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Related Concept Videos

Knee Joint01:23

Knee Joint

3.4K
The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
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Ankle Joint01:10

Ankle Joint

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Use of interrupted time-series analyses in evaluating health economic outcomes following implementation of multilayer water-tight wound closure in a primary total joint arthroplasty population.

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A Case Series of Successful Abdominal Closure Utilizing a Novel Technique Combining a Mechanical Closure System with a Biologic Xenograft that Accelerates Wound Healing
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Advanced Multi-Layer Watertight Closure versus Conventional Closure in Total Hip and Knee Replacement Surgery.

Jana L Flener1, Brian Po-Han Chen2, Frank R Ernst3

  • 1Proliance Orthopedic Associates, Renton, WA, USA.

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|July 25, 2024
PubMed
Summary

Advanced multi-layer, watertight closure in total joint replacement significantly reduces hospital stay and reoperation rates. This method also increases the likelihood of patients being discharged directly home, improving overall outcomes.

Keywords:
dermabond prineostratafixtotal joint arthroplastywound closure

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Area of Science:

  • Orthopedic Surgery
  • Surgical Wound Management
  • Health Economics

Background:

  • Total joint replacement procedures increasingly utilize advanced multi-layer, watertight closure techniques.
  • Conventional closure methods involve sutures and skin staples.

Purpose of the Study:

  • To compare clinical and economic outcomes of advanced multi-layer, watertight closure versus conventional closure in total joint replacement.
  • To evaluate the impact on surgical site infections, length of stay, and readmissions.

Main Methods:

  • A retrospective study compared 434 patients with advanced closure to 1394 patients with conventional closure for hip or knee arthroplasty.
  • Multivariable regression analysis assessed outcomes including length of stay, reoperations, and discharge status.

Main Results:

  • Advanced closure was associated with a significantly longer time to readmission (89.9 vs 51.1 days) and lower reoperation rates within 90 days (0.0% vs 2.6%).
  • Patients with advanced closure had a shorter mean hospital stay (1.10 vs 1.65 days) and were more likely to be discharged home (OR: 4.61).

Conclusions:

  • Advanced multi-layer, watertight closure is linked to shorter inpatient stays and higher home discharge rates in total hip and knee arthroplasty.
  • This closure method is a valuable component of optimized surgical workflows, potentially benefiting high-risk patients.