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https://www.readbyqxmd.com/read/27886354/a-retrospective-analysis-of-the-merits-and-challenges-associated-with-simultaneous-bilateral-tha-using-the-direct-anterior-approach
#1
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
#2
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...
November 23, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#3
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
#4
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...
November 11, 2016: 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
#5
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...
October 29, 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
#6
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
#7
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...
October 19, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27737298/ceramic-femoral-heads-for-all-patients-an-argument-for-cost-containment-in-hip-surgery
#8
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
#9
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...
October 7, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27708733/patch-augmented-rotator-cuff-repair-and-superior-capsule-reconstruction
#10
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
#11
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...
September 30, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27687918/does-laminar-airflow-make-a-difference-to-the-infection-rates-for-lower-limb-arthroplasty-a-study-using-the-national-joint-registry-and-local-surgical-site-infection-data-for-two-hospitals-with-and-without-laminar-airflow
#12
S Singh, S Reddy, Raj Shrivastva
This study compared the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) data for total hip replacements (THRs) and total knee replacements (TKRs) from Hospital A [with laminar airflow (LAF)] and Hospital B (without LAF). These hospitals were originally managed by two different trusts that subsequently merged. Consequently, the theatres in Hospital A have always had LAF and those in Hospital B had only conventional ventilation systems. As this merger happened before the establishment of the NJR, it puts us in a unique position, enabling direct comparison of the revision rates for infected hip and knee replacements between the two hospitals that follow similar infection protocols...
September 29, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27631647/navigated-small-implants-in-knee-reconstruction
#13
Norberto Confalonieri, Alessio Biazzo, Pietro Cerveri, Chris Pullen, Alfonso Manzotti
PURPOSE: At the beginning of this century, unprecedented interest in the concept of using less invasive approaches for the treatment of knee degenerative diseases was ignited. Initial interest in this approach was about navigated and non-navigated knee reconstruction using small implants and conventional total knee arthroplasty. METHODS: To this end, a review of the published literature relating to less invasive compartmental arthroplasty of the knee using computer-based alignment techniques and on soft tissue-dedicated small implants is presented...
September 15, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27605686/hyaluronic-acid-injections-for-treatment-of-advanced-osteoarthritis-of-the-knee-utilization-and-cost-in-a-national-population-sample
#14
Jack W Weick, Harpreet S Bawa, Douglas R Dirschl
BACKGROUND: The prevalence of knee osteoarthritis is increasing in the aging U.S. POPULATION: The efficacy and cost-effectiveness of the use of hyaluronic acid (HA) injections for the treatment of knee osteoarthritis are debated. In this study, we assessed the utilization and costs of HA injections in the 12 months preceding total knee arthroplasty (TKA) and evaluated the usage of HA injections in end-stage knee osteoarthritis management in relation to other treatments...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27600571/-primary-radial-head-arthroplasty-in-trauma-complications
#15
K Schmidt-Horlohé, S Buschbeck, D Wincheringer, M Weißenberger, R Hoffmann
Radial head fractures are common injuries in elbow trauma. Non-displaced fractures are best treated conservatively. Simple but displaced fractures require anatomic reduction and fixation, typically using screws. The treatment course for complex fractures with multiple fragments is still being debated, as results are less predictable. Radial head resection is not advised if concomitant injuries of the coronoid process or the collateral ligaments with instability are present. Favorable outcomes following open reduction and fixation using plates were reported recently...
October 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27595069/blood-management-in-total-knee-arthroplasty-updates-and-debates
#16
EDITORIAL
Kang-Il Kim
No abstract text is available yet for this article.
September 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27593372/postoperative-patient-education-in-physiotherapy-after-hip-arthroplasty-patients-perspective
#17
Anna-Maija Jäppinen, Harri Hämäläinen, Tarja Kettunen, Arja Piirainen
The objective of the present study was to explore postoperative patient education in physiotherapy from total hip arthroplasty (THA) patients' perspectives, which has been a little-studied area of research. The usefulness of rehabilitation protocols after THA has been debated over the years, and there are no clear guidelines for physiotherapy after THA METHODS: The data for the present qualitative study were collected from nine patients with THA by using individual interviews at the hospital after surgery. The interviews were audio-recorded and analysed by using a phenomenographic method RESULTS: Four different categories of postoperative patient education in physiotherapy after hip arthroplasty were produced: trust while in hospital; preparing for going home; managing at home; and regaining physical fitness...
September 4, 2016: Musculoskeletal Care
https://www.readbyqxmd.com/read/27567057/intravenous-vs-intra-articular-tranexamic-acid-in-total-knee-arthroplasty-a-randomized-double-blind-trial
#18
Navendu Goyal, Darren B Chen, Ian A Harris, Neville J Rowden, George Kirsh, Samuel J MacDessi
BACKGROUND: Tranexamic acid (TXA) is commonly used in primary total knee arthroplasty (TKA); however, the most appropriate route of administration is still debated. This study was conducted to compare the 2 most commonly used routes of TXA administration, intravenous (IV) and intra-articular (IA). METHODS: This study was conducted as a double-blind, randomized, noninferiority trial and included patients undergoing primary unilateral TKA. Patients were randomized to receive IV or IA TXA and compared for postoperative fall in hemoglobin (Hb) on day 1 (primary outcome) and day 2, and blood transfusion rates, length of stay, and complications...
July 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27559465/operative-management-of-lumbar-degenerative-disc-disease
#19
REVIEW
Yu Chao Lee, Mario Giuseppe Tedesco Zotti, Orso Lorenzo Osti
Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union...
August 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27547384/recent-advances-in-the-treatment-of-hip-fractures-in-the-elderly
#20
REVIEW
Joshua C Rozell, Mark Hasenauer, Derek J Donegan, Mark Neuman
The treatment of hip fractures in the elderly represents a major public health priority and a source of ongoing debate among orthopaedic surgeons and anesthesiologists. Most of these injuries are treated with surgery in an expedient fashion. From the surgical perspective, there are certain special considerations in this population including osteoporosis, pre-existing arthritis, age, activity level, and overall health that contribute to the type of surgical fixation performed. Open reduction and internal fixation versus arthroplasty remain the two major categories of treatment...
2016: F1000Research
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