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https://www.readbyqxmd.com/read/29033158/revision-total-knee-arthroplasty-for-periprosthetic-joint-infection-is-associated-with-increased-postoperative-morbidity-and-mortality-relative-to-noninfectious-revisions
#1
Venkat Boddapati, Michael C Fu, David J Mayman, Edwin P Su, Peter K Sculco, Alexander S McLawhorn
BACKGROUND: Periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) is a devastating complication. The short-term morbidity profile of revision TKA performed for PJI relative to non-PJI revisions is poorly characterized. The purpose of this study is to determine 30-day postoperative outcomes after revision TKA for PJI, relative to primary TKA and aseptic revision TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2015 was queried for primary and revision TKA cases...
September 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29032478/total-knee-arthroplasty-in-patients-with-a-history-of-illicit-intravenous-drug-abuse
#2
David E Bauer, Andreas Hingsammer, Lukas Ernstbrunner, Alexander Aichmair, Andrea B Rosskopf, Franziska Eckers, Karl Wieser, Sandro F Fucentese
PURPOSE: Injection drug users are at high risk for both infection with blood-borne pathogens, namely, human immune deficiency virus (HIV), hepatitis-B, -C virus, various bacterial infections, as well as early primary and secondary joint degeneration. When total knee arthroplasty (TKA) is anticipated the risk of septic complications is a major concern. The purpose of this study was to assess the clinical and radiographic outcome of patients with a history of intravenous drug use after total knee arthroplasty...
October 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29032308/comparison-of-mode-of-failure-between-primary-and-revision-total-knee-arthroplasties
#3
H Liang, J K Bae, C H Park, K I Kim, D K Bae, S J Song
INTRODUCTION: Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. HYPOTHESIS: The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA...
October 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29029354/cost-analysis-of-sending-routine-pathology-specimens-following-total-joint-arthroplasty-in-the-age-of-bundled-payments
#4
Hayden S Holbrook, Johannes F Plate, Maxwell K Langfitt, Jason E Lang, John S Shields
Bundled payment plans are being developed as a means to curb healthcare spending. Routine histology following total hip arthroplasties (THA) and total knee arthroplasties (TKA) is standard practice at many institutions. Recently, the value of this practice has been questioned as histologic diagnoses in THA and TKA rarely differ from the clinical diagnoses. The goal of this study is to identify discrepant and discordant diagnoses following THA and TKA at an academic medical center and to calculate the cost-saving potential in the setting of a bundled payment plan...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29028624/foot-pressure-pattern-hindfoot-deformities-and-their-associations-with-foot-pain-in-individuals-with-advanced-medial-knee-osteoarthritis
#5
Isao Saito, Kyoji Okada, Masahiko Wakasa, Hidekazu Abe, Akira Saito
This survey clarified foot pressure patterns and hindfoot deformities in individuals with advanced knee osteoarthritis (OA) and analyzed their associations with foot pain. Sixty-four individuals with unilateral knee OA who underwent total knee arthroplasty (TKA) were divided into the following groups: no foot pain (n=26; men:women, 4:22; mean age, 73.7 years), foot pain resolved after TKA (12; 2:10; 75.8), and foot pain remaining after TKA (26; 4:22; 74.7). Elderly individuals without pain or deformity in either knee (54; 10:44; 74...
October 6, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29026941/neutral-alignment-leads-to-higher-knee-society-scores-after-total-knee-arthroplasty-in-preoperatively-non-varus-patients-a-prospective-clinical-study-using-3d-ct
#6
Omer Slevin, Anna Hirschmann, Filippo F Schiapparelli, Felix Amsler, Rolf W Huegli, Michael T Hirschmann
PURPOSE: The optimal coronal alignment is still under debate. However, in most of the studies, alignment was only assessed using radiographs, which are not accurate enough for assessment of tibial and femoral TKA position. The primary purpose of this study was to assess the relationship between coronal TKA alignment using 3D-reconstructed CTs and clinical outcome in patients with preoperative varus in comparison with patients with natural or valgus deformity. It was the hypothesis that neutral limb alignment shows a better outcome after TKA...
October 12, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29026354/novel-regional-techniques-for-total-knee-arthroplasty-promote-reduced-hospital-length-of-stay-an-analysis-of-106-patients
#7
Salman Thobhani, Lauren Scalercio, Clint E Elliott, Bobby D Nossaman, Leslie C Thomas, Dane Yuratich, Kim Bland, Kristie Osteen, Matthew E Patterson
BACKGROUND: Novel regional techniques, including the adductor canal block (ACB) and the local anesthetic infiltration between the popliteal artery and capsule of the knee (IPACK) block, provide an alternative approach for controlling pain following total knee arthroplasty (TKA). This study compared 3 regional techniques (femoral nerve catheter [FNC] block alone, FNC block with IPACK, and ACB with IPACK) on pain scores, opioid consumption, performance during physical therapy, and hospital length of stay in patients undergoing TKA...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29025351/utilization-of-robotic-arm-assisted-total-knee-arthroplasty-for-soft-tissue-protection
#8
Assem A Sultan, Nicolas Piuzzi, Anton Khlopas, Morad Chughtai, Nipun Sodhi, Michael A Mont
Despite the well-established success of total knee arthroplasty (TKA), iatrogenic ligamentous and soft tissue injuries are infrequent, but potential complications that can have devastating impact on clinical outcomes. These injuries are often related to technical errors and excessive soft tissue manipulation, particularly during bony resections. Recently, robotic-arm assisted TKA was introduced and demonstrated promising results with potential technical advantages over manual surgery in implant positioning and mechanical accuracy...
October 13, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29022797/surgery-performed-by-supervised-registrars-does-not-adversely-affect-medium-term-functional-outcomes-after-total-knee-replacement
#9
N Beattie, J F Maempel, S Roberts, H B Waterson, G Brown, I J Brenkel, P J Walmsley
Introduction Although total knee arthroplasty (TKA) is an index procedure for orthopaedic registrars, there is a lack of published research as to the effects of surgery when performed by supervised trainees. The aim of this study was to compare functional outcomes up to five years after primary TKA performed by consultants and trainee surgeons. Methods A retrospective analysis was conducted of prospectively collected data for 609 consecutive patients (339 female, 270 male) undergoing TKA. Patients were assessed preoperatively as well as at 18 months, three years and five years postoperatively, and American Knee Society objective knee and functional scores (AKSK and AKSF) were recorded...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29022751/prospective-psychometric-characterization-of-hip-and-knee-arthroplasty-patients
#10
Silas Hinsch Gylvin, Anders Fink-Jensen, Henrik Kehlet, Christoffer Calov Jørgensen, Mogens Berg Laursen, Kirill Gromov, Henrik Morville Schroder, Susanne Jung Høvsgaard, Heidi Raahauge Wede, Phillip Raphael Kyle, Per Bech
BACKGROUND: Psychiatric conditions and psychopharmacological treatments have been demonstrated to be important risk-factors for prolonged hospital length of stay, readmission and morbidity, following fast-track total hip (THA) and total knee arthroplasty (TKA). AIMS: The aim of the study was to provide a detailed description of the preoperative psychiatric characteristics of a well-defined patient population undergoing THA and TKA, using the 90-item Symptom Checklist (SCL-90-R)...
October 12, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/29021879/a-comparison-of-plain-radiography-with-computer-tomography-in-determining-coronal-and-sagittal-alignments-following-total-knee-arthroplasty
#11
G N Solayar, J Chinappa, I A Harris, D B Chen, S J Macdessi
Introduction: Optimal coronal and sagittal component positioning is important in achieving a successful outcome following total knee arthroplasty (TKA). Modalities to determine post-operative alignment include plain radiography and computer tomography (CT) imaging. This study aims to determine the accuracy and reliability of plain radiographs in measuring coronal and sagittal alignment following TKA. Materials and Methods: A prospective, consecutive study of 58 patients undergoing TKA was performed comparing alignment data from plain radiographs and CT imaging...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29017801/influence-of-increased-posterior-tibial-slope-in-total-knee-arthroplasty-on-knee-joint-biomechanics-a-computational-simulation-study
#12
Kyoung-Tak Kang, Yong-Gon Koh, Juhyun Son, Oh-Ryong Kwon, Jun-Sang Lee, Sae-Kwang Kwon
BACKGROUND: The reconstructed posterior tibial slope (PTS) plays a significant role in restoring knee kinematics in cruciate-retaining-total knee arthroplasty (TKA). A few studies have reported the effect of the PTS on biomechanics. METHODS: This study investigates the effect of the PTS on tibiofemoral (TF) kinematics, patellofemoral (PF) contact stress, and forces at the quadriceps, posterior cruciate ligament (PCL) and collateral ligament after cruciate-retaining-TKA using computer simulations...
September 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29016401/evaluation-of-the-effectiveness-of-neuromuscular-electrical-stimulation-after-total-knee-arthroplasty-a-meta-analysis
#13
Alessandro Bistolfi, Jessica Zanovello, Riccardo Ferracini, Fabrizio Allisiardi, Elisa Lioce, Ernesta Magistroni, Paola Berchialla, Ilaria Da Rold, Giuseppe Massazza
OBJECTIVE: to evaluate the efficacy of the use of the neuromuscular electrical stimulation (NMES) after total knee arthroplasty (TKA). DESIGN: a systematic review of randomized controlled trials (MEDLINE, PubMed, Cochrane Library, and PEDro) using PICOS approach to formulate the research question, Controlled terms and Boolean operators. Inclusion and exclusion criteria were defined in advance. "Neuromuscular electrical stimulation" and "total knee arthroplasty" were used as keywords...
October 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28993087/the-influence-of-patient-gender-on-morbidity-following-total-hip-or-total-knee-arthroplasty
#14
Bryce A Basques, Joshua A Bell, Robert A Sershon, Craig J Della Valle
BACKGROUND: Little research has focused on the influence of gender on postoperative morbidity following total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study aimed to compare operative time, length of stay, 30-day complications, and readmissions based on patient gender. METHODS: The prospectively collected National Surgical Quality Improvement Program registry from 2005 to 2014 was queried to identify primary elective THA and TKA patients. Multivariate regression was used to compare the rates of 30-day adverse events, rates of readmission, operative time, and postoperative length of stay between men and women...
September 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28993079/lateral-femoral-epicondylar-osteotomy-for-correction-of-fixed-valgus-deformity-in-total-knee-arthroplasty-a-technical-note
#15
Jacob M Conjeski, Giles R Scuderi
BACKGROUND: Multiple surgical techniques exist to restore limb alignment and to balance soft tissues in valgus knees during total knee arthroplasty (TKA). One technique is to perform a lateral femoral epicondylar osteotomy. METHODS: A retrospective analysis was performed on all patients with a fixed valgus deformity that was corrected with a lateral femoral epicondylar osteotomy during TKA. Preoperative and postoperative Knee Society Knee Scores, knee stability, range of motion, and radiographic alignment were recorded...
September 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28993076/unicompartmental-knee-arthroplasty-achieves-greater-flexion-with-no-difference-in-functional-outcome-quality-of-life-and-satisfaction-vs-total-knee-arthroplasty-in-patients-younger-than-55-years-a-propensity-score-matched-cohort-analysis
#16
Graham Seow-Hng Goh, Hamid Rahmatullah Bin Abd Razak, Darren Keng-Jin Tay, Shi-Lu Chia, Ngai-Nung Lo, Seng-Jin Yeo
BACKGROUND: Improvements in surgical techniques, implant design, and adherence to indications have resulted in favorable outcomes after unicompartmental knee arthroplasty (UKA), particularly in an older population. However, no studies have compared the performance of contemporary UKA and total knee arthroplasty (TKA) in a young population. METHODS: Prospectively collected registry data of 160 UKAs performed in 160 patients younger than 55 years were reviewed. Propensity scores generated using logistic regression were used to adjust for confounding variables of age, gender, body mass index, preoperative range of motion, Knee Society Score, Oxford Knee Score, and Short-Form 36, allowing matching of the TKA cohort to the UKA cohort in a 1:1 ratio using the nearest-neighbor method...
September 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28988303/high-performance-of-%C3%AE-defensin-lateral-flow-assay-synovasure-in-the-diagnosis-of-chronic-knee-prosthetic-infections
#17
Giovanni Balato, Vincenzo Franceschini, Tiziana Ascione, Alfredo Lamberti, Michele D'Amato, Andrea Ensini, Andrea Baldini
PURPOSE: This prospective study was undertaken to evaluate the diagnostic accuracy of the Synovasure™ α-defensin lateral flow assay to detect or exclude infection and to compare it to the sensitivity and specificity of other diagnostic criteria according to the International Consensus Group on Periprosthetic Joint Infection (PJI). METHODS: All patients who have undergone revision total knee arthroplasty (TKA) from September 2015 to July 2016 were included: 16 chronic (more than 3 months after performing arthroplasty) infections and 35 aseptic joints were identified...
October 7, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28987921/tka-patients-with-unsatisfying-knee-function-show-changes-in-neuromotor-synergy-pattern-but-not-joint-biomechanics
#18
Marzieh M Ardestani, Philip Malloy, Denis Nam, Aaron G Rosenberg, Markus A Wimmer
Nearly 20% of patients who have undergone total knee arthroplasty (TKA) report persistent poor knee function. This study explores the idea that, despite similar knee joint biomechanics, the neuro-motor synergies may be different between high-functional and low-functional TKA patients. We hypothesized that (1) high-functional TKA recruit a more complex neuro-motor synergy pattern compared to low-functional TKA and (2) high-functional TKA patients demonstrate more stride-to-stride variability (flexibility) in their synergies...
September 28, 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/28986675/does-the-grading-of-chondromalacia-patellae-influence-anterior-knee-pain-following-total-knee-arthroplasty-without-patellar-resurfacing
#19
Guo-Chun Zha, Shuo Feng, Xiang-Yang Chen, Kai-Jin Guo
OBJECTIVES: The influence of chondromalacia patellae (CMP) on post-operative anterior knee pain (AKP) following total knee arthroplasty (TKA) remains controversial, and few studies have focused on the relationship between them. The purpose of this study was to determine whether different CMP grades affect the incidence of AKP after TKA without patellar resurfacing. METHODS: We performed a retrospective analysis of prospectively collected data on 290 TKAs with the use of the low contact stress mobile-bearing prosthesis, without patellar resurfacing in 290 patients from February 2009 to January 2013...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28985252/age-and-sex-based-recovery-curves-to-track-functional-outcomes-in-older-adults-with-total-knee-arthroplasty
#20
Yong-Hao Pua, Felicia Jie-Ting Seah, Cheryl Lian-Li Poon, John Wei-Ming Tan, Ross Alan Clark, Jennifer Suet-Ching Liaw, Hwei-Chi Chong
Background: older adults with total knee arthroplasty (TKA) frequently undergo rehabilitation to address limited knee flexion range-of-motion, quadriceps weakness and gait speed limitations. This study aimed to develop age- and sex-specific recovery curves of knee flexion range-of-motion, quadriceps strength and fast gait speed post-TKA. Methods: a population-based sample of 2,987 patients undergoing primary TKA participated, of whom 2015 (68%) were 65 years of age or older...
August 30, 2017: Age and Ageing
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