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Knee replacement complications

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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
#1
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
https://www.readbyqxmd.com/read/29457404/-perioperative-and-drug-management-of-patients-with-rheumatoid-arthritis-treated-with-joint-replacement
#2
REVIEW
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Jie Shi, Wei Wang, Xiao-le He, Xu-Sheng Li
Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29431491/customizable-pre-printed-consent-forms-a-solution-in-light-of-the-montgomery-ruling
#3
Deborah Owen, Nick Aresti, Alex Mulligan, Dennis Kosuge
INTRODUCTION: This article presents an audit cycle supported quality improvement project addressing best practice in the consent process for lower limb arthroplasty which takes into account the new standard in surgical consent and the importance of material risks. METHODS: 50 consecutive total hip and total knee replacement consent forms over a 3-month period were reviewed for legibility and completeness. Following the introduction of a new, pre-printed but customizable consent form the review process was repeated...
February 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29427125/survival-complications-and-functional-outcomes-of-cemented-megaprostheses-for-high-grade-osteosarcoma-around-the-knee
#4
Chunlin Zhang, Jianping Hu, Kunpeng Zhu, Tao Cai, Xiaolong Ma
PURPOSE: We initiated a retrospective study on the long-term survival of cemented endoprostheses for bone tumours around the knee to answer the following questions: (1) What was the survival of these patients? (2) What was the overall survival of cemented prostheses around the knee? (3) What types of failures were observed in these reconstructions? (4) Did the survival and complications vary according to the site of the implant? (5) What was the functional result after cemented prosthesis replacement around the knee? METHODS: From January 2006 to December 2013, 108 consecutive patients with an average age of 25 years, who had mature bone development as evidenced by imaging examinations, underwent 108 cemented endoprosthetic knee replacements for osteosarcoma resection...
February 9, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29390496/a-study-on-dynamic-monitoring-components-and-risk-factors-of-embolism-during-total-knee-arthroplasty
#5
Kang Lu, Mingtao Xu, Wei Li, Kai Wang, Dawei Wang
BACKGROUND: Fat embolism is a common complication of orthopedic surgery. However, the exact component and risk factor responsible for this complication remains unelucidated. This study aimed to detect the origin of the pulmonary embolus and identify relevant risk factors of pulmonary embolism in total knee replacement. METHODS: A total of 40 osteoarthritis patients who underwent primary unilateral TKA were recruited into this study. Transesophageal echocardiography (TEE) was utilized to dynamically monitor the embolism...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388452/different-competing-risks-models-for-different-questions-may-give-similar-results-in-arthroplasty-registers-in-the-presence-of-few-events
#6
Stéphanie Van Der Pas, Rob Nelissen, Marta Fiocco
Background and purpose - In arthroplasty registry studies, the analysis of time to revision is complicated by the competing risk of death. There are no clear guidelines for the choice between the 2 main adjusted analysis methods, cause-specific Cox and Fine-Gray regression, for orthopedic data. We investigated whether there are benefits, such as insight into different aspects of progression to revision, to using either 1 or both regression methods in arthroplasty registry studies in general, and specifically when the length of follow-up is short relative to the expected survival of the implants...
February 1, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29387645/clinical-evidence-of-traditional-vs-fast-track-recovery-methodologies-after-total-arthroplasty-for-osteoarthritic-knee-treatment-a-retrospective-observational-study
#7
Sergio Castorina, Claudia Guglielmino, Paola Castrogiovanni, Marta Anna Szychlinska, Francesco Ioppolo, Paolo Massimino, Pietro Leonardi, Christian Maci, Maurizio Iannuzzi, Angelo Di Giunta, Giuseppe Musumeci
Background: During the last years, programs to enhance postoperative recovery and decrease morbidity after total knee arthroplasty, have been developed across a variety of surgical procedures and referred to as "Fast-Track Surgery". In this study we aimed to find some answers in the management of osteoarthritic patients subjected to total knee arthroplasty, by using the Fast-Track methodology. To this purpose we evaluated parameters such as early mobilization of patients, better pain management, bleeding, possible complications, reduced hospitalization time, an overall improved recovery and patient satisfaction...
July 2017: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/29368238/use-of-modular-megaprosthesis-in-managing-chronic-end-stage-periprosthetic-hip-and-knee-infections-is-there-an-increase-in-relapse-rate
#8
Pablo S Corona, Matias Vicente, Mireia Lalanza, Carles Amat, Luis Carrera
BACKGROUND: Bone loss is a common problem in periprosthetic joint infection (PJI) scenarios. Modular megaprosthesis (MP) could offer a limb salvage solution in such situations. Concerns about risk of infection relapse, reinfection and implant longevity exist regarding MP use in cases of chronic PJI, rather than standard implants. We therefore sought to analyze our results with MP use in chronic PJI cases. METHODS: We performed a retrospective analysis of 29 MP patients...
January 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29363280/disparities-in-total-knee-replacement-population-losses-in-quality-adjusted-life-years-due-to-differential-offer-acceptance-and-complication-rates-for-black-americans
#9
Hannah M Kerman, Savannah R Smith, Karen C Smith, Jamie E Collins, Lisa G Suter, Jeffrey N Katz, Elena Losina
OBJECTIVE: Total knee replacement (TKR) is an effective treatment for end-stage knee osteoarthritis (OA). American racial minorities undergo fewer TKRs than Whites. We estimated quality-adjusted life years (QALYs) lost for Black knee OA patients due to differences in TKR offer, acceptance, and complication rates. METHODS: We used the Osteoarthritis Policy Model, a computer simulation of knee OA, to predict QALY outcomes for Black and White knee OA patients with and without TKR...
January 24, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29338761/is-total-femoral-replacement-for-non-oncologic-and-oncologic-indications-a-safe-procedure-in-limb-preservation-surgery-a-single-center-experience-of-22-cases
#10
Andreas Toepfer, Norbert Harrasser, Isabel Petzschner, Florian Pohlig, Ulrich Lenze, Ludger Gerdesmeyer, Ruediger von Eisenhart-Rothe, Heinrich Mühlhofer, Christian Suren
BACKGROUND: Several surgical options for the reconstruction of massive bone defects have been described and include biologic methods with autografts and allografts, and the use of tumor endoprostheses (total femoral replacement, TFR). Several types of modular TFR are available, but nevertheless unpredictable outcomes and high complication rates have been described from most authors. The present study aims to compare results after TFR performed with modular total femur prosthesis MML (Fa...
January 16, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29328749/thromboembolic-diseases-and-the-use-of-vena-cava-filters
#11
Samanthi De Silva
Mr GW is a 77-year-old gentleman who is hoping to have a total knee replacement of his left knee. He underwent a knee replacement on the right in 2011 under spinal anaesthetic, where his postoperative period was complicated by a saddle pulmonary embolus (PE).
April 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29322905/pre-discharge-postoperative-radiographs-after-primary-total-knee-replacement-tradition-or-science
#12
S N Sambandam, V Khanna, G Rohinikumar, V Mounasamy
Consistent evidence exists on the inutility of immediate postoperative radiographs after a total knee replacement (TKR). We hypothesized that eliminating the pre-discharge film would not have any effect on the postoperative patient outcomes. Retrospective analysis of prospectively collected data was performed on 220 knees. Patients undergoing a simple primary TKR operated by 2 surgeons (Surgeon A and B) from January 2013 to July 2015 were divided into 2 groups (Groups 1 and 2 having 112 and 108 knees respectively)...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29298664/the-prevention-of-delirium-in-elderly-with-obstructive-sleep-apnea-podesa-study-protocol-for-a-multi-centre-prospective-randomized-controlled-trial
#13
Jean Wong, David Lam, Stephen Choi, Mandeep Singh, Naveed Siddiqui, Sanjeev Sockalingam, Frances Chung
BACKGROUND: Delirium is a common problem that occurs in 5-50% of elderly individuals following surgery. Patients who develop delirium after surgery are at increased risk for serious complications. Recent studies suggest that patients with obstructive sleep apnea (OSA), a sleep disorder characterized by repeated episodes of complete or partial blockage of the upper airway - are at greater risk to develop delirium. OSA is more common in elderly individuals but is often undiagnosed. Identification and treatment of unrecognized OSA may reduce the incidence of postoperative delirium...
January 3, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#14
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29247814/clinical-application-of-different-operative-approach-of-total-knee-replacement-in-knee-valgus-patients-retrospective-cohort-study
#15
Chong-Jun Guo, Jun Liu, Dong-Sheng Niu, Jun Ma, Bo Kou, Hai-Jiao Zhang, Shao-Wei Xu, Xiao-Di Mu, Lv-Lin Yang, Hua Zhang
PURPOSE: According to the severity of knee valgus, different operative approaches were applied in total knee replacement. Hence, we assessed the safety and efficacy of different operative approaches in the level IV study. METHODS: From May 2011 to March 2014, a retrospectively analysis was conducted among 31 patients with knee valgus (mild in 10 cases, moderate in 8 cases and severe in 13 cases based on Keblish grade). Medial approach trip knee replacement was performed in mild and moderate patients, which were assigned as medial approach group...
December 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29228407/-sport-after-total-knee-and-hip-arthroplasty
#16
Friedrich Boettner, Maximilian F Kasparek, Kilian Rueckl, Christian Liebau
The introduction of new materials and better implant coatings seems to provide the prerequisites for more intense physical activities after total joint arthroplasties of the lower extremity. Despite recent advances in implant design and materials, recommendations for sport after total joint arthroplasty have not been updated over the past 20 years. The introduction of modern uncemented fixation as well as highly cross-linked polyethylene into total hip arthroplasty allow for a more active life-style without an increased risk of loosening or complications...
December 2017: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/29226208/brucella-arthritis-following-total-knee-arthroplasty-in-a-patient-with-hemophilia-a-case-report
#17
Seyed Mohammad J Mortazavi, Mohammad R Sobhan, Hamed Mazoochy
Total knee arthroplasty (TKA) is a rewarding procedure in patients with hemophilia and end stage knee hemophilic arthropathy. However, this procedure might be associated with complications such as infection. There periprosthetic joint infection in patients with hemophilia is very well known, though we are not aware of any previous report on Brucella infection in this group of patients. Here, we reported a 28-year old man with Brucella infection of total knee replacement who initially underwent a conservative treatment followed bya two-stage revision...
September 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29224190/metabolic-surgery-for-the-treatment-of-type-2-diabetes-in-obese-individuals
#18
REVIEW
David E Cummings, Francesco Rubino
Several bariatric operations originally designed to promote weight loss have been found to powerfully treat type 2 diabetes, causing remission in most cases, through diverse mechanisms additional to the secondary consequences of weight loss. These observations have prompted consideration of such operations as 'metabolic surgery', used expressly to treat diabetes, including among patients who are only mildly obese or merely overweight. Large, long-term observational studies consistently demonstrate that bariatric/metabolic surgery is associated with reductions in all cardiovascular risk factors, actual cardiovascular events, microvascular diabetes complications, cancer and death...
December 9, 2017: Diabetologia
https://www.readbyqxmd.com/read/29208310/equivalent-mortality-and-complication-rates-following-periprosthetic-distal-femur-fractures-managed-with-either-lateral-locked-plating-or-a-distal-femoral-replacement
#19
Jason S Hoellwarth, Mitchell S Fourman, Lawrence Crossett, Mark Goodman, Peter Siska, Gele B Moloney, Ivan S Tarkin
INTRODUCTION: Management of distal femur fractures above total knee arthroplasty (TKA) remains challenging. Two common surgical options are locked lateral plating (LLP) and distal femoral arthroplasty (DFR). Unfortunately, approximately 30-50% of patients may die within one year of injury, require further surgery, or not regain prior mobility performance. We compared 87 LLP to 53 DFR patients - to our knowledge the largest comparative study - focusing on 90- and 365-day mortality, mobility maintenance, and further surgery...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29204489/the-cyclops-lesion-after-bicruciate-retaining-total-knee-replacement
#20
Mark A Klaassen, Jerry L Aikins
The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees) in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One lesion occurred in an active sportswoman...
December 2017: Arthroplasty Today
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