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https://www.readbyqxmd.com/read/28936909/predictors-of-chronic-pain-following-total-knee-replacement-in-females-and-males-an-exploratory-study
#1
Tanja Bossmann, Torsten Brauner, Scott Wearing, Thomas Horstmann
AIM: This study explored whether nociceptive (NS) and autonomic nervous system (ANS) dysregulation and psychological distress were predictive of pain 6 months after primary total knee replacement. PATIENTS & METHODS: ANS and NS regulation, psychological distress and self-reported pain, stiffness and function were evaluated preoperatively in 56 patients. Pain severity measured 6 months after surgery was used as the primary outcome in an analysis of covariance model...
September 22, 2017: Pain Management
https://www.readbyqxmd.com/read/28936362/albumin-protein-cleavage-affects-the-wear-and-friction-of-ultra-high-molecular-weight-polyethylene
#2
Yasha Dwivedi, Michel P Laurent, Shravan Sarvepalli, Thomas M Schmid, Markus A Wimmer
It is well established that the total protein concentration and albumin-to-globulin ratio influence the wear of ultra-high molecular polyethylene (UHMWPE, "polyethylene") in joint prostheses. A factor on wear not yet studied, but of possible clinical relevance, is protein cleavage. Such cleavage is expected in the presence of an inflammatory response and as a result of wear processes at the articular interface. The aim of this study was to compare the tribological behavior of polyethylene articulated against an orthopedic wrought CoCrMo alloy for three lubricants: cleaved albumin, uncleaved albumin, and newborn calf serum (control)...
September 2017: Lubricants
https://www.readbyqxmd.com/read/28929828/increased-risk-of-aseptic-loosening-for-43-525-rotating-platform-vs-fixed-bearing-total-knee-replacements
#3
Oystein Gothesen, Stein Hakon L Lygre, Michelle Lorimer, Stephen Graves, Ove Furnes
Background and purpose - Given similar functional outcomes with mobile and fixed bearings, a difference in survivorship may favor either. This study investigated the risk of aseptic loosening for the most used subtypes of mobile-bearing rotating-platform knees, in Norway and Australia. Patients and methods - Primary TKRs reported to the Norwegian and Australian joint registries, between 2003 and 2014, were analyzed with aseptic loosening as primary end-point and all revisions as secondary end-point. We hypothesized that no difference would be found in the rate of revision between rotating-platform and the most used fixed-bearing TKRs, or between keeled and non-keeled tibia...
September 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28914139/the-influence-of-geometric-design-variables-on-the-kinematic-performance-of-a-surface-guided-total-knee-replacement
#4
Shabnam Pejhan, Eric Bohm, Jan-Mels Brandt, Urs Wyss
OBJECTIVE: Tibiofemoral geometries in a total knee replacement (TKR) affect the performance of an implant during activities of daily living. The specially shaped components of a surface-guided TKR aim to control the tibiofemoral motion, such that a normal pattern of motion is achieved, even at high flexion angles. The purpose of this study was to assess the influence of the design parameters on the kinematic behavior of such an implant. A combination of design variables was determined that resulted in the least deviation from the design kinematic target...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28914105/bone-and-subcutaneous-adipose-tissue-pharmacokinetics-of-vancomycin-in-total-knee-replacement-patients
#5
Mats Bue, Mikkel Tøttrup, Pelle Hanberg, Otto Langhoff, Hanne Birke-Sørensen, Theis M Thillemann, Torben L Andersson, Kjeld Søballe
Background and purpose - The incidence of orthopedic methicillin-resistant Staphylococcus aureus (MRSA) infections is increasing. Vancomycin may therefore play an increasingly important role in orthopedic perioperative antimicrobial prophylaxis. Studies investigating perioperative bone and soft tissue concentrations of vancomycin are sparse and challenged by a lack of appropriate methods. We assessed single-dose plasma, subcutaneous adipose tissue (SCT) and bone concentrations of vancomycin using microdialysis in male patients undergoing total knee replacement...
September 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28899326/is-inpatient-rehabilitation-after-a-routine-total-knee-replacement-justified
#6
Andreas Loefler
No abstract text is available yet for this article.
September 18, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28884103/lateral-patellar-retinacular-release-changes-over-the-last-ten-years
#7
REVIEW
Leonardo Pini Rosalem Marciano da Fonseca, Ednei Haruo Kawatake, Alberto de Castro Pochini
Lateral retinacular release is a useful resource in knee surgery that can be used for disorders of the extensor mechanism. For many years, it was indiscriminately used in the treatment of the various patellofemoral joint alterations, with conflicting functional results. This study aimed to analyze the changes that have occurred in the indications and clinical effectiveness of lateral retinacular release by reviewing the relevant literature of the past ten years, comparing it to the classic literature on the subject...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28868567/gait-analysis-of-patients-with-an-off-the-shelf-total-knee-replacement-versus-customized-bi-compartmental-knee-replacement
#8
Henry Wang, Jonathan Foster, Natasha Franksen, Jill Estes, Lindsey Rolston
INTRODUCTION: Newer TKR designs have been introduced to the market with the aim of overcoming common sizing problems with older TKR designs. Furthermore, since a sizable percentage of patients with OA present with disease limited to the medial/lateral knee compartment in addition to the patellofemoral joint, for whom, a customized bi-compartmental knee replacement (BKR) is available as a treatment option. To date, there is very little information regarding knee strength and mechanics during gait for patients implanted with these modern TKR and BKR designs...
September 4, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28860683/simultaneous-ipsilateral-knee-arthroscopy-and-unicondylar-knee-arthroplasty-is-effective-for-bicompartmental-symptoms
#9
Akshay Lakra, Taylor Murtaugh, Jeffrey A Geller, William Macaulay, Roshan P Shah
BACKGROUND: Patients with unicompartmental radiographic arthritis but bicompartmental symptoms pose a clinical challenge. Some surgeons may perceive it as a contraindication for unicondylar knee arthroplasty (UKA). We investigated patient outcomes 2 years after simultaneous ipsilateral arthroscopy and UKA as compared to a similar group of patients who had total knee replacement (TKA) for a similar clinical presentation. METHODS: We identified 9 patients with simultaneous ipsilateral arthroscopy and UKA between 2004 and 2013, and 12 clinically similar patients treated with TKA...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28856946/spontaneous-hit-syndrome-post-knee-replacement-surgery-with-delayed-recovery-of-thrombocytopenia-a-case-report-and-literature-review
#10
Dilli Ram Poudel, Sushil Ghimire, Rashmi Dhital, Daniel A Forman, Theodore E Warkentin
Recently published reports have established a heparin-induced thrombocytopenia (HIT)-mimicking thromboembolic disorder without proximate heparin exposure, called spontaneous HIT syndrome. Although the pathophysiology remains unclear, anti-platelet factor 4 (PF4)/heparin antibodies possibly triggered by exposure to knee cartilage glycosaminoglycans or other non-heparin polyanions found on bacterial surfaces and nucleic acids have been postulated. We present a 53-year-old female receiving antithrombotic prophylaxis with aspirin following right total knee replacement surgery (without perioperative or any previous lifetime heparin exposure) who acutely presented with high-risk pulmonary embolism (PE) and right great saphenous vein thrombophlebitis on postoperative day (POD) 14; her platelet count at presentation was 13 × 10(9)/L...
September 2017: Platelets
https://www.readbyqxmd.com/read/28854533/safety-aspects-of-preoperative-high-dose-glucocorticoid-in-primary-total-knee-replacement
#11
C C Jørgensen, F T Pitter, H Kehlet
Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation Database for Fast-track Hip and Knee Replacement introduced preoperative methylprednisolone (MP) 125 mg as part of a multimodal analgesic protocol in TKA. We analysed the risk of length of hospital stay (LOS) >4 days, 30 and 90 day readmissions in patients with MP vs patients having TKA before the use of MP and adjusted for comorbidity and place of surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28854487/the-study-of-stresses-characteristic-of-contact-mechanism-in-total-knee-replacement-using-two-dimensional-finite-element-analysis
#12
Shyh-Chour Huang
The knee joint is one of the more important parts in the human body. Its continuous involvement in the human movement makes it prone to breakage. Due to small contact area, the contact pressure is quite large in this joint. Therefore, the understanding of stresses behavior in knee joint contact is a necessity. In this study, we investigated the stresses behavior in the tibial insert by FEA. A two-dimensional FE model representing the knee joint contact mechanism was created. In the elastic simulation, the contact pressure dropped by 0...
2017: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/28853192/resection-accuracy-of-patient-specific-cutting-guides-in-total-knee-replacement
#13
Gregory C Wernecke, Scott Taylor, Penny Wernecke, Samuel J MacDessi, Darren B Chen
BACKGROUND: Patient-specific guides (PSGs) have been thoroughly investigated with regards to reconstitution of mechanical alignment in total knee arthroplasty (TKA). The ability to replicate the preoperative surgical plan is essential for optimal outcomes but intraoperative measurements to confirm accurate progression through the operation are limited. This leads to our clinical question: can PSGs replicate the planned bone resection depth during TKA? METHODS: This is a prospective case series of 118 patients who underwent TKA using magnetic resonance imaging-based patient-specific cutting guides...
August 29, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28853118/occlusion-training-pilot-study-for-postoperative-lower-extremity-rehabilitation-following-primary-total-knee-arthroplasty
#14
Christopher L Gaunder, Michael P Hawkinson, David J Tennent, Creighton C Tubb
With continued emphasis on the value of healthcare, factors such as quality of life and patient reported outcomes are critical in evaluating high-demand procedures such as knee replacement surgery. Equally important to the surgery itself is maximizing the effectiveness and efficiency of the treatment, both preoperatively and postoperatively, which can have a significant effect the final outcome. Technical outcomes of total knee replacement are generally considered excellent; however, many patients continue to have postoperative pain, functional limitations, and low treatment satisfaction...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28842793/knee-function-after-limb-salvage-surgery-for-malignant-bone-tumor-comparison-of-megaprosthesis-and-distal-femur-allograft-with-epiphysis-sparing
#15
Sébastien Pesenti, Emilie Peltier, Vincent Pomero, Guillaume Authier, Lionel Roscigni, Elke Viehweger, Jean-Luc Jouve
PURPOSE: Limb salvage surgery is increasingly used for the treatment of distal femur bone sarcomas. Total knee replacement using megaprosthesis and epiphysis-sparing biologic reconstruction using an allograft are widely used in order to preserve joint motion. We aimed to compare the results of these procedures using gait analysis in patients undergoing limb salvage surgery. METHODS: Fifteen patients were included, nine undergoing allograft with epiphysis sparing (Allograft group) and six undergoing megaprosthesis (Megaprosthesis group)...
August 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28830464/using-bayesian-statistics-to-estimate-the-likelihood-a-new-trial-will-demonstrate-the-efficacy-of-a-new-treatment
#16
David J Biau, Samuel Boulezaz, Laurent Casabianca, Moussa Hamadouche, Philippe Anract, Sylvie Chevret
BACKGROUND: The common frequentist approach is limited in providing investigators with appropriate measures for conducting a new trial. To answer such important questions and one has to look at Bayesian statistics. METHODS: As a worked example, we conducted a Bayesian cumulative meta-analysis to summarize the benefit of patient-specific instrumentation on the alignment of total knee replacement from previously published evidence. Data were sourced from Medline, Embase, and Cochrane databases...
August 22, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28821515/does-the-person-s-context-influence-engagement-in-life-activities-following-primary-knee-replacement-results-from-a-canadian-prospective-cohort-study
#17
Aileen M Davis, Viji Venkataramanan, Jessica Bytautas-Sillanpää, Anthony V Perruccio, Rosalind Wong, Lisa Carlesso, Fiona Webster
OBJECTIVE: The impact of the context of a person's life on recovery from surgical interventions is not well understood. This study evaluated if people's social, environmental and biomedical context was associated with change in frequency in engagement in life activities after total knee replacement (TKR). METHODS: 418 people aged 30+ years who had TKR were followed presurgery to 1 year postsurgery. The outcome was change in frequency in engagement in life activities measured by the Late Life Disability Index (LLDI)...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28820012/effect-of-rotational-prosthetic-alignment-variation-on-tibiofemoral-contact-pressure-distribution-and-joint-kinematics-in-total-knee-replacement
#18
Xin Xie, Roy Rusly, John D DesJardins, Frank Voss, Kim Chillag, Martine LaBerge
In total knee replacement surgery, implant alignment is one of the most important criteria for successful long-term clinical outcome. During total knee replacement implantation, femoral and tibial alignment are determined through appropriate bone resections, which could vary based on patient anatomy, implant design and surgical technique and further influence loading conditions and clinical outcomes. The current research focused on three critical alignment parameters for total knee replacement insertion: femoral component internal/external (I/E) rotation, varus-valgus tibiofemoral angulation and posterior tibial slope...
August 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28807525/experimental-and-computational-analysis-of-micromotions-of-an-uncemented-femoral-knee-implant-using-elastic-and-plastic-bone-material-models
#19
Sanaz Berahmani, Dennis Janssen, Nico Verdonschot
It is essential to calculate micromotions at the bone-implant interface of an uncemented femoral total knee replacement (TKR) using a reliable computational model. In the current study, experimental measurements of micromotions were compared with predicted micromotions by Finite Element Analysis (FEA) using two bone material models: linear elastic and post-yield material behavior, while an actual range of interference fit was simulated. The primary aim was to investigate whether a plasticity model is essential in order to calculate realistic micromotions...
July 29, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28805694/progenitor-cells-from-cartilage-grade-specific-differences-in-stem-cell-marker-expression
#20
Marija Mazor, Annabelle Cesaro, Mazen Ali, Thomas M Best, Eric Lespessaille, Hechmi Toumi
Recent research has confirmed the presence of Mesenchymal stem cell (MSC)-like progenitors (MPC) in both normal and osteoarthritic cartilage. However, there is only limited information concerning how MPC markers are expressed with osteoarthritis (OA) progression. The purpose of this study was to compare the prevalence of various MPC markers in different OA grades. Human osteoarthritic tibial plateaus were obtained from ten patients undergoing total knee replacement. Each sample had been classified into a mild or severe group according to OARSI scoring...
August 12, 2017: International Journal of Molecular Sciences
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