Orthopedic Research and Reviews最新文献

{"title":"Improving the Management of Patients with Osteoporosis Undergoing Spinal Fusion: The Need for a Bone Mineral Density-Matched Interbody Cage.","authors":"Steven M Falowski,&nbsp;Sebastian F Koga,&nbsp;Trent Northcutt,&nbsp;Laszlo Garamszegi,&nbsp;Jeremi Leasure,&nbsp;Jon E Block","doi":"10.2147/ORR.S339222","DOIUrl":"https://doi.org/10.2147/ORR.S339222","url":null,"abstract":"<p><p>With an increasingly aging population globally, a confluence has emerged between the rising prevalence of degenerative spinal disease and osteoporosis. Fusion of the anterior spinal column remains the mainstay surgical intervention for many spinal degenerative disorders. However, decreased vertebral bone mineral density (BMD), quantitatively measured by dual x-ray absorptiometry (DXA), complicates treatment with surgical interbody fusion as weak underlying bone stock increases the risk of post-operative implant-related adverse events, including cage subsidence. There is a necessity for developing cages with advanced structural designs that incorporate bioengineering and architectural principles to tailor the interbody fusion device directly to the patient's BMD status. Specifically, lattice-designed cages that mimic the web-like structure of native cancellous bone have demonstrated excellent resistance to post-operative subsidence. This article provides an introductory profile of a spinal interbody implant designed intentionally to simulate the lattice structure of human cancellous bone, with a similar modulus of elasticity, and specialized to match a patient's bone status across the BMD continuum. The implant incorporates an open pore design where the degree of pore compactness directly corresponds to the patient's DXA-defined BMD status, including patients with osteoporosis.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"281-288"},"PeriodicalIF":2.0,"publicationDate":"2021-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/f1/orr-13-281.PMC8684416.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39745150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Kyphosis Reduction Using Cantilever Method in Thoracolumbar Spondylitis Tuberculosis: A Short-Term Follow-Up.","authors":"Didik Librianto,&nbsp;Ismail Hadisoebroto Dilogo,&nbsp;Achmad Fauzi Kamal,&nbsp;Ifran Saleh,&nbsp;Fachrisal Ipang,&nbsp;Dina Aprilya","doi":"10.2147/ORR.S342365","DOIUrl":"https://doi.org/10.2147/ORR.S342365","url":null,"abstract":"<p><strong>Background: </strong>Kyphosis in spondylitis tuberculosis (STb) is more than just a cosmetic issue. It has a potentially detrimental effect on both spine-associated structures and cardiopulmonary function. It can be corrected in any stage of STb; however, the corrective surgery is challenging, especially in the late case, in which the additional stiffness of the spine can come into consideration. To date, the cantilever technique is still a gold standard for sagittal plane deformity correction. However, no study to date has explored its effectiveness for thoracolumbar kyphotic deformity, especially that caused by spondylitis tuberculosis.</p><p><strong>Methods: </strong>This is a retrospective study of 16 consecutive cases of spondylitis tuberculosis with thoracolumbar kyphosis that underwent corrective surgery in our center in the period of 2020-2021. We aim to evaluate the effectiveness of the cantilever technique that we use for kyphotic correction in thoracolumbar STb patients.</p><p><strong>Results: </strong>At the 3-months follow-up, the mean Cobb angle was 14.6°±10.27°, with the mean gain of 20.90°±12.00° and positively correlate with the thoracolumbar kyphosis (TLK) correction (68.69%, r = 0.654, p = 0.001). The mean thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were 30.6°±13.08°, 39.4°±16.02°, and 1.4±4.09 cm, respectively, with sagittal Cobb difference of 12.70±9.85.</p><p><strong>Conclusion: </strong>The kyphotic Cobb angle reduction by cantilever technique in the thoracolumbar area significantly improved the thoracolumbar kyphosis and realign the spinal sagittal axis. Thus, the cantilever technique remains the gold standard for sagittal plane deformity correction which can be applied for kyphotic deformity correction in thoracolumbar STb cases.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"275-280"},"PeriodicalIF":2.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/2e/orr-13-275.PMC8651210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39711067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Ponseti Technique in an Eleven-Year-Old with Bilateral Untreated Clubfoot: A Case Report.","authors":"Maria Wong,&nbsp;Mazelan Ali,&nbsp;Aik Saw","doi":"10.2147/ORR.S342738","DOIUrl":"https://doi.org/10.2147/ORR.S342738","url":null,"abstract":"<p><p>We report the case of an eleven-year-old girl with untreated bilateral clubfoot. She had a total of nine long leg castings changed weekly, Achilles tendon Z-lengthening and posterior ankle release followed by another six weeks of long leg cast immobilization post-operatively. We encouraged using night-time foot abduction brace for twelve months. Independent walking was achieved six months post-treatment. No recurrence was noted at eighteen months following treatment. The modified Ponseti weekly casting method was successful up to adolescent age; however, more cast changes, longer stretching before each cast application and posterior ankle release will be needed to achieve functional correction.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"247-254"},"PeriodicalIF":2.0,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/16/orr-13-247.PMC8648273.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39703837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Literature Review and Expert Opinion for the Use of Viscosupplementation with Hyaluronic Acid in Different Localizations of Osteoarthritis.","authors":"Alberto Migliore,&nbsp;Gianfranco Gigliucci,&nbsp;Lyudmila Alekseeva,&nbsp;Raveendhara R Bannuru,&nbsp;Tomasz Blicharski,&nbsp;Demirhan Diracoglu,&nbsp;Athanasios Georgiadis,&nbsp;Hesham Hamoud,&nbsp;Natalia Martusevich,&nbsp;Marco Matucci Cerinic,&nbsp;Jan Perduk,&nbsp;Imre Szerb,&nbsp;Tomáš Trč,&nbsp;Xavier Chevalier","doi":"10.2147/ORR.S336185","DOIUrl":"https://doi.org/10.2147/ORR.S336185","url":null,"abstract":"<p><p>Osteoarthritis (OA) is a significant cause of disability. Considering the increasing diffusion of the viscosupplementation (VS) with hyaluronic acid (HA), the International Symposium Intra Articular Treatment (ISIAT) appointed a Technical Expert Panel (TEP) to identify the criteria for successful VS with a specific HA in OA; this through a systematic literature review (SLR), performed following the PRISMA guidelines interrogating Medline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Grey Matters and American College of Rheumatology (ACR/EULAR) databases and the opinion of international experts. The research included only studies on adults and humans without limitations of language or time of publication. Researchers extracted both quantitative and qualitative data from each study. Mixed Methods Appraisal Tool (MMAT) was used to perform quality analysis for the level of evidence. The SLR retrieved 385 papers, 25 of which were suitable for the analysis. The TEP focused on the different formulations of the product Sinovial^® [HA 0.8%, HA 1.6%, HA 2%, 800-1200 kDa, HA 3.2% (1400-2100 kDa/65-110 kDa)]. The choice was due to the vast amount of evidence available. The TEP weighed the evidence in two rounds of a Delphi survey; the results, and any disagreement, were discussed in a final session. Three domains were considered: 1) the patients' characteristics associated with the best results; 2) the contraindications and the conditions linked to increased risk of failure; 3) the clinical conditions in which VS is considered appropriate. The TEP concluded that VS with HA is safe and effective in the treatment of knee and hip OA of grades I to III and that it is possible to undertake VS in other situations (eg grade IV Kellgren-Lawrence - KL); a comprehensive examination of the patient should be performed before the procedure.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"255-273"},"PeriodicalIF":2.0,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/cc/orr-13-255.PMC8648269.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39703838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monophasic Synovial Sarcoma in the Elbow Misclassified but Successfully Treated as Ewing's Sarcoma with Chemotherapy.","authors":"Maria Cecilia Madariaga,&nbsp;Alexander Duke,&nbsp;Syed T Hoda,&nbsp;Fazel Khan","doi":"10.2147/ORR.S332441","DOIUrl":"https://doi.org/10.2147/ORR.S332441","url":null,"abstract":"<p><p>To the best of the authors' knowledge, this is the first published case of monophasic synovial sarcoma (SS) initially diagnosed as Ewing's sarcoma (ES), yet successfully treated with chemotherapy in a 24-year-old patient. The initial diagnosis showed a monotonous round cell tumor and positivity for CD99, characteristic of ES; however, the cytology was negative for the classic EWSR1 rearrangement of ES. The patient was treated with the standard chemotherapy protocol of ES - COG AEWS1031 Regimen A with vincristine, doxorubicin, cyclophosphamide, and mesna - as well as with wide resection. Post-resection tissue submission showed additional morphologic features which led to a re-evaluation of the classification of the tumor as well as additional molecular studies; these revealed positivity for translocations of SS18 (18q11.1) in 100% of the nuclei, which is most characteristic of SS, thus, reclassifying the neoplasm as a SS tumor. This case underscores the importance of considering several pathologic entities in the differential diagnosis of small, round blue cell tumors, including ES, SS, and lymphoma. It also demonstrates the importance of using chromosomal identification for a more definitive diagnosis, rather than relying on histological features and markers which are found in more than one tumor classification. There is conflicting evidence of the impact of chemotherapy on survival in SS, as it is primarily treated with radiation therapy. Since SS is rare, prospective studies on the effect of chemotherapy on survival are limited in number. However, our case study demonstrates that chemotherapy is another modality that can be used in the treatment of SS neoplasms.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"241-245"},"PeriodicalIF":2.0,"publicationDate":"2021-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/c8/orr-13-241.PMC8636951.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39946471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Benchmarking Total Hip Arthroplasty Implants Using Data from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI).","authors":"Heather A Chubb, Eric R Cornish, Brian R Hallstrom, Richard E Hughes","doi":"10.2147/ORR.S325042","DOIUrl":"10.2147/ORR.S325042","url":null,"abstract":"<p><strong>Background: </strong>Benchmarking arthroplasty implant revision risk is an informative way to address implant performance. National benchmarking efforts exist in the United Kingdom, Netherlands, and Australia. Recently, the International Prosthesis Benchmarking Working Group, including representatives from industry, academia, and national registries, produced a guideline describing arthroplasty benchmarking methodology. The proposal was applied to data from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) to assess its feasibility for benchmarking implants in the United States.</p><p><strong>Methods: </strong>Primary elective total hip arthroplasty procedures performed for osteoarthritis between 2/15/2012 and 12/31/2018 and their associated revisions were identified in the MARCQI registry. The guidelines recommend that all prostheses combinations receive an early benchmark if they have at least 250 procedures at risk and the revision rate does not exceed the pre-determined standard of 2% at 2 years and 3% at 5 years.</p><p><strong>Results: </strong>A total of 72,949 primary cases met the inclusion criteria. Of these, 1369 had revisions. Twenty-nine and six stem/cup combinations satisfied the minimum case requirement at 2 and 5 years, respectively. Three implant combinations would not receive a benchmark at 2 years: Secur-Fit/Trident, Anthology/Reflection 3, Taperloc 133/G7.</p><p><strong>Conclusion: </strong>The guideline can be implemented in the United States by a regional registry. Moreover, not all hip implants currently in use would receive an early benchmark. This raises concern as these implant combinations represent a significant number of cases in Michigan, some with increasing utilization.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"215-228"},"PeriodicalIF":2.0,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/b2/orr-13-215.PMC8627892.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39683928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Biportal Endoscopic Lumbar Interbody Fusion: A Technical Note and an Outcome Comparison with the Conventional Minimally Invasive Fusion.","authors":"Asrafi Rizki Gatam,&nbsp;Luthfi Gatam,&nbsp;Harmantya Mahadhipta,&nbsp;Ajiantoro Ajiantoro,&nbsp;Omar Luthfi,&nbsp;Dina Aprilya","doi":"10.2147/ORR.S336479","DOIUrl":"https://doi.org/10.2147/ORR.S336479","url":null,"abstract":"<p><strong>Background: </strong>In the past few decades, the minimally invasive technique for spine surgery has developed extensively from the scope of decompression until fusion surgeries to reduce damages to the normal anatomical structure. Unilateral biportal endoscopic lumbar interbody fusion (ULIF) is one of the fusion options which is readily available without a sophisticated minimal invasive instrument. Our aim is to introduce ULIF experience in our center and comparing the result with conventional minimally invasive lumbar interbody fusion (MIS-TLIF).</p><p><strong>Methods: </strong>This is a retrospective cohort study of 145 lumbar spondylolisthesis cases that underwent fusion surgery with either ULIF or the conventional MIS-TLIF. All of the patients were observed within a 12-month follow-up period to evaluate the back pain and leg pain Visual Analogue Score (VAS), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and fusion rate.</p><p><strong>Results: </strong>The leg pain VAS was similarly improved in both groups. ULIF has a significant back pain improvement on direct post operation and at the 3-months follow-up (<i>p</i> value 0.032 and 0.046 respectively). ULIF group also had a significantly better improvement of ODI scores on the early post-operative period (<i>p</i>=0.045). However, both groups similarly showed improvement of ODI score and the SF-36 at the 3-, 6-, and 12- months follow up.</p><p><strong>Conclusion: </strong>Full endoscopic fusion surgery with ULIF offers a comparable long-term outcome and a significantly better back pain VAS reduction in short-term follow up compared to the conventional MIS-TLIF. ULIF, with further improvement, can be the next gold standard in managing degenerative lumbar spine conditions.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"229-239"},"PeriodicalIF":2.0,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/08/1e/orr-13-229.PMC8628045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39683929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Claw Hand Deformity: A Rare Complication of Herpes Zoster.","authors":"Tachit Jiravichitchai,&nbsp;Waree Chira-Adisai,&nbsp;Monratta Panuwannakorn,&nbsp;Sasisopin Kiertiburanakul","doi":"10.2147/ORR.S339064","DOIUrl":"https://doi.org/10.2147/ORR.S339064","url":null,"abstract":"<p><p>Distal upper extremity weakness is a rare complication after herpes zoster, which can be easily misdiagnosed by other nerve entrapment syndromes. We present a 31-year-old immunocompromised woman who developed a claw-like deformity of her right hand after full medical treatment and resolution of herpes zoster. The electrodiagnostic finding was compatible with right multiple mononeuropathies of the median and ulnar nerves, ongoing axonal loss, unlike the nerve entrapment patterns. The early recognition and early electrodiagnosis of herpes zoster-induced distal motor weakness, especially in the upper extremity, is necessary to exclude the nerve entrapment syndrome and to be the baseline for functional motor recovery prediction. The prognosis of functional motor recovery is considered good but may take months to years to accomplish. Rehabilitation management plays an important role after full medical treatment.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"209-214"},"PeriodicalIF":2.0,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/27/orr-13-209.PMC8607187.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39655857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of Internal Bracing in Elbow Medial UCL Stabilization: From Biomechanics to Clinical Application and Patient Outcomes.","authors":"Andre Anvari,&nbsp;Amir Fathi,&nbsp;Ioanna K Bolia,&nbsp;Eric Piatt,&nbsp;Laith K Hasan,&nbsp;Aryan Haratian,&nbsp;Alexander E Weber,&nbsp;Frank A Petrigliano","doi":"10.2147/ORR.S321890","DOIUrl":"https://doi.org/10.2147/ORR.S321890","url":null,"abstract":"<p><p>Ulnar collateral ligament (UCL) reconstruction has been successfully utilized to treat symptomatic UCL insufficiency in overhead athletes. Despite the overall success of the procedure, attempts have been made to improve upon the original technique with the goal of hastening return to sport. Most recently, there has been interest in repairing or reconstructing the native ligament with internal brace (IB) augmentation. Biomechanical cadaveric studies assessing UCL repair with IB augmentation have attempted to evaluate the efficacy of this treatment; however, the literature is seemingly divided on its benefit. Preliminary clinical studies suggest internal bracing may allow a faster return to sport than conventional techniques. The purpose of this review was to provide an analysis of the current evidence on IB augmentation in UCL repair of the elbow as it pertains to biomechanical advantages/disadvantages, reported surgical techniques, and clinical outcomes in comparison with traditional UCL reconstruction techniques.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"201-208"},"PeriodicalIF":2.0,"publicationDate":"2021-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/d3/orr-13-201.PMC8541765.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39569980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of Tranexamic Acid in Surgical Orthopaedic Practice: Indications and Current Considerations.","authors":"Aryan Haratian,&nbsp;Tara Shelby,&nbsp;Laith K Hasan,&nbsp;Ioanna K Bolia,&nbsp;Alexander E Weber,&nbsp;Frank A Petrigliano","doi":"10.2147/ORR.S321881","DOIUrl":"https://doi.org/10.2147/ORR.S321881","url":null,"abstract":"<p><p>Tranexamic acid (TXA) is a lysine analog that exhibits an anti-fibrinolytic effect by directly preventing the activation of plasminogen as well as inhibiting activated plasmin from degrading fibrin clots, thereby promoting hemostasis and reducing the duration and quantity of blood loss. The aims of this study were to summarize the indications, routes of administration, safety, and clinical outcomes of TXA use throughout the different subspecialities in orthopedic surgery. Given that orthopedic procedures such as TKA, THA, fracture fixation, and various spine surgeries involve significant intraoperative blood loss, TXA is indicated in providing effective perioperative hemostasis. Additionally, use of TXA in orthopedic trauma has been indicated as a measure to reduce blood loss especially in a group with potential for hemodynamic compromise. TXA has been implicated in reducing the risk of blood transfusions in orthopedic trauma, joint surgery, and spine surgery, although this effect is not seen as prominently in sports medicine procedures. There remains disagreement in literature as to whether TXA via any route of administration can improve other clinically significant outcomes such as hospital length of stay and total operative time. Procedures that rely extensively on clarity on visualization of the surgical field such as knee and shoulder arthroscopies can greatly benefit from the use of TXA, thereby leading to less intraoperative bleeding, with better visual clarity of the surgical field. While most studies agree thrombosis due to TXA is unlikely, new research in cells and animal models are evaluating whether TXA can negatively impact other aspects of musculoskeletal physiology, however with conflicting results thus far. As of now, TXA remains a safe and effective means of promoting hemostasis and reducing intraoperative blood loss in orthopedic surgery.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"187-199"},"PeriodicalIF":2.0,"publicationDate":"2021-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/37/orr-13-187.PMC8541761.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39569979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}