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Knee replacement complications

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https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#1
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-health-care-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#2
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28314985/the-role-of-new-oral-anticoagulants-in-orthopaedics-an-update-of-recent-evidence
#3
REVIEW
Dimitrios V Papadopoulos, Ioannis Kostas-Agnantis, Ioannis Gkiatas, Andreas G Tsantes, Panagiota Ziara, Anastasios V Korompilias
Rivaroxaban, dabigatran, apixaban and edoxaban are the four available new oral anticoagulants (NOAC) which are currently approved for venous thromboembolism prophylaxis after total hip and knee replacement. Large phase 3 and phase 4 studies comparing NOAC with low molecular weight heparins have shown similar results regarding the efficacy and safety of these two categories of anticoagulants. Management of bleeding complications is a matter of great significance. Three reversal agents have been developed: idarucizumab, andexanet alfa and ciraparantag...
March 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28271180/metal-wear-induced-pseudotumour-following-an-endoprosthetic-knee-replacement-for-ewing-sarcoma
#4
Richard Craig, Marianna Vlychou, Catherine L McCarthy, Christopher L M H Gibbons, N A Athanasou
Pseudotumours are well recognised as a complication of metal-on-metal hip arthroplasties and are thought to develop on the basis of an innate and adaptive immune response to cobalt-chrome (Co-Cr) wear particles. We report a case of a large pseudotumour that developed following a knee endoprosthetic replacement (EPR) undertaken for Ewing sarcoma. The lesion contained necrotic and degenerate connective tissue in which there were numerous scattered metal wear-containing macrophages, eosinophil polymorphs, lymphocytes, plasma cells and aseptic lymphocyte-dominated vascular-associated lesion-like lymphoid aggregates...
March 7, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#5
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28260153/effects-of-different-methods-of-using-pneumatic-tourniquet-in-patients-undergoing-total-knee-arthroplasty-a-randomized-control-trial
#6
Y Zhang, D Li, P Liu, X Wang, M Li
BACKGROUND: The goal of this work was to investigate the effects of different methods of using pneumatic tourniquet on reducing blood loss in patients undergoing cemented total knee arthroplasty (TKA). METHODS: One hundred and fifty patients undergoing unilateral cemented TKA were randomly divided into three groups (50 patients per group). The tourniquet was used during the entire operation (Group A), used from the beginning of operation to the completion of joint replacement (Group B), and from the beginning of osteotomy to the completion of arthroplasty (Group C)...
March 4, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28257351/the-experience-of-intense-pain-nursing-management-and-interventions
#7
Norma Kiser-Larson
Personal stories of illness give depth to otherwise clinical descriptions of diagnoses. This article offers an autobiographical narrative of complications after total knee replacement surgery. Diagnosis and nursing management of acute compartment syndrome, nociceptive and neuropathic origins of pain, pharmacologic and nursing interventions for pain, the use of prayer in illness, and compassionate caring from a Christian perspective are discussed.
April 2017: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
https://www.readbyqxmd.com/read/28256494/total-knee-replacement-in-a-resource-constrained-environment-a-preliminary-report
#8
U E Anyaehie, G O Eyichukwu, C U Nwadinigwe
INTRODUCTION: Total knee replacement surgery is relatively new in Nigeria and available in few centres only. It has been evolving at a slow pace because of the lack of facilities, structures and adequate surgical expertise alongside patient ignorance and poverty. OBJECTIVE: The aim of this article is to review the cases done in a resource constrained institution in Nigeria and report the short term outcomes. METHODOLOGY: All the patients that were booked for Total knee replacement, using same prosthesis over a 40 month period, were recruited into the study...
March 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28243690/-erratum-to-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
No abstract text is available yet for this article.
February 27, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28231650/blood-sparing-efficacy-of-oral-tranexamic-acid-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28144717/-individualized-unicondylar-knee-replacement-use-of-patient-specific-implants-and-instruments
#19
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
#20
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
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