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https://www.readbyqxmd.com/read/29792786/imageless-navigation-total-hip-arthroplasty-an-evaluation-of-operative-time
#1
Epaminondas Markos Valsamis, David Ricketts, Adnan Hussain, Amir-Reza Jenabzadeh
INTRODUCTION: Imageless navigation has been successfully integrated in knee arthroplasty but its effectiveness in total hip arthroplasty (THA) has been debated. It has consistently been shown that navigation adds significant time and cost to the operation. Further, the relative success of traditional hip replacements has impeded the adoption of new techniques. METHODS: We compared the operative time between fifty total hip replacements with and without the use of imageless navigation by a single senior surgeon in a retrospective study...
2018: SICOT-J
https://www.readbyqxmd.com/read/29779404/is-intra-articular-injection-of-synvisc-associated-with-a-delay-to-knee-arthroplasty-in-patients-with-knee-osteoarthritis
#2
Kevin L Ong, Maria Runa, Edmund Lau, Roy Altman
Objective There is debate about the effectiveness of intra-articular (IA) hyaluronic acid (HA) injections. We asked the following questions: (1) What is the epidemiology of IA HA use in knee arthroplasty (KA) patients? (2) Is Synvisc associated with a delay to KA? (3) Is there a difference in the delay to KA with the number of HA courses? Design The Optum Clinformatics data set (2006-June 2016) was used to identify patients with knee osteoarthritis (OA). Patients who did not receive IA HA were identified, along with those who received Synvisc or non-Synvisc HA...
May 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29762111/direct-anterior-approach-has-lower-deep-infection-frequency-than-less-invasive-direct-lateral-approach-in-primary-total-hip-arthroplasty
#3
Sean A Sutphen, Keith R Berend, Michael J Morris, Adolph V Lombardi
Debate continues over the direct anterior (DA) approach. The purpose of this study is to compare the frequency of deep infection between a DA approach and a less invasive direct lateral (LIDL) approach in a large consecutive series of primary total hip arthroplasty (THA). The authors identified 5702 primary THAs performed between 2007 and 2014. DA approach was used in 3540 hips and LIDL in 2162. Patient records were reviewed. Statistical analysis of reoperation, infection- or wound-related complication, and deep infection was performed...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29734847/body-mass-index-and-in-hospital-postoperative-complications-following-primary-total-hip-arthroplasty
#4
Usha Gurunathan, Cameron Anderson, Kate E Berry, Sarah L Whitehouse, Ross W Crawford
BACKGROUND: The influence of obesity measured in terms of body mass index (BMI) on the complication rates following total hip arthroplasty (THA) is a matter of debate. METHODS: This retrospective study conducted at a tertiary referral centre at Brisbane, Australia, examines the association between BMI and in-hospital postoperative complications, length of operating time and duration of hospital stay in 964 patients, who underwent THA from 2006 to 2010. RESULTS: Amongst patients undergoing primary THA, when compared to the normal weight patients, those with BMI between 25 kg/m2 and 29...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29731320/the-largest-survivorship-and-clinical-outcomes-study-of-the-fixed-bearing-stryker-triathlon-partial-knee-replacement-a-multi-surgeon-single-centre-cohort-study-with-a-minimum-of-two-years-of-follow-up
#5
S W F Middleton, P J Schranz, V I Mandalia, A D Toms
BACKGROUND: The surgical management of isolated medial compartment degenerative disease of the knee causes debate. Unicompartmental arthroplasty options include fixed and mobile bearing implant designs with fixed bearing becoming increasingly popular. We present the largest cohort of a fixed bearing single radius design, Stryker Triathlon Partial Knee Replacement (PKR). METHODS: We prospectively collected demographic data and patient reported outcome measures (PROMs) on our cohort of PKR implants since its adoption in our unit, 2009 until March 2015...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29729936/single-stage-bilateral-medial-oxford-unicompartmental-knee-arthroplasty-a-case-control-study-of-perioperative-blood-loss-complications-and-functional-results
#6
Arnaud Clavé, Emeline Gauthier, Navraj S Nagra, François Fazilleau, A Anthony Le Sant, Frédéric Dubrana
BACKGROUND: The benefits and risks of a single-stage medial UKA remains a subject of debate because of the theoretically higher risk of complications and specifically blood loss. The aim of this study was to evaluate the perioperative blood loss, risks and the functional results of single-stage bilateral medial Oxford Unicompartmental Knee Arthroplasty (OUKA) compared to a standard unilateral medial OUKA procedure (control group). HYPOTHESIS: the blood loss observed during bilateral single-stage medial Oxford UKA is not different from that of the control group...
May 3, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29721464/unicompartmental-knee-replacement-in-patients-aged-70-years-and-older
#7
Alberto Ventura, Claudio Legnani, Enrico Borgo
Introduction: The management of isolated unicompartmental osteoarthritis in the patient aged 70 years and older is an issue of debate. The purpose of the present study was to retrospectively evaluate the outcomes of patients aged over 70 years who underwent unicompartmental knee replacement (UKR) for the treatment of isolated unicompartmental osteoarthritis. The hypothesis was that this represents a safe and viable procedure leading to improved functional outcome in elderly patients affected by isolated unicompartmental osteoarthritis...
October 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/29683803/is-cemented-or-cementless-femoral-stem-fixation-more-durable-in-patients-older-than-75-years-of-age-a-comparison-of-the-best-performing-stems
#8
Michael Tanzer, Stephen E Graves, Andrea Peng, Andrew J Shimmin
BACKGROUND: There is ongoing debate concerning the best method of femoral fixation in older patients receiving primary THA. Clinical studies have shown high survivorship for cemented and cementless femoral stems. Arthroplasty registry studies, however, have universally shown that cementless stems are associated with a higher rate of revision in this patient population. It is unclear if the difference in revision rate is a reflection of the range of implants being used for these procedures rather than the mode of fixation...
April 9, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29656129/no-difference-in-implant-survivorship-and-clinical-outcomes-between-full-cementless-and-full-cemented-fixation-in-primary-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#9
REVIEW
Kai Zhou, Haoda Yu, Jinglong Li, Haoyang Wang, Zongke Zhou, Fuxing Pei
BACKGROUND: The debate over the use of cemented or cementless fixation in total knee arthroplasty (TKA) has never stopped since cementless fixation was introduced. We undertook a systematic review and meta-analysis to evaluate the optimal mode of fixation (full-cementless vs. full-cemented) in TKA. METHODS: PubMed, Embase, and the Cochrane Library databases up to July 2017 were searched to identify randomised controlled trials (RCTs) and quasi-RCTs comparing full-cementless TKA and full-cemented TKA...
April 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29627258/does-prior-failed-debridement-compromise-the-outcome-of-subsequent-two-stage-revision-done-for-periprosthetic-joint-infection-following-total-knee-arthroplasty
#10
Ashok Rajgopal, Inayat Panda, Arun Rao, Vivek Dahiya, Himanshu Gupta
BACKGROUND: There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). METHODS: This is a retrospective study of a consecutive series of 184 knees that completed 2-stage revision TKA for PJI, operated by a single surgeon between January 2000 and July 2011...
March 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29613922/risk-reduction-compared-with-access-to-care-quantifying-the-trade-off-of-enforcing-a-body-mass-index-eligibility-criterion-for-joint-replacement
#11
Nicholas J Giori, Derek F Amanatullah, Shalini Gupta, Thomas Bowe, Alex H S Harris
BACKGROUND: Morbidly obese patients with severe osteoarthritis benefit from successful total joint arthroplasty. However, morbid obesity increases the risk of complications. Because of this, some surgeons enforce a body mass index (BMI) eligibility criterion above which total joint arthroplasty is denied. In this study, we investigate the trade-off between avoiding complications and restricting access to care when enforcing BMI-based eligibility criteria for total joint arthroplasty. METHODS: In this retrospective cohort study, the Veterans Health Administration (VHA) Corporate Data Warehouse (CDW) and Veterans Affairs Surgical Quality Improvement Program (VASQIP) databases were reviewed for patients undergoing total joint arthroplasty from October 2011 through September 2014...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29578494/patient-specific-instruments-routine-use-over-conventional-total-knee-arthroplasty-remains-inconclusive-analysis-of-961-cases
#12
Antonio Klasan, Philipp Dworschak, Thomas J Heyse, Matthias Lahner, Dominik Malcherczyk, Turgay Efe, Bilal Farouk El-Zayat
BACKGROUND: An increasing demand for total knee arthroplasty (TKA) has pushed innovations in the industry and created a promising new technique called patient specific instruments (PSI). Early reports had promising results such as reducing operative time, cost, and improved alignment. More recent reports are conflicting. OBJECTIVE: We aimed to evaluate bleeding, operative time, complication rates, and in-hospital stay. METHODS: A monocentric retrospective analysis was performed on a total of 961 patients that met inclusion criteria...
March 16, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29576638/is-combined-administration-of-tranexamic-acid-better-than-both-intravenous-and-topical-regimes-for-total-loss-hidden-loss-and-post-operative-swelling-a-randomized-control-trial
#13
Jatin Prakash, Jong-Keun Seon, Eun-Kyoo Song, Dong-Hyun Lee, Hong-Yeol Yang, Cheng Jin
Background: Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic acid (TXA) in last decade has emerged as an effective and safe way to decrease postoperative bleeding and transfusion rates. Although there is little doubt on the efficacy of the drug, the debate on ideal mode is more recent. We undertook this study to find out the most effective and yet safest way of TXA administration. Materials and Methods: A single institution - two hospital-based, double-blinded, prospective, randomized control trial was conducted from January 2015 to December 2015...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29573914/prior-high-tibial-osteotomy-does-not-affect-the-survival-of-total-knee-arthroplasties-results-from-the-danish-knee-arthroplasty-registry
#14
Anders El-Galaly, Poul T Nielsen, Steen L Jensen, Andreas Kappel
BACKGROUND: High tibial osteotomy (HTO) is a joint preserving treatment of unicompartmental osteoarthritis in the knee. In cases with insufficient or deteriorating clinical results patients may undergo a total knee arthroplasty (TKA). The influence of prior HTO on TKA survival is debated. METHODS: We conducted a population-based registry study comparing 1044 primary TKAs in patients with prior HTO to 63,763 de novo TKAs inserted from 1997 to 2015. Implant survival was estimated by Kaplan-Meier analysis with revision of any kind as endpoint...
February 28, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29502687/editorial-commentary-are-we-running-out-of-treatments-for-osteoarthritis-of-the-knee
#15
EDITORIAL
Louis F McIntyre
A considerable body of literature with high-level evidence has been published in the past 15 years calling into question the value of arthroscopic surgery in treating osteoarthritis of the knee (OAK). This, plus recent guidelines advising against the use of conservative treatments such as hyaluronic viscosupplementation, threatens to limit patient access to treatment for a chronic disease state with no known cure. The disease burden of OAK is considerable and represents one of the largest health care dollar expenditures in the United States and the world...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29463360/severe-arthritic-changes-following-acetabular-labral-repair-and-femoroplasty-in-an-air-force-pilot
#16
Christopher J Sardon, Mathew L Resnick
BACKGROUND: Acetabular labral tears in the hip have become an increasingly common finding in active duty members due to improved diagnostic capabilities. This has led to a dramatic increase in operative management despite a lack of evidence to support clear long-term benefits. Literature review demonstrated overwhelmingly positive short-term outcomes for labral repairs; however, scattered case reports exist demonstrating debilitating outcomes in young patients, ultimately resulting in total hip arthroplasty...
February 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29462043/equal-pay-for-equal-work-medicare-procedure-volume-and-reimbursement-for-male-and-female-surgeons-performing-total-knee-and-total-hip-arthroplasty
#17
Emma B Holliday, Christina Brady, William C Pipkin, Jeremy S Somerson
BACKGROUND: The observed sex gap in physician salary has been the topic of much recent debate in the United States, but it has not been well-described among orthopaedic surgeons. The objective of this study was to evaluate for sex differences in Medicare claim volume and reimbursement among orthopaedic surgeons. METHODS: The Medicare Provider Utilization and Payment Public Use File was used to compare claim volume and reimbursement between female and male orthopaedic surgeons in 2013...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29422350/the-ideal-total-hip-replacement-bearing-surface-in-the-young-patient-a-prospective-randomized-trial-comparing-alumina-ceramic-on-ceramic-with-ceramic-on-conventional-polyethylene-15-year-follow-up
#18
Amit Atrey, Jesse I Wolfstadt, Nasir Hussain, Amir Khoshbin, Sarah Ward, Mohammad Shahid, Emil H Schemitsch, James P Waddell
BACKGROUND: The optimum bearing surface for total hip arthroplasty remains debatable. We have previously published our outcome at 10 years and this represents the 15-year follow-up. METHODS: A total of 58 hips (in 57 patients with a mean age of 42 years) were randomized to receive either ceramic-on-ceramic (CoC) or ceramic-on-polyethylene (CoP) total hip arthroplasty. We prospectively followed for survivorship, functional outcomes (using the Harris Hip Score and the St Michael's Hip Score [SMH]), and radiological outcomes...
December 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29398257/a-comparison-of-mobile-and-fixed-bearing-unicompartmental-knee-arthroplasty-at-a-minimum-10-year-follow-up
#19
Michael E Neufeld, Anthony Albers, Nelson V Greidanus, Donald S Garbuz, Bassam A Masri
BACKGROUND: The long-term survivorship and functional outcomes of the mobile-bearing (MB) compared to the fixed-bearing (FB) unicompartmental knee arthroplasty (UKA) implant design remain a topic of debate. The aim of the current study was to compare the survivorship and functional outcomes of MB and FB UKA at a minimum 10-year follow-up. METHODS: We retrospectively reviewed 106 consecutive medial UKAs (89 patients) from our institution with a minimum 10-year follow-up...
January 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29395744/tourniquet-time-in-total-knee-arthroplasty
#20
Lasse E Rasmussen, Henriette A Holm, Per W Kristensen, Per Kjaersgaard-Andersen
BACKGROUND: Whether the arterial tourniquet in total knee arthroplasty (TKA) is a friend or a foe is still debated. Longer ischemia causes hypoxic damage; yet short duration of a tourniquet may influence outcome. Understanding the time-dependent influence of the tourniquet in TKA patients could improve the overall outcome and safety. The purpose of the study was to measure the tourniquet-induced time-dependent alterations in skeletal muscle metabolism in TKA to establish a 'safe tourniquet time...
March 2018: Knee
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