Advances in Joint Replacement
|
|
|
- Mildred Nelson
- 5 years ago
- Views:
Transcription
1 Advances in Joint Replacement Seth Greenky, MD Chairman, Musculoskeletal Services, St. Joseph s Hospital Partner, Syracuse Orthopedic Specialists Associate Clinical Professor, Upstate Medical Center CoMedical Director, Operation Walk Syracuse March 2, 2018
2 Preoperative: Hardstops None Surgery Exclusion/Hardstop List (surgery not to proceed without review by Joint Council) BMI<19 BMI >40 Hgb A-1 C >8.0 Day of Surgery Glucose >170 Hgb <12 No intra-articular injections of any medication for 3 months prior to surgery Cardiology Consult for any pt > 75 or if has seen cardiologist in 5 years prior to surgery Smoking: Must stop for minimum of 14 days TSH (draw at time of Hgb A-1C) Albumen <3.5 gm/dl (draw at time of Hgb A-1C)
3 Preoperative: Physical Therapy None Prehab Conditioning & Education
4 Preoperative: Patient Education Minimal Mandatory Joint Classes Written patient guides Coaches
5 Preoperative: Care Coordination Patient led Nurse Navigators Patient Engagement Tools
6 Preoperative: Patient Resources Few to None SOS Patient Ambassador Program
7 Preoperative: Informed Consent/Shared Decision Making Physician Led Shared Decision Making
8 Preoperative: Preadmission Testing H&P H&P Robust Preop Clearance & Optimization Process Anemia Management/Iron Infusion Nutritional Counseling MRSA Screening
9 Hospitalization: Day of Surgery Intake & Prep General Admission day of surgery or night before surgery Dedicated Ortho Rapid Admit Nurses
10 Hospitalization: Anesthesia Primarily General Anesthesia administered in the OR Epidural anesthesia Short Acting Spinal Anesthesia Regional Blocks (adductor canal, femoral) Dedicated ortho anesthesia teams Dedicated Preinduction Area for Spinals & Blocks
11 Hospitalization: Intraoperative Generalized OR Team Single OR Room Skin Closure with Staples/Bulky Dressing Urinary Catheter is standard of care Orthopedic Specialty Teams Flip Rooms Skin closure alternatives such as Dermabond Prineo Aquacel Dressings Controlled hypotension Tranexamic Acid Aquamantys
12 Hospitalization: Intraoperative Hip Approaches: Hip Approaches: Posterolateral Anterolateral Direct Anterior Direct Superior Posterolateral Anterolateral
13 Hip Approaches Posterolateral Lateral Direct Anterior Direct Superior
14 Hospitalization: Intraoperative Technology None Robotics Navigation PSI Patient Specific Instrumentation
15 Surgical Site Infection Prevention Minimal In-Room Traffic Ultraviolet Lights Surgical Hoods MRSA Screening and Decolonization Antibiotic Dosing, Timing, and Selection Medicated Irrigations Perioperative Normothermia Strict Perioperative Glucose Control Anemia Management Surgical Hand Asepsis and Skin Prep Advances Procedural Hardstops Patient Education
16
17 Hospitalization: Intraoperative Unicompartmental Arthritis Unicompartmental Arthritis: Treatment: Total Knee Replacement Treatment: Unicompartmental or Partial Knee Replacement
18 Hospitalization: Intraoperative Implants Materials and Fixation Cemented prostheses Porous coated Polyethylene Early ceramic technology Metal on Metal metallosis Perfection of alloys Advancement in porous ingrowth Pressfit knees Cross-linked polyethylene Vitamin E Polyethylene Advanced ceramic technology Manufacturing advancements 3-D Printing
19 Pain Management Demerol/Vistaril On Call to OR No Intraoperative Intervention Preoperative Pain Cocktail Preoperative medications to be administered just prior to transport to Operating Room: Acetaminophen 975mg PO Neurontin 600 mg PO Decadron 8 mg IVP, *hold if patient is a Diabetic or if stress dose steroids are ordered* Zofran 4 mg IVP IR Oxycodone 10 mg PO if less than 70 years old - OR- IR Oxycodone 5 mg PO if 70 years old or older- Hold if patient took opioid today prior to admission Reglan 10mg IVP Other: Intraoperative Injection: Morphine, Toradol, Bupivacaine Postoperatively: Pain Buster PO Narcotics Epidural Morphine PCA Ice Bags Preoperative Regional Blocks: Adductor canal and femoral Postoperatively: Minimal Opioids Toradol, Tramadol, and Tylenol Automated Icing Units
20 Hospitalization: Postoperative Care Foley Catheter VTE Prophylaxis: Coumadin No catheter and bladder scan VTE Prophylaxis: ASA 81 mg QD **risk stratification**
21 Hospitalization: Postoperative Mobility Stand at bedside on day of surgery Strict Hip Precautions OOB & ambulate day of surgery 90% stair savvy Minimal Hip Precautions approach sensitive DA/Lateral (Harding)/Direct Superior Approach: no hip precautions Posterior lateral: avoid flexion combined with internal rotation x3 weeks
22 Physical Therapy/Activity Responsibility of the Physical Therapist Total Knee Replacement: Inpatient and Homecare and/or Rehab Responsibility of the Patient Total Knee Replacement: Goal is OP PT Only Total Hip Replacement: Inpatient and Homecare and/or Rehab Return to work no sooner than 3 months Total Hip Replacement: Two Schools of Thought: Plan A initiate PT at days postop Plan B possibly not necessary but if needed, begin at weeks Return to work at 3-5 weeks for hips and 6-10 weeks for knees
23 Discharge Disposition Short Term Rehab: 80% Short Term Rehab: <30% Homecare Service: 100% Homecare Services: 30% Home with OP PT Only: 40%
24 Outcomes Correlate with Volume
25
26
27
28 Questions?
Day of Surgery Discharge after Unicompartmental Knee Arthroplasty (UKA): An Effective Perioperative Pathway. Jay Patel, MD Hoag Orthopedic Institute
Day of Surgery Discharge after Unicompartmental Knee Arthroplasty (UKA): An Effective Perioperative Pathway Jay Patel, MD Hoag Orthopedic Institute UKA Rapid Recovery Protocol Purpose of Study Describe
EMERGING EVIDENCE AND BEST PRACTICES TO PREVENT SSI IN COLON PROCEDURES
EMERGING EVIDENCE AND BEST PRACTICES TO PREVENT SSI IN COLON PROCEDURES Clifford Ko, MD, MS, MSHS, FACS, FASCRS Professor of Surgery UCLA Director, ACS NSQIP, American College of Surgeons EVIDENCE Ban
ENHANCED RECOVERY PROTOCOLS FOR KNEE REPLACEMENT
ENHANCED RECOVERY PROTOCOLS FOR KNEE REPLACEMENT Jeff Gadsden, MD, FRCPC, FANZCA Associate Professor Duke University Department of Anesthesiology Regional Anesthesia and Acute Pain Medicine DISCLOSURES
Enhanced Recovery after Surgery
Enhanced Recovery after Surgery AKA ERAS What is Enhanced Recovery (ER)? Paradigm shift in surgery and surgical care of the patient Philosophy of care Perioperative continuum Multidisciplinary Patient
ST. DOMINIC-JACKSON MEMORIAL HOSPITAL JACKSON, MISSISSIPPI
Date & Time Post-Op Inpatient General Orthopedic Page 1 of 5 Pharmacy Mnemonic: POIGOP1 1. Admit as inpatient to Dr. 2.Diagnosis: 3.Admit to PACU and then to floor ICU 4.Radiology: AP Pelvis in PACU AP
(Page 1 of 5) Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental Knee Left Total Hip Revision Total Shoulder
(Page 1 of 5) Allergies/Sensitivities/Reactions: Height: Inches cm Weight: Kg Pounds = Automatic = Physician s option, Check off to Order Diagnosis: Procedure: Right Total Knee Replacement Unicompartmental
Multi-Modal Pain Management
Multi-Modal Pain Management July 14th, 2017 Todd Edmiston, MD Disclosures None Fellowship training in Sports and Adult Reconstruction Director of Orthopaedic Center, South Baldwin Regional Medical Center,
Baptist Health Lexington. ERAS Protocols
Baptist Health Lexington ERAS Protocols Enhanced Recovery After Surgery BHLex Colorectal ERAS Protocol Preoperative Patient/Family Education: PAT and office, ERAS brochure & educational flyer/checklist
Anesthetic Techniques for Rapid Recovery in Total Knee Arthroplasty
Anesthetic Techniques for Rapid Recovery in Total Knee Arthroplasty Scott T. Ball, MD Chief, Adult Joint Reconstruction Department of Orthopaedic Surgery University of California, San Diego Disclosures
Disclosures. Total knee and Total Hip Replacement, a Fast Track. Outline of my talk. What is Fast Track Arthroplasty? I have nothing to disclose
Total knee and Total Hip Replacement, a Fast Track Muhammad I Shaikh M.D.,Ph.D. Associate Professor of Anesthesiology, UCSF Outline of my talk Definition of Fast Track Principles of FT as applied to Orthopedics
Same Day Total Joint Replacement A Byproduct of Synergy from a Comprehensive Approach. Disclosures. Just 25 Years Ago
Total Joint Replacement A Byproduct of Synergy from a Comprehensive Approach Richard Berger, MD Rush Medical Center Chicago, IL Disclosures Zimmer, Inc Microport, inc Just 25 Years Ago Arthroscopic ACL
Outpatient Total Knee Arthroplasty: Anesthetic Implications
Outpatient Total Knee Arthroplasty: Anesthetic Implications Anthony Edelman, MD, MBA Clinical Assistant Professor Director, Division of Orthopedic Anesthesia Disclosures None Objectives Examine current
Assessment. Consults & Referrals
University of Virginia Health System Clinical Pathway: Whipple Enhanced Recovery After () LOS: 4-5 days Date of Origin/Revision: June 29, 2016/September 6, 2017/January 31, 2018 : SAS : : : D1 D2 D 3/
Early Recovery after Surgery (ERAS):
Early Recovery after Surgery (ERAS): Applying Consistently What We ve Known for 20 Years Dr. Kurt Heiss, MD Objectives Laying Foundation: Who, Why Explore Components: What Start a Program: How and When
Click to edit Master subtitle style
Does Enhanced Recovery Improve Outcomes? Click to edit Master subtitle style Kaare Weber, MD Director of Surgery Associate Medical Director, Surgery A MEMBER OF THE MONTEFIORE HEALTH SYSTEM mes? Click
Partial Knee Replacement
Partial Knee Replacement A partial knee replacement removes damaged cartilage from the knee and replaces it with prosthetic implants. Unlike a total knee replacement, which removes all of the cartilage,
Acute Peri-Operative Pain Management Strategies
Slide 1 Acute Peri-Operative Pain Management Strategies Phillip Gallegos, MD USAP Pinnacle Anesthesiologist Director of Anesthesia and Peri-Operative Medicine BOSHA Slide 2 ERAS Enhanced Recovery After
Management of Hip Fractures
Management of Hip Fractures in the Elderly Patient David A. Brown MD COL U.S. Army Ret. The Center for Orthopedics and Neurosurgery Optimizing Management of Hip Fractures in the Elderly Patient Optimizing
Objectives GRAND TOTAL OF 4! SAME DAY SURGERY TJA NICHOLAS SOTEREANOS MD DISCLOSURES - ZIMMER CONSULTANT 04/12/2016 REMEMBER PATIENTS NEED PROVIDERS
SAME DAY SURGERY TJA NICHOLAS SOTEREANOS MD DISCLOSURES - ZIMMER CONSULTANT EXEC. VICE CHAIRMAN ORTHOPAEDICS ALLEGHENY GENERAL HOSPITAL Objectives DISJOINTED RAMBLINGS OF AN OLD MAD MAN INTERSPERSED WITH
TOTAL HIP REPLACEMENT Doug Thompson, MD PROCEDURE The purpose of the total hip replacement procedure is to replace diseased worn joint cartilage with
PROCEDURE The purpose of the total hip replacement procedure is to replace diseased worn joint cartilage with metal and plastic to reduce or eliminate pain, decrease deformity, and improve function. An
Turlough O Hare, MD, FRCPC, MSc Assistant Clinical Professor, Department of Anesthesia, St. Joseph s Healthcare Hamilton McMaster University
Turlough O Hare, MD, FRCPC, MSc Assistant Clinical Professor, Department of Anesthesia, St. Joseph s Healthcare Hamilton McMaster University To understand the current options available to best manage pain
Quality Improvement Updates Foley Discontinuation Protocol Surgical Care Improvement Project
Quality Improvement Updates Foley Discontinuation Protocol Surgical Care Improvement Project Barbara J Martin, RN, MBA Quality Consultant, Center for Clinical Improvement Indwelling Urinary Catheters Insertion,
PARTIAL KNEE REPLACEMENT
PARTIAL KNEE REPLACEMENT A partial knee replacement removes damaged cartilage from the knee and replaces it with prosthetic implants. Unlike a total knee replacement, which removes all of the cartilage,
Initials * Page 1 of 6. (place patient label here) Patient Name: Diagnosis: Allergies with reaction type:
Patient Name: Diagnosis: Allergies with reaction type: Orthopedic Upper Ext Post Op Version 3 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro General Medical
Evaluating the Effectiveness of Current Orthopaedic Pain Management Strategies
Evaluating the Effectiveness of Current Orthopaedic Pain Management Strategies TOPICS: Impact of Health Care Changes Current Strategies in Surgical Pain Management Implementing and Evaluating Pain Management
Orthopedic Admission Hip Fracture Version 2 1/25/2017
Patient Name: Initial each page and Sign/Date/Time last page Diagnosis: Allergies with reaction type: Orthopedic Admission Hip Fracture Version 2 1/25/2017 Patient Placement Patient Status If the physician
WHS POSTOPERATIVE POWERPLAN CHANGES
Medications simplified and standardized to improve safety and effectiveness in the management of pain, itching, nausea/vomiting. Management: o The Anesthesiologist will continue to manage pain in the PACU.
Development and Utilization of Standardized Hip Fracture Guidelines
Development and Utilization of Standardized Hip Fracture Guidelines Sally Knight RN Clinical Quality Nurse Lori Smith RN Clinical Quality Nurse Deborah Newall RN Orthopedic Program Coordinator Wallace
Total Hip Replacement Post Op Version 4 4/20/17
Patient Name: Diagnosis: Allergies with reaction type: Total Hip Replacement Post Op Version 4 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro General Medical
Nerve Blocks & Long Acting Analgesia for Plastic Surgeons. Karol A Gutowski, MD, FACS
Nerve Blocks & Long Acting Analgesia for Plastic Surgeons Karol A Gutowski, MD, FACS Disclosures None related to this topic Why is Non-Opioid Analgesia Important Opioid epidemic Less opioid use Less PONV
TOTAL KNEE REPLACEMENT Doug Thompson, MD PROCEDURE The purpose of the total knee replacement procedure is to replace diseased worn joint cartilage
PROCEDURE The purpose of the total knee replacement procedure is to replace diseased worn joint cartilage with metal and plastic to reduce or eliminate pain, decrease deformity, and improve function. An
Enhanced Recovery Thoracic Surgery. Esophagus Pathway
Enhanced Recovery Thoracic Surgery Esophagus Pathway Preoperative Patient Education/Expectations for Hospital and Home Medical Risk Consultation: Cardiac Clearance and PFTs for All Patients Surgery Wellness
Hip Hemiarthroplasty Post Op Version 2 4/20/17
Patient Name: Diagnosis: Allergies with reaction type: Hip Hemiarthroplasty Post Op Version 2 4/20/17 Patient Placement General Diagnosis/Procedure: Preferred Location/Unit Ortho/Neuro PCU ICU General
TOTAL HIP ARTHROPLASTY (Total Hip Replacement)
(Total Hip Replacement) The Hip Joint The hip is a ball and socket joint. The joint is formed by the head of the femur (thighbone) and the acetabulum (pelvis). The bones are coated in cartilage, which
Credentials: Advances in Hip Arthritis Treatment. About My Former Practice: What is Arthritis?
Advances in Hip Arthritis Treatment C. Brian Blackwood, MD www.boulderhipandknee.com (303) 974-4705 Credentials: University Of Washington- SOM University of New Mexico- Residency Coon Joint Replacement
1. Attending Physician: Dr Syn Pager: Cell: Co-Morbidities:
BARIATRIC SURGERY IMMEDIATE POST-OP PLAN (Includes Post Op Day 1) Denotes order requirement Antibiotic administered in the OR at: 1. Attending Physician: Dr Syn Pager: 740-6545 Cell: 438-9415 2. To remain
Anesthesia for Total Hip and Knee Arthroplasty
Anesthesia for Total Hip and Knee Arthroplasty Typical approach Describe anesthesia technique Rather Describe issues with THA and TKA How anesthesia can modify Issues Total Hip Total Knee Blood Loss ++
Pre-Operative Patient Instruction Form for a Robotic Partial Knee Replacement
Pre-Operative Patient Instruction Form for a Robotic Partial Knee Replacement What s Next: You will schedule a visit with your Primary Care Physician for a pre-operative history and physical to make sure
Management of elective cervical and lumbar spine surgery candidates age 18 years and older.
IMPORTANCE OF FOCUS According to the Spine Journal (2009), projections based on national health expenditure for spine surgery indicate spine surgical procedures/revisions are expected to grow significantly
REVERSE SHOULDER REPLACEMENT
REVERSE SHOULDER REPLACEMENT The Reverse Shoulder Replacement is designed specifically for the use in shoulders with a deficient rotator cuff and arthritis, as well as other difficult shoulder reconstructive
Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other
![Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other](/thumbs/96/128298591.jpg "Neurosurgery Pre-Op [1710] Patient Name MRN. General. Nursing. Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT [ ] Other")
Neurosurgery Pre-Op [1710] Patient Name MRN General Case Request [ ] Case request operating room Scheduling/ADT, Scheduling/ADT Inpatient Only Procedure (Single Response) ( ) Admit to Inpatient Diagnosis:
Objectives. Challenges of Geriatric Fractures. Faith Trial. Overview. Evidence 3/13/2017
Challenges of Geriatric Fractures Brian Buck, DO March 3, 2017 31st Annual Geriatric Conference Pearls of Geriatric Care Objectives Identify challenges of osteoporotic bone Describe some of the techniques
The intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia
The intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia This study has been published: The intensity of preoperative pain is directly correlated
TOTAL KNEE ARTHROPLASTY OUTPATIENT TOURNIQUETLESS
TOTAL KNEE ARTHROPLASTY OUTPATIENT TOURNIQUETLESS The key to total knee arthroplasty is to be prepared to dedicate yourself to the post-operative course that will best ensure a good outcome. THE main determinate
The in-hospital management of COPD-exacerbation includes three core processes:
Appendix 1A. Process flow for in-hospital management of COPDexacerbation The in-hospital management of COPD-exacerbation includes three core processes: 1. Diagnostic assessment 2. Pharmacological management
Evolutions in Geriatric Fracture Care Preparing for the Silver Tsunami
Evolutions in Geriatric Fracture Care Preparing for the Silver Tsunami James Holstine, DO Medical Director for the Joint Replacement Center, Geriatric Fracture Center, Orthopedic Surgeon PeaceHealth Whatcom
JOINT REPLACEMENT SEMINAR
JOINT REPLACEMENT SEMINAR WELCOME! Please write down any questions you may have during the presentation. We will host a question and answer session at the end.!! PRESENTER:! Jennifer Kiermaier, RN! Joint
What happens during your hospital stay. Revised May 23, 2012
What happens during your hospital stay Revised May 23, 2012 Day of Surgery Have the Valet service park your vehicle and come into the main entrance Go to Patient Registration in the main lobby of the hospital
Agenda. Case Discussions. Managing Acute & Chronic Pain (requiring opioid analgesics) in Patients on MAT. Daniel Alford, MD Disclosures
Managing Acute & Chronic Pain (requiring opioid analgesics) in Patients on MAT Case Discussions August 26, 2014 PCSS MAT Webinar Sponsored by the American Psychiatric Association Daniel P. Alford, MD,
Presentation at ACS NSQIP National Conference in July Surgical Site Infection Reduction Strategies
Presentation at ACS NSQIP National Conference in July 2015 Surgical Site Infection Reduction Strategies PeaceHealth Sacred Heart Medical Center at RiverBend Level II Trauma Center 379 Beds 15,060 cases
Thank you for choosing Saint Joseph s Hospital Health Center for your spine surgery. Updated Jan 2017
Thank you for choosing Saint Joseph s Hospital Health Center for your spine surgery Updated Jan 2017 This class is designed to give you some basic, important information about spine surgery We will cover
Total Knee Replacement
Total Knee Replacement A total knee replacement, also known as total knee arthroplasty, involves removing damaged portions of the knee, and capping the bony surfaces with man-made prosthetic implants.
Patient Label Here. ORTHOPEDIC POST-OPERATIVE ADMIT PLAN (Includes Post Op Days 1-2) Antibiotic administered in the OR at:
ORTHOPEDIC POST-OPERATIVE ADMIT PLAN (Includes Post Op Days 1-2) A UMC Health System Performance Improvement Initiative for use in all units where surgical patients receive care in support of Surgical
Intro Who should read this document 2 Key practice points 2 What is new in this version 3 Background 3 Guideline Subsection headings
Enhanced Recovery for Major Urology and Gynaecological Classification: Clinical Guideline Lead Author: Dr Dominic O Connor Additional author(s): Jane Kingham Authors Division: Anaesthesia Unique ID: DDCAna3(12)
Contributions To Safer Surgery At Valley Medical center
Contributions To Safer Surgery At Valley Medical center Safe Surgery Initiatives The Joint Commission World Health Organization Institute for Healthcare Improvement WSHA Qualis Safe Surgery Initiatives
TOTAL JOINT REPLACEMENT REHABILITATION
TOTAL JOINT REPLACEMENT REHABILITATION Tammy King, PT, MHS, DPT President, Achieve Home Care, Adjunct Professor, South University PTA Program POLL OPEN WHICH CATEGORY BEST CAPTURES YOUR CREDENTIALS? 1
Pain Management Protocol in Adolescent Idiopathic Spinal Fusion Reduces Length of Stay and Complications
Pain Management Protocol in Adolescent Idiopathic Spinal Fusion Reduces Length of Stay and Complications Abstract Authors: Karen Martin, RHIT, CPHQ - Surgical Clinical Reviewer - Quality Management Analyst,
The Hip from Cradle to Grave. Haemish Crawford Ascot Hospital Starship Children s Hospital
The Hip from Cradle to Grave Haemish Crawford Ascot Hospital Starship Children s Hospital Developmental dysplasia hip DDH Irritable vs. septic hip Perthes disease Slipped Upper Femoral Epiphysis (SUFE)
Total Joint Replacement
Total Joint Replacement Physical Therapy: Therapy begins the day of or day after surgery, depending on your doctor. You are expected to participate in 2 sessions per day. Total Knee Replacement Patients
Summary of Delirium Clinical Practice Guideline Recommendations Post Operative
Summary of Delirium Clinical Practice Guideline Recommendations Post Operative Intensive Care Unit Clinical Practice Guideline for Postoperative Clinical Practice Guidelines for the Delirium in Older Adults;
9/5/17. Anesthetic considerations for patients with implanted devices for treating chronic pain and more. Objectives:
Anesthetic considerations for patients with implanted devices for treating chronic pain and more Alaa Abd-Elsayed, MD, MPH Medical Director, UW Pain Services Medical Director, Pain Clinic Section Head,
FINAL PROGRAM SCHEDULE
AAOS/AAHKS/The Hip Society Meeting the Challenges of Total Hip Arthroplasty: Approaches, Complications and Contemporary Issues FINAL PROGRAM SCHEDULE 16.5 CME Credits July 20 22, 2017 OLC Education & Conference
LONG TERM CARE FACILITY ADMIT ORDERS
Page 1 of 7 LONG TERM CARE FACILITY ADMIT ORDERS ADMISSION: Admit patient to Skilled Nursing Facility: Admit patient to Acute Rehabilitation Facility: Admit patient to Subacute Rehabilitation Facility:
Sébastien LUSTIG MD, PhD, Prof *,** Tristan Ferry ** Frederic Laurent ** *Albert Trillat Center- Lyon, **CRIOA Lyon
SICOT Meeting Roma September 2016 Risk factors of periprosthetic infection and my experience of how to prevent an infection Sébastien LUSTIG MD, PhD, Prof *,** Tristan Ferry ** Frederic Laurent ** *Albert
Enhanced Recovery from Total Knee Arthroplasty. Danielle Stahla, BSN January 27, 2016
Enhanced Recovery from Total Knee Arthroplasty Danielle Stahla, BSN January 27, 2016 Indications for TKA Goals of Total Knee Replacement Surgery Decrease pain Improve muscle strength Increase range of
To staple or to sew. Zeng Xuan Hu
To staple or to sew Zeng Xuan Hu Fast Track Surgery Multimodal Rehabilitation Accelerated recovery Accelerated rehabilitation Enhanced recovery Optimize perioperative care by reducing the expected stress
TOTAL HIP REPLACEMENT:
THR Prosthesis Design TOTAL HIP REPLACEMENT: PROSTHESIS DESIGN FEATURES JESS JOHNSTON & MELINDA ZIETH History of Hip Prosthesis Joint Replacement Registry Implant Design Technology & Future History and
DAYTON CHILDREN S HOSPITAL CLINICAL PRACTICE GUIDELINES
DATO CHILDRE S HOSPITAL CLIICAL PRACTICE GUIDELIES DISCLAIMER: This Clinical Practice Guideline (CPG) generally describes a recommended course of treatment for patients with the identified health needs.
Alberta Surgical Fractured Hip Care Pathway Version 3: Last Updated February 9, 2018
Alberta Surgical Fractured Hip Care Pathway Assessment / Pain Mngmt EMS Transport Neurovascular assessment Vital signs Pain assessment Splint only (no traction) Position of comfort Start IV and use appropriate
TOTAL KNEE REPLACEMENT. Surgical Treatment for Advanced Pain due to Arthritis. Dr. Adam S. Rosen
TOTAL KNEE REPLACEMENT Surgical Treatment for Advanced Pain due to Arthritis Dr. Adam S. Rosen What is Arthritis? How do you treat Arthritis? Arthritis is an inflammation of the joint due to loss of cartilage.
1 of 5. Integrated Order Set Inpatient, Adult. Gynecological Surgery Enhanced Recovery Orders apply to patients 18 years and older.
Orders apply to patients 18 years and older. All preprinted doses are based on normal renal and hepatic function and must be assessed for adjustment against the individual patient s renal and hepatic function
TOTAL HIP REPLACEMENT JOHN R. MOORE, IV, M.D.
TOTAL HIP REPLACEMENT JOHN R. MOORE, IV, M.D. Since you have progressed to the point of serious consideration of total hip replacement, there is a great deal of information that is important for you to
Page 1 of 6. Appendix 1
Page 1 Appendix 1 Rotation Objectives and Schedule 1. Introductory Month 4 weeks 2. Total Joints 4 weeks a. Diagnosis and management of hip and knee arthritis b. Indications for surgery c. Implant selection;
EARLY CLINICAL RESULTS OF PRIMARY CEMENTLESS TOTAL KNEE ARTHROPLASTY
EARLY CLINICAL RESULTS OF PRIMARY CEMENTLESS TOTAL KNEE ARTHROPLASTY Benkovich V. Perry T., Bunin A., Bilenko V., Unit for Joint Arthroplasty, Soroka Medical Center Ben Gurion University of Negev Beer
Lumbar Fusion. Reference Guide for PACU CLINICAL PATHWAY. All patient variances to the pathway are to be circled and addressed in the progress notes.
Reference Guide for PACU Lumbar Fusion CLINICAL PATHWAY All patient variances to the pathway are to be circled and addressed in the progress notes. This Clinical Pathway is intended to assist in clinical
ADVANCES IN JOINT REPLACEMENT AND REHABILITATION IMPLICATIONS
ADVANCES IN JOINT REPLACEMENT AND REHABILITATION IMPLICATIONS VALENTIN ANTOCI JR. MD PHD Hip and Knee Surgeon Assistant Professor of Orthopedic Surgery Alpert Medical School with Brown University University
A Best Practice Clinical Care Pathway for Major Amputation Surgery
A Best Practice Clinical Care Pathway for Major Amputation Surgery April 2016 Introduction The perioperative mortality rate after major lower limb amputation in the UK is unacceptably high in modern medical
Is Local Infiltration Analgesia (LIA) a Safe and Effective Method for Post-Operative Pain Management After a Unilateral Total Knee Arthroplasty (TKA)?
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2013 Is Local Infiltration Analgesia (LIA)
AMI Talking Points. Provide appropriate treatment to Acute MI patients with these core measures:
AMI Provide appropriate treatment to Acute MI patients with these core measures: Aspirin received within 24 hours of arrival or contraindication documented Primary PCI Received Within 90 Minutes of Hospital
Bariatric Surgery Post Op Plan PACU Phase
Bariatric Surgery Post Op Plan PACU Phase PHYSICIAN S Weight Allergies Admit/Discharge/Transfer Patient Status Pt Status: Inpatient (LOS > 2 midnights) Pt Status: Observation (LOS < 2 midnights) Code Status
Loss of Independence is associated with readmission and delayed death in older surgical patients
Loss of Independence is associated with readmission and delayed death in older surgical patients @BerianJulia July 18, 2016 ACS NSQIP 2016 Annual Meeting Julia R. Berian MD,MS; Clifford Y. Ko MD,MS,MSHS;
Pre-op Clinical Triad - Pulmonary. Sammy Pedram, MD FCCP Assistant Professor of Medicine Pulmonary & Critical Care Medicine March 16, 2018
Pre-op Clinical Triad - Pulmonary Sammy Pedram, MD FCCP Assistant Professor of Medicine Pulmonary & Critical Care Medicine March 16, 2018 Disclosures none Case Mr. G is a 64 year-old man who presents to
Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017
Patient Name: Diagnosis: Allergies with reaction type: Bariatric Surgery Post Op Day Version 2 Approved 11/13/2017 Diagnosis Preferred Location/Unit Surgical ICU Code Status: Full Code Activity Ambulate
Ambulatory Knee Arthroplasty
Ambulatory Knee Arthroplasty Harlan B. Levine, MD Hartzband Center for Hip & Knee Replacement Hackensack University Medical Center Hackensack, New Jersey Disclosure Zimmer Consultant Biomet Consultant
OUTPATIENT TOTAL HIP REPLACEMENT JOHN R. MOORE, IV, M.D.
OUTPATIENT TOTAL HIP REPLACEMENT JOHN R. MOORE, IV, M.D. Since you have progressed to the point of serious consideration of total hip replacement, there is a great deal of information that is important
Minimally Invasive Hip and Knee Replacement in the Active Patient
Minimally Invasive Hip and Knee Replacement in the Active Patient Updates and Emerging Technologies in Diagnosis, Treatment, and Outcomes Ravi K. Bashyal, MD NorthShore University HealthSystem Department
DIRECT SUPERIOR HIP APPROACH IN TOTAL HIP ARTHROPLASTY. Anil Thomas, MD Adult Reconstruction Peachtree Orthopedics Atlanta, GA
DIRECT SUPERIOR HIP APPROACH IN TOTAL HIP ARTHROPLASTY Anil Thomas, MD Adult Reconstruction Peachtree Orthopedics Atlanta, GA Disclosures None Direct Superior Approach History and development of the approach
Meeting the Challenges of Total Hip Arthroplasty: Approaches, Complications and Contemporary Issues
AAOS/AAHKS/The Hip Society Meeting the Challenges of Total Hip Arthroplasty: Approaches, Complications and Contemporary Issues 16.5 CME Credits SURGICAL SKILLS July 20 22, 2017 OLC Education & Conference
Cartilage : elastic tissue to cushion Ligaments : connects bone to bone Tendons : connects muscle to bone
Dr. (Prof.) Anil Arora MS (Ortho) DNB (Ortho) Dip SIROT (USA) FAPOA (Korea), FIGOF (Germany), FJOA (Japan) Commonwealth Fellow Joint Replacement (Royal National Orthopaedic Hospital, London, UK) Senior
Analgesia for ERAS programs. Dr Igor Lemech VMO Anaesthetist Wagga Wagga Base Hospital
Analgesia for ERAS programs Dr Igor Lemech VMO Anaesthetist Wagga Wagga Base Hospital Disclosure I have received honoraria from Mundipharma and MSD The new Wagga Wagga Rural Referral Centre Scope Analgesic
ESCOME Pre-Course Outline (v1.09)
ESCOME Pre-Course Outline (v1.09) 1. Basics of Spinal Disorders Introduction to Spinal Surgery Spinal Anatomy Introduction to Vertebral Anatomical Concepts Anatomy and Function of Joints and Ligaments
Vanguard. Total Knee System
Vanguard Total Knee System Why remove healthy ligaments? DISCOVER NATURE AT WORK Bicruciate preserving total knee arthroplasty Thanks to a group of dedicated surgeons and designers, Biomet proudly introduces
The Perioperative Care Chain is Only as Strong as its weakest link
The Perioperative Care Chain is Only as Strong as its weakest link Associate Professor Kerin Fielding The University of Notre Dame, Australia School of Medicine, Sydney Outline The perioperative chain
Gabapentin Does Not Improve Analgesia Outcomes For Total Joint Replacement. Manyat Nantha-Aree, MD
Gabapentin Does Not Improve Analgesia Outcomes For Total Joint Replacement Manyat Nantha-Aree, MD Objective n Preliminary results of MOBILE study in total hip and knee arthroplasty Background n Gabapentin=
ALTRU HEALTH SYSTEM Grand Forks, ND STANDARD GUIDELINE
ALTRU HEALTH SYSTEM Grand Forks, ND STANDARD GUIDELINE Title: BACLOFEN PUMP PROGRAM (INTRATHECAL) Issued by: Physical Medicine and Outpatient Therapy Date: 6/99 Reviewed: 2/17 Revision: 2/11 Page: 1 of
Cartilage Repair Center
Cartilage Repair Center Tom Minas, MD, MS 901 45 th Street, Kimmel Building West Palm Beach, FL 33407 P: 561-844-5255 F: 561-844-5945 Gwen Watkins, Admin Ext 246 www.cartilagerepaircenter.org www.paleyinstitute.org
PRE- AND POST-SURGERY INSTRUCTIONS FOR SPINE PATIENTS
PRE- AND POST-SURGERY INSTRUCTIONS FOR SPINE PATIENTS Medications: Narcotics: The orthopaedic office does not prescribe narcotics for pain prior to operations, with some exceptions. If you have pain that
If you reduce variability in volume administration, HOW. you can reduce post-surgical complications, LOS and associated costs 1-4
A large body of clinical evidence* demonstrates If you reduce variability in volume administration, you can reduce post-surgical complications, LOS and associated costs 1-4 Complications Too Dry Too Wet
Physician Orders ADULT: Ortho Total Joint Plan
Initiate Orders Phase Non Categorized R Powerplan Open Care Sets/Protocols/PowerPlans Initiate Powerplan Phase Phase: Ortho Total Joint Preop Phase, When to Initiate: Other-See Special Instructions, initiate
Rotator Cuff Repair Protocol
Rotator Cuff Repair Protocol Applicability: Physician Practices Date Effective: 11/2016 Department: Rehabilitation Services Supersedes: Rotator Cuff Repair (Beattie) Date Last Reviewed / or Date Last Revision: