Proceeding of CME on Post Operative Management of Arthroplasty

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CME 15/07/2022 Summary

PRESENTER

MODERATOR Dr. Abhay Kulkarni,

Dr. Mohit Shete, MBBS, DNB (Ortho), Fellowship in Sports Medicine, Fellowship in Arthroscopy & Arthroplasty, (Germany)

Professor, Head of Department, Rajiv Gandhi Medical College, Kalwa, Thane, Mumbai, Maharashtra, India.

Commonest Post-arthroplasty Complications Include: = Infection – surgical wound/deep infection = Wound healing problems = Thromboembolic disease = Neurological injury = Restriction of movements = Persistent pain and dissatisfaction = Stiffness, malalignment, instability

Impact of inflammation & edema on healing Excessive swelling would lead to: = Restricted movements ⇒ delayed rehabilitation = Increased chances of infection

Trypsin, Bromelain, Rutoside plays important role in = Pain management = Promote healing = Prevent swelling = Prevent infections

Limitations with use of NSAIDs Efficacy limitations: = Effect limited to COX inhibition = Negative impact on wound healing Safety concerns: = Gastro-intestinal irritation = Renal disturbances = Cardiovascular events = Potential hepatotoxicity

Enhanced antibiotic penetration with Trypsin, Bromelain, & Rutoside = Trypsin, Bromelain, Rutoside combination has been shown to increase the absorption of antibiotics = The ↑ absorption - primarily driven by the Bromelain component = This action has been reported with multiple antibiotics and with different routes of application including subcutaneous and intramuscular routes

Most perceived clinical benefit with Trypsin, Bromelain, & Rutoside = Reduction of edema Þ promote healing = Pain management = Enhanced perfusion Þ better healing = Help in penetration of antibiotics Þ infection prevention


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