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"Total knee arthroplasty"

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https://www.readbyqxmd.com/read/28731957/longitudinal-postoperative-course-of-pain-and-dysfunction-following-total-knee-arthroplasty
#1
Katherine Hadlandsmyth, M Bridget Zimmerman, Roohina Wajid, Kathleen A Sluka, Keela Herr, Charles R Clark, Nicolas O Noiseux, John J Callaghan, Barbara A Rakel
OBJECTIVES: While the majority of patients undergoing Total Knee Arthroplasty report substantial improvement in pain and function, a significant subset experience persistent post-surgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6 weeks post-TKA, to six month outcomes. This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6 weeks and 6 months post-TKA...
July 20, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28729762/combination-of-bone-marrow-mesenchymal-stem-cells-and-cartilage-fragments-contribute-to-enhanced-repair-of-osteochondral-defects
#2
Mohammed Abbas
Cartilage tissue engineering using stem cells and biomaterials is considered a promising approach despite poor outcomes. We hypothesise that articular cartilage fragments provides native environmental cues to enhance stem cell differentiation. As such we evaluated the chondrogenic differentiation and repair of critical size defect in a human explant osteochondral model (OD) using bone marrow derived mesenchymal stem cells (BM-MSCs) and homogenised cartilage. BM-MSCs were established from the bone-marrow plugs of patients undergoing total knee arthroplasty and characterized...
2017: Bioinformation
https://www.readbyqxmd.com/read/28728882/variation-in-the-cost-of-5-common-operations-in-the-united-states
#3
Elliot Wakeam, George Molina, Neel Shah, Stuart R Lipsitz, David C Chang, Atul A Gawande, Alex B Haynes
BACKGROUND: Health care costs are an important policy focus in the United States. The magnitude and drivers of variation in the costs of common operative procedures are not well understood. We sought to characterize variation in costs across hospitals. METHODS: We used data from the Nationwide Inpatient Sample from 2001-2011 for 5 elective operations: colectomy, coronary artery bypass graft, total knee arthroplasty, cesarean section, and lung resection. Hospitals were benchmarked for each using hierarchical risk- and reliability-adjustment methods to generate an observed-to-expected cost ratio, which was adjusted for patient demographics, comorbidity, wage index, and procedure complexity...
July 17, 2017: Surgery
https://www.readbyqxmd.com/read/28727583/serum-bupivacaine-concentration-after-periarticular-injection-with-a-mixture-of-liposomal-bupivacaine-and-bupivacaine-hcl-during-total-knee-arthroplasty
#4
Michael J Buys, Marian F Murphy, Christine M Warrick, Nathan L Pace, Jeremy M Gililland, Christopher E Pelt, Byron R Bankhead, John L Patzkowsky, Ken B Johnson
BACKGROUND AND OBJECTIVES: A relatively new technique to reduce postoperative pain for total knee arthroplasty is to inject a mixture of 266 mg of liposomal bupivacaine and 125 mg of 0.25% bupivacaine HCl with epinephrine 1:300,000 around the knee joint at the time of surgery. Currently, no publications report serum bupivacaine concentrations over time after periarticular injection of liposomal mixed with free bupivacaine. This information is important to ensure safe serum bupivacaine concentrations are maintained especially when considering supplemental or rescue peripheral nerve blocks...
July 20, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28725981/certolizumab-pegol-was-effective-for-treating-residual-synovitis-after-total-knee-arthroplasty-in-a-patient-with-rheumatoid-arthritis-therapeutic-monitoring-by-ultrasound
#5
Shin-Ya Kawashiri, Tohru Michitsuji, Atsushi Kawakami
We present the case of a 59-year-old female who developed rheumatoid arthritis in 2007. Right total knee arthroplasty (TKA) was performed in 2008. Although she was treated with methotrexate (MTX) after the operation, this treatment was insufficient. Infliximab (IFX) was introduced in 2001, and she achieved clinical remission. Left TKA was performed in October 2014. Because active synovitis was not detected by ultrasound after the operation, IFX was discontinued. She had been treated with MTX 8 mg weekly. However, arthralgia of the bilateral knees developed in March 2015...
July 19, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#6
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28724345/simultaneous-bilateral-total-knee-arthroplasty-in-hemophilia-is-it-recommended
#7
E Carlos Rodriguez-Merchan
Simultaneous bilateral total knee arthroplasty (TKA) is a potentially cost-saving manner of caring for patients with hemophilia who have bilateral symptomatic hemophilic knee arthropathy. Because factor VIII is used only once in bilateral TKA, it is performed in hemophilia to reduce costs. Areas covered: This article reviews the potential role of simultaneous bilateral TKA in patients with hemophilia. Expert commentary: Although two recent reports have mentioned the benefits of simultaneous bilateral TKA in patients with hemophilia, the data are still scant and preliminary...
July 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28723758/total-knee-arthroplasty-conversion-after-a-failed-lateral-closing-wedge-high-tibial-osteotomy-with-knee-hyperextension-and-secondary-ankle-degeneration-a-case-report
#8
Chen Yao, Xingquan Xu, Sheng Zhou, Xiaoxiao Song, Dongquan Shi, Qing Jiang
RATIONALE: High tibial osteotomy (HTO) has been used widely for medial compartment knee osteoarthritis to correct the deformity and relieve symptoms, especially in young patients who are willing to maintain the high activity level. However, the change of bone morphology, ligament imbalance, limb malalignment, and other complications may influence the short-term outcomes of HTO. Some cases may even require conversion to TKA shortly after HTO because of the loss of correction or pain due to accelerated osteoarthritis...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723749/effects-of-sealing-the-intramedullary-femoral-canal-in-total-knee-arthroplasty-a-randomized-study
#9
Xu Li, Xiang-Bei Qi, Xue Han, Wei Wang, Jian-Ning Liu, Ji-Chao Guo, Zhi-Yong Li
BACKGROUND: This study investigates the clinical effects of sealing the femoral canal by intramedullary alignment instrumentation in total knee arthroplasty (TKA). METHODS: One hundred twenty consecutive patients with knee osteoarthritis, who underwent unilateral TKA, were enrolled in the study and equally randomized into 2 groups: the sealing group and the control group. In the sealing group, the femoral canal was sealed with autogenous bone and cement using intramedullary alignment instrumentation, while the femoral hole was left open for patients in the control group...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721459/measurement-of-lower-limb-alignment-there-are-within-person-differences-between-weight-bearing-and-non-weight-bearing-measurement-modalities
#10
Daphne A L Schoenmakers, Peter Z Feczko, Bert Boonen, Martijn G M Schotanus, Nanne P Kort, Pieter J Emans
PURPOSE: Previous studies have compared weight-bearing mechanical leg axis (MLA) measurements to non-weight-bearing measurement modalities. Most of these studies compared mean or median values and did not analyse within-person differences between measurements. This study evaluates the within-person agreement of MLA measurements between weight-bearing full-length radiographs (FLR) and non-weight-bearing measurement modalities (computer-assisted surgery (CAS) navigation or MRI). MATERIALS AND METHODS: Two independent observers measured the MLA on pre- and postoperative weight-bearing FLR in 168 patients...
July 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28719942/factors-contributing-to-patient-satisfaction-and-expectations-following-computer-assisted-total-knee-arthroplasty
#11
Masahiro Hasegawa, Yohei Naito, Toshio Yamaguchi, Hiroki Wakabayashi, Akihiro Sudo
No abstract text is available yet for this article.
July 18, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28719941/pain-control-in-total-knee-arthroplasty
#12
Randa K Elmallah, Morad Chughtai, Anton Khlopas, Jared M Newman, Kim L Stearns, Martin Roche, Michael A Kelly, Steven F Harwin, Michael A Mont
No abstract text is available yet for this article.
July 18, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28712797/evaluation-of-a-patient-decision-aid-for-unicompartmental-or-total-knee-arthroplasty-for-medial-knee-osteoarthritis
#13
Christopher de Jesus, Dawn Stacey, Geoffrey F Dervin
BACKGROUND: Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28712028/internal-femoral-component-rotation-adversely-influences-load-transfer-in-total-knee-arthroplasty-a-cadaveric-navigated-study-using-the-verasense-device
#14
William A Manning, Kanishka M Ghosh, Alasdair Blain, Lee Longstaff, Steven P Rushton, David J Deehan
PURPOSE AND HYPOTHESIS: Correct femoral component rotation at knee arthroplasty influences patellar tracking and may determine function at extremes of movement. Additionally, such malrotation may deleteriously influence flexion/extension gap geometry and soft tissue balancing kinematics. Little is known about the effect of subtle rotational change upon load transfer across the tibiofemoral articulation. Our null hypothesis was that femoral component rotation would not influence load across this joint in predictable manner...
July 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28711951/optimizing-patellar-positioning-during-total-knee-arthroplasty-an-anatomical-and-clinical-study
#15
Chahine Assi, Nadim Kheir, Camille Samaha, Mary Deeb, Kaissar Yammine
INTRODUCTION: Optimal positioning of the patellar component is crucial for the success of a total knee arthroplasty (TKA). Usually, the patellar component is placed empirically over the presumed centre of the patellar cut. Medialization of the prosthetic patella has been recommended; however, no evidence-based guidelines have been reported. MATERIAL AND METHOD: This anatomical study aims to quantify a pre-defined optimal location for positioning of the patellar component with regard to the centre of the patellar cut...
July 15, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28711589/fixation-strength-of-a-polyetheretherketone-femoral-component-in-total-knee-arthroplasty
#16
Lennert de Ruiter, Dennis Janssen, Adam Briscoe, Nico Verdonschot
INTRODUCTION: Introducing polyetheretherketone (PEEK) polymer as a material for femoral components in total knee arthroplasty (TKA) could potentially lead to a reduction of the cemented fixation strength. A PEEK implant is more likely to deform under high loads, rendering geometrical locking features less effective. Fixation strength may be enhanced by adding more undercuts or specific surface treatments. The aim of this study is to measure the initial fixation strength and investigate the associated failure patterns of three different iterations of PEEK-OPTIMA(®) implants compared with a Cobalt-Chromium (CoCr) component...
July 12, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28709832/relationship-between-patients-in-hospital-affects-recovery-from-total-knee-arthroplasty-tka-a-prospective-study
#17
Teng Lijia, Zeng Rui-Xi, Gong Long, Chen Lei, Liu Yujie, He Jin-Yun, Wang Zhen-Hu
BACKGROUND: The interaction between patients is rather important source of information about surgery and recovery. Patients always prefer particularly to compare themselves with others of relatively similar ability, opinion and situation. Exploration of patients' dyads, however, is rare and needs further elaboration as to the significance of fellow patients. This study was designed to determine in whether and how preoperative assignment affects TKA's results. METHODS: We assessed early post-operative outcomes in a cohort of 520 TKA patients...
July 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28709756/postoperative-outcomes-associated-with-neuraxial-vs-general-anesthesia-following-bilateral-total-knee-arthroplasty
#18
Jeffrey B Walker, Patrick L Nguyen, Ulrich H Schmidt, Rodney A Gabriel
BACKGROUND: There is sparse evidence on the benefit of neuraxial (NA) vs general anesthesia (GA) as the primary anesthetic in postoperative outcomes following bilateral total knee arthroplasty. We sought to elucidate differences in outcomes in this surgical population using a national database. METHODS: We used data from the National Surgical Quality Improvement Program from 2007 to 2013 and compared rates of various postoperative outcomes in propensity-matched cohorts (NA vs GA)...
June 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28709613/a-regional-registry-study-of-216-patients-investigating-if-patient-satisfaction-after-total-knee-arthroplasty-changes-over-a-time-period-of-five-to-20years
#19
Odei Shannak, Jeya Palan, Colin Esler
AIMS: To determine the temporal changes in patient dissatisfaction following primary knee arthroplasty surgery (TKA). PATIENTS AND METHODS: Three hundred and ninety patients that had previously indicated they were either dissatisfied or unsure with their TKA at one-year post-surgery in our region were mailed a simple questionnaire in addition to the Oxford Knee Score and EQ-5D. RESULTS: A 55% response rate was achieved. The mean follow-up time period was 9...
August 2017: Knee
https://www.readbyqxmd.com/read/28708301/quantification-of-interfacial-motions-following-primary-and-revision-total-knee-arthroplasty-a-verification-study-versus-experimental-data
#20
Noel Conlisk, Colin R Howie, Pankaj Pankaj
Motion at the bone-implant interface, following primary or revision knee arthroplasty, can be detrimental to the long term survival of the implant. This study employs experimentally verified computational models of the distal femur to characterise the relative motion at the bone-implant interface for three different implant types; a posterior stabilising implant (PS), a total stabilising implant (TS) with short stem (12mm x 50mm), and a total stabilising implant (TS) with long offset stem (19mm x 150mm with a 4mm lateral offset)...
July 14, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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