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Knee replacement complications

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https://www.readbyqxmd.com/read/28545177/mid-term-results-of-oxford-medial-unicompartmental-knee-arthroplasty-in-young-asian-patients-less-than-60-years-of-age-a-minimum-5-year-follow-up
#1
Yeong-Joon Kim, Bu-Hwan Kim, Seong-Ho Yoo, Suk-Woong Kang, Chang-Hun Kwack, Moo-Ho Song
Purpose: The purpose of this study was to evaluate the efficacy of unicompartmental knee arthroplasty (UKA) in young active Asian patients by analyzing clinical outcomes, complications and survival rates. Materials and Methods: Eighty-two knees were evaluated with a minimum follow-up of 5 years after Oxford phase 3 UKA in patients less than 60 years of age at the time of surgery. Their mean age was 54.7 years (range, 44 to 59 years). The mean follow-up period was 8...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28538534/enhanced-recovery-after-surgery-for-hip-and-knee-replacements
#2
David P Gwynne-Jones, Ginny Martin, Chris Crane
BACKGROUND: Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. PURPOSE: To compare outcomes following the introduction of an ERAS program for hip and knee replacements developed at our institution with a historical cohort of patients. METHODS: ERAS protocols were developed at our institution for patients undergoing hip and knee joint replacements...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28532493/distal-femoral-replacement-with-the-mml-system-a-single-center-experience-with-an-average-follow-up-of-86%C3%A2-months
#3
Andreas Toepfer, Norbert Harrasser, Paul-Ruben Schwarz, Florian Pohlig, Ulrich Lenze, Heinrich M L Mühlhofer, Ludger Gerdesmeyer, Ruediger von Eisenhart-Rothe, Christian Suren
BACKGROUND: The aim of this study was to compare the functional outcomes and complication rates after distal femoral replacement (DFR) performed with the modular Munich-Luebeck (MML) modular prosthesis (ESKA/Orthodynamics, Luebeck, Germany) in patients being treated for malignant disease or failed total knee arthroplasty. METHODS: A retrospective review of patient charts and a functional investigation (involving Musculoskeletal Tumor Society Score [MSTS], American Knee Society Score [AKSS], Oxford Knee Score [OKS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Toronto Extremity Salvage Score [TESS], the 12-Item Short-Form [SF-12] Health Survey, and a failure classification system developed by Henderson et al...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#4
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#5
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28497104/stress-fracture-of-the-lateral-femoral-condyle-after-total-knee-arthroplasty
#6
Mohammad M Sarzaeem, Mahmood Jabalameli
BACKGROUND: This is to assess one of the rare complications after total knee replacement and to assess risk factors of failure. METHODS: 11 patients with varus knee and an average age of 67 years underwent TKA between 2005 and 2013. All patients returned with a sudden sharp knee pain, disability to walk and significant decrease in ROM about 4 to 8 weeks after surgery. Radiographic examination revealed a lateral femoral condylar stress fracture. RESULTS: After analyzing the images, we found common characteristics among all patients, which might be attributable to the later fracture including varus deformity>25, femoral component lateralization, and valgus correction...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#7
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#8
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28476929/the-case-of-the-mysterious-vanishing-spleen-autosplenectomy-complicating-pneumococcal-sepsis
#9
Georgina Moritz, Megan Jenkins, Dushyant Shetty, Julie Blundell
A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion. This was unexpected as an ultrasound in intensive care 10 weeks previously had demonstrated a normal spleen...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28462215/condylar-constrained-system-in-primary-total-knee-replacement-our-experience-and-literature-review
#10
Luigi Sabatini, Salvatore Risitano, Lorenzo Rissolio, Andrea Bonani, Francesco Atzori, Alessandro Massè
BACKGROUND: Constrained condylar knee (CCK) prosthesis are common used for revision surgery but can also help surgeons to improve implant stability in primary knee arthroplasty, in fact in severe knee arthrosis with serious deformity associated with a significant instability a more constrained articulation is required. With introduction of second generation of semi-constrained prosthesis, rate of complication is real decreased and a good survival rate and functional score results is showed...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28454368/anti-osteoclastic-agent-denosumab-for-a-giant-cell-tumor-of-the-bone-with-concurrent-paget-s-disease-a-case-report
#11
Takaaki Tanaka, John Slavin, Sue-Anne McLachlan, Peter Choong
Paget's disease of the bone may predispose the development of malignant bone tumors such as osteosarcoma. Giant cell tumor (GCT) as a consequence of Paget's disease is rare. Bone GCT is characterized by rapid growth, the destruction of bone, extension to the surrounding soft tissue and abnormal bone turnover caused by an abnormality of the receptor activator of nuclear factor-κB (RANK)-RANK ligand (RANKL) pathway. Denosumab is a RANK-RANKL inhibitor, which is used to treat osteoporosis and bone GCT. In the current study, a 60-year-old male presented with severe pain located between the right thigh and the knee...
April 2017: Oncology Letters
https://www.readbyqxmd.com/read/28448707/-joint-replacement-and-giant-cell-tumor-report-of-8-cases
#12
J G Martínez-Estrada, O Santamaría-Bahena
INTRODUCTION: The giant-cell tumor is an aggressive neoplasia, represents approximately from the 5 the 8.6% of primary bone tumors; more of 50% affects the pelvic extremity, being able to affect the totality of the bones. OBJECTIVE: To present the case series of tumors around the knee and hip that we offered a tumoral joint replacement as an alternative to amputation. MATERIAL AND METHODS: We present eight cases of extensive giant cells tumors, we did en bloc resection and tumoral joint replacement...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28439702/a-comparison-of-apixaban-and-dabigatran-etexilate-for-thromboprophylaxis-following-hip-and-knee-replacement-surgery
#13
Adriane Mayer, Philipp Schuster, Bernd Fink
INTRODUCTION: Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out...
April 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#14
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/28389759/risk-factors-for-amputation-in-periprosthetic-knee-infection
#15
Alan Giovanni Polanco-Armenta, Adrián Miguel-Pérez, Adrián Huetzemani Rivera-Villa, Manuel Ignacio Barrera-García, María Guadalupe Sánchez-Prado, Alberto Vázquez-Noya, Fernando Vidal-Cervantes, José de Jesús Guerra-Jasso, José Manuel Pérez-Atanasio
Treatment for prosthetic knee replacement is becoming more common. Infection is an arthroplasty-related complication leading to prolonged hospitalization, multiple surgical procedures, permanent loss of the implant, impaired function, impaired quality of life and even amputation of the limb. Previous studies have evaluated the risk factors associated with periprosthetic knee infection, but scarce information related to risk factors associated with amputation in this group of patients is available. The purpose of this study was to identify risk factors for amputation in periprosthetic infected knee through a case-control study, analyzing patients treated from January 2012 to November 2016 in a hospital with a high incidence of this diagnosis...
April 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28370637/cost-effectiveness-analysis-of-single-use-negative-pressure-wound-therapy-dressings-snpwt-to-reduce-surgical-site-complications-ssc-in-routine-primary-hip-and-knee-replacements
#16
Leo M Nherera, Paul Trueman, Sudheer L Karlakki
We sought to evaluate the cost-effectiveness of single-use negative pressure wound therapy in patients undergoing primary hip and knee replacements using effectiveness data from a recently completed non-blinded randomized controlled trial. A decision analytic model was developed from UK National Health Service perspective using data from a single-centre trial. 220 patients were randomized to treatment with either single-use negative pressure wound therapy or standard care i.e., film dressings of clinician choice and followed for 6 weeks...
April 1, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28367692/operative-wound-complications-following-total-ankle-arthroplasty
#17
Christopher E Gross, Kamran S Hamid, Cynthia Green, Mark E Easley, James K DeOrio, James A Nunley
BACKGROUND: Wound complications following total ankle replacement (TAR) potentially lead to devastating consequences. The aim of this study was to compare the operative and demographic differences in patients with and without major wound problems which required operative management. We hypothesized that increased tourniquet and operative time would negatively influence wound healing. METHODS: We identified a consecutive series of 762 primary TARs performed between December 1999 and April 2014 whose data were prospectively collected...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28364321/satisfactory-outcomes-following-combined-unicompartmental-knee-replacement-and-anterior-cruciate-ligament-reconstruction
#18
REVIEW
Andrea Volpin, S G Kini, D E Meuffels
PURPOSE: There exist limited options for treatment of patients with combined medial compartment arthritis and anterior cruciate ligament (ACL) deficiency. Ideal treatment is one that offers lasting relief of symptoms not compromising any future surgery. Unicompartmental knee replacement has shown consistently good results in the relatively young and active population, but there is a high reported incidence of failure up to 20%, if performed in ACL-deficient knees. One of the recognized treatment modality is combined ACL reconstruction and unicompartmental arthroplasty...
March 31, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#19
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-healthcare-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#20
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
June 2017: Medical Care
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