Controversial Topics in Total Knee Arthroplasty: A Five-Year Update (Part 2)

Abstract

To summarize a practical approach to the prevention of venous thromboembolism (VTE) in various patient groups undergoing orthopedic surgery or with lower extremity fractures. BACKGROUND: Patients undergoing hip arthroplasty, knee arthroplasty, hip fracture surgery and patients with major lower extremity injuries are at particularly high risk for VTE. In this population, routine use of thromboprophylaxis has been standard-of-care for many years. Before thromboprophylaxis was widely used, deep vein thrombosis (DVT), which was most often clinically silent, occurred in 40-60% of these patients; pulmonary embolism (PE) occurred in 5-10% of patients; and fatal embolism was one of the most common causes of death. The use of evidence-based thromboprophylaxis in these patients has been shown to reduce the risk of DVT by at least 50% and, as a result, major and fatal VTE are now uncommon. A large number of clinical trials have assessed many different thromboprophylaxis modalities in orthopedic surgery.

Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years

“…However, few literature sources have evaluated the level of evidence (LOE) in the field of knee arthroplasty [8]. Even less studies evaluate shift of trends in research topics but only represent felt trends or experts’ agreements [1, 22]. Understanding changes in publishing characteristics over time, by topic, by origin and by gender are critical, especially with the rising demands of publishing in academia.…”

“…Although knee arthroplasty is a successful procedure to treat end‐stage osteoarthritis, 20% of patients are not satisfied with their outcome [15]. Therefore, notable variations and developments in surgical techniques with many controversies arose over time [22]. Especially as the number of knee arthroplasties is continuously rising worldwide, high‐quality research and evidence‐based recommendations are required to evaluate those techniques and improve outcome.…”

Transcutaneous Electrical Acupoint Stimulation Attenuates Lung Injury Caused by Tourniquet-induced Limb Ischemia/reperfusion During Lower Extremity Surgery: A Randomized Controlled Trial

“…Tourniquet placement is routinely used in orthopedic surgery to provide bloodless eld and reduce intraoperative blood loss, which is an essential procedure in the process of lower extremity surgical operation including total knee arthroplasty (TKA) and fracture reduction [1][2][3]. However, tourniquet application leads to several complications associated with ischemia and reperfusion (I/R) injury to both local tissue and vital remote organs, even death [4,5].…”