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Total knee replacement

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https://www.readbyqxmd.com/read/29221471/in-home-versus-hospital-preoperative-balance-and-proprioceptive-training-in-patients-undergoing-tkr-rationale-design-and-method-of-a-randomized-controlled-trial
#1
José-María Blasco, Celedonia Igual-Camacho, Sergio Roig-Casasús
BACKGROUND: Severe knee osteoarthritis, as well as the surgical procedure of total knee replacement that aims to reduce its symptoms, cause great deterioration on the proprioceptive system. Taking this fact into account, and considering that balance abilities positively influence the capacity to perform basic functional tasks, this trial aims to find the short and mid-term effects of a preoperative balance and proprioceptive training when conducted by patients undergoing total knee replacement...
December 8, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29217856/adductor-canal-block-for-post-operative-analgesia-after-simultaneous-bilateral-total-knee-replacement-a-randomised-controlled-trial-to-study-the-effect-of-addition-of-dexmedetomidine-to-ropivacaine
#2
Rakhee Goyal, Gaurav Mittal, Arun Kumar Yadav, Rishab Sethi, Animesh Chattopadhyay
Background and Aims: Knee replacement surgery causes tremendous post-operative pain and adductor canal block (ACB) is used for post-operative analgesia. This is a randomised, controlled, three-arm parallel group study using different doses of dexmedetomidine added to ropiavcaine for ACB. Methods: A total of 150 patients aged 18-75 years, scheduled for simultaneous bilateral total knee replacement, received ultrasound-guided ACB. They were randomised into three groups -Group A received ACB with plain ropivacaine; Groups B and C received ACB with ropivacaine and addition of dexmedetomidine 0...
November 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29213219/a-review-on-bone-mineral-density-loss-in-total-knee-replacements-leading-to-increased-fracture-risk
#3
REVIEW
M Gundry, S Hopkins, K Knapp
The link between low bone mineral density (BMD) scores leading to greater fracture risk is well established in the literature; what is not fully understood is the impact of total knee replacements/revisions or arthroplasties on BMD levels. This literature review attempts to answer this question. Several different databases using specific key terms were searched, with additional papers retrieved via bibliographic review. Based on the available evidence, total knee replacements/revisions and arthroplasties lower BMD and thus increase fracture risk...
2017: Clinical Reviews in Bone and Mineral Metabolism
https://www.readbyqxmd.com/read/29212384/articular-and-subcutaneous-adipose-tissues-of-rheumatoid-arthritis-patients-represent-equal-sources-of-immunoregulatory-mesenchymal-stem-cells
#4
Urszula Skalska, Ewa Kuca-Warnawin, Anna Kornatka, Iwona Janicka, Urszula Musiałowicz, Tomasz Burakowski, Ewa Kontny
Adipose-derived mesenchymal stem cells (ASCs) have immunoregulatory properties, but their activity is dependent on signals provided by the local microenvironment. It is likely that highly inflammatory milieu of rheumatoid joint affects ASCs activity. To test this hypothesis, the function of rheumatoid ASCs derived from articular adipose tissue (AT-ASCs) and ASCs derived from subcutaneous adipose tissue (Sc-ASCs) has been analysed. Articular adipose tissue (infrapatellar fat pad) and subcutaneous adipose tissue (from the site of skin closure with sutures) were obtained from rheumatoid arthritis (RA) patients undergoing total knee joint replacement surgery...
December 6, 2017: Autoimmunity
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
#5
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/29208013/patients-and-surgeons-provide-endorsement-of-core-domains-for-total-joint-replacement-clinical-trials
#6
Anh Hoang, Susan M Goodman, Iris Y Navarro-Millán, Lisa A Mandl, Mark P Figgie, Mathias P Bostrom, Douglas E Padgett, Peter K Sculco, Alexander S McLawhorn, Jasvinder A Singh
BACKGROUND: Our objective in this study was to examine whether stakeholders further endorse the core domain set proposed by the Outcome Measures in Rheumatology Trials (OMERACT) total joint replacement (TJR) working group. METHODS: We emailed a survey to 3810 hip/knee arthroplasty patients and 49 arthroplasty surgeons at a high-volume arthroplasty center to rate the importance of each core domain (i.e., pain, function, patient satisfaction, revision surgery, adverse events, and death) and two additional domains (i...
December 6, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29207811/comparative-evaluation-of-ropivacaine-and-fentanyl-versus-ropivacaine-and-fentanyl-with-clonidine-for-postoperative-epidural-analgesia-in-total-knee-replacement-surgery
#7
Shivali Panwar, Preeti S Govind, Parag Jyoti Duarah, Hari Kishan Mahajan, Smita Anil Korde
Introduction: Clonidine an alpha 2 adrenoceptor agonist possesses analgesic properties and has been used as an adjuvant in epidural analgesia. The addition of clonidine to other analgesics may result in enhanced analgesia through additive mechanisms or synergistic mechanisms. The enhanced analgesia may lead to a decrease in the dosage of analgesic drugs along with reduction of side effects. Aim: The purpose of this study was to evaluate the effect of adding clonidine to epidural ropivacaine and fentanyl mixture in terms of quality of analgesia and side effects in patients of total knee replacement surgery...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29207792/clinical-evaluation-of-efficacy-and-performance-of-all-poly-tibial-freedom%C3%A2-total-knee-system-for-treating-osteoarthritis-patients-three-year-follow-up-study
#8
Avatar Singh, Kanwar Kulwinder Singh
Introduction: Advancement in technology in terms of design and building materials has made Total Knee Replacement (TKR) a highly effective, safe, and predictable orthopedic procedure. Aim: To review the clinical outcomes for efficacy and performance of Freedom Total Knee System for the management of Osteoarthritis (OA), at a minimum of three years follow up. Materials and Methods: For this retrospective, post-marketing study, clinical data of patients treated with Freedom Total Knee System was retrieved from the clinical records after approval from the Institutional Ethics Committee ...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29204501/academic-productivity-among-fellowship-associated-adult-total-joint-reconstruction-surgeons
#9
Adam Z Khan, Benjamin V Kelley, Ankur D Patel, David R McAllister, Natalie L Leong
Background: The Hirsch index (h-index) is a measure that evaluates both research volume and quality-taking into consideration both publications and citations of a single author. No prior work has evaluated academic productivity and contributions to the literature of adult total joint replacement surgeons. This study uses h-index to benchmark the academic impact and identify characteristics associated with productivity of faculty members at joint replacement fellowships. Methods: Adult reconstruction fellowship programs were obtained via the American Association of Hip and Knee Surgeons website...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29204489/the-cyclops-lesion-after-bicruciate-retaining-total-knee-replacement
#10
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
https://www.readbyqxmd.com/read/29203035/-perspective-of-the-transition-from-reusable-instruments-to-single-use-ancillary-in-orthopedic-surgery
#11
J Steelandt, T Vaillant, C Duhamel, S Haghighat, J-M Féron, P Paubel, A-L Cordonnier
OBJECTIVES: Since 2009, single-use (SU) ancillaries for total knee arthroplasty (TKA) and total hip arthroplasty (THA) have been marketed to replace reusable ancillaries. The concept is not innovative but their use in orthopedics is still uncommon. An assessment has been done for the use of SU ancillary in Assistance publique-hôpitaux de Paris with the consequences for the patient, the surgeon and the hospital. METHODS: A technical and a clinical review has been done with those devices in 2015...
December 1, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29202806/risk-factors-for-joint-replacement-in-knee-osteoarthritis-a-15-year-follow-up-study
#12
Flemming K Nielsen, Niels Egund, Anette Jørgensen, Anne Grethe Jurik
BACKGROUND: To evaluate whether clinical, radiographic or MRI findings are associated with long term risk for total knee arthroplasty (TKA) in persons with knee osteoarthritis. METHODS: We performed a follow-up analysis of 100 persons with knee osteoarthritis who participated in a clinical trial between 2000 and 2002. Clinical data as well as radiography and MRI of the inclusion knee were obtained in all participants. Data on TKA procedures were extracted from The Danish National Patient Register...
December 4, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29200355/comparing-the-effects-of-reference-pricing-and-centers-of-excellence-approaches-to-value-based-benefit-design
#13
Hui Zhang, David W Cowling, Matthew Facer
Various health insurance benefit designs based on value-based purchasing have been promoted to steer patients to high-value providers, but little is known about the designs' relative effectiveness and underlying mechanisms. We compared the impact of two designs implemented by the California Public Employees' Retirement System on inpatient hospital total hip or knee replacement: a reference-based pricing design for preferred provider organizations (PPOs) and a centers-of-excellence design for health maintenance organizations (HMOs)...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29199469/an-exploratory-study-of-the-long-term-impact-of-difficulty-kneeling-after-total-knee-replacement
#14
Daniel Fletcher, Andrew J Moore, Ashley W Blom, Vikki Wylde
PURPOSE: To explore the long-term impact of difficulty with kneeling and how healthcare services could be improved to help patients kneel after total knee replacement. PATIENTS AND METHODS: Telephone interviews were conducted with 56 patients who had extreme difficulty kneeling at 7-10 years after knee replacement. Patients were asked about reasons for difficulty kneeling, how it impacted upon their lives, and experiences of healthcare services. Responses were recorded on a standardized proforma and a descriptive content analysis performed...
December 3, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29196384/trends-in-joint-replacement-surgery-in-patients-with-rheumatoid-arthritis
#15
Bradley L Young, Shawna L Watson, Jorge L Perez, Gerald McGwin, Jasvinder A Singh, Brent A Ponce
OBJECTIVE: This study analyzed trends in large total joint arthroplasties (TJA) and in the proportion of these procedures performed on patients with rheumatoid arthritis (RA). METHODS: The US Nationwide Inpatient Sample (2002-2012) was used to identify the incidences of total shoulder (TSA), elbow (TEA), knee (TKA), hip (THA), and ankle (TAA) arthroplasty and the proportion of these performed with coexisting RA. RESULTS: The prevalence of RA among patients with TJA increased 3...
December 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29195854/hypothermia-in-total-joint-arthroplasty-a-wake-up-call
#16
Jordan B Simpson, Vijai S Thomas, Sabir K Ismaily, Pavel I Muradov, Philip C Noble, Stephen J Incavo
BACKGROUND: Total joint patients are particularly vulnerable to perioperative hypothermia (PH) (combined effects of anesthesia, radiation, and convective heat loss from exposed skin surfaces and cool temperatures in the operating room). There are limited studies on PH in these patients. METHODS: In a retrospective review of 204 patients undergoing primary hip and 179 undergoing primary knee replacement surgeries, time and temperature parameters were collected from the electronic health records from preoperative and postoperative recovery room nursing assessments, intraoperative anesthesia records, and floor nursing notes...
November 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29195220/a-comprehensive-combined-experimental-and-computational-framework-for-pre-clinical-wear-simulation-of-total-knee-replacements
#17
A Abdelgaied, J Fisher, L M Jennings
A more robust pre-clinical wear simulation framework is required in order to simulate wider and higher ranges of activities, observed in different patient populations such as younger more active patients. Such a framework will help to understand and address the reported higher failure rates for younger and more active patients (National_Joint_Registry, 2016). The current study has developed and validated a comprehensive combined experimental and computational framework for pre-clinical wear simulation of total knee replacements (TKR)...
November 17, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29191443/a-meta-analysis-of-patellar-replacement-in-total-knee-arthroplasty-for-patients-with-knee-osteoarthritis
#18
Xiao-Bo Tang, Jian Wang, Pei-Long Dong, Rong Zhou
BACKGROUND: This meta-analysis (MA) aims at comparing the clinical outcomes of resurfacing and nonresurfacing the patella in patients undergoing total knee arthroplasty in the treatment of knee osteoarthritis. METHODS: Randomized controlled trials were included by retrieving data from electronic English databases. Both fixed and random-effects models were employed, and standardized mean difference and 95% confidence intervals were calculated. Stata13.1 software was used for statistical analysis for all the studies included to compare the differences in improving Knee Society Clinical Score and Knee Society Function Score as well as the reduction in rates of infection, reoperation, and anterior knee pain...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29191076/customized-surface-guided-knee-implant-contact-analysis-and-experimental-test
#19
Ida Khosravipour, Shabnam Pejhan, Yunhua Luo, Urs P Wyss
Contact pressure and stresses on the articulating surface of the tibial component of a total knee replacement are directly related to the joint contact forces and the contact area. These stresses can result in wear and fatigue damage of the ultra-high-molecular-weight polyethylene. Therefore, conducting stress analysis on a newly designed surface-guided knee implant is necessary to evaluate the design with respect to the polyethylene wear. Finite element modeling is used to analyze the design's performance in level walking, stair ascending and squatting...
November 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29189881/satisfactory-functional-and-radiological-outcomes-can-be-expected-in-young-patients-under-45%C3%A2-years-old-after-open-wedge-high-tibial-osteotomy-in-a-long-term-follow-up
#20
Michael E Hantes, Prodromos Natsaridis, Antonios A Koutalos, Yohei Ono, Nikolaos Doxariotis, Konstantinos N Malizos
PURPOSE: To report the long-term outcomes of medial open wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis in patients younger than 45 years old. It was hypothesized that the correction of knee alignment would result in preservation of knee function in a long-term follow-up. METHODS: Patients under 45 years old, who underwent MOWHTO for symptomatic medial compartment knee osteoarthritis between 2001 and 2005 were retrospectively reviewed after a minimum of 10 years...
November 30, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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