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Knee replacement complications

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https://www.readbyqxmd.com/read/29911082/the-use-of-tourniquet-during-total-knee-replacement-in-patients-with-and-without-popliteal-artery-calcification
#1
Thiago Vivacqua, Murilo Barroso, Pedro Matos, Rodrigo Pires E Albuquerque, Naasson Cavanellas, João Maurício Barretto
Objective: Identify the clinical and surgical complications associated with the use of a tourniquet in total knee arthroplasty in patients with or without calcification of the popliteal artery. Methods: The study was performed retrospectively, analyzing 58 patients with calcification of the popliteal artery and 57 patients as a control group. Results: The case group patients were significantly older than patients in the control group; however, this had no impact on the clinical outcome in the analyzed period...
March 2018: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29896557/arthroplasty-care-redesign-related-to-the-comprehensive-care-for-joint-replacement-model-results-at-a-tertiary-academic-medical-center
#2
Chancellor F Gray, Hernan A Prieto, Andrew T Duncan, Hari K Parvataneni
Background: Total joint arthroplasty (TJA) remains the highest expenditure in the Centers for Medicare and Medicaid Services (CMS) budget. One model to control cost is the Comprehensive Care for Joint Replacement (CJR) model. There has been no published literature to date examining the efficacy of CJR on value-based outcomes. The purpose of this study was to determine the efficacy and sustainability of a multidisciplinary care redesign for total joint arthroplasty under the CJR paradigm at an academic tertiary care center...
June 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29881304/resource-use-and-costs-associated-with-opioid-induced-constipation-following-total-hip-or-total-knee-replacement-surgery
#3
Eric T Wittbrodt, Tong J Gan, Catherine Datto, Charles McLeskey, Meenal Sinha
Purpose: Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC). Patients and methods: This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29881177/minimally-invasive-versus-conventional-approaches-in-total-knee-replacement-arthroplasty-a-review-of-the-literature
#4
REVIEW
Themistoklis Tzatzairis, Aliki Fiska, Athanasios Ververidis, Konstantinos Tilkeridis, Konstantinos Kazakos, Georgios I Drosos
Background: Life expectancy lengthening and aging of population resulted in dramatically increase of patients with osteoarthritis. Total knee arthroplasty is widely used as the gold standard in order to relieve pain, correct deformity and restore function. A contemporary and controversial topic, is that of minimally invasive surgery for TKA. The minimally invasive approaches are based on the concept that they don't violate the extensor mechanism, resulting in earlier functional recovery, shorter hospital stay and enhanced patients' overall satisfaction...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29880403/health-literacy-and-surgery-expectations-in-total-hip-and-knee-arthroplasty-patients
#5
Kristie B Hadden, Latrina Y Prince, Marty K Bushmiaer, Jamie C Watson, C Lowry Barnes
OBJECTIVES: This study assessed patients' health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers. METHODS: A convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study. RESULTS: Results demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery...
May 28, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29878899/do-hospitals-performing-frequent-neuraxial-anesthesia-for-hip-and-knee-replacements-have-better-outcomes
#6
Stavros G Memtsoudis, Jashvant Poeran, Nicole Zubizarreta, Ashley Olson, Crispiana Cozowicz, Eva E Mörwald, Edward R Mariano, Madhu Mazumdar
BACKGROUND: Neuraxial anesthesia is increasingly recommended for hip/knee replacements as some studies show improved outcomes on the individual level. With hospital-level studies lacking, we assessed the relationship between hospital-level neuraxial anesthesia utilization and outcomes. METHODS: National data on 808,237 total knee and 371,607 hip replacements were included (Premier Healthcare 2006 to 2014; 550 hospitals). Multivariable associations were measured between hospital-level neuraxial anesthesia volume (subgrouped into quartiles) and outcomes (respiratory/cardiac complications, blood transfusion/intensive care unit need, opioid utilization, and length/cost of hospitalization)...
June 7, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29806814/risk-factors-for-infection-revision-death-blood-transfusion-and-longer-hospital-stay-3-months-and-1-year-after-primary-total-hip-or-knee-arthroplasty
#7
Chanseok Rhee, Lynn Lethbridge, Glen Richardson, Michael Dunbar
BACKGROUND: Total joint replacement (TJR) is increasingly performed in older patients with more comorbidities, who are considered at higher risk for postoperative complications. We aimed to identify and calculate the odds ratio of the risk factors for infection, revision and death 3 months and 1 year after TJR as well as for postoperative blood transfusion and longer hospital stay. METHODS: We analyzed all primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) cases in Nova Scotia between Apr...
June 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29799669/participation-in-regular-physical-activity-after-total-knee-or-hip-arthroplasty-for-osteoarthritis-prevalence-associated-factors-and-type
#8
Justine M Naylor, Natasha Pocovi, Joseph Descallar, Kathryn A Mills
OBJECTIVE: This study aimed to describe the: rates of participation in regular physical activity (PA) pre- and 3-years following knee or hip arthroplasty; factors associated with participation post-surgery; and types of activity undertaken. METHODS: A previously acquired, multicentre, prospective cohort of knee or hip arthroplasty recipients was followed-up 3-years post-surgery. Regular participation in PA was defined as participation in PA ≥1 times/week, excluding incidental activities...
May 25, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29799668/the-impact-of-information-presentation-format-on-preferencefor-total-knee-replacement-surgery
#9
Liana Fraenkel, W Benjamin Nowell, Christine E Stake, Shilpa Venkatachalam, Rachel Eyler, George Michel, Ellen Peters
BACKGROUND: Patients have a poor understanding of outcomes related to total knee replacement (TKR) surgery, with most underestimating the potential benefits and overestimating the risk of complications. In this study, we sought to compare the impacts of descriptive information alone or in combination with an icon array (IA), experience condition (images), or spinner on participants' preference for TKR. METHODS: 648 members of an online arthritis network were randomized to one of four outcome presentation formats: numeric only, numeric with an IA, numeric with a set of 50 images, and numeric with a functional spinner...
May 25, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29797093/posterior-dislocation-following-revision-total-knee-replacement-arthroplasty-a-case-report-and-literature-analysis
#10
REVIEW
Ho Min Lee, Jong Pil Kim, Phil Hyun Chung, Suk Kang, Young Sung Kim, Bo Seong Go
Knee dislocation following total knee replacement arthroplasty is a rare but serious complication. The incidence of dislocation following primary total knee arthroplasty with posterior stabilized implants ranges from 0.15 to 0.5%, and posterior dislocation after revision total knee arthroplasty is even rarer. Here, we report the case of a 76-year-old male who presented with posterior dislocation after posterior stabilized revision total knee arthroplasty.
May 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29791703/biological-intercalary-reconstruction-with-bone-grafts-after-joint-sparing-resection-of-the-lower-limb-is-this-an-effective-and-durable-solution-for-joint-preservation
#11
Francesco Muratori, Francesca Totti, Antonio D'Arienzo, Maurizio Scorianz, Guido Scoccianti, Giovanni Beltrami, Francesco Rosario Campo, Carmine Citarelli, Rodolfo Capanna, Domenico Andrea Campanacci
Due to advances in neoadjuvant therapies and preoperative imaging modalities, joint-sparing resections have become appealing in bone tumor surgery. However, the intercalary reconstruction of metadiaphyseal bone defects of the femur and the tibia after juxta-articular tumor resection remains challenging. Both biological and prosthetic reconstructions have been used for joint-sparing resections, but little is known about the long-term outcome of these procedures. The authors reviewed a consecutive series of 64 patients treated with joint-sparing intercalary resection and reconstruction with bone grafts...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29788949/range-of-motion-after-total-knee-arthroplasty-in-hemophilic-arthropathy
#12
Radovan Kubeš, Peter Salaj, Rastislav Hromádka, Josef Včelák, Aleš Antonín Kuběna, Monika Frydrychová, Štěpán Magerský, Michal Burian, Martin Ošťádal, Jan Vaculik
BACKGROUND: Outcomes of total knee replacement in cases of hemophilic patients are worse than in patients who undergo operations due to osteoarthritis. Previous publications have reported varying rates of complications in hemophilic patients, such as infection and an unsatisfactory range of motion, which have influenced the survival of prostheses. Our retrospective study evaluated the data of hemophilic patients regarding changes in the development of the range of motion. METHODS: The data and clinical outcomes of 72 total knee replacements in 45 patients with hemophilia types A and B were reviewed retrospectively...
May 22, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29780621/thromboembolism-prophylaxis-in-orthopaedics-an-update
#13
Dimitrios A Flevas, Panayiotis D Megaloikonomos, Leonidas Dimopoulos, Evanthia Mitsiokapa, Panayiotis Koulouvaris, Andreas F Mavrogenis
Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death.Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%.VTE prophylaxis methods are divided into mechanical and pharmacological...
April 2018: EFORT open reviews
https://www.readbyqxmd.com/read/29780620/day-case-surgery-for-total-hip-and-knee-replacement-how-safe-and-effective-is-it
#14
Stefan Lazic, Oliver Boughton, Catherine F Kellett, Deiary F Kader, Loïc Villet, Charles Rivière
Multimodal protocols for pain control, blood loss management and thromboprophylaxis have been shown to benefit patients by being more effective and as safe (fewer iatrogenic complications) as conventional protocols.Proper patient selection and education, multimodal protocols and a well-defined clinical pathway are all key for successful day-case arthroplasty.By potentially being more effective, cheaper than and as safe as inpatient arthroplasty, day-case arthroplasty might be beneficial for patients and healthcare systems...
April 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29762447/gastrocnemius-myocutaneous-flaps-for-knee-joint-coverage
#15
Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29757058/outcomes-following-hip-and-knee-replacement-in-diabetic-versus-nondiabetic-patients-and-well-versus-poorly-controlled-diabetic-patients-a-prospective-cohort-study
#16
Erik Lenguerrand, Andrew D Beswick, Michael R Whitehouse, Vikki Wylde, Ashley W Blom
Background and purpose - The impact of diabetes and glycemic control before joint replacement on clinical and patient-reported outcomes is unclear. We compared pain, function, complications, and length of hospital stay in diabetic and nondiabetic patients receiving primary total hip (THR) or knee replacement (TKR) and compared these outcomes in patients with poorly controlled versus well-controlled diabetes. Patients and methods - We conducted a prospective cohort study of patients undergoing primary THR (n = 300) or TKR (n = 287) for osteoarthritis...
May 14, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29737288/effect-of-different-types-of-anticoagulants-in-the-prevention-of-venous-thrombosis-in-the-operation-of-knee-joint-bone-operation
#17
Wensheng Xu, Tao Zhang, Zenghua Yang, Lin Nie
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29735456/effect-of-different-types-of-anticoagulants-in-the-prevention-of-venous-thrombosis-in-the-operation-of-knee-joint-bone-operation
#18
Wensheng Xu, Tao Zhang, Zenghua Yang, Lin Nie
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29721359/acute-cauda-equina-syndrome-following-orthopedic-procedures-as-a-result-of-epidural-anesthesia
#19
Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields
Background: Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction. Case Description: The first patient underwent a hip replacement and received 5 mL of 1% lidocaine epidural anesthesia. Postoperatively, when the patient developed an acute CES, the lumbar magnetic resonance imaging (MRI) scan demonstrated clumping/posterior displacement of nerve roots of the cauda equina consistent with adhesive arachnoiditis attributed to the patient's previous L4-L5 lumbar decompression/fusion...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29703630/mid-to-long-term-survivorship-of-oxidised-zirconium-total-knee-replacements-performed-in-patients-under-50years-of-age
#20
Alexander W Glover, Alasdair J A Santini, John S Davidson, Jill A Pope
BACKGROUND: Oxidised zirconium has the wear properties of ceramic with the breakage resistance of metal. This results in less wear and is of benefit to younger, higher demand patients. We report the short- to mid-term survival of 103 Profix zirconium total knee replacements performed in patients under 50years of age at time of surgery. METHODS: Data was collected prospectively and survival analysis undertaken with strict end points used. SF (Short Form) 12 and WOMAC (Western Ontario and McMaster University) scores were recorded at pre-operatively and at twelve months, one, three, five, seven and ten years...
April 24, 2018: Knee
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