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https://www.readbyqxmd.com/read/30063591/patient-risk-factors-do-not-impact-90-day-readmission-and-emergency-department-visitation-after-total-ankle-arthroplasty-implications-for-the-comprehensive-care-for-joint-replacement-cjr-bundled-payment-plan
#1
Daniel Cunningham, Vasili Karas, James DeOrio, James Nunley, Mark Easley, Samuel Adams
BACKGROUND: The Comprehensive Care for Joint Replacement (CJR) model provides bundled payments for in-hospital care and care within 90 days following discharge for Medicare beneficiaries undergoing lower-extremity joint replacement involving the hip, knee, or ankle (total hip arthroplasty, total knee arthroplasty, or total ankle arthroplasty [TAA]). The study hypothesis was that patient comorbidities are associated with readmissions, emergency department (ED) utilization, and subspecialist wound-healing consultation, which are examples of costly contributors to postoperative health-care spending...
August 1, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29996862/plasma-d-dimer-is-not-useful-in-the-prediction-of-deep-vein-thrombosis-after-total-knee-arthroplasty-in-patients-using-rivaroxaban-for-thromboprophylaxis
#2
Cheng-Ta Wu, Bradley Chen, Jun-Wen Wang, Shih-Hsiang Yen, Chung-Cheng Huang
BACKGROUND: Venous thromboembolism (VTE) is a serious complication following total joint replacement. The use of rivaroxaban, a highly selective and direct factor Xa inhibitor, has been used widely as a safe and efficacious way to prevent VTE after total joint replacements. However, little is known about the diagnostic efficacy of plasma D-dimer test on deep vein thrombosis (DVT) in patients using rivaroxaban for thromboprophylaxis. The study is aimed to investigate the trend and the diagnostic efficacy of D-dimer test on DVT in patients with primary total knee arthroplasty (TKA) using rivaroxaban for thromboprophylaxis...
July 11, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29737288/effect-of-different-types-of-anticoagulants-in-the-prevention-of-venous-thrombosis-in-the-operation-of-knee-joint-bone-operation
#3
Wensheng Xu, Tao Zhang, Zenghua Yang, Lin Nie
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29735456/effect-of-different-types-of-anticoagulants-in-the-prevention-of-venous-thrombosis-in-the-operation-of-knee-joint-bone-operation
#4
Wensheng Xu, Tao Zhang, Zenghua Yang, Lin Nie
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29541841/much-ado-about-nothing-the-effect-of-tourniquet-time-on-an-accelerated-rehabilitation-programme-following-total-knee-replacement-tkr
#5
William Wynell-Mayow, Muhammad Zahid Saeed
BACKGROUND: The WHO includes osteoarthritis as a disease of priority, owing to its significant impact on quality of life, and globally increasing prevalence. Hospital budgets are under pressure to ration knee replacements and shorten inpatient stays. Prolonged tourniquet application has been hypothesised to extend recovery through pain and reduced mobility. PATIENTS AND METHODS: A total of 123 elective total knee replacements meeting inclusion criteria took place from July 2015 to October 2017 at the Royal Free Hospital...
August 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28746213/is-combined-topical-and-intravenous-tranexamic-acid-superior-to-single-use-of-tranexamic-acid-in-total-joint-arthroplasty-a-meta-analysis-from-randomized-controlled-trials
#6
REVIEW
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid (TXA) versus the single use of either application in patients with total knee and hip arthroplasty (TKA and THA). METHODS: Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, and the Cochrane Library. Randomized control trials (RCTs) of patients prepared for total joint arthroplasty that compared combined TXA with placebo were retrieved...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614226/tranexamic-acid-plus-diluted-epinephrine-versus-tranexamic-acid-alone-for-blood-loss-in-total-joint-arthroplasty-a-meta-analysis
#7
REVIEW
Zhanxia Yu, Lulan Yao, Qin Yang
BACKGROUND: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)). METHODS: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28190568/predictable-factors-of-deep-venous-thrombosis-in-patients-undergoing-spine-surgery
#8
Terumasa Ikeda, Hiroshi Miyamoto, Kazuki Hashimoto, Masao Akagi
BACKGROUND: DVT is one of the major postoperative complications of joint replacement surgery of the lower extremity which can cause catastrophic complications such as pulmonary embolism. However, little is known about the incidence of DVT after spine surgery. The purpose of this study was to examine predictable factors of DVT after spine surgery. METHODS: This study included 194 patients who underwent spine surgery (104 males, 90 females, mean age 65.7 years). Postoperative DVT was detected using duplex ultrasonography (DUS)...
March 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28053389/is-pre-operative-assessment-of-coagulation-profile-with-thrombelastography-teg-useful-in-predicting-venous-thromboembolism-vte-following-orthopaedic-surgery
#9
Apurve Parameswaran, Vignesh P Krishnamoorthy, Anil T Oommen, Anita Jasper, Ravi J Korula, Sukesh C Nair, Pradeep M Poonnoose
INTRODUCTION: Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. METHODS: The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27987602/cost-analysis-and-implications-of-routine-deep-venous-thrombosis-duplex-ultrasound-scanning-after-endovenous-ablation
#10
REVIEW
Luis Suarez, Erica Tangney, Thomas F O'Donnell, Mark D Iafrati
BACKGROUND: Duplex ultrasound (DUS) is performed by the majority of physicians after endovenous ablation (EVA) of the great saphenous vein to screen for endovenous heat-induced thrombosis (EHIT) at the saphenofemoral junction extending into the femoral vein. Several factors should be considered in assessing the value and cost of routine DUS after EVA: the natural history of EHIT is poorly defined, the incidence appears low, and the majority are both asymptomatic and Kabnick type 2 (projecting only slightly into the femoral vein)...
January 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/27986370/effects-of-ethyl-chloride-spray-on-early-recovery-after-total-knee-arthroplasty-a-prospective-study
#11
RANDOMIZED CONTROLLED TRIAL
Wang Rui, Gong Long, Geng Li, Yu Yang, Li Hengjin, Wang Zhenhu
BACKGROUND: Ethyl chloride spray as a common cooling modality has been widely used in acute sports injuries and joint injection procedures. Several clinical studies reported that use of ethyl chloride has positive effects on swelling, pain reduction and recovery from sports injuries. The main aim of present study was to analyze whether postoperative use of ethyl chloride spray benefits results after primary total knee arthroplasty (TKA). METHODS: Between April 1, 2014 and October 21, 2015, 306 subjects undergoing primary TKA used ethyl chloride spray for improving recovery from the damage from surgery...
January 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27977590/intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-replacement-a-meta-analysis
#12
COMPARATIVE STUDY
Pei Zhang, Yuan Liang, Pengtao Chen, Yongchao Fang, Jinshan He, Jingcheng Wang
BACKGROUND: As the prevalence of total hip arthroplasty (THA) is increasing, it is usually associated with considerable blood loss. Tranexamic acid (TXA) has been reported to reduce perioperative blood loss in hip joint arthroplasty. But the best route of TXA administration continues to be controversial. So, we conducted a meta-analysis that integrated all data from the 7 included trials to compare the effectiveness and safety of topical and intravenous TXA administration in primary THA...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27385941/duplex-ultrasonography-has-limited-utility-in-detection-of-postoperative-dvt-after-primary-total-joint-arthroplasty
#13
Shaleen Vira, Austin J Ramme, Michael J Alaia, David Steiger, Jonathan M Vigdorchik, Frederick Jaffe
BACKGROUND: Duplex ultrasound is routinely used to evaluate suspected deep venous thrombosis after total joint arthroplasty. When there is a clinical suspicion for a pulmonary embolism, a chest angiogram (chest CTA) is concomitantly obtained. QUESTIONS/PURPOSES: Two questions were addressed: First, for the population of patients who receive duplex ultrasound after total joint arthroplasty, what is the rate of positive results? Second, for these patients, how many of these also undergo chest CTA for clinical suspicion of pulmonary embolus and how many of these tests are positive? Furthermore, what is the correlation between duplex ultrasound results and chest CTA results? METHODS: A retrospective chart review was conducted of total joint replacement patients in 2011 at a single institution...
July 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27352130/comparison-of-venous-thromboembolism-after-total-artificial-joint-replacement-between-musculoskeletal-tumors-and-osteoarthritis-of-the-knee-by-a-single-surgeon
#14
COMPARATIVE STUDY
Dong Fu, Yiqiong Zhao, Jiakang Shen, Zhengdong Cai, Yingqi Hua
The purpose of this study was to compare and evaluate the event of VTE (Venous Thromboembolism Event) after total artificial joint replacement between two groups diagnosed with either musculoskeletal tumors or osteoarthritis (OA) of the knee. From 2004 to 2014, a total of 1,402 patients (308 in tumor group, 1,094 in OA group) were involved in this study. The rate of asymptomatic DVT (Deep vein thrombosis) was significantly higher in tumor group when compared with OA group. Though both the incidence of symptomatic DVT and PE (Pulmonary embolism) were slightly higher in tumor group, no significant difference was detected...
2016: PloS One
https://www.readbyqxmd.com/read/27271721/-substantiation-of-the-system-of-thrombus-formation-prevention-in-treatment-of-patients-with-hip-joint-pathology-against-the-background-of-arterial-insufficiency-of-the-lower-extremities
#15
I F Akhtyamov, B G Ziatdinov, E S Shigaev
AIM: To evaluate effectiveness of electroneurostimulation of the shin muscles as a constituent part of the prevention of TEC in the hip joint pathology at the hospital stage of treatment. MATERIAL AND METHODS: With this purpose, there was conducted the extended comparative analysis of the parameters of the blood coagulation system in 27 patients with pathology of the hip joints and the stated concomitant vascular insufficiency. The comparison group comprised 50 patients with uncomplicated pathology of the hip joint who underwent hip joint replacement surgery...
2016: Khirurgiia
https://www.readbyqxmd.com/read/27213284/stacked-modalities-thromboprophylactic-therapy-for-patients-undergoing-total-knee-replacement-surgery
#16
Limin Jiang, Shudong Zhang, Yuchi Zhao
Thromboprophylaxis is a controversial and challenging topic in joint replacement surgery. Mechanical prophylaxis in combination with the use of anticoagulants have been shown to have greater efficacy than single modalities. But the early use of anticoagulants has the potential to increases the risk of postoperative bleeding. The purpose of this study was to evaluate the thromboprophylactic effects of sequential combined method using early-mechanical compression with delayed rivaroxaban in total knee arthroplasty...
March 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27020783/total-knee-replacement-with-tibial-tubercle-osteotomy-in-rheumatoid-patients-with-stiff-knee
#17
Ahmed Salem Eid, Wael Ahmed Mohamed Nassar, Tamer Abdelmeguid Mohamed Fayyad
PURPOSE: Total knee arthroplasty (TKA) is a well-proven modality that can provide pain relief and restore mobility for rheumatoid arthritis (RA) patients with advanced joint destruction. Patellar ligament avulsion, especially in presence of poor bone quality and knee stiffness, is one of the special considerations that must be addressed in this unique population of patients. This study aimed to determine the functional results in a series of rheumatoid patients with stiff knee and end-stage joint destruction who underwent tibial tubercle osteotomy during TKA...
November 2016: International Orthopaedics
https://www.readbyqxmd.com/read/26989978/hospital-charges-associated-with-never-events-comparison-of-anterior-cervical-discectomy-and-fusion-posterior-lumbar-interbody-fusion-and-lumbar-laminectomy-to-total-joint-arthroplasty
#18
COMPARATIVE STUDY
Alan H Daniels, Satoshi Kawaguchi, Alec G Contag, Farbod Rastegar, Garrett Waagmeester, Paul A Anderson, Melanie Arthur, Robert A Hart
OBJECTIVE Beginning in 2008, the Centers for Medicare and Medicaid Service (CMS) determined that certain hospital-acquired adverse events such as surgical site infection (SSI) following spine surgery should never occur. The following year, they expanded the ruling to include deep vein thrombosis (DVT) and pulmonary embolism (PE) following total joint arthroplasty. Due to their ruling that "never events" are not the payers' responsibility, CMS insists that the costs of managing these complications be borne by hospitals and health care providers, rather than billings to health care payers for additional care required in their management...
August 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/26938762/preventive-effects-of-different-drugs-on-asymptomatic-lower-extremities-deep-venous-thrombosis-after-artificial-joint-replacement-a-mixed-treatment-comparison
#19
Jing-Bo Shao, Cai-Fang Ni, Peng-Fei Duan, Yong-Hai Jin
This network meta-analysis aims to compare the preventive effects of 8 drugs (edoxaban, dabigatran, apixaban, rivaroxaban, warfarin, bemiparin, ximelagatran, and enoxaparin) on asymptomatic deep venous thrombosis (DVT) of lower extremities after artificial joint replacement. PubMed, Cochrane Library, and Embase were searched from their inception through October 2015 for randomized controlled trials comparing 8 drugs for the prevention of asymptomatic DVT of lower extremities after artificial joint replacement...
February 1, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/26934731/association-of-coagulation-factors-viii-xi-xiii-polymorphisms-with-coagulation-factor-activities-and-deep-vein-thrombosis-after-artificial-joints-replacement
#20
Wei Su, Meirong Lv, Xiaodong Xu, Bin Li, Hai-Yan Liu, Bo Ning, Ye Li
The study aims at investigating the effects of coagulation factors VIII/XI/XIII polymorphisms in coagulation factor activities and deep vein thrombosis (DVT). A total of 130 patients with history of artificial joint replacement surgery were recruited, including 65 patients with DVT (cases) and 65 patients without DVT (controls). Cases and controls had comparable age, sex, and body mass index. Activities of VIII/XI and XIII were, respectively, detected by 1 phase anticoagulation method and microtitrimetry. Polymorphisms of VIII rs1800291 (3591C>G), XI rs2289252 (25264C>T), and XIII rs5985 (103G>T) were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)...
November 2016: American Journal of Therapeutics
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