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Knee replacement complications

Joan Manuel Burdeus González-Solís, Iván Díez-Santacoloma, Albert Isidro Llorens
Anterior tibial tubercle (ATT) osteotomy facilitates exposure in knee arthroplasty. However, it is not without complications. We have introduced some technical modifications that reduce the surgical aggression by designing a short osteotomy that does not invade the intramedullary canal, and synthesizing it with three cerclage wires with a particular layout that increases the solidity of the system. A retrospective review was performed on the surgical revision of total knee replacement cases intervened in our center that required an ATT osteotomy from February 2014 to February 2015, and who had a minimum clinical follow-up of 12 months...
October 21, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Nicholas Arlas, Harry Jergesen
Factors endemic in safety-net hospitals may breed poor outcomes in hip and knee arthroplasty. This review highlights these challenges and discusses strategies to reduce operative risk and promote better surgical outcomes. Sub-optimally managed medical co-morbidities, poverty, and substance abuse are examples of challenges common in safety-net hospital populations and are associated with poor surgical outcomes. Patient management strategies that positively affect surgical outcomes may be nonexistent, underfunded, or underused...
2016: Journal of Health Care for the Poor and Underserved
Christoffer C Jørgensen, Henrik Kehlet
Background - The benefit of preoperative bridging in surgical patients with continuous anticoagulant therapy is debatable, and drawing of meaningful conclusions may have been limited by mixed procedures with different thromboembolic and bleeding risks in most published studies. Patients and methods - This was an observational cohort treatment study in consecutive primary unilateral total hip and knee arthroplasty patients between January 2010 and November 2013 in 8 Danish fast-track departments. Data were collected prospectively on preoperative comorbidity and anticoagulants in patients with preoperative vitamin K antagonist (VKA) treatment...
October 19, 2016: Acta Orthopaedica
Basim Kamil Hassan, Ram Benny Christian Dessau, Arne Sahlström
BACKGROUND: Permanent renal dysfunction is considered as being a serious complication which may occur after major surgery and which furthermore may lead to increased morbidity and mortality. The objective of this study was to analyze the incidence of long-term postoperative renal dysfunction after primary total hip and knee joint replacements. METHODS: Long-term postoperative renal dysfunction was analyzed in a retrospective study of 1301 consecutive primary total hip and knee joint replacements performed between January 2009 and December 2013...
October 19, 2016: Journal of Orthopaedic Surgery and Research
Jamshed J Dalal, Anil Dhall, Abhay Bhave
Oral vitamin K antagonists (VKA) such as warfarin have been the mainstay of therapy for stroke prevention in patients with non valvular atrial fibrillation (NVAF) while low-molecular-weight heparin, fondaparinux and adjusted-dose warfarin or aspirin have been routinely used for thromboembolism (VTE) prophylaxis in patients undergoing total hip or knee replacement. However, VKAs are associated with considerable limitations, including increased risk of bleeding and narrow therapeutic window. Novel oral anticoagulants (NOACs, now referred as Non Vit K dependent oral anticoagulants), including the direct thrombin inhibitor dabigatran and direct Factor Xa inhibitors such as rivaroxaban and apixaban are now approved alternatives to warfarin for prophylaxis of stroke and systemic embolic events (SEE) in patients with NVAF and treatment and prophylaxis of VTE...
April 2016: Journal of the Association of Physicians of India
Surachai Kotirum, Bunchai Chongmelaxme, Nathorn Chaiyakunapruk
To analyze the cost-utility of oral dabigatran etexilate, enoxaparin sodium injection, and no intervention for venous thromboembolism (VTE) prophylaxis after total hip or knee replacement (THR/TKR) surgery among Thai patients. A cost-utility analysis using a decision tree model was conducted using societal and healthcare payers' perspectives to simulate relevant costs and health outcomes covering a 3-month time horizon. Costs were adjusted to year 2014. The willingness-to-pay threshold of THB 160,000 (USD 4926) was used...
October 4, 2016: Journal of Thrombosis and Thrombolysis
Bayan Ghalimah, Amre Hamdi
INTRODUCTION: Infection poses a substantial challenge after joint replacement. CASE PRESENTATION: We report a 53-year-old female with multiple co-morbidities, who underwent unilateral total knee arthroplasty. Her postoperative course was complicated by acute cholecystitis necessitating cholecystectomy. CONCLUSION: In patients who require joint replacement surgery, careful and detailed preoperative assessment is important to identify those at risk for this complication in order to provide timely treatment...
April 2016: Journal of Orthopaedic Case Reports
Karim Masmoudi, Yamen Grissa, Sofien Benzarti, Hassen Cheikhrouhou, Zied Mensi
INTRODUCTION: Periprosthetic patellar fracture after total knee arthroplasty (TKA) is a rare complication. Their management can be very challenging with unpredictable results. Literature analysis showed few articles about this complication, but no publication has described the management of open patella fracture around total knee arthroplasty. CASE PRESENTATION: We report a unique case of an open patellar fracture above a total knee arthroplasty, sustained by a 56-year-old female patient...
April 2016: Journal of Orthopaedic Case Reports
Mohammed Shaath, Mohamed Sukeik, Saadallah Mortada, Sean Masterson
Compartment syndrome is a rare complication of total knee replacement (TKR) surgery that needs prompt diagnosis and treatment as it may be associated with high morbidity and mortality. We have found very few reports in the literature describing compartment syndrome after TKRs and therefore, present a relevant case which occurred in the immediate postoperative phase and was treated with fasciotomy and subsequent operations to close the soft tissue defects.
September 18, 2016: World Journal of Orthopedics
Amaia Ormaza, Jesús Moreta, Javier Mosquera, Oskar Sáez de Ugarte, José Luis Martinez-de Los Mozos
Tear of the quadriceps tendon after revision or primary total knee arthroplasty is a rare complication, but when it occurs, this injury has serious functional consequences. In complete tears, the outcome of direct repair is unpredictable, and several authors recommend that the suture should be reinforced. Several techniques have been described, including the use of autografts, allografts, and synthetic mesh. The goal of this study was to assess the outcomes of a reconstruction technique augmented with synthetic mesh...
September 19, 2016: Orthopedics
Norberto Confalonieri, Alessio Biazzo, Pietro Cerveri, Chris Pullen, Alfonso Manzotti
PURPOSE: At the beginning of this century, unprecedented interest in the concept of using less invasive approaches for the treatment of knee degenerative diseases was ignited. Initial interest in this approach was about navigated and non-navigated knee reconstruction using small implants and conventional total knee arthroplasty. METHODS: To this end, a review of the published literature relating to less invasive compartmental arthroplasty of the knee using computer-based alignment techniques and on soft tissue-dedicated small implants is presented...
September 15, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kuang-Ming Liao, Hsueh-Yi Lu
The incidence and prevalence of chronic obstructive pulmonary disease (COPD) is associated with increasing age. Osteoarthritis is also a growing problem in the aging population, and total knee replacement (TKR) is a common surgical procedure for this population. An increasing number of COPD patients are receiving TKR, but few studies have examined the complications and outcomes after TKR in COPD patients. The purpose of this study was to investigate the complications, including mortality, wound infections, hospitalization readmission, pneumonia (PN), and cerebrovascular accidents (CVAs) in patients with COPD after receiving TKR...
September 2016: Medicine (Baltimore)
Alexandra I Stavrakis, Nelson F SooHoo
BACKGROUND: This study provides an updated comparison of the reoperation rates following primary ankle arthrodesis and total ankle replacement on the basis of observational, population-based data from California. We previously reported data from 1995 to 2004, and our current study includes new data from 2005 to 2010. Our hypothesis was that total ankle replacement would demonstrate increasing utilization and lower complication rates given advances in implant design and growth in surgeon experience...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
Adam Daniel Gerrard, Ben Brooks, Peter Asaad, Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Postoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; and the Cochrane Central Register of Controlled Trials (CENTRAL)...
September 3, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Xiaoyu Yan, Xiaohua Gu, Lei Zhou, Houweng Lin, Bin Wu
BACKGROUND AND OBJECTIVES: Apixaban and enoxaparin are indicated for preventing venous thromboembolism (VTE). The aim of this study was to evaluate the cost effectiveness of apixaban versus enoxaparin for the prophylaxis of VTE and associated long-term complications in Chinese patients after total knee replacement (TKR). METHODS: A decision model, which included both acute VTE (represented as a decision tree) and the long-term complications of VTE (represented as a Markov model), was developed to assess the economic outcomes of the two prophylactic strategies for Chinese patients after TKR...
August 31, 2016: Clinical Drug Investigation
S M J Mortazavi, B Haghpanah, M M Ebrahiminasab, T Baghdadi, G Toogeh
INTRODUCTION: Haemophilic arthropathy (HA) is a debilitating complication of haemophilia which leads to TKA in severe cases. AIM: We conducted a prospective study of the outcome of TKA in our haemophilia cohort to define the outcomes in this population and increase the cost effectiveness of the procedure in our developing country. METHODS: We reviewed patients with haemophilia who underwent TKA between April 2010 and April 2014. Patients with at least 6 months of follow-up were included...
August 26, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Aslam Ejaz, Faiz Gani, Yuhree Kim, Timothy M Pawlik
BACKGROUND: Comparative data on surgeon payments for operative procedures are not well documented. We sought to assess variations in surgeon payments after common general and orthopedic operations using a nationally representative sample of privately insured patients. METHODS: A total of 486,506 patients who underwent a general (appendectomy, cholecystectomy, colectomy) or orthopedic (total knee replacement, total hip replacement) operation between 2010-2012 were identified from the Truven Health MarketScan database...
August 20, 2016: Surgery
Yvonne R A Kerkhoff, Nienke M Kosse, Wieneke P Metsaars, Jan Willem K Louwerens
BACKGROUND: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed. This prospective study presents the long-term survivorship and postoperative complications of the STAR prosthesis. METHODS: Between May 1999 and June 2008, 134 primary total ankle arthroplasties were performed using the STAR prosthesis in 124 patients...
August 18, 2016: Foot & Ankle International
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
PURPOSE: Laboratory diagnostics are part of the routine before and after operations. In all specialist surgical disciplines, including orthopaedic surgery, the acute-phase protein CRP is used to detect inflammatory processes, especially infections. The potential influence of patient gender on the postoperative course of CRP after TKA implantation is still unclear. In order to achieve a more precise evaluation of the complication-free general CRP course after TKA, the objective of the present study is to test the hypothesis that the p...
October 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Guido Scoccianti, Filippo Frenos, Giovanni Beltrami, Domenico Andrea Campanacci, Rodolfo Capanna
INTRODUCTION: Infection in megaprostheses remains an unsolved problem, with a rate of occurrence ranging from 5% to 12%. Silver coating of medical devices has recently been proposed to reduce infection rate because of the antibacterial effect of silver. This innovation could be particularly interesting for megaprostheses, but few data have been reported in the literature. MATERIALS AND METHODS: From June 2010 to August 2014 a modified MegaC System megaprosthesis with an innovative peripheral silver-added layer of titanium alloy ('Porag') was implanted in 33 patients after previous infection (21 patients) or at high risk for infection because of local or general conditions (12 patients)...
August 11, 2016: Injury
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