Possible Link Between Aerobic Exercise and Improvement in Cognitive Function in Patients With Vascular-Based Impairment

‘Proof of Concept’ Study Points to Possible Link Between Aerobic Exercise and Improvement in Cognitive Function in Patients With Vascular-Based Impairment

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Although results are far from conclusive, a recently published “proof of concept” study points to the possibility that aerobic exercise could improve cognitive performance among older adults with a type of impairment caused by problems with blood supply to the brain.

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Does Accelerated Physical Therapy After Elective Primary Hip and Knee Arthroplasty Facilitate Early Discharge?

Does Accelerated Physical Therapy After Elective Primary Hip and Knee Arthroplasty Facilitate Early Discharge?

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most effective surgical procedures in modern medicine. Use of primary THA in the United States is projected to increase by 174% by 2030, to 532,000 cases annually, and the estimate for TKA is even greater.1 Hospital length of stay (LOS) accounts for a significant portion of the overall cost of these procedures. Reducing LOS to limit costs without compromising patient safety, satisfaction, and outcomes remains the goal at all joint arthroplasty centers. Rapid-recovery or fast-track clinical pathways limiting opioid use and emphasizing patient education and early (day-of-surgery) mobilization have been shown to reduce LOS without compromising patient outcomes.2-5 Factors correlated with LOS after THA include surgical approach, use of multimodal analgesia, obesity, age, and social situations or living conditions.4,6-10Our institution recently implemented a protocol in which certified physical therapists provide accelerated (day-of-surgery) physical therapy (PT) for all total joint arthroplasty patients. For the study reported here, we hypothesized that, compared with PT started on postoperative day 1 (POD-1), PT started day of surgery (Day 0) would result in shorter LOS for unilateral primary THA and TKA patients. In addition, we wanted to evaluate any predischarge differences in function, as measured by gait distance, between the groups.

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Vascular Injury in Orthopedic Trauma

Vascular Injury in Orthopedic Trauma

Vascular injury associated with orthopedic trauma is a potentially limb- and life-threatening event that represents a challenge for every orthopedic surgeon and clinician involved in the primary care of trauma patients. Whether encountered in the emergency department or in the elective setting, loss of limb or life can easily occur if the diagnosis of an associated vascular injury is missed or delayed. Under these circumstances, a rapid and accurate diagnosis, as well as a thorough understanding of the management priorities implicated is of paramount importance for successful salvage of the limb.

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