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Biomedical subjects

Russell E Windsor

Publications and source records attributed to Russell E Windsor.

6 recordsLinked to original sources

VenaFlow plus Lovenox vs VenaFlow plus aspirin for thromboembolic disease prophylaxis in total knee arthroplasty.

Two hundred seventy-five patients undergoing unilateral total knee arthroplasty were prospectively randomized to receive spinal epidural anesthesia (SEA), a VenaFlow calf compression device, and enoxaparin (group A) or SEA, VenaFlow, and aspirin (group B). Aspirin was started on the day of surgery, whereas enoxaparin was started 48 hours after surgery. Anticoagulants were continued for 4 weeks after surgery. All patients had an in-hospital ultrasound screening test on postoperative days 3 to 5 and a second follow-up ultrasound 4 to 6 weeks after surgery. The overall deep venous thrombosis rates in groups A and B were 14.1% and 17.8% (P = not significant), respectively. When used in combination with pneumatic compression devices and SEA, enoxaparin was not superior to aspirin in preventing deep venous thrombosis after total knee arthroplasty.

Adult↗

Hybrid component fixation in revision total knee arthroplasty.

UNLABELLED: We retrospectively analyzed the midterm survivor rate of revision total knee arthroplasty using hybrid stem fixation. We included 33 patients, 21 women and 12 men with an average age of 68 years (range, 57-80 years). Revision was performed for aseptic loosening in 16 patients, aseptic loosening and knee instability in five patients, instability in seven patients, infection in three patients, and postoperative stiffness and pain in two patients. The average follow-up was 38 months. Three knees (9%) were revised during the follow-up period. Two patients (6%) underwent revision for aseptic loosening and one patient (3%) for deep implant infection. The average knee score improved from 42 points (range, 10 to 60) to 83 points (range, 60 to 100). The average functional score improved from 48 points (range, 15-65 points) to 76 points (range, 46-99 points). All patients had no pain (13%) or moderate/occasional pain (87%) during walking. The average ROM improved from 94 degrees (range, 45 degrees-125 degrees) to 105 degrees (range, 70 degrees-125 degrees). Hybrid component fixation is a useful treatment option in revision total knee arthroplasty. The revision rate for aseptic loosening within a three year follow-up is 6%. LEVEL OF EVIDENCE: Therapeutic study, level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.

Aged↗

Clostridium infection in a knee extensor mechanism allograft: case report and review.

An unusual case of Clostridium perfringens infection after an allograft reconstruction of an extensor mechanism in a multiply revised total knee arthroplasty is reported. The case occurred in an elderly patient with an underlying bleeding dyscrasia who had previously undergone two revision total knee arthroplasties. The patient was treated by open irrigation, debridement, removal of allograft and prosthesis, intravenous antibiotics, and implantation of an antibiotic impregnated cement spacer utilizing an intramedullary rod.

Aged↗

High tibial osteotomy.

High tibial osteotomy is effective for managing a variety of knee conditions, including gonarthrosis with varus or valgus malalignment, osteochondritis dissecans, osteonecrosis, posterolateral instability, and chondral resurfacing. The fundamental goals of the procedure are to unload diseased articular surfaces and to correct angular deformity at the tibiofemoral articulation. Although the clinical success of total knee arthroplasty has resulted in fewer high tibial osteotomies being done during the past decade, the procedure remains useful in appropriately selected patients with unicompartmental knee disease. Renewed interest in high tibial osteotomy has occurred for a number of reasons. These include the prevalence of physiologically young active patients presenting with medial compartment osteoarthritis; the advent of new techniques for performing the procedure (ie, improved instrumentation and fixation plates for medial opening wedge osteotomy, dynamic external fixation for medial opening wedge osteotomy, and improved instrumentation for lateral closing wedge osteotomy); and the need to concomitantly correct malalignment when performing chondral resurfacing procedures (ie, autologous chondrocyte transplantation, mosaicplasty, and microfracture).

Arthritis↗