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TKA outcomes

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https://www.readbyqxmd.com/read/28093635/different-intraoperative-kinematics-stability-and-range-of-motion-between-cruciate-substituting-ultracongruent-and-posterior-stabilized-total-knee-arthroplasty
#1
Hagen Fritzsche, Franziska Beyer, Anne Postler, Jörg Lützner
PURPOSE: The aim of this study was the comparison of intraoperative kinematics, stability, and range of motion (ROM) between the native osteoarthritic knee and cruciate-substituting fixed-bearing total knee arthroplasty (TKA) using both an ultracongruent (UC) and a posterior-stabilized (PS) insert design in the same patient. We hypothesized less knee flexion and less antero-posterior stability in the UC TKA. METHODS: Intraoperative measurements of kinematics, stability, and ROM were performed in 40 patients before soft-tissue release and bone cuts, and after implantation of the final femoral and tibial implants with both a UC insert and a PS insert...
January 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#2
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28089798/a-meta-analysis-of-external-fixation-versus-open-reduction-and-internal-fixation-for-complex-tibial-plateau-fractures
#3
REVIEW
Xing-Wen Zhao, Jian-Xiong Ma, Xin-Long Ma, Xuan Jiang, Yin Wang, Fei Li, Bin Lu
PURPOSE: Both external fixation(ExFx) and open reduction and internal fixation(ORIF) were used to treat complex tibial plateau fractures, but it was not sure which one was better. So we did this meta-analysis to evaluate the outcomes of ExFx and ORIF in managing complex tibial plateau fractures. METHODS: Articles published before August 5, 2016 were selected from PubMed, Cochrane library, and some other electronic database. Relevant journals were also searched manually with no language limited...
January 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#4
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#5
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28088227/simplified-chinese-version-of-the-forgotten-joint-score-fjs-for-patients-who-underwent-joint-arthroplasty-cross-cultural-adaptation-and-validation
#6
Shiqi Cao, Ning Liu, Wuxiang Han, Yunpeng Zi, Fan Peng, Lexiang Li, Qiwei Fu, Yi Chen, Weijie Zheng, Qirong Qian
BACKGROUND: The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS). METHODS: Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study...
January 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28088207/cytokine-and-neuropeptide-levels-are-associated-with-pain-relief-in-patients-with-chronically-painful-total-knee-arthroplasty-a-pilot-study
#7
Jasvinder A Singh, Siamak Noorbaloochi, Keith L Knutson
BACKGROUND: There are few studies with an assessment of the levels of cytokines or neuropeptides as correlates of pain and pain relief in patients with painful joint diseases. Our objective was to assess whether improvements from baseline to 2-months in serum cytokine, chemokine and substance P levels were associated with clinically meaningful pain relief at 2-months post-injection in patients with painful total knee arthroplasty (TKA). METHODS: Using data from randomized trial of 60 TKAs, we assessed the association of change in cytokine/chemokine/Substance P levels with primary study outcome, clinically important improvement in Western Ontario McMaster Osteoarthritis Index (WOMAC) pain subscale at 2-months post-injection using Student's t-tests and Spearman's correlation coefficient (non-parametric)...
January 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28079176/adductor-canal-block-versus-femoral-nerve-block-for-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#8
Duan Wang, Yang Yang, Qi Li, Shen-Li Tang, Wei-Nan Zeng, Jin Xu, Tian-Hang Xie, Fu-Xing Pei, Liu Yang, Ling-Li Li, Zong-Ke Zhou
Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength. The meta-analysis was designed to evaluate whether ACB exhibited better outcomes with respect to quadriceps strength, pain control, ambulation ability, and complications. PubMed, Embase, Web of Science, Wan Fang, China National Knowledge Internet (CNKI) and the Cochrane Database were searched for RCTs comparing ACB with FNB after TKAs...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28077124/important-patient-characteristics-differ-prior-to-total-knee-arthroplasty-and-total-hip-arthroplasty-between-switzerland-and-the-united-states
#9
Patricia D Franklin, Hermes Miozzari, Panayiotis Christofilopoulos, Pierre Hoffmeyer, David C Ayers, Anne Lübbeke
BACKGROUND: Outcomes after total knee (TKA) and hip (THA) arthroplasty are often generalized internationally. Patient-dependent factors and preoperative symptom levels may differ across countries. We compared preoperative patient and clinical characteristics from two large cohorts, one in Switzerland, the other in the US. METHODS: Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed at a large Swiss hospital and in a US national sample...
January 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28072902/development-of-an-encompassing-questionnaire-for-evaluating-the-outcomes-following-total-knee-arthroplasty
#10
Morad Chughtai, Anton Khlopas, Melbin Thomas, Chukwuweike U Gwam, Julio J Jauregui, Randa K Elmallah, Martin Roche, Michael A Mont
INTRODUCTION: There are many standardized scales and questionnaires used to evaluate TKA patients; however, individually they do not always assess patients adequately. Consequently, many are used in combinations to provide a thorough evaluation. However, this leads to redundancy, confusion, and an excessive patient time-burden. Therefore, the purpose of this study was to develop a usable combined knee questionnaire that combines questions in a non-redundant manner. Specifically, we aimed to: 1) create a combined knee questionnaire that encompasses questions from multiple systems, while eliminating redundancy; 2) correlate the new system with the existing validated questionnaires; and 3) determine the length of time it takes to administer this new questionnaire...
10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28065627/revision-total-hip-and-knee-arthroplasties-after-solid-organ-transplant
#11
Cameron K Ledford, Joseph M Statz, Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: As solid organ transplant (SOT) patients' survival improves, the number undergoing total hip (THA) and total knee arthroplasty (TKA) is increasing. Accordingly, the number of revision procedures in this higher-risk group is also increasing. The goals of this study were to identify the most common failure mechanisms, associated complications, clinical outcomes, and patient survivorship of SOT patients after revision THA or TKA. METHODS: A retrospective review identified 39 revision procedures (30 revision THAs and 9 revision TKAs) completed in 37 SOT patients between 2000 and 2013...
December 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28065624/outcome-of-unicondylar-knee-arthroplasty-vs-total-knee-arthroplasty-for-early-medial-compartment-arthritis-a-randomized-study
#12
Vikas Kulshrestha, Barun Datta, Santhosh Kumar, Gaurav Mittal
BACKGROUND: With increasing number of patients with early osteoarthritis of knee opting for total knee arthroplasty (TKA), there has been increase in patients dissatisfied with surgical outcomes. It is being presumed that offering unicondylar knee arthroplasty (UKA) to them would improve outcomes. METHODS: Primary objective of our study was to look for any difference in patient-reported outcome and function at 2-year follow-up in patients undergoing UKA as compared to TKA...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28061515/spacer-based-gap-balancing-in-total-knee-arthroplasty-clinical-success-with-a-reproducible-technique
#13
Frédéric Lavoie
Purpose Proper coronal and transverse ligament balancing is an important aspect of total knee arthroplasty (TKA) and has an impact on postoperative outcome. Many variations of the gap balancing technique were described to address this challenge, most of them using various tensioning devices, but none for which the use is widespread. The aim of this paper is to describe a gap technique variant for TKA using spacer blocks and report the clinical results for a cohort of patients on which it was used. Methods A total of 114 TKAs were performed in 101 patients using a standardized surgical technique that integrates ligament balancing with sizing and positioning of the femoral component...
January 6, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28060788/outpatient-total-hip-arthroplasty-total-knee-arthroplasty-and-unicompartmental-knee-arthroplasty-a-systematic-review-of-the-literature
#14
Michael Pollock, Lyndsay Somerville, Andrew Firth, Brent Lanting
BACKGROUND: The demand for total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) is growing rapidly because of the proven success of these procedures and an increase in the aging population. However, resources are limited and health-care budgets are finite. Recently, a number of care providers have started performing these procedures on an outpatient basis, with the patients being discharged from the hospital on the day of surgery. The primary objective of this systematic review was to examine the evidence regarding the safety and feasibility of performing THA, TKA, or UKA on an outpatient basis...
December 27, 2016: JBJS Reviews
https://www.readbyqxmd.com/read/28060227/preoperative-opioid-use-is-associated-with-early-revision-after-total-knee-arthroplasty-a-study-of-male-patients-treated-in-the-veterans-affairs-system
#15
Alon Ben-Ari, Howard Chansky, Irene Rozet
BACKGROUND: Opioid use is endemic in the U.S. and is associated with morbidity and mortality. The impact of long-term opioid use on joint-replacement outcomes remains unknown. We tested the hypothesis that use of opioids is associated with adverse outcomes after total knee arthroplasty (TKA). METHODS: We performed a retrospective analysis of patients who had had TKA within the U.S. Veterans Affairs (VA) system over a 6-year period and had been followed for 1 year postoperatively...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28053257/knee-joint-distraction-compared-with-total-knee-arthroplasty-a-randomised-controlled-trial
#16
J A D van der Woude, K Wiegant, R J van Heerwaarden, S Spruijt, P J Emans, S C Mastbergen, F P J G Lafeber
AIMS: Knee joint distraction (KJD) is a relatively new, knee-joint preserving procedure with the goal of delaying total knee arthroplasty (TKA) in young and middle-aged patients. We present a randomised controlled trial comparing the two. PATIENTS AND METHODS: The 60 patients ≤ 65 years with end-stage knee osteoarthritis were randomised to either KJD (n = 20) or TKA (n = 40). Outcomes were assessed at baseline, three, six, nine, and 12 months. In the KJD group, the joint space width (JSW) was radiologically assessed, representing a surrogate marker of cartilage thickness...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28053251/bias-and-unicompartmental-knee-arthroplasty
#17
D W Murray, A D Liddle, A Judge, H Pandit
We recently published a paper comparing the incidence of adverse outcomes after unicompartmental and total knee arthroplasty (UKA and TKA). The conclusion of this study, which was in favour of UKA, was dismissed as "biased" in a review in Bone & Joint 360 Although this study is one of the least biased comparisons of UKA and TKA, this episode highlights the biases that exist both for and against UKA. In this review, we explore the different types of bias, particularly selection, reporting and measurement. We conclude that comparisons between UKA and TKA are open to bias...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28050638/patients-control-preferences-and-results-in-knee-arthroplasty
#18
G Filardo, A Roffi, G Merli, T Marcacci, F Berti Ceroni, D Raboni, E Kon, M Marcacci
PURPOSE: Patient engagement in a patient-physician decision-making process has been correlated with satisfaction and clinical outcomes. Aim of this study is to evaluate if patient control preference may also influence TKA results. METHODS: One hundred and seventy-six patients (120w-56m, age 66 ± 9 years, BMI 28 ± 4) underwent TKA and were prospectively evaluated, before surgery and at 6 and 12 months. The preoperative assessment included the Control Preference Scale (CPS) and other scales measuring psychological aspects (STAI, BDI, TSK), as well as SF12 (physical and mental subscales) and the assessment of pain and function...
January 3, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28050637/depressed-patients-feel-more-pain-in-the-short-term-after-total-knee-arthroplasty
#19
Raúl Torres-Claramunt, Pedro Hinarejos, Jorge Amestoy, Joan Leal, Juan Sánchez-Soler, Lluís Puig-Verdié, Joan C Monllau
PURPOSE: The hypothesis of this study was that depressive patients feel more pain in the immediate TKA postoperative period in comparison with non-depressed patients. METHODS: The diagnosis of depression was made with the Geriatric Depression Scale Short Form. The Visual Analogic Score (VAS) was registered each 8 h during the first 3 days. The mean and maximum VAS and the number of analgesic rescues required in this period were calculated in 803 consecutive TKAs...
January 3, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28042121/conversion-of-a-unicompartmental-knee-arthroplasty-to-a-total-knee-arthroplasty-can-we-achieve-a-primary-result
#20
E Thienpont
OBJECTIVES: Unicompartmental knee arthroplasty (UKA) is a potential treatment for isolated bone on bone osteoarthritis when limited to a single compartment. The risk for revision of UKA is three times higher than for total knee arthroplasty (TKA). The aim of this review was to discuss the different revision options after UKA failure. MATERIALS AND METHODS: A search was performed for English language articles published between 2006 and 2016. After reviewing titles and abstracts, 105 papers were selected for further analysis...
January 2017: Bone & Joint Journal
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