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Hip and knee arthroplasty

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https://www.readbyqxmd.com/read/28339001/centers-for-medicare-medicaid-services-comprehensive-care-for-joint-replacement-the-present-and-future-for-orthopedic-surgeons
#1
Craig A Hogan, Melanie F Sandoval, Lauren M Uhler
The primary aim of this article is to describe the structure and challenges of Medicare and Medicaid reimbursement for a total hip or knee arthroplasty within the context of the Comprehensive Care for Joint Replacement model. The secondary aims are to identify potential challenges for reimbursement and solutions to overcome challenges for the orthopedic surgeon, and to describe and compare the current and projected reimbursement structures for total arthroplasty procedures. Final decisions on reimbursement for total arthroplasty as outlined by the Centers for Medicare & Medicaid Services are reviewed...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28337731/arthroplasty-registries-around-the-world-valuable-sources-of-hip-implant-revision-risk-data
#2
REVIEW
Richard E Hughes, Aditi Batra, Brian R Hallstrom
PURPOSE OF REVIEW: National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28336947/an-ideal-dielectric-coat-to-avoid-prosthesis-rf-artefacts-in-magnetic-resonance-imaging
#3
U Zanovello, L Matekovits, L Zilberti
The number of people submitted to total hip or knee arthroplasty increased in the last years and it is likely to grow further. Hence, the importance of a proper investigation tool that allows to determine and recognize the potential presence of perioperative and/or postoperative diseases becomes clear. Although the Magnetic Resonance Imaging (MRI) technique demonstrated several advantages over the other common tomography tools, it suffers from the arise of image artefacts if it is performed in presence of metallic prostheses...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28336035/effect-of-tranexamic-acid-on-transfusion-rates-following-total-joint-arthroplasty-a-cost-and-comparative-effectiveness-analysis
#4
REVIEW
Perry J Evangelista, Michael W Aversano, Emmanuel Koli, Lorraine Hutzler, Ifeoma Inneh, Joseph Bosco, Richard Iorio
Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336024/postoperative-pain-self-management-behavior-in-patients-who-underwent-total-knee-or-hip-arthroplasty
#5
Ning-Ning Zhu, Pei-Pei Xu, Ting-Ting Lei, Ting Sun, Sally Wai-Chi Chan
The self-management of acute postoperative pain is not well researched. This cross-sectional study investigates postoperative pain and pain self-management behavior. We recruited 127 patients who underwent total knee or total hip arthroplasty in an acute care hospital. We measured postoperative pain intensity and pain self-management behavior for three postoperative days. The results showed that the participants experienced mild and moderate pain intensity and perceived moderate to severe pain interference, which influenced their mood, sleep patterns, ability to walk, and performance of general activities and rehabilitation exercises...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28331989/does-the-tibia-component-design-affect-the-need-for-offset-stems-in-revision-total-knee-arthroplasty
#6
X Foruria, T Schmidt-Braekling, D Arana Nabarte, M Faschingbauer, M Kasparek, F Boettner
INTRODUCTION: The stem/keel location varies between anatomic and symmetric revision tibial baseplates. The current study investigates the impact of an anatomic versus symmetric stem location on the need for offset couplers in revision total knee arthroplasty. MATERIALS AND METHODS: Hip to ankle standing radiographs and lateral radiographs of 75 patients were analyzed using digital templating software. The offset in the anterior-posterior as well as medial-lateral plane between the center of the tibial diaphysis and the stem of the tibial baseplate were determined for an anatomic and symmetric tibial baseplate, respectively...
March 22, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28330757/does-new-instrumentation-improve-radiologic-alignment-of-the-oxford%C3%A2-medial-unicompartmental-knee-arthroplasty
#7
Ki-Mo Jang, Hong Chul Lim, Seung-Beom Han, Chandong Jeong, Seul-Gi Kim, Ji-Hoon Bae
BACKGROUND: A new instrument system has been introduced to improve the accuracy and reproducibility of implant positioning in Oxford® unicompartmental knee arthroplasty (UKA). This study aimed to determine if the new instrumentation could improve postoperative implant positioning and limb alignment, and reduce the occurrence of outliers in Oxford® UKA. METHODS: A total of 77 cases of Oxford® UKA with the new instrumentation were included. Individual matching for the conventional instrument group was performed according to age, sex, and body mass index...
March 19, 2017: Knee
https://www.readbyqxmd.com/read/28326415/help-my-rating-looks-bad-coding-comorbidities-in-arthroplasty
#8
Joseph D Galloway, Frank R Voss
In medicine today, there is a trend toward increasing transparency. Higher quality and better value are being sought, and one of the methods being used is publicly reported health care outcomes. However, there is a problem that comes from our loss of anonymity. Physicians who are being individually watched have to choose between doing what is best for the patient and doing what would look good when it is publicly reported. Often this might mean choosing not to treat a particularly sick patient who is unlikely to have a good outcome...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326404/comparing-contemporary-revision-burden-among-hip-and-knee-joint-replacement-registries
#9
Brian J McGrory, Caryn D Etkin, David G Lewallen
BACKGROUND: Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28324232/reducing-surgical-site-infections-following-total-hip-and-knee-arthroplasty-an-israeli-experience
#10
R Finkelstein, O Eluk, T Mashiach, D Levin, B Peskin, G Nirenberg, S Karkabi, M Soudri
PURPOSE: To assess the changes observed in surgical site infection (SSI) rates following total joint arthroplasty (TJA) after the introduction of an infection control programme and evaluate the risk factors for the development of these infections. DESIGN: Prospective cohort study. SETTING: Large tertiary medical centre in Israel. METHODS: Data about SSIs and potential prophylaxis-, patient-, and procedure-related risk factors were collected for all patients who underwent elective total hip and total knee arthroplasty during the study period...
March 21, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28319822/comparison-of-intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-and-knee-arthroplasty-an-updated-meta-analysis
#11
REVIEW
Jinwei Xie, Qinsheng Hu, Qiang Huang, Jun Ma, Yiting Lei, Fuxing Pei
BACKGROUND: The appropriate route for administering tranexamic acid in primary total hip (THA) and knee arthroplasty (TKA) remains controversial. The purpose of this meta-analysis was to compare the efficacy and safety of topical or intravenous tranexamic acid. METHODS: PubMed, EMBASE, and the Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) comparing topical and intravenous tranexamic acid following primary THA or TKA...
March 10, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-health-care-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#12
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28318868/management-of-periprosthetic-joint-infection-the-more-we-learn-the-less-we-know
#13
Robert A Henderson, Matthew S Austin
BACKGROUND: Despite the tremendous and long-standing success of total hip arthroplasty and total knee arthroplasty as treatments for end-stage arthritis, periprosthetic joint infection (PJI) remains a rare but feared complication of these procedures. METHODS: This review highlights some of the difficulties inherent to studying PJI. These include the difficulty in powering studies to capture this relatively uncommon complication, as well as the heterogeneity in clinical presentation and manifestations associated with the diagnosis and treatment of PJI...
February 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318406/use-of-a-shoulder-abduction-brace-after-arthroscopic-rotator-cuff-repair-a-study-on-gait-performance-and-falls
#14
Yuma Sonoda, Takashi Nishioka, Ryo Nakajima, Shinji Imai, Piers Vigers, Taku Kawasaki
BACKGROUND: Fall prevention is essential in patients after arthroscopic rotator cuff repair because of the high risk of re-rupture. However, there are no reports related to falls that occur during the early postoperative period, while the affected limb is immobilized. OBJECTIVES: This study assessed gait performance and falls in patients using a shoulder abduction brace after arthroscopic rotator cuff repair. STUDY DESIGN: Prospective cohort and postoperative repeated measures...
March 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28306737/alcohol-consumption-and-the-risk-of-postoperative-mortality-and-morbidity-after-primary-hip-or-knee-arthroplasty-a-register-based-cohort-study
#15
Torill A Rotevatn, Henrik Bøggild, Christinna R Olesen, Christian Torp-Pedersen, Rikke N Mortensen, Per F Jensen, Charlotte Overgaard
OBJECTIVE: To investigate the implications of low and moderate preoperative alcohol consumption on postoperative mortality and morbidity after primary hip and knee arthroplasty. METHODS: A total of 30,799 patients who underwent primary hip or knee arthroplasty between January 1st, 2005 and October 8th, 2011 with information on preoperative alcohol consumption (0 grams of pure alcohol/week, >0-168 g/week, >168-252 g/week, and >252 g/week) were identified through the Danish Anesthesia Database...
2017: PloS One
https://www.readbyqxmd.com/read/28302462/the-impact-of-mechanical-and-restricted-kinematic-alignment-on-knee-anatomy-in-total-knee-arthroplasty
#16
Abdulaziz M Almaawi, Jonathan R B Hutt, Vincent Masse, Martin Lavigne, Pascal-Andre Vendittoli
BACKGROUND: Total knee arthroplasty (TKA), aiming at neutral mechanical alignment (MA), inevitably modifies the patient's native knee anatomy. Another option is kinematic alignment (KA), which aims to restore the original anatomy of the knee. The aim of this study was to evaluate the variations in lower limb anatomy of a patient population scheduled for TKA, and to assess the use of a restricted KA TKA protocol and compare the resulting anatomic modifications with the standard MA technique...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#17
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28301858/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#18
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain...
April 2017: Pain
https://www.readbyqxmd.com/read/28299385/no-impact-of-under-correction-and-joint-line-obliquity-on-clinical-outcomes-of-total-knee-arthroplasty-for-the-varus-knee
#19
Richard D Rames, Michael Mathison, Zachary Meyer, Robert L Barrack, Denis Nam
PURPOSE: It has been hypothesized that under-correction of a preoperative varus deformity may be more natural and improve outcomes after total knee arthroplasty (TKA). This study's purpose was to assess the impact of hip-knee-ankle (HKA) alignment and joint line obliquity on TKA outcomes for the varus knee. METHODS: All patients with a preoperative varus deformity received both preoperative and postoperative standing, full-length radiographs from which two independent observers performed radiographic measurements including the HKA axis and mechanical medial proximal tibial angle (mMPTA)...
March 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28298194/patient-endorsement-of-the-outcome-measures-in-rheumatology-omeract-total-joint-replacement-tjr-clinical-trial-draft-core-domain-set
#20
Jasvinder A Singh, Michelle Dowsey, Peter F Choong
BACKGROUND: A patient- and surgeon-Delphi-derived Outcome Measures in Rheumatology (OMERACT) draft core domain set for total joint arthroplasty (TJR) trials was recently developed. Our objective was to obtain further patient stakeholder endorsement of draft core domain set for TJR clinical trials. METHODS: We surveyed two patient groups: (1) OMERACT patient partners; and (2) patients who had undergone hip or knee TJR. Patients received an introductory email with explanations about the core domain set and instructions to rate the core domains, i...
March 15, 2017: BMC Musculoskeletal Disorders
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