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Total knee arthroplasty

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https://www.readbyqxmd.com/read/28345414/fresh-osteochondral-allograft-transplantation-for-fractures-of-the-knee
#1
Guilherme C Gracitelli, Luis Eduardo Passarelli Tirico, Julie C McCauley, Pamela A Pulido, William D Bugbee
Objective The purpose of this study was to evaluate functional outcomes and allograft survivorship among patients with knee fracture who underwent fresh osteochondral allograft (OCA) transplantation as a salvage treatment option. Design Retrospective analysis of prospectively collected data. Setting Department of Orthopaedic Surgery at one hospital. Patients Fresh OCAs were implanted for osteochondral lesions after knee fracture in 24 males and 15 females with an average age of 34 years. Twenty-nine lesions (74%) were tibial plateau fractures, 6 (15%) were femoral condyle fractures, and 4 (10%) were patella fractures...
April 2017: Cartilage
https://www.readbyqxmd.com/read/28345356/dysregulation-of-tissue-factor-thrombin-activatable-fibrinolysis-inhibitor-and-fibrinogen-in-patients-undergoing-total-joint-arthroplasty
#2
Christopher Wanderling, Jeffrey Liles, Elissa Finkler, Peter Carlsgaard, William Hopkinson, Nil Guler, Debra Hoppensteadt, Jawed Fareed
Total joint arthroplasty (TJA) of the hip or knee (THA, TKA) has become an increasingly common procedure. While TJA is a successful treatment for individuals experiencing degenerative joint diseases, it is well known that one of the most common perioperative complications of TJA is deep venous thrombosis (DVT). To profile tissue factor (TF), microparticle-tissue factor (MP-TF), thrombin-activatable fibrinolysis inhibitor (TAFI), and fibrinogen levels in patients undergoing TJA to determine potential preexisting Hemostatic dysregulation...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28344902/isolation-and-characterization-of-human-articular-chondrocytes-from-surgical-waste-after-total-knee-arthroplasty-tka
#3
Jakob Naranda, Lidija Gradišnik, Mario Gorenjak, Matjaž Vogrin, Uroš Maver
BACKGROUND: Cartilage tissue engineering is a fast-evolving field of biomedical engineering, in which the chondrocytes represent the most commonly used cell type. Since research in tissue engineering always consumes a lot of cells, simple and cheap isolation methods could form a powerful basis to boost such studies and enable their faster progress to the clinics. Isolated chondrocytes can be used for autologous chondrocyte implantation in cartilage repair, and are the base for valuable models to investigate cartilage phenotype preservation, as well as enable studies of molecular features, nature and scales of cellular responses to alterations in the cartilage tissue...
2017: PeerJ
https://www.readbyqxmd.com/read/28343831/stepping-toward-objective-outcomes-a-prospective-analysis-of-step-count-after-total-joint-arthroplasty
#4
Meredith P Crizer, Gregory S Kazarian, Andrew N Fleischman, Jess H Lonner, Mitchell G Maltenfort, Antonia F Chen
BACKGROUND: Functional recovery monitoring after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is often limited to surgeon-based assessment and patient self-reporting rather than objective measures. However, traditional outcomes may not reliably gauge return of function. The goal of this study was to evaluate and compare an objective measure of postoperative recovery, daily step-count, with patient self-reported outcomes. METHODS: Prospectively, 589 patients used a mobile step-tracking application to record daily steps...
March 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343830/fall-risk-score-at-the-time-of-discharge-predicts-readmission-following-total-joint-arthroplasty
#5
Bheeshma Ravi, Zhang Nan, Adam J Schwartz, Henry D Clarke
BACKGROUND: Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343827/diabetes-mellitus-and-hyperglycemia-and-the-risk-of-aseptic-loosening-in-total-joint-arthroplasty
#6
Hilal Maradit Kremers, Cathy D Schleck, Eric A Lewallen, Dirk R Larson, Andre J Van Wijnen, David G Lewallen
BACKGROUND: It is unknown to what extent diabetes mellitus modifies the long-term risk of aseptic loosening in total hip arthroplasty (THA) and total knee arthroplasty (TKA). We examined the association between diabetes mellitus, perioperative hyperglycemia, and the likelihood of revisions for aseptic loosening. METHODS: We studied 16,085 primary THA and TKA procedures performed at a large tertiary care hospital between 2002 and 2009. All blood glucose values around the time of surgery (within 1 week) were retrieved...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343826/diagnosis-of-periprosthetic-joint-infection-an-algorithm-based-approach
#7
Nicholas T Ting, Craig J Della Valle
BACKGROUND: Periprosthetic joint infection (PJI) remains one of the most challenging and devastating modes of failure after total hip and knee arthroplasties. Despite the profound urgency and impact of PJI on an individual and societal basis, historically, there have not been standardized definitions of and diagnostic algorithms for infection after total joint arthroplasty. METHODS: In a recent symposium, the American Academy of Hip and Knee Surgeons put forth a standardized approach to the prevention, diagnosis, and management of the patient with a suspected PJI...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343824/assessment-of-corrosion-fretting-and-material-loss-of-retrieved-modular-total-knee-arthroplasties
#8
Audrey J Martin, Kirsten A Seagers, Douglas W Van Citters
BACKGROUND: Modular junctions in total hip arthroplasties have been associated with fretting, corrosion, and debris release. The purpose of this study is to analyze damage severity in total knee arthroplasties of a single design by qualitative visual assessment and quantitative material loss measurements to evaluate implant performance and patient impact via material loss. METHODS: Twenty-two modular knee retrievals of the same manufacturer were identified from an institutional review board-approved database...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343823/process-improvement-project-using-tranexamic-acid-is-cost-effective-in-reducing-blood-loss-and-transfusions-after-total-hip-and-total-knee-arthroplasty
#9
Harry A Demos, Zilan X Lin, William R Barfield, Sylvia H Wilson, Dawn C Robertson, Vincent D Pellegrini
BACKGROUND: Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. METHODS: After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343822/the-new-surgical-technique-for-improving-total-knee-and-hip-arthroplasty-outcomes-patient-selection
#10
Kevin Magone, Bernard P Kemker, Nataliya Pilipenko, Erin O'Connor, Norman Walter, Theresa Atkinson
BACKGROUND: Inclusion of patient satisfaction scores in setting reimbursements has been suggested by health care policy makers to contain cost and improve outcomes. The Short Form 36 Health Survey (SF-36) score provides a health-related quality of life (HRQoL) measure of arthroplasty outcome. Although previous work identified factors that influence this score for hip and knee arthroplasty patients, they did not focus on how a surgeon might use this information in a clinical setting. The present study examined whether relatively simple criteria might identify patients more likely to experience minimal HRQoL improvement...
March 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343821/use-of-chronic-methadone-before-total-knee-arthroplasty
#11
Ferdinand J Chan, Andrew M Schwartz, Jason Wong, Cynthia Chen, Bharat Tiwari, Sun Jin Kim
BACKGROUND: A subset of patients who undergo total knee arthroplasty (TKA) are on methadone maintenance. They require more and often unpredictable quantities of opioids to function as effective painkillers. This study aims to compare the opioid requirements and the immediate postoperative course for patients on methadone maintenance with those who are not, after a TKA. METHODS: A retrospective, case-control study was performed. From 2005 to 2010, 36 patients, who underwent a unilateral TKA, on chronic methadone maintenance were identified...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28342696/measurement-of-change-on-medial-and-lateral-joint-gaps-by-navigation-system-in-multi-radius-ps-tka
#12
Yeesuk Kim, Jin Kyu Lee, Kyu-Sung Chung, Doo-Yeon Lee, Choong Hyeok Choi
BACKGROUND: The purpose of this study was to evaluate the joint gap kinematics in posterior-stabilized total knee arthroplasty (PS TKA). METHODS: Between January 2010 and April 2011, 44 consecutive patients (55 knees) who underwent primary PS TKA using the navigation system were assessed. There were 37 women and 7 men with a mean age at operation of 63 years (range; 58-73 years). After fixation of all components with cement and insertion of polyethylene trial insert, medial and lateral joint gap measurements were carried out without distraction force and separately using a navigation system on each flexion angles...
March 22, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28342028/disparities-in-knee-and-hip-arthroplasty-outcomes-an-observational-analysis-of-the-acs-nsqip-clinical-registry
#13
Peter Cram, Gillian Hawker, John Matelski, Bheeshma Ravi, Andrew Pugely, Rajiv Gandhi, Timothy Jackson
BACKGROUND: Disparities in total joint arthroplasty (TJA) have largely been studied in single center studies and using administrative data. Our objective was to investigate differences in TJA outcomes in white men, black men, white women, and black women using a large international registry. METHODS: We used 2010-2013 data from the ACS-NSQIP to identify four groups of adults (white men, black men, white women, black women) who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA)...
March 24, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28341878/sports-activity-is-maintained-or-increased-following-total-knee-arthroplasty
#14
Caroline Hepperger, Peter Gföller, E Abermann, Christian Hoser, Hanno Ulmer, Elmar Herbst, Christian Fink
PURPOSE: The purpose of this study was to investigate sports activities and functional abilities in patients following total knee arthroplasty (TKA). It was hypothesized that patients who had undergone TKA would return to a higher activity level as that experienced preoperatively. METHODS: Two hundred patients were included in this prospective single-cohort study. All the patients completed subjective questionnaires (Tegner Activity Level, Oxford Knee Score, Visual Analog Scale for pain) prior to surgery as well as at 6, 12, and 24 months postoperatively...
March 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28341281/uncemented-metal-backed-tantalum-patellar-components-in-total-knee-arthroplasty-have-a-high-fracture-rate-at-midterm-follow-up
#15
Jeremy Y Chan, Nicholas J Giori
BACKGROUND: There is interest in uncemented total knee arthroplasty due to the hope for long-term biologic fixation, but limited data are available regarding uncemented tantalum patellar components. The purpose of this study was to evaluate the radiographic outcomes of uncemented tantalum patellar implants at midterm follow-up. METHODS: We retrospectively reviewed a consecutive series of 30 knees in 29 patients who underwent cementless total knee arthroplasty with an uncemented metal-backed tantalum patella between September 2006 and April 2009...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28341278/early-outcomes-of-kinematic-alignment-in-primary-total-knee-arthroplasty-a-meta-analysis-of-the-literature
#16
P Maxwell Courtney, Gwo-Chin Lee
BACKGROUND: Kinematic alignment in total knee arthroplasty (TKA) seeks to more anatomically align the knee prosthesis to promote more physiological kinematics. However, there are questions about the durability, function, and complication rate of a non-mechanically aligned TKA. Therefore, the purpose of this study is to perform a systematic review and meta-analysis to evaluate early outcomes after kinematic alignment. METHODS: Two independent reviewers performed a systematic review of the English literature using both the MEDLINE and Embase databases searching for studies on kinematic TKA...
February 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28341034/outcome-assessment-in-total-knee-arthroplasty-a-systematic-review-and-critical-appraisal
#17
REVIEW
Toni Lange, Elisabeth Rataj, Christian Kopkow, Jörg Lützner, Klaus-Peter Günther, Jochen Schmitt
BACKGROUND: The Outcome Measures in Rheumatology (OMERACT) initiative developed a core outcome set (COS) of domains to assess effectiveness of interventions for knee osteoarthritis. These domains (pain, physical function, patient global assessment, imaging at 1 year) should be assessed in every trial to make research evidence meaningful and comparable. We systematically evaluated and critically appraised the use of measurement instruments and outcome domains in prospective studies evaluating patients with knee osteoarthritis undergoing total knee arthroplasty (TKA) and assessed their accordance with the OMERACT COS...
February 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28340617/the-efficacy-of-pregabalin-for-the-management-of-postoperative-pain-in-primary-total-knee-and-hip-arthroplasty-a-meta-analysis
#18
REVIEW
Fei Li, Jianxiong Ma, Mingjie Kuang, Xuan Jiang, Ying Wang, Bin Lu, Xingwen Zhao, Lei Sun, Xinlong Ma
OBJECTIVE: A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy of pregabalin for the management of postoperative pain in patients undergoing primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA). METHOD: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. RevMan 5.3 software was selected to conduct the meta-analysis...
March 24, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28340610/the-importance-of-informational-clinical-and-personal-support-in-patient-experience-with-total-knee-replacement-a-qualitative-investigation
#19
Laurie J Goldsmith, Nitya Suryaprakash, Ellen Randall, Jessica Shum, Valerie MacDonald, Richard Sawatzky, Samar Hejazi, Jennifer C Davis, Patrick McAllister, Stirling Bryan
BACKGROUND: Total knee arthroplasty (TKA) is the most frequently performed joint replacement surgery in North America. Patient perspectives on TKA have been investigated in various ways, including finding as many as 20% of TKA patients are dissatisfied with their surgical outcomes. Understanding the patient experience with TKA broadly and in relation to patient satisfaction is a key gap in existing literature. METHODS: We report on the qualitative component of a mixed methods prospective cohort study examining patient experience and satisfaction post-TKA for adults in British Columbia, Canada...
March 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28339430/comparative-effectiveness-review-of-cooled-versus-pulsed-radiofrequency-ablation-for-the-treatment-of-knee-osteoarthritis-a-systematic-review
#20
Anita Gupta, Daniel P Huettner, Matthew Dukewich
BACKGROUND: Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain in patients who have failed conservative treatment or who are not suitable candidates for surgical treatment. OBJECTIVE: This systematic review aimed to analyze published studies on radiofrequency ablation to provide an overview of the current knowledge regarding variations in procedures, nerve targets, adverse events, and temporal extent of clinical benefit...
March 2017: Pain Physician
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