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https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#1
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28078394/kinematics-of-a-bicruciate-retaining-total-knee-arthroplasty
#2
Thomas J Heyse, Joshua Slane, Geert Peersman, Margo Dirckx, Arne van de Vyver, Philipp Dworschak, Susanne Fuchs-Winkelmann, Lennart Scheys
PURPOSE: The recently reintroduced bicruciate-retaining Total Knee Arthroplasty (BCR TKA) is an interesting approach in the quest for close replication of knee joint biomechanics and kinematics closer to the native knee. Therefore, this study aimed at providing a detailed biomechanical view on the functional resemblance of BCR TKA to the native knee joint. METHODS: Seven fresh-frozen full leg cadaver specimens (76 ± 10 year) were mounted in a 6 degrees-of-freedom kinematic rig that applied a dynamic squatting motion knee flexion...
January 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#3
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28073671/fast-track-recovery-technique-applied-to-primary-total-hip-and-knee-replacement-surgery-analysis-of-costs-and-complications
#4
C Wilches, J D Sulbarán, J E Fernández, J M Gisbert, J M Bausili, X Pelfort
PURPOSE: To determine the cost reduction and complication rates of using an enhanced recovery pathway (Fast-track) when compared to traditional recovery in primary total hip replacement (THR) and total knee replacement (TKR), as well as to determine if there were significant differences in complication rates. MATERIAL AND METHODS: Retrospective review of 100 primary total arthroplasties using the Fast-track recovery system and another 100 using conventional recovery...
January 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28073138/-long-term-complications-due-to-polyethylene-wear-in-total-knee-arthroplasty-a-case-report
#5
Matthias Aurich
This is the case of an 84-year-old patient 18 years after total knee replacement. Regular follow-up examinations did not take place beyond 10 years of implantation, so that subsequent wear of the polyethylene insert was not detected. The patient presented because of knee pain, swelling of the calf, and a drop foot. Examination showed a large ganglion with pressure on the peroneal nerve, and a loose knee replacement with severe inlay wear and extensive osteolysis around the tibial and femoral implants. This rare case demonstrates the importance of regular clinical and radiological follow-up examinations after total joint replacements, particularly in the long term...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28070864/factors-that-affect-the-content-of-cadmium-nickel-copper-and-zinc-in-tissues-of-the-knee-joint
#6
Wojciech Roczniak, Barbara Brodziak-Dopierała, Elżbieta Cipora, Agata Jakóbik-Kolon, Joanna Kluczka, Magdalena Babuśka-Roczniak
Osteoarthritis causes the degradation of the articular cartilage and periarticular bones. Trace elements influence the growth, development and condition of the bone tissue. Changes to the mineral composition of the bone tissue can cause degenerative changes and fractures. The aim of the research was to determine the content of cadmium (Cd), nickel (Ni), copper (Cu) and zinc (Zn) in the tibia, the femur and the meniscus in men and women who underwent a knee replacement surgery. Samples were collected from 50 patients, including 36 women and 14 men...
January 9, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#7
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28061841/supervised-neuromuscular-exercise-prior-to-hip-and-knee-replacement-12-month-clinical-effect-and-cost-utility-analysis-alongside-a-randomised-controlled-trial
#8
Linda Fernandes, Ewa M Roos, Søren Overgaard, Allan Villadsen, Rikke Søgaard
BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery...
January 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28060228/risk-adjusted-hospital-outcomes-in-medicare-total-joint-replacement-surgical-procedures
#9
Donald E Fry, Michael Pine, Susan M Nedza, David G Locke, Agnes M Reband, Gregory Pine
BACKGROUND: Comparative measurement of hospital outcomes can define opportunities for care improvement and will assume great importance as alternative payment models for inpatient total joint replacement surgical procedures are introduced. The purpose of this study was to develop risk-adjusted models for Medicare inpatient and post-discharge adverse outcomes in elective lower-extremity total joint replacement and to apply these models for hospital comparison. METHODS: Hospitals with ≥50 qualifying cases of elective total hip replacement and total knee replacement from the Medicare Limited Data Set database of 2010 to 2012 were studied...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28060227/preoperative-opioid-use-is-associated-with-early-revision-after-total-knee-arthroplasty-a-study-of-male-patients-treated-in-the-veterans-affairs-system
#10
Alon Ben-Ari, Howard Chansky, Irene Rozet
BACKGROUND: Opioid use is endemic in the U.S. and is associated with morbidity and mortality. The impact of long-term opioid use on joint-replacement outcomes remains unknown. We tested the hypothesis that use of opioids is associated with adverse outcomes after total knee arthroplasty (TKA). METHODS: We performed a retrospective analysis of patients who had had TKA within the U.S. Veterans Affairs (VA) system over a 6-year period and had been followed for 1 year postoperatively...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#11
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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
#12
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/28053387/reference-axes-for-optimal-femoral-rotational-alignment-in-varus-osteoarthritic-indian-knees-a-ct-based-study
#13
A V Gurava Reddy, Rajat Kumar Mathur, Aakash Mugalur, Krishna Kiran Eachempati, Anil Reddy
BACKGROUND: Optimal rotational alignment of femoral component is important for longevity and success of total knee replacement. Whiteside line (WL), posterior condylar axis (PCA) and femoral transepicondylar axis are various intra-operative landmarks to guide femoral rotation. Each of these has its pros and cons. The aims of our study were to assess the relationship of posterior condylar axis and the antero-posterior axis of femur with the surgical epicondylar axis and evaluate whether degree of deformity or severity of osteoarthritis alters the rotational alignment of the femur when posterior condylar axis is taken as a reference...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053383/retrospective-study-of-asymmetric-vs-symmetric-tibial-plates-and-ultracongruent-vs-posterior-stabilized-inserts-in-indian-population-an-indian-experience-of-natural-knee-ii
#14
Ajay Deep Singh
BACKGROUND: Results of asymmetric tibial base plates vs symmetric tibial base plates and ultracongruent insert vs posterior stabilized insert in Indian population. METHODS: A total of 47 knee replacements with mean age of 65.2 years in 38 patients (16 males and 22 females) between 2007-2011 were included. Natural Knee II (21 models) were compared with 26 models of other knees (12 PFC-Sigma, one PFC-RPF, 10 Nexgen and three Vanguard). RESULTS: The ultracongruent insert of NK II lead to creation of greater post-op mean flexion deformity of 18° (range 15-20°) as compared to 5...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28052489/preoperative-education-prior-to-elective-knee-arthroplasty-surgery-does-not-change-patient-outcomes
#15
Lawrence Stephen Moulton, Peter A Evans, Ian Starks, Tony Smith
Enhanced recovery programmes have improved outcomes following elective arthroplasty surgery. There are few studies assessing the role of patient education. In our enhanced recovery programme, all patients are offered the chance to attend a preoperative education class. Not all patients attend, enabling a comparison of outcomes. We have published data demonstrating that patients undergoing hip arthroplasty have improved outcomes. In the present article, we present data for total knee arthroplasty. Using a prospectively collected database, we identified all patients undergoing elective primary total knee arthroplasty...
January 4, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28051883/hydrogels-for-precision-meniscus-tissue-engineering-a-comprehensive-review
#16
Ana Rey-Rico, Magali Cucchiarini, Henning Madry
The meniscus plays a pivotal role to preserve the knee joint homeostasis. Lesions to the meniscus are frequent, have a reduced ability to heal, and may induce tibiofemoral osteoarthritis. Current reconstructive therapeutic options mainly focus on the treatment of lesions in the peripheral vascularized region. In contrast, few approaches are capable of stimulating repair of damaged meniscal tissue in the central, avascular portion. Tissue engineering approaches are of high interest to repair or replace damaged meniscus tissue in this area...
January 4, 2017: Connective Tissue Research
https://www.readbyqxmd.com/read/28050590/focal-cutaneous-mucinosis-after-knee-replacement-a-rare-entity-successfully-treated-with-intralesional-polidocanol
#17
Mark E Juhl, Michael Sidiropoulos, Sasha Antonijevic, Milena Lyon, Aleksandar Krunic
No abstract text is available yet for this article.
January 2017: JAAD Case Reports
https://www.readbyqxmd.com/read/28050540/keblish-s-lateral-surgical-approach-enhances-patellar-tilt-in-valgus-knee-arthroplasty
#18
José Roberto Tonelli Filho, Marcus Ceregatti Passarelli, João Alberto Salles Brito, Gustavo Constantino Campos, Alessandro Rozim Zorzi, João Batista de Miranda
OBJECTIVE: To compare the clinical and radiological outcomes of conventional medial and lateral approaches for total knee replacement in the valgus osteoarthritic knee. METHODS: In this randomized controlled trial, 21 patients with valgus knee osteoarthritis were randomized to total knee replacement through medial or lateral approach. The primary outcome was radiographic patellar tilt. Secondary outcomes were visual analog scale of pain, postoperative levels of hemoglobin, and clinical aspect of the operative wound...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28050539/comparative-analysis-of-pain-in-patients-who-underwent-total-knee-replacement-regarding-the-tourniquet-pressure
#19
Marcos George de Souza Leão, Gladys Pedrosa Martins Neta, Lucas Inoue Coutinho, Thiago Montenegro da Silva, Yacov Machado Costa Ferreira, Waryla Raissa Vasconcelos Dias
OBJECTIVES: To evaluate through the visual analog scale (VAS) the pain in patients undergoing total knee replacement (TKR) with different pressures of the pneumatic tourniquet. METHODS: An observational, randomized, descriptive study on an analytical basis, with 60 patients who underwent TKR, divided into two groups, which were matched: a group where TKR was performed with tourniquet pressures of 350 mmHg (standard) and the other with systolic blood pressure plus 100 mmHg (P + 100)...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28049019/the-causal-role-of-smoking-on-the-risk-of-hip-or-knee-replacement-due-to-primary-osteoarthritis-a-mendelian-randomisation-analysis-of-the-hunt-study
#20
M B Johnsen, G Å Vie, B S Winsvold, J H Bjørngaard, B O Åsvold, M E Gabrielsen, L M Pedersen, A I Hellevik, A Langhammer, O Furnes, G B Flugsrud, F Skorpen, P R Romundstad, K Storheim, L Nordsletten, J A Zwart
OBJECTIVE: Smoking has been associated with a reduced risk of hip and knee osteoarthritis (OA) and subsequent joint replacement. The aim of the present study was to assess whether the observed association is likely to be causal. METHOD: 55,745 participants of a population-based cohort were genotyped for the rs1051730 C > T single-nucleotide polymorphism (SNP), a proxy for smoking quantity among smokers. A Mendelian randomization analysis was performed using rs1051730 as an instrument to evaluate the causal role of smoking on the risk of hip or knee replacement (combined as total joint replacement (TJR))...
January 1, 2017: Osteoarthritis and Cartilage
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