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https://www.readbyqxmd.com/read/28437545/union-knee-alignment-and-clinical-outcomes-of-patients-treated-with-autologous-bone-grafting-for-medial-tibial-defects-in-primary-total-knee-arthroplasty
#1
Kunihiro Hosaka, Shu Saito, Teruyasu Oyama, Hirohisa Fujimaki, Eiji Cho, Kanki Ishigaki, Yasuaki Tokuhashi
Autologous bone grafting is an established method to overcome bone deficiencies in primary total knee arthroplasty (TKA). However, recently, metal augments have been used by many surgeons. Although autologous bone grafting is a common technique, few large studies have described its success in achieving bone union in primary TKA. The goal of this study was to evaluate primary TKA with autologous bone grafting for tibial defects. A total of 68 knees that had undergone arthroplasty with autologous bone grafting with more than 1 year of follow-up were evaluated...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#2
Ireneusz Babiak, Piotr Pędzisz, Jakub Janowicz, Mateusz Kulig, Paweł Małdyk
BACKGROUND: Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. MATERIAL AND METHODS: The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28434698/influence-of-component-rotation-in-total-knee-arthroplasty-on-tibiofemoral-kinematics-a-cadaveric-investigation
#3
Guenther Maderbacher, Armin Keshmiri, Hans R Springorum, Hermann Maderbacher, Joachim Grifka, Clemens Baier
BACKGROUND: Physiological tibiofemoral kinematics have been shown to be important for good knee function after total knee arthroplasty (TKA). The purpose of the present study was to investigate the influence of component rotation on tibiofemoral kinematics during knee flexion. We asked which axial component alignment best reconstructs physiological tibiofemoral kinematics and which combinations should be avoided. METHODS: Ten healthy cadaveric knees were examined...
April 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28433427/do-medial-pivot-kinematics-correlate-with-patient-reported-outcomes-after-total-knee-arthroplasty
#4
Lucian C Warth, Marshall K Ishmael, Evan R Deckard, Mary Ziemba-Davis, R Michael Meneghini
BACKGROUND: Many total knee arthroplasty (TKA) implants are designed to facilitate a medial pivot kinematic pattern. The purpose of this study was to determine whether intraoperative medial pivot kinematic patterns are associated with improved patient outcomes. METHODS: A retrospective review of consecutive primary TKAs was performed. Sensor-embedded tibial trials determined kinematic patterns intraoperatively. The center of rotation (COR) was identified from 0° to 90° and from 0° to terminal flexion, and designated medial-pivot or non-medial pivot based on accepted criteria...
March 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28433348/the-influence-of-polyethylene-bearing-thickness-on-the-tibiofemoral-kinematics-of-a-bicruciate-retaining-total-knee-arthroplasty
#5
Geert Peersman, Josh Slane, Margo Dirckx, Arne Vandevyver, Philipp Dworschak, Thomas J Heyse, Lennart Scheys
BACKGROUND: The recently reintroduced bicruciate retaining Total Knee Arthroplasty (BCR TKA) is an effort to reproduce kinematics closer to the native knee. However, there is no data on appropriate balancing with this implant. Balancing is crucial and challenging as medial and lateral polyethylene (PE) inlays are modular, which allows for placement of different thicknesses in the medial and lateral compartments. This study aimed at providing a detailed kinematic view on balancing BCR TKA...
April 19, 2017: Knee
https://www.readbyqxmd.com/read/28431129/cooled-radiofrequency-ablation-of-the-genicular-nerves-for-chronic-pain-due-to-knee-osteoarthritis-six-month-outcomes
#6
Zachary L McCormick, Marc Korn, Rajiv Reddy, Austin Marcolina, David Dayanim, Ryan Mattie, Daniel Cushman, Meghan Bhave, Robert J McCarthy, Dost Khan, Geeta Nagpal, David R Walega
Objective. : Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). Design. : Cross-sectional survey. Setting.:  Academic pain medicine center. Subjects.:  Consecutive patients with knee OA and 50% or greater pain relief following genicular nerve blocks who underwent genicular nerve C-RFA. Methods.:  Survey administration six or more months after C-RFA...
April 19, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28430692/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-postoperative-chronic-opioid-use-among-patients-undergoing-total-knee-arthroplasty-evidence-from-the-marketscan-database
#7
Eric C Sun, Brian T Bateman, Stavros G Memtsoudis, Mark D Neuman, Edward R Mariano, Laurence C Baker
BACKGROUND: Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. METHODS: Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28426262/feasibility-of-outpatient-total-hip-and-knee-arthroplasty-in-unselected-patients
#8
Kirill Gromov, Per Kjærsgaard-Andersen, Peter Revald, Henrik Kehlet, Henrik Husted
Background and purpose - The number of patients who are suitable for outpatient total hip and knee arthroplasty (THA and TKA) in an unselected patient population remains unknown. The purpose of this prospective 2-center study was to identify the number of patients suitable for outpatient THA and TKA in an unselected patient population, to investigate the proportion of patients who were discharged on the day of surgery (DOS), and to identify reasons for not being discharged on the DOS. Patients and methods - All consecutive, unselected patients who were referred to 2 participating centers and who were scheduled for primary THA and TKA were screened for eligibility for outpatient surgery with discharge to home on DOS...
April 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28421308/an-intelligent-remote-monitoring-system-for-total-knee-arthroplasty-patients
#9
Yunus Msayib, Patrick Gaydecki, Michael Callaghan, Nicola Dale, Sheheera Ismail
For the first six weeks following total knee arthroplasty (TKA), a patient will attend an outpatient clinic typically seen twice weekly. Here, an exercise regime is performed and improvement assessed using a hand held goniometer that measures the maximum angle of knee flexion, an important metric of progress. Additionally a series of daily exercises is performed at home, recorded in a diary. This protocol has problems. Patients must attend the hospital with assistance since they are not permitted to drive for six weeks following the procedure; appointments are sometimes missed; there are occasionally not enough physiotherapy appointment available; furthermore, it is difficult to be sure that patients are compliant with their exercises at home...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28420544/disclosing-agents-for-the-intraoperative-identification-of-biofilms-on-orthopedic-implants
#10
Joshua A Parry, Melissa J Karau, Sanjeev Kakar, Arlen D Hanssen, Robin Patel, Matthew P Abdel
BACKGROUND: Disclosing agents are dyes used in dentistry to colorize plaque (biofilm) and may offer a means for intraoperative detection of biofilms on orthopedic implants. Methylene blue (MB) stains biofilm and is safely used in orthopedic applications. Injection of MB into acutely infected prosthetic knees before debridement may enable visualization of biofilm, which could influence treatment decisions. The aims of this study were to determine if MB could be used to visualize biofilm on total knee arthroplasty (TKA) implants and to determine if MB staining has an antimicrobial effect that might interfere with subsequent culture...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28420413/is-combined-use-of-intravenous-and-intraarticular-tranexamic-acid-superior-to-intravenous-or-intraarticular-tranexamic-acid-alone-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#11
Bobin Mi, Guohui Liu, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: Tranexamic acid (TXA) has been proven to be effective in reducing blood loss and transfusion rate after total knee arthroplasty (TKA) without increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Recently, an increasing number of studies have been interested in applying combined intravenous (IV) with intraarticular (IA) tranexamic acid in total knee arthroplasty. The purpose of this meta-analysis was to compare the blood loss and complications of combined TXA with IV TXA or IA TXA on TKA...
April 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28418577/prospective-assessment-of-sleep-quality-before-and-after-primary-total-joint-replacement
#12
Blaine T Manning, Sean M Kearns, Daniel D Bohl, Tori Edmiston, Scott M Sporer, Brett R Levine
Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#13
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28413514/effect-of-pre-emptive-analgesia-by-continuous-femoral-nerve-block-on-early-postoperative-cognitive-function-following-total-knee-arthroplasty-in-elderly-patients
#14
Li-Qin Deng, Lei-Na Hou, Feng-Xiang Song, Han-Yue Zhu, Hai-Ying Zhao, Gang Chen, Jing-Jing Li
To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30)...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28413140/is-day-of-surgery-associated-with-adverse-clinical-and-economic-outcomes-following-primary-total-knee-arthroplasty
#15
Matthew R Boylan, Dean C Perfetti, Qais Naziri, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
BACKGROUND: As orthopedics transition to value-based purchasing, hospitals and providers are incentivized to identify inefficiencies of care delivery. In our experience, weekends are characterized by decreased staffing of ancillary services to coordinate patient discharges, which can lead to prolonged hospital stays for many of our primary total knee arthroplasty (TKA) admissions. METHODS: We identified 115,053 patients who underwent primary TKA on a weekday between 2009 and 2013 in New York State...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28413136/opioid-use-after-total-knee-arthroplasty-trends-and-risk-factors-for-prolonged-use
#16
Nicholas A Bedard, Andrew J Pugely, Robert W Westermann, Kyle R Duchman, Natalie A Glass, John J Callaghan
BACKGROUND: The United States is in the midst of an opioid epidemic. Little is known about perioperative opioid use for total knee arthroplasty (TKA). The purpose of this study was to identify rates of preoperative opioid use, evaluate postoperative trends and identify risk factors for prolonged use after TKA. METHODS: Patients who underwent primary TKA from 2007-2014 were identified within the Humana database. Postoperative opioid use was measured by monthly prescription refill rates...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28412054/community-pharmacy-transition-of-care-services-and-rural-hospital-readmissions-a-case-study
#17
Allison P Patton, Yifei Liu, D Matthew Hartwig, Justin R May, Jessica Moon, Steven C Stoner, Kendall D Guthrie
OBJECTIVES: To explore community pharmacist involvement in the transition of care (TOC) process for patients discharged with acute myocardial infarction (AMI), heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), or elective total hip or knee arthroplasty (THA/TKA). SETTING: Patients discharged from a 60-bed acute care hospital located in rural Missouri were seen by a community pharmacist in 2 independent community pharmacy chain locations...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28410836/low-preoperative-bmd-is-related-to-high-migration-of-tibia-components-in-uncemented-tka-92-patients-in-a-combined-dexa-and-rsa-study-with-2-year-follow-up
#18
Mikkel R Andersen, Nikkolaj S Winther, Thomas Lind, Henrik M Schrøder, Gunnar Flivik, Michael M Petersen
BACKGROUND: The fixation of uncemented tibia components in total knee arthroplasty may rely on the bone quality of the tibia; however, no previous studies have shown convincing objective proof of this. Component migration is relevant as it has been shown to predict aseptic loosening. METHODS: We performed 2-year follow-up of 92 patients who underwent total knee arthroplasty surgery with an uncemented tibia component. Bone mineral density (BMD; g/cm(2)) of the tibia host bone was measured preoperatively using dual energy X-ray absorptiometry...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28409138/range-of-motion-predictability-after-total-knee-arthroplasty-with-medial-pivot-prosthesis
#19
Lúcio Honório de Carvalho Júnior, Bruno Presses Teixeira, Cláudio Otávio da Silva Bernardes, Luiz Fernando Machado Soares, Matheus Braga Jacques Gonçalves, Eduardo Frois Temponi
OBJECTIVE: To assess whether there the final range of motion (ROM) results achieved by patients undergoing total knee arthroplasty (TKA) with prosthesis using Medial Pivot design are predictable. METHODS: Between January and August of 2014, 155 patients with primary osteoarthritis of knee who underwent TKA using the prosthesis ADVANCE(®) Medial Pivot were prospectively assessed. All ROM measures were made and recorded before, during, and after surgery. All patients were clinically assessed preoperatively and postoperatively (15, 45 days, three months, six months, one year, and annually thereafter after surgery); their functional status was assessed using the WOMAC questionnaire...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28409135/evaluation-of-serum-levels-of-c-reactive-protein-after-total-knee-arthroplasty
#20
João Maurício Barretto, Fabrício Bolpato Loures, Rodrigo Sattamini Pires E Albuquerque, Filipe das Neves Bezerra, Rafael Vinagre Faro, Naasson Trindade Cavanellas
OBJECTIVE: To evaluate the behavior of C-reactive protein (CRP) levels in the first three weeks after total knee arthroplasty (TKA) and define the factors related to its variation. METHODS: We evaluated the CRP values in 103 patients undergoing primary TKA. Serum CRP was measured on the day before surgery, and on the third and twenty-first days after the procedure. RESULTS: PCR showed sudden increase on the third day after surgery, reaching the mean value of 111...
March 2017: Revista Brasileira de Ortopedia
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