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Hip. Knee

Joseph D Lamplot, Anchal Bansal, Joseph T Nguyen, Robert H Brophy
BACKGROUND: The risk of subsequent joint replacement following an index joint replacement for osteoarthritis and the association of this risk with demographic and patient-specific factors are not well understood. The purpose of this study was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. METHODS: The Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) of New York was used to identify the first (primary) total hip arthroplasty (THA), total knee arthroplasty (TKA), or total shoulder arthroplasty (TSA) and the risk of subsequent joint replacement in the contralateral or a different joint over 5 to 8 years...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Etienne Desrochers, Jonathan Harnie, Adam Doelman, Marie-France Hurteau, Alain Frigon
KEY POINTS: The control of locomotion is thought to be generated by activating groups of muscles that perform similar actions, which are termed muscle synergies. Here, we investigated if muscle synergies are controlled at the level of the spinal cord. We did this by comparing muscle activity in the legs of cats during stepping on a treadmill before and after a complete spinal transection that abolishes commands from the brain. We show that muscle synergies were maintained following spinal transection, validating the concept that muscle synergies for locomotion are primarily controlled by circuits of neurons within the spinal cord...
October 18, 2018: Journal of Physiology
Katrin Brodbeck, Stefanie Kern, Sylvia Schick, Arnd Steinbrück, Michael Schwerer, Birgit Bayer, Katja Anslinger, Steffen Peldschus
INTRODUCTION: Cell-free DNA (cfDNA) elevations were remarked in the blood of trauma patients. Published increases refer to comparative values of a healthy control group, ignoring thereby inter- and intra-individual differences under normal conditions. The aim of this study was to quantify cfDNA in patients in the time course of a planned orthopedic surgery, which constitutes the advantage of obtaining individual pre- and post-trauma values for each patient. By this approach, a basis should be established for the potential future application of cfDNA as biomarker for the detection of mild injuries related to volunteer experiments in forensic biomechanics...
October 16, 2018: International Journal of Legal Medicine
Pelle B Petersen, Henrik Kehlet, Christoffer C Jørgensen
Background and purpose - Acute myocardial infarction (MI) is a leading cause of mortality following total hip and knee arthroplasty (THA/TKA). The reported 30-day incidence of MI varies from 0.3% to 0.9%. However, most data derive from administration and insurance databases or large RCTs with potential confounding factors. We studied the incidence of and potential modifiable risk factors for postoperative MI in a large, multicenter optimized "fast-track" THA/TKA setting. Patients and methods - A prospective cohort study was conducted on consecutive unselected elective primary unilateral THA and TKA, using prospective information on comorbidities and complete 90-day follow-up from the Danish National Patient Registry...
October 17, 2018: Acta Orthopaedica
Mohammad Samadian, Monireh Ahmadi Bani, Navid Golchin, Mohammad Ali Mardani, John S Head, Mokhtar Arazpour
Study Design: Pilot study. Purpose: Evaluation of two different hip-knee-ankle-foot orthoses (HKAFOs; medial linkage reciprocating gait orthosis [MLRGO] and isocentric reciprocating gait orthosis [IRGO]) using gait and postural stability analysis in four subjects with spinal cord injury (SCI). Overview of Literature: To the best of our knowledge, no study has evaluated postural stability in subjects with SCI when using MLRGO and IRGO. Methods: The relative efficacy of each orthosis was evaluated with relevant gait parameters, and an assessment of postural stability and sway during usage was made...
October 18, 2018: Asian Spine Journal
Natsuki Sado, Shinsuke Yoshioka, Senshi Fukashiro
In humans, hip abductor and lumbar lateral flexor muscles are well-developed as side-to-side lumbopelvic stabilizers. We hypothesized that the hip abductors and lumbar lateral flexors act as energy generators during a running single-leg jump, although they are generally recognized as stabilizers. We collected kinematics and ground reaction force data in running single-leg jumps by 13 male high jumpers and calculated three-dimensional kinetic variables. Hip abduction and lumbosacral lateral flexion towards free leg side torques were exerted during almost the entire take-off phase, exerting positive power during the terminal 2/3 of the phase...
October 16, 2018: International Journal of Sports Medicine
Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Correia Pinto, Sameer Naranje, Ashish Shah
INTRODUCTION/AIM: Recent comparisons of suture versus metal staple skin closure on the rates of wound complications in orthopaedic surgeries have yielded conflicting results. Several studies have since started to approach this question based on anatomic location, comparing suture versus staple closure in total hip and knee arthroplasty and acetabulum fracture surgery. Ankle fractures are one of the most commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutaneous support...
August 22, 2018: Foot
Thomas Perneger, Anne Lübbeke
PURPOSE: Self-rated health is a commonly used patient-reported outcome, but its responsiveness to is not well documented. We examined the ability of self-rated health to capture health changes attributable to a highly effective surgical intervention. METHODS: Prospective study of patients with severe osteoarthritis of the hip (N = 990) or knee (N = 907) who underwent total hip replacement (THA) or total knee replacement (TKA). Self-rated health was assessed pre-operatively and 1 year after surgery on a scale between "excellent" and "poor," along with other health items (other 11 items of the SF12 questionnaire) and multi-item Pain and Function scales...
October 15, 2018: Quality of Life Research
C Kaiser, F P Tillmann, J Löchter, S Landgraeber, M Jäger
PURPOSE: Elective hip or knee replacement is an optimal, standardised orthopaedic surgical procedure. The influence of chronic kidney disease, defined as an estimated glomerular filtration rate (eGFR) of 15-45 ml/min/1.73 m2 body surface area (BSA) (KDIGO stage G3a-G4), on the duration of hospitalisation, perioperative decrease in haemoglobin (Hb) levels, and transfusion rates after orthopaedic procedures has not been fully clarified. Our study, therefore, aimed to evaluate the impact of chronic kidney disease on the previously mentioned variables...
October 15, 2018: International Urology and Nephrology
Enda King, Chris Richter, Andy Franklyn-Miller, Katherine Daniels, Ross Wadey, Mark Jackson, Ray Moran, Siobhan Strike
Whilst anterior cruciate ligament injury commonly occurs during change of direction (CoD) tasks, there is little research on how athletes execute CoD after anterior cruciate ligament reconstruction (ACLR). The aims of this study were to determine between-limb and between-test differences in performance (time) and joint kinematics and kinetics during planned and unplanned CoD. One hundred and fifty-six male subjects carried out 90° maximal effort, planned and unplanned CoD tests in a 3D motion capture laboratory 9 months after ACLR...
September 29, 2018: Journal of Biomechanics
Nicole M Mueske, Sylvia Õunpuu, Deirdre D Ryan, Bitte S Healy, Jeffrey Thomson, Paul Choi, Tishya A L Wren
BACKGROUND: Gait analysis provides quantitative data that can be used to supplement standard clinical evaluation in identifying and understanding gait problems. It has been established that gait analysis changes treatment decision making for children with cerebral palsy, but this has not yet been studied in other diagnoses such as spina bifida. RESEARCH QUESTION: To determine the effects of gait analysis data on pathology identification and surgical recommendations in children with spina bifida...
October 9, 2018: Gait & Posture
Sean P Ryan, Cary Politzer, Cynthia Green, Samuel Wellman, Michael Bolognesi, Thorsten Seyler
Malnutrition is not uncommon in arthroplasty patients, and hypoalbuminemia has been shown to be predictive of postoperative complications. The authors sought to compare albumin concentration with a global assessment of physical health, the American Society of Anesthesiologists (ASA) score, to further discriminate the importance of albumin in predicting postoperative complications. A cohort of 128,412 patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) were identified from 2005 to 2015 through use of the American College of Surgeons National Surgical Quality Improvement Program database...
October 15, 2018: Orthopedics
Robert D Smith, Krysia S Dziedzic, Jonathan G Quicke, Melanie A Holden, Gretl A McHugh, Emma L Healey
OBJECTIVE: To identify and evaluate the measurement properties of self-report physical activity (PA) instruments suitable for those with osteoarthritis (OA). METHODS: A comprehensive two-stage systematic review using multiple electronic databases from inception until July 2018. Stage One sought to identify all self-reported PA instruments used in populations with joint pain attributable to OA in the foot, knee, hip or hand. Stage Two searched for and appraised studies investigating the measurement properties of the instruments identified...
October 15, 2018: Arthritis Care & Research
Henrik Kehlet, Girish P Joshi
No abstract text is available yet for this article.
October 12, 2018: Anesthesia and Analgesia
Kemble K Wang, Jean L Stout, Andrew J Ries, Tom F Novacheck
AIM: To assess interobserver reliability in the interpretation of three-dimensional gait analysis (3DGA) of children with gait disorders within a single institution. METHOD: Seven experienced interpreters in our institution participated in a quality-assurance program reviewing one unique patient's 3DGA data every 3 months. Between 2014 and 2017, 15 patients' data were interpreted (14 with spastic cerebral palsy, 1 with myelodysplasia). Interpreters were asked to select 'yes', 'no', or 'indeterminate' from a list of problems and treatment recommendations...
October 15, 2018: Developmental Medicine and Child Neurology
Cecilia Rogmark, Ammar Jobory, Oscar Unger, Inger Nilsson, Louise Dahlqvist
PURPOSE: To describe which types of assistive devices prescribed and actually used, either due to precautions or due to true functional reasons, after hip fracture-related hemiarthroplasty. MATERIALS AND METHODS: About 394 patients cluster-randomized 2010-2014 at a university hospital. Control group with standard postoperative precautions to reduce dislocations, mandatory assistive devices and knee brace for 6 weeks (in cognitively impaired) compared to non-precaution group with assistive devices only if needed...
October 14, 2018: Disability and Rehabilitation. Assistive Technology
Adolph J Yates, Joshua M Kerr, Mark I Froimson, Craig J Della Valle, James I Huddleston
BACKGROUND: Total knee arthroplasty (TKA) was removed from the Centers for Medicare and Medicaid Services (CMS) Inpatient-Only (IPO) list starting January 1, 2018. Many hospitals responded by instructing surgeons to schedule all TKAs as outpatient procedures, and some local Medicare Advantage contractors began to expect outpatient status for all or most TKA cases. This activity and ensuing confusion has caused considerable unintended disruption for surgeons, hospitals, and patients. The purpose of this study was to gauge the impact on providers and patients...
September 21, 2018: Journal of Arthroplasty
Hosam E Matar, Paula Stritch, Nicholas Emms
Interprosthetic femur fractures between total hip and total knee replacements are challenging injuries with rising incidence. Stability of the either implants, quality, and quantity of remaining bone as well as patients' comorbidities play an important role in operative management. Open reduction and internal fixation, advanced revision arthroplasty techniques, and megaprostheses are available options. In more complex cases, custom-made implants maybe necessary to achieve immediate weight-bearing and restore function...
2018: Journal of Long-term Effects of Medical Implants
Megan A Bryanton, Martin Bilodeau
PURPOSE: The purpose of this investigation was to evaluate alterations in muscular effort and temporal characteristics of their activity during the sit-to-stand (STS) due to isolated fatiguing of the knee extensors, as indicated by declines in torque output. METHODS: Surface electromyography of the lower extremity was recorded in healthy young (n = 11) and older (n = 11) adults as they ascended from a seated position, before and after dynamic knee extension exercise...
October 13, 2018: European Journal of Applied Physiology
Gabriel Zeitoune, Jurandir Nadal, Luiz Alberto Batista, Leonardo Metsavaht, Anna Paula Moraes, Gustavo Leporace
BACKGOUND: Leg length discrepancy (LLD) can be related to different pathologies, due to an inadequate distribution of mechanical loads, as well as gait kinematics asymmetries resulted from LLD. RESEARCH QUESTION: To validate a model to predict anatomical LLD (ALLD) based on gait kinematics. METHODS: Gait of 39 participants with different lower limb pathologies and mild discrepancy were collected. Pelvic, hip, knee and ankle kinematics were measured with a 3D motion analysis system and ALLD, femur discrepancy (FD) and tibia discrepancy (TD) were measured by a computerized digital radiograph...
September 29, 2018: Gait & Posture
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