This procedure provides consistent and reproducible results in carefully selected patients and allows them an early return to sporting activities with minimal residual morbidity.
Purpose
There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic.
Methods
The consensus statements were generated using an anonymised 3 round modified Delphi questionnaire, sent to an international panel of 38 knee surgeons, with an 80% agreement being set as the limit for consensus. The responses were analysed using descriptive statistics with measures like mode, median and box plots. Feedback was provided to all panelists based on responses from the previous rounds to help generate the consensus.
Results
Six consensus statements were generated after the three rounds of Delphi. Patient factors, prolonged surgery duration and family history of thrombogenic events emerged as the main points to be taken into consideration for prophylaxis.
Conclusion
It was established through this study, that there exists a select group of patients undergoing arthroscopic surgery that justify the usage of VTE prophylaxis. The expert responses to most of the questions in different scenarios favoured usage of VTE prophylaxis based on patient factors like advanced age, past history of VTE, smoking, oral contraceptive use etc.
Level of evidence
Level V.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00167-022-06973-w.
Introduction: Knee osteoarthritis (OA) is a progressive degenerative condition and is a significant contributor toward physical disability in the aging population. The current
In recent times orthopedic surgeons have faced three common dilemmas in their day-to-day practice. These include changing patient profiles (fitness addict senior citizens), challenges in patient care (nonhealing osteoporotic fracture), and extensive use of whey proteins and other supplements by youngsters. Neutraceuticals science plays a vital role and is a valuable tool for orthopedicians in these scenarios complementing well with the standard of care. The recent COVID-19 pandemic and widespread misinformation have brought to the forefront limitations of science, social media's influence, and nutraceutical medicine's role in enhancing health and well-being. As nutraceuticals are in focus from all healthcare stakeholders -doctors, patients, and service providers an expert consensus is required to enhance bone, joints, and muscle health. A group of national orthopedics experts came together to achieve this consensus. The literature review on pharmacology, clinical data, and experts' experience in using nutraceuticals, formed the base of this consensus. This expert consensus will help bridge the void due to the absence of national and international guidelines on integrating modern and nutraceutical medicine. It will facilitate better patient care for bone, joint, and muscle health.
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