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Knee replacement complications

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https://www.readbyqxmd.com/read/29663554/implant-associated-bacterial-biofilm-and-quorum-sensing-in-periprosthetic-joint-infections
#1
Jake A Mooney, Eric M Pridgen, Robert Manasherob, Gina Suh, Helen E Blackwell, Annelise E Barron, Paul L Bollyky, Stuart B Goodman, Derek F Amanatullah
Periprosthetic joint infection (PJI) continues to be a common complication after total knee arthroplasty and total hip arthroplasty leading to severe morbidity and mortality. With an aging population and increasing prevalence of total joint replacement procedures, the burden of PJI will be felt not only by individual patients, but in increased healthcare costs. Current treatment of PJI is inadequate resulting in incredibly high failure rates. This is believed to be largely mediated by the presence of bacterial biofilms...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29662786/comparison-of-topical-and-intravenous-administration-of-tranexamic-acid-for-blood-loss-control-during-total-joint-replacement-review-of-literature
#2
REVIEW
Georgi P Georgiev, Panayot P Tanchev, Zlatka Zheleva, Plamen Kinov
Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA) without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use...
April 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29658483/bacteriology-and-risk-factors-associated-with-periprosthetic-joint-infection-after-primary-total-knee-arthroplasty-retrospective-study-of-2543-cases
#3
K T Siu, F Y Ng, P K Chan, H Ch Fu, C H Yan, K Y Chiu
INTRODUCTION: Periprosthetic joint infection after total knee arthroplasty is a serious complication. This study aimed to identify risk factors and bacteriological features associated with periprosthetic joint infection after primary total knee arthroplasty performed at a teaching hospital. METHODS: We reviewed 2543 elective primary total knee arthroplasties performed at our institution from 1993 to 2013. Data were collected from the Hong Kong Hospital Authority's Clinical Data Analysis and Reporting System, the Infection Control Team, and the joint replacement division registry...
April 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29643169/safety-and-feasibility-evaluation-of-tourniquets-for-total-knee-replacement-safe-tkr-study-protocol
#4
Peter Dh Wall, Imran Ahmed, Andrew Metcalfe, Andrew J Price, Kate Seers, Charles E Hutchinson, Helen Parsons, Jane Warwick, Bushra Rahman, Jaclyn Brown, Martin Underwood
INTRODUCTION: This study is designed to determine whether a full randomised controlled trial (RCT) examining the clinical effectiveness and safety of total knee replacement surgery with or without a tourniquet is warranted and feasible. METHOD AND ANALYSIS: Single centre, patient-blinded and assessor-blinded RCT. A computer-generated randomisation service will allocate 50 participants into one of two trial treatments, surgery with or without a tourniquet. The primary objective is to estimate recruitment, crossovers and follow-up of patients...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29628676/metal-hypersensitivity-in-total-hip-and-knee-arthroplasty-current-concepts
#5
REVIEW
Samuel Akil, Jared M Newman, Neil V Shah, Natasha Ahmed, Ajit J Deshmukh, Aditya V Maheshwari
Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, presentation, diagnosis, and management of MHS. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628553/a-comparative-study-of-botulinum-toxin-a-with-triamcinolone-compared-to-triamcinolone-alone-in-the-treatment-of-osteoarthritis-of-knee
#6
Divya Shukla, Smitha K Sreedhar, Virendra Rastogi
Introduction: This study compares the efficacy in terms of pain relief and complications of intra-articular Botulinum toxin-A (BoNT-A) with intra-articular Triamcinolone versus Triamcinolone alone in the treatment of osteoarthritic knee pain of severe grade. If effective, BoNT-A may help in reducing the long term adverse effects due to prolonged analgesic consumption and reduce/delay requirement of knee replacement surgeries. Materials and Methods: In this prospective study, 30 patients of either sex, aged between 40 to 60 years with physical status ASA classes I or II suffering from knee joint osteoarthritis with knee pain and functional impairment were divided into 2 groups: The OA patients which received Botulinum toxin-A with Triamcinolone (Group A) & OA patients which received only Triamcinolone (Group B)...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29626655/complications-and-cost-of-single-stage-vs-two-stage-bilateral-unicompartmental-knee-arthroplasty-a-case-control-study
#7
C Siedlecki, P Beaufils, B Lemaire, N Pujol
BACKGROUND: Single-stage bilateral knee arthroplasty, even when unicompartmental, remains controversial, chiefly due to the risk of peri-operative complications. The primary objective of this study was to compare the short-term complication rate and cost of single- vs. two-stage bilateral unicompartmental knee arthroplasty (UCA). The secondary objective was to compare total hospital stay lengths and motion-range recovery. HYPOTHESIS: Single-stage bilateral UCA is a cost-saving alternative that is not associated with higher complication rates compared to two-stage bilateral UCA...
April 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29599835/antibacterial-effects-of-bacteriocins-isolated-from-lactobacillus-rhamnosus-atcc-53103-in-a-rabbit-model-of-knee-implant-infection
#8
Bin Zhou, Defeng Zhang
Infection following orthopedic surgery is a major complication that can have serious implications on patient health. The present study aimed to investigate the antibacterial effects of bacteriocins obtained from Lactobacillus rhamnosus on a rabbit model of Staphylococcus aureus infection following knee replacement surgery. Blood samples were collected 1, 2, 3, 4 and 5 days after bacteriocin injection, and C-reactive protein (CRP) and interleukin (IL)-6 levels were measured using commercial ELISA kits. In addition, biofilm formation was evaluated by fluorescence microscopy...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29594324/under-corrected-knees-do-not-fail-more-than-aligned-knees-at-8-years-in-fixed-severe-valgus-total-knee-replacement
#9
Bertrand Boyer, Régis Pailhé, Nassima Ramdane, David Eichler, Franck Remy, Matthieu Ehlinger, Gilles Pasquier
PURPOSES: A fixed severe valgus knee is a surgical challenge. A safe post-operative Hip-Knee-Ankle angle (HKA) range of 180° ± 4 was recommended, but recent studies mentioned equal results from outliers of this range. Nevertheless, no distinction was made between varus and valgus knees, as well as over-corrected or under-corrected knees. Did post-operative nonaligned total knee replacements (TKR) from fixed severe valgus knees behave differently from the properly aligned population? Did over-corrected knees behave differently from under-corrected knees? METHODS: Through a multi-center retrospective cohort study, we provided 557 knees of at least 10° of minimal pre-operative valgus; in this population 75 presented a post-operative Hip-Knee-Ankle angle (HKA) outside of the 180° ± 4 range; 23 of them had at least 5° of varus; 52 of them had at least 5° of valgus...
March 28, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29581890/recurrent-discitis-in-the-acute-rehab-setting-a-case-report
#10
Kunj Patel, Lauren Hutts, Stephen Porter, Zachary Fausel, Dale Strasser
Introduction: Discitis is an infection of the intervertebral disc space that can lead to paralysis, sepsis, epidural abscess, or other life-threatening complications if left untreated and may sometimes present with limited laboratory abnormalities to clue a diagnosis. Case presentation: We present a case of a 67-year-old female in an acute rehabilitation setting who had presenting symptoms of sudden unexplained back pain refractory to pain control. She had a previous history of discitis and multiple failed knee replacement surgeries secondary to MSSA infections...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29574549/simultaneous-same-anaesthetic-bilateral-total-knee-arthroplasty-has-low-mortality-and-complication-rates
#11
Eugene Wong, Chu Luan Nguyen, Sean Park, David Parker
PURPOSE: The benefits of simultaneous bilateral total knee arthroplasty (SBTKR) include reduced hospital costs, single anaesthetic exposure and in many cases is also the patient's preference. Despite these potential benefits, risk-adversity with respect to assumed complications and mortality make it difficult for the orthopaedic surgeon and patient to make an informed decision. This study aimed to address the inconsistencies and lack of consensus in previous literature regarding the short-term complications and clinical safety of SBTKR in patients with end-stage knee osteoarthritis (OA)...
March 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29573697/changes-in-total-knee-arthroplasty-design-affect-in-vivo-kinematics-in-a-redesigned-total-knee-system-a-fluoroscopy-study
#12
Francesco Zambianchi, Francesco Fiacchi, Vincenzo Lombari, Luca Venturelli, Andrea Marcovigi, Andrea Giorgini, Fabio Catani
BACKGROUND: Journey II Bi-Cruciate-Stabilized knee system was designed to overcome the complications of Journey Bi-Cruciate-Stabilized, including ilio-tibial band inflammation and episodes of dislocation. The purpose of this study was to assess differences in knee kinematics between the first and second-generation design by means of video-fluoroscopy. Re-designed prosthesis in-vivo kinematics was analyzed during activities of daily living and results were eventually compared with those of the previous system, as reported in a previously published study...
March 20, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29569138/tumour-endoprosthesis-replacement-in-the-proximal-tibia-after-intra-articular-knee-resection-in-patients-with-sarcoma-and-recurrent-giant-cell-tumour
#13
Jendrik Hardes, Marcel-Philipp Henrichs, Georg Gosheger, Wiebke Guder, Markus Nottrott, Dimosthenis Andreou, Eike Bormann, Maria Eveslage, Gregor Hauschild, Arne Streitbürger
PURPOSE: Proximal tibia replacements are commonly associated with post-operative complications and poor functional results due to an insufficiency of the extensor mechanism. METHODS: This study evaluated the clinical results with a special emphasis of the extensor mechanism reconstruction with a reattachment tube and complications after intra-articular resection of the proximal tibia and reconstruction with a tumour endoprosthesis (MUTARS®) in 98 patients (median age 18 years) with malignant bone tumours or giant cell tumours...
March 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29559424/total-knee-replacement-and-the-effect-of-technology-on-cocreation-for-improved-outcomes-and-delivery-qualitative-multi-stakeholder-study
#14
Yasmin van Kasteren, Jill Freyne, M Sazzad Hussain
BACKGROUND: The growth in patient-centered care delivery combined with the rising costs of health care have perhaps not unsurprisingly been matched by a proliferation of patient-centered technology. This paper takes a multistakeholder approach to explore how digital technology can support the cocreation of value between patients and their care teams in the delivery of total knee replacement (TKR) surgery, an increasingly common procedure to return mobility and relieve pain for people suffering from osteoarthritis...
March 20, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29541841/much-ado-about-nothing-the-effect-of-tourniquet-time-on-an-accelerated-rehabilitation-programme-following-total-knee-replacement-tkr
#15
William Wynell-Mayow, Muhammad Zahid Saeed
BACKGROUND: The WHO includes osteoarthritis as a disease of priority, owing to its significant impact on quality of life, and globally increasing prevalence. Hospital budgets are under pressure to ration knee replacements and shorten inpatient stays. Prolonged tourniquet application has been hypothesised to extend recovery through pain and reduced mobility. PATIENTS AND METHODS: A total of 123 elective total knee replacements meeting inclusion criteria took place from July 2015 to October 2017 at the Royal Free Hospital...
March 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29499827/venous-thromboembolism-disease-prophylaxis-in-foot-and-ankle-surgery
#16
REVIEW
Bonnie Y Chien, Tonya Dixon, Daniel Guss, Christopher DiGiovanni
There are limited data to guide the use of venous thromboembolism disease (VTED) prophylaxis after foot and ankle surgery. Although there is general consensus that the overall risk is lower than after hip or knee replacement, subpopulations of patients may be at relatively heightened risk. Furthermore, existing data are often conflicting regarding the efficacy of prophylaxis, with little acknowledgment of the tradeoffs between VTED prophylaxis and potential complications associated with the use of such medications...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29498932/force-plates-may-be-used-for-dynamic-analyses-of-endoprostheses-explantation-procedures
#17
Hendrik Kohlhof, Sebastian Köhring, Dieter Christian Wirtz, Hartmut Witte
The number of hip and knee arthroplasty replacement surgeries is increasing steadily. In combination with demographic aging and the number of periprosthetic complications, this development has lead to the phenomenon where the need for revision surgery is rising. The problem is, that, while implantation procedures of hip arthroplasties are more or less standardized, explantation is a non-standardized task for experienced specialists, due to the unpredictability of the adequate loosening method. The surgeon often only gets to decide on which tools and methods may be applied to detach the prosthesis, only after getting access to the operation site...
March 2, 2018: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/29494747/insurance-status-affects-in-hospital-complication-rates-after-total-knee-arthroplasty
#18
David R Veltre, Paul H Yi, David C Sing, Emily J Curry, Atsushi Endo, Eric L Smith, Xinning Li
Insurance status has been shown to be a predictor of patient morbidity and mortality. The purpose of this study was to evaluate the effect of patient insurance status on the in-hospital complication rates following total knee arthroplasty. Data were obtained from the Nationwide Inpatient Sample (2004 through 2011). Patient demographics and comorbidities were analyzed and stratified by insurance type. Analysis was performed with a matched cohort comparing complication rates between patients with Medicare vs private insurance using the coarsened exact matching algorithm and multivariable logistic regression...
March 1, 2018: Orthopedics
https://www.readbyqxmd.com/read/29489645/electroacupuncture-for-postoperative-pain-management-after-total-knee-arthroplasty-protocol-for-a-systematic-review-and-meta-analysis
#19
Jie Xiong, Huiying Li, Xiaoya Li, Lihe Wang, Pengfei Zhao, Dongfang Meng, Zong Xing Wei, Taotao Tian
BACKGROUND: Total knee arthroplasty (TKA) is one of the most common joint replacement surgeries in the United States. Postoperative pain is still a major complication after TKA. Electroacupuncture (EA) has been commonly used in clinical practice for pain after TKA, but its effects and safety remain uncertain. This protocol is described for a systematic review to investigate the beneficial effects and safety of EA for postoperative pain after TKA. METHODS: Randomized controlled trials (RCTs) related to EA treatment of pain after TKA will be collected from 3 databases of English literature, namely PubMed, Embase, and Cochrane Library, and 4 databases of Chinese literatures, namely CBM, CNKI, VIP and Wanfang database...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29460013/eurospine-2017-full-paper-award-time-to-remove-our-rose-tinted-spectacles-a-candid-appraisal-of-the-relative-success-of-surgery-in-over-4500-patients-with-degenerative-disorders-of-the-lumbar-spine-hip-or-knee
#20
Anne F Mannion, Franco M Impellizzeri, Michael Leunig, Dezsö Jeszenszy, Hans-Jürgen Becker, Daniel Haschtmann, Stefan Preiss, Tamas F Fekete
PURPOSE: Studies comparing the outcome of spine surgery with that of large-joint replacement report equivocal findings. The patient-reported outcome measures (PROMs) used in such studies are typically generic and may not be sufficiently sensitive to the successes/failures of treatment. This study compared different indices of "success" in patients undergoing surgery for degenerative disorders of the lumbar spine, hip, or knee, using a validated, multidimensional, and joint-specific PROM...
February 19, 2018: European Spine Journal
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