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https://www.readbyqxmd.com/read/29648889/patient-reported-allergies-do-not-predict-poorer-promis-function-pain-and-depression-scores-following-foot-and-ankle-surgery
#1
Devon C Nixon, Brian M Cusworth, Jeremy J McCormick, Jeffrey E Johnson, Sandra E Klein
BACKGROUND: Identifying preoperative risk factors that may portend poorer operative outcomes remains a topic of current interest. In hip and knee arthroplasty patients, the presence of patient-reported allergies (PRAs) has been associated with worse pain and function after joint replacement. However, these results have not been replicated across studies, including in shoulder arthroplasty cases. The impact of PRAs on foot and ankle outcomes has yet to be studied. The purpose of our study was to evaluate whether PRAs influence patient-reported outcome in foot and ankle surgery...
April 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29643693/joint-perception-and-patient-perceived-satisfaction-after-total-hip-and-knee-arthroplasty-in-the-american-population
#2
Matthew Varacallo, Rajit Chakravarty, Kevin Denehy, Andrew Star
Background: Total hip (THA) and knee arthroplasty (TKA) are two of the most successful procedures in orthopedics. Current evaluation trends focus on patient-reported outcomes. We sought to compare the changing WOMAC scores from various time points from pre-operative to 1-year follow-up between separate THA and TKA cohorts. In addition, we compared THA and TKA patients' joint perception, satisfaction, and function via a questionnaire. Methods: One hundred elective THA (n = 50) and TKA (n = 50) patients at one institution were randomly selected and contacted between 2 and 4 years after the index surgery...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29643169/safety-and-feasibility-evaluation-of-tourniquets-for-total-knee-replacement-safe-tkr-study-protocol
#3
Peter Dh Wall, Imran Ahmed, Andrew Metcalfe, Andrew J Price, Kate Seers, Charles E Hutchinson, Helen Parsons, Jane Warwick, Bushra Rahman, Jaclyn Brown, Martin Underwood
INTRODUCTION: This study is designed to determine whether a full randomised controlled trial (RCT) examining the clinical effectiveness and safety of total knee replacement surgery with or without a tourniquet is warranted and feasible. METHOD AND ANALYSIS: Single centre, patient-blinded and assessor-blinded RCT. A computer-generated randomisation service will allocate 50 participants into one of two trial treatments, surgery with or without a tourniquet. The primary objective is to estimate recruitment, crossovers and follow-up of patients...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29643154/associations-between-preoperative-oxford-hip-and-knee-scores-and-costs-and-quality-of-life-of-patients-undergoing-primary-total-joint-replacement-in-the-nhs-england-an-observational-study
#4
Peter Eibich, Helen A Dakin, Andrew James Price, David Beard, Nigel K Arden, Alastair M Gray
OBJECTIVES: To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). DESIGN: Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. SETTING: UK secondary care. PARTICIPANTS: Men and women undergoing primary THR or TKR...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29642931/bariatric-surgery-improves-knee-function-and-not-knee-pain-in-the-early-postoperative-period
#5
Amre Hamdi, Alia T Albaghdadi, Bayan Ghalimah, Abdullah Alnowiser, Anas Ahmad, Abdulmalik Altaf
BACKGROUND: Obesity remains the strongest predictor of knee osteoarthritis (OA). Studies have reported improvement in knee pain and function post-bariatric surgery secondary to weight loss and reduced mechanical loading, yet others found increased rates of total knee arthroplasty (TKA) in that patient population. To address this controversy, our study aimed to further assess the effect of surgically induced, "rapid" weight loss on knee pain and function. METHODS: Obese patients with chronic knee pain, who were undergoing bariatric surgery, were enrolled and surveyed preoperatively and 3 months postoperatively...
April 11, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29628683/short-term-outcomes-of-long-duration-versus-short-duration-tourniquet-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#6
Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay, Manish Kumar Tiwari
Introduction: A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628679/patellofemoral-arthroplasty-current-concepts
#7
REVIEW
Rory Cuthbert, Saket Tibrewal, Sheo B Tibrewal
Isolated patellofemoral arthritis (IPA) is a debilitating condition characterised by a loss of articular cartilage on the patella facets, the trochlear groove or both. By definition, patients with IPA must have normal cartilage in the tibiofemoral compartments of their knee. It is therefore logical to pursue arthroplasty which corrects the abnormality while sparing healthy bone and preserving the knee's native kinematics, which is the premise underpinning patellofemoral arthroplasty (PFA). However, its use remains controversial, with many surgeons still favouring total knee replacement (TKR) in these patients...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628676/metal-hypersensitivity-in-total-hip-and-knee-arthroplasty-current-concepts
#8
REVIEW
Samuel Akil, Jared M Newman, Neil V Shah, Natasha Ahmed, Ajit J Deshmukh, Aditya V Maheshwari
Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, presentation, diagnosis, and management of MHS. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628565/postoperative-cognitive-dysfunction-in-indian-patients-undergoing-total-knee-replacement-under-spinal-anesthesia
#9
Praful Kilaru, A Ramachandra Reddy, Maryada Venketeshwar Reddy, Brijesh Kidiyoor, Vinay Mathew Joseph, Annapareddy Venkata Gurava Reddy
Introduction: Total knee replacement is a common surgical procedure in the elderly. The number of surgeries has increased owing to the increasing life expectancy of the population and better functional outcomes postsurgery. Postoperative cognitive dysfunction (POCD) is an identified entity postsurgery in elderly but most of the studies have been on patients undergoing cardiac and other nonorthopaedic surgeries. The studies have shown variable incidence due to selection bias. We studied the incidence and probable predictive factors of POCD in elderly Indian population undergoing total knee replacement under spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628549/comparison-of-efficacy-of-epidural-ropivacaine-versus-bupivacaine-for-postoperative-pain-relief-in-total-knee-replacement-surgeries
#10
Sidharth Bhasin, Mridul Dhar, Deepak Kumar Sreevastava, Rajiv Nair, Saurabh Chandrakar
Background: Epidural analgesia has become the standard of care for knee replacement surgeries worldwide. Bupivacaine has been used successfully for many years. Epidural ropivacaine is now being used increasingly and seems to have benefits other than just pain relief, in terms of a better safety profile. Aim: To compare the efficacy of bupivacaine 0.125% (Group B) versus two concentrations of ropivacaine 0.1% (Group R1) and 0.2% (Group R2), in terms of pain scores, requirement of rescue analgesia, related adverse effects, and duration of postoperative (PO) hospital stay...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627736/regression-models-to-predict-the-behavior-of-the-coefficient-of-friction-of-aisi-316l-on-uhmwpe-under-iso-14243-3-conditions
#11
A L Garcia-Garcia, M Alvarez-Vera, L A Montoya-Santiyanes, I Dominguez-Lopez, J L Montes-Seguedo, J C Sosa-Savedra, J D O Barceinas-Sanchez
Friction is the natural response of all tribosystems. In a total knee replacement (TKR) prosthetic device, its measurement is hindered by the complex geometry of its integrating parts and that of the testing simulation rig operating under the ISO 14243-3:2014 standard. To develop prediction models of the coefficient of friction (COF) between AISI 316L steel and ultra-high molecular weight polyethylene (UHMWPE) lubricated with fetal bovine serum dilutions, the arthrokinematics and loading conditions prescribed by the ISO 142433: 2014 standard were translated to a simpler geometrical setup, via Hertz contact theory...
March 27, 2018: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29626655/complications-and-cost-of-single-stage-vs-two-stage-bilateral-unicompartmental-knee-arthroplasty-a-case-control-study
#12
C Siedlecki, P Beaufils, B Lemaire, N Pujol
BACKGROUND: Single-stage bilateral knee arthroplasty, even when unicompartmental, remains controversial, chiefly due to the risk of peri-operative complications. The primary objective of this study was to compare the short-term complication rate and cost of single- vs. two-stage bilateral unicompartmental knee arthroplasty (UCA). The secondary objective was to compare total hospital stay lengths and motion-range recovery. HYPOTHESIS: Single-stage bilateral UCA is a cost-saving alternative that is not associated with higher complication rates compared to two-stage bilateral UCA...
April 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29622481/pre-clinical-assessment-of-total-knee-replacement-anterior-posterior-constraint
#13
C Halewood, K K Athwal, A A Amis
Pre-clinical, bench-top assessment of Total Knee Replacements (TKR) can provide information about the inherent constraint provided by a TKR, which does not depend on the condition of the patient undergoing the arthroplasty. However little guidance is given by the ASTM standard on test configurations such as medial-lateral (M:L) loading distribution, flexion angle or restriction of secondary motions. Using a purpose built rig for a materials testing machine, four TKRs currently in widespread clinical use, including medial-pivot and symmetrical condyle types, were tested for anterior-posterior translational constraint...
March 30, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29617634/surgical-weight-loss-to-improve-functional-status-trajectories-following-total-knee-arthroplasty-swift-trial-rationale-design-and-methods
#14
Peter N Benotti, Christopher D Still, G Craig Wood, Jamie L Seiler, Christopher J Seiler, Shane P Thomas, Anthony T Petrick, Michael Suk, Brian A Irving
Total Knee Arthroplasty (TKA, also known as total knee replacement) is a highly effective surgical intervention for the restoration of physical function and improving quality of life in patients with disabling knee osteoarthritis. Recent data suggest that obesity is a major risk factor in the pathogenesis and progression of knee osteoarthritis, with increases in body mass index (BMI, kg/m2 ) directly correlating with the prevalence of knee osteoarthritis. However, recent data also suggest that there are increased risks associated with TKAs when performed in patients with morbid obesity (BMI > 40 kg/m2 )...
April 1, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29614710/patient-reported-outcome-measures-proms-in-patients-undergoing-patellofemoral-arthroplasty-and-total-knee-replacement-a-comparative-study
#15
Fabio Luigi Perrone, Steffen Baron, Eduardo M Suero, Christian Lausmann, Daniel Kendoff, Akos Zahar, Thorsten Gehrke, Mustafa Citak
BACKGROUND: Incongruity in the evaluation of outcomes between patients and surgeons has led to an increasing utilization of patient-reported outcome measures (PROMs) as an evaluation method of outcome. OBJECTIVE: The aim of this study was to compare Oxford Knee Score (OKS), KOOS-PS and Kujala Score results in patients who received either PFA or TKA with and without patella resurfacing in the tretament of knee osteoarthritis. METHODS: A total of 50 patients (PFA = 19 patients; TKA with patelloplasty = 15 patients; TKA with patellar resurfacing = 16 patients) undergone surgery between 2011 and 2014 and were included for final analysis...
March 23, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29608733/a-physical-therapist-administered-physical-activity-intervention-after-total-knee-replacement-protocol-for-a-randomized-controlled-trial
#16
Meredith B Christiansen, Louise M Thoma, Hiral Master, Laura A Schmitt, Ryan Pohlig, Daniel K White
Background: The definitive treatment for knee osteoarthritis is a total knee replacement, which results in a clinically meaningful improvement in pain and physical function. However, evidence suggests that physical activity (PA) remains unchanged after total knee replacement (TKR). Objective: The objective of this study is to investigate the efficacy, fidelity, and safety of a physical therapist-administered PA intervention for people after TKR. Design: This study is a protocol for a randomized controlled trial...
March 28, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29607472/subvastus-versus-medial-parapatellar-approach-in-primary-total-knee-replacement-an-assessment-of-early-function
#17
M E Ugbeye, S E Itakpe, O J Ayodabo
BACKGROUND: Total knee replacements are increasingly being carried out for the arthritic knee. This procedure is constantly being improved upon in order to improve outcome. There is currently no consensus of the best surgical approach for primary total knee arthroplasty. This study aims to test the hypothesis that the subvastus approach has significantly better early functional outcomes compared to the medial parapatellar approach. STUDY DESIGN: Patients with bilateral knee arthritis who met the inclusion criteria were randomised into either the subvastus or medial parapatellar approach over a twelve month period...
January 2018: West African Journal of Medicine
https://www.readbyqxmd.com/read/29603823/effects-of-nurse-led-lower-extremity-strength-training-on-knee-function-recovery-in-patients-who-underwent-total-knee-replacement
#18
Yu-Hua Lin, Su-Ying Lee, Wei-Ren Su, Chia-Chan Kao, Ta-Wei Tai, Tai-Been Chen
AIM: The purpose of this study was to examine the effects of lower extremity muscle strength training (LEMST) on knee function recovery and QoL in patients who underwent total knee replacement (TKR). BACKGROUND: Patients with knee osteoarthritis (OA) after surgery experience decreased knee function that impacts their quality of life (QoL). However, patients typically lack a long-term, home-based, and continuous leg exercise training method, and rarely have studies explored the effects of exercise training on knee function recovery and QoL...
March 31, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29601379/moderate-to-severe-renal-insufficiency-is-associated-with-high-mortality-after-hip-and-knee-replacement
#19
Pyry Jämsä, Esa Jämsen, Heini Huhtala, Antti Eskelinen, Niku Oksala
BACKGROUND: In patients having elective hip or knee replacements, many comorbid conditions, including diabetes, cardiovascular disease, and congestive heart failure, are associated with postoperative mortality. Renal failure and a history of renal transplantation also increase mortality. However, the effect of different stages of chronic kidney disease on patients' prognoses is unclear. QUESTIONS/PURPOSES: (1) What is the risk of postoperative mortality in different stages of chronic kidney disease after elective hip or knee replacement and does the risk increase with mild renal insufficiency? (2) How severe is the risk of death in patients with chronic kidney disease compared with other major medical comorbidities such as diabetes, cardiovascular disease, and congestive heart failure? (3) Are there risk factor combinations associated with especially poor survival? METHODS: Using longitudinally maintained databases, the records of 18,575 patients (median age 69 years, 63% female, median body mass index 29 kg/m) undergoing elective hip and knee replacements from a single center between 2002 and 2011 were analyzed in this retrospective study...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29600261/total-knee-replacement-sizing-shoe-size-is-a-better-predictor-for-implant-size-than-body-height
#20
Sarah Trainor, Jamie Collins, Hannah Mulvey, Wolfgang Fitz
Background: Various sizes of implants need to be available during surgery. The purpose of this paper is to compare body height and shoe size with implant sizes in patients who underwent total knee replacement surgery to see which biomarker is a better predictor for preoperative planning to determine implant size. Methods: A total of 100 knees, belonging to 50 females and 50 males, were observed. Participants' body height and shoe size were collected and correlated to implant sizes of a current, frequently used, standard total knee replacement (TKR) implant...
March 2018: Archives of Bone and Joint Surgery
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