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Joint replacement

Kristine M Fischenich, Hannah M Pauly, Jackson T Lewis, Travis S Bailey, Tammy L Haut Donahue
Pressure distribution of the native ovine knee meniscus was compared to a medial meniscectomy and three treatment conditions including a suture reattachment of the native tissue, an allograft, and a novel thermoplastic elastomer hydrogel (TPE) construct. The objective of this study was to assess the efficacy of a novel TPE hydrogel construct at restoring joint pressure and distribution. Limbs were loaded in uniaxial compression at 45°, 60°, and 75° flexion and from 0 to 181 kg. The medial meniscectomy decreased contact area by approximately 50% and doubled the mean and maximum pressure reading for the medial hemijoint...
June 19, 2018: Annals of Biomedical Engineering
Tim Ramczykowski, Christiane Kruppa, Thomas Armin Schildhauer, Marcel Dudda
BACKGROUND: The role of illicit drug abuse in total joint arthroplasty is largely unknown and is likely underestimated. Patients with drug addictions often suffer from septic osteoarthritis or a necrosis of the femoral head. Purpose of the study was to evaluate the operative management and clinical outcome of total hip replacement in patients with a history of intravenous drug abuse. METHODS: This retrospective study included 15 patients with a history of intravenous drug abuse who underwent total hip arthroplasty...
June 19, 2018: Archives of Orthopaedic and Trauma Surgery
Mohamed Ghanem, Christina Pempe, Dirk Zajonz, Andreas Roth, Christoph-Eckhard Heyde, Christoph Josten
Introduction: Infection of the knee joint after primary total knee arthroplasty is a serious complication. In this work, we would like to evaluate the mid-term results after two-stage revision of total knee replacement in periprosthetic infection using dynamic spacer, in particular with regard to the function of the knee joint after reimplantation. Patients and methods: In this retrospective study, we included patients who were treated in our clinic between 2005 and 2013 due to infection of the knee after total knee arthroplasty...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
S Campi, S J Mellon, D Ridley, B Foulke, C A F Dodd, H G Pandit, D W Murray
Objectives: The primary stability of the cementless Oxford Unicompartmental Knee Replacement (OUKR) relies on interference fit (or press fit). Insufficient interference may cause implant loosening, whilst excessive interference could cause bone damage and fracture.The aim of this study was to identify the optimal interference fit by measuring the force required to seat the tibial component of the cementless OUKR (push-in force) and the force required to remove the component (pull-out force)...
March 2018: Bone & Joint Research
Joanne Stocks, Nicole Ky Tang, David A Walsh, Sophie C Warner, Hollie L Harvey, Wendy Jenkins, Abhishek Abhishek, Michael Doherty, Ana M Valdes
Background: Disturbed sleep is strongly correlated with chronic pain. The aim of this study was to examine the association between sleep disturbance and incident joint pain focusing on neuropathic-like pain symptoms. Methods: A total of 423 individuals who had undergone total joint replacement (TJR) for osteoarthritis were assessed at the mean time of 3.6 years post-surgery and again at 5.9 years post-TJR, using the Medical Outcomes Survey sleep subscale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and painDETECT questionnaire instruments...
2018: Journal of Pain Research
Vicente M Cabrera, Patricia Marrero, Khaled K Abu-Amero, Jose M Larruga
BACKGROUND: The main unequivocal conclusion after three decades of phylogeographic mtDNA studies is the African origin of all extant modern humans. In addition, a southern coastal route has been argued for to explain the Eurasian colonization of these African pioneers. Based on the age of macrohaplogroup L3, from which all maternal Eurasian and the majority of African lineages originated, the out-of-Africa event has been dated around 60-70 kya. On the opposite side, we have proposed a northern route through Central Asia across the Levant for that expansion and, consistent with the fossil record, we have dated it around 125 kya...
June 19, 2018: BMC Evolutionary Biology
Gwyn N Lewis, Rosalind S Parker, Sheena Sharma, David A Rice, Peter J McNair
Objective: Many studies have provided evidence of altered brain structure in chronic pain conditions, as well as further adaptations following treatment that are coincident with changes in pain. Less is known regarding how these structural brain adaptations relate to assessments of nociceptive processing. The current study aimed to investigate brain structure in people with knee osteoarthritis (OA) before and after total knee arthroplasty (TKA) and to investigate the relationships between these findings and quantitative sensory testing (QST) of the nociceptive system...
June 15, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Lane Koenig, Chaoling Feng, Fang He, Jennifer T Nguyen
BACKGROUND: After the first year in the Comprehensive Care for Joint Replacement (CJR) model, hospitals must repay Medicare for spending above a target price. Hospitals are incentivized to reduce spending in a 90-day episode and generate internal cost savings through, for example, the use of lower-cost implants. METHODS: We used a Markov model to compare quality-adjusted life-years and lifetime costs of total hip arthroplasty, under Medicare fee-for-service (baseline) and under alternative revision rate assumptions (prospective CJR scenarios)...
June 15, 2018: Journal of Arthroplasty
Kuan-Ting Wu, Pei-Shan Lee, Wen-Yi Chou, Shu-Hua Chen, Yee-Tzu Huang
BACKGROUND: The World Health Organization (WHO) reported that nearly 25% of people will suffer from physical disability owing to the bone and joint problems until 2050. The condition of patients with this type of difficulty could be improved by increasing positive self-efficacy and instigating suitable medical treatment to implement self-efficacy for functional ability (SEFA) and physical functional ability self-care. In this study, we aim to evaluate the influence of social support on SEFA in patients after total hip arthroplasty...
June 18, 2018: Journal of Orthopaedic Surgery and Research
Todd A Rubin, Matthew J Gluck, Michael R Hausman
Essex-Lopresti Lesions are rare injuries that are often missed in the acute setting. Delayed intervention may lead to chronic wrist and elbow pain and overall poor outcomes. The literature currently supports treatments that involve shortening of the ulna to reduce the relative degree of ulnar impaction, followed by attempted reduction of the distal radioulnar joint. Although such techniques may help to temporarily reduce wrist pain secondary to ulnar impaction, they do not address the proximal migration of the radius and ipsilateral radial head dislocation at the elbow...
June 14, 2018: Techniques in Hand & Upper Extremity Surgery
Audun Stubhaug, Harald Breivik
No abstract text is available yet for this article.
December 29, 2017: Scandinavian Journal of Pain
Rajesh Malhotra, Deepak Gautam, Bhavuk Garg, Anjan Trikha
We wish to present a case of 47-year-old patient with Juvenile Rheumatoid Arthritis and ankylosis of both hips and both knees treated by bilateral hip and knee arthroplasty in a single anaesthesia i.e. Quadruple joint replacement in single sitting. He was back on his feet from his bed-ridden state within the fortnight following surgery. He has been followed up for four years and has been performing his activities of daily living independently. We discuss the preoperative planning, surgical details and post-operative rehabilitation and unique challenges pertaining to this case...
May 2018: Archives of Bone and Joint Surgery
Timothy E Hereford, Kipp A Cryar, Paul K Edwards, Eric R Siegel, C Lowry Barnes, Simon C Mears
BACKGROUND: Patients taking narcotics chronically are more likely to have worse outcomes after total joint arthroplasty. These negative outcomes may be avoided when modifiable risk factors such as narcotic use are identified and improved before elective joint replacement. An accurate assessment of narcotic use is needed to identify patients before surgery. This study examines the amount of reported narcotic use in patients with hip or knee osteoarthritis and compares this with the narcotic prescriptions recorded in our state's drug prescription monitoring database...
May 29, 2018: Journal of Arthroplasty
Giancarlo Castaman
The health benefits of prophylactic dosing regimens for clotting factor therapy in patients with hemophilia include reduced joint damage and improved quality of life and, as such, prophylaxis is recommended in treatment guidelines. However, many patients with hemophilia B are treated on demand, and prophylaxis has been utilized less frequently than in hemophilia A. Areas covered: This review discusses the opportunities and evidence for prophylaxis in hemophilia B, in the context of treatment guidelines and with regard to factor IX (FIX) replacement therapies, including long-acting recombinant FIX (rFIX)...
June 18, 2018: Expert Review of Hematology
Hwa Sen Chua, Sarah L Whitehouse, Michelle Lorimer, Richard De Steiger, Linda Guo, Ross W Crawford
BACKGROUND: Total knee arthroplasty (TKA) is an effective procedure for relieving pain and restoring function in osteoarthritis, with a significant proportion of patients having severe disease bilaterally. However, although there are differences in patient selection criteria for bilateral procedures, there is no consensus regarding the optimal timing for bilateral TKA. The aim of this study was to compare rates and causes of revision and 30-day mortality between simultaneous and staged bilateral TKA using data from the Australian Orthopaedic Association National Joint Replacement Registry...
May 17, 2018: Journal of Arthroplasty
Sorin Siegler, Tobias Konow, Claudio Belvedere, Andrea Ensini, Rewati Kulkarni, Alberto Leardini
Joint surface interaction and ligament constraints determine the kinematic characteristics of the ankle and subtalar joints. Joint surface interaction is characterized by joint contact mechanics and by relative joint surface position potentially characterized by distance mapping. While ankle contact mechanics was investigated, limited information is available on joint distance mapping and its changes during motion. The purpose of this study was to use image-based distance mapping to quantify this interaction at the ankle and subtalar joints during tri-planar rotations of the ankle complex...
June 7, 2018: Journal of Biomechanics
Chun-Hung Chang, Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Wing-Wai Wong, Ming-Chau Chang, Wei-Ming Chen
INTRODUCTION: Evidence about the optimal timing for total hip replacement (THR) in HIV-positive patients is scant. HYPOTHESIS: Preoperative criteria: cluster of differentiation 4 (CD4) counts>200 cells/mm3 and an undetectable HIV virus load before THR, improve infection rates, aseptic loosenings, and functional outcomes. MATERIALS AND METHODS: We recruited 16 HIV-positive patients who had undergone 25 THRs between 2003 and 2015. None had hemophilia, and none were intravenous drug users (IVDUs)...
June 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jessica E Carter, Srinivas Pyati, Frances A Kanach, Ann Miller W Maxwell, Charles M Belden, Christopher M Shea, Thomas Van de Ven, Jillian Thompson, Helen Hoenig, Karthik Raghunathan
BACKGROUND: Complementary integrative health therapies have a perioperative role in the reduction of pain, analgesic use, and anxiety, and increasing patient satisfaction. However, long implementation lags have been quantified. The Consolidated Framework for Implementation Research (CFIR) can help mitigate this translational problem. METHODS: We reviewed evidence for several nonpharmacological treatments (CFIR domain: characteristics of interventions) and studied external context and organizational readiness for change by surveying providers at 11 Veterans Affairs (VA) hospitals (domains: outer and inner settings)...
June 12, 2018: Anesthesia and Analgesia
Saurabh Lal, Emily A Caseley, Richard M Hall, Joanne L Tipper
The adverse biological impact of orthopaedic wear debris currently limits the long-term safety of human joint replacement devices. We investigated the role of particle size, surface composition and donor variation in influencing the biological impact of silicon nitride as a bioceramic for orthopaedic applications. Silicon nitride particles were compared to the other commonly used orthopaedic biomaterials (e.g. cobalt-chromium and Ti-6Al-4V alloys). A novel biological evaluation platform was developed to simultaneously evaluate cytotoxicity, inflammatory cytokine release, oxidative stress, and genotoxicity potential of particles using peripheral blood mononuclear cells (PBMNCs) from individual human donors...
June 14, 2018: Scientific Reports
Martina Bleyer, Tina Risch, Christian Roos, Franz-Josef Kaup, Kerstin Mätz-Rensing
  A captive-born adult female Nilgiri langur ( Semnopithecus johnii) developed an edematous swelling of the left thigh and a firm mass around the right ankle joint. The animal also suffered from lethargy and anorexia and was euthanized because of poor general condition. Necropsy revealed that the skeletal muscle of the left thigh had been replaced by a multilocular cystic mass containing numerous sand-grain-sized whitish structures. Small cysts were also present in the lung and the myocardium. The mass of the right ankle joint was histologically consistent with a myxosarcoma...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
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