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https://www.readbyqxmd.com/read/28731957/longitudinal-postoperative-course-of-pain-and-dysfunction-following-total-knee-arthroplasty
#1
Katherine Hadlandsmyth, M Bridget Zimmerman, Roohina Wajid, Kathleen A Sluka, Keela Herr, Charles R Clark, Nicolas O Noiseux, John J Callaghan, Barbara A Rakel
OBJECTIVES: While the majority of patients undergoing Total Knee Arthroplasty report substantial improvement in pain and function, a significant subset experience persistent post-surgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6 weeks post-TKA, to six month outcomes. This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6 weeks and 6 months post-TKA...
July 20, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28729306/hospital-variation-in-allogeneic-transfusion-and-extended-length-of-stay-in-primary-elective-hip-and-knee-arthroplasty-a-cross-sectional-study
#2
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Cynthia So-Osman, M Elske van den Akker-van Marle, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
OBJECTIVES: Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. DESIGN: Cross-sectional medical record review study...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728444/determinants-of-pain-disability-health-related-quality-of-life-and-physical-performance-in-patients-with-knee-osteoarthritis-awaiting-total-joint-arthroplasty
#3
Véronique Lowry, Philippe Ouellet, Pascal-André Vendittoli, Lisa C Carlesso, Timothy H Wideman, François Desmeules
PURPOSE: In patients suffering from knee osteoarthritis awaiting knee arthroplasty, to measure associations between several selected determinants and pain, disability, health-related quality of life and physical performance. MATERIAL AND METHODS: Validated self-reported measures were collected: (1) Western Ontario and McMaster Universities Osteoarthritis Index, (2) Lower Extremity Functional Scale (LEFS) and (3) Short-Form 36 (SF-36). Physical performance was also assessed with four validated performance tests...
July 20, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28725981/certolizumab-pegol-was-effective-for-treating-residual-synovitis-after-total-knee-arthroplasty-in-a-patient-with-rheumatoid-arthritis-therapeutic-monitoring-by-ultrasound
#4
Shin-Ya Kawashiri, Tohru Michitsuji, Atsushi Kawakami
We present the case of a 59-year-old female who developed rheumatoid arthritis in 2007. Right total knee arthroplasty (TKA) was performed in 2008. Although she was treated with methotrexate (MTX) after the operation, this treatment was insufficient. Infliximab (IFX) was introduced in 2001, and she achieved clinical remission. Left TKA was performed in October 2014. Because active synovitis was not detected by ultrasound after the operation, IFX was discontinued. She had been treated with MTX 8 mg weekly. However, arthralgia of the bilateral knees developed in March 2015...
July 19, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28724345/simultaneous-bilateral-total-knee-arthroplasty-in-hemophilia-is-it-recommended
#5
E Carlos Rodriguez-Merchan
Simultaneous bilateral total knee arthroplasty (TKA) is a potentially cost-saving manner of caring for patients with hemophilia who have bilateral symptomatic hemophilic knee arthropathy. Because factor VIII is used only once in bilateral TKA, it is performed in hemophilia to reduce costs. Areas covered: This article reviews the potential role of simultaneous bilateral TKA in patients with hemophilia. Expert commentary: Although two recent reports have mentioned the benefits of simultaneous bilateral TKA in patients with hemophilia, the data are still scant and preliminary...
July 20, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28723917/evidence-base-and-practice-variation-in-acute-care-processes-for-knee-and-hip-arthroplasty-surgeries
#6
Marcel Mayer, Justine Naylor, Ian Harris, Helen Badge, Sam Adie, Kathryn Mills, Joseph Descallar
BACKGROUND: Lack of evidence contributes to unnecessary variation in treatment costs and outcomes. This study aimed to identify from interventions historically used for total knee or hip arthroplasty (TKA, THA): i) if routine use is supported by high-level evidence; ii) whether surgeon use aligns with the evidence. METHODS: Part 1: Systematic search of electronic library databases for systematic reviews and practice guidelines concerning seven acute-care interventions...
2017: PloS One
https://www.readbyqxmd.com/read/28723758/total-knee-arthroplasty-conversion-after-a-failed-lateral-closing-wedge-high-tibial-osteotomy-with-knee-hyperextension-and-secondary-ankle-degeneration-a-case-report
#7
Chen Yao, Xingquan Xu, Sheng Zhou, Xiaoxiao Song, Dongquan Shi, Qing Jiang
RATIONALE: High tibial osteotomy (HTO) has been used widely for medial compartment knee osteoarthritis to correct the deformity and relieve symptoms, especially in young patients who are willing to maintain the high activity level. However, the change of bone morphology, ligament imbalance, limb malalignment, and other complications may influence the short-term outcomes of HTO. Some cases may even require conversion to TKA shortly after HTO because of the loss of correction or pain due to accelerated osteoarthritis...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723749/effects-of-sealing-the-intramedullary-femoral-canal-in-total-knee-arthroplasty-a-randomized-study
#8
Xu Li, Xiang-Bei Qi, Xue Han, Wei Wang, Jian-Ning Liu, Ji-Chao Guo, Zhi-Yong Li
BACKGROUND: This study investigates the clinical effects of sealing the femoral canal by intramedullary alignment instrumentation in total knee arthroplasty (TKA). METHODS: One hundred twenty consecutive patients with knee osteoarthritis, who underwent unilateral TKA, were enrolled in the study and equally randomized into 2 groups: the sealing group and the control group. In the sealing group, the femoral canal was sealed with autogenous bone and cement using intramedullary alignment instrumentation, while the femoral hole was left open for patients in the control group...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721459/measurement-of-lower-limb-alignment-there-are-within-person-differences-between-weight-bearing-and-non-weight-bearing-measurement-modalities
#9
Daphne A L Schoenmakers, Peter Z Feczko, Bert Boonen, Martijn G M Schotanus, Nanne P Kort, Pieter J Emans
PURPOSE: Previous studies have compared weight-bearing mechanical leg axis (MLA) measurements to non-weight-bearing measurement modalities. Most of these studies compared mean or median values and did not analyse within-person differences between measurements. This study evaluates the within-person agreement of MLA measurements between weight-bearing full-length radiographs (FLR) and non-weight-bearing measurement modalities (computer-assisted surgery (CAS) navigation or MRI). MATERIALS AND METHODS: Two independent observers measured the MLA on pre- and postoperative weight-bearing FLR in 168 patients...
July 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28712798/region-and-insurance-plan-type-influence-discharge-disposition-after-hip-and-knee-arthroplasty-evidence-from-the-privately-insured-us-population
#10
Marina Soley-Bori, Rene Soria-Saucedo, Bora Youn, Alex B Haynes, Ryan Macht, Colleen M Ryan, Jeffrey C Schneider, Lewis E Kazis
BACKGROUND: Little is known about regional variation in the use of postacute care services after elective procedures, such as total hip or knee arthroplasty (THA/TKA), and how insurance type may influence it. The goal of this study is to assess the influence of region and insurance arrangements on discharge disposition. METHODS: A representative sample of the privately insured US population with THA or TKA in 2009 or 2010 was obtained from the MarketScan database applying individual-level weights from the Medical Expenditure Panel Survey...
June 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28712797/evaluation-of-a-patient-decision-aid-for-unicompartmental-or-total-knee-arthroplasty-for-medial-knee-osteoarthritis
#11
Christopher de Jesus, Dawn Stacey, Geoffrey F Dervin
BACKGROUND: Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28711951/optimizing-patellar-positioning-during-total-knee-arthroplasty-an-anatomical-and-clinical-study
#12
Chahine Assi, Nadim Kheir, Camille Samaha, Mary Deeb, Kaissar Yammine
INTRODUCTION: Optimal positioning of the patellar component is crucial for the success of a total knee arthroplasty (TKA). Usually, the patellar component is placed empirically over the presumed centre of the patellar cut. Medialization of the prosthetic patella has been recommended; however, no evidence-based guidelines have been reported. MATERIAL AND METHOD: This anatomical study aims to quantify a pre-defined optimal location for positioning of the patellar component with regard to the centre of the patellar cut...
July 15, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28711589/fixation-strength-of-a-polyetheretherketone-femoral-component-in-total-knee-arthroplasty
#13
Lennert de Ruiter, Dennis Janssen, Adam Briscoe, Nico Verdonschot
INTRODUCTION: Introducing polyetheretherketone (PEEK) polymer as a material for femoral components in total knee arthroplasty (TKA) could potentially lead to a reduction of the cemented fixation strength. A PEEK implant is more likely to deform under high loads, rendering geometrical locking features less effective. Fixation strength may be enhanced by adding more undercuts or specific surface treatments. The aim of this study is to measure the initial fixation strength and investigate the associated failure patterns of three different iterations of PEEK-OPTIMA(®) implants compared with a Cobalt-Chromium (CoCr) component...
July 12, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28709832/relationship-between-patients-in-hospital-affects-recovery-from-total-knee-arthroplasty-tka-a-prospective-study
#14
Teng Lijia, Zeng Rui-Xi, Gong Long, Chen Lei, Liu Yujie, He Jin-Yun, Wang Zhen-Hu
BACKGROUND: The interaction between patients is rather important source of information about surgery and recovery. Patients always prefer particularly to compare themselves with others of relatively similar ability, opinion and situation. Exploration of patients' dyads, however, is rare and needs further elaboration as to the significance of fellow patients. This study was designed to determine in whether and how preoperative assignment affects TKA's results. METHODS: We assessed early post-operative outcomes in a cohort of 520 TKA patients...
July 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28709613/a-regional-registry-study-of-216-patients-investigating-if-patient-satisfaction-after-total-knee-arthroplasty-changes-over-a-time-period-of-five-to-20years
#15
Odei Shannak, Jeya Palan, Colin Esler
AIMS: To determine the temporal changes in patient dissatisfaction following primary knee arthroplasty surgery (TKA). PATIENTS AND METHODS: Three hundred and ninety patients that had previously indicated they were either dissatisfied or unsure with their TKA at one-year post-surgery in our region were mailed a simple questionnaire in addition to the Oxford Knee Score and EQ-5D. RESULTS: A 55% response rate was achieved. The mean follow-up time period was 9...
August 2017: Knee
https://www.readbyqxmd.com/read/28706378/soft-tissue-damage-during-total-knee-arthroplasty-focus-on-tourniquet-induced-metabolic-and-ionic-muscle-impairment
#16
REVIEW
Constantin Mayer, Alexander Franz, Jan-Frieder Harmsen, Fina Queitsch, Michael Behringer, Johannes Beckmann, Rüdiger Krauspe, Christoph Zilkens
PURPOSE: Advantages of tourniquet use in TKA include benefits for surgeons and patients, varying from a bloodless operation site to a reduced intervention time. The time under ischemia and the reperfusion period are crucial phases for affected soft-tissue, most commonly the extensor mechanism. CASE REPORTS: documented its impact on soft-tissue, ranging from necrotic muscle damage to systemic inflammation. Recently, research regarding tourniquet application patterns discuss clinical outcome parameters in the context of soft-tissue damage, excluding the underlying pathophysiological mechanisms...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28704747/two-cases-of-late-medial-instability-of-the-knee-due-to-hip-disease-after-total-knee-arthroplasty
#17
Masanori Tsubosaka, Tomoyuki Matsumoto, Koji Takayama, Naoki Nakano, Ryosuke Kuroda
INTRODUCTION: There are few specific reports of late medial instability after total knee arthroplasty (TKA). We described two cases of late medial instability of the knee due to hip disease with osteoarthritis or rheumatoid arthritis after TKA, which required revision TKA. PRESENTATION OF CASES: An 82-year-old woman experienced right femoral neck fracture due to a fall that required conservative treatment at age 77 years and underwent left TKA at age 80 years. A 68-year-old woman underwent left TKA at age 54 years, right TKA at age 64 years, and left THA at age 67 years...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28704746/a-case-report-of-an-anterior-tibial-artery-pseudo-aneurysm-open-surgical-management-a-rare-complication-post-total-knee-arthroplasty
#18
Kang Lie Darius Aw, Choon Chieh Tan, Jack Kian Ch'ng, Siew Ping Chng
INTRODUCTION: Complications involving injury to neurological and vascular structures are infrequently reported after total knee arthroplasty (TKA). They are associated with significant morbidity and can be limb threatening. PRESENTATION OF CASE: We present a patient with an anterior tibial artery (ATA) aneurysm post total knee arthroplasty. A 69-year-old female was referred for a swelling over her left antero-lateral aspect of her leg 4 years post TKA. Radiological investigations showed an ATA pseudo aneurysm...
June 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28702380/patient-specific-instrumentation-in-total-knee-arthroplasty-should-we-adopt-it
#19
REVIEW
Ana Sofia Teles Rodrigues, Manuel António Pereira Gutierres
Total knee arthroplasty (TKA) is a surgical procedure of paramount relevance that restores a substantial degree of function in arthritic knees. Increased consideration has been given to the influence of limb alignment on longevity after TKA, as errors in component placement can be associated with inferior function and compromised long-term performance. Consequently, numerous studies comparing patient-specific instrumentation (PSI) to standard instruments (SI) have been published. Patient-specific approaches use preoperative imaging to create specific materials for each patient's anatomy and were designed to achieve a higher rate of success in TKA, causing the entire procedure to be more efficient and cost-effective...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28701852/encouraging-treatment-algorithm-for-computer-assisted-navigated-total-knee-arthroplasty-tka-a-retrospective-cohort-analysis
#20
J Cip, M Widemschek, C Bach, P Ruckenstuhl, T Benesch, K Studer, A Martin
OBJECTIVE: Navigated computer-assisted total knee arthroplasty (TKA) shows inconclusive mid- to long-term outcome results and is limited by increased costs, surgery-time and an additional learning curve. We introduced a treatment algorithm preserving computer-assisted TKA for patients with adipositas-per-magna, posttraumatic leg-deformities, osteosynthetic material in-situ or reduced preoperative X-ray quality. METHODS: 237 primary unilateral TKA were allocated based on the treatment concept described above...
September 2017: Journal of Orthopaedics
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