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TKA outcomes

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https://www.readbyqxmd.com/read/28648711/patient-reported-outcomes-can-be-used-to-identify-patients-at-risk-for-total-knee-arthroplasty-revision-and-potentially-individualize-postsurgery-follow-up
#1
Hilal Maradit Kremers, Walter K Kremers, Daniel J Berry, David G Lewallen
BACKGROUND: Patient-reported outcomes are increasingly used as complementary measures to clinical outcomes in total knee arthroplasty (TKA). However, their prognostic importance has yet to be established. We aimed to determine whether the long-term revision risk in TKA relates to pain and Knee Society Score (KSS) measures at baseline, 1, and 2 years. METHODS: This was a registry-based study of primary TKA procedures at a large tertiary care institution between 1995 and 2010...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648704/total-knee-arthroplasty-using-bicruciate-stabilized-or-posterior-stabilized-knee-implants-provided-comparable-outcomes-at-2-years-a-prospective-multicenter-randomized-controlled-clinical-trial-of-patient-outcomes
#2
Jennie M Scarvell, Diana M Perriman, Paul N Smith, David G Campbell, Warwick J M Bruce, Bo Nivbrant
BACKGROUND: The bicruciate-stabilized (BCS) knee arthroplasty was developed to replicate normal knee kinematics. We examined the hypothesis that patients with osteoarthritis requiring total knee arthroplasty (TKA) will have better functional outcome and satisfaction with the BCS implant compared with an established posterior cruciate-stabilized implant. METHODS: This multicenter, randomized, controlled trial compared the clinical outcomes of a BCS implant against an established posterior cruciate-stabilized implant with 2-year follow-up...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28648702/a-dual-pivot-pattern-simulating-native-knee-kinematics-optimizes-functional-outcomes-after-total-knee-arthroplasty
#3
R Michael Meneghini, Evan R Deckard, Marshall K Ishmael, Mary Ziemba-Davis
BACKGROUND: Few studies on kinematics correlate patterns to functional outcomes after total knee arthroplasty (TKA). The purpose of this study was to determine if lateral pivot motion in early flexion and medial pivot in high flexion, simulating native knee kinematics, produces superior clinical outcomes. A second objective was to determine if specific kinematic patterns produce superior outcomes. METHODS: One hundred twenty consecutive TKAs were performed using sensor trials to record intraoperative knee kinematics...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28644188/surgical-techniques-for-total-knee-arthroplasty-measured-resection-gap-balancing-and-hybrid
#4
Neil P Sheth, Adeel Husain, Charles Lenwood Nelson
Total knee arthroplasty (TKA) is effective in managing end-stage degenerative joint disease. Achieving favorable clinical outcomes is predicated on proper implant alignment, sizing, and rotation as well as adequate soft-tissue balancing. Modern TKA implants are designed to address the fundamental needs of attaining stability in both flexion and extension and of optimizing patellar tracking. Measured resection and gap balancing are the two different techniques used to implant the TKA components used today. Both techniques have been validated as durable and successful, and each has unique advantages and disadvantages...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28642657/negative-pressure-wound-therapy-in-the-treatment-of-complex-injuries-after-total-knee-arthroplasty
#5
Camilo Partezani Helito, Daniel Kamura Bueno, Pedro Nogueira Giglio, Marcelo Batista Bonadio, José Ricardo Pécora, Marco Kawamura Demange
OBJECTIVE: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. METHODS: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico((r)) device for NPWT in addition to standard treatment of infection or dehiscence in our institution...
March 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28641971/comorbidities-have-a-greater-impact-than-age-alone-in-the-outcomes-of-octogenarian-total-knee-arthroplasty
#6
Kae Sian Tay, Eric W L Cher, Karen Zhang, Seang Beng Tan, Tet Sen Howe, Joyce S B Koh
BACKGROUND: Increasing age and various comorbidities are known risk factors for complications after total knee arthroplasty (TKA), but data on the impact of total comorbidity burden is scarce. We investigated the effect of age and total comorbidity burden on outcomes after primary TKA in octogenarians (OGs). METHODS: A matched-pair comparison study was conducted using prospectively collected TKA registry data in a large tertiary institution. Between 2006 and 2011, consecutive OGs undergoing primary unilateral TKA, with minimum 2-year follow-up, were matched 1:1 with younger controls based on demographic and surgical variables...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28634096/reconstruction-of-disrupted-extensor-mechanism-after-total-knee-arthroplasty
#7
C T Lim, Derek F Amanatullah, James I Huddleston, Alex H S Harris, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: Disruption of the extensor mechanism after total knee arthroplasty (TKA) is a debilitating complication that results in extension lag, limited range of motion, difficulty in walking, frequent falls, and chronic pain. This study presents the clinical and radiographic results of reconstruction after extensor mechanism disruption in TKA patients. METHODS: Consecutive patients with allograft reconstruction of extensor mechanism after TKA were identified retrospectively from an academic tertiary center for revision TKA...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#8
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622842/two-stage-knee-arthrodesis-with-a-modular-intramedullary-nail-due-to-septic-failure-of-revision-total-knee-arthroplasty-with-extensor-mechanism-deficiency
#9
Max J Friedrich, Jan Schmolders, Matthias D Wimmer, Andreas C Strauss, Milena M Ploeger, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
BACKGROUND: Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28617518/tibiofemoral-instability-after-primary-total-knee-arthroplasty-posterior-stabilized-implants-for-obese-patients
#10
Ata Can, Fahri Erdogan, Ayse Ovul Erdogan
Tibiofemoral instability is a common complication after total knee arthroplasty (TKA), accounting for up to 22% of all revision procedures. Instability is the second most common cause of revision in the first 5 years after primary TKA. In this study, 13 knees with tibiofemoral instability after TKA were identified among 693 consecutive primary TKA procedures. Patient demographics, body mass index, clinical symptoms, previous deformity, previous knee surgery, complications, interval between index TKA and first tibiofemoral instability, causes of instability, and interval between index TKA and revision TKA were retrospectively reviewed...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28614237/can-intravenous-steroid-administration-reduce-postoperative-pain-scores-following-total-knee-arthroplasty-a-meta-analysis
#11
Li-Zhi Xing, Li Li, Lan-Ju Zhang
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate whether intravenous steroids would result in reduced acute pain and postoperative nausea and vomiting (PONV) among patients undergoing total knee arthroplasty (TKA). METHODS: Electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, were searched to identify articles published from database inception to July 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614226/tranexamic-acid-plus-diluted-epinephrine-versus-tranexamic-acid-alone-for-blood-loss-in-total-joint-arthroplasty-a-meta-analysis
#12
Zhanxia Yu, Lulan Yao, Qin Yang
BACKGROUND: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)). METHODS: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28610442/the-effect-of-a-corrective-functional-exercise-program-on-postural-thoracic-kyphosis-in-teenagers-a-randomized-controlled-trial
#13
Qiang Feng, Mei Wang, Yanfeng Zhang, Yu Zhou
OBJECTIVE: To investigate the effects of a corrective functional exercise program on postural thoracic kyphosis in teenagers in China. DESIGN: A single-blind randomized controlled trial including students with a thoracic kyphosis angle (TKA) >40° measured using the SpinalMouse. SETTING: China Institute of Sport Science and three middle schools in Beijing, China. SUBJECTS: A total of 181 subjects were included in this trial; of these, 164 subjects were included in the analyses (intervention group, n = 81; control group, n = 83)...
June 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28601393/oxidized-zirconium-versus-cobalt-chromium-against-the-native-patella-in-total-knee-arthroplasty-patellofemoral-outcomes
#14
Fabrizio Matassi, Tommaso Paoli, Roberto Civinini, Christian Carulli, Massimo Innocenti
BACKGROUND: Oxidized zirconium (OxZr) has demonstrated excellent mechanical properties in vitro when used against articular cartilage; less coefficient of friction and less chondral damage have been found when compared with cobalt-chromium (CoCr) implants. However, controversy exists as to whether implants with a zirconium femoral component articulate safely with a native patella in total knee arthroplasty (TKA). To answer this question, the clinical and radiographic results were analysed from a group of patients who underwent a TKA with patella retention; the OxZr versus CoCr femoral components were compared...
June 7, 2017: Knee
https://www.readbyqxmd.com/read/28600378/association-between-preoperative-anaemia-with-length-of-hospital-stay-among-patients-undergoing-primary-total-knee-arthroplasty-in-singapore-a-single-centre-retrospective-study
#15
Hairil Rizal Abdullah, Yilin Eileen Sim, Ying Hao, Geng Yu Lin, Geoffrey Haw Chieh Liew, Ecosse L Lamoureux, Mann Hong Tan
OBJECTIVES: Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. METHODS: Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014...
June 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28598560/effects-of-unilateral-tourniquet-used-in-patients-undergoing-simultaneous-bilateral-total-knee-arthroplasty
#16
Pei-Lai Liu, De-Qiang Li, Yuan-Kai Zhang, Qun-Shan Lu, Liang Ma, Xue-Zhi Bao, Meng Zhang
OBJECTIVE: To assess the benefits of use of a tourniquet in one limb in patients undergoing simultaneous bilateral total knee arthroplasty (TKA). METHODS: A prospective randomized trial was designed to evaluate the outcomes of unilateral tourniquet use during simultaneous bilateral TKA. A total of 52 (36 women and 16 men) patients with osteoarthritis who underwent simultaneous bilateral primary TKA between January 2010 and January 2015 were assigned randomly to tourniquet (TG) or non-tourniquet (NG) groups prior to surgery...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28594501/prevention-and-diagnosis-of-periprosthetic-knee-infection
#17
Bilal Mahmood, Mouhanad M El-Othmani, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Total knee arthroplasty (TKA) has become an increasingly common treatment option for patients who have debilitating knee arthritis. TKA is a relatively safe and efficient procedure that results in promising outcomes and has a positive effect on a patient's quality of life. More TKAs are being performed annually because the procedure substantially reduces pain and improves functionality; however, as the number of TKAs continues to rise, there is concern for potential complications that may result in prosthetic joint failure...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28585995/outcomes-of-primary-total-knee-arthroplasty-in-patients-with-hematopoietic-stem-cell-transplantation
#18
Brian P Chalmers, Cameron K Ledford, Kevin I Perry, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28583757/intravenous-acetaminophen-in-multimodal-pain-management-for-patients-undergoing-total-knee-arthroplasty-a-randomized-double-blind-placebo-controlled-trial
#19
Minako Murata-Ooiwa, Sachiyuki Tsukada, Motohiro Wakui
BACKGROUND: Although multimodal pain management including periarticular multidrug injection can provide excellent pain relief in the early postoperative period after total knee arthroplasty (TKA), rebounding pain remains an important challenge. A randomized, double-blind, placebo-controlled trial was performed to investigate the efficacy of adding intravenous acetaminophen to multimodal pain management for TKA. METHODS: We enrolled 67 patients scheduled for unilateral TKA...
May 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28583752/management-of-knee-rheumatoid-arthritis-and-tibia-nonunion-with-one-stage-total-knee-arthroplasty-and-intramedullary-nailing-a-report-of-two-cases
#20
Fahri Erdogan, Ilker Abdullah Sarikaya, Ata Can, Baris Gorgun
Total knee arthroplasty (TKA) is a surgical procedure which is widely used in the treatment of gonarthrosis secondary to rheumatoid arthritis (RA). The incidence of stress fractures in tibia in the patients with RA is higher compared to normal patients. In this study, we report two cases of TKA and intramedullary nailing in RA patients with severe knee arthritis and tibial nonunion. Both patients had a satisfactory clinical outcome with radiological healing of the tibial fracture.
June 2, 2017: Acta Orthopaedica et Traumatologica Turcica
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