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Total knee arthroplasty

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https://www.readbyqxmd.com/read/28091766/pre-operative-intra-articular-deep-tissue-sampling-with-novel-retrograde-forceps-improves-the-diagnostics-in-periprosthetic-joint-infection
#1
Matthias D Wimmer, Milena M Ploeger, Max J Friedrich, Thomas Hügle, Sascha Gravius, Thomas M Randau
BACKGROUND: Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28089667/periprosthetic-fractures-of-the-distal-femur-after-total-knee-arthroplasty-plate-versus-nail-fixation
#2
REVIEW
Sara Shippee Wallace, Daniel Bechtold, Adam Sassoon
: The incidence of periprosthetic fractures about a TKA is increasing. Traditionally these fractures are classified by their location and prosthesis integrity. In the setting of a supracondyar fracture about a well-fixed prosthesis, both plate and nail fixation of the fracture present themselves as options, each with unique benefits and pitfalls. Through review and discussion of the literature, we aim to describe some of the patient, fracture, and implant related factors that should be considered when planning fixation of periprosthetic fractures about a TKA...
January 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#3
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089467/the-evolution-of-implant-design-decreases-the-incidence-of-lateral-release-in-primary-total-knee-arthroplasty
#4
Jonathan E Webb, Heidi Y Yang, Jamie E Collins, Elena Losina, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Appropriate balancing of the patellofemoral joint (PFJ) using a lateral release can help to prevent patellar instability in total knee arthroplasty (TKA). Contemporary total knee implant designs are characterized by enhanced trochlear geometry more similar to native knee anatomy to minimize instability and reduce utilization of a lateral release. METHODS: We retrospectively reviewed consecutive TKA cases from a single senior surgeon's practice with 3 successive total knee designs: the Press-Fit Condylar (PFC), the Sigma, and the ATTUNE (DePuy, Warsaw, IN)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#5
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089185/joint-replacement-volume-positively-correlates-with-improved-hospital-performance-on-centers-for-medicare-and-medicaid-services-quality-metrics
#6
Rachel A Sibley, Vanessa Charubhumi, Lorraine H Hutzler, Albit R Paoli, Joseph A Bosco
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089184/bone-wax-is-effective-in-reducing-blood-loss-after-total-knee-arthroplasty
#7
Ing H Moo, Jerry Y Q Chen, Eric H Pagkaliwaga, See W Tan, Kein B Poon
BACKGROUND: Total knee arthroplasty (TKA) is associated with major blood loss and blood transfusion is often required. This study aimed to evaluate the efficacy of bone wax in reducing blood loss and transfusion rates after TKA. METHODS: A prospective randomized controlled study that included 100 patients undergoing primary unilateral TKA with cement was conducted in a tertiary center between March 2014 and June 2014. The bone wax group received 2.5 g of bone wax, applied onto the uncovered bone around the prostheses and the nail holes before the tourniquet was released, whereas the control group had hemostasis achieved using electrocautery only...
December 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28088227/simplified-chinese-version-of-the-forgotten-joint-score-fjs-for-patients-who-underwent-joint-arthroplasty-cross-cultural-adaptation-and-validation
#8
Shiqi Cao, Ning Liu, Wuxiang Han, Yunpeng Zi, Fan Peng, Lexiang Li, Qiwei Fu, Yi Chen, Weijie Zheng, Qirong Qian
BACKGROUND: The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS). METHODS: Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study...
January 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28088207/cytokine-and-neuropeptide-levels-are-associated-with-pain-relief-in-patients-with-chronically-painful-total-knee-arthroplasty-a-pilot-study
#9
Jasvinder A Singh, Siamak Noorbaloochi, Keith L Knutson
BACKGROUND: There are few studies with an assessment of the levels of cytokines or neuropeptides as correlates of pain and pain relief in patients with painful joint diseases. Our objective was to assess whether improvements from baseline to 2-months in serum cytokine, chemokine and substance P levels were associated with clinically meaningful pain relief at 2-months post-injection in patients with painful total knee arthroplasty (TKA). METHODS: Using data from randomized trial of 60 TKAs, we assessed the association of change in cytokine/chemokine/Substance P levels with primary study outcome, clinically important improvement in Western Ontario McMaster Osteoarthritis Index (WOMAC) pain subscale at 2-months post-injection using Student's t-tests and Spearman's correlation coefficient (non-parametric)...
January 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28087396/influence-of-coronal-bowing-on-the-lower-alignment-and-the-positioning-of-component-in-navigation-and-conventional-total-knee-arthroplasty
#10
Hideo Kobayashi, Yasushi Akamatsu, Ken Kumagai, Yoshihiro Kusayama, Masato Aratake, Tomoyuki Saito
BACKGROUND: Coronal alignment is an important factor for the function and longevity of total knee arthroplasty (TKA). Coronal bowing of the lower extremity is common among Asians and it may pose a risk for malalignment of the lower leg and malposition of component. HYPOTHESIS: We hypothesized that coronal bowing itself has a risk for malalignment of the lower leg and malposition of femoral / tibial components and that navigation TKA is beneficial for patients with coronal bowing...
January 10, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28086940/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-for-analgesia-following-total-knee-arthroplasty-a-prospective-feasibility-study
#11
Brian M Ilfeld, Christopher A Gilmore, Stuart A Grant, Michael P Bolognesi, Daniel J Del Gaizo, Amorn Wongsarnpigoon, Joseph W Boggs
BACKGROUND: Peripheral nerve stimulation has been used for decades to treat chronic pain but has not been used for postoperative analgesia due to multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gauge leads enabling percutaneous insertion, ultrasound guidance for accurate introduction, and stimulators small enough to be adhered to the skin, neurostimulation may now be provided in a similar manner to continuous peripheral nerve blocks...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#12
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079634/characteristics-of-patients-with-satisfactory-functional-gain-following-total-joint-arthroplasty-in-a-postacute-rehabilitation-setting
#13
Avital Hershkovitz, Marina Vesilkov, Yichayaou Beloosesky, Shai Brill
BACKGROUND AND PURPOSE: Total joint arthroplasty (TJA) is an effective and successful treatment of osteoarthritis of the hip and knee as quantified by several measures, such as pain relief, improved walking, improved self-care, functions, and increased quality of life. Data are lacking as to the definition of a satisfactory functional gain in a postacute setting and identifying the characteristics of older patients with TJA who may achieve that gain. Our aim was to characterize patients who may achieve a satisfactory functional gain in a postacute rehabilitation setting following TJA...
January 10, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28079176/adductor-canal-block-versus-femoral-nerve-block-for-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#14
Duan Wang, Yang Yang, Qi Li, Shen-Li Tang, Wei-Nan Zeng, Jin Xu, Tian-Hang Xie, Fu-Xing Pei, Liu Yang, Ling-Li Li, Zong-Ke Zhou
Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28078867/plasma-endocannabinoid-behaviour-in-total-knee-and-hip-arthroplasty
#15
R Ottria, L Cappelletti, A Ravelli, M Mariotti, F Gigli, S Romagnoli, P Ciuffreda, G Banfi, L Drago
Endocannabinoids are a class of lipid mediators involved in a wide range of physiological pathways including pain perception, and immunological defences. In particular, the involvement of endocannabinoids in bone metabolism and bone resorption has recently been studied. Moreover, one study on total knee arthroplasty describes the probable role of endocannabinoids in pain perception after surgery. The aim of the present study was to evaluate variations of endocannabinoid concentrations in patients undergoing total hip or total knee arthroplasty before and after surgery...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28078394/kinematics-of-a-bicruciate-retaining-total-knee-arthroplasty
#16
Thomas J Heyse, Joshua Slane, Geert Peersman, Margo Dirckx, Arne van de Vyver, Philipp Dworschak, Susanne Fuchs-Winkelmann, Lennart Scheys
PURPOSE: The recently reintroduced bicruciate-retaining Total Knee Arthroplasty (BCR TKA) is an interesting approach in the quest for close replication of knee joint biomechanics and kinematics closer to the native knee. Therefore, this study aimed at providing a detailed biomechanical view on the functional resemblance of BCR TKA to the native knee joint. METHODS: Seven fresh-frozen full leg cadaver specimens (76 ± 10 year) were mounted in a 6 degrees-of-freedom kinematic rig that applied a dynamic squatting motion knee flexion...
January 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28077538/magnesium-sulphate-attenuates-acute-postoperative-pain-and-increased-pain-intensity-after-surgical-injury-in-staged-bilateral-total-knee-arthroplasty-a-randomized-double-blinded-placebo-controlled-trial
#17
H-J Shin, E-Y Kim, H-S Na, T K Kim, M-H Kim, S-H Do
BACKGROUND: We evaluated the effect of magnesium sulphate on increased pain in 44 patients undergoing staged bilateral total knee arthroplasty (TKA). METHODS: The magnesium group (n=22) and the control group (n=22) received magnesium sulphate and isotonic saline, respectively, throughout the surgery. Postoperative pain (visual analogue scale, VAS) at rest and the amounts of patient-controlled analgesia (PCA, fentanyl) and rescue analgesia (ketoprofen) administered during the first 48 h were compared between the two groups and within each group between the first and second TKA...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077396/the-effects-of-kinematically-aligned-total-knee-arthroplasty-on-stress-at-the-medial-tibia-a-case-study-for-varus-knee
#18
S Nakamura, Y Tian, Y Tanaka, S Kuriyama, H Ito, M Furu, S Matsuda
OBJECTIVES: Little biomechanical information is available about kinematically aligned (KA) total knee arthroplasty (TKA). The purpose of this study was to simulate the kinematics and kinetics after KA TKA and mechanically aligned (MA) TKA with four different limb alignments. MATERIALS AND METHODS: Bone models were constructed from one volunteer (normal) and three patients with three different knee deformities (slight, moderate and severe varus). A dynamic musculoskeletal modelling system was used to analyse the kinematics and the tibiofemoral contact force...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28077394/metal-backed-versus-all-polyethylene-unicompartmental-knee-arthroplasty-proximal-tibial-strain-in-an-experimentally-validated-finite-element-model
#19
C E H Scott, M J Eaton, R W Nutton, F A Wade, S L Evans, P Pankaj
OBJECTIVES: Up to 40% of unicompartmental knee arthroplasty (UKA) revisions are performed for unexplained pain which may be caused by elevated proximal tibial bone strain. This study investigates the effect of tibial component metal backing and polyethylene thickness on bone strain in a cemented fixed-bearing medial UKA using a finite element model (FEM) validated experimentally by digital image correlation (DIC) and acoustic emission (AE). MATERIALS AND METHODS: A total of ten composite tibias implanted with all-polyethylene (AP) and metal-backed (MB) tibial components were loaded to 2500 N...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28077124/important-patient-characteristics-differ-prior-to-total-knee-arthroplasty-and-total-hip-arthroplasty-between-switzerland-and-the-united-states
#20
Patricia D Franklin, Hermes Miozzari, Panayiotis Christofilopoulos, Pierre Hoffmeyer, David C Ayers, Anne Lübbeke
BACKGROUND: Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. METHODS: Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample...
January 11, 2017: BMC Musculoskeletal Disorders
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