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https://www.readbyqxmd.com/read/27694513/early-outcomes-of-twin-peg-mobile-bearing-unicompartmental-knee-arthroplasty-compared-with-primary-total-knee-arthroplasty
#1
Z C Lum, A V Lombardi, J M Hurst, M J Morris, J B Adams, K R Berend
AIMS: Since redesign of the Oxford phase III mobile-bearing unicompartmental knee arthroplasty (UKA) femoral component to a twin-peg design, there has not been a direct comparison to total knee arthroplasty (TKA). Thus, we explored differences between the two cohorts. PATIENTS AND METHODS: A total of 168 patients (201 knees) underwent medial UKA with the Oxford Partial Knee Twin-Peg. These patients were compared with a randomly selected group of 177 patients (189 knees) with primary Vanguard TKA...
October 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27682287/postoperative-pain-relief-and-functional-outcome-following-total-knee-arthroplasty-a-prospective-comparative-audit-of-three-analgesic-regimes
#2
A Rajeev, N Tumia, K Karn, S Kashyap, D Mayne
Pain control plays a key role in joint-replacement -surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus -local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0...
August 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/27587519/the-technique-of-delivery-of-peri-operative-analgesia-does-not-affect-the-rehabilitation-or-outcomes-following-total-knee-arthroplasty
#3
D A McDonald, A H Deakin, B M Ellis, Y Robb, T E Howe, A W G Kinninmonth, N B Scott
AIMS: This non-blinded randomised controlled trial compared the effect of patient-controlled epidural analgesia (PCEA) versus local infiltration analgesia (LIA) within an established enhanced recovery programme on the attainment of discharge criteria and recovery one year after total knee arthroplasty (TKA). The hypothesis was that LIA would increase the proportion of patients discharged from rehabilitation by the fourth post-operative day but would not affect outcomes at one year. PATIENTS AND METHODS: A total of 242 patients were randomised; 20 were excluded due to failure of spinal anaesthesia leaving 109 patients in the PCEA group and 113 in the LIA group...
September 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/26878539/improvement-in-harris-hip-score-after-cementless-total-hip-arthroplasty-in-young-active-adults-with-secondary-hip-arthritis-a-short-term-follow-up-result
#4
Tariq Siddique, Ranjit Kumar Sah, Faisal Masood, Syed Muhammad Awais
OBJECTIVE: To determine the improvement in Harris Hip Score after non-cemented total hip replacement in younger patients with secondary hip joint arthritis. METHODS: The quasi-experimental study was conducted at Unit I, Department of Orthopaedic Surgery and Traumatology, Mayo Hospital, Lahore, and comprised patients diagnosed clinically and radiologically as secondary hip joint arthritis from September 2009 to December 2014. Harris Hip Score was calculated pre-operatively...
November 2015: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/26733642/the-modern-hybrid-total-hip-arthroplasty-for-primary-osteoarthritis-at-the-hospital-for-special-surgery
#5
A González Della Valle, N Sharrock, M Barlow, L Caceres, G Go, E A Salvati
We describe our technique and rationale using hybrid fixation for primary total hip arthroplasty (THA) at the Hospital for Special Surgery. Modern uncemented acetabular components have few screw holes, or no holes, polished inner surfaces, improved locking mechanisms, and maximised thickness and shell-liner conformity. Uncemented sockets can be combined with highly cross-linked polyethylene liners, which have demonstrated very low wear and osteolysis rates after ten to 15 years of implantation. The results of cement fixation with a smooth or polished surface finished stem have been excellent, virtually eliminating complications seen with cementless fixation like peri-operative femoral fractures and thigh pain...
January 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/26658198/does-regional-anaesthesia-improve-outcome
#6
REVIEW
P M Hopkins
This review examines the recent evidence of an impact of regional anaesthesia on important clinical outcomes. Evidence was obtained from a variety of studies, with increasing numbers of analyses of large databases being prominent. The benefits and limitations of these approaches are considered in order to provide a context for interpretation of the data they generate. There should be little argument that correctly performed and appropriately used regional anaesthetic techniques can provide the most effective postoperative analgesia for the duration of the block, but the majority of studies suggest that this does not translate into improved longer-term surgical outcomes...
December 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26637678/knee-manipulation-under-anaesthetic-following-total-knee-arthroplasty-a-matched-cohort-design
#7
I Dzaja, E M Vasarhelyi, B A Lanting, D D Naudie, J L Howard, L Somerville, R W McCalden, S J MacDonald
The purpose of this study was to compare clinical outcomes of total knee arthroplasty (TKA) after manipulation under anaesthesia (MUA) for post-operative stiffness with a matched cohort of TKA patients who did not requre MUA. In total 72 patients (mean age 59.8 years, 42 to 83) who underwent MUA following TKA were identified from our prospective database and compared with a matched cohort of patients who had undergone TKA without subsequent MUA. Patients were evaluated for range of movement (ROM) and clinical outcome scores (Western Ontario and McMaster Universities Arthritis Index, Short-Form Health Survey, and Knee Society Clinical Rating System) at a mean follow-up of 36...
December 2015: Bone & Joint Journal
https://www.readbyqxmd.com/read/26568709/the-influence-of-subluxation-on-the-severity-of-symptoms-disability-and-the-results-of-operative-treatment-in-tmc-osteoarthritis-with-total-joint-arthroplasty
#8
Solveig K A Larsen, Ann Mai Østergaard, Torben B Hansen
BACKGROUND: The role of subluxation in staging of the severity of osteoarthritic changes remains unclear. The aim of this study was to evaluate the influence of subluxation of symptomatic osteoarthritic trapeziometacarpal (TMC) joint regarding severity of symptoms, disability, and results of operative treatment in TMC osteoarthritis with total joint arthroplasty. METHODS: We included 172 hands in 137 patients (32 males and 105 females), mean age 59 years (44-74 years), with a combination of radiological signs of TMC osteoarthritis and clinical symptoms in the study...
December 2015: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/26387125/predictors-of-hospital-readmission-following-revision-total-knee-arthroplasty
#9
Philip J Belmont, Gens P Goodman, Marina Rodriguez, Julia O Bader, Brian R Waterman, Andrew J Schoenfeld
PURPOSE: Hospital readmission is emerging as an important quality measure, yet modifiable predictors of readmission remain unknown. This study was designed to identify risk factors for readmission following revision total knee arthroplasty. METHODS: The National Surgical Quality Improvement Program dataset was queried to identify patients undergoing revision total knee arthroplasty from 2011 to 2012. Patient demographics, medical co-morbidities, laboratory values, surgical characteristics and surgical outcomes were examined using bivariate and multivariate logistic regression to identify significant predictors for readmission within 30 days of discharge...
October 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/26269416/regional-analgesia-for-improvement-of-long-term-functional-outcome-after-elective-large-joint-replacement
#10
REVIEW
Arthur Atchabahian, Gary Schwartz, Charles B Hall, Claudette M Lajam, Michael H Andreae
BACKGROUND: Regional analgesia is more effective than conventional analgesia for controlling pain and may facilitate rehabilitation after large joint replacement in the short term. It remains unclear if regional anaesthesia improves functional outcomes after joint replacement beyond three months after surgery. OBJECTIVES: To assess the effects of regional anaesthesia and analgesia on long-term functional outcomes 3, 6 and 12 months after elective major joint (knee, shoulder and hip) replacement surgery...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26227482/comparison-of-patient-outcomes-in-periarticular-and-intraarticular-local-anaesthetic-infiltration-techniques-in-total-knee-arthroplasty
#11
COMPARATIVE STUDY
Michael Perret, Philip Fletcher, Laura Firth, Piers Yates
BACKGROUND: The use of local infiltration analgesia in the setting of knee arthroplasty is well established. There are no studies to date which have directly compared differences in infiltration techniques. The purpose of this study is to establish if a difference in patient outcomes exists when the infiltrate is injected into the periarticular tissues or directly into the joint. METHODS: One hundred and forty-two consecutive patients waitlisted for primary total knee arthroplasty were enrolled after primary exclusion criteria were applied...
2015: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/26099755/spinal-anaesthesia-with-adjunctive-intrathecal-morphine-versus-continuous-lumbar-plexus-blockade-a-randomised-comparison-for-analgesia-after-hip-replacement
#12
RANDOMIZED CONTROLLED TRIAL
M J Fredrickson, T K Danesh-Clough
Following elective total hip replacement, both continuous lumbar plexus blockade and spinal anaesthesia (with adjunctive intrathecal morphine) have shown early outcome benefits over opioid analgesia and single-injection nerve block. However, the two techniques have not been compared in a prospective randomised manner. Our study examined 50 patients undergoing elective hip joint replacement who were randomised to receive spinal anaesthesia (with adjunctive intrathecal morphine 0.1 mg) or patient-controlled continuous lumbar plexus blockade...
July 2015: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/25653286/femoral-nerve-infusion-after-primary-total-knee-arthroplasty-a-prospective-double-blind-randomised-and-placebo-controlled-trial
#13
M C Wyatt, T Wright, J Locker, K Stout, C Chapple, J C Theis
OBJECTIVES: Effective analgesia after total knee arthroplasty (TKA) improves patient satisfaction, mobility and expedites discharge. This study assessed whether continuous femoral nerve infusion (CFNI) was superior to a single-shot femoral nerve block in primary TKA surgery completed under subarachnoid blockade including morphine. METHODS: We performed an adequately powered, prospective, randomised, placebo-controlled trial comparing CFNI of 0.125% bupivacaine versus normal saline following a single-shot femoral nerve block and subarachnoid anaesthesia with intrathecal morphine for primary TKA...
February 2015: Bone & Joint Research
https://www.readbyqxmd.com/read/25522681/total-intravenous-general-anaesthesia-vs-spinal-anaesthesia-for-total-hip-arthroplasty-a-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
A Harsten, H Kehlet, P Ljung, S Toksvig-Larsen
BACKGROUND: The choice of anaesthetic technique for patients undergoing joint arthroplasty is debatable. The hypothesis of this study was that general anaesthesia would generate a more favourable recovery profile than spinal anaesthesia. METHODS: We randomly allocated 120 patients to either intrathecal bupivacaine or general anaesthesia with target-controlled infusion of remifentanil and propofol. Length of hospital stay assessed as meeting discharge criteria was the primary outcome parameter...
March 2015: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/25313700/-current-status-of-total-hip-and-knee-replacements-in-germany-results-of-a-nation-wide-survey
#15
MULTICENTER STUDY
T Jaschinski, D Pieper, M Eikermann, S Steinhausen, C Linke, T Heitmann, M Pani, E Neugebauer
BACKGROUND: Total hip and knee replacements are very frequently performed operative procedures in German hospitals. Despite the high number of cases, only few data on treatment procedures of the clinical routine and their impact on postoperative length of stay and clinical outcome are available. The aim of our survey was to gain detailed insights of the treatment procedures in patients scheduled for elective hip or knee replacement in order to extract recommendations for improving patient care...
October 2014: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/25198980/the-incidence-of-postoperative-urinary-retention-in-patients-undergoing-elective-hip-and-knee-arthroplasty
#16
M A Fernandez, S Karthikeyan, M Wyse, P Foguet
INTRODUCTION: Postoperative urinary retention requiring urethral catheterisation increases the risk of joint sepsis following arthroplasty. Spinal anaesthesia with opiate administration is used widely in lower limb arthroplasty. We sought to establish whether the choice of opiate agent had any effect on the incidence of postoperative retention and therefore the risk of joint sepsis. METHODS: A total of 445 consecutive patients who underwent primary elective lower limb arthroplasty were reviewed retrospectively...
September 2014: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/24947590/recovery-after-anaesthesia-and-surgery
#17
EDITORIAL
O Ljungqvist, L S Rasmussen
No abstract text is available yet for this article.
July 2014: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/24819349/the-effectiveness-of-kinesio-taping%C3%A2-after-total-knee-replacement-in-early-postoperative-rehabilitation-period-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
V Donec, A Kriščiūnas
BACKGROUND: The number of total knee replacements performed each year is increasing. Among the main impediments to functional recovery after these surgeries include postoperative edema, pain, lower limb muscle strength deficits, all of which point to a need to identify safe, effective postoperative rehabilitation modalities. AIM: The aim of this paper was to evaluate the effectiveness of Kinesio Taping® (KT) method in reducing postoperative pain, edema, and improved knee range of motion recovery after total knee replacement (TKR) operation in early postoperative rehabilitation period...
August 2014: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/24760453/-the-impact-of-capsular-repair-on-the-dislocation-rate-after-primary-total-hip-arthroplasty-a-retrospective-analysis-of-1972-cases
#19
T Prietzel, N Hammer, S Schleifenbaum, D Adler, M Pretzsch, L Köhler, M Petermann, M Farag, S Panzert, S Bauer, G von Salis-Soglio
BACKGROUND: Dislocation is the second most frequently encountered complication in primary total hip arthroplasty (THA) and occurs more commonly in the early postoperative rehabilitation phase. Sir Charnley recommended the "avoidance of resection of the capsule" and emphasised its contribution to hip joint stability in THA. Several authors, however, doubted its significance and considered resection of the capsule to be essential. Since 2002, some surgeons increasingly adopted a modified, less invasive technique of THA via Bauer approach, including the preservation and repair of the hip joint capsule with focus on maintaining its acetabular origin...
April 2014: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/24749261/-comparative-assessment-of-prolonged-femoral-nerve-blockade-and-epidural-analgesia-for-postoperative-pain-in-total-knee-joint-arthroplasty
#20
RANDOMIZED CONTROLLED TRIAL
B T Churadze, S A Sevalkin, M V Zadorozhnyĭ, P A Volkov, V A Gur'ianov
The study deals with two mostly discussed techniques of postoperative analgesia for total knee joint arthroplasty. Surgeries were performed under subarachnoid anaesthesia with intravenous sedation. 9 patients of first group in received prolonged femoral nerve blockade as a component of multimodal analgesia. 8 patients of second group received epidural infusion of naropine. If basic technique of analgesia was not effective patients received trimeperidine 20 mg intramuscular. Patients of second group had less pain syndrome (in order to visual analogue scale) and did not need additional administration of opioids...
November 2013: Anesteziologiia i Reanimatologiia
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