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The addition of intrathecal morphine (ITM) to neuraxial anesthesia during total knee arthroplasty (TKA) to achieve postoperative analgesia can elicit opioid-related side effects. The other methods of pain alleviation and side effect reduction, including multimodal analgesia, are challenging. This study aimed to determine the efficacy of various ITM dosages for primary unilateral TKA with periarticular injection (PI).
This randomized double-blind controlled trial was conducted at Vajira Hospital between April 2018 and March 2019. Patients undergoing TKA were randomized into 3 groups no ITM (M
), ITM 0.1 mg (M
), and ITM 0.2 mg (M
). All patients received PI. Postoperative pain scores, side effects of ITM, and orthopedic outcomes were compared.
The trial enrolled 102 patients M
(n= 32), M
(n= 35), and M
(n= 35). The postoperative pain scores and rescue analgesic consumption of groups M
and M
did not differ significantly within the first 24 hours and were significantly lower than those in grouhan those in patients administered 0.2 mg of ITM.During total knee arthroplasty, balancing is necessary for long-term stability and longevity of implants as improper balancing leads to abnormal surface strain. A routine practice among surgeons is to add more posterior slope to the proximal tibia to provide an increase in the flexion gap to balance the knee throughout the entire range of motion, particularly when doing cruciate-retaining knees. The aim of this technique guide is to provide a simple estimate of the posterior slope added or subtracted when cutting the proximal tibia using a standard extramedullary guide. It can also be applied to predict the amount of coronal change instituted using a standard extramedullary drop guide. Orforglipron chemical structure Using a few basic calculations with a sine equation, a surgeon can accurately predict the amount of change in the slope applied when cutting the proximal tibia. This can be done to control the degree of slope added to the anterior-posterior direction and can be used to predict coronal alignment changes as well. This technique can be applied to any length extramedullary guide and applied across all companies to provide surgeons with an exact degree change in the tibial slope and coronal alignment with simple calculations.
Although a successful operation, almost 20% of patients are dissatisfied with total knee arthroplasty (TKA). The purpose of this retrospective cohort study was to see if a medial congruent (MC) polyethylene would offer satisfactory early outcomes and patient satisfaction after TKA.
We reviewed prospectively collected data on 327 TKAs using multiple bearings within the same implant system. Ninety-six received an MC bearing, 70 received a cruciate-retaining (CR) bearing, and 161 received a posterior-stabilized (PS) bearing. We evaluated the visual analog scale pain scores and range of motion (ROM) at 2 weeks, 6 weeks, 3 months, and 1 year; Patient-Reported Outcomes Measurement Information System (PROMIS-10) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 3 months and 1 year; and Forgotten Joint Score (FJS-12) at 1 year.
All groups had similar KOOS and PROMIS-10 scores. MC knees had lower visual analog scale scores than PS knees at all time points (
< .05) and a higher ROM than PS at 2 weeks (98.6 vs 93.7,
= .002). MC knees had a significantly higher FJS-12 than CR knees (71.6 vs 58.7,
= .02). More MC knees were "very satisfied" than CR (92.6% vs 81.5%,
= .04). Fewer MC knees were "not at all satisfied" than CR (1.2% vs 9.2%,
= .04). There were similar satisfaction ratings with MC and PS.
An MC bearing provided similar or improved early pain, ROM, KOOS, PROMIS-10, FJS-12, and patient satisfaction as compared with standard bearings in TKA.
An MC bearing provided similar or improved early pain, ROM, KOOS, PROMIS-10, FJS-12, and patient satisfaction as compared with standard bearings in TKA.The Polish Panel Survey, POLPAN, one of the longest continuously run panel studies in Europe, is designed to facilitate research on the socio-economic structure, inequalities and the individual life course under conditions of social change in Poland. POLPAN is well suited for studying how women's and men's health and wellbeing are influenced by their life conditions, such as financial and social resources, that Poland's post-1989 profound socio-economic transformations impacted, and how health outcomes further shape individuals' attitudes and behaviours. Initiated in 1987-88, POLPAN has been fielded in five-year intervals, most recently in 2018, with wave-specific samples representative of the Polish adult population and response rates for full panelists consistently above 70%. In POLPAN, health assessment measures are collected in all waves, as part of respondents' multi-dimensional and life course inequality profile. Data on self-rated physical and psychological health, collected since 1998 (Wave Three), are complemented with respondents' Nottingham Health Profile and core anthropometric information about personal weight and height (Wave Five onwards); health and wellbeing related reasons for work interruptions (since Wave Four); information on extensive hospital stays (Wave Six onwards) and respondents' chronic or protracted illnesses (in Wave Six), respondents' disability status (all waves). The newly released integrated 1988-2018 POLPAN dataset is available on Harvard Dataverse, or upon request, via e-mail [email protected] paper presents data of medical choices determining physicians' profit and patients' health benefit under three levels of market competition monopoly, duopoly, and quadropoly. The data was collected from 136 German university students in an incentivized laboratory experiment. The designed experimental parameters and the formula for computing the payoff matrices of the games are described in this paper as well. This data was analyzed by Ge and Godager [5] who employed quantal response equilibrium choice models to investigate the relationship between market competition and determinism in behavior under a quantal response equilibrium paradigm. This data contributes to future investigation on alternative game theoretic equilibrium concepts and the development of empirical methods for studying strategic choice behavior.
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