process begins pre-operatively with an appropriate orthopaedic assessment of the patient and determination of the need for surgery. The orthopaedic team must motivate the patient, and ensure that the expectations of the patient, family and surgeon are aligned. In conjunction with our affiliated hospitalist group that performs almost all pre-admission testing, we have established guidelines for patient selection for outpatient arthroplasty. The
Introduction. Over the past several decades, numerous surgical procedures have been perfected in the inpatient hospital setting and then evolved into
Introduction. Traditionally an inpatient hospital stay has been required for all joint replacement surgery. The three primary drivers of cost for joint replacement have been implant cost, other hospital charges and postoperative rehabilitation costs. The three primary reasons that have made hospitalization necessary are pain control, therapy and possible transfusion. Advances in surgical technique, implants, comprehensive blood management, and multimodal pain management have allowed a marked reduction in the hospital stay required, eliminated the need for extensive formal rehabilitation. The purpose of this study is to evaluate if hip resurfacing can be performed safely and cost-effectively as an
INTRODUCTION. The benefits of combining enhanced recovery after surgery (ERAS) interventions with an
To progress to a same day surgery program for arthroplasty, it is important that we examine and resolve the issues of why patients stay in the hospital. The number one reason is fear and anxiety for the unknown and for surgical pain. The need for hospital stay is also related to risk arising from comorbidities and medical complications. Patients also need an extended stay to manage the side effects of our treatment, including after-effects of narcotics and anesthesia, blood loss, and surgical trauma. The process begins pre-operatively with an appropriate orthopaedic assessment of the patient and determination of the need for surgery. The orthopaedic team must motivate the patient, and ensure that the expectations of the patient, family and surgeon are aligned. In conjunction with our affiliated hospitalist group that performs almost all pre-admission testing, we have established guidelines for patient selection for outpatient arthroplasty. The
Purpose. Traditionally, an inpatient hospital stay has been required for joint replacement surgery. The three primary drivers of cost for joint replacement have been implant cost, other hospital charges and postoperative rehabilitation costs. The three primary reasons that have made hospitalization necessary are pain control, blood loss / transfusion, and monitoring patients with comorbidities. Advances in surgical technique, implants, comprehensive blood management, and multimodal pain management have allowed a marked reduction in the hospital stay required and have eliminated the need for extensive formal rehabilitation. The purpose of this study is to evaluate if hip resurfacing can be performed safely and cost-effectively as an