Rothman Institute Manual of Total Joint Arthroplasty: Protocol-Based Care

Section 1:: Preoperative

• Indications and Contraindications for Total Joint Arthroplasty
• Preoperative Radiographic Evaluation
• Consent:: When and Where?
• Perioperative Patient Evaluation
• Additional Testing and Preoperative Consultation
• Management of Preoperative Medications
• Prehabilitation for Total Knee Arthroplasty and Total Hip Arthroplasty
• Clinical Examination of the Hip
• Clinical Examination of the Knee
• Preoperative Nutritional Optimization
• Smoking Cessation
• Perioperative Optimization of the Diabetic Patient
• Optimization of the Patient with Cardiopathy
• Optimization of the Renal Failure Patient
• Optimization of Chronic Obstructive Pulmonary Disease
• Optimization of Sleep Apnea
• Optimization of Anemia
• Preadmission Testing and Preoperative Consultation
• Preoperative Templating
• Implant Selection for Total Hip Arthroplasty
• Implant Choices in Total Knee Arthroplasty

Section 2:: Perioperative

• Intraoperative Deep Vein Thrombosis Prophylaxis
• Multimodal Pain Management in Total Knee Arthroplasty
• Multimodal Pain Management in Total Hip Arthroplasty
• Peripheral and Neuraxial Blocks for Analgesia After Total Joint Arthroplasty:: Indications and Techniques
• Preoperative Antibiotics
• Tranexamic Acid
• Intraoperative Steroid Administration
• Anesthetic Techniques in Total Joint Arthroplasty:: Neuraxial Anesthesia
• Anesthetic Techniques in Total Joint Arthroplasty:: General Anesthesia
• Skin Preparation
• Tourniquet Use in Total Knee Arthroplasty
• Operating Room Universal Precautions
• Surgical Hand Antisepsis Practices
• Operating Room Traffic
• Draping
• Direct Anterior Approach to Total Hip Arthroplasty
• Surgical Approaches to Hip:: Direct Lateral
• Surgical Approaches:: Posterior Hip
• Medial Parapatellar Approach for Total Knee Arthroplasty
• Subvastus and Midvastus Approach to the Knee
• Unicompartmental Knee Arthroplasty
• Patellofemoral Arthroplasty
• Total Hip Arthroplasty in Patients with Metabolic Bone Disease
• Total Hip Arthroplasty in Protrusio Acetabuli
• Total Hip Arthroplasty in Patients with Proximal Femoral Deformity
• Total Knee Arthroplasty for Patients with Severe Deformity
• Antibiotic Cement
• Computer-Assisted Total Knee Arthroplasty
• Patient-Specific Instrumentation
• Management of Vascular Complications:: Hip
• Management of Vascular Complications in Total Knee Arthroplasty
• Surgical Drains
• Wound Closure
• Urinary Catheter in Primary Total Joint Arthroplasty
• Surgical Dressing in Total Joint Arthroplasty
• Postoperative X-rays (Hips and Knees)
• Heterotopic Ossification Prevention

Section 3:: Postoperative Management

• Operative Note Dictation in Total Joint Arthroplasty
• Postoperative Fluid Management
• Venous Thromboembolism Prophylaxis for Total Joint Arthroplasty
• Risk Stratification for Venous Thromboembolism After Total Joint Arthroplasty
• Sleeping Aids After Total Joint Arthroplasty
• Postoperative Gastrointestinal Complications
• Routine Postoperative Laboratory Investigations
• Postoperative Antibiotic Prophylaxis
• Wound Care and Dressings
• Transfusions
• Fever Management
• Oxygen Desaturation Management
• Altered Mental Status and Postoperative Neurologic Abnormalities
• Weight-Bearing After Total Joint Arthroplasty
• Management of Urinary Retention After Total Joint Arthroplasty
• Management of Cardiac Arrhythmias
• Management of Diagnosed Deep Vein Thrombosis
• Management of Diagnosed Pulmonary Embolism
• Physical and Occupational Therapy After Total Knee Arthroplasty
• Physical and Occupational Therapy After Total Hip Arthroplasty
• Discharge Destination:: Rehabilitation vs Home
• Home Physical Therapy After Total Joint Arthroplasty
• Discharge Pain Medications
• Activity Modification After Total Hip Arthroplasty
• Continuous Passive Motion for Rehabilitation After Total Knee Arthroplasty
• Follow-Up Times and Goals After Total Joint Arthroplasty
• Antibiotic Prophylaxis for Minor Procedures After Total Joint Arthroplasty
• Restarting Medications

Section 4 Complications

• Management of Wound Drainage After Total Joint Arthroplasty
• Postoperative Blister
• Postoperative Infection Investigation
• Management of Acute Periprosthetic Hip Infection
• Management of Acute Infection:: Knee
• Management of Chronic Infection
• Management of Dislocated Hip:: Early vs Late
• Management of Intraoperative Fractures During Total Hip Arthroplasty
• Management of Intraoperative Fractures During Total Knee Arthroplasty
• Management of Periprosthetic Hip Fractures
• Management of Postoperative Periprosthetic Knee Fractures
• Management of the Swollen Limb in the Early Postoperative Patient
• Management of Residual Leg Length Discrepancy After Total Hip Arthroplasty
• Management of Stiff Knee After Total Knee Arthroplasty
• Management of Painful Total Knee Arthroplasty
• Management of Neurologic Deficit:: Hip
• Management of Neurologic Deficit:: Knee