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Biomedical subjects

Steven B Haas

Publications and source records attributed to Steven B Haas.

7 recordsLinked to original sources
PubMed2006

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↗
PubMed2006

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.

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PubMed2006

Minimally invasive total knee arthroplasty: the mini midvastus approach.

Minimally invasive knee surgery offers the potential for earlier return of motion. To ascertain whether this potential is realized we retrospectively reviewed 335 consecutive patients (391 knees) who underwent minimally invasive total knee arthroplasties from September 2001 to September 2004 using the mini midvastus approach. There were 248 women and 87 men, with an average preoperative range of motion (ROM) of 109 degrees. Sixty-three percent of patients had a body mass index of less than 30% and 33% had a body mass index from 30 to 39. Patients received epidural anesthesia and a posterior-stabilized knee. We obtained Knee Society scores and determined ROM. The mean ROM at 6 weeks postoperatively was 111 degrees, 121 degrees at 3 months, and 125 degrees at 1 year and 2 years postoperatively. Knee Society scores were 95 or over at all followup periods. Postoperative ROM was related to preoperative ROM, although patients with less preoperative motion had the greatest improvements at 6 weeks and 3 months postoperatively. We observed no increased complication rate with this approach. Minimally invasive total knee arthroplasty with a mini midvastus approach was associated with rapid functional recovery and substantial improvements in ROM. This procedure can be performed safely and provides high Knee Society scores short term.

Adult↗
PubMed2004

Minimally invasive total knee replacement through a mini midvastus approach: a comparative study.

Between September 2001 and September 2002, forty consecutive minimally invasive total knee replacements were done. A modified midvastus approach was used and the patella was subluxed, but not everted. We compared the results of this group with an age-matched and sex-matched cohort of total knee replacements done between June 2000 and September 2001 with a standard technique. A posterior-stabilized knee (Genesis II) was used in both groups. Patients achieved motion considerably faster in the minimally invasive total knee replacement group. Mean flexion for minimally invasive total knee replacement at 6 and 12 weeks was 114 degrees (range, 90-132 degrees ) and 122 degrees (range, 103-135 degrees ) respectively, compared with 95 degrees (range, 65-125 degrees ) and 110 degrees (range, 80-125 degrees ) for the control group. Improved range of motion was also seen at one year postoperatively. The average range of motion at one year postoperatively in the minimally invasive total knee replacement was 125 degrees (range, 110-135 degrees ) compared with 116 degrees (range, 95-130 degrees ) in the Control Group. Postoperative Knee Society scores were also higher in the minimally invasive total knee replacement group. There was no difference in xray alignment. There were no infections, extensor mechanism or neurovascular complications. The mini midvastus approach without patella eversion combined with a small incision was associated with a more rapid functional recovery and improved range of motion in total knee replacement without compromising implant positioning.

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