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https://www.readbyqxmd.com/read/28292485/a-cost-effectiveness-analysis-of-reverse-total-shoulder-arthroplasty-versus-hemiarthroplasty-for-the-management-of-complex-proximal-humeral-fractures-in-the-elderly
#1
Georg Osterhoff, Nathan N O'Hara, Jennifer D'Cruz, Sheila A Sprague, Nick Bansback, Nathan Evaniew, Gerard P Slobogean
BACKGROUND: There is ongoing debate regarding the optimal surgical treatment of complex proximal humeral fractures in elderly patients. OBJECTIVES: To evaluate the cost-effectiveness of reverse total shoulder arthroplasty (RTSA) compared with hemiarthroplasty (HA) in the management of complex proximal humeral fractures, using a cost-utility analysis. METHODS: On the basis of data from published literature, a cost-utility analysis was conducted using decision tree and Markov modeling...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28222649/a-randomized-control-trial-to-evaluate-the-effectiveness-of-intravenous-intra-articular-and-topical-wash-regimes-of-tranexamic-acid-in-primary-total-knee-arthroplasty
#2
Jatin Prakash, Jong-Keun Seon, Yong Jin Park, Cheng Jin, Eun-Kyoo Song
BACKGROUND: The efficacy of tranexamic acid to decrease post-operative blood loss and blood transfusion is well established in literature. However, the ideal mode of administration is debatable. Limited literature has compared all the available modes of administration including intravenous (IV), topical irrigation and retrograde through drain. We hypothesized that no difference would be present in either form of administration of tranexamic acid. METHODS: Fifty patients in four groups were enrolled for study...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28150224/isolated-acetabular-revision-with-femoral-stem-retention-after-bipolar-hip-arthroplasty
#3
Nobuhiro Kaku, Tomonori Tabata, Hiroaki Tagomori, Hiroshi Tsumura
INTRODUCTION: In bipolar hemiarthroplasty, migration of the outer cup component into the acetabular cup, with evidence of severe osteolysis in the acetabulum, commonly occurs without loosening of the femoral component. The merits of retaining the stable femoral component in these cases have been debated. Our study aimed to determine whether revision of the acetabular component in isolation could be successfully performed. MATERIALS AND METHODS: The data of 54 patients (61 hips), 44 women, and 10 men, aged 67...
February 1, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28126027/functional-analysis-of-distraction-arthroplasty-in-the-treatment-of-ankle-osteoarthritis
#4
Hongmou Zhao, Wenqing Qu, Yi Li, Xiaojun Liang, Ning Ning, Yan Zhang, Dong Hu
BACKGROUND: Ankle joint distraction arthroplasty (AJDA) is an alternative surgical procedure for the management of moderate to severe ankle osteoarthritis. However, the benefit of this procedure and failure relative factors are still in debate. The purpose of the current study was to evaluate the functional outcomes of AJDA in treatment of moderate to severe ankle OA and to evaluate the relative factors correlated with treatment failure. METHODS: Forty-six van Dijk stages II and III ankle osteoarthritis patients were included...
January 26, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28060233/single-anesthetic-versus-staged-bilateral-total-hip-arthroplasty-a-matched-cohort-study
#5
Matthew T Houdek, Cody C Wyles, Chad D Watts, Eric R Wagner, Rafael J Sierra, Robert T Trousdale, Michael J Taunton
BACKGROUND: There is debate regarding the role of single-anesthetic versus staged bilateral total hip arthroplasty (THA) for patients with end-stage bilateral osteoarthritis. Studies have shown that single-anesthetic bilateral THA is associated with systemic complications, but there are limited data comparing patient outcomes in a matched setting of bilateral THA. METHODS: We identified 94 patients (188 hips) who underwent single-anesthetic bilateral THA. Fifty-seven percent of the patients were male...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28002921/restoring-the-femoral-offset-prevent-early-migration-of-the-stem-in-total-hip-arthroplasty-an-ebra-fca-study
#6
G Vicenti, G Solarino, A Spinarelli, M Carrozzo, G Picca, R Maddalena, F Rifino, B Moretti
The use of modular stems is still debated and controversial. Some authors have highlighted a number of disadvantages of modular prostheses including high costs, the tendency to fracture, the fretting and corrosion and the increased production of debris. Other authors have emphasized several advantages to adapt the prosthesis to the morphometric differences of patients, to allow better accuracy in restoring the anatomy and biomechanics of hip joint. The advantages of the modular devices appear to be more evident in patients with developmental dysplasia of the hip (DDH)...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/27999924/low-friction-arthroplasty-and-dual-mobility-cup-a-new-gold-standard
#7
Jean Louis Prudhon, Régis Verdier, Jacques H Caton
INTRODUCTION: Low friction arthroplasty (LFA) introduced by Sir John Charnley was the gold standard for many years. Dislocation and infection are the first causes for early revision. Late failures are polyethylene (PE) wear and loosening. Due to dislocation risk we slowly switched to the use of LFA with dual mobility cups (DMC). The purposes of this study are (1) to assess whether our changes have improved outcomes and (2) what is the new gold standard? MATERIAL AND METHODS: We selected from an observational registry of 1,091 cases of hybrid Charnley total hip arthroplasty (THA)...
December 20, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27996349/similar-migration-in-computer-assisted-and-conventional-total-knee-arthroplasty
#8
Gunnar Petursson, Anne Marie Fenstad, Øystein Gøthesen, Kristin Haugan, Gro Sævik Dyrhovden, Geir Hallan, Stephan M Röhrl, Arild Aamodt, Kjell G Nilsson, Ove Furnes
Background and purpose - Computer-assisted surgery (CAS) in total knee arthroplasty (TKA) has been used in recent years in the hope of improving the alignment and positioning of the implant, thereby achieving a better functional outcome and durability. However, the role of computer navigation in TKA is still under debate. We used radiostereometric analysis (RSA) in a randomized controlled trial (RCT) to determine whether there are any differences in migration of the tibial component between CAS- and conventionally (CONV-) operated TKA...
December 20, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27987644/using-patient-reported-outcomes-for-economic-evaluation-getting-the-timing-right
#9
Chris Schilling, Michelle M Dowsey, Philip M Clarke, Peter F Choong
BACKGROUND: Patient-reported outcome measures (PROMs) are becoming increasingly popular in orthopedic surgery. Preoperative and postoperative follow-up often elicit PROMs in the form of generic quality-of-life instruments (e.g., Short Form health survey SF-12 [SF-12]) that can be used in economic evaluation to estimate quality-adjusted life-years (QALYs). However, the timing of postoperative measurement is still under debate. OBJECTIVES: To explore the timing of postoperative PROMs collection and the implications for bias in QALY estimation for economic evaluation...
December 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27886354/a-retrospective-analysis-of-the-merits-and-challenges-associated-with-simultaneous-bilateral-tha-using-the-direct-anterior-approach
#10
Matthew L Brown, Johannes F Plate, David C Holst, Daniel N Bracey, Matthew W Bullock, Jason E Lang
INTRODUCTION: 15%-20% of patients presenting for total hip arthroplasty (THA) have bilateral disease. While simultaneous bilateral THA is of interest to patients and surgeons, debate persists regarding its merits. The majority of previous reports on simultaneous bilateral THA involve patients in the lateral decubitus position, which require repositioning, prepping and draping, and exposure of a fresh wound to pressure and manipulation for the contralateral THA. The purpose of this study was to compare complications, component position, and financial parameters for simultaneous versus staged bilateral THAs using the direct anterior approach (DAA)...
November 14, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27879150/acetabular-cup-position-and-risk-of-dislocation-in-primary-total-hip-arthroplasty
#11
REVIEW
Kurt G Seagrave, Anders Troelsen, Henrik Malchau, Henrik Husted, Kirill Gromov
Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We performed a systematic review to describe the different methods for measuring cup placement, target zones for cup positioning, and the association between cup positioning and dislocation following primary THA. Methods - A systematic search of literature in the PubMed database was performed (January and February 2016) to identify articles that compared acetabular cup positioning and the risk of dislocation...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#12
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27834161/periprosthetic-infection-following-primary-hip-and-knee-arthroplasty-the-impact-of-limiting-the-postoperative-surveillance-period
#13
Virginia R Roth, Robyn Mitchell, Julie Vachon, Stéphanie Alexandre, Kanchana Amaratunga, Stephanie Smith, Mary Vearncombe, Ian Davis, Dominik Mertz, Elizabeth Henderson, Michael John, Lynn Johnston, Camille Lemieux, Linda Pelude, Denise Gravel
BACKGROUND Hip and knee arthroplasty infections are associated with considerable healthcare costs. The merits of reducing the postoperative surveillance period from 1 year to 90 days have been debated. OBJECTIVES To report the first pan-Canadian hip and knee periprosthetic joint infection (PJI) rates and to describe the implications of a shorter (90-day) postoperative surveillance period. METHODS Prospective surveillance for infection following hip and knee arthroplasty was conducted by hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) using standard surveillance definitions...
February 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27816690/multifragmentary-dislocated-humeral-head-fracture-a-case-report-of-a-successful-head-preserving-treatment-strategy-despite-delayed-presentation
#14
Matthias Bungartz, Georg Matziolis, Sebastian Rohe, Olaf Brinkmann
INTRODUCTION: Head preserving, delayed osteosynthesis five days after a luxated, multifragmentary humeral head fracture is rarely seen and a challenge for the surgeon. PRESENTATION OF CASE: This case history describes the case of a 69-year-old female with delayed head preserving treatment of a dislocated multifragmentary humeral head fracture using intramedullary nailing, avoiding a primary trauma arthroplasty after strict refusal of the patient despite poor prognosis and high risk of avascular humeral head necrosis...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27780348/increased-femoral-component-size-options-improves-manipulation-rate-in-females-and-knee-society-clinical-scores-in-males
#15
Nathan J Turnbull, Keith R Berend, Vincent Y Ng, Joanne B Adams, David A Crawford, Adolph V Lombardi
INTRODUCTION: The gender-specific total knee arthroplasty (TKA) debate focuses on differences in distal femoral mediolateral to anteroposterior aspect ratio between males and females. However, randomized studies have been unable to demonstrate significant differences in outcomes utilizing gender-specific implants. No studies have examined the effect of intermediate femoral component sizes on outcome. We compared outcomes before and after intermediate sizing availability. MATERIALS AND METHODS: We identified 331 patients (413 knees) who underwent primary TKA between 2003 and 2004 with a single complete knee system...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27759465/thromboembolic-and-major-bleeding-events-in-relation-to-perioperative-bridging-of-vitamin-k-antagonists-in-649-fast-track-total-hip-and-knee-arthroplasties
#16
Christoffer C Jørgensen, Henrik Kehlet
Background - The benefit of preoperative bridging in surgical patients with continuous anticoagulant therapy is debatable, and drawing of meaningful conclusions may have been limited by mixed procedures with different thromboembolic and bleeding risks in most published studies. Patients and methods - This was an observational cohort treatment study in consecutive primary unilateral total hip and knee arthroplasty patients between January 2010 and November 2013 in 8 Danish fast-track departments. Data were collected prospectively on preoperative comorbidity and anticoagulants in patients with preoperative vitamin K antagonist (VKA) treatment...
February 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/27737298/ceramic-femoral-heads-for-all-patients-an-argument-for-cost-containment-in-hip-surgery
#17
Cody C Wyles, Benjamin A McArthur, Eric R Wagner, Matthew T Houdek, Jose H Jimenez-Almonte, Robert T Trousdale
Trunnionosis and taper corrosion have recently emerged as problems in total hip arthroplasty (THA). No longer restricted to metal-on-metal bearings, these phenomena now affect an increasing number of metal-on-polyethylene THAs and are exacerbated by modularity. Resulting increases in metal toxicity and patient morbidity, and the added costs of toxicity surveillance and revision surgery, will place a substantial economic burden on many health systems. Although they are more expensive than cobalt-chrome heads, ceramic femoral heads make metal toxicity a nonissue...
September 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27717989/total-ankle-arthroplasty-versus-ankle-arthrodesis-for-the-treatment-of-end-stage-ankle-arthritis-a-meta-analysis-of-comparative-studies
#18
REVIEW
Hyun Jung Kim, Dong Hun Suh, Jae Hyuk Yang, Jin Woo Lee, Hak Jun Kim, Hyeong Sik Ahn, Seung Woo Han, Gi Won Choi
PURPOSE: Total ankle arthroplasty (TAA) and ankle arthrodesis (AA) are the main surgical treatment options for end-stage ankle arthritis. Although the superiority of each modality remains debated, there remains a lack of high-quality evidence-based studies, such as randomized controlled clinical trials, and meta-analyses of comparative studies. We performed a meta-analysis of comparative studies to determine whether there is a significant difference between these two procedures in terms of (i) clinical scores and patient satisfaction, (ii) re-operations, and (iii) complications...
January 2017: International Orthopaedics
https://www.readbyqxmd.com/read/27708733/patch-augmented-rotator-cuff-repair-and-superior-capsule-reconstruction
#19
M Petri, J A Greenspoon, S G Moulton, P J Millett
BACKGROUND: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27695880/-current-aspects-of-therapy-of-rhizoarthrosis
#20
REVIEW
T Lögters, S Gehrmann, J Windolf
In patients with carpometacarpal osteoarthritis of the thumb, treatment strategies should be based on functional impairment and pain. Although X‑ray imaging is an integral component of the diagnostics, it is of subordinate importance for the therapy algorithm. Conservative therapy is always the first step in the chain of treatment. The efficacy of non-operative treatment, including intermittent immobilization using splinting and the application of technical assist devices in the daily routine has been proven to achieve pain relief...
December 2016: Der Unfallchirurg
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