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arthroscopy and arthroplasty

Daniel W Griffin, Matthew J Kinnard, Peter M Formby, Michael P McCabe, Terrence D Anderson
BACKGROUND: The indications for hip preservation surgery have expanded to include treatment of hip pathology in older adults. While several studies have examined the efficacy of hip arthroscopy in the setting of osteoarthritis, there has been no review of outcomes in older adults. PURPOSE: To review the outcomes of hip arthroscopy in older adults and identify factors associated with treatment failures. STUDY DESIGN: Systematic review. METHODS: PubMed, EMBASE, and the Cochrane Library were searched through March 2016 for studies reporting outcomes of primary hip arthroscopy in patients older than 40 years...
October 18, 2016: American Journal of Sports Medicine
Leif Claassen, Sarah Ettinger, Marc-Frederic Pastor, Stefan Budde, Henning Windhagen, Thilo Floerkemeier
INTRODUCTION: The diagnostic algorithm in cases of assumed low-grade infection after total knee arthroplasty is discussed controversial. The aim of this study was to evaluate the reliability of neosynovium biopsies via knee arthroscopies in predicting a periprosthetic knee joint infection (PJI). METHODS: From 2010 to 2015, 56 consecutive patients received a diagnostic arthroscopy of the knee joint by reason of an assumed PJI. In 34 cases, a revision arthroplasty was performed after the diagnostic arthroscopy...
October 12, 2016: Archives of Orthopaedic and Trauma Surgery
Ohannes F Plate, Andrew D Wohler, Matthew L Brown, Daniel Sun, Nora F Fino, Jason E Lang
INTRODUCTION: Stiffness and loss of motion following total knee arthroplasty (TKA) is a complex and multifactorial complication that may require manipulation under anesthesia (MUA). However, patient and surgical factors that potentially influence the development of knee stiffness following TKA are not fully understood. The purpose of this study was to identify patient and surgical factors that may influence range of motion loss following TKA by assessing a cohort of patients that underwent MUA and comparing them to a matched cohort of patients without complications...
October 6, 2016: Surgical Technology International
Jens Ole Laursen
PURPOSE: The HemiCAP-Wave® implant for the patellofemoral resurfacing treatment of large cartilage lesions and osteoarthritis (OA) was introduced in 2009. The outcome of a prospective cohort study of 18 patients with large trochlea lesions or isolated OA treated with the HemiCAP-Wave® implant is presented with up to a 6-year survival rate, and hypothesised short-to mid-term reduced pain and improved function. METHODS: Indication for treatment with the HemiCAP-Wave® implant was a symptomatic, large cartilage lesion in trochlea demonstrated by MRI or arthroscopy, which was ICRS grades 3-4 and larger than 4 cm(2)...
October 6, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ross Elledge, Jason Green, Alan Attard
Surgery of the temporomandibular joint (TMJ) is increasingly recognised as a subspecialist area of interest within our specialty and many procedures such as arthroscopy, arthroplasty, and replacement of the TMJ are becoming increasingly centralised and restricted to certain regions. We previously made a national survey of trainees and have sought to augment this with a survey of trainers to find out the nature of practice and patterns of referral nationally. We have also examined the consultants' expectations of competent final-year trainees...
September 26, 2016: British Journal of Oral & Maxillofacial Surgery
Sufian S Ahmad, Roland Becker, Antonia F Chen, Sandro Kohl
PURPOSE: Due to the juvenility of research in the field of periprosthetic joint infection (PJI), approaches employed for diagnosis of PJI vary amongst surgeons in different geographic regions. The aim of this study was to determine common diagnostic approaches utilized by European knee arthroplasty surgeons for the diagnosis of PJI. METHODS: A task force was established for questionnaire development, consisting of surgeons and clinical researchers who each had a record of publishing in the field of PJI...
October 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Nolan S Horner, Seper Ekhtiari, Nicole Simunovic, Marc R Safran, Marc J Philippon, Olufemi R Ayeni
PURPOSE: To (1) report clinical outcomes, complication rates, and total hip arthroplasty (THA) conversion rates for patients age 40 or older who underwent hip arthroscopy, and (2) report any age-related predictors of outcome identified in the literature. METHODS: MEDLINE, EMBASE, and PubMed were searched for relevant studies and pertinent data were abstracted from eligible studies. No meta-analysis was performed because of heterogeneity amongst studies. RESULTS: Seventeen studies were included in this review comprising 16,327 patients, including 9,954 patients age 40 or older...
September 10, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
J W Thomas Byrd, Kay S Jones, Paul C Chin
Successful hip arthroscopy depends on proper patient selection and reasonable patient expectations. The purpose of this study is to report the results of hip arthroscopy in orthopaedic surgeons who represent the most informed cohort. This report is based on a retrospective review of prospectively collected data among 24 orthopaedic surgeons (1 bilateral). Follow-up averaged 48 months (range 12-120 months). They were all males with an average age of 45 years (range 30-64 years). All improved with an average of 18 points (preoperative 75; post-operative 93); although one underwent repeat arthroscopy and one was converted to total hip arthroplasty at 54 months...
July 2016: Journal of Hip Preservation Surgery
Kuei Siong Andy Yeo, Wen Siang Kevin Lim, Yee Han Dave Lee
INTRODUCTION: There are currently no guidelines supporting the use of routine chemoprophylaxis to prevent deep vein thrombosis (DVT) in arthroscopic surgery. Studies and meta-analysis show opposing views on its routine use in arthroscopy. This study aimed to examine the incidence of DVT in a prospective cohort of knee arthroscopy and knee arthroplasty patients, and to analyse the risk factors contributing to DVT. METHODS: All patients scheduled to undergo knee arthroscopy or arthroplasty over a two-year period were included...
August 2016: Singapore Medical Journal
Brian M Capogna, Michael K Ryan, John P Begly, Kristofer E Chenard, Siddharth A Mahure, Thomas Youm
PURPOSE: To examine clinical outcomes and survivorship in patients aged 60 years or older who underwent hip arthroscopy for management of hip pain. METHODS: Prospectively collected data for patients 60 or older undergoing hip arthroscopy were obtained. All patients were indicated for hip arthroscopy based on standard preoperative examination as well as routine and advanced imaging. Demographic data, diagnosis, and details regarding operative procedures were collected...
August 17, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Allan Gross, Jeffrey M Muir
Osteoarthritis is a ubiquitous condition, affecting 26 million Americans each year, with up to 17% of adults over age 75 suffering from one variation of arthritis. The hip is one of the most commonly affected joints and while there are conservative options for treatment, as symptoms progress, many patients eventually turn to surgery to manage their pain and dysfunction. Early surgical options such as osteotomy or arthroscopy are reserved for younger, more active patients with less severe disease and symptoms...
September 2016: Medical Hypotheses
Kevin J DiSilvestro, Adam J Santoro, Fotios P Tjoumakaris, Eric A Levicoff, Kevin B Freedman
BACKGROUND: Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive...
August 4, 2016: Clinical Orthopaedics and related Research
Darrin J Trask, James S Keene
BACKGROUND: Data on the efficacy of microfracture for treatment of chondral defects in the hip are currently limited, and the recommended criteria for its use (minimal osteoarthritis; a focal, contained lesion <4 cm(2) in size) have been taken from those that were established for the knee. PURPOSE: To determine if the current microfracture (ie, knee) criteria are appropriate for chondral lesions in the hip. STUDY DESIGN: Case series; Level of evidence, 4...
July 27, 2016: American Journal of Sports Medicine
Vybhav Jetty, Charles J Glueck, Richard A Freiberg, Ping Wang
Venous thromboembolism is uncommon after knee arthroscopy, and there are no guidelines for thromboprophylaxis in elective routine knee arthroscopy. Preoperative evaluation of common thrombophilias should provide guidance for postarthroscopy thromboprophylaxis in otherwise healthy patients who are at high risk for venous thromboembolism. This study assessed 10 patients with venous thromboembolism after total hip or knee arthroplasty. Patients were assessed if venous thromboembolism occurred within 6 months after knee arthroscopy (n=10) or total hip or knee arthroplasty (n=21)...
July 25, 2016: Orthopedics
Jason A Boyd, Ian M Gradisar
Several orthopedic registries have described the incidence of total knee arthroplasty (TKA) in patients who have undergone knee arthroscopy. Patient risk factors may play a role in the conversion rate from knee arthroscopy to TKA. This study quantifies the incidence of conversion of knee arthroscopy to TKA from a US mixed-payer database and describes some common patient risk factors for conversion. The medical records of more than 50 million patients who were treated between 1998 and 2014 were mined with a commercially available software platform...
July 25, 2016: Orthopedics
David E Hartigan, Itay Perets, John P Walsh, Mary R Close, Benjamin G Domb
BACKGROUND: Symptomatic global retroversion of the acetabulum, as diagnosed on plain radiographs of the pelvis, has traditionally been treated with reverse periacetabular osteotomy, which improves posterior undercoverage and eliminates the anterior pincer lesion. There is a paucity of literature on hip arthroscopy in this group, secondary to theoretical concern of iatrogenic dysplasia, subsequent instability, and arthritis. PURPOSE: To evaluate the outcomes of hip arthroscopy for patients with a radiographic diagnosis of acetabular retroversion, using patient-reported outcomes, visual analog scale (VAS), patient satisfaction, and pre- and postoperative Tönnis grades...
October 2016: American Journal of Sports Medicine
David M Levy, Benjamin D Kuhns, Jaskarndip Chahal, Marc J Philippon, Bryan T Kelly, Shane J Nho
PURPOSE: To determine whether the hip arthroscopy literature to date has shown outcomes consistent with published patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) estimates. METHODS: All clinical investigations of hip arthroscopy using modified Harris Hip Score (mHHS) and/or Hip Outcome Score (HOS) outcomes with at least 1 year of follow-up were reviewed. Ninety-one studies (9,746 hips) were included for review. Eighty-one studies (9,317 hips) contained only primary hip arthroscopies and were the primary focus of this review...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
M Yeung, M Kowalczuk, N Simunovic, O R Ayeni
OBJECTIVE: Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia. METHODS: A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015...
June 2016: Bone & Joint Research
Sivashankar Chandrasekaran, Nader Darwish, Chengcheng Gui, Parth Lodhia, Carlos Suarez-Ahedo, Benjamin G Domb
BACKGROUND: Osteoarthritis adversely impacts hip arthroscopy outcomes. The purpose of this study was to conduct a matched-pair analysis with a mean follow-up of 2 years to evaluate the outcomes following hip arthroscopy in patients with Tönnis grade-2 osteoarthritis. METHODS: Data were prospectively collected on all patients undergoing hip arthroscopy during the study period from April 2008 to December 2012. Patients were excluded if they had previous hip conditions...
June 15, 2016: Journal of Bone and Joint Surgery. American Volume
Tadros B J, Stafford G H
INTRODUCTION: Tuberculosis (TB) still remains a common problem in the UK and, with the increasing number of patients being offered arthroplasties; periprosthetic involvement is not uncommon anymore. However, the diagnosis of TB infected arthroplasties still remains difficult and misdiagnosis is common, therefore delaying treatment. CASE REPORT: We describe a 36-years old Caucasian female with no known history of TB who presented with hip pain thought to be due to femoro-acetabular impingement (FAI)...
January 2016: Journal of Orthopaedic Case Reports
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