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https://www.readbyqxmd.com/read/29335747/patellar-resurfacing-versus-patellar-retention-in-primary-total-knee-arthroplasty-a-systematic-review-of-overlapping-meta-analyses
#1
REVIEW
Alberto Grassi, Riccardo Compagnoni, Paolo Ferrua, Stefano Zaffagnini, Massimo Berruto, Kristian Samuelsson, Eleonor Svantesson, Pietro Randelli
PURPOSE: The need of patellar resurfacing in total knee arthroplasty (TKA) is a subject of debate. This systematic review of overlapping meta-analyses aimed to assess and analyze current evidence regarding patellar resurfacing and non-resurfacing in TKA. METHODS: A systematic literature search was performed in March 2017 in PubMed, CINAHL and Cochrane Library. Inclusion criteria were meta-analysis of randomized controlled trials that compared TKA with and without patellar resurfacing considering as outcomes re-operations rate, complications, anterior knee pain, functional scores...
January 15, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29325724/rheumatoid-arthritis-disease-modifying-agents-and-periprosthetic-joint-infection-what-does-a-joint-surgeon-need-to-know
#2
REVIEW
Mehrnoush H Yeganeh, Michael M Kheir, Alisina Shahi, Javad Parvizi
The incidence of periprosthetic joint infection (PJI) among patients with rheumatoid arthritis (RA) is 1.6× greater than in patients undergoing the same procedure for osteoarthritis. This higher risk "may" be due to the immunosuppressive therapies for RA patients including corticosteroids, such as prednisone, and disease-modifying antirheumatic drugs (DMARDs), such as methotrexate. There is a debate about the role of DMARDs in increasing the incidence of subsequent PJI. Studies show conflicting results, with some demonstrating no significant increase in the rates of PJI and some finding otherwise...
November 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29291158/antibiotic-prophylaxis-and-dair-treatment-in-primary-total-hip-and-knee-arthroplasty-a-national-survey-in-the-netherlands
#3
Ewout S Veltman, Dirk Jan F Moojen, Rob Ghh Nelissen, Rudolf W Poolman
BACKGROUND: To prevent postoperative infection the use of systemic antibiotic prophylaxis is common ground. Type of antibiotic used and duration of prophylaxis are subject to debate. In case of suspected early periprosthetic infection a debridement, antibiotics and implant retention (DAIR) procedure is treatment of first choice. This study evaluated the antibiotic prophylaxis and DAIR treatment protocols nationwide as well as reporting of these DAIR procedures to the national joint registry...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29285567/management-of-symptomatic-knee-osteoarthritis-in-obesity-a-survey-of-orthopaedic-surgeons-opinions-and-practice
#4
Daniel S Hill, Matthew Freudmann, Jamie C Sergeant, Tim Board
INTRODUCTION: The aim of this survey was to explore knee surgeons' opinions and practices regarding the management of symptomatic knee osteoarthritis in obesity. METHODS: Questionnaires were sent electronically to all consultant members of the British Association for Surgery of the Knee. RESULTS: The response rate was 52%. The survey showed considerable practice variation and divided opinion on the evidence base. The majority stated that weight loss should be the first-line treatment...
December 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29280006/minimally-invasive-unicompartmental-knee-arthroplasty
#5
REVIEW
Jean-Yves Jenny
The exact indication for a unicompartmental knee arthroplasty (UKA) remains debated. Minimally invasive techniques have been developed to decrease the surgical trauma related to the prosthesis implantation, and this technique is well fitted to UKA. However, there are concerns about loss of accuracy with minimally invasive techniques. Furthermore, rapid recovery techniques have been developed in order to reduce the length of hospital stay. Again, UKA is well fitted to these new developments of postoperative care...
December 26, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29247357/tibial-internal-rotation-negatively-affects-clinical-outcomes-in-total-knee-arthroplasty-a-systematic-review
#6
REVIEW
Alfredo Schiavone Panni, Francesco Ascione, Marco Rossini, Adriano Braile, Katia Corona, Michele Vasso, Michael T Hirschmann
PURPOSE: The aim of this systematic review is to analyze the effect of tibial rotational alignment after total knee arthroplasty (TKA) on clinical outcomes and assess the eventual cut-off values for tibial TKA rotation leading to poor outcomes. METHODS: A detailed and systematic search from 1997 to 2017 of the Pubmed, Medline, Cochrane Reviews, and the Google Scholar databases was performed using the keyword terms "total knee arthroplasty", "total knee replacement", "tibial alignment", "tibial malalignement", "tibial rotation", "rotational error", "axis", "angle", "tibial malrotation", "clinical outcome", in several combinations...
December 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29208330/what-is-the-impact-of-advancing-age-on-the-outcomes-of-total-hip-arthroplasty
#7
Benjamin P d'S Murphy, Michelle M Dowsey, Tim Spelman, Peter F M Choong
BACKGROUND: The global demand for total hip arthroplasty (THA) is increasing, underscoring its moniker as the "operation of the century." However, debate still exists as to whether the elderly who undergo the operation achieve the same outcomes as those younger. In this study, we sought to investigate the association between older age and the risks and benefits of THA. METHODS: In this study, we aimed to compare the risks and benefits of THA of those aged ≥80 years vs those <80 years...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29189125/use-of-antibiotic-loaded-biomaterials-for-the-management-of-bone-prosthesis-infections-rationale-and-limits
#8
Matilde Tschon, Maria Sartori, Deyanira Contartese, Gianluca Giavaresi, Nicolo Nicoli Aldini, Milena Fini
BACKGROUND: Periprosthetic joint infection still represents a challenging issue for the orthopedic community. In the United States approximately a million joint arthroplasties are performed each year, with infection rates ranging from 1 to 2%: revisions has significant implications in health care costs and appropriate resources management. The use of locally applied antibiotics as a prophylaxis measure or as a component of the therapeutic approach in primary or revision surgery is finalized at eliminating any microorganism and strengthening the effectiveness of systemic therapy...
November 29, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29176493/the-relative-effects-of-manual-versus-automatic-exposure-control-on-radiation-dose-to-vital-organs-in-total-hip-arthroplasty
#9
Katharine D Harper, Shidong Li, Rachel Jennings, Kamil M Amer, Christopher Haydel, Sayed Ali
INTRODUCTION: Technologic advances have reduced medical radiation exposure while maintaining image quality. The purpose of this study was to determine the effects of the presence of total hip arthroplasty implants, compared with native hips, on radiation exposure of the most radiosensitive organs when manual and automatic exposure control settings are used. METHODS: Detection probes were placed at six locations (stomach, sigmoid colon, right pelvic wall, left pelvic wall, pubic symphysis, and anterior pubic skin) in a cadaver...
November 20, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29174023/antibiotic-treatment-of-asymptomatic-bacteriuria-prior-to-hip-and-knee-arthroplasty-a-systematic-review-of-the-literature
#10
REVIEW
Alistair I W Mayne, Peter S E Davies, James M Simpson
BACKGROUND: There is significant debate as to whether routine antibiotic treatment of asymptomatic bacteriuria (ASB) in arthroplasty patients reduces the risk of subsequent PJI. No previous systematic reviews have been undertaken on this subject. The aim of this systematic review was to investigate whether antibiotic treatment of asymptomatic bacteriuria in arthroplasty patients reduces the risk of prosthetic joint infection and to investigate whether the organisms cultured in peri-operative urine samples are the same as those responsible for subsequent prosthetic joint infections...
November 21, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29169720/treatment-of-radial-head-fractures-and-need-for-revision-procedures-at-1%C3%A2-and%C3%A2-2%C3%A2-years
#11
Eli S Kupperman, Asher I Kupperman, Scott A Mitchell
PURPOSE: Optimal treatment strategies for radial head fractures remain a subject of debate. We examined national practice patterns in the management of radial head fractures to determine rates of surgical treatment, type of surgery employed, and the incidence of reoperation. METHODS: Between 2007 and 2011, we identified patients with radial head fractures along with their associated injuries by International Classification of Diseases, Ninth Revision codes in a national database of orthopedic insurance records...
November 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29165342/knee-and-ankle-arthroplasty-in-hemophilia
#12
REVIEW
Luigi Piero Solimeno, Gianluigi Pasta
Today, major surgical procedures can be safely performed in hemophilic patients with chronic arthropathy, using available factor concentrates. In this setting, total knee replacement is considered the "gold standard", while the use of total ankle replacement is still debated. Indeed, the unsatisfactory results obtained with the previous available design of implants did not raise enthusiasm as knee or hip replacement. Recently, the introduction of new implant designs and better reported outcomes have renewed the interest in total ankle replacement in people with hemophilia...
November 22, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29160130/the-effect-of-bearing-type-on-the-outcome-of-total-hip-arthroplasty
#13
Rinne M Peters, Liza N Van Steenbergen, Martin Stevens, Paul C Rijk, Sjoerd K Bulstra, Wierd P Zijlstra
Background and purpose - Alternative bearing surfaces such as ceramics and highly crosslinked polyethylene (HXLPE) were developed in order to further improve implant performance of total hip arthroplasties (THAs). Whether these alternative bearing surfaces result in increased longevity is subject to debate. Patients and methods - Using the Dutch Arthroplasty Register (LROI), we identified all patients with a primary, non-metal-on-metal THA implanted in the Netherlands in the period 2007-2016 (n = 209,912). Cumulative incidence of revision was calculated to determine differences in survivorship of THAs according to bearing type: metal-on-polyethylene (MoPE), metal-on-HXLPE (MoHXLPE), ceramic-on-polyethylene (CoPE), ceramic-on-HXLPE (CoHXLPE), ceramic-on-ceramic (CoC), and oxidized-zirconium-on-(HXL)polyethylene (Ox(HXL)PE)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29153864/changes-in-markers-of-thrombin-generation-and-interleukin-6-during-unicondylar-knee-and-total-knee-arthroplasty
#14
Edwin P Su, Lauren E Mount, Allina A Nocon, Thomas P Sculco, George Go, Nigel E Sharrock
BACKGROUND: Total knee arthroplasty (TKA) is associated with a risk of thromboembolism requiring routine thromboprophylaxis, but there is debate about the risk with unicondylar knee arthroplasty (UKA) as it is a more minor procedure. We sought to investigate the relative risk of thromboembolism with UKA compared to TKA and one-staged bilateral TKA (BTKA) by measuring the increase in circulating biochemical markers of thrombin generation during the procedures. Degree of surgical trauma was also assessed by measuring interleukin-6, a marker of metabolic injury...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29135661/reconsidering-the-affordable-care-act-s-restrictions-on-physician-owned-hospitals-analysis-of-cms-data-on-total-hip-and-knee-arthroplasty
#15
P Maxwell Courtney, Brian Darrith, Daniel D Bohl, Nicholas B Frisch, Craig J Della Valle
BACKGROUND: Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29114630/unicompartmental-knee-arthroplasty-modes-of-failure-and-conversion-to-total-knee-arthroplasty
#16
REVIEW
Michele Vasso, Katia Corona, Rocco D'Apolito, Giuseppe Mazzitelli, Alfredo Schiavone Panni
Despite the excellent success rates of the modern unicompartmental knee arthroplasty (UKA), results of knee replacement registries still shows a relatively high revision and failure rate for UKA, especially when compared with traditional total knee arthroplasty (TKA). Bearing dislocation continues to be advocated as the predominant mechanism of failure in mobile UKA, whereas polyethylene wear and aseptic loosening remains the main cause of failure of fixed UKA. Degeneration of the unreplaced compartments has been reported in both mobile and fixed designs...
March 2017: Joints
https://www.readbyqxmd.com/read/29076886/effects-of-forced-air-warming-on-airflow-around-the-operating-table
#17
Kazuhiro Shirozu, Tetsuya Kai, Hidekazu Setoguchi, Nobuyasu Ayagaki, Sumio Hoka
BACKGROUND: Forced air warming systems are used to maintain body temperature during surgery. Benefits of forced air warming have been established, but the possibility that it may disturb the operating room environment and contribute to surgical site contamination is debated. The direction and speed of forced air warming airflow and the influence of laminar airflow in the operating room have not been reported. METHODS: In one institutional operating room, we examined changes in airflow speed and direction from a lower-body forced air warming device with sterile drapes mimicking abdominal surgery or total knee arthroplasty, and effects of laminar airflow, using a three-dimensional ultrasonic anemometer...
October 26, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29026941/neutral-alignment-leads-to-higher-knee-society-scores-after-total-knee-arthroplasty-in-preoperatively-non-varus-patients-a-prospective-clinical-study-using-3d-ct
#18
Omer Slevin, Anna Hirschmann, Filippo F Schiapparelli, Felix Amsler, Rolf W Huegli, Michael T Hirschmann
PURPOSE: The optimal coronal alignment is still under debate. However, in most of the studies, alignment was only assessed using radiographs, which are not accurate enough for assessment of tibial and femoral TKA position. The primary purpose of this study was to assess the relationship between coronal TKA alignment using 3D-reconstructed CTs and clinical outcome in patients with preoperative varus in comparison with patients with natural or valgus deformity. It was the hypothesis that neutral limb alignment shows a better outcome after TKA...
October 12, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28988612/cost-analysis-complications-and-discharge-disposition-associated-with-simultaneous-vs-staged-bilateral-total-knee-arthroplasty
#19
Ali H Sobh, Matthew P Siljander, Anthony J Mells, Denise M Koueiter, Drew D Moore, Mark S Karadsheh
BACKGROUND: Simultaneous vs staged bilateral total knee arthroplasty (BTKA) has long been debated. The primary objective of this study was to compare actual hospital costs and complication rates in patients undergoing simultaneous BTKA (simBTKA) and staged BTKA (staBTKA) at a single institution. METHODS: A total joint arthroplasty database from a single hospital was used to identify all patients who underwent primary BTKA from 2013 to 2016 and divided into simultaneous and staged groups...
September 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28886100/biomechanical-evaluation-of-tibial-bone-adaptation-after-revision-total-knee-arthroplasty-a-comparison-of-different-implant-systems
#20
María Paz Quilez, Belen Seral, María Angeles Pérez
The best methods to manage tibial bone defects following total knee arthroplasty remain under debate. Different fixation systems exist to help surgeons reconstruct knee osseous bone loss (such as tantalum cones, cement, modular metal augments, autografts, allografts and porous metaphyseal sleeves) However, the effects of the various solutions on the long-term outcome remain unknown. In the present work, a bone remodeling mathematical model was used to predict bone remodeling after total knee arthroplasty (TKA) revision...
2017: PloS One
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