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TKA outcomes

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https://www.readbyqxmd.com/read/29457342/soft-tissue-balancing-in-total-knee-arthroplasty-using-sensor-guided-assessment-is-there-a-learning-curve
#1
Monther A Gharaibeh, Darren B Chen, Samuel J MacDessi
BACKGROUND: Sensor-guided assessment for soft tissue balance in total knee arthroplasty (TKA) has been reported to improve patient satisfaction and self-reported outcome scores. As more surgeons adopt this technology in TKA, we performed this study to identify if there is a learning curve with its use. METHODS: Analysis of a total of 90 consecutive cases was performed in this study. Initial and final intercompartmental pressure differences were recorded before and after knee ligament balancing...
February 18, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29454556/validity-and-responsiveness-of-the-two-minute-walk-test-for-measuring-functional-recovery-after-total-knee-arthroplasty
#2
Aasis Unnanuntana, Pakpoom Ruangsomboon, Worawut Keesukpunt
BACKGROUND: The 2-minute walk test (2mwt) is a performance-based test that evaluates functional recovery after total knee arthroplasty (TKA). This study evaluated its validity compared with the modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), modified Knee Score, Numerical Pain Rating Scale, and Timed Up and Go test, and its responsiveness in assessing functional recovery in TKA patients. METHODS: This prospective cohort study included 162 patients undergoing primary TKA between 2013 and 2015...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452971/medial-overhang-of-the-tibial-component-is-associated-with-higher-risk-of-inferior-knee-injury-and-osteoarthritis-outcome-score-pain-after-knee-replacement
#3
Christian S Nielsen, Audrey Nebergall, James Huddleston, Thomas Kallemose, Henrik Malchau, Anders Troelsen
BACKGROUND: The aim of this prospective multicenter study is to investigate the association among (1) tibial site-specific overhang of medial, anterior, and lateral overhang in relation to Knee Injury and Osteoarthritis Outcome Score pain 1 year after surgery (1 Y KOOS pain) and (2) the malalignment of TKA components including overall malalignment in relation to 1 Y KOOS pain. METHODS: From 10 centers, across 4 continents, 323 patients were enrolled from October 2011 to February 2014...
December 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452296/development-and-persistence-of-suspected-neuropathic-pain-after-total-knee-arthroplasty-in-individuals-with-osteoarthritis
#4
Matthew Fitzsimmons, Eloise Carr, Linda Woodhouse, Geoff P Bostick
BACKGROUND: Despite the effectiveness of total knee arthroplasty (TKA) for osteoarthritis (OA), up to 20% will report knee pain 1-year after surgery. One possible reason is the development of neuropathic pain before or after TKA. OBJECTIVE: To longitudinally describe suspected neuropathic pain in patients pre- and post-TKA and to explore relationships between pre-TKA suspected neuropathic pain and post-TKA outcomes. DESIGN: Prospective observational study...
February 13, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29437056/efficacy-and-safety-of-intra-articular-versus-intravenous-tranexamic-acid-in-reducing-perioperative-blood-loss-in-total-knee-arthroplasty-a-prospective-randomized-double-blind-equivalence-trial
#5
RANDOMIZED CONTROLLED TRIAL
K N Subramanyam, P Khanchandani, P V Tulajaprasad, J Jaipuria, A V Mundargi
AIMS: The aims of this study were to compare the efficacy and safety of intra-articular and intravenous (IV) tranexamic acid (TXA) in controlling perioperative blood loss in total knee arthroplasty (TKA) using a randomized, double-blinded equivalence trial. PATIENTS AND METHODS: A total of 182 patients aged between 45 and 75 years undergoing unilateral TKA at a tertiary centre were randomized to receive TXA, either 1.5 g intra-articularly after closure of the wound (n = 91) or two doses of 10 mg/kg IV (n = 91)...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29433583/mid-term-survivorship-of-cruciate-retaining-versus-posterior-stabilized-total-knee-arthroplasty-using-modular-mini-keel-tibial-implants
#6
Cheng-Pang Yang, Kuo-Yao Hsu, Yu-Han Chang, Yi-Sheng Chan, Hsin-Nung Shih, Alvin Chao-Yu Chen
BACKGROUND: Reports of diverse outcomes in modular mini-keel tibial componentry for total knee arthroplasty (TKA) have raised concerns about early aseptic loosening. Cruciate-retaining (CR) prostheses, using mini-keel implants, have yet to be reported and compared to posterior-stabilizing (PS) designs. METHODS: A retrospective, case-matched study of 91 consecutive TKAs (n = 46 CR; n = 45 PS prostheses), using modular mini-keel tibial componentry with a 45-mm drop down stem extension, was conducted...
February 13, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29432263/perioperative-inpatient-use-of-selective-serotonin-reuptake-inhibitors-is-associated-with-a-reduced-risk-of-tha-and-tka-revision
#7
Jie J Yao, Hilal Maradit Kremers, Walter K Kremers, David G Lewallen, Daniel J Berry
BACKGROUND: Depression is common in the general population, and so it is likewise common among patients undergoing THA and TKA. Depression is associated with lower perioperative patient-reported outcomes and an increased risk of postoperative complications. Antidepressants are effective in managing symptoms of depression and may potentially contribute to better functional status and better clinical outcomes after THA and TKA. QUESTIONS/PURPOSES: We examined (1) whether perioperative depression is associated with all-cause revisions, revisions for aseptic loosening, revisions without infection, and periprosthetic joint infections (PJIs) in patients undergoing THA and TKA; and (2) whether perioperative antidepressant use reduces the risk of all-cause revisions, revisions for aseptic loosening, aseptic revisions, and PJIs in patients undergoing THA and TKA...
February 8, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29430491/total-knee-arthroplasty-in-patients-with-retention-of-prior-hardware-material-what-is-the-outcome
#8
Jorge Manrique, Mohammad R Rasouli, Camilo Restrepo, Mitchell G Maltenfort, Jonathan Beri, Jeffrey Oliver, Raj Patel, Javad Parvizi
Background: There is an information gap in literature regarding postoperative outcome of total knee arthroplasty (TKA) in patients with hardware in-situ from the previous knee surgery. The present study aims to evaluate impact of retained hardware on short-term outcome of TKA patients. Methods: Perioperative radiographs of patients who had undergone TKA between 2007 and 2012 were reviewed and patients in whom partial or complete retention of hardware was evident after TKA were included...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29430490/does-a-previous-high-tibial-osteotomy-hto-influence-the-long-term-function-or-survival-of-a-total-knee-arthroplasty-tka
#9
REVIEW
E Carlos Rodriguez-Merchan
High tibial osteotomy (HTO) is a well established technique for the treatment of medial osteoarthritis of the knee with varus malalignment. The outcome of total knee arthroplasty (TKA) after HTO remains uncertain. The aim of this paper is to revise the literature with the aim of answering the following question: Does a previous (HTO) influence the long-term function or survival of a TKA?. The search engine was MedLine. The keywords used were: total knee arthroplasty after high tibial osteotomy. One hundred and ten articles were found...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29429882/mepivacaine-spinal-anesthesia-facilitates-rapid-recovery-in-total-knee-arthroplasty-compared-to-bupivacaine
#10
M Chad Mahan, Toufic R Jildeh, Troy N Tenbrunsel, Jason J Davis
BACKGROUND: Mepivacaine as a spinal anesthetic for rapid recovery in total knee arthroplasty (TKA) has not been assessed. The purpose of this study is to compare spinal mepivacaine vs bupivacaine for postoperative measures in patients undergoing primary TKA. METHODS: Retrospective review of a prospectively collected single-institution database was performed on 156 consecutive patients who underwent primary TKA. Fifty-three patients were administered mepivacaine and 103 patients were administered bupivacaine...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29428984/tibial-component-coverage-and-rotational-alignment-accuracy-after-mobile-bearing-total-knee-arthroplasty
#11
Yoshinori Ishii, Hideo Noguchi, Junko Sato, Hana Ishii, Koji Todoroki, Shin-Ichi Toyabe
BACKGROUND: Tibial component coverage (TCC) and tibial rotational angle (TRA) have been studied simultaneously in simulations, but not in clinical studies after total knee arthroplasty (TKA). The purposes of this study were (1) to evaluate TCC and rotational setting postoperatively in mobile-bearing TKA patients and (2) to compare the results with previously published simulation data. METHODS: We prospectively examined 100 patients who underwent primary TKA using the LCS® Total Knee System (LCS) posterior cruciate ligament-substituting prosthesis...
February 10, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29428466/irrigation-and-debridement-for-early-periprosthetic-knee-infection-is-it-effective
#12
Rajkishen Narayanan, Afshin A Anoushiravani, Ameer M Elbuluk, Kevin K Chen, Edward M Adler, Ran Schwarzkopf
BACKGROUND: Irrigation and debridement (I&D) is performed for early management of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Symptom reporting is a subjective measure and may miss direct management of PJI. Utilizing an objective time interval from index procedure to I&D may better inform treatment decisions. METHODS: From 2009 to 2017, retrospective review was performed of 55 knee PJI cases at our institution. All patients underwent polyethylene liner exchange and I&D for PJI...
January 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29426792/twelve-year-follow-up-of-navigated-computer-assisted-versus-conventional-total-knee-arthroplasty-a-prospective-randomized-comparative-trial
#13
Johannes Cip, Florian Obwegeser, Thomas Benesch, Christian Bach, Paul Ruckenstuhl, Arno Martin
BACKGROUND: Navigated computer-assisted total knee arthroplasty (TKA) was introduced to expedite long-term survival based on improved postoperative implantation accuracy. However, long-term outcome data after 10 years or more are rare, even available meta-analyses show controversial study results. METHODS: In a prospective randomized trial, 100 conventional TKAs (group CONV) were compared with 100 computer-assisted TKAs (group NAV) after a mean follow-up of 12 years postoperatively...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29423545/improved-walking-distance-and-range-of-motion-predict-patient-satisfaction-after-tka
#14
Stefaan Van Onsem, Matthias Verstraete, Sebastiaan Dhont, Bert Zwaenepoel, Catherine Van Der Straeten, Jan Victor
PURPOSES: The focus in the evaluation of total knee arthroplasty has shifted from objective measures of implant position and knee function, to patient-reported outcome measures (PROMs). The relation between these two measures was investigated and the possibility of prediction of the patient satisfaction level was evaluated by defining thresholds for improvement of (1) range of motion (ROM), (2) 6-min walk test (6MWT), (3) sit-to-stand test (STS) and (4) quadriceps force after TKA? METHODS: Fifty-seven patients were prospectively tested at preoperative and 6 months postoperative intervals...
February 8, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29417168/patient-reported-outcome-metrics-following-total-knee-arthroplasty-are-influenced-differently-by-patients-body-mass-index
#15
J M Giesinger, F L Loth, D J MacDonald, K Giesinger, J T Patton, A H R W Simpson, C R Howie, David F Hamilton
PURPOSE: This study investigated the impact of body mass index (BMI) on improvement in patient outcomes (pain, function, joint awareness, general health and satisfaction) following total knee arthroplasty (TKA). METHODS: Data were obtained for primary TKAs performed at a single centre over a 12-month period. Data were collected pre-operatively and 12-month postoperatively with the Oxford Knee Score (OKS) measuring pain and function, the EQ-5D-3L measuring general health status, the Forgotten Joint Score-12 (FJS-12) measuring joint awareness and a single question on treatment satisfaction...
February 7, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29416347/total-knee-arthroplasty-improving-outcomes-with-a-multidisciplinary-approach
#16
REVIEW
James E Feng, David Novikov, Afshin A Anoushiravani, Ran Schwarzkopf
Total knee arthroplasty (TKA) is the most commonly performed inpatient surgical procedure within the USA and is estimated to reach 3.48 million procedures annually by 2030. As value-based care initiatives continue to focus on hospital readmission rates and patient satisfaction, it has become essential for health care providers to develop and implement a multidisciplinary approach to enhance TKA outcomes while minimizing unnecessary expenditures. Through this necessity, clinical care pathways have been developed to standardize, organize, and improve the quality and efficiency of patient care while simultaneously encouraging the collaboration among various medical care providers...
2018: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29414612/comparing-adductor-canal-block-with-local-infiltration-analgesia-in-total-knee-arthroplasty-a-prospective-blinded-and-randomized-clinical-trial
#17
Qian Jun Tong, Yean Chin Lim, Huae Min Tham
STUDY OBJECTIVE: Total knee arthroplasty (TKA) is associated with significant pain post-operatively. Our hypothesis is that adductor canal block (ACB) would be superior to local infiltration analgesia (LIA) in terms of providing analgesia, while still preserving quadriceps strength and enabling early postoperative rehabilitation. DESIGN: A prospective, blinded and randomized clinical trial between LIA and ACB was conducted. SETTING: Tertiary care urban hospital...
January 25, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29411900/in-vivo-comparison-of-medialized-dome-and-anatomic-patellofemoral-geometries-using-subject-specific-computational-modeling
#18
Azhar A Ali, Erin M Mannen, Paul J Rullkoetter, Kevin B Shelburne
Successful outcome following total knee arthroplasty (TKA) with patella resurfacing is partly determined by the restoration of patellofemoral (PF) function and recovery of the quadriceps mechanism. The current study compared two patellar TKA geometries (medialized dome and anatomic) to determine their impact on PF mechanics and quadriceps function. In-vivo, subject-specific patellar mechanics were evaluated using a sequential experimental and modeling approach. First, stereo radiography, marker-based motion capture, and force plate data were collected for TKA patients (10 dome, 10 anatomic) performing a knee extension and lunge...
February 7, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29408472/tranexamic-acid-plus-drain-clamping-can-reduce-blood-loss-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#19
REVIEW
Lele Liao, You Chen, Qi Tang, Yi-Yue Chen, Wan-Chun Wang
BACKGROUND: The efficacy of tranexamic acid (TXA) plus drain-clamping in reducing blood loss after total knee arthroplasty (TKA) is controversial. This meta-analysis aimed to identify whether combined tranexamic acid and drain-clamping was superior to TXA alone, drain clamping alone and control treatments. METHODS: We searched the PubMed, EMBASE, Web of Science and Google databases and the Cochrane Database of Systematic Reviews. Patients prepared for primary TKA and who underwent TXA plus drain-clamping for blood loss were included in this meta-analysis...
February 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29405135/an-update-on-technical-interpretative-and-clinical-relevance-of-antimicrobial-synergy-testing-methodologies
#20
REVIEW
Shakti Laishram, Agila Kumari Pragasam, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
Testing for antimicrobial interactions has gained popularity in the last decade due to the increasing prevalence of drug-resistant organisms and limited options for the treatment of these infections. In vitro combination testing provides information, on which two or more antimicrobials can be combined for a good clinical outcome. Amongst the various in vitro methods of drug interactions, time-kill assay (TKA), checkerboard (CB) assay and E-test-based methods are most commonly used. Comparative performance of these methods reveals the TKA as the most promising method to detect synergistic combinations followed by CB assay and E-test...
October 2017: Indian Journal of Medical Microbiology
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