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Knee replacement complications

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https://www.readbyqxmd.com/read/28231650/blood-sparing-efficacy-of-oral-tranexamic-acid-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#1
Qunn Jid Lee, Wai Yee Ching, Yiu Chung Wong
Purpose: Tranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA. Materials and Methods: All patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28211301/early-results-of-patellofemoral-inlay-resurfacing-arthroplasty-using-the-hemicap-wave-prosthesis
#2
Akash Patel, Zakir Haider, Amarjit Anand, Dominic Spicer
BACKGROUND: Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210821/p-f-c-sigma-%C3%A2-cruciate-retaining-fixed-bearing-versus-mobile-bearing-knee-arthroplasty-a-prospective-comparative-study-with-minimum-10-year-follow-up
#3
O Riaz, A Aqil, G Sisodia, G Chakrabarty
AIMS: To prospectively compare long-term clinical and radiological outcomes following a cruciate retaining fixed-bearing (FB) and a mobile-bearing (MB) primary total knee replacement (TKR). METHODS: We prospectively reviewed 113 TKRs in 99 patients (14 bilateral) with a PFC sigma cruciate retaining rotating platform system, at an average follow-up of 11.1 years (range 10-12). Results were contrasted with those from 89 TKRs in 72 patients (17 bilateral) with a PFC sigma cruciate fixed-bearing prosthesis, at an average follow-up of 12...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28195304/association-between-psychological-health-and-wound-complications-after-surgery
#4
P Britteon, N Cullum, M Sutton
BACKGROUND: Surgical wound complications remain a major cause of morbidity, leading to higher costs and reduced quality of life. Although psychological health is widely considered to affect wound healing, the evidence on wound outcomes after surgery is mixed. Studies generally focus on small samples of patients undergoing a specific procedure and have limited statistical power. METHODS: This study investigated the relationship between three different measures of anxiety and/or depression and seven adverse surgical outcomes using observational data collected before and after surgery between 2009 and 2011...
February 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#5
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
February 10, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28174415/comparison-of-enoxaparin-and-rivaroxaban-in-balance-of-anti-fibrinolysis-and-anticoagulation-following-primary-total-knee-replacement-a-pilot-study
#6
Jinwei Xie, Jun Ma, Qiang Huang, Chen Yue, Fuxing Pei
BACKGROUND This study aimed to assess whether the efficacy of tranexamic acid (TXA) would be altered when rivaroxaban or enoxaparin was used for thromboprophylaxis in primary total knee replacement (TKR). It was hypothesized that the hemostatic effect of TXA would be better with the use of enoxaparin. MATERIAL AND METHODS A randomized clinical trial was conducted on 194 patients undergoing primary TKR for osteoarthritis. An intravenous dose of 15 mg/kg (TXA) and 1 g topical TXA were used. Patients randomly received enoxaparin or rivaroxaban prophylaxis when the drainage was less than 30 ml/h 6-8 h postoperatively...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28169136/in-vitro-wear-of-ultrahigh-molecular-weight-polyethylene-and-vitamin-e-blended-highly-cross-linked-polyethylene-in-linked-semiconstrained-total-elbow-replacement-prostheses
#7
Oludele O Popoola, Brian L Kincaid, Kimberly Mimnaugh, Mark Marqueling
BACKGROUND: The objectives of this study were to develop a clinically relevant in vitro elbow wear test and to compare the polyethylene wear of 2 total elbow replacement prostheses, one that uses conventional gamma-irradiated polyethylene (CPE) and one that uses vitamin E blended and cross-linked polyethylene (VE-HXPE) bushings. MATERIALS AND METHODS: The test protocol applied 0° to 85° flexion-extension motions and imposed a constant 4.5° varus malalignment of the ulnar relative to the humeral implant under a variable joint load profile at a frequency of 1 Hz...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28164047/management-of-infected-total-knee-arthroplasty-by-a-new-innovative-customized-articulating-knee-spacer-an-early-experience
#8
Dhiraj P Marothi, Vipin Sharma, Ashish N Sheth, Vikram I Shah, L Bharath, J A Pachore
INTRODUCTION: Management of infected total knee arthroplasty (TKA) is a challenge to patient and surgeon alike. Two-stage exchange is the universally acclaimed method to tackle this problem. Various spacer devices are available for the first stage surgery for local delivery of antibiotics. Here, we report our experience with management of infected TKA patients with our indigenously designed and produced knee spacer. CASE REPORT: Between 2012 and 2013, 28 patients with infected total knee replacement (TKR) have been managed by our indigenous knee spacer...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28150297/time-course-and-reasons-for-90-day-mortality-in-fast-track-hip-and-knee-arthroplasty
#9
C C Jørgensen, H Kehlet
BACKGROUND: Post-operative mortality is an important adverse outcome, including in total hip (THA) and knee arthroplasty (TKA). However, whether mortality is due to anaesthetic/surgical complications, surgically induced organ dysfunction or unrelated to surgery is rarely considered. METHODS: Prospective observational study in 13,775 consecutive THA/TKAs with similar fast-track protocols and a median length of stay of 2 days. Complete 90-days follow-up through national registries, followed by review of medical records and death certificates...
February 1, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28144717/-individualized-unicondylar-knee-replacement-use-of-patient-specific-implants-and-instruments
#10
J Arnholdt, B M Holzapfel, L Sefrin, M Rudert, J Beckmann, A F Steinert
OBJECTIVE: Unicompartmental knee replacement in patients with osteoarthritis (OA) of the medial compartment. Individualized instruments and implants with a planning protocol for optimal fit. The individualized instruments and implants (ConforMIS Inc.; Burlington, MA, USA) are manufactured based on a computed tomography scan of the affected lower extremity and are provided together with a planning protocol (iView®) of the surgery. INDICATIONS: Unicompartmental OA of the knee (Kellgren & Lawrence stage IV) or Morbus Ahlbäck after unsuccessful conservative or joint preserving surgery...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28144716/bicompartmental-individualized-knee-replacement-use-of-patient-specific-implants-and-instruments-iduo%C3%A2
#11
A F Steinert, J Beckmann, B M Holzapfel, M Rudert, J Arnholdt
OBJECTIVE: Bicompartmental knee replacement in patients with combined osteoarthritis (OA) of the medial or lateral and patellofemoral compartment. Patient-specific instruments and implants (ConforMIS iDuo™) with a planning protocol for optimal implant fit. INDICATIONS: Bicompartmental OA of the knee (Kellgren & Lawrence stage IV) affecting both the medial or lateral and patellofemoral compartment after unsuccessful conservative or joint-preserving surgery. CONTRAINDICATIONS: Tricompartmental OA, knee ligament instabilities, knee deformities >15° (varus, valgus, extension deficit)...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28131634/comminuted-intraarticular-fractures-of-the-tibial-plateau-lead-to-posttraumatic-osteoarthritis-of-the-knee-current-treatment-review
#12
REVIEW
Matthias Aurich, Veit Koenig, Gunther Hofmann
Posttraumatic osteoarthritis (PTOA) of the knee is a common complication after intra- and extra-articular fractures. Moreover, PTOA may also be a result of isolated cartilage defects, meniscus resections, and ligament injuries. There are various methods of treatment of knee joint fractures. However, in the final stage of a PTOA, when nonoperative treatment fails, endoprosthetic joint replacement is the method of choice. Primary total knee replacement (TKR) for the treatment for a fracture of the knee joint is a rare indication, even at major treatment centers...
January 25, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28128085/antiphospholipid-syndrome-with-anti%C3%AE-2glicoprotein-1-antibodies-as-the-cause-of-recurrent-tibial-vein-thrombosis-in-sapho-syndrome
#13
Hanna Przepiera-Będzak, Marek Brzosko
The antiphospholipid antibody syndrome is defined by the presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism (1). SAPHO syndrome is a rare disease, characterized by specific clinical manifestations of synovitis, acne pustulosis, hyperostosis, and osteitis. It is a disease that manifests with a combination of osseous and articular manifestations associated with skin lesions (2). Venous thrombosis complicating SAPHO syndrome seems to be uncommon with an unclear pathogenesis (3-9)...
December 2016: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28122467/high-blood-metal-ion-levels-in-19-of-22-patients-with-metal-on-metal-hinge-knee-replacements
#14
Minna Laitinen, Jyrki Nieminen, Aleksi Reito, Toni-Karri Pakarinen, Piia Suomalainen, Konsta Pamilo, Jyrki Parkkinen, Tonis Lont, Antti Eskelinen
Background and purpose - There has been increasing alarm regarding metal-on-metal (MoM) joint replacements leading to elevated levels of metal ions and adverse reactions to metal debris (ARMDs). There is little information available concerning the prevalence of and risk factors for these adverse reactions, except with MoM hip joint replacements. We determined the levels of metal ions in blood and the rate of revision due to ARMDs in patients treated with MoM hinge total knee arthroplasty (TKA). Patients and methods - 22 patients with TKAs and MoM hinge connecting mechanisms were studied for whole-blood chromium and cobalt levels at 6 months, 1 year, and/or ≥2 years after surgery...
January 26, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28116277/broken-pieces-of-circlage-wire-lying-in-soft-tissue-envelope-around-knee-joint-a-case-report-and-review-of-literature
#15
Anoop Kalia, Kavin Khatri, Jagdeep Singh, Kapil Bansal, Mohammed Sagy
INTRODUCTION: The migration of circlage wires used in tension band wiring construct of patella fractures in the posterior soft tissue envelope surrounding the knee joint has been rarely reported. CASE PRESENTATION: A 60-year-old woman presented to us with pain over medial aspect of right knee joint. She underwent open reduction and internal fixation for a patellar fracture which she sustained 4 years back and subsequently underwent kirschner wire(k wire) removal for the same around 2 years back...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28115800/a-3%C3%A2-year-minimum-follow-up-of-endoprosthetic-replacement-for-distal-femoral-fractures-an-alternative-treatment-option
#16
A Atrey, N Hussain, O Gosling, P Giannoudis, A Shepherd, S Young, J Waite
INTRODUCTION: Although the use of an endoprosthesis for distal femoral fractures remains a valid treatment option the widespread use is in its infancy. METHODOLOGY: In this retrospective case series, we review cases of distal femoral fracture treated with endoprosthetic replacement (EPR). The outcomes we assessed were the time to start mobilising, the time to discharge, morbidity and mortality as well as an Oxford knee score to assess pain and function and also the early survivorship...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#17
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#18
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28073671/fast-track-recovery-technique-applied-to-primary-total-hip-and-knee-replacement-surgery-analysis-of-costs-and-complications
#19
C Wilches, J D Sulbarán, J E Fernández, J M Gisbert, J M Bausili, X Pelfort
PURPOSE: To determine the cost reduction and complication rates of using an enhanced recovery pathway (Fast-track) when compared to traditional recovery in primary total hip replacement (THR) and total knee replacement (TKR), as well as to determine if there were significant differences in complication rates. MATERIAL AND METHODS: Retrospective review of 100 primary total arthroplasties using the Fast-track recovery system and another 100 using conventional recovery...
January 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28073138/-long-term-complications-due-to-polyethylene-wear-in-total-knee-arthroplasty-a-case-report
#20
Matthias Aurich
This is the case of an 84-year-old patient 18 years after total knee replacement. Regular follow-up examinations did not take place beyond 10 years of implantation, so that subsequent wear of the polyethylene insert was not detected. The patient presented because of knee pain, swelling of the calf, and a drop foot. Examination showed a large ganglion with pressure on the peroneal nerve, and a loose knee replacement with severe inlay wear and extensive osteolysis around the tibial and femoral implants. This rare case demonstrates the importance of regular clinical and radiological follow-up examinations after total joint replacements, particularly in the long term...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
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