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Joint replacement

P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
B C C Khoo, J K Brown, R L Prince
OBJECTIVES: In recent years quantitative computed tomography (QCT) has allowed precise non-invasive, three dimensional, in vivo measurement of hip structure in large numbers of individuals. The effects of ageing on proximal femur structure are reported and implications for the prevention of hip prosthesis loosening and hip fracture considered. DESIGN, SETTING AND PARTICIPANTS: An observational cross-sectional study of proximal femur QCT in 719 unselected female European descent aged 20 to 89 years recruited from US and Australian populations...
2016: PloS One
Paul R Harmatz, Eugen Mengel, Tarekegn Geberhiwot, Nicole Muschol, Christian J Hendriksz, Barbara K Burton, Elisabeth Jameson, Kenneth I Berger, Andrea Jester, Marsha Treadwell, Zlatko Sisic, Celeste Decker
Efficacy and safety of elosulfase alfa enzyme replacement therapy (ERT) were assessed in an open-label, phase 2, multi-national study in Morquio A patients aged ≥5 years unable to walk ≥30 meters in the 6-min walk test. Patients received elosulfase alfa 2.0 mg/kg/week intravenously for 48 weeks. Efficacy measures were functional dexterity, pinch/grip strength, mobility in a modified timed 25-foot walk, pain, quality of life, respiratory function, and urine keratan sulfate (KS). Safety/tolerability was also assessed...
October 24, 2016: American Journal of Medical Genetics. Part A
Anurati Saha, Rebecca Rolfe, Simon Carroll, Daniel J Kelly, Paula Murphy
Chondrogenesis in vivo is precisely controlled in time and space. The entire limb skeleton forms from cells at the core of the early limb bud that condense and undergo chondrogenic differentiation. Whether they form stable cartilage at the articular surface of the joint or transient cartilage that progresses to hypertrophy as endochondral bone, replacing the cartilage template of the skeletal rudiment, is spatially controlled over several days in the embryo. Here, we follow the differentiation of cells taken from the early limb bud (embryonic day 11...
October 22, 2016: Cell and Tissue Research
Ruud L van den Brink, Peter R Murphy, Sander Nieuwenhuis
Our ability to sustain attention for prolonged periods of time is limited. Studies on the relationship between lapses of attention and psychophysiological markers of attentional state, such as pupil diameter, have yielded contradicting results. Here, we investigated the relationship between tonic fluctuations in pupil diameter and performance on a demanding sustained attention task. We found robust linear relationships between baseline pupil diameter and several measures of task performance, suggesting that attentional lapses tended to occur when pupil diameter was small...
2016: PloS One
Xiangyan Ruan, Yamei Cui, Juan Du, Fengyu Jin, Alfred Otto Mueck
INTRODUCTION: The climacteric symptoms during peri- and postmenopause have not been extensively studied in China. To further understanding of the characteristics of Chinese women during their menopausal transition, the aim of the study was to compare the prevalence and severity of climacteric symptoms of peri- and postmenopausal Chinese women. METHODS: The retrospective descriptive study was carried out in perimenopausal and postmenopausal women from 20 provinces of China who visited Beijing Obstetrics & Gynecology hospital during 2008-2015...
October 21, 2016: Journal of Psychosomatic Obstetrics and Gynaecology
Nicola Krähenbühl, Lukas Zwicky, Lilianna Bolliger, Sabine Schädelin, Beat Hintermann, Markus Knupp
BACKGROUND: Good clinical and radiographic short-term results have been reported for patients who underwent realignment surgery of the hindfoot for treatment of early- and mid-stage ankle osteoarthrosis (OA). However, no mid- to long-term results have been reported. The aim of this study was to gain a better insight into the indications and contraindications for realignment surgery. METHODS: Two hundred ninety-four patients (298 ankles) underwent realignment surgery between December 1999 and June 2013...
October 10, 2016: Foot & Ankle International
Masayuki Kyomoto, Toru Moro, Shihori Yamane, Yoshio Takatori, Sakae Tanaka, Kazuhiko Ishihara
The surface and substrate of a cross-linked polyethylene (CLPE) liner are designed to achieve resistance against oxidative degradation in the construction of hip joint replacements. In this study, we aimed to evaluate the oxidative degradation caused by lipid absorption of a highly hydrophilic nanometer-scaled thickness layer prepared by grafting a poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) layer and a high-dose gamma-ray irradiated CLPE with vitamin E blending (HD-CLPE[VE]). The HD-CLPE(VE) and PMPC-grafted HD-CLPE(VE) exhibited extremely high oxidation resistance regardless of lipid absorption, even though residual-free radical levels were detectable...
October 11, 2016: Biomaterials
Joanna Pietrzak, Paulina Kwarta, Michał Karbownik, Łukasz Mokros, Paula Zdanowicz, Dawid Miśkowiec, Andrzej Witusik, Adam Antczak, Tadeusz Pietras
: The progression of the inflammatory process in the course of rheumatoid arthiritis (RA) may cause a permanent destruction of joints, which in case of bigger ones (i.e. hip or knee) may be particularly a psychological burden for a patient. AIM: The aim of the study was to verify whether implantation of hip or knee endoprosthesis affect anxiety and depressive symptoms among patients with RA. MATERIALS AND METHODS: The study enrolled a group of 128 rheumatoid arthritis patients, including 64 patients before and 64 patients after the joint replacement procedure...
October 19, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
R L Xing, L R Zhao, P M Wang
High-turnover type bone metabolism derangement has been considered to be one of the major causes of osteoarthritis (OA). Bisphosphonates can attach to hydroxyapatite binding sites on bony surfaces, particularly those which are undergoing active bone resorption. To evaluate the effectiveness of bisphosphonates in OA treatment, literature databases were searched from inception to February 28, 2016 for clinical studies of bisphosphonates for OA treatment. All randomized controlled trials in which bisphosphonates therapy was compared with a placebo or a conventional medication, were selected...
2016: SpringerPlus
Michael J Zelefsky, Marisa A Kollmeier, Elan Gorshein, Xin Pei, Marina Torres, Sean McBride, Laura Happersett, Gil'ad N Cohen, Yoshiya Yamada
BACKGROUND AND PURPOSE: To evaluate the incidence and predictors of hip toxicity postradiotherapy for localized prostate cancer. METHODS AND MATERIALS: 4067 prostate cancer patients were treated with external beam radiotherapy (EBRT; n=2569; 63%) or brachytherapy with or without supplemental EBRT (n=1508; 27%). 43% (n=1738) were treated with neo-adjuvant and concurrent ADT and 57% (n=2329) with radiotherapy alone. Hip toxicity was defined as moderate or severe pain upon ambulation with or without the need for hip-revision surgery...
October 15, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Basim Kamil Hassan, Ram Benny Christian Dessau, Arne Sahlström
BACKGROUND: Permanent renal dysfunction is considered as being a serious complication which may occur after major surgery and which furthermore may lead to increased morbidity and mortality. The objective of this study was to analyze the incidence of long-term postoperative renal dysfunction after primary total hip and knee joint replacements. METHODS: Long-term postoperative renal dysfunction was analyzed in a retrospective study of 1301 consecutive primary total hip and knee joint replacements performed between January 2009 and December 2013...
October 19, 2016: Journal of Orthopaedic Surgery and Research
Lola Corzo, Susana Rodríguez, Ramón Alejo, Lucía Fernández-Novoa, Gjumrakch Aliev, Ramón Cacabelos
Menopause is a natural event in women´s lives leading to the cessation of menstruation and the reproductive function due to loss of the ovarian follicular function. Menopause-derived estrogen deprivation and related endocrine factors are linked to some symptoms of middle-aged women, such as hot flashes, aches, joint pain, stiffness, depressed mood, bone degeneration, nutritional dysfunction, or difficulty to maintain body mass. Clinical approaches to these problems often involve hormone replacement therapy (HRT) and other modalities of therapeutic intervention...
October 14, 2016: Current Drug Metabolism
Sophie C Warner, Ana M Valdes
PURPOSE OF REVIEW: Osteoarthritis is a common complex disorder with a strong genetic component. Other identified risk factors such as increasing age and overweight do not fully explain the risk of osteoarthritis. Here, we highlight the main findings from genetic association studies on osteoarthritis to date. RECENT FINDINGS: Currently, genetic association studies have identified 21 independent susceptibility loci for osteoarthritis. Studies have focused on hip, knee and hand osteoarthritis, as well as posttotal joint replacement and minimum joint space width, a proxy for cartilage thickness...
October 17, 2016: Current Opinion in Rheumatology
Panna Sanga, Nathaniel Katz, Elena Polverejan, Steven Wang, Kathleen M Kelly, Juergen Haeussler, John Thipphawong
OBJECTIVE: To evaluate long-term safety and efficacy of fulranumab in patients with moderate-to-severe chronic osteoarthritis (OA) knee or hip pain. METHODS: In this placebo-controlled, phase-2 double-blind (DB) extension study, patients who were equally randomized to 1mgQ4wk, 3mgQ8wk, 3mgQ4wk, 6mgQ8wk, or10mgQ8wk fulranumab (s.c.) or placebo in the 12-week DB efficacy phase, and completed this DB efficacy phase, were eligible to continue the dose throughout a 92-week extension phase followed by a 24-week posttreatment follow-up (PFTU)...
October 16, 2016: Arthritis & Rheumatology
Terry K Morgan, Emilie Jensen, Jeong Lim, Russell Riggs
BACKGROUND: Intra-articular hyaluronic acid (HA) injection is an intermediate option between analgesics and knee joint replacement in patients with osteoarthritis (OA). Our objective was to test whether image-guided HA injections may improve knee OA outcomes after 6 months of treatment independent of potential covariates. METHODS: This is a retrospective case series with multivariate outcome-based analysis of 207 consecutive adult patients with mild to severe knee OA treated at a single out-patient clinic employing fluoroscopy-guided HA injections...
December 2015: Sports Medicine—Open
Kathryn E Myhre, Bryant J Webber, Thomas L Cropper, Juste N Tchandja, Dale M Ahrendt, Christopher A Dillon, Roy W Haas, Samantha L Guy, Mary T Pawlak, Susan P Federinko
BACKGROUND: Anemia has been implicated in adverse health outcomes of athletes and military trainees, ranging from overuse injuries to degraded physical and cognitive performance. The purpose of this study was to investigate prevalence of anemia among US Air Force (USAF) basic trainees, to compare physical performance and discharge rates between anemic and non-anemic trainees, and to determine the risks and relative risks of being discharged for anemic versus non-anemic women and men. METHODS: All USAF basic trainees were screened for anemia between July 2013 and January 2014, during an 8-week basic training course at Joint Base San Antonio-Lackland, TX...
December 2016: Sports Medicine—Open
Sho Kayumi, Yoshiyuki Takayama, Atsuro Yokoyama, Nana Ueda
BACKGROUND: The purpose of this study was to investigate the influence of occlusal forces (the contractile force of masticatory muscles) exerted during occlusal adjustment on the distribution of the forces among teeth, implants, and temporomandibular joints (TMJs) in intercuspal clenching in cases with bilateral missing molars and premolars by using finite element analysis. METHODS: A three-dimensional finite element model of the mandible with eight implants in the premolar and molar regions was constructed...
December 2015: Int J Implant Dent
Ilse Degreef
Dupuytren disease is highly prevalent and the finger contractures can be very extensile, compromising the patients' hand function. To restore full function, contractures have been addressed by cutting the causative strands for nearly 200 years, ever since Baron Guillaume Dupuytren demonstrated his technique at the beginning of the nineteenth century. Surgery can be minimal (fasciotomy) or quite invasive (fasciectomy and even skin replacement). However, in the last decade translational research has introduced the non-surgical technique of enzymatic fasciotomy with collagenase injections...
June 2016: Rheumatol Ther
Sara C Keller, Sara E Cosgrove, Yvonne Higgins, Damani A Piggott, Greg Osgood, Paul G Auwaerter
Background.  The use of suppressive antibiotics in treatment of orthopedic hardware infections (OHIs), including spinal hardware infections, prosthetic joint infections, and infections of internal fixation devices, is controversial. Methods.  Over a 4-year period at 2 academic medical centers, patients with OHI who were treated with debridement and retention of hardware components, with single-stage exchange, or without surgery were studied to determine whether use of oral antibiotics for at least 6 months after diagnosis impacts successful treatment of the infection at 1 year after diagnosis...
October 2016: Open Forum Infectious Diseases
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