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https://www.readbyqxmd.com/read/28235533/comparison-of-ropivacaine-with-and-without-fentanyl-vs-bupivacaine-with-fentanyl-for-postoperative-epidural-analgesia-in-bilateral-total-knee-replacement-surgery
#1
Ashish Khanna, Rakesh Saxena, Amitabh Dutta, Neelam Ganguly, Jayashree Sood
STUDY OBJECTIVES: Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.1% with/without fentanyl 2.5 μg/mL vs plain bupivacaine 0.0625% with fentanyl 2.5 μg/mL in patients undergoing bilateral TKR...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28231650/blood-sparing-efficacy-of-oral-tranexamic-acid-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#2
Qunn Jid Lee, Wai Yee Ching, Yiu Chung Wong
Purpose: Tranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA. Materials and Methods: All patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28231649/optimal-timing-for-hemoglobin-concentration-determination-after-total-knee-arthroplasty-day-1-versus-day-2
#3
Mahdi Yacine Khalfaoui, Charles Godavitarne, Michael C P Wilkinson
Purpose: Postoperative hemoglobin (Hb) determination remains an essential parameter for quantifying blood loss following total knee replacement (TKR) surgery and guiding transfusion practice. In this study we aimed to ascertain the optimal timing for Hb determination postoperatively and assess its relationship to serum hematocrit (Hct). Materials and Methods: This was a retrospective cohort analysis of 61 consecutive patients undergoing preoperative, day 1 and day 2 Hb and Hct concentration determination following TKR surgery...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28228047/visible-glove-perforation-in-total-knee-arthroplasty
#4
Lee Qunn Jid, Mak Wai Ping, Wong Yiu Chung, Wai Yuk Leung
PURPOSE: The risk of superficial surgical site infection (SSI) and periprosthetic joint infection (PJI) after glove perforation is not evident. This study was to identify risk factors for glove perforation in primary TKR (total knee replacement) and the risk of subsequent superficial SSI and PJI. METHODS AND MATERIALS: Results of visible glove perforation of both inner and outer gloves during TKR were reviewed. A case-control analysis was performed on the preoperative and operative variables to identify predictive risk factors for glove perforation...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28227886/development-of-an-open-source-cosimulation-method-of-the-knee
#5
Anne Schmitz, Davide Piovesan, Anne Schmitz, Davide Piovesan, Anne Schmitz, Davide Piovesan
Rigid body dynamics and soft tissue loads are solved simultaneously in a cosimulation framework to couple musculoskeletal dynamics and tissue mechanics. The goal of this work was to implement a validated, open-source cosimulation framework of the knee to determine how this coupling affects computed cartilage loads. The kinematic knee joint of a generic whole body model in the open-source software OpenSim was replaced by a previously developed discrete element knee model that consisted of a six degree of freedom (dof) tibiofemoral joint and one dof patellofemoral joint...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223094/a-decade-of-the-catalonian-arthroplasty-register-racat-variability-exhaustivity-and-survival-of-prostheses-between-2005-and-2014
#6
J Arias-de la Torre, A Capdevila, O Martínez, L Domingo, M Marinelli, N Robles, J Nardi, L Puig-Verdié, F Pallisó, M Espallargues
BACKGROUND AND AIM: The Catalonian Arthroplasty Register (RACat) is a public health-based population register used to analyse and evaluate hip and knee replacements in Catalonia. The aim of this study is to present the outcomes after 10 years in operation (January 2005-December 2014). METHODOLOGY: Using the information from the RACat and the minimum basic data set at hospital discharge, an analysis was made of the quality and exhaustivity of the data, as well as a descriptive analysis of the patients, prostheses, and care process...
February 17, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28222709/combined-application-versus-topical-and-intravenous-application-of-tranexamic-acid-following-primary-total-hip-arthroplasty-a-meta-analysis
#7
Pei Zhang, Yuan Liang, Pengtao Chen, Yongchao Fang, Jinshan He, Jingcheng Wang
BACKGROUND: The use of intravenous (IV) or topical tranexamic acid (TXA) in total hip arthroplasty has been proven to be effective and safe in total hip arthroplasty. However, which of these two administration routes is better has not been determined. The combined administration of TXA has been used in total knee arthroplasty with satisfactory results. We hypothesized that combined application of TXA may be the most effective way without increased rate of thrombotic events such as deep vein thrombosis (DVT) and pulmonary embolisms (PE) in patients subjected to primary total hip replacement (THA)...
February 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28217891/a-comprehensive-behavioral-and-exercise-intervention-improves-physical-function-and-activity-participation-after-total-knee-replacement-a-pilot-randomized-study
#8
Sara R Piva, Gustavo J Almeida, Alexandra B Gil, Anthony M DiGioia, Diane L Helsel, Gwendolyn A Sowa
OBJECTIVE: To test the feasibility of a comprehensive behavioral intervention (CBI) program that combines intense exercises with an education program to be implemented at a later stage (3 months) post total knee replacement (TKR), and to get a first impression of the effects of the CBI as compared to a standard of care exercise (SCE) program on the outcomes of physical function and physical activity. METHODS: 44 subjects participated in a 3-month program of either CBI or SCE followed by 3 months of home exercise program...
February 19, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28217654/evidence-based-optimization-of-the-fast-track-approach-to-total-knee-replacement-do-we-need-to-interpret-the-information-better
#9
EDITORIAL
Giuseppe Milano
No abstract text is available yet for this article.
October 2016: Joints
https://www.readbyqxmd.com/read/28216311/meniscal-extrusion-and-bone-marrow-lesions-are-associated-with-incident-and-progressive-knee-osteoarthritis
#10
Andrew J Teichtahl, Flavia M Cicuttini, François Abram, Yuanyuan Wang, Jean-Pierre Pelletier, Pierre Dodin, Johanne Martel-Pelletier
OBJECTIVE: Whether meniscal extrusion and bone marrow lesions (BMLs) are independently associated with the risk of knee osteoarthritis (OA) is unknown. METHODS: Data was extracted from the Osteoarthritis Initiative (OAI) cohort. Participants were grouped according to the absence (Kellgren-Lawrence (KL) grade ≤ 1, n = 2120) or presence (KL ≥ 2, n = 2249) of ROA. Baseline meniscal extrusion and tibial BMLs were assessed. Tibial plateau cartilage volume was assessed at baseline and 72 months, while radiographic disease was assessed at baseline and 48 months...
February 12, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28211301/early-results-of-patellofemoral-inlay-resurfacing-arthroplasty-using-the-hemicap-wave-prosthesis
#11
Akash Patel, Zakir Haider, Amarjit Anand, Dominic Spicer
BACKGROUND: Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210821/p-f-c-sigma-%C3%A2-cruciate-retaining-fixed-bearing-versus-mobile-bearing-knee-arthroplasty-a-prospective-comparative-study-with-minimum-10-year-follow-up
#12
O Riaz, A Aqil, G Sisodia, G Chakrabarty
AIMS: To prospectively compare long-term clinical and radiological outcomes following a cruciate retaining fixed-bearing (FB) and a mobile-bearing (MB) primary total knee replacement (TKR). METHODS: We prospectively reviewed 113 TKRs in 99 patients (14 bilateral) with a PFC sigma cruciate retaining rotating platform system, at an average follow-up of 11.1 years (range 10-12). Results were contrasted with those from 89 TKRs in 72 patients (17 bilateral) with a PFC sigma cruciate fixed-bearing prosthesis, at an average follow-up of 12...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28209371/the-effect-of-patient-age-at-intervention-on-risk-of-implant-revision-after-total-replacement-of-the-hip-or-knee-a-population-based-cohort-study
#13
Lee E Bayliss, David Culliford, A Paul Monk, Sion Glyn-Jones, Daniel Prieto-Alhambra, Andrew Judge, Cyrus Cooper, Andrew J Carr, Nigel K Arden, David J Beard, Andrew J Price
BACKGROUND: Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing for surgery. METHODS: We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement...
February 13, 2017: Lancet
https://www.readbyqxmd.com/read/28208936/supra-hepatic-inferior-vena-cava-thrombosis-surgical-challenges
#14
Senthil Muthuraman, Anand Ramamurthy, Mahesh Gopashetty, Cuddalore Sadasivam Vijayshankar, Anand Khakhar
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a chronic affliction characterized by numerous liver and kidney cysts. There is a gradual but progressive renal and liver impairment which may require combined liver-kidney transplantation. Compression of the retrohepatic Inferior Vena Cava (IVC) by an enlarged polycystic liver may impede clear visualization on pre-operative imaging and miss an underlying thrombosis or obliteration. This may result in an intra-operative surprise. Management can be challenging requiring modification of conventional surgical approach...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203605/femoral-and-tibial-tunnel-diameter-and-bioabsorbable-screw-findings-after-double-bundle-acl-reconstruction-in-5-year-clinical-and-mri-follow-up
#15
Tommi Kiekara, Antti Paakkala, Piia Suomalainen, Heini Huhtala, Timo Järvelä
BACKGROUND: Tunnel enlargement is frequently seen in short-term follow-up after anterior cruciate ligament reconstruction (ACLR). According to new evidence, tunnel enlargement may be followed by tunnel narrowing, but the long-term evolution of the tunnels is currently unknown. HYPOTHESIS/PURPOSE: The hypothesis was that tunnel enlargement is followed by tunnel narrowing caused by ossification as seen in follow-up using magnetic resonance imaging (MRI). The purpose of this study was to evaluate the ossification pattern of the tunnels, the communication of the 2 femoral and 2 tibial tunnels, and screw absorption findings in MRI...
February 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28203596/intra-articular-implantation-of-mesenchymal-stem-cells-part-2-a-review-of-the-literature-for-meniscal-regeneration
#16
Matthew J Kraeutler, Justin J Mitchell, Jorge Chahla, Eric C McCarty, Cecilia Pascual-Garrido
Knee osteoarthritis (OA) after partial or total meniscectomy is a prevalent issue that patients must face. Various methods of replacing meniscal tissue have been studied to avoid this progression, including meniscal allograft transplantation, meniscal scaffolds, and synthetic meniscus replacement. Studies have shown that meniscal scaffolds may improve symptoms but have not been shown to prevent progression of OA. Recently, mesenchymal stem cells (MSCs) have been proposed as a possible biological therapy for meniscal regeneration...
January 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28197692/feasibility-of-establishing-an-australian-acl-registry-a-pilot-study-by-the-australian-orthopaedic-association-national-joint-replacement-registry-aoanjrr
#17
Christina Lekkas, Richard Clarnette, Stephen E Graves, Sophia Rainbird, David Parker, Michelle Lorimer, Roger Paterson, Justin Roe, Hayden Morris, Julian A Feller, Peter Annear, Ben Forster, David Hayes
PURPOSE: Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry...
February 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28196392/patellofemoral-osteochondral-allografts-can-we-improve-the-matching-process
#18
Jason R Determann, James E Fleischli, Donald F D'Alessandro, Dana P Piasecki
An important consideration for the successful use of fresh osteochondral allografts for the patellofemoral joint is selection of appropriately sized donor allografts. This is particularly challenging for matching grafts to the patella because of the substantial variability in articular contour that exists. At present, selection of donor patellae is based only on the width of the proximal tibia, with no established means of quantifying basic patellar size, facet configuration, or articular contour. We hypothesized that using a combination of standard radiographic measurements to generate an accurate profile of the recipients native patella would result in a more accurate donor graft...
February 14, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28196044/is-oxinium-losing-its-luster-commentary-on-an-article-by-christopher-j-vertullo-mbbs-fracs-orth-faortha-et-al-twelve-year-outcomes-of-an-oxinium-total-knee-replacement-compared-with-the-same-cobalt-chromium-design-an-analysis-of-17-577-prostheses-from-the-australian
#19
https://www.readbyqxmd.com/read/28196043/measures-of-the-appropriateness-of-elective-orthopaedic-joint-and-spine-procedures
#20
Jeffrey N Katz, Amelia R Winter, Gillian Hawker
Total knee arthroplasty and total hip arthroplasty are 2 of the most commonly performed elective orthopaedic procedures. They are remarkably successful in relieving pain and improving function in individuals with advanced, symptomatic arthritis. Since, in addition to providing benefits, these procedures pose risks, it is important to provide clinicians with guidance in determining which patients should undergo total joint replacement surgery. The development of the RAND approach in 1986 and its application to total hip and knee replacement have enabled clinicians, payers, and others to assess the appropriateness of past and current procedures for particular patients...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
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