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Total knee arthroplasty

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https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#1
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#2
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28213168/patients-with-total-knee-arthroplasty-do-not-use-all-of-their-available-range-of-knee-flexion-during-functional-activities
#3
Jodie A McClelland, Julian A Feller, Hylton B Menz, Kate E Webster
BACKGROUND: Recent research designed to improve outcome from total knee arthroplasty has included focus on strategies that increase the range of post-operative knee flexion. Patients with knee arthroplasty can now expect >100° of knee flexion following surgery, but it is not clear whether this improved range of motion facilitates outcome or whether patients take advantage of this range when completing daily functional activities. The aim of this study was to investigate the knee flexion angles used during daily functional activities that specifically required high degrees of knee flexion...
February 7, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28211301/early-results-of-patellofemoral-inlay-resurfacing-arthroplasty-using-the-hemicap-wave-prosthesis
#4
Akash Patel, Zakir Haider, Amarjit Anand, Dominic Spicer
BACKGROUND: Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28211285/can-local-infiltration-analgesia-increase-satisfaction-in-postoperative-short-term-pain-control-in-total-knee-arthroplasty
#5
David Barastegui, I Robert, E Palau, S Haddad, M Reverte-Vinaixa, L Lorente, M Cots
BACKGROUND: One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient's early functional outcomes. OBJECTIVES: Compare length of stay (LOS) short-term pain control, and patients' satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA. PATIENTS AND METHODS: Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210821/p-f-c-sigma-%C3%A2-cruciate-retaining-fixed-bearing-versus-mobile-bearing-knee-arthroplasty-a-prospective-comparative-study-with-minimum-10-year-follow-up
#6
O Riaz, A Aqil, G Sisodia, G Chakrabarty
AIMS: To prospectively compare long-term clinical and radiological outcomes following a cruciate retaining fixed-bearing (FB) and a mobile-bearing (MB) primary total knee replacement (TKR). METHODS: We prospectively reviewed 113 TKRs in 99 patients (14 bilateral) with a PFC sigma cruciate retaining rotating platform system, at an average follow-up of 11.1 years (range 10-12). Results were contrasted with those from 89 TKRs in 72 patients (17 bilateral) with a PFC sigma cruciate fixed-bearing prosthesis, at an average follow-up of 12...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28210787/articular-surface-mounted-navigated-total-knee-arthroplasty-improves-the-reliability-of-component-alignment
#7
N D Clement, D MacDonald, A G Burgess, C R Howie
PURPOSE: The primary aim was to compare the early knee-specific functional outcome after articular surface mounted (ASM) navigation with non-navigated TKA. The secondary aims were to compare general physical and mental health improvement, patient satisfaction, and reliability of component alignment in the sagittal and coronal planes between ASM navigated TKA with that of non-navigated TKA. METHODS: Prospective functional outcome and radiographic data were collect for 123 patients undergoing ASM navigation and 172 patients undergoing non-navigated TKA by a high volume single surgeon...
February 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28209278/the-impact-of-coronal-plane-alignment-on-polyethylene-wear-and-damage-in-total-knee-arthroplasty-a-retrieval-study
#8
Pieter-Jan T K Vandekerckhove, Matthew G Teeter, Douglas D R Naudie, James L Howard, Steven J MacDonald, Brent A Lanting
BACKGROUND: Coronal plane alignment is one of the contributing factors to polyethylene wear in total knee arthroplasty. METHODS: Based on 95 retrieved polyethylene inserts, wear and damage patterns were analyzed in relationship to the overall mechanical alignment and to the position of the tibial component. RESULTS: A progression of wear was observed with progressively mechanical varus alignment. However, there was significantly more damage in the lateral compartment in the mild and moderate varus group compared to the valgus group...
January 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209277/revision-arthroplasty-for-the-management-of-stiffness-after-primary-tka
#9
Joaquin Moya-Angeler, Marcel A Bas, H John Cooper, Matthew S Hepinstall, Jose A Rodriguez, Giles R Scuderi
BACKGROUND: The aim of this study was to evaluate the results of revision surgery for the treatment of stiffness after total knee arthroplasty (TKA). METHODS: An IRB-approved retrospective review was performed to identify patients who were revised due to stiffness after a primary TKA. Patients were included when at least one major component had to be revised due to stiffness after primary TKA with a minimum follow-up of 2 years. Patients with history of previous infection and those treated with isolated polyethylene exchange were excluded...
January 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209276/the-aahks-clinical-research-award-what-are-the-costs-of-knee-osteoarthritis-in-the-year-prior-to-total-knee-arthroplasty
#10
Nicholas A Bedard, Spencer B Dowdle, Christopher A Anthony, David E DeMik, Michael A McHugh, Kevin J Bozic, John J Callaghan
BACKGROUND: Despite American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPGs) related to the non-arthroplasty management of osteoarthritis (OA) of the knee, non-recommended treatments remain in common use. We sought to determine the costs associated with non-arthroplasty management of knee OA in the year prior to total knee arthroplasty (TKA) and stratify them by CPG recommendation status. METHODS: The Humana database was reviewed from 2007 to 2015 for primary TKA patients...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209275/contact-kinematic-differences-between-gap-balanced-vs-measured-resection-techniques-for-single-radius-posterior-stabilized-total-knee-arthroplasty
#11
Matthew G Teeter, Kevin I Perry, Xunhua Yuan, James L Howard, Brent A Lanting
BACKGROUND: Measured resection (MR) and gap balancing (GB) are common surgical techniques for total knee arthroplasty (TKA). Controversy has arisen as each conceptually differs in how the knee is balanced through bone and soft tissue management. The objective of the present study was to compare both the frequency of condylar liftoff and the location of femorotibial contact from extension through midflexion between patients undergoing GB or MR TKA. METHODS: A total of 24 knees (23 patients) were randomly assigned at referral to either a surgeon performing MR or GB TKA with the same single radius, posterior-stabilized implant (12 per cohort)...
January 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209274/long-term-durability-of-ceramic-tri-condylar-knee-implants-a-minimum-15-year-follow-up
#12
Shinichiro Nakamura, Hiromu Ito, Kenji Nakamura, Shinichi Kuriyama, Moritoshi Furu, Shuichi Matsuda
BACKGROUND: Ceramic bearings are not commonly used in total knee arthroplasty (TKA). So far, little information is available about whether long-term survivorship and good clinical outcomes can be ensured with ceramic knee implants. The purposes of the present study were to evaluate the clinical and radiological outcomes, and to assess the long-term durability of a ceramic tri-condylar implant. METHODS: A total of 507 consecutive TKAs were carried out using a ceramic tri-condylar femoral implant...
January 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209273/venous-thromboembolic-disease-in-revision-vs-primary-total-knee-arthroplasty
#13
Matthew R Boylan, Dean C Perfetti, Bhaveen H Kapadia, Ronald E Delanois, Carl B Paulino, Michael A Mont
BACKGROUND: Venous thromboembolic disease (VTED) is a serious complication of primary and revision total knee arthroplasty (TKA). However, the incidence and risk of VTED for revision compared with primary TKA cases have not been well-described. METHODS: We identified 225,584 TKAs (208,954 primaries, 16,630 revisions) in the 2003-2012 Statewide Planning and Research Cooperative System database. Odds ratios (ORs) expressed the risk of VTED for revision vs primary TKA, and models were adjusted for age, gender, race, and Charlson comorbidity scores...
January 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209272/midterm-clinical-and-radiographic-results-of-mobile-bearing-revision-total-knee-arthroplasty
#14
Raymond H Kim, J Ryan Martin, Douglas A Dennis, Charlie C Yang, Jason M Jennings, Gwo-Chin Lee
BACKGROUND: Constrained implants are frequently required in revision total knee arthroplasty (TKA) and are associated with an increase in aseptic component loosening and damage or wear to the constraining mechanisms, compared with primary TKA. The purpose of the following study was to evaluate the midterm clinical and radiographic results including the incidence of bearing complications in a group of patients undergoing revision TKA using mobile-bearing revision TKA implants. METHODS: We retrospectively reviewed 316 consecutive mobile-bearing revision TKAs performed at 2 centers between 2006 and 2010...
January 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#15
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203021/-comparision-for-clinical-efficiency-of-continuous-adductor-canal-block-and-femoral-nerve-block-in-total-knee-arthroplasty
#16
M W Zhao, N Wang, L Zeng, M Li, Z K Zhao, H Zhang, H Tian
OBJECTIVE: To compare the pain control efficiency of continuous adductor canal block (ACB) and femoral nerve block (FNB) in total knee arthroplasty. METHODS: From April to September 2016, patients with severe knee osteoarthritis undergoing primary unilateral total knee arthroplasty (TKA) were prospectively observed, and all the patients were randomized received ultrasound-guided continuous ACB or FNB after surgery. Numeric pain rating scales(NPRS)pain scores in rest and activity 2, 6, 12, 24 and 48 h after surgery were collected, and the preoperative and postoperative quadriceps strength at 24 and 48 h were analyzed...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28203020/-effect-of-continuous-femoral-nerve-block-combined-with-periarticular-local-infiltration-analgesia-on-early-operative-functional-recovery-after-total-knee-arthroplasty-a-randomized-double-blind-controlled-study
#17
Y Deng, T L Jiang, X X Yang, M Li, J Wang, X Y Guo
OBJECTIVE: To investigate the effects of early rehabilitation training after total knee arthroplasty surgery by continuous femoral nerve block (CFNB) with or without periarticular local infiltration analgesia (PLIA). METHODS: In this randomized, double-blind, controlled study, 100 patients under-going primary unilateral total knee arthroplasty in patients with knee osteoarthritis were enrolled. All the patients received CFNB for postoperative analgesia before combined spinal epidural anesthesia...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28202207/catastrophic-varus-collapse-of-the-tibia-in-obese-total-knee-arthroplasty
#18
Thomas K Fehring, Keith A Fehring, Lucas A Anderson, Jesse E Otero, Bryan D Springer
BACKGROUND: Mechanical complications have been underemphasized in reports on total knee arthroplasty (TKA) in obese patients. Noticing an increased prevalence of varus collapse of the tibia in obese total knee patients, we sought to determine if variability in proximal tibial cancellous bone strength played a role in failure. We attempted to define a cancellous threshold above which alternative methods of fixation should be used. METHODS: One thousand one hundred six revision TKAs from 2004-2014 identified 35 patients with varus collapse of the tibia, defined as a change in component position of >10°...
January 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28196619/development-and-verification-of-novel-porous-titanium-metaphyseal-cones-for-revision-total-knee-arthroplasty
#19
Ahmad Faizan, Manoshi Bhowmik-Stoker, Amanda E Kirk, Viktor E Krebs, Steven F Harwin, R Michael Meneghini
BACKGROUND: Porous metaphyseal cones are widely used in revision knee arthroplasty. A new system of porous titanium metaphyseal cones has been designed based on the femoral and tibial morphology derived from a computed tomography-based anatomical database. The purpose of this study is to evaluate the initial mechanical stability of the new porous titanium revision cone system by measuring the micromotion under physiologic loading compared with a widely-used existing porous tantalum metaphyseal cone system...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28196567/the-effect-of-preoperative-education-on-postoperative-pain-after-joint-surgery-an-integrative-literature-review
#20
Mary Ashley Barry
As the number of total knee arthroplasty surgeries continues to increase and the length of hospital stay is trending down, preoperative education continues to be an important factor to support positive postoperative outcomes. The purpose of this literature review is to examine whether preoperative education for patients undergoing total knee arthroplasty affects postoperative pain management compared to those who do not receive this education. Findings from the literature review indicate that receiving preoperative education before a total knee arthroplasty does not impact pain management in the postoperative phase...
February 1, 2017: Creative Nursing
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