This volume describes the most recent medical guidelines for perioperative management in arthroplasty with the aim of facilitating excellent control of bleeding/thrombosis, pain and infection. For each area - hemostasis control, pain control and infection control - hot topics of key practical importance are discussed and contrasting perspectives are presented on controversial issues, covering the views of different practitioners and specialties. Using the information contained in this book, the practitioner will be in an excellent position to meet the principal goals of perioperative medical management. The information provided will assist in the choice of a multimodal guideline that minimizes the complication rate regarding bleeding and thromboembolism while not interfering with the patient's recovery. Similarly, effective means of pain control and an optimized pain control protocol are discussed with a view to shortening hospital stay and achieving functional milestones that meet the patient's expectations. Finally, host, wound and environmental factors relevant to infection and its prevention are explained, with discussion of the best means of prophylaxis, treatment and imaging.
Surgeons, anesthesiologists and all medical practitioners and staff involved in the field of total hip and knee arthroplasty will find this book to be of value in their daily clinical practice. It will assist in the provision of enhanced medical management that ensures quicker recovery of the patient with fewer complications.
HEMOSTASIS CONTROL (bleeding/thromboembolism) 1 Modern blood management in arthroplasty.- 2 How to reach 0% transfusion rate in TKA.- 3 Antiplatelet therapy in patients with coronary stent undergoing orthopedic surgery: is it still no man's land?.- 4 Controversy: Are LMWHs still the gold standard in arthroplasty? Arguments in favour.- 5 Controversy: Are LMWHs still the gold standard in arthroplasty? Arguments against.- 6 Controversy: A low hemoglobin transfusion trigger is not dangerous. Arguments in favour.- 7 Controversy: A low hemoglobin transfusion trigger is not dangerous. Arguments against.- 8 Controversy: Detection of DVT: all patients need pre and postop ultrasound screening.- 9 PAIN CONTROL What works and what does not work for pain control in arthroplasty.- 10 Patient mental preparation to the arthroplasty procedure.- 11 Optimized pain control protocol.- 12 Cost-effectiveness of the various modalities for pain control.- 13 How to avoid chronic pain after hip and knee arthroplasty.- 14 Pain management in total knee arthroplasty: a surgeon-anesthesiologist cooperation.- 15 Dealing with pain in a "Fast track" protocol: the experience of a European professional.- 16 Dealing with pain in a "Fast track" protocol: the experience from USA.- 17 Perspectives: Best technique for local wound infiltrations.- 18 INFECTION CONTROL Prevention of infection: the host factors.- 19 Prevention of infection: the wound factors.- 20 Prevention of infection: the environmental factors.- 21 The fight against the slime: can we ever win?.- 22 Anti-biofilm agents: where are we?.- 23 The best prophylaxis for primary arthroplasty.- 24 Perspectives: How to deal with 38.5 C fever after arthroplasty. The infectivologist's point of view.- 25 Perspectives: How to deal with 38.5 C fever after arthroplasty. The surgeon's point of view.- 26 Perspectives: Prolonged wound drainage (7 days) after hip arthroplasty.