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Total knee arthroplasty

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https://www.readbyqxmd.com/read/28654699/early-mobilisation-after-total-hip-or-knee-arthroplasty-a-multicentre-prospective-observational-study
#1
Matthew J Chua, Andrew J Hart, Rajat Mittal, Ian A Harris, Wei Xuan, Justine M Naylor
OBJECTIVE: Early mobilisation is recommended following total hip arthroplasty (THA) or total knee arthroplasty (TKA) to prevent venous thromboembolism (VTE). We sought to determine the proportions of patients that first mobilised on post-operative day 0 (POD 0) and factors associated with earlier time to mobilisation. METHODS: A prospective cohort study was conducted involving patients with hip or knee osteoarthritis who had undergone primary unilateral THA (n = 818) and TKA (n = 989) at 19 Australian hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/28654559/the-role-of-preoperative-radiological-severity-sensory-testing-and-temporal-summation-on-chronic-postoperative-pain-following-total-knee-arthroplasty
#2
Kristian Kjær Petersen, Ole Simonsen, Mogens Berg Laursen, Lars Arendt-Nielsen
OBJECTIVES: Knee osteoarthritis (KOA) can be associated with local and central sensitization. As an indicator of the central gain, facilitated temporal summation of pain (TSP) has been found in KOA patients. This facilitation is predictive of the development of chronic postoperative pain after total knee arthroplasty (TKA). Other studies have suggested hypoesthesia/hypoalgesia to thermal stimuli as a feature in KOA. This study investigated associations between preoperative TSP, thermal sensitivity and radiological severity for the development of chronic postoperative pain after TKA...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28653546/cruciate-retaining-compared-with-posterior-stabilised-nexgen-total-knee-arthroplasty-results-at-10-years-in-a-matched-cohort
#3
Aiw Mayne, H P Harshavardhan, L R Johnston, W Wang, A Jariwala
INTRODUCTION Debate has persisted for many years about whether to sacrifice or replace the posterior cruciate ligament when performing total knee arthroplasty. A paucity of long-term follow-up studies comparing outcomes between cruciate-retaining and posterior-stabilised knees exist. We aimed to compare results at ten-year follow-up. METHODS A matched paired study comparing a cohort of 107 Zimmer Nexgen® Cruciate Retaining (CR) patients with a cohort of 107 Nexgen Posterior-Stabilised (PS) knees matched for age, sex, body mass index and preoperative American Knee Society score was undertaken...
June 27, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28653182/coronal-femoral-tka-position-significantly-influences-in-vivo-patellar-loading-in-unresurfaced-patellae-after-primary-total-knee-arthroplasty
#4
Omer Slevin, Florian A Schmid, Filippo-Franco Schiapparelli, Helmut Rasch, Felix Amsler, Michael T Hirschmann
PURPOSE: As patellar tracking and loading is influenced by tibial tuberosity and trochlear groove (TT-TG) distance, patellar height, thickness and tilt as well as TKA component position, it was our hypothesis that these parameters significantly correlate with patellar BTU intensity and localization in SPECT/CT. The purpose of the study was to investigate whether TKA component position as well as the height, thickness and tilt of the unresurfaced patella influences the intensity and the distribution pattern of BTU in SPECT/CT...
June 26, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28651579/total-knee-arthroplasty-with-corrective-osteotomy-for-knee-osteoarthritis-associated-with-malunion-after-tibial-plateau-fracture-a-case-report
#5
Toshihiro Hosokawa, Yuji Arai, Shuji Nakagawa, Toshikazu Kubo
BACKGROUND: When surgeons perform total knee arthroplasty in patients with knee osteoarthritis due to malunion following fractures around the knee joint, corrective osteotomy is recommended for severe deformities. Most such deformities are coronal plane varus or valgus deformities, and reports of sagittal plane flexion or extension deformities are rare. We describe a case in which a one-stage total knee arthroplasty was performed with extension corrective osteotomy in the sagittal plane...
June 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28648711/patient-reported-outcomes-can-be-used-to-identify-patients-at-risk-for-total-knee-arthroplasty-revision-and-potentially-individualize-postsurgery-follow-up
#6
Hilal Maradit Kremers, Walter K Kremers, Daniel J Berry, David G Lewallen
BACKGROUND: Patient-reported outcomes are increasingly used as complementary measures to clinical outcomes in total knee arthroplasty (TKA). However, their prognostic importance has yet to be established. We aimed to determine whether the long-term revision risk in TKA relates to pain and Knee Society Score (KSS) measures at baseline, 1, and 2 years. METHODS: This was a registry-based study of primary TKA procedures at a large tertiary care institution between 1995 and 2010...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648709/optimizing-mechanical-alignment-with-modular-stems-in-revision-tka
#7
Andrew N Fleischman, Ibrahim Azboy, Camilo Restrepo, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Although mechanical alignment is critical for optimal function and long-term implant durability, the role of modular stems in achieving ideal alignment is unclear. METHODS: We identified 319 revision total knee arthroplasty from 2003-2013, for which stem length, stem diameter, and stem fixation method were recorded prospectively. Three-dimensional canal-filling ratio, the product of canal-filling ratio at the stem tip in both the anteroposterior and lateral planes, and alignment were measured radiographically...
May 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648707/location-of-the-common-peroneal-nerve-in-valgus-knees-is-the-reported-safe-zone-for-well-aligned-knees-applicable
#8
Dejin Yang, Hongyi Shao, Yixin Zhou, Hao Tang, Shengjie Guo
BACKGROUND: Lateral soft-tissue release can jeopardize the common peroneal nerve (CPN) in total knee arthroplasty for valgus knees. Previous studies reporting safe zones to protect the CPN were based on well-aligned knees. We conducted this study to compare the localization of the CPN in well-aligned knees and in valgus knees. METHODS: We conducted a consecutive 3-dimensional radiographic study on magnetic resonance images of 58 well-aligned knees and 39 valgus knees...
June 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648704/total-knee-arthroplasty-using-bicruciate-stabilized-or-posterior-stabilized-knee-implants-provided-comparable-outcomes-at-2-years-a-prospective-multicenter-randomized-controlled-clinical-trial-of-patient-outcomes
#9
Jennie M Scarvell, Diana M Perriman, Paul N Smith, David G Campbell, Warwick J M Bruce, Bo Nivbrant
BACKGROUND: The bicruciate-stabilized (BCS) knee arthroplasty was developed to replicate normal knee kinematics. We examined the hypothesis that patients with osteoarthritis requiring total knee arthroplasty (TKA) will have better functional outcome and satisfaction with the BCS implant compared with an established posterior cruciate-stabilized implant. METHODS: This multicenter, randomized, controlled trial compared the clinical outcomes of a BCS implant against an established posterior cruciate-stabilized implant with 2-year follow-up...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648702/a-dual-pivot-pattern-simulating-native-knee-kinematics-optimizes-functional-outcomes-after-total-knee-arthroplasty
#10
R Michael Meneghini, Evan R Deckard, Marshall K Ishmael, Mary Ziemba-Davis
BACKGROUND: Few studies on kinematics correlate patterns to functional outcomes after total knee arthroplasty (TKA). The purpose of this study was to determine if lateral pivot motion in early flexion and medial pivot in high flexion, simulating native knee kinematics, produces superior clinical outcomes. A second objective was to determine if specific kinematic patterns produce superior outcomes. METHODS: One hundred twenty consecutive TKAs were performed using sensor trials to record intraoperative knee kinematics...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28646825/early-outpatient-physical-therapy-may-improve-range-of-motion-in-primary-total-knee-arthroplasty
#11
Tanner McGinn, Morad Chughtai, Anton Khlopas, Paige Grasmick, Arun B Mullaji, Steven F Harwin, Anil Bhave, Michael A Mont
No abstract text is available yet for this article.
June 24, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28645839/antibiotic-prophylaxis-adequacy-in-knee-arthroplasty-and-surgical-wound-infection-prospective-cohort-study
#12
J A Del-Moral-Luque, A Checa-García, Á López-Hualda, M C Villar-Del-Campo, J Martínez-Martín, F J Moreno-Coronas, J Montejo-Sancho, G Rodríguez-Caravaca
OBJECTIVE: Antibiotic prophylaxis is the most suitable tool for preventing surgical wound infection. This study evaluated adequacy of antibiotic prophylaxis in surgery for knee arthroplasty and its effect on surgical site infection. MATERIAL AND METHOD: Prospective cohort study. We assessed the degree of adequacy of antibiotic prophylaxis, the causes of non-adequacy, and the effect of non-adequacy on surgical site infection. Incidence of surgical site infection was studied after a maximum incubation period of a year...
June 20, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28645703/mapping-of-the-anterior-tibial-profile-to-identify-accurate-reference-points-for-sagittal-alignment-of-tibial-component-in-total-knee-arthroplasty
#13
Gianluca Cinotti, Ettore Caruso, Luigi Orsina, Giuseppe La Torre, Francesca Romana Ripani
BACKGROUND: Although standard instrumentation is the procedure most frequently used to implant a total knee arthroplasty (TKA), high rates of malalignment of tibial component are reported using this technique. Anatomical landmarks for sagittal alignment have been little investigated and the best reference axis which parallels the mechanical axis is yet to be established. HYPOTHESIS: Mapping the anterior tibial profile (ATP) may allow the identification of segmental zones of the ATP parallel to the mechanical axis which can be use to align the extramedullary rod...
June 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28644188/surgical-techniques-for-total-knee-arthroplasty-measured-resection-gap-balancing-and-hybrid
#14
Neil P Sheth, Adeel Husain, Charles Lenwood Nelson
Total knee arthroplasty (TKA) is effective in managing end-stage degenerative joint disease. Achieving favorable clinical outcomes is predicated on proper implant alignment, sizing, and rotation as well as adequate soft-tissue balancing. Modern TKA implants are designed to address the fundamental needs of attaining stability in both flexion and extension and of optimizing patellar tracking. Measured resection and gap balancing are the two different techniques used to implant the TKA components used today. Both techniques have been validated as durable and successful, and each has unique advantages and disadvantages...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#15
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28642665/osteoporosis-in-brazilian-patients-awaiting-knee-arthroplasty
#16
David Sadigursky, Luiz Alberto Barretto, Diogo Maciel Vieira Lobão, Rogério Jamil Fernandes Carneiro, Paulo Oliveira Colavolpe
OBJECTIVE: The primary objective of this study was to determine the prevalence of osteoporosis and osteopenia prior to total knee arthroplasty (TKA) in female patients. As a secondary objective, we evaluated the incidence of hip fractures, types of drugs to treat osteoporosis and serum vitamin D levels. METHOD: This is a transversal, descriptive and observational study which evaluated 60 women above age 55 prior to total knee replacement. RESULTS: Mean patient age was 71...
May 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28642657/negative-pressure-wound-therapy-in-the-treatment-of-complex-injuries-after-total-knee-arthroplasty
#17
Camilo Partezani Helito, Daniel Kamura Bueno, Pedro Nogueira Giglio, Marcelo Batista Bonadio, José Ricardo Pécora, Marco Kawamura Demange
OBJECTIVE: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. METHODS: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico((r)) device for NPWT in addition to standard treatment of infection or dehiscence in our institution...
March 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28642656/local-periarticular-analgesia-in-total-knee-arthroplasty
#18
David Sadigursky, Daniel Pereira Simões, Raphael Araújo de Albuquerque, Monize Zórnio Silva, Rogério Jamil Carneiro Fernandes, Paulo Oliveira Colavolpe
OBJECTIVE: To evaluate the use of infiltration of periarticular analgesic agents intraoperatively in total knee arthroplasty (TKA), with regard to benefits, reduction of pain, opioid consumption, improvement of range of motion and early ambulation. METHODS: To analyze the benefits of periarticular drug infiltration, the patients submitted to TKA were evaluated, being separated into two groups. One group received the local periarticular infiltration protocol containing 0...
March 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28642164/joint-loading-and-proximal-tibia-subchondral-trabecular-bone-microarchitecture-differ-with-walking-gait-patterns-in-end-stage-knee-osteoarthritis
#19
Bryant C Roberts, Lucian B Solomon, Graham Mercer, Karen J Reynolds, Dominic Thewlis, Egon Perilli
OBJECTIVES: To (1) stratify subgroups according to their distinct walking gait patterns in end-stage knee osteoarthritis (OA) patients; (2) compare measures of joint loading and proximal tibia subchondral trabecular bone (STB) microarchitecture among subgroups. DESIGN: Twenty-five knee OA patients undergoing total knee arthroplasty had pre-operative gait analysis. Following surgery, excised tibial plateaus were micro-CT-scanned and STB microarchitecture analysed in four tibial condylar regions of interest...
June 19, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#20
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
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