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Journal of Arthroplasty

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https://www.readbyqxmd.com/read/30219266/the-application-of-thromboelastography-in-understanding-and-management-of-ecchymosis-after-total-knee-arthroplasty
#1
Jian Wang, Hai-Lun Zhu, Zhan-Jun Shi, Yang Zhang
BACKGROUND: Ecchymosis is a common complication after total knee arthroplasty (TKA). However, only a few studies have been conducted to determine the coagulation status of these patients. Using thromboelastography (TEG), a new technique recording the viscoelastic changes of a whole-blood sample, this study was performed to understand the ecchymosis-related coagulation status and its risk factors. METHODS: Seventy-five patients receiving unilateral TKA were recruited in this observational study...
August 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30224099/mortality-during-total-knee-periprosthetic-joint-infection
#2
Zachary C Lum, Kyle M Natsuhara, Trevor J Shelton, Mauro Giordani, Gavin C Pereira, John P Meehan
BACKGROUND: Periprosthetic joint infections (PJIs) are fraught with multiple complications including poor patient-reported outcomes, disability, reinfection, disarticulation, and even death. We sought to perform a systematic review asking the question: (1) What is the mortality rate of a PJI of the knee undergoing 2-stage revision for infection? (2) Has this rate improved over time? (3) How does this compare to a normal cohort of individuals? METHODS: We performed a database search in MEDLINE/EMBASE, PubMed, and all relevant reference studies using the following keywords: "periprosthetic joint infection," "mortality rates," "total knee arthroplasty," and "outcomes after two stage revision...
August 25, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30224100/septic-revision-total-knee-arthroplasty-treatment-of-metaphyseal-bone-defects-using-metaphyseal-sleeves
#3
Sebastian M Klim, Florian Amerstorfer, Gerwin A Bernhardt, Patrick Sadoghi, Gerald Gruber, Roman Radl, Andreas Leithner, Mathias Glehr
BACKGROUND: Bone loss is a severe problem in septic revision total knee arthroplasty (RTKA). The use of porous coated metaphyseal sleeves is a promising treatment option for metaphyseal bone defects. The currently published midterm results remain limited and no study has been focused exclusively on septic cases. Our aim was to determine the implant survivorship (with special focus on osseointegration) and the clinical and radiological midterm outcome of metaphyseal sleeve fixation in septic RTKA surgery (minimum follow-up of 2 years)...
August 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30217401/total-hip-arthroplasty-in-young-patients-in-the-netherlands-trend-analysis-of-19-000-primary-hip-replacements-in-the-dutch-arthroplasty-register
#4
Martijn F L Kuijpers, Gerjon Hannink, Liza N van Steenbergen, Berend W Schreurs
BACKGROUND: Total hip arthroplasty (THA) is one of the most successful interventions in medical care. Because of shifting trends in THA and failure rates being higher in younger patients, we aimed to assess trends in implant fixation, bearing type, head diameter, and surgical approach in patients younger than 55 years in the Netherlands using data from the Dutch Arthroplasty Register. METHODS: Trends in the method of implant fixation, bearing type, head diameter, and surgical approach were analyzed over year of surgery (2007-2016) and over age groups (<25, 25-29, 30-34, 35-39, 40-44, 45-49, and 50-54 years)...
August 22, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30213544/conventional-polyethylene-in-total-hip-arthroplasty-in-young-patients-survivorship-wear-analysis-and-clinical-outcomes-between-15-and-20-years
#5
Jeffrey B Stambough, Richard D Rames, Gail E Pashos, William J Maloney, John M Martell, John C Clohisy
BACKGROUND: Total hip arthroplasty (THA) remains a successful procedure for most patients. However, there is a paucity of information regarding the long-term performance of conventional polyethylene (CPE) bearings in young patients undergoing THA. METHODS: After accounting for incomplete follow-up of a prospective cohort of 123 THAs in patients ≤50 years, we performed a retrospective review of 101 hips in 84 patients (82.1%) with an average 17.1-year follow-up (14...
August 22, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30201213/evaluation-of-a-preoperative-optimization-protocol-for-primary-hip-and-knee-arthroplasty-patients
#6
David N Bernstein, Tiffany C Liu, Angela L Winegar, Lauren W Jackson, Jessica L Darnutzer, Kelsey M Wulf, John T Schlitt, Mauricio A Sardan, Kevin J Bozic
BACKGROUND: Preoperative optimization of risk factors has been suggested as a strategy to improve the value of total joint arthroplasty (TJA) care. We assessed the implementation of a TJA preoperative optimization protocol and its impact on length of hospital stay, discharge destination, 90-day readmissions, and hospital direct variable costs. METHODS: This retrospective cohort study included adults undergoing primary elective TJA from 07/2015-09/2016 at an urban tertiary care hospital...
August 22, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30197215/association-between-knee-malalignment-and-ankle-degeneration-in-patients-with-end-stage-knee-osteoarthritis
#7
Kai Xie, Xu Jiang, Xuequan Han, Songtao Ai, Xinhua Qu, Mengning Yan
BACKGROUND: The association between knee malalignment and ankle degeneration has not been well established. This study aimed at determining whether knee malalignment and compensatory ankle morphology to knee malalignment are associated with the development and progression of ankle osteoarthritis (OA) in patients with end-stage knee OA. METHODS: We retrospectively reviewed 96 patients (106 knees) who underwent total knee arthroplasty. The progression of ankle OA, knee alignment, and ankle morphology were evaluated based on digital radiographs...
August 22, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30197219/a-comparative-study-between-uncemented-and-hybrid-total-hip-arthroplasty-in-octogenarians
#8
Aziz Ahmad, Yusuf Mirza, Aled R Evans, Kar H Teoh
BACKGROUND: The aim of this prospective cohort study is to evaluate the outcome of octogenarian patients undergoing uncemented total hip arthroplasty (THA) with a control group of similarly aged patients undergoing hybrid THA with a minimum 5-year follow-up. METHODS: Clinical outcomes including intraoperative and postoperative complications, blood transfusion, revision rate, and mortality were recorded. Radiological analysis of preoperative and postoperative radiographs assessed bone quality, implant fixation, and any subsequent loosening...
August 20, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30197217/skilled-nursing-facilities-after-total-knee-arthroplasty-the-time-for-selective-partnerships-is-now
#9
Sean P Ryan, Daniel E Goltz, Claire B Howell, David E Attarian, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Bundled payment initiatives for total knee arthroplasty (TKA) patients are dramatically impacted by discharges to skilled nursing facilities (SNFs), making target prices set by the Center for Medicare and Medicaid Services difficult to achieve. However, we hypothesized that a granular examination of SNF discharges would reveal that some may disproportionately increase costs compared to others. METHODS: The institutional database was retrospectively queried for primary TKA patients under bundled payment initiatives...
August 18, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30195654/modern-dual-mobility-cups-in-revision-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#10
Jay M Levin, Assem A Sultan, Jeffrey A O'Donnell, Nipun Sodhi, Anton Khlopas, Nicolas S Piuzzi, Michael A Mont
BACKGROUND: The purpose of this systematic review is to analyze the outcomes of dual-mobility (DM) cups in revision total hip arthroplasty (THA). Specifically, we evaluated the following: (1) all-cause and aseptic survivorship rates; (2) dislocation rates; (3) complications; and (4) clinical outcomes reported using validated health status measures. METHODS: A comprehensive literature search included studies that reported the following: (1) re-revision rates, (2) complications, and (3) clinical outcomes following DM use in revision THA...
August 18, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30122433/corrigendum-to-factors-affecting-wear-of-constrained-polyethylene-tibial-inserts-in-total-knee-arthroplasty-journal-of-arthroplasty-31-2016-1340-1345
#11
Hee-Nee Pang, Hamid Rahmatullah Bin Abd Razak, Paul Jamieson, Matthew G Teeter, Douglas D R Naudie, Steven J MacDonald
No abstract text is available yet for this article.
August 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30217400/the-hidden-cost-of-commercial-antibiotic-loaded-bone-cement-a-systematic-review-of-clinical-results-and-cost-implications-following-total-knee-arthroplasty
#12
John D King, Dustin H Hamilton, Cale A Jacobs, Stephen T Duncan
BACKGROUND: The purpose of this systematic review is to compare deep prosthetic joint infections (PJIs) between total knee arthroplasty (TKA) patients treated with either antibiotic-loaded bone cement (ALBC) or plain bone cement, and to explore the potential cost implications of commonly used bone cement regimens. We hypothesized that ALBC would not substantially reduce PJIs and would thereby present an unnecessary cost to the healthcare system. METHODS: Using the PRISMA guidelines, we reviewed articles through May 2017 involving primary TKA patients with both ALBC cohort and plain bone cement cohort...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30197218/peripheral-nerve-blocks-vs-periarticular-injections-in-total-knee-arthroplasty
#13
Andrew S Chung, Mark J Spangehl
In patients undergoing surgery, optimal pain management is associated with improved perioperative outcomes, patient satisfaction with surgery, and a more rapid functional recovery. In recent years, the employment of multimodal pain management strategies has become increasingly widespread. In particular, there has been an explosion in the use of peripheral nerve blockade and periarticular injections in total knee arthroplasty. However, there is significant variability in the administration of either modality of anesthesia...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30195655/influence-of-posterior-tibial-slope-on-kinematics-after-cruciate-retaining-total-knee-arthroplasty
#14
Toshitaka Fujito, Tetsuya Tomita, Takaharu Yamazaki, Kosaku Oda, Hideki Yoshikawa, Kazuomi Sugamoto
BACKGROUND: The purpose of this study was to investigate the influence of posterior tibial slope (PTS) on knee kinematics after cruciate-retaining total knee arthroplasty (CR-TKA). These influences were evaluated using a prosthesis designed with high geometric conformity to the medial articular surface under the weight-bearing condition of deep knee bending. METHODS: We evaluated 71 knees (52 patients) after CR-TKA using 2- to 3-dimensional registration techniques...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30193882/managing-prolonged-pain-after-surgery-examining-the-role-of-opioids
#15
Eric S Schwenk, John-Paul J Pozek, Eugene R Viscusi
A notable minority of patients experience persistent postsurgical pain and some of these patients consequently have prolonged exposure to opioids. Risk factors for prolonged opioid use after surgery include preoperative opioid use, anxiety, substance abuse, and alcohol abuse. The window to intervene and potentially prevent persistent opioid use after surgery is short and may best be accomplished by both surgeon and anesthesiologist working together. Anesthesiologists in particular are well positioned in the perioperative surgical home model to affect multiple aspects of the perioperative experience, including tailoring intraoperative medications and providing consultation for possible discharge analgesic regimens that can help minimize opioid use...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30193881/internal-validation-of-a-predictive-model-for-complications-after-total-hip-arthroplasty
#16
Kyle N Kunze, Jefferson Li, Kamran Movassaghi, Adam B Wiggins, Scott M Sporer, Brett R Levine
BACKGROUND: Total hip arthroplasty (THA) is projected to increase in prevalence and associated complications will impose significant cost on the US healthcare system. The purpose of this study is to validate a predictive model for postoperative complications utilizing a novel 11-component hip-specific questionnaire encompassing preoperatively available clinical and radiographic data. METHODS: Consecutive primary THA patients between January 2014 and January 2016 were included...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30193880/cross-validation-of-arthroplasty-records-between-arthroplasty-and-hospital-discharge-registers-self-reports-and-medical-records-among-a-cohort-of-14-220-women
#17
Ville Turppo, Reijo Sund, Joonas Sirola, Heikki Kröger, Jukka Huopio
BACKGROUND: There are no actual validation studies of the Finnish Arthroplasty Register (FAR), and only a few studies about the accuracy of self-reported hip and knee arthroplasty exist. Therefore, we examine how reliably total hip (THA) and knee (TKA) arthroplasties can be identified from multiple data sources, including self-reports, the hospital discharge register, the arthroplasty register, and medical records. METHODS: Data from the FAR and from the Finnish Hospital Discharge Register (FHDR) during the years 1980-2010 were cross-checked to identify all THA and TKA events for the Kuopio Osteoporosis Risk Factor and Prevention Study cohort (n = 14,220)...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30177301/introduction-how-should-the-joint-surgeon-respond-to-the-opioid-crisis
#18
EDITORIAL
William A Jiranek
No abstract text is available yet for this article.
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30173942/proximal-femoral-shape-changes-the-risk-of-a-leg-length-discrepancy-after-primary-total-hip-arthroplasty
#19
Young Wook Lim, James I Huddleston, Stuart B Goodman, William J Maloney, Derek F Amanatullah
BACKGROUND: To evaluate how canal morphology affects the technical aspects of total hip arthroplasty, we investigated the effects of femoral cortical index (FCI) on the re-establishment of leg length at the conclusion of surgery. METHODS: We retrospectively reviewed age, gender, body mass index, and radiographs of 516 patients with osteoarthritis or osteonecrosis who underwent unilateral cementless primary total hip arthroplasty between 2008 and 2015. Patients were divided into level of FCI and leg length discrepancy (LLD)...
August 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30172415/identifying-reasons-for-failed-same-day-discharge-following-primary-total-hip-arthroplasty
#20
James F Fraser, Jonathan R Danoff, Jorge Manrique, Michael J Reynolds, William J Hozack
BACKGROUND: As total hip arthroplasty (THA) gains popularity in ambulatory surgery centers, it is important to understand the causes of failed same-day discharge (SDD). The purpose of this study is to (1) identify reasons for an overnight stay among patients selected as candidates for SDD following THA and (2) determine what pre-operative factors are more common among patients who fail SDD. METHODS: This is a prospective cohort study of patients undergoing THA who were identified as candidates for SDD (<75 years, ambulate without walker, American Society of Anesthesiologists score 1-3, body mass index <40 kg/m2 , and agreed to SDD pre-operatively)...
August 9, 2018: Journal of Arthroplasty
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