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Hip and knee arthroplasty

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https://www.readbyqxmd.com/read/28091766/pre-operative-intra-articular-deep-tissue-sampling-with-novel-retrograde-forceps-improves-the-diagnostics-in-periprosthetic-joint-infection
#1
Matthias D Wimmer, Milena M Ploeger, Max J Friedrich, Thomas Hügle, Sascha Gravius, Thomas M Randau
BACKGROUND: Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28089185/joint-replacement-volume-positively-correlates-with-improved-hospital-performance-on-centers-for-medicare-and-medicaid-services-quality-metrics
#2
Rachel A Sibley, Vanessa Charubhumi, Lorraine H Hutzler, Albit R Paoli, Joseph A Bosco
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28088603/hospital-readmissions-after-surgery-how-important-are-hospital-and-specialty-factors
#3
Robert H Hollis, Laura A Graham, Joshua S Richman, Melanie S Morris, Hillary J Mull, Tyler S Wahl, Edith Burns, Laurel A Copeland, Gordon L Telford, Amy K Rosen, Kamal F Itani, Jeffrey Whittle, Todd H Wagner, Mary T Hawn
BACKGROUND: Hospital readmission rates after surgery may represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. STUDY DESIGN: For general, orthopedic, and vascular specialties at Veterans Affairs hospitals during 2008-2014, 30-day risk-adjusted readmission rates were estimated for six high-volume procedures and each specialty...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28079634/characteristics-of-patients-with-satisfactory-functional-gain-following-total-joint-arthroplasty-in-a-postacute-rehabilitation-setting
#4
Avital Hershkovitz, Marina Vesilkov, Yichayaou Beloosesky, Shai Brill
BACKGROUND AND PURPOSE: Total joint arthroplasty (TJA) is an effective and successful treatment of osteoarthritis of the hip and knee as quantified by several measures, such as pain relief, improved walking, improved self-care, functions, and increased quality of life. Data are lacking as to the definition of a satisfactory functional gain in a postacute setting and identifying the characteristics of older patients with TJA who may achieve that gain. Our aim was to characterize patients who may achieve a satisfactory functional gain in a postacute rehabilitation setting following TJA...
January 10, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28078867/plasma-endocannabinoid-behaviour-in-total-knee-and-hip-arthroplasty
#5
R Ottria, L Cappelletti, A Ravelli, M Mariotti, F Gigli, S Romagnoli, P Ciuffreda, G Banfi, L Drago
Endocannabinoids are a class of lipid mediators involved in a wide range of physiological pathways including pain perception, and immunological defences. In particular, the involvement of endocannabinoids in bone metabolism and bone resorption has recently been studied. Moreover, one study on total knee arthroplasty describes the probable role of endocannabinoids in pain perception after surgery. The aim of the present study was to evaluate variations of endocannabinoid concentrations in patients undergoing total hip or total knee arthroplasty before and after surgery...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28077124/important-patient-characteristics-differ-prior-to-total-knee-arthroplasty-and-total-hip-arthroplasty-between-switzerland-and-the-united-states
#6
Patricia D Franklin, Hermes Miozzari, Panayiotis Christofilopoulos, Pierre Hoffmeyer, David C Ayers, Anne Lübbeke
BACKGROUND: Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. METHODS: Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample...
January 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28077008/is-decreasing-mortality-in-total-hip-and-knee-arthroplasty-patients-dependent-on-patients-comorbidity
#7
Eva N Glassou, Alma B Pedersen, Torben B Hansen
Background and purpose - Mortality after primary total hip and knee arthroplasty (THA and TKA) has declined, and the proportion of THA and TKA patients with comorbid conditions has increased. We therefore wanted to examine changes in comorbidity burden over time and the impact of comorbid on mortality following primary total hip and knee arthroplasty in patients with osteoarthritis. Patients and methods - We used the Danish arthroplasty registers to identify THA and TKA patients from 1996 through 2013. From administrative databases, we collected data on pre-surgery hospital history for all patients, which were used to calculate the Charlson comorbidity index (CCI)...
January 12, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28073671/fast-track-recovery-technique-applied-to-primary-total-hip-and-knee-replacement-surgery-analysis-of-costs-and-complications
#8
C Wilches, J D Sulbarán, J E Fernández, J M Gisbert, J M Bausili, X Pelfort
PURPOSE: To determine the cost reduction and complication rates of using an enhanced recovery pathway (Fast-track) when compared to traditional recovery in primary total hip replacement (THR) and total knee replacement (TKR), as well as to determine if there were significant differences in complication rates. MATERIAL AND METHODS: Retrospective review of 100 primary total arthroplasties using the Fast-track recovery system and another 100 using conventional recovery...
January 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28071952/the-decline-of-elective-operating-at-major-trauma-centres
#9
A Memarzadeh, H Taki, E K Tissingh, P Hull
INTRODUCTION Major trauma is a leading cause of death in those aged under 40 years. In order to improve the care for multiply injured patients, the major trauma network was activated in April 2012 in England. Its goal was to link all district hospitals to major trauma centres (MTCs) and allow for rapid transfer of patients. Anecdotally, this has affected elective orthopaedic operating at MTCs. The aim of this study was to compare the number of lower limb arthroplasty procedures performed before and after the establishment of the trauma network...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28070149/outcome-analysis-of-hip-or-knee-arthroplasty-in-patients-with-cirrhotic-liver-disease
#10
Young-Jun Seol, Taek-Rim Yoon, Dong-Hyun Lee, Sun-Ho Lee, Kyung-Soon Park
OBJECTIVE: Present helpful measures to prevent expected complications that occur in patients with liver cirrhosis undergoing arthroplasty. METHODS: 218 patients who underwent hip or knee arthroplasty were included in this study. Prognoses of patients with underlying disease of liver cirrhosis and those without are compared with measures. RESULTS: Patients with liver cirrhosis show an increase in amount of bleeding, hospital stay and infection rate compared to those who do not...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28065627/revision-total-hip-and-knee-arthroplasties-after-solid-organ-transplant
#11
Cameron K Ledford, Joseph M Statz, Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: As solid organ transplant (SOT) patients' survival improves, the number undergoing total hip (THA) and total knee arthroplasty (TKA) is increasing. Accordingly, the number of revision procedures in this higher-risk group is also increasing. The goals of this study were to identify the most common failure mechanisms, associated complications, clinical outcomes, and patient survivorship of SOT patients after revision THA or TKA. METHODS: A retrospective review identified 39 revision procedures (30 revision THAs and 9 revision TKAs) completed in 37 SOT patients between 2000 and 2013...
December 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28060788/outpatient-total-hip-arthroplasty-total-knee-arthroplasty-and-unicompartmental-knee-arthroplasty-a-systematic-review-of-the-literature
#12
Michael Pollock, Lyndsay Somerville, Andrew Firth, Brent Lanting
BACKGROUND: The demand for total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) is growing rapidly because of the proven success of these procedures and an increase in the aging population. However, resources are limited and health-care budgets are finite. Recently, a number of care providers have started performing these procedures on an outpatient basis, with the patients being discharged from the hospital on the day of surgery. The primary objective of this systematic review was to examine the evidence regarding the safety and feasibility of performing THA, TKA, or UKA on an outpatient basis...
December 27, 2016: JBJS Reviews
https://www.readbyqxmd.com/read/28053389/is-pre-operative-assessment-of-coagulation-profile-with-thrombelastography-teg-useful-in-predicting-venous-thromboembolism-vte-following-orthopaedic-surgery
#13
Apurve Parameswaran, Vignesh P Krishnamoorthy, Anil T Oommen, Anita Jasper, Ravi J Korula, Sukesh C Nair, Pradeep M Poonnoose
INTRODUCTION: Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. METHODS: The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053250/the-painful-total-ankle-arthroplasty-a-diagnostic-and-treatment-algorithm
#14
REVIEW
E Vulcano, M S Myerson
The last decade has seen a considerable increase in the use of in total ankle arthroplasty (TAA) to treat patients with end-stage arthritis of the knee. However, the longevity of the implants is still far from that of total knee and hip arthroplasties. The aim of this review is to outline a diagnostic and treatment algorithm for the painful TAA to be used when considering revision surgery. Cite this article: Bone Joint J 2017;99-B:5-11.
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28052489/preoperative-education-prior-to-elective-knee-arthroplasty-surgery-does-not-change-patient-outcomes
#15
Lawrence Stephen Moulton, Peter A Evans, Ian Starks, Tony Smith
Enhanced recovery programmes have improved outcomes following elective arthroplasty surgery. There are few studies assessing the role of patient education. In our enhanced recovery programme, all patients are offered the chance to attend a preoperative education class. Not all patients attend, enabling a comparison of outcomes. We have published data demonstrating that patients undergoing hip arthroplasty have improved outcomes. In the present article, we present data for total knee arthroplasty. Using a prospectively collected database, we identified all patients undergoing elective primary total knee arthroplasty...
January 4, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28046049/health-care-needs-and-support-for-patients-undergoing-treatment-for-prosthetic-joint-infection-following-hip-or-knee-arthroplasty-a-systematic-review
#16
Setor K Kunutsor, Andrew D Beswick, Tim J Peters, Rachael Gooberman-Hill, Michael R Whitehouse, Ashley W Blom, Andrew J Moore
BACKGROUND: Hip and knee arthroplasty are common interventions for the treatment of joint conditions, most notably osteoarthritis. Although many patients benefit from surgery, approximately 1% of patients develop infection afterwards known as deep prosthetic joint infection (PJI), which often requires further major surgery. OBJECTIVE: To assess support needs of patients undergoing treatment for PJI following hip or knee arthroplasty and to identify and evaluate what interventions are routinely offered to support such patients...
2017: PloS One
https://www.readbyqxmd.com/read/28041771/the-effect-of-comorbidities-on-discharge-disposition-and-readmission-for-total-joint-arthroplasty-patients
#17
Jakub Sikora-Klak, Bradley Zarling, Christopher Bergum, Jeffrey C Flynn, David C Markel
BACKGROUND: As the annual demand and number of total joint arthroplasty cases increase, so do concerns of outcomes of patient with specific comorbidities relative to outcomes and costs of care. METHODS: The study cohort included 2009 primary total knee arthroplasty (TKA) patients and 905 total hip arthroplasty patients. Discharge disposition was classified as discharge to any facility or home. The comorbidities of the patients who were readmitted and those without a 90-day event were also evaluated...
November 29, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28040399/operative-time-affects-short-term-complications-in-total-joint-arthroplasty
#18
Kyle R Duchman, Andrew J Pugely, Christopher T Martin, Yubo Gao, Nicholas A Bedard, John J Callaghan
BACKGROUND: Increased operative time has been associated with increased complications after total joint arthroplasty (TJA). The purpose of the present study was to investigate the effect of operative time on short-term complications after TJA while also identifying patient and operative factors associated with prolonged operative times. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2011-2013 to identify all patients who underwent primary total hip or knee arthroplasty...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28034481/complications-following-outpatient-total-joint-arthroplasty-an-analysis-of-a-national-database
#19
P Maxwell Courtney, Anthony J Boniello, Richard A Berger
BACKGROUND: As outpatient total hip (THA) and knee arthroplasties (TKA) increase in popularity, concerns exist about the safety of discharging patients home the same day. The purpose of this study is to determine the complications associated with outpatient total joint arthroplasty (TJA) and to identify high-risk patients who should be excluded from these protocols. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for all patients who underwent primary TKA or THA from 2011 to 2014...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28032697/patient-specific-orthopaedic-implants
#20
REVIEW
Jack M Haglin, Adam E M Eltorai, Joseph A Gil, Stephen E Marcaccio, Juliana Botero-Hincapie, Alan H Daniels
Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy. Patient-specific implant (PSI) technology aims to reduce overall procedural costs, minimize surgical time, and maximize patient outcomes by achieving better biomechanical implant fit. With this commercially-available technology, computed tomography or magnetic resonance images can be used in conjunction with specialized computer programs to create preoperative patient-specific surgical plans and to develop custom cutting guides from 3-D reconstructed images of patient anatomy...
November 2016: Orthopaedic Surgery
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