Biomedical subjects

Joanne B Adams

Publications and source records attributed to Joanne B Adams.

4 recordsLinked to original sources

PubMed2003

The relationship of lateral release and tourniquet deflation in total knee arthroplasty.

A total of 242 knees in 198 patients undergoing total knee arthroplasty were reviewed to evaluate the effect of tourniquet deflation on lateral release rates, possible variables associated with the need for lateral release, and adequacy of intraoperative evaluation on final radiographs. The need for lateral release was determined using the "no-thumbs" and "full contact" rules and visual evaluation. Lateral release was performed after tourniquet deflation. A total of 171 (71%) knees needed a lateral release before tourniquet deflation. After tourniquet deflation, only 53 (22%) required lateral release, representing a 69% reduction. Obesity was the only other significant factor in lateral release requirement. Based on the observations of this study, it is recommended that the need for lateral release be evaluated after tourniquet deflation. A 69% reduction in lateral release supports the hypothesis that tourniquet pressure has an effect on patellar tracking. Lateral release appears to be effective in restoring normal patellar tilt, and obesity increases its need.

Adult↗

PubMed2002

Pain management for joint arthroplasty: preemptive analgesia.

Scheduled preoperative and postoperative analgesia should be offered in a multimodal management model. By a combined drug synergy effect, the central nervous system, afferent pathways, and peripheral wound site are modified collectively. In an ongoing effort to improve perioperative pain management, we retrospectively compared the results of a previously reported pain management protocol with 2 more recent groups of patients managed with modified pain protocols. In the earlier control protocol, epidural anesthesia was discontinued on arrival to the postanesthesia care unit, and regularly scheduled oral opioids and intravenous hydromorphone for breakthrough pain were initiated. The first more recent group used epidural anesthesia, and the second group used spinal anesthesia. Both protocols featured the use of cyclooxygenase-2-inhibiting anti-inflammatory medication administered for 2 weeks preoperatively and continued for 10 days postoperatively and patient-controlled analgesia for 24 hours followed by scheduled oral opioids.

Aged↗

PubMed2002

Why a taper?

Explore the source record for details and available documents.

Femur↗

PubMed2002

Stem modularity: rarely necessary in primary total hip arthroplasty.

A retrospective review of two consecutive series of cementless primary THA performed simultaneously from November 1987 to February 1994 within a single orthopedic practice by three surgeons was conducted. A series using non-modular Mallory-Head Porous (Biomet Inc, Warsaw, Ind) femoral components was compared to a series using modular Sivash Range of Motion (DePuy, Warsaw, Ind) femoral components to evaluate whether modularity of the femoral stem body is necessary in cementless primary THA. Clinically and radiographically, both components performed at comparable levels with equally satisfactory results. Both series demonstrated effective femoral fixation as evidenced by excellent Engh fixation scores. However, this study has shown the importance of circumferential proximal porous-coating to form an effective seal, preventing the propagation of particulate debris. Modular systems were associated with a higher degree of technical difficulty, operative time, and blood loss.

Arthroplasty, Replacement, Hip↗