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https://www.readbyqxmd.com/read/28822068/polyethylene-damage-increases-with-varus-implant-alignment-in-posterior-stabilized-and-constrained-condylar-knee-arthroplasty
#1
Zhichang Li, Christina I Esposito, Chelsea N Koch, Yuo-Yu Lee, Douglas E Padgett, Timothy M Wright
BACKGROUND: Implant malalignment in primary TKA has been reported to increase stresses placed on the bearing surfaces of implant components. We used a longitudinally maintained registry coupled with an implant retrieval program to consider whether preoperative, postoperative, or prerevision malalignment was associated with increased risk of revision surgery after TKA. QUESTIONS/PURPOSES: (1) What is the relative polyethylene damage on medial and lateral compartments of the tibial plateaus from revised TKAs? (2) Does coronal TKA alignment affect implant performance, such that TKAs aligned in varus are predisposed to experience increased polyethylene damage? (3) Does TKA alignment differ between postoperative and prerevision radiographs, and if so, what does this difference suggest about the mechanical contact load placed on a knee with a TKA? METHODS: Between 2007 and 2012, we performed 18,065 primary TKAs at our institution...
August 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28819598/two-staged-bilateral-femoral-alignment-osteotomy-with-concomitant-total-knee-arthroplasty-in-an-achondroplasia-patient-a-case-report
#2
Sebastian G Walter, Tobias Schwering, Stefan Preiss
INTRODUCTION: Achondroplasia is the most common form of dwarfism in humans and is orthopedically characterized by shortened extremities and an exaggerated lumbar lordosis. The surgical challenges are maintenance of axial alignment during limb lengthening as well as joint preservation and alignment restoration. CASE REPORT: We present a 46-year-old female suffering from achondroplasia with severe pain in both knees. Severe varus deformities of both femurs and degeneration of both knee joints became apparent on clinical and radiological examination...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28816906/comparison-of-liposomal-bupivacaine-with-bupivicaine-pain-pump-in-tka-patients-commentary-on-an-article-by-eric-b-smith-md-et-al-periarticular-liposomal-bupivacaine-injection-versus-intra-articular-bupivacaine-infusion-catheter-for-analgesia-after-total-knee
#3
https://www.readbyqxmd.com/read/28815146/quantifying-the-relative-change-in-physical-activity-after-total-knee-arthroplasty-using-accelerometer-based-measurements
#4
Vibhu Agarwal, Mathew Smuck, Nigam H Shah
Osteoarthritis is amongst the top five most disabling conditions affecting Americans over 65 years of age and imposes an annual economic burden estimated at $ 89.1 billion. Nearly half of the cost of care of Osteoarthritis is attributable to hospitalizations for total knee arthroplasties (TKA) and total hip arthroplasties (THA). The current clinical practice relies predominantly on subjective assessment of physical function and pain via patient reported outcome measures (PROM) that have proven inadequate for providing a validated, reliable and responsive measure of TKA outcomes...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814320/intrathecal-morphine-versus-femoral-nerve-block-for-pain-control-after-total-knee-arthroplasty-a-meta-analysis
#5
Yi Tang, Xu Tang, Qinghua Wei, Hui Zhang
BACKGROUND: This meta-analysis aims to illustrate the efficacy and safety of intrathecal morphine (ITM) versus femoral nerve block (FNB) for pain control after total knee arthroplasty (TKA). METHODS: In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, Cami Info. Inc., Casalini databases, EBSCO databases, Verlag database and Google database. Data on patients prepared for TKA surgery in studies that compared ITM versus FNB for pain control after TKA were collected...
August 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28811109/the-risk-of-acute-infection-following-intra-articular-corticosteroid-injection-into-a-pre-existing-total-knee-arthroplasty
#6
Emily S Mills, Michael B Elman, Jared R H Foran
BACKGROUND: No previous studies have investigated the risk of infection following intra-articular corticosteroid injection (IACI) into a pre-existing total knee arthroplasty (TKA). The aim of this study is to determine the risk of acute infection following IACI into a pre-existing TKA. METHODS: A retrospective chart review identified all patients at a single institution between October 2009 and May 2015 that had an ipsilateral knee injection subsequent to a TKA...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28811107/local-efficacy-of-periarticular-morphine-injection-in-simultaneous-bilateral-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#7
Kentaro Iwakiri, Yoichi Ohta, Akio Kobayashi, Yukihide Minoda, Hiroaki Nakamura
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to reduce postoperative pain following total knee arthroplasty (TKA). Despite its analgesic effect, it frequently causes nausea, which is an adverse effect of opioids. It is inconclusive whether the intraoperative injection of periarticular morphine is effective peripherally. The aim of this study was to assess whether the addition of morphine to unilateral periarticular knee injections improves postoperative pain, range of motion, and swelling in patients undergoing simultaneous bilateral TKA...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28807470/persistent-pulmonary-embolism-rates-following-total-knee-arthroplasty-even-with-prophylactic-anticoagulants
#8
Mark P Cote, Anthony Chen, Yue Jiang, Vincent Cheng, Jay R Lieberman
BACKGROUND: Symptomatic pulmonary embolism (PE), a significant and life-threatening complication following total knee arthroplasty (TKA), has been described as a "never event." Despite a number of advancements in care, PE continues to occur following TKA. This study evaluates symptomatic PE rates over time in TKA patients enrolled in multicenter randomized clinical trials assessing the efficacy of venous thromboembolism prophylaxis regimens. METHODS: The MEDLINE and Cochrane Central Register of Controlled Trials were searched to identify clinical trials assessing prophylactic anticoagulation in patients undergoing TKA between January 1995 and December 2016...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803816/midterm-adjusted-survival-comparing-the-best-performing-unicompartmental-and-total-knee-arthroplasties-in-a-registry
#9
Stefano A Bini, Guy Cafri, Monti Khatod
BACKGROUND: Recent literature suggests that the difference in revision risk between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be influenced by surgeon volume and other confounders. We hypothesized that implant selection might decrease the relative risk of revision in an adjusted model. METHODS: We selected the best performing (BP) primary UKAs and TKAs performed for osteoarthritis between January 2001 and December 2012 collected through a joint replacement registry...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803758/association-between-body-weight-and-proximal-tibial-bone-mineral-density-after-bilateral-total-knee-arthroplasty
#10
Yoshinori Ishii, Hideo Noguchi, Junko Sato, Hana Ishii, Koji Todoroki, Shin-Ichi Toyabe
BACKGROUND: Proximal tibial bone mineral density (BMD) has been studied for its potential impact on subsidence and loosening of the tibial component after total knee arthroplasty (TKA). However, no known studies of proximal tibial BMD after TKA have evaluated the effect of major impact factors such as body weight (BW), muscle strength, and level of activity. We aim to determine whether factors such as level of activity, quadriceps strength, BW, gender, age, and prosthetic design affect proximal tibial BMD over the mid- to long-term following TKA...
August 10, 2017: Knee
https://www.readbyqxmd.com/read/28802778/cryotherapy-treatment-after-unicompartmental-and-total-knee-arthroplasty-a-review
#11
REVIEW
Morad Chughtai, Nipun Sodhi, Michael Jawad, Jared M Newman, Anton Khlopas, Anil Bhave, Michael A Mont
BACKGROUND: Cryotherapy is widely utilized to enhance recovery after knee surgeries. However, the outcome parameters often vary between studies. Therefore, the purpose of this review is to compare (1) no cryotherapy vs cryotherapy; (2) cold pack cryotherapy vs continuous flow device cryotherapy; (3) various protocols of application of these cryotherapy methods; and (4) cost-benefit analysis in patients who had unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). METHODS: A search for "knee" and "cryotherapy" using PubMed, EBSCO Host, and SCOPUS was performed, yielding 187 initial reports...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802777/local-infiltration-analgesia-with-liposomal-bupivacaine-improves-pain-scores-and-reduces-opioid-use-after-total-knee-arthroplasty-results%C3%A2-of-a-randomized-controlled-trial
#12
Michael A Mont, Walter B Beaver, Stanley H Dysart, John W Barrington, Daniel J Del Gaizo
BACKGROUND: Local infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. METHODS: Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed with bupivacaine HCl 0...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802773/active-physiotherapy-interventions-following-total-knee-arthroplasty-in-the-hospital-and-inpatient-rehabilitation-settings-a-systematic-review-and-meta-analysis
#13
REVIEW
Kate G Henderson, Jason A Wallis, David A Snowdon
BACKGROUND: Physiotherapy is a routine component of postoperative management following total knee arthroplasty (TKA). As the demand for surgery increases it is vital that postoperative physiotherapy interventions are effective and efficient. OBJECTIVES: Determine the most beneficial active physiotherapy interventions in acute hospital and inpatient rehabilitation for improving pain, activity, range of motion and reducing length of stay for adults who have undergone TKA...
February 1, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28801877/are-barbed-sutures-associated-with-90-day-reoperation-rates-after-primary-tka
#14
Daniel C Austin, Benjamin J Keeney, Brendan E Dempsey, Karl M Koenig
BACKGROUND: Studies have suggested that barbed sutures for wound closure in TKAs are an acceptable alternative to standard methods. However others have observed a higher risk of wound-related complications with barbed sutures. QUESTIONS/PURPOSES: (1) Do 90-day TKA reoperation rates differ between patients undergoing a barbed suture arthrotomy closure compared with a traditional interrupted closure? (2) Do the 90-day reoperation rates of wound-related, deep infection, and arthrotomy failure complications differ between barbed suture and traditional closures? METHODS: A retrospective analysis of a longitudinally maintained institutional primary TKA database was conducted on all TKAs performed between April 2011 and September 2015...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28801816/are-tkas-performed-in-high-volume-hospitals-less-likely-to-undergo-revision-than-tkas-performed-in-low-volume-hospitals
#15
Elke Jeschke, Mustafa Citak, Christian Günster, Andreas Matthias Halder, Karl-Dieter Heller, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Thorsten Gehrke
BACKGROUND: High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies have analyzed implant survival after primary TKA in high-volume centers. QUESTIONS/PURPOSES: Is the risk of revision surgery higher when receiving a TKA in a low-volume hospital than in a high-volume hospital? METHODS: Using nationwide billing data of the largest German healthcare insurer for inpatient hospital treatment, we identified 45,165 TKAs in 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone knee replacement surgery between January 2012 and December 2012...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28801208/projected-increase-in-total-knee-arthroplasty-in-the-united-states-an-alternative-projection-model
#16
M C S Inacio, E W Paxton, S E Graves, R S Namba, S Nemes
OBJECTIVE: The purpose of our study was to estimate the future incidence rate (IR) and volume of primary total knee arthroplasty (TKA) in the United States from 2015 to 2050 using a conservative projection model that assumes a maximum IR of procedures. Furthermore, our study compared these projections to a model assuming exponential growth, as done in previous studies, for illustrative purposes. METHODS: A population based epidemiological study was conducted using data from US National Inpatient Sample (NIS) and Census Bureau...
August 8, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28800859/the-role-of-psychiatric-diagnoses-for-outcome-after-hip-and-knee%C3%A2-arthroplasty
#17
Silas H Gylvin, Christoffer C Jørgensen, Anders F Jensen, Gunnar H Gislason, Henrik Kehlet
BACKGROUND: Surgical patients receiving psychopharmacologic treatment have been associated with adverse outcomes in total hip and knee arthroplasty (THA and TKA). The purpose of this study was to investigate whether a specific high-risk group of patients receiving psychopharmacologic treatment could be identified based upon a nationwide psychiatric diagnosis register. METHODS: From 7 different orthopedic centers, 8288 THA and TKA patients were included from January 2010 to November 2012 of which 943 (11...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28800855/radiographic-analysis-of-the-lower-limbs-using-the-hip-calcaneus-line-in-healthy-individuals-and-in-patients-with-varus-knee-osteoarthritis
#18
Toshikazu Tanaka, Koji Takayama, Shingo Hashimoto, Noriyuki Kanzaki, Shinya Hayashi, Ryosuke Kuroda, Tomoyuki Matsumoto
BACKGROUND: Several recent reports define the line from the centre of the femoral head to the lowest point of the calcaneus. The purpose of this study was to comparatively examine the usefulness of the hip-calcaneus (HC) line and hip-ankle (HA) line for the evaluation of lower-limb alignment in healthy individuals and in patients with osteoarthritis (OA). METHODS: Participants included 34 healthy individuals (mean age, 26.4years) and 34 patients with OA (mean age, 74...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28800854/up-to-seven-years-follow-up-of-short-cemented-stems-in-complex-primary-total-knee-arthroplasty-a-prospective-study
#19
Mathieu Angers-Goulet, Martin Bédard
BACKGROUND: Although primary total knee arthroplasty (TKA) shows good clinical, functional and radiological results, it can be complicated by certain conditions or pathologies. The main objective of this study was to evaluate the global performance of short cemented metaphyseal stem components in patients undergoing complex primary TKA. METHODS: This is a single-surgeon prospective case series of 91 patients who underwent complex primary TKA requiring short stem fixation between January 2009 and October 2014...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28799964/the-effect-of-adductor-canal-block-on-knee-extensor-muscle-strength-6-weeks-after-total-knee-arthroplasty-a-randomized-controlled-trial
#20
Nicolas Rousseau-Saine, Stephan R Williams, François Girard, Luc J Hébert, Florian Robin, Luc Duchesne, Frédéric Lavoie, Monique Ruel
BACKGROUND: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown. We hypothesized that 48 hours of continuous ACB immediately after TKA would improve KES 6 weeks after TKA, compared to placebo...
August 9, 2017: Anesthesia and Analgesia
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