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Hip. Knee

Du Hyun Ro, Heejin Jin, Jae-Young Park, Myung Chul Lee, Sungho Won, Hyuk-Soo Han
PURPOSE: This study hypothesized that the use of bisphosphonates (BPs) after total joint arthroplasty (TJA) is associated with a lower implant revision rate. This study aimed (1) to investigate the association between BP use and the revision rate of TJA and (2) to determine the relationship between the medication period and the revision rate of TJA. METHODS: National Health Insurance Service data on surgeries, medications, diagnoses, and screenings of 50 million Koreans were reviewed...
December 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Chester J Donnally, Augustus J Rush, Sebastian Rivera, Rushabh M Vakharia, Ajit M Vakharia, Dustin H Massel, Frank J Eismont
Background: To determine if the timing of a lumbar epidural steroid injection (LESI) effects rates of post-operative infection in patients receiving a non-fusion lumbar decompression (LDC) due to degenerative disc disease (DDD). Lumbar pain due to DDD can frequently be temporized or definitively treated with epidural injections. While there is ample literature regarding the infection risks associated with corticosteroid injections prior to hip/knee replacements, there are few studies relating to the spine...
September 2018: Journal of Spine Surgery (Hong Kong)
Cedric Maillot, Anthony Leong, Ciara Harman, Alberto Morelli, Richard Mospan, Justin Cobb, Charles Rivière
BACKGROUND: The kinematic alignment (KA) technique for total knee arthroplasty (TKA) is an emerging implant positioning philosophy that aims to restore constitutional knee anatomy to improve knee kinematics. At present, the KA technique aims to reconstruct native femorotibial (FT) joint alignment, however there is still insufficient consideration towards the inter-individual trochlear anatomy variability. Poor trochlear restoration may compromise clinical outcomes. Our study aimed at assessing the anatomical relationship between the native trochlea and other FT anatomical parameters...
December 10, 2018: Knee
Jared M Newman, Marcelo B P Siqueira, Alison K Klika, Robert M Molloy, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Continuous wound drainage after arthroplasty can lead to the development of a periprosthetic joint infection. Closed incisional negative pressure wound therapy (ciNPWT) has been reported to help alleviate drainage and other wound complications. The purpose of this prospective randomized controlled trial is to compare the use of ciNPWT with our standard of care dressing in revision arthroplasty patients who were at high risk to develop wound complications. METHODS: A total of 160 patients undergoing elective revision arthroplasty were prospectively randomized to receive either ciNPWT or a silver-impregnated occlusive dressing after surgery in a single institution...
November 17, 2018: Journal of Arthroplasty
Nima Eftekhary, James E Feng, Afshin A Anoushiravani, Ran Schwarzkopf, Jonathan M Vigdorchik, William J Long
BACKGROUND: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's inpatient experience. This study aims to assess whether HCAHPS scores differ between patients undergoing primary total joint arthroplasty (TJA) and patients undergoing revision TJA. METHODS: Patients who underwent primary or revision total hip or total knee arthroplasty (THA or TKA) and returned a completed HCAHPS survey were included in this study...
November 20, 2018: Journal of Arthroplasty
Olivia J Bono, Christopher W Olcott, Robert Carangelo, James P Jamison, Russell G Tigges, Carl T Talmo, James V Bono
While femoral intramedullary alignment has been found to be the most accurate and reproducible method for proper femoral component orientation in total knee arthroplasty, certain situations preclude the use of intramedullary alignment, such as ipsilateral long-stem total hip arthroplasty, femoral shaft deformity (congenital or post-traumatic), capacious femoral canal, and retained hardware. These cases require alternative alignment guides, that is, extramedullary alignment. The purpose of this study was to determine the accuracy of intramedullary alignment in reproducing the femoral anatomic axis...
December 13, 2018: Journal of Knee Surgery
Natalie H Vaughn, Mitchell F Dunklebarger, Mark W Mason
BACKGROUND: Patients often are asked to report walking distances before joint arthroplasty and when discussing their results after surgery, but little evidence demonstrates whether patient responses accurately represent their activity. QUESTIONS/PURPOSES: Are patients accurate in reporting distance walked, when compared with distance measured by an accelerometer, within a 50% margin of error? METHODS: Patients undergoing THA or TKA were recruited over a 16-month period...
December 4, 2018: Clinical Orthopaedics and related Research
Georg Bergmann, Ines Kutzner, Alwina Bender, Jörn Dymke, Adam Trepczynski, Georg N Duda, Dieter Felsenberg, Philipp Damm
During whole body vibrations, the total contact force in knee and hip joints consists of a static component plus the vibration-induced dynamic component. In two different cohorts, these forces were measured with instrumented joint implants at different vibration frequencies and amplitudes. For three standing positions on two platforms, the dynamic forces were compared to the static forces, and the total forces were related to the peak forces during walking. A biomechanical model served for estimating muscle force increases from contact force increases...
2018: PloS One
Johanne Martel-Pelletier, Emmanuel Maheu, Jean-Pierre Pelletier, Ludmila Alekseeva, Ouafa Mkinsi, Jaime Branco, Pierre Monod, Frédéric Planta, Jean-Yves Reginster, François Rannou
BACKGROUND AND AIMS: Although osteoarthritis (OA) is managed mainly in primary care, general practitioners (GPs) are not always trained in its diagnosis, which leads to diagnostic delays, unnecessary resource utilization, and suboptimal patient outcomes. METHODS: To address this situation, an International Rheumatologic Board (IRB) of 8 experts from 3 continents developed guidelines for the diagnosis of OA in primary care. The focus was three major topologies: hip, knee, and hand/finger OA...
December 11, 2018: Aging Clinical and Experimental Research
Lara El Khoury, Richard Furie
Human granulocytic anaplasmosis (HGA) is a tickborne rickettsial disease caused by the bacterium Anaplasma phagocytophilum. Reported cases have increased with the highest incidence in the Northeast. To our knowledge, this is the first report of anaplasmosis associated with an inflammatory arthritis. A 64-year-old man, with a history of Crohn's disease controlled on budesonide, presented to the emergency room in August 2017 with a week history of headache, sore throat, fever, myalgias, rash, and joint pain. There was no clinical evidence of active Crohn's disease...
December 11, 2018: Clinical Rheumatology
Fuzhen Yuan, Zewen Sun, Haijun Wang, Yourong Chen, Jiakuo Yu
PURPOSE: A cutting guide technique for patella resurfacing in total knee arthroplasty was expected to result in less patellofemoral syndromes. The aim of this study was to identify differences in the patellofemoral function, clinical outcomes, and radiographic parameters between the freehand and cutting guide patellar resection techniques in patients undergoing total knee arthroplasty. METHODS: A prospective randomized controlled trial was conducted. The study was registered in a public trials registry (International Standard Randomized Trial No...
December 11, 2018: International Orthopaedics
Satoru Hashizume, Hiroaki Hobara, Yoshiyuki Kobayashi, Mitsunori Tada, Masaaki Mochimaru
The inter-individual variability of running technique is an important factor affecting the negative work of lower extremity joints that leads to muscle damage. Our study examines the relationships between the negative work of the lower extremity joints and the associated mechanical parameters that account for inter-individual variability in the negative work. Twenty-four young male adults were asked to run on a runway at a speed of 3.0 m·s -1 . Multiple linear regression analysis was conducted to examine the relationships between the negative work and the associated mechanical parameters for each lower extremity joint...
September 2018: Sports medicine international open
Rune D Bech, Ole Ovesen, Jens Lauritsen, Claus Emmeluth, Peter Lindholm, Søren Overgaard
Background and purpose: Local infiltration analgesia (LIA) supports early mobilization after hip and knee arthroplasty. Inspired by this, we studied the effectiveness of wound infiltration with the long acting local anesthetic ropivacaine in an effort to decrease the need for postoperative opioids after osteosynthesis of extracapsular hip fracture. Methods: Forty-nine patients undergoing osteosynthesis with a sliding hip screw were randomized into two groups in a double-blind study (ClinicalTrials...
2018: Pain Research & Management: the Journal of the Canadian Pain Society
W A M van Lieshout, C D Martijn, B T J van Ginneken, R J van Heerwaarden
INTRODUCTION: Medial closing wedge high tibial osteotomy (CWHTO) for valgus deformity correction was first described by Coventry whom performed an additional reefing of the medial collateral ligament (MCL) to prevent instability postoperative. In our clinic the additional reefing procedure has never been performed and instability has not been reported routinely by patients. Using instrumented laxity testing, pre- and postoperative valgus and varus knee laxity can be measured objectively...
December 10, 2018: Journal of Experimental Orthopaedics
Georgios Orfanos, Justin Lim, Bishoy Youssef
BACKGROUND: The increasing demand for arthroplasty has resulted in an inevitable rise in the number of periprosthetic fractures around implants. Survival factors looking into patient's comorbidities and how they influence outcome are rare. This study aims to identify correlations between survival post-injury and pre-existing comorbidities. METHODS: A total of 144 patients underwent operative treatment for either a hip or a knee periprosthetic fracture from January 2008 to August 2017 at our Major Trauma Hospital...
December 7, 2018: Archives of Orthopaedic and Trauma Surgery
Timothy L Tan, Michael M Kheir, Noam Shohat, Dean D Tan, Matthew Kheir, Chilung Chen, Javad Parvizi
Background: Culture-negative periprosthetic joint infection (PJI) is a challenging condition to treat. The most appropriate management of culture-negative PJI is not known, and there is immense variability in the treatment outcome of this condition. The purpose of this study was to elucidate the characteristics, outcomes, and risk factors for failure of treatment of culture-negative PJI. Methods: A retrospective review of 219 patients (138 hips and 81 knees) who had undergone surgery for the treatment of culture-negative PJI was performed utilizing a prospectively collected institutional PJI database...
September 25, 2018: JB & JS open access
Joseph F Konopka, Yuo-Yu Lee, Edwin P Su, Alexander S McLawhorn
Background: The quality-adjusted life year (QALY) is the preferred outcome measurement for cost-effectiveness analysis in health care. QALYs measure patient health-related quality of life with use of a value between 0 and 1. Few studies have provided original data delineating QALYs after hip and knee arthroplasty. In the present study, we evaluated patient utility preoperatively and 2 years after total hip arthroplasty, hip resurfacing, revision hip arthroplasty, total knee arthroplasty, unicompartmental knee arthroplasty, and revision knee arthroplasty...
September 25, 2018: JB & JS open access
Juan C Suarez, Ahmed A Al-Mansoori, Wilfredo J Borroto, Jesus M Villa, Preetesh D Patel
Background: Overlapping surgery occurs when a surgeon performs 2 procedures in an overlapping time frame. This practice is commonplace in the setting of total joint arthroplasty and is intended to increase patient access to experienced surgeons, improve efficiency, and advance the surgical competence of surgeons and trainees. The practice of overlapping surgery has been questioned because of safety and ethical concerns. As the literature is scarce on this issue, we evaluated the unplanned hospital readmission and reoperation rates associated with overlapping and non-overlapping total joint arthroplasty procedures...
September 25, 2018: JB & JS open access
John H Harp
Background: Airborne microbe-carrying particles in the operating-room environment during total joint replacement are a risk factor for periprosthetic joint infection. The present study focuses on a simple environmental test, based on practices used in aseptic cleanrooms, to quantify the deposition of microbe-carrying particles onto the sterile field. Methods: Settle plates are exposed Petri dishes. A settle plate test system and sampling plan were developed from current practices used in aseptic manufacturing...
September 25, 2018: JB & JS open access
Arnaud Fischbacher, Karine Peltier, Olivier Borens
Background: There is a constant increase of joint arthroplasties performed, with an infectious risk of 1-2%. Different therapeutic options for prosthetic-joint infections exist, but surgery remains essential. With a two-stage exchange procedure, a success rate above 90% can be expected. Currently, there is no consensus regarding the optimal interval duration between explantation and reimplantation. This retrospective study aimed to assess the economic impact of a two-stage exchange from a single-hospital perspective...
2018: Journal of bone and joint infection
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