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Total knee arthroplasty

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https://www.readbyqxmd.com/read/28433428/effect-of-risk-acceptance-for-bundled-care-payments-on-clinical-outcomes-in-a-high-volume-total-joint-arthroplasty-practice-after-implementation-of-a-standardized-clinical-pathway
#1
James R Kee, Paul K Edwards, Charles L Barnes
BACKGROUND: The Bundled Payments for Care Improvement (BPCI) initiative and the Arkansas Payment Improvement (API) initiative seek to incentivize reduced costs and improved outcomes compared with the previous fee-for-service model. Before participation, our practice initiated a standardized clinical pathway (CP) to reduce length of stay (LOS), readmissions, and discharge to postacute care facilities. METHODS: This practice implemented a standardized CP focused on patient education, managing patient expectations, and maximizing cost outcomes...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28433427/do-medial-pivot-kinematics-correlate-with-patient-reported-outcomes-after-total-knee-arthroplasty
#2
Lucian C Warth, Marshall K Ishmael, Evan R Deckard, Mary Ziemba-Davis, R Michael Meneghini
BACKGROUND: Many total knee arthroplasty (TKA) implants are designed to facilitate a medial pivot kinematic pattern. The purpose of this study was to determine whether intraoperative medial pivot kinematic patterns are associated with improved patient outcomes. METHODS: A retrospective review of consecutive primary TKAs was performed. Sensor-embedded tibial trials determined kinematic patterns intraoperatively. The center of rotation (COR) was identified from 0° to 90° and from 0° to terminal flexion, and designated medial-pivot or non-medial pivot based on accepted criteria...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28433348/the-influence-of-polyethylene-bearing-thickness-on-the-tibiofemoral-kinematics-of-a-bicruciate-retaining-total-knee-arthroplasty
#3
Geert Peersman, Josh Slane, Margo Dirckx, Arne Vandevyver, Philipp Dworschak, Thomas J Heyse, Lennart Scheys
BACKGROUND: The recently reintroduced bicruciate retaining Total Knee Arthroplasty (BCR TKA) is an effort to reproduce kinematics closer to the native knee. However, there is no data on appropriate balancing with this implant. Balancing is crucial and challenging as medial and lateral polyethylene (PE) inlays are modular, which allows for placement of different thicknesses in the medial and lateral compartments. This study aimed at providing a detailed kinematic view on balancing BCR TKA...
April 19, 2017: Knee
https://www.readbyqxmd.com/read/28431586/expression-of-calcitonin-gene-related-peptide-in-the-infrapatellar-fat-pad-in-knee-osteoarthritis-patients
#4
Jun Aikawa, Kentaro Uchida, Shotaro Takano, Gen Inoue, Atsushi Minatani, Masayuki Miyagi, Dai Iwase, Hiroyuki Sekiguchi, Manabu Mukai, Masashi Takaso
BACKGROUND: The infrapatellar fat pad (IPFP) has been implicated as a possible source of osteoarthritis (OA) development and knee pain due to the production of inflammatory mediators and the existence of nerve fibers within this structure. Calcitonin gene-related peptide (CGRP) is a vasodilatory neuropeptide that is localized to joint tissues and has recently been implicated in the development of knee OA and OA pain. To date, however, the expression levels of CGRP in the IPFP of human knee OA patients have not been examined...
April 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28431129/cooled-radiofrequency-ablation-of-the-genicular-nerves-for-chronic-pain-due-to-knee-osteoarthritis-six-month-outcomes
#5
Zachary L McCormick, Marc Korn, Rajiv Reddy, Austin Marcolina, David Dayanim, Ryan Mattie, Daniel Cushman, Meghan Bhave, Robert J McCarthy, Dost Khan, Geeta Nagpal, David R Walega
Objective. : Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). Design. : Cross-sectional survey. Setting.:  Academic pain medicine center. Subjects.:  Consecutive patients with knee OA and 50% or greater pain relief following genicular nerve blocks who underwent genicular nerve C-RFA. Methods.:  Survey administration six or more months after C-RFA...
April 19, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28430692/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-postoperative-chronic-opioid-use-among-patients-undergoing-total-knee-arthroplasty-evidence-from-the-marketscan-database
#6
Eric C Sun, Brian T Bateman, Stavros G Memtsoudis, Mark D Neuman, Edward R Mariano, Laurence C Baker
BACKGROUND: Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. METHODS: Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28427385/differences-between-native-and-prosthetic-knees-in-terms-of-cross-sectional-morphology-of-the-femoral-trochlea-a-study-based-on-three-dimensional-models-and-virtual-total-knee-arthroplasty
#7
Zhe Du, Shichang Chen, Mengning Yan, Bing Yue, You Wang
BACKGROUND: The cross-sectional morphology of the prosthetic knee is crucial to understanding patellar motion and quadriceps strength after total knee arthroplasty. However, few comparative evaluations of the cross-sectional morphology of the femoral trochlea have been performed in the native knee and currently available femoral implants, and the relationship between the trochlear anatomy of prosthetic components and post-operative patellofemoral complications remains unclear. We aimed to investigate the differences in cross-sectional morphology of the femoral trochlea between native knees and prosthetic femoral components...
April 20, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28426262/feasibility-of-outpatient-total-hip-and-knee-arthroplasty-in-unselected-patients
#8
Kirill Gromov, Per Kjærsgaard-Andersen, Peter Revald, Henrik Kehlet, Henrik Husted
Background and purpose - The number of patients who are suitable for outpatient total hip and knee arthroplasty (THA and TKA) in an unselected patient population remains unknown. The purpose of this prospective 2-center study was to identify the number of patients suitable for outpatient THA and TKA in an unselected patient population, to investigate the proportion of patients who were discharged on the day of surgery (DOS), and to identify reasons for not being discharged on the DOS. Patients and methods - All consecutive, unselected patients who were referred to 2 participating centers and who were scheduled for primary THA and TKA were screened for eligibility for outpatient surgery with discharge to home on DOS...
April 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28423941/guide-pin-placement-technique-for-total-ankle-replacement-in-patients-who-had-ipsilateral-total-knee-arthroplasty
#9
Natalie Hua, Aprajita Nakra, Jerome K Steck
We describe a simple technique for guide pin placement for total ankle replacement in patients who underwent previous ipsilateral total knee arthroplasty. LEVELS OF EVIDENCE: Level V.
April 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28421308/an-intelligent-remote-monitoring-system-for-total-knee-arthroplasty-patients
#10
Yunus Msayib, Patrick Gaydecki, Michael Callaghan, Nicola Dale, Sheheera Ismail
For the first six weeks following total knee arthroplasty (TKA), a patient will attend an outpatient clinic typically seen twice weekly. Here, an exercise regime is performed and improvement assessed using a hand held goniometer that measures the maximum angle of knee flexion, an important metric of progress. Additionally a series of daily exercises is performed at home, recorded in a diary. This protocol has problems. Patients must attend the hospital with assistance since they are not permitted to drive for six weeks following the procedure; appointments are sometimes missed; there are occasionally not enough physiotherapy appointment available; furthermore, it is difficult to be sure that patients are compliant with their exercises at home...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#11
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28420413/is-combined-use-of-intravenous-and-intraarticular-tranexamic-acid-superior-to-intravenous-or-intraarticular-tranexamic-acid-alone-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#12
Bobin Mi, Guohui Liu, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: Tranexamic acid (TXA) has been proven to be effective in reducing blood loss and transfusion rate after total knee arthroplasty (TKA) without increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Recently, an increasing number of studies have been interested in applying combined intravenous (IV) with intraarticular (IA) tranexamic acid in total knee arthroplasty. The purpose of this meta-analysis was to compare the blood loss and complications of combined TXA with IV TXA or IA TXA on TKA...
April 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28418963/optimizing-analgesia-for-total-knee-arthroplasty-a-networked-comparison
#13
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28418842/effects-of-tlr-2-nf-%C3%AE%C2%BAb-signaling-pathway-on-the-occurrence-of-degenerative-knee-osteoarthritis-an-in-vivo-and-in-vitro-study
#14
Yi-Xun Liu, Guo-Dong Wang, Xiao Wang, Yong-Le Zhang, Tian-Lun Zhang
The study aims to explore the effects of TLR-2/NF-κB signaling pathway on the occurrence of degenerative knee osteoarthritis (OA). Degenerative knee OA and normal cartilage samples were collected from patients with degenerative knee OA receiving total knee arthroplasty and amputation. Expressions of TLR-2, NF-κB and MMP-13 were determined by qRT-PCR and immunochemistry. The chondrocytes were divided into control, IL-1β, IL-1β + anti-TLR-2 and IL-1β + PDTC groups. MTT assay and flow cytometry were performed to determine proliferation and apoptosis of the chondrocytes...
March 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28418577/prospective-assessment-of-sleep-quality-before-and-after-primary-total-joint-replacement
#15
Blaine T Manning, Sean M Kearns, Daniel D Bohl, Tori Edmiston, Scott M Sporer, Brett R Levine
Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#16
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28417690/global-scientific-production-in-the-field-of-knee-arthroplasty-a-cross-sectional-survey-of-research-activities
#17
Lu Wang, Lingxia Li, Cai Cheng, Hua Tian, Yang Li, Minwei Zhao
Objective To determine the quantity and quality of articles in the field of knee arthroplasty worldwide and elucidate the characteristics of global scientific production. Methods Web of Science was used to identify articles in the field of knee arthroplasty from 2011 to 2015. The total number of papers, number of papers per capita, total number of citations, and mean number of citations were collected. Results In total, 11,590 papers were identified. The number of publications significantly increased from 2011 to 2015...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#18
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28416824/-gait-analysis-at-the-early-stage-after-direct-anterior-approach-in-total-hip-arthroplasty
#19
H Y Wang, P D Kang, Y Nie, H Y Zhao, Z Y Yang, F X Pei
OBJECTIVE: To evaluate the result of operation and gait analysis at the early stage after direct anterior approach (DAA) in total hip arthroplasty (THA). METHODS: In this study, 20 patients who suffered from necrosis of femoral head or developmental dysplasia of the hip were scheduled to undergo THA. The basic information and visual analogue scale (VAS) score, Harris score before and after surgery were recorded. All of the patients finished the gait analysis before the surgery and 6 weeks and 12 weeks after the surgery, the data were compared with those of normal adult people...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28413514/effect-of-pre-emptive-analgesia-by-continuous-femoral-nerve-block-on-early-postoperative-cognitive-function-following-total-knee-arthroplasty-in-elderly-patients
#20
Li-Qin Deng, Lei-Na Hou, Feng-Xiang Song, Han-Yue Zhu, Hai-Ying Zhao, Gang Chen, Jing-Jing Li
To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30)...
April 2017: Experimental and Therapeutic Medicine
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