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https://www.readbyqxmd.com/read/29684655/effect-of-fluid-challenge-on-renal-resistive-index-after-major-orthopaedic-surgery-a-prospective-observational-study-using-doppler-ultrasonography
#1
Fabrice Ferré, Philippe Marty, Cédric Folcher, Matt Kurrek, Vincent Minville
BACKGROUND: A postoperative renal resistive index (RRI) > 0.70 has the best threshold to early predict acute kidney injury (AKI). The response of RRI to a postoperative fluid challenge (FC) is unknown. The aim of our study was to assess the impact of a FC on RRI in suspected hypovolaemia patients after orthopaedic surgery. DESIGN: In this single-centre observational study, we prospectively screened 156 patients in the recovery room after having undergone a hip or knee replacement...
April 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29678502/monitoring-of-glycolytic-activity-secondary-to-ischaemia-in-knee-replacement-surgery
#2
V J León-Muñoz, A J Lisón-Almagro, C H Hernández-García, M López-López
OBJECTIVES: To non-invasively assess tissue lesion secondary to ischaemia applied during knee replacement surgery. Secondary objectives: to assess whether this lesion correlates with the duration of ischaemia and whether instrumental and gender variables influence it. MATERIAL AND METHODS: Prospective cohort study. Pre and postoperative serum lactate levels have been determined as an indicator of glycolytic activity secondary to ischaemia in 88 patients. Serum lactate determination was performed by reactive strips of enzymatic-amperometric detection on capillary blood...
April 17, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29672324/lidocaine-patch-to-treat-postoperative-tourniquet-pain-after-total-knee-replacement-a-case-report
#3
Brittney M Clark, Gabriel L Pagani-Estevez, Rebecca L Johnson
Intraoperative tourniquet-related pain is well recognized by anesthesiologists, but postoperative tourniquet-related pain has received little attention. We present a patient who underwent a total knee arthroplasty under general anesthesia and an adductor canal nerve block. She complained of intractable thigh pain postoperatively. Lidocaine 5% patches completely resolved her postoperative tourniquet-related pain.
April 17, 2018: A&A practice
https://www.readbyqxmd.com/read/29671497/osteoarthritis-rapid-evidence-review
#4
Mark H Ebell
Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Radiography can confirm the diagnosis and may be helpful before surgical referral, but findings generally do not correlate well with symptoms. Exercise, physical therapy, knee taping, and tai chi are beneficial for knee OA. Medical therapy provides modest benefits in pain reduction and functional improvement; however, nonsteroidal anti-inflammatory drugs, tramadol, and other opioids have significant potential harms...
April 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29671342/human-articular-chondrocytes-retain-their-phenotype-in-sustained-hypoxia-while-normoxia-promotes-their-immunomodulatory-potential
#5
Claire Mennan, John Garcia, Helen McCarthy, Sharon Owen, Jade Perry, Karina Wright, Robin Banerjee, James B Richardson, Sally Roberts
Objective To assess the phenotype of human articular chondrocytes cultured in normoxia (21% O2 ) or continuous hypoxia (2% O2 ). Design Chondrocytes were extracted from patients undergoing total knee replacement ( n = 5) and cultured in ~21% (normoxic chondrocytes, NC) and 2% (hypoxic chondrocytes, HC) oxygen in both monolayer and 3-dimensional (3D) pellet culture and compared with freshly isolated chondrocytes (FC). Cells were assessed by flow cytometry for markers indicative of mesenchymal stromal cells (MSCs), chondrogenic-potency and dedifferentiation...
April 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29669607/the-impact-of-the-medicaid-healthcare-associated-condition-program-on-mediastinitis-following-coronary-artery-bypass-graft
#6
Heather E Hsu, Alison Tse Kawai, Rui Wang, Maximilian S Jentzsch, Chanu Rhee, Kelly Horan, Robert Jin, Donald Goldmann, Grace M Lee
OBJECTIVEIn 2012, the Centers for Medicare and Medicaid Services expanded a 2008 program that eliminated additional Medicare payment for mediastinitis following coronary artery bypass graft (CABG) to include Medicaid. We aimed to evaluate the impact of this Medicaid program on mediastinitis rates reported by the National Healthcare Safety Network (NHSN) compared with the rates of a condition not targeted by the program, deep-space surgical site infection (SSI) after knee replacement.DESIGNInterrupted time series with comparison group...
April 19, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29669383/total-knee-arthroplasty-versus-osteochondral-allograft-prevalence-and-risk-factors-following-tibial-plateau-fractures
#7
Lasun O Oladeji, Tina K Dreger, Eli L Pratte, Charles A Baumann, James P Stannard, David A Volgas, Gregory J Della Rocca, Brett D Crist
Orthopaedic surgeons commonly have the misconception that patients with tibial plateau fractures will likely go on to posttraumatic knee arthritis requiring total knee arthroplasty (TKA). In younger patients, osteochondral allograft (OCA) transplantation is an alternative method to address posttraumatic knee arthritis. The purpose of this study was (1) to identify our institutional failure rate following tibial plateau open reduction and internal fixation (ORIF) (failure was defined as conversion to TKA or OCA); (2) to determine if there are patient- or injury-related risk factors predictive of failure; and (3) to characterize differences between patients treated with TKA versus those treated with OCA transplantation...
April 18, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29668473/the-history-of-bone-tumour-treatment-and-the-state-of-the-art-in-vienna
#8
Rainer Kotz
PURPOSES: Bone tumours have been a tragedy for the patient in any time period. In the majority of the cases it occurs in children or young adults. In the past the affected limbs could not be spared and the overall prognosis was poor. METHODS: Chemotherapy successfully introduced for the purpose of overcoming the poor overall prognosis (Rosen and Jaffe) and tumour prostheses were invented for the purpose of salvaging the affected limbs (Marcove, Scales, Campanacci, Sivas, Salzer)...
December 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/29667235/contrast-enhanced-computed-tomography-cect-attenuation-is-associated-with-stiffness-of-intact-knee-cartilage
#9
Reza Nickmanesh, Rachel C Stewart, Brian D Snyder, Mark W Grinstaff, Bassam A Masri, David R Wilson
Contrast-enhanced computed tomography (CECT) using charged contrast-agents enables quantification of cartilage glycosaminoglycan content. Since glycosaminoglycan content is a key determinant of cartilage compressive stiffness, CECT measurements have the potential to non-invasively assess cartilage stiffness. The objective of this study was to determine whether CECT attenuation, using a cationic contrast-agent (CA4 +), correlates with the stiffness of intact cartilage. Six fresh femoral and six fresh tibial compartments with intact cartilage were obtained from patients undergoing total knee replacement surgery...
April 17, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29666689/painful-pes-anserine-bursitis-following-total-knee-replacement-surgery-two-cases
#10
Mohamed A M Ariff, Mohd I A C Ros, Nor H M Yahaya
Pes anserine bursitis (PAB) is an inflammation of the bursa located between the medial aspect of the tibia and the hamstring muscles. It is common in patients with degenerative or inflammatory knee arthritis, usually has a self-limiting course and tends to respond well to conservative treatment. However, painful PAB directly following total knee replacement surgery is rare. We report two such cases who were diagnosed via ultrasonography at the Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, in 2015...
February 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29666082/knee-joint-instability-after-total-knee-replacement-in-a-patient-with-ehlers-danlos-syndrome-the-role-of-insert-changes-as-practical-solution
#11
Ajmal Farid, Stefan Beekhuizen, Joris van der Lugt, Marijn Rutgers
Treatment of knee joint instability in patients with hypermobile Ehlers-Danlos syndrome (EDS) can be challenging. A 53-year-old woman with hypermobile EDS underwent bilateral total knee replacement (TKR) due to valgus osteoarthritis. During follow-up, she developed hypermobility of both knee replacements. Revision of the insert resolved the issue in her left knee; however, the right TKR required two insert exchanges and unfortunately instability persisted. Therefore, a revision to a constrained prosthesis was performed...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29664872/team-approach-the-management-of-infection-after-total-knee-replacement
#12
Chun Hoi Yan, Carla Renata Arciola, Alex Soriano, L Scott Levin, Thomas W Bauer, Javad Parvizi
No abstract text is available yet for this article.
April 17, 2018: JBJS Reviews
https://www.readbyqxmd.com/read/29663554/implant-associated-bacterial-biofilm-and-quorum-sensing-in-periprosthetic-joint-infections
#13
Jake A Mooney, Eric M Pridgen, Robert Manasherob, Gina Suh, Helen E Blackwell, Annelise E Barron, Paul L Bollyky, Stuart B Goodman, Derek F Amanatullah
Periprosthetic joint infection (PJI) continues to be a common complication after total knee arthroplasty and total hip arthroplasty leading to severe morbidity and mortality. With an aging population and increasing prevalence of total joint replacement procedures, the burden of PJI will be felt not only by individual patients, but in increased healthcare costs. Current treatment of PJI is inadequate resulting in incredibly high failure rates. This is believed to be largely mediated by the presence of bacterial biofilms...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29663192/human-knee-meniscus-regeneration-strategies-a-review-on-recent-advances
#14
REVIEW
Mamatha M Pillai, J Gopinathan, R Selvakumar, Amitava Bhattacharyya
PURPOSE OF REVIEW: Lack of vascularity in the human knee meniscus often leads to surgical removal (total or partial meniscectomy) in the case of severe meniscal damage. However, complete recovery is in question after such removal as the meniscus plays an important role in knee stability. Thus, meniscus tissue regeneration strategies are of intense research interest in recent years. RECENT FINDINGS: The structural complexity and inhomogeneity of the meniscus have been addressed with processing technologies for precisely controlled three dimensional (3D) complex porous scaffold architectures, the use of biomolecules and nanomaterials...
April 16, 2018: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/29662786/comparison-of-topical-and-intravenous-administration-of-tranexamic-acid-for-blood-loss-control-during-total-joint-replacement-review-of-literature
#15
REVIEW
Georgi P Georgiev, Panayot P Tanchev, Zlatka Zheleva, Plamen Kinov
Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA) without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use...
April 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29662566/focal-increased-tc-99m-mdp-uptake-in-the-nutrient-foramen-of-the-femoral-diaphysis-on-bone-spect-ct
#16
Hwajin Cha, Soo Bin Park, Hyun-Joo Kim
We present images of an 83-year-old female with a history of osteoporosis and bilateral total knee replacement arthroplasty, referred for bone scintigraphy and single-photon emission computed tomography (SPECT)/computed tomography (CT), owing to left knee pain. No trauma to, or intense exercise of, the knee was reported. The bone scan and SPECT/CT revealed a focally increased Tc-99m methylene diphosphonate (MDP) uptake in the medial cortex of the left femoral diaphysis with matched linear radiolucency on CT images...
April 2018: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29659363/-late-diagnosis-of-whim-sydrome
#17
María V Paolini, Silvia Danielian, Emma Prieto, María Fernanda Tami, Matías M Oleastro, Diego S Fernández Romero
WHIM syndrome is a primary autosomal dominant immuno deficiency due to CXCR4 mutations characterized by mucocutaneous warts, hypogammaglobulinemia, recurrent bacterial infections and myelokathesis. Treatment consists in prophylactic antibiotics, immunoglobulin replacement and granulocyte or granulocyte/monocyte colony stimulating factors. We present the case of a 21 year old woman who showed leukopenia at 10 months of age and one year later multiple infections with hypogammaglobulinemia requiring intravenous immunoglobulin...
2018: Medicina
https://www.readbyqxmd.com/read/29658483/bacteriology-and-risk-factors-associated-with-periprosthetic-joint-infection-after-primary-total-knee-arthroplasty-retrospective-study-of-2543-cases
#18
K T Siu, F Y Ng, P K Chan, H Ch Fu, C H Yan, K Y Chiu
INTRODUCTION: Periprosthetic joint infection after total knee arthroplasty is a serious complication. This study aimed to identify risk factors and bacteriological features associated with periprosthetic joint infection after primary total knee arthroplasty performed at a teaching hospital. METHODS: We reviewed 2543 elective primary total knee arthroplasties performed at our institution from 1993 to 2013. Data were collected from the Hong Kong Hospital Authority's Clinical Data Analysis and Reporting System, the Infection Control Team, and the joint replacement division registry...
April 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29658386/finite-element-evaluation-of-the-newest-iso-testing-standard-for-polyethylene-total-knee-replacement-liners
#19
Steven P Mell, Spencer Fullam, Markus A Wimmer, Hannah J Lundberg
Current treatment for end-stage osteoarthritis is total knee replacement. Given that the number of total knee replacement surgeries is expected to approach 3.48 million by 2030, understanding long-term failure is important. One of the preclinical tests for total knee replacements is carried out using mechanical wear testing under generic walking conditions. Used for this purpose is the International Standards Organization's generic walking profile. Recently this standard was updated by reversing the direction of anterior/posterior translation and internal/external rotation...
April 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29657848/medial-subvastus-versus-the-medial-parapatellar-approach-for-total-knee-replacement-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
James R Berstock, James R Murray, Michael R Whitehouse, Ashley W Blom, Andrew D Beswick
Twenty randomized controlled trials comprising 1893 primary total knee replacements were included in this review.The subvastus approach conferred superior results for mean difference (MD) in time to regain an active straight leg raise (1.7 days, 95% confidence interval [CI] 1.0 to 2.3), visual analogue score for pain on day one (0.8 points on a scale out of 10, 95% CI 0.2 to 1.4) and total range of knee movement at one week (7°, 95% CI 3.2 to 10.7). The subvastus approach also resulted in fewer lateral releases (odds ratio 0...
March 2018: EFORT open reviews
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