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hip and knee replacement

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https://www.readbyqxmd.com/read/28934966/effectiveness-of-an-interactive-telerehabilitation-system-with-home-based-exercise-training-in-patients-after-total-hip-or-knee-replacement-study-protocol-for-a-multicenter-superiority-no-blinded-randomized-controlled-trial
#1
Sarah Eichler, Sophie Rabe, Annett Salzwedel, Steffen Müller, Josefine Stoll, Nina Tilgner, Michael John, Karl Wegscheider, Frank Mayer, Heinz Völler
BACKGROUND: Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain...
September 21, 2017: Trials
https://www.readbyqxmd.com/read/28932503/effect-of-high-tibial-osteotomy-on-hip-biomechanics-in-patients-with-genu-varum-a%C3%A2-prospective-cohort-study
#2
Mehdi Moghtadaei, Ali Yeganeh, Bahram Boddouhi, Atefe Alaee, Hossein Farahini, Babak Otoukesh
BACKGROUND AND AIMS: The aim of this study is to evaluate the effect of proximal tibia osteotomy on hip biomechanics. METHODS: This cohort study was conducted on 50 knees of 37 patients divided into two groups of unilateral and bilateral surgeries during 2015-2016. Patients underwent medial open-wedge osteotomy of proximal tibia. Axial alignment of lower limb radiography was carried out for the patients before and after the osteotomy. RESULTS: Findings from unilateral and bilateral high tibial osteotomies demonstrated that the average of greater trochanter (GT) angle from femoral head center and also the average angle of knee varus were significantly decreased (P = 0...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28926095/model-based-assessment-using-conventional-bioequivalence-limits-to-ensure-safety-and-efficacy-of-rivaroxaban-in-patients-undergoing-hip-or-knee-replacement
#3
Mario González-Sales, Lanyan Fang, Myong-Jin Kim, Liang Zhao
We evaluated whether the current bioequivalence limit is adequate to ensure safety and efficacy of rivaroxaban in patients under total hip arthroplasty and total knee arthroplasty based on its model informed benefit/risk profile. Clinical data from a total of 7145 patients from 3 phase 2 and 4 phase 3 clinical trials were included in the current model-based exposure-response analysis. The relationships between rivaroxaban exposure measurements (ie, minimum or trough, maximum, average concentration, and area under the concentration-time curve [AUC] at steady state) and clinical outcomes (ie, the probabilities of major bleeding [MB] and venous thromboembolism [VTE]) were modeled using NONMEM 7...
September 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28918008/a-finite-element-study-on-the-mechanical-response-of-the-head-neck-interface-of-hip-implants-under-realistic-forces-and-moments-of-daily-activities-part-2
#4
Khosro Fallahnezhad, Hamidreza Farhoudi, Reza H Oskouei, Mark Taylor
A finite element model was developed to investigate the effect of loading regimes caused by various daily activities on the mechanical behaviour of the head-neck taper junction in modular hip replacements. The activities included stair up, stair down, sit to stand, stand to sit, one leg standing and knee bending. To present the real mechanical environment of the junction, in addition to the force components, the frictional moments produced by the frictional sliding of the head and cup were applied to a CoCr/CoCr junction having a 12/14 taper with a proximal mismatch angle of 0...
September 7, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28917522/does-physical-activity-change-following-hip-and-knee-replacement-matched-case-control-study-evaluating-physical-activity-scale-for-the-elderly-data-from-the-osteoarthritis-initiative
#5
T O Smith, M Mansfield, J Dainty, G Hilton, C J V Mann, C M Sackley
OBJECTIVES: To determine whether physical activity measured using the Physical Activity Scale for the Elderly (PASE), changes during the initial 24 months post-total hip (THR) or knee replacement (TKR), and how this compares to a matched non-arthroplasty cohort. DESIGN: Case-controlled study analysis of a prospectively collected dataset. SETTING: USA community-based. PARTICIPANTS: 116 people post-THR, 105 people post-TKR compared to 663 people who had not undergone THR or TKR, or had hip or knee osteoarthritis...
September 13, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28913405/post-acute-care-disparities-in-total-joint-arthroplasty
#6
Roy H Lan, Atul F Kamath
BACKGROUND: Understanding the socioeconomic factors that influence hospitalization and post-discharge metrics after joint replacement is important for identifying key areas of improvement in the delivery of orthopaedic care. METHODS: An institutional administrative data set of 2869 patients from an academic arthroplasty referral center was analyzed to quantify the relationship between socioeconomic factors and post-acute rehabilitation care received, length of stay, and cost of care...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28901992/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-elderly
#7
Sibylle Kozek-Langenecker, Christian Fenger-Eriksen, Emmanuel Thienpont, Giedrius Barauskas
: The risk for postoperative venous thromboembolism (VTE) is increased in patients aged more than 70 years and in elderly patients presenting with co-morbidities, for example cardiovascular disorders, malignancy or renal insufficiency. Therefore, risk stratification, correction of modifiable risks and sustained perioperative thromboprophylaxis are essential in this patient population. Timing and dosing of pharmacoprophylaxis may be adopted from the non-aged population. Direct oral anti-coagulants are effective and well tolerated in the elderly; statins may not replace pharmacological thromboprophylaxis...
September 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28898559/changes-in-physical-activity-after-total-hip-or-knee-arthroplasty-a-systematic-review-and-meta-analysis-of-6-and-12-month-outcomes
#8
Thomas Hammett, Aram Simonian, Monica Austin, Robert Butler, Kelli D Allen, Leila Ledbetter, Adam P Goode
OBJECTIVE: Little is known about the extent to which physical activity (PA) changes following total knee or hip joint replacement relative to pain, physical function and quality of life. Our objective was to conduct a systematic review and meta-analysis on changes in PA relative to pain, quality of life and physical function after total knee or hip joint replacement. METHODS: We searched PubMed (Medline), Embase and Cinahl, for peer-reviewed, English-language cohort studies measuring PA with an accelerometer from pre-surgery to post-surgery...
September 12, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#9
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
September 8, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28883822/the-role-of-the-chemokine-system-in-tissue-response-to-prosthetic-by-products-leading-to-periprosthetic-osteolysis-and-aseptic-loosening
#10
REVIEW
Tereza Dyskova, Jiri Gallo, Eva Kriegova
Millions of total joint replacements are performed annually worldwide, and the number is increasing every year. The overall proportion of patients achieving a successful outcome is about 80-90% in a 10-20-years time horizon postoperatively, periprosthetic osteolysis (PPOL) and aseptic loosening (AL) being the most frequent reasons for knee and hip implant failure and reoperations. The chemokine system (chemokine receptors and chemokines) is crucially involved in the inflammatory and osteolytic processes leading to PPOL/AL...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28878516/enhanced-recovery-principles-applied-to-revision-hip-and-knee-arthroplasty-reduces-length-of-stay-and-blood-transfusion
#11
Michael Kent, Nick Calvert, Kevin Blades, Alex Swann, Piers Yates
INTRODUCTION: This is the first study reporting the application of Enhanced Recovery Principles (ERP) to revision arthroplasty. METHOD: Retrospective series of 132 revision hip and knee replacements treated with ERP. RESULTS: Infiltration was associated with reduced LOS in knees (6 vs 8.5 days), lower PCA usage and incidence of transfusion in knees (2 vs 3 days) and hips (1 vs 6 days). Revisions for infection had a longer LOS (5.4 vs 11...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28872537/in-treating-arthritis-of-the-knee-beware-the-ipsilateral-hip-commentary-on-an-article-by-joerg-huber-md-et-al-the-influence-of-arthritis-in-other-major-joints-and-the-spine-on-the-one-year-outcome-of-total-hip-replacement-a-prospective-multicenter-cohort-study
#12
https://www.readbyqxmd.com/read/28870301/perioperative-pain-management-and-anesthesia-a-critical-component-to-rapid-recovery-total-joint-arthroplasty
#13
REVIEW
Matthew W Russo, Nancy L Parks, William G Hamilton
Multimodal pain management has become the standard of care following total hip and knee replacement. The advantages include decreasing opioid consumption and its associated side effects, facilitating earlier mobilization, and faster return to function. An effective rapid recovery protocol includes the use of multiple different types of medications targeting each area of the pain pathway, preemptive analgesia, regional nerve blockade, and local infiltration analgesia.
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28869185/gait-variability-and-motor-control-in-patients-with-knee-osteoarthritis-as-measured-by-the-uncontrolled-manifold-technique
#14
Gwenllian Fflur Tawy, Philip Rowe, Leela Biant
Knee osteoarthritis (OA) causes pain, reduced muscular strength and stiffness of the affected joint. In response, the motor control mechanism is altered, potentially compromising stability during acts of daily living. Reduced walking stability can be quantified in terms of gait variability. This study therefore aimed to identify and quantify the effects of knee arthritis on gait variability. Fifty adults (25 males/25 females) with end-stage OA of the knee sufficiently symptomatic to require joint replacement, walked on a self-paced treadmill for 2min...
August 18, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28865425/silver-coated-modular-megaendoprostheses-in-salvage-revision-arthroplasty-after-periimplant-infection-with-extensive-bone-loss-a-pilot-study-of-34-patients
#15
Dirk Zajonz, Undine Birke, Mohamed Ghanem, Torsten Prietzel, Christoph Josten, Andreas Roth, Johannes K M Fakler
BACKGROUND: Hip and knee replacements in patients with bone defects after infection correlates with high rates of reinfection. In this vulnerable patient population, the prevention of reinfection is to be considered superordinate to the functionality and defect bridging. The use of silver coating of aseptic implants as an infection prophylaxis is already proven; however, the significance of these coatings in septic reimplantation of large implants is still not sufficiently investigated...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28854533/safety-aspects-of-preoperative-high-dose-glucocorticoid-in-primary-total-knee-replacement
#16
C C Jørgensen, F T Pitter, H Kehlet
Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation Database for Fast-track Hip and Knee Replacement introduced preoperative methylprednisolone (MP) 125 mg as part of a multimodal analgesic protocol in TKA. We analysed the risk of length of hospital stay (LOS) >4 days, 30 and 90 day readmissions in patients with MP vs patients having TKA before the use of MP and adjusted for comorbidity and place of surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28844631/improving-value-in-total-hip-and-knee-arthroplasty-the-role-of-high-volume-hospitals
#17
P Maxwell Courtney, Nicholas B Frisch, Daniel D Bohl, Craig J Della Valle
BACKGROUND: Recent healthcare reform efforts have focused on improving the quality of total joint replacement care while reducing overall costs. The purpose of this study is to determine if higher volume centers have lower costs and better outcomes than lower volume hospitals. METHODS: We queried the Centers for Medicare and Medicaid Services (CMS) Inpatient Charge Data and identified 2702 hospitals that performed a total of 458,259 primary arthroplasty procedures in 2014...
August 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28838614/implementation-of-preoperative-screening-criteria-lowers-infection-and-complication-rates-following-elective-total-hip-arthroplasty-and-total-knee-arthroplasty-in-a-veteran-population
#18
Fernando D Nussenbaum, David Rodriguez-Quintana, Sara M Fish, David M Green, Catherine W Cahill
BACKGROUND: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures with a risk of complications. Attempting to minimize complications, our institution implemented preoperative screening criteria for patients undergoing elective total joint replacement. Our study aimed to determine if screening criteria lowered total complications and/or surgical site infections (SSI). METHODS: Two groups of consecutive patients undergoing TKA and THA at a single Veterans Affairs facility were evaluated prior to and after implementation of screening criteria, 520 and 475 respectively...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28827734/integrative-epigenomics-transcriptomics-and-proteomics-of-patient-chondrocytes-reveal-genes-and-pathways-involved-in-osteoarthritis
#19
Julia Steinberg, Graham R S Ritchie, Theodoros I Roumeliotis, Raveen L Jayasuriya, Matthew J Clark, Roger A Brooks, Abbie L A Binch, Karan M Shah, Rachael Coyle, Mercedes Pardo, Christine L Le Maitre, Yolande F M Ramos, Rob G H H Nelissen, Ingrid Meulenbelt, Andrew W McCaskie, Jyoti S Choudhary, J Mark Wilkinson, Eleftheria Zeggini
Osteoarthritis (OA) is a common disease characterized by cartilage degeneration and joint remodeling. The underlying molecular changes underpinning disease progression are incompletely understood. We investigated genes and pathways that mark OA progression in isolated primary chondrocytes taken from paired intact versus degraded articular cartilage samples across 38 patients undergoing joint replacement surgery (discovery cohort: 12 knee OA, replication cohorts: 17 knee OA, 9 hip OA patients). We combined genome-wide DNA methylation, RNA sequencing, and quantitative proteomics data...
August 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28821515/does-the-person-s-context-influence-engagement-in-life-activities-following-primary-knee-replacement-results-from-a-canadian-prospective-cohort-study
#20
Aileen M Davis, Viji Venkataramanan, Jessica Bytautas-Sillanpää, Anthony V Perruccio, Rosalind Wong, Lisa Carlesso, Fiona Webster
OBJECTIVE: The impact of the context of a person's life on recovery from surgical interventions is not well understood. This study evaluated if people's social, environmental and biomedical context was associated with change in frequency in engagement in life activities after total knee replacement (TKR). METHODS: 418 people aged 30+ years who had TKR were followed presurgery to 1 year postsurgery. The outcome was change in frequency in engagement in life activities measured by the Late Life Disability Index (LLDI)...
August 18, 2017: BMJ Open
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