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Hip and knee arthroplasty

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https://www.readbyqxmd.com/read/28522245/pin-site-complications-associated-with-computer-assisted-navigation-in-hip-and-knee-arthroplasty
#1
Eli Kamara, Zachary P Berliner, Matthew S Hepinstall, H John Cooper
BACKGROUND: There has been a great increase in the use of navigation technology in joint arthroplasty. In most types of navigation-assisted surgery, several temporary navigation pins are placed in the patient. Goals of this study are (1) to identify complications and (2) risk factors associated with placement of these pins. METHODS: This is a retrospective cohort study of all navigation-assisted hip and knee arthroplasty performed a single institution over a 3-year period...
April 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28522244/low-molecular-weight-heparin-and-the-relative-risk-of-surgical-site-bleeding-complications-results-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-of-venous-thromboprophylaxis-in-patients-after-total-joint-arthroplasty
#2
REVIEW
Kary Suen, Roger N Westh, Leonid Churilov, Andrew J Hardidge
BACKGROUND: Venous thromboembolism causes significant morbidity and mortality in patients after total joint arthroplasty. Although network meta-analyses have demonstrated a benefit of various thromboprophylactic agents, there remains a concern in the surgical community regarding the resulting wound complications. There is currently no systematic review of the surgical site bleeding complications of thromboprophylactic agents. The aim of this study was to systematically review the surgical site bleeding outcomes of venous thromboembolism prophylaxis in this population...
April 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28521834/incidence-of-total-hip-or-knee-replacement-due-to-osteoarthritis-in-relation-to-thyroid-function-a-prospective-cohort-study-the-nord-tr%C3%A3-ndelag-health-study
#3
Alf Inge Hellevik, Marianne Bakke Johnsen, Arnulf Langhammer, Anne Marie Fenstad, Ove Furnes, Kjersti Storheim, John Anker Zwart, Gunnar Flugsrud, Lars Nordsletten
BACKGROUND: To study whether thyroid function was associated with risk of hip or knee replacement due to primary osteoarthritis. METHODS: In a prospective cohort study, data from the second and third survey of the Nord-Trøndelag Health Study were linked to the Norwegian Arthroplasty Register in order to identify total hip or knee replacement as a result of primary osteoarthritis. RESULTS: Among 37 891 participants without previously known thyroid disease we recorded 978 total hip replacements (THRs) and 538 total knee replacements (TKRs) during a median follow-up time of 15...
May 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28515981/a-six-week-supervised-exercise-and-educational-intervention-after-total-hip-arthroplasty-a-case-series
#4
Federico Pozzi, Kathleen Madara, Joseph A Zeni
BACKGROUND AND PURPOSE: Most rehabilitation interventions after total hip arthroplasty (THA) are not designed to return patients to high-levels of physical activity and, thus, low levels of physical activity and residual weakness are common. The purpose of this case series was to describe the feasibility and preliminary efficacy of an exercise and education intervention for patients after THA who have already completed formal outpatient physical therapy. STUDY DESIGN: Case series...
April 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28512080/using-text-messaging-in-long-term-arthroplasty-follow-up-a-pilot-study
#5
Oliver Blocker, Alison Bullock, Rhidian Morgan-Jones, Adel Ghandour, James Richardson
BACKGROUND: Patient-reported outcome measures (PROMs) and mobile technology have the potential to change the way patients are monitored following joint replacement surgery. OBJECTIVE: The aim of this study was to determine the feasibility of text messaging to record PROMs in long-term follow-up of hip and knee arthroplasty. Our participants were 17 patients 2-years-plus post hip or knee arthroplasty attending clinic with a mobile telephone number on record. METHODS: A simple PROM (Oswestry Very Short Form) was texted to the patient...
May 16, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28511195/safety-aspects-of-postanesthesia-care-unit-discharge-without-motor-function-assessment-after-spinal-anesthesia-a-randomized-multicenter-semiblinded-noninferiority-controlled-trial
#6
Eske Kvanner Aasvang, Christoffer Calov Jørgensen, Mogens Berg Laursen, Jacob Madsen, Søren Solgaard, Mogens Krøigaard, Per Kjærsgaard-Andersen, Hans Mandøe, Torben Bæk Hansen, Jørgen Ulrich Nielsen, Niels Krarup, Annette Elisabeth Skøtt, Henrik Kehlet
BACKGROUND: Postanesthesia care unit (PACU) discharge without observation of lower limb motor function after spinal anesthesia has been suggested to significantly reduce PACU stay and enhance resource optimization and early rehabilitation but without enough data to allow clinical recommendations. METHODS: A multicenter, semiblinded, noninferiority randomized controlled trial of discharge from the PACU with or without assessment of lower limb motor function after elective total hip or knee arthroplasty under spinal anesthesia was undertaken...
June 2017: Anesthesiology
https://www.readbyqxmd.com/read/28507734/adverse-effect-profile-comparison-of-pain-regimens-with-and-without-intravenous-acetaminophen-in-total-hip-and-knee-arthroplasty-patients
#7
Alyssa Gallipani, A Scott Mathis, Hoytin Lee Ghin, Germin Fahim
BACKGROUND: The use of adjunct, non-opioid agents is integral for pain control following total hip and knee arthroplasty. Literature comparing safety profiles of intravenous acetaminophen versus opioids is lacking. OBJECTIVE: To determine whether there is a difference in frequency and type of adverse effects between intravenous acetaminophen-treated and non-intravenous acetaminophen-treated patients. Primary safety endpoints included any adverse effect noted in the electronic medical record post-surgically...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#8
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28503200/a-retrospective-cohort-study-of-adverse-events-in-patients-undergoing-orthopaedic-surgery
#9
Joel J Gagnier, Hal Morgenstern, Patrick Kellam
BACKGROUND: This study's objective was to identify adverse events following common orthopaedic procedures, and to estimate the incidence rates and risks of these events and their associations with age, sex, and comorbidities. METHODS: This retrospective cohort study manually reviewed and extracted electronic medical data on the incidence and predictors of adverse events that occurred within 90 days of the 50 most frequent orthopaedic surgeries at an academic hospital in 2010...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28503126/in-vitro-and-ex-vivo-measurement-of-prophylactic-dabigatran-concentrations-with-a-new-ecarin-based-thromboelastometry-test
#10
Mareike Kristina Körber, Elisabeth Langer, Martin Köhr, Klaus-Dieter Wernecke, Wolfgang Korte, Christian von Heymann
BACKGROUND: An increasing number of oral anticoagulants has been approved, including dabigatran etexilate (DE). DE is a direct thrombin inhibitor that requires no routine monitoring, but, if necessary (e.g. urgent surgery etc.), the diluted thrombin time measured with Hemoclot® has shown reliable results. So far, no point-of-care (PoC) assay is available to measure DE effects. The EcaTEM assay uses ecarin to initiate the coagulation cascade at the step of thrombin generation and measures the clotting time (CT) by thromboelastometry...
April 2017: Transfusion Medicine and Hemotherapy
https://www.readbyqxmd.com/read/28502535/even-cementless-surgeons-use-cement
#11
A Gulati, A R J Manktelow
BACKGROUND: Patients presenting with hip arthritis have huge variability in anatomy, bone quality, and functional expectation. These can contribute to a varying degree of complexity on both the femoral and acetabular sides. Surgeons should be aware of all the various options in fixation, bearing surface, and surgical technique. METHODS: In this article, based on a presentation given at the recent American Association of Hip and Knee Surgeons meeting in Dallas, we will discuss why and how cemented fixation can, and indeed should, be considered when making decisions regarding how a primary, complex primary, or revision hip arthroplasty should be performed...
March 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28502346/kinematics-and-function-of-total-ankle-replacements-versus-normal-ankles
#12
REVIEW
Justin M Kane, Scott Coleman, James W Brodsky
End-stage ankle arthritis produces severe functional disability, quantifiable by gait abnormalities. In all categories of gait parameters, total ankle arthroplasty (TAA) satistically significantly improves function, compared to patients' preoperative function. There are increases in step length, cadence and velocity; in sagittal plane motion of the ankle, as well has hip and knee motion, and in ankle power and moment. These functional gait improvements correspond to clinical improvements of pain relief and satisfaction...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28501678/the-risk-of-venous-thromboembolism-with-aspirin-compared-to-anticoagulants-after-hip-and-knee-arthroplasty
#13
Janet N Chu, Judith Maselli, Andrew D Auerbach, Margaret C Fang
BACKGROUND: Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthroplasty has not been well-defined, particularly in more contemporary patient populations. We compared rates of post-operative VTE between patients who received aspirin-only versus anticoagulants after hip or knee arthroplasty, using data from a large US-based administrative database...
April 12, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28494480/implementation-and-effects-of-enhanced-recovery-after-surgery-for-hip-and-knee-replacements-and-fractured-neck-of-femur-in-new-zealand-orthopaedic-services
#14
Suzanne Proudfoot, Brandon Bennett, Simon Duff, Julie Palmer
AIM: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results. METHOD: ERAS protocols were developed for hip and knee TJA and fractured NOF. Breakthrough Series collaborative methodology was used to implement the ERAS protocols in 18 DHBs...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28493422/differences-in-presentation-progression-and-rates-of-arthroplasty-between-hip-and-knee-osteoarthritis-observations-from-an-osteoarthritis-cohort-study-a-clear-role-for-conservative-management
#15
Chamila Dabare, Kim Le Marshall, Albert Leung, Caroline J Page, Peter F Choong, Keith K Lim
AIM: To describe the natural progression and the rates of arthroplasty of a cohort of hip and knee osteoarthritis (OA) patients. METHODS: An observational study of 247 consecutive patients who attended an OA clinic between May 2008 and August 2009. Follow-up survey was conducted from July 2014 to December 2014, with the primary end point being joint replacement surgery. RESULTS: One hundred and sixty-seven patients had knee OA and 80 patients had hip OA...
May 10, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28493210/in-search-of-the-optimal-wound-dressing-material-following-total-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#16
REVIEW
Gaurav Sharma, Sang Wook Lee, Oliver Atanacio, Javad Parvizi, Tae Kyun Kim
BACKGROUND: Various types of dressing materials are available for wound care following hip and knee arthroplasty. However, it is unclear if one material is more beneficial than the others in terms of wound complications and fluid handling capacity. RESEARCH QUESTIONS: We performed a meta-analysis of randomized controlled trials comparing alternative wound dressing materials for the post-operative management of wounds following THA and TKA with respect to (1) incidence of wound complications including infection and (2) fluid handling capacity...
May 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28489131/incidence-of-delirium-in-postoperative-patients-treated-with-total-knee-and-hip-arthroplasty
#17
Felipe de Santana Bosmak, Patrick Teller Gibim, Sandra Guimarães, Adriano Luiz Ammirati
Introduction: Delirium is a common disorder that can potentiate mortality and comorbidity rates of patients hospitalized in intensive care units. Patients undergoing major orthopedic surgeries, such as knee and hip arthroplasty, are particularly vulnerable as they often have multiple risk factors for this disorder. Method: Descriptive study of the incidence of delirium in patients treated with total knee and hip arthroplasty, given the advanced age and comorbidities in this population...
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28486957/cost-effectiveness-of-surgical-interventions-for-the-management-of-osteoarthritis-a-systematic-review-of-the-literature
#18
Hanin Kamaruzaman, Philip Kinghorn, Raymond Oppong
BACKGROUND: The primary purpose of this study is to assess the existing evidence on the cost-effectiveness of surgical interventions for the management of knee and hip osteoarthritis by systematically reviewing published economic evaluation studies. METHODS: A systematic review was conducted for the period 2004 to 2016. Electronic databases were searched to identify both trial and model based economic evaluation studies that evaluated surgical interventions for knee and hip osteoarthritis...
May 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28486159/trends-of-thromboprophylaxis-and-complications-after-major-lower-limb-orthopaedic-surgeries-in-korea-national-health-insurance-claim-data
#19
Sunyoung Kim, Hongyup Ahn, Soon-Ae Shin, Jong-Heon Park, Chang Won Won
BACKGROUND: In Western countries, prophylaxis for venous thromboembolism (VTE) following major lower limb orthopaedic surgeries is recommended. However, that has not been the case in Asian countries, where the reported incidence of postoperative VTE has been low. The present study examined trends in VTE prophylaxis prescriptions and related complications following major lower limb orthopaedic surgeries in South Korea. DESIGN/PARTICIPANTS: Using claim data from the National Health Insurance Corporation, 263,664 patients aged 65years or older who underwent major orthopaedic surgeries (total hip arthroplasty [THA], total knee arthroplasty [TKA], or hip fracture surgery [HFS]) between 2008 and 2012 were included...
April 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28481385/an-assessment-of-the-safety-of-an-orthopedic-specialty-hospital-a-5-year-experience
#20
Eric M Padegimas, Matthew L Ramsey, Matthew Austin, Javad Parvizi, Gerald R Williams, Kelly Doyle, Michael E West, Richard H Rothman, Alexander R Vaccaro, Surena Namdari
One of the goals of orthopedic specialty hospitals is to provide safe and efficient care to medically optimized patients. The authors' orthopedic specialty hospital is a physician-owned, 24-bed facility that accommodates a multispecialty orthopedic practice in the areas of spine, hip and knee arthroplasty, shoulder and elbow, sports, foot and ankle, and hand surgery. The purpose of this study was to examine the first 5 years of an institutional experience with an orthopedic specialty hospital and to determine if any procedures were at increased risk of postoperative transfer...
May 8, 2017: Orthopedics
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