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Knee replacement complications

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https://www.readbyqxmd.com/read/28988294/development-and-proposal-of-a-scoring-system-for-giant-cell-tumour-of-the-bone-around-the-knee
#1
Deng-Xing Lun, Yong-Cheng Hu, Xiong-Gang Yang, Zhen Wang, Xiu-Chun Yu, Su-Jia Wu, Zhao-Ming Ye, Han Wang
PURPOSE: The purpose of this study was to provide the surgeons with effective and reliable guidelines for surgical decision-making by establishing a scoring system for giant cell tumour (GCTSS) based on evidence and expert opinion. METHODS: The modified Delphi technique and analytic hierarchy process were used to establish the GCTSS. The GCTSS was defined and classified based on different surgical methods using data from 207 patients collected retrospectively between October 2003 and December 2014...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28965944/predictors-of-outcome-after-primary-total-joint-replacement
#2
Markus Weber, Benjamin Craiovan, Michael L Woerner, Timo Schwarz, Joachim Grifka, Tobias F Renkawitz
BACKGROUND: Total hip and knee replacements are frequently performed curative treatment options in end-stage arthritis. In this study, we analyzed clinical outcome, complications, and predictors of outcome in modern joint replacement. METHODS: In a retrospective analysis of over 2000 primary total hip and knee replacements from our institutional joint registry, responder rates for positive outcome as defined by the OMERACT-OARSI criteria, postoperative complication rates, and patient-reported outcome measures (EQ-5D, WOMAC) within the first year were compared between hip and knee replacements...
September 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28964919/prospective-assessment-of-patients-knowledge-and-informational-needs-and-of-surgeon-to-patient-information-transfer-before-and-after-knee-or-hip-arthroplasty
#3
L Billon, B Dcaudin, G Pasquier, A Lons, V Deken-Delannoy, A-F Germe, P Odou, H Migaud
BACKGROUND: Patients are playing an increasingly large role in their own management and must therefore receive clear, complete, and comprehensible information. In the field of hip and knee arthroplasty, little is known about the level of patient knowledge and effectiveness of surgeon-to-patient information transfer. We therefore designed a prospective observational study with the objective of assessing four factors: patient knowledge during management, quality of information transfer, informational needs, and factors associated with the level of knowledge...
September 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28950794/the-optimal-protocol-to-reduce-blood-loss-and-blood-transfusion-after-unilateral-total-knee-replacement-low-dose-ia-txa-plus-30-min-drain-clamping-versus-drainage-clamping-for-the-first-3-h-without-ia-txa
#4
Joo Hyun Park, Sung Wook Choi, Eun Ho Shin, Myung Hoon Park, Myung Ku Kim
INTRODUCTION: Although intraarticular tranexamic acid (IA-TXA) administration or drainage clamping are popular methods used to reduce blood loss after total knee replacement (TKR), the protocol remains controversial. We aimed (1) to establish new protocols through investigating whether two methods, that is, low-dose (500 mg) IA-TXA plus 30-min drain clamping and drainage clamping for the first 3 h without IA-TXA, can reduce blood loss and blood transfusion after unilateral TKR and (2) to make recommendations related to clinical application...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#5
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
September 8, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28861196/patellofemoral-joint-arthroplasty-early-results-and-functional-outcome-of-the-zimmer-gender-solutions-patello-femoral-joint-system
#6
Donald Osarumwense, Farhan Syed, Obi Nzeako, Segun Akilapa, Omer Zubair, Jon Waite
BACKGROUND: Improved knee prosthesis designs have led to an increase in the use of patellofemoral arthroplasty as a primary treatment option in recent times. We report the early results and outcomes of the Zimmer Gender Solutions Patello-Femoral Joint (PFJ) system used to treat isolated patellofemoral osteoarthritis (PFA). METHODS: We retrospectively reviewed and analysed data of patients who underwent PFJ replacement (PFJR) at our institution with a minimum follow-up of 2 years...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28854533/safety-aspects-of-preoperative-high-dose-glucocorticoid-in-primary-total-knee-replacement
#7
C C Jørgensen, F T Pitter, H Kehlet
Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation Database for Fast-track Hip and Knee Replacement introduced preoperative methylprednisolone (MP) 125 mg as part of a multimodal analgesic protocol in TKA. We analysed the risk of length of hospital stay (LOS) >4 days, 30 and 90 day readmissions in patients with MP vs patients having TKA before the use of MP and adjusted for comorbidity and place of surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28854408/wound-dehiscence-after-total-knee-arthroplasty
#8
Mohammad Ali Sazegari, Fateme Mirzaee, Fateme Bahramian, Zohreh Zafarani, Hamidreza Aslani
INTRODUCTION: Wound dehiscence is one of the most common complications of surgical ulcer, involving the breaking open of the surgical incision along the stitch. This condition is a severe complication of total knee arthroplasty. PRESENTATION OF CASE: We report a case of a 59-year-old female patient with diabetes who underwent a total knee arthroplasty in which all layers of wounds were dehiscence and prosthetic was exposed. DISCUSSION: Wound dehiscence is a complication after total knee arthroplasty especially in diabetic patient...
August 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28844631/improving-value-in-total-hip-and-knee-arthroplasty-the-role-of-high-volume-hospitals
#9
P Maxwell Courtney, Nicholas B Frisch, Daniel D Bohl, Craig J Della Valle
BACKGROUND: Recent healthcare reform efforts have focused on improving the quality of total joint replacement care while reducing overall costs. The purpose of this study is to determine if higher volume centers have lower costs and better outcomes than lower volume hospitals. METHODS: We queried the Centers for Medicare and Medicaid Services (CMS) Inpatient Charge Data and identified 2702 hospitals that performed a total of 458,259 primary arthroplasty procedures in 2014...
August 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28838614/implementation-of-preoperative-screening-criteria-lowers-infection-and-complication-rates-following-elective-total-hip-arthroplasty-and-total-knee-arthroplasty-in-a-veteran-population
#10
Fernando D Nussenbaum, David Rodriguez-Quintana, Sara M Fish, David M Green, Catherine W Cahill
BACKGROUND: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures with a risk of complications. Attempting to minimize complications, our institution implemented preoperative screening criteria for patients undergoing elective total joint replacement. Our study aimed to determine if screening criteria lowered total complications and/or surgical site infections (SSI). METHODS: Two groups of consecutive patients undergoing TKA and THA at a single Veterans Affairs facility were evaluated prior to and after implementation of screening criteria, 520 and 475 respectively...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28837455/revision-total-knee-arthroplasty-for-the-management-of-periprosthetic-fractures
#11
Paul R T Kuzyk, Evan Watts, David Backstein
Periprosthetic fractures after total knee arthroplasty (TKA) can present reconstructive challenges. Not only is the procedure technically complex, but patients with these fractures may have multiple comorbidities, making them prone to postoperative complications. Early mobilization is particularly beneficial in patients with multiple comorbidities. Certain patient factors and fracture types may make revision TKA the ideal management option. Periprosthetic fractures around the knee implant occur most frequently in the distal femur, followed by the tibia and the patella...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28828124/radiological-difficulty-in-identifying-unicompartmental-knee-replacement-dislocation
#12
Oruaro Adebayo Onibere, Iain Stevenson, Fraser Jonathan Gill
Unicondylar knee replacement is a relatively common elective orthopedic procedure but is not often seen in the Emergency Department setting. Familiarity with normal clinical and radiological appearances is difficult to gain. Dislocation of the mobile bearing component "spacer" is a known complication of unicondylar knee replacements, and these patients will initially present to the accident and Emergency Department. In this setting, an accurate and prompt diagnosis is necessary to appropriately manage the patient's condition...
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28821515/does-the-person-s-context-influence-engagement-in-life-activities-following-primary-knee-replacement-results-from-a-canadian-prospective-cohort-study
#13
Aileen M Davis, Viji Venkataramanan, Jessica Bytautas-Sillanpää, Anthony V Perruccio, Rosalind Wong, Lisa Carlesso, Fiona Webster
OBJECTIVE: The impact of the context of a person's life on recovery from surgical interventions is not well understood. This study evaluated if people's social, environmental and biomedical context was associated with change in frequency in engagement in life activities after total knee replacement (TKR). METHODS: 418 people aged 30+ years who had TKR were followed presurgery to 1 year postsurgery. The outcome was change in frequency in engagement in life activities measured by the Late Life Disability Index (LLDI)...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28819590/minimally-invasive-total-hip-replacement-in-an-ipsilateral-post-traumatic-above-knee-amputation-a-case-report
#14
Sanjeev Patnaik, Biswaranjan Nayak, Akshaya Kumar Sahoo, Nabin Kumar Sahu
INTRODUCTION: Total hip replacement (THR) is a highly successful operation in alleviating pain and improving the overall function of the hip, in end-stage arthritis of the hip, in otherwise fit patients. However, THR as a surgical option in post-traumatic hip arthritis with ipsilateral above-knee amputation is rarely reported. CASE REPORT: We are presenting a case report of a 30-year-old male, who had previously underwent an above-knee amputation due to road-traffic accident, presenting 24 h after the injury with segmental fracture femur and popliteal artery laceration, for which the limb could not be salvaged...
March 2017: Journal of Orthopaedic Case Reports
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/28776632/interprosthetic-fractures-of-the-femur
#16
Nicholas M Romeo, Reza Firoozabadi
As the rate of hip and knee arthroplasty procedures increases, so will the rate of interprosthetic fractures. Several factors, including bone quality, bone quantity, and stability of the prosthetic components, play a role in determining the appropriate operative treatment. Patients with stable components should undergo reduction and internal fixation, while patients with loose components should undergo either revision arthroplasty, with or without additional fixation, or conversion to total femur replacement...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28775218/predictive-factors-for-length-of-hospital-stay-following-primary-total-knee-replacement-in-a-total-joint-replacement-centre-in-hong-kong
#17
C K Lo, Q J Lee, Y C Wong
INTRODUCTION: The demand for total knee replacement in Hong Kong places tremendous economic burden on our health care system. Shortening hospital stay reduces the associated cost. The aim of this study was to identify perioperative predictors of length of hospital stay following primary total knee replacement performed at a high-volume centre in Hong Kong. METHODS: We retrospectively reviewed all primary total knee replacements performed at Yan Chai Hospital Total Joint Replacement Centre from October 2011 to October 2015...
October 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28767456/effects-of-anaesthesia-and-analgesia-on-long-term-outcome-after-total-knee-replacement-a-prospective-observational-multicentre-study
#18
Dario Bugada, Massimo Allegri, Marco Gemma, Andrea L Ambrosoli, Giuseppe Gazzerro, Fernando Chiumiento, Doriana Dongu, Fiorella Nobili, Andrea Fanelli, Paolo Ferrua, Massimo Berruto, Gianluca Cappelleri
BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28765007/combined-intravenous-topical-and-oral-tranexamic-acid-administration-in-total-knee-replacement-evaluation-of-safety-in-patients-with-previous-thromboembolism-and-effect-on-hemoglobin-level-and-transfusion-rate
#19
Joris A Jansen, Joost R C Lameijer, Barbara A M Snoeker
BACKGROUND: The aims of this study were to investigate the safety of combined intravenous, oral and topical tranexamic acid (TXA) in primary total knee replacement. We assessed dose-related efficacy on hemoglobin level, transfusion, length of stay and thromboembolic complications. In addition, TXA safety in patients with previous history of thromboembolism >12months ago was monitored specifically. METHODS: From January 2013 until January 2016, 922 patients were included who received TXA after primary total knee replacement...
July 29, 2017: Knee
https://www.readbyqxmd.com/read/28760121/comparison-of-intravenous-and-intra-articular-tranexamic-acid-in-reducing-blood-loss-in-primary-total-knee-replacement
#20
Marek Lacko, Robert Cellar, Daniela Schreierova, Gabriel Vasko
OBJECTIVES: This study aims to compare the efficacy and safety of intra-articular tranexamic acid (TA) versus intravenous (IV) TA in the reduction of perioperative blood loss and the degree of early postoperative complications associated with primary unilateral cemented total knee replacement. PATIENTS AND METHODS: This prospective randomized study included 90 patients (36 males, 54 females; mean age 68.7 years; range 47 to 82 years) with knee osteoarthritis undergoing a unilateral cemented total knee replacement...
August 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
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