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Frederick, Maryland, United States

Kapadia B.H.,Sinai Hospital of Baltimore Baltimore
Surgical technology international | Year: 2012

Venous thromboembolic disease remains a serious complication following lower extremity total joint arthroplasty. Postoperative thromboembolic complications, which include symptomatic deep vein thrombosis, bleeding, and pulmonary embolus, are recognized causes of patient morbidity, mortality, increased length of stay, and higher healthcare costs. Various thromboprophylaxis guidelines have been recommended to prevent and thereby reduce the incidence of such events. However, despite various studies exploring prophylaxis measures, the incidence of venous thromboembolic events has remained relatively unchanged over the past 10 years. We therefore aimed to: (1) evaluate the current 2011 American Academy of Orthopaedic Surgeons (AAOS) and the 2012 American College of Chest Physicians (ACCP) recommendations concerning venous thromboembolic disease after lower extremity joint arthroplasty; and (2) report on different modalities of prophylaxis, specifically, pharmacological agents, mechanical compression devices, and inferior vena cava filters. Both AAOS and ACCP guidelines recommend a combined approach with mechanical compression devices and pharmacological prophylaxis. A major difference is that the AAOS work group does not recommend specific pharmacological agents, whereas the ACCP guidelines give specific recommendations. Additionally, routine primary thromboprophylaxis with inferior vena cava filters is only recommended when there are contraindications to anticoagulation therapy. Source

Mont M.A.,Sinai Hospital of Baltimore Baltimore
Surgical technology international | Year: 2012

Because total knee arthroplasty is one of the most common orthopaedic procedures, it is important that the medical community continually strive for cost reductions. This prospective controlled trial aimed to determine if cost decreases could be achieved in non-navigated and navigated procedures by replacing traditional saws, cutting blocks, and trials with a specialized single-use system. Costs were lowered by an estimated $140.00-220.00 per surgery as a result of fewer instrument trays being reprocessed, and an estimated $75.00-330.00 per instrument case due to a 10-24-minute time savings during tray rewrapping. This study has positive financial implications for patients, hospitals, institutions, and third-party carriers. Source

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