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A Comprehensive Anesthesia Protocol That Emphasizes Peripheral Nerve Blockade for Total Knee and Total Hip Arthroplasty
James R. Hebl, MD; Sandra L. Kopp, MD; Mir H. Ali, MD, PHD; Terese T. Horlocker, MD; John A. Dilger, MD; Robert L. Lennon, DO; Brent A. Williams, MS; Arlen D. Hanssen, MD; Mark W. Pagnano, MD
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Dec 01;87(suppl 2):63-70. doi: 10.2106/JBJS.E.00491
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Recently, advances in radiographic imaging and surgical instrumentation have allowed experienced orthopaedic surgeons to perform total hip and total knee replacement surgery with surgical exposures that are less extensive than those associated with traditional techniques1,2. Commonly referred to as "minimally invasive total hip and total knee arthroplasty," these techniques are now being touted as important surgical advancements. The introduction of minimally invasive total hip and total knee techniques has been accompanied by substantial concomitant changes in perioperative anesthetic techniques, rapid rehabilitation protocols, and changes in patient education and expectations. However, the specific contribution of each of these changes to observed improvements after contemporary total hip and total knee arthroplasty remains unclear.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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