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Knee replacement complications

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https://www.readbyqxmd.com/read/27900474/bone-scan-usefulness-in-patients-with-painful-hip-or-knee-prosthesis-10-situations-that-can-cause-pain-other-than-loosening-and-infection
#1
REVIEW
Sofia Vaz, Teresa C Ferreira, Lucília Salgado, Frédéric Paycha
In recent years, with the higher median life expectancy, the number of hip and knee replacements has increased. Clinical examination and morphological studies are essential to evaluate patients with a painful arthroplasty. Nuclear medicine examinations also play an important role, their main usefulness being the exclusion of prosthesis complications. Nevertheless, conventional examinations, namely bone scan and white blood cell scintigraphy, can also identify complications, such as loosening and infection. This study describes the normal and pathologic patterns of a bone scan and exemplifies ten common situations that can cause pain in patients with hip or knee arthroplasty, other than loosening and infection, which can be disclosed on a bone scintigraphy...
November 30, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27895368/does-obesity-affects-early-infection-after-total-knee-arthroplasty-a-comparison-of-obese-vs-non-obese-patients
#2
Waseem Ahmed, Riaz Hussain Lakdawala, Yasir Mohib, Aurangzeb Qureshi, Rizwan Haroon Rashid
Surgical site infection (SSI) is a disastrous complication after total knee arthroplasty (TKA) which can cause prosthesis loosening and may end up in septicaemia. The incidence of infection reported to be in the range of 0.3-12.4% for primary TKA. Significantly higher infection rate is found in the morbidly obese patients. The current study compared the immediate rate of post-total knee replacement wound infection in the obese versus non-obese population. The cross-sectional study was conducted at Aga Khan University Hospital (AKUH) and comprised patients undergoing TKA for primary knee osteoarthritis...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27891054/patellofemoral-joint-arthroplasty-our-experience-in-isolated-patellofemoral-and-bicompartmental-arthritic-knees
#3
L Sabatini, M Schirò, F Atzori, G Ferrero, A Massè
INTRODUCTION: Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27878804/assessment-of-cardiovascular-risk-in-patients-undergoing-total-joint-alloplasty-the-crash-joint-study
#4
Pawel Legosz, Marcin Kotkowski, Anna E Platek, Pawel Maldyk, Bartosz Krzowski, Anna Rys, Karolina Semczuk, Filip M Szymanski, Krzysztof J Filipiak
BACKGROUND: Risk assessment is of particular importance for patients undergoing surgical interventions. Orthopedic procedures, especially total joint alloplasty are major procedure associated with high perioperative risk, as well as one of the highest rates of complications. The aim of the present study was to establish the prevalence of classical and non-classical cardiovascular risk factors in patients undergoing total hip or knee alloplasty. METHODS: The CRASH-JOINT (Cardiovascular Risk Assessment ScHeme in JOINT alloplasty) was a prospective, epidemiological study performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27871512/case-report-management-of-differential-diagnosis-and-treatment-of-severe-anaphylaxis-in-the-setting-of-spinal-anesthesia
#5
Brian M Osman, Joni M Maga, Sebastian M Baquero
The purpose of this case report is to educate fellow anesthesiologists of a complicated differential diagnosis for sudden cardiovascular collapse after spinal anesthesia. We report a case where anaphylaxis occurred while under spinal anesthesia and resulted in difficult resuscitation. A 58-year-old woman undergoing bilateral knee replacements under spinal anesthesia experienced sudden seizure and cardiovascular collapse from acute anaphylactic shock while administering a cephalosporin. Local anesthetic toxicity, high spinal, and anaphylaxis were considered due to overlapping of symptoms...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869619/five-year-survival-of-20-946-unicondylar-knee-replacements-and-patient-risk-factors-for-failure-an-analysis-of-german-insurance-data
#6
Elke Jeschke, Thorsten Gehrke, Christian Günster, Joachim Hassenpflug, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Andreas Halder
BACKGROUND: Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. METHODS: Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27846360/-non-traumatic-posterior-instability-in-primary-total-knee-replacement-and-its-revision
#7
E Carbó, R Laguna, F Del Moral, J Barrientos, J Vaquero
BACKGROUND: Dislocation after total knee arthroplasty is a rare complication and a difficult problem to address. When the flexion gap is larger than the extension gap and the collateral ligaments are injured, instability and knee arthroplasty dislocation can occur. MATERIAL AND METHODS: We report the case of a patient presenting with a posterior dislocation of a posterior-stabilized prosthesis without trauma. Frank instability in varus stress test and a positive anterior drawer test with tibial internal rotation dismissed the conservative treatment...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27827290/-knee-joint-distraction-a-solution-for-young-patients-with-osteoarthritis-of-the-knee
#8
T M Piscaer, O P van der Jagt, T Gosens
The current treatment for patients with end-stage generalised osteoarthritis of the knee is total knee replacement. In a recent paper in Plos One the authors examined an alternative approach, namely knee joint distraction. On the basis of a model, they claim that this treatment can postpone total knee replacement for about 20 years. This would reduce the costs for the healthcare services and improve quality of life for these patients. Although these claims seem promising, the model is only based on extrapolations of short-term results of small cohort studies...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27826627/-complications-and-costs-in-primary-knee-replacement-surgery-in-an-endoprosthetics-centre-influence-of-state-of-training
#9
C Windisch, S Brodt, E Röhner, G Matziolis
BACKGROUND: This work examines the hypothesis that in endoprosthesis implantation there are differences between experienced primary and senior caregivers (S-Op) and less experienced follow-up assistants (T-Op) with respect to process-relevant parameters. The main hypothesis is that compared to S‑Op, T‑Op cause significantly longer surgery times and thus additional operating theatre costs. As sub-hypotheses, differences in various perioperative (p-o) parameters between T‑Op and S‑Op were examined...
November 8, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27806517/current-trends-in-knee-arthroplasty
#10
Mohammadjavad Zehtab, Mohammadhassan Kaseb, Mohammadnaghi Tahmasebi, Mohammad Ayati Firoozabadi
Total knee arthroplasty (TKA) is a commonly performed surgical procedure designed to alleviate knee pain and improve function in individuals with knee osteoarthritis the purpose of collecting the latest information and updating the reports is to summarize the published articles and inform the colleagues. In so doing, the articles published in American journals of arthroplasty and joint surgery and the proceedings of the conferences that were mostly held in 2004 have been utilized so that delicate and precise spotlights retrieved from scholars' breakthroughs can be applied in daily medical practices...
July 25, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27795948/effect-of-body-mass-index-on-functional-outcome-in-primary-total-knee-arthroplasty-a-single-institution-analysis-of-2180-primary-total-knee-replacements
#11
Shane C O'Neill, Joseph S Butler, Adam Daly, Darren F Lui, Patrick Kenny
AIM: To evaluate the effect of body mass index (BMI) on short-term functional outcome and complications in primary total knee arthroplasty. METHODS: All patients undergoing primary total knee arthroplasty at a single institution between 2007 and 2013 were identified from a prospective arthroplasty database. 2180 patients were included in the study. Age, gender, BMI, pre- and post-operative functional scores [Western Ontario and McMaster University Arthritis Index (WOMAC) and SF-36], complications and revision rate were recorded...
October 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27790392/is-total-knee-replacement-justified-in-the-morbidly-obese-a-systematic-review
#12
Raju Vaishya, Vipul Vijay, David Wamae, Amit Kumar Agarwal
Total knee replacement (TKR) comprises a significant, growing aspect in the management of patients with advanced arthritis of the knee for which conservative medical therapy has failed. Obesity, a rising epidemic, is considered an important independent risk factor in the development of osteoarthritis (OA). An aging population and increasing incidence of obesity contribute to a higher prevalence of OA and a subsequent greater need for TKR. The numbers of morbidly obese (MO) people undergoing TKR has consistently been rising...
September 23, 2016: Curēus
https://www.readbyqxmd.com/read/27787574/outcome-of-knee-revisions-for-osteoarthritis-and-inflammatory-arthritis-with-postero-stabilized-arthroplasties-a-mean-ten-year-follow-up-with-90-knee-revisions
#13
Philippe Hernigou, Arnaud Dubory, Damien Potage, François Roubineau, Charles Henri Flouzat-Lachaniette
PURPOSE: Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require revision total knee replacement. Few studies have compared post-operative complications, results and risk of re-revision in RA and OA patients. MATERIAL AND METHODS: Forty-five RA patients who had undergone revision TKA from 1998 to 2010 were selected and matched with 45 OA patients who had revision during the same period. Results of the use of a revision postero-stabilized implant in osteoarthritis were compared to results of its use in inflammatory arthritis...
October 27, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27770285/anterior-tibial-tubercle-osteotomy-using-cerclage-wire-fixation-in-total-knee-replacement-a-modification-of-the-usual-technique
#14
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
https://www.readbyqxmd.com/read/27763467/hip-and-knee-replacement-in-safety-net-hospitals-recognizing-the-challenges
#15
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
https://www.readbyqxmd.com/read/27759465/thromboembolic-and-major-bleeding-events-in-relation-to-perioperative-bridging-of-vitamin-k-antagonists-in-649-fast-track-total-hip-and-knee-arthroplasties
#16
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
https://www.readbyqxmd.com/read/27756352/is-there-a-risk-of-permanent-renal-dysfunction-after-primary-total-hip-and-knee-joint-replacements
#17
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
https://www.readbyqxmd.com/read/27734642/current-perspective-on-use-of-noac-in-clinical-practice-in-india
#18
REVIEW
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
https://www.readbyqxmd.com/read/27704332/a-cost-utility-analysis-of-dabigatran-enoxaparin-and-usual-care-for-venous-thromboprophylaxis-after-hip-or-knee-replacement-surgery-in-thailand
#19
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
https://www.readbyqxmd.com/read/27703950/acute-cholecystitis-following-total-knee-replacement-a-case-report-and-literature-review
#20
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
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