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https://www.readbyqxmd.com/read/29359322/evolution-of-bias-and-sample-size-in-postoperative-pain-management-trials-after-hip-and-knee-arthroplasty
#1
A P H Karlsen, J B Dahl, O Mathiesen
BACKGROUND: Bias (systematic error) and small trial sample size (random error) may induce imprecise and exaggerated treatment effects in randomised controlled trials (RCTs). To avoid this, SPIRIT- and CONSORT-guidelines, and Cochrane Collaboration bias recommendations were developed. We investigated risk of bias and trial sample size development over time in postoperative pain trials. METHODS: This study was based on data from two systematic reviews regarding pain management after total hip arthroplasty (THA) or total knee arthroplasty (TKA)...
January 22, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29232265/the-value-of-preoperative-exercise-and-education-for-patients-undergoing-total-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#2
Rebecca Moyer, Kathy Ikert, Kristin Long, Jacquelyn Marsh
BACKGROUND: Existing evidence regarding the value of preoperative education and/or exercise (prehabilitation) for patients undergoing total joint replacement is conflicting. The purpose of this study was to conduct an updated, comprehensive systematic review with meta-analyses to determine the longitudinal effects and efficacy of prehabilitation on postoperative outcomes in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: We searched 11 electronic databases (MEDLINE, AMED, CINAHL, Embase, Scopus, ProQuest, PEDro, SportDiscus, PsycINFO, and Cochrane) from their inception to May 2016 for randomized controlled trials that compared changes in pain, function, strength, anxiety, and hospital length of stay following THA or TKA...
December 12, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/29212683/-hot-joints-infection-protocol-reduces-unnecessary-post-operative-re-admissions-following-total-hip-and-knee-arthroplasty
#3
J Dattilo, D Gittings, M Sloan, R Charette, E Hume, G-C Lee
AIMS: To evaluate the effectiveness of an institutionally developed algorithm for evaluation and diagnosis of prosthetic joint injection and to determine the impact of this protocol on overall hospital re-admissions.p PATIENTS AND METHODS: We retrospectively evaluated 2685 total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients prior to (1263) and following (1422) the introduction of an infection detection protocol. The protocol used conservative thresholds for C-reactive protein to direct the medical attendant to aspirate the joint...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29129615/patients-with-major-depressive-disorder-experience-increased-perception-of-pain-and-opioid-consumption-following-total-joint-arthroplasty
#4
Jennifer I Etcheson, Chukwuweike U Gwam, Nicole E George, Sana Virani, Michael A Mont, Ronald E Delanois
BACKGROUND: Pain in the immediate postoperative period following total joint arthroplasty is influenced by various patient factors, including major depressive disorder (MDD). Therefore, this study aimed to compare the patient perception of pain and opioid consumption between patients with and without MDD who received either a total knee arthroplasty (TKA) or total hip arthroplasty (THA). Specifically, we compared (1) pain intensity, (2) lengths of stay, (3) opioid consumption, and (4) patient perception of pain control...
October 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29080048/total-knee-arthroplasty-in-patients-with-prior-ipsilateral-hip-arthrodesis
#5
Borja de la Hera, Rafael Rubio-Quevedo, Angeles Gomez-Garcia, Alejandro Gomez-Rice
Only a few articles based on the management of symptomatic knee osteoarthritis in patients with prior ipsilateral hip arthrodesis have been reported, and there are no clear criteria for the best treatment option [to carry out a total knee arthroplasty (TKA)-or to take down the hip fusion and conversion to a total hip arthroplasty-THA, and after that to carry out the TKA]. We report two cases, a 72-year-old male who underwent a left hip arthrodesis at 28 because of a trauma and a 51-year-old woman who underwent a left hip arthrodesis at 9 years because of a congenital dislocation...
October 27, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28815146/quantifying-the-relative-change-in-physical-activity-after-total-knee-arthroplasty-using-accelerometer-based-measurements
#6
Vibhu Agarwal, Mathew Smuck, Nigam H Shah
Osteoarthritis is amongst the top five most disabling conditions affecting Americans over 65 years of age and imposes an annual economic burden estimated at $ 89.1 billion. Nearly half of the cost of care of Osteoarthritis is attributable to hospitalizations for total knee arthroplasties (TKA) and total hip arthroplasties (THA). The current clinical practice relies predominantly on subjective assessment of physical function and pain via patient reported outcome measures (PROM) that have proven inadequate for providing a validated, reliable and responsive measure of TKA outcomes...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28776090/postoperative-pain-and-patient-satisfaction-are-not-influenced-by-daytime-and-duration-of-knee-and-hip-arthroplasty-a-prospective-cohort-study
#7
A Benditz, G Maderbacher, Florian Zeman, Joachim Grifka, Markus Weber, Frederik von Kunow, Felix Greimel, Armin Keshmiri
PURPOSE: The number of total hip and knee arthroplasties (THA and TKA) is steadily increasing. Many factors that influence pain have been reported, but little is known about the correlation between the time of day and the duration of surgery and postoperative pain. On one hand, surgical interventions are performed faster due to economic pressure; on the other hand, obtaining sound surgical skills and a thorough education are most important for young surgeons, particularly at university hospitals...
August 3, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28760738/characteristics-associated-with-joint-replacement-in-early-symptomatic-knee-or-hip-osteoarthritis-6-year-results-from-a-nationwide-prospective-cohort-study-check
#8
Alex N Bastick, Jurgen Damen, Rintje Agricola, Reinoud W Brouwer, Patrick Je Bindels, Sita Ma Bierma-Zeinstra
BACKGROUND: Many patients with osteoarthritis (OA) of the knee and/or hip undergo total joint replacement (TJR) because of severely progressed symptoms. AIM: To determine patient and disease characteristics associated with undergoing TJR in participants with recent-onset knee and/or hip OA. DESIGN AND SETTING: Participants with hip or knee pain from the nationwide prospective Cohort Hip and Cohort Knee (CHECK) study were included. METHOD: The outcome measure was total hip arthroplasty (THA) or total knee arthroplasty (TKA) during 6 years of follow-up...
October 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28682889/femoral-nerve-block-versus-fascia-iliaca-block-for-pain-control-in-total-knee-and-hip-arthroplasty-a-meta-analysis-from-randomized-controlled-trials
#9
REVIEW
Xin Wang, Yuan Sun, Li Wang, Xuelian Hao
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to compare the efficiency and safety between femoral nerve block (FNB) and fascia iliaca block (FIB) for postoperative pain control in patients undergoing total knee and hip arthroplasties. METHODS: A systematic search was performed in Medline (1966-2017.05), PubMed (1966-2017.05), Embase (1980-2017.05), ScienceDirect (1985-2017.05) and the Cochrane Library. Inclusion criteria (1) Participants: Only published articles enrolling adult participants that with a diagnosis of end-stage of osteoarthritis and prepared for unilateral TKA or THA; (2) Interventions: The intervention group received FIB for postoperative pain management; (3) Comparisons: The control group was received FNB for postoperative pain control; (4) Outcomes: Visual analogue scale (VAS) scores in different periods, opioids consumption, length of stay and postoperative complications; (5) Study design: clinical randomized control trials (RCTs) were regarded as eligible in our study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28657567/bone-scan-in-painful-knee-arthroplasty-obsolete-or-actual-examination
#10
Giuseppe Niccoli, Domenico Mercurio, Fabrizio Cortese
ptic loosening, instability and infection are the major causes of TKA failure. For many years, nuclear medicine (NM) imaging was helpful to frame a painful total joint arthroplasty. The differentiation of septic from aseptic prosthetic loosening is critical. The latest AAOS guidelines to detect periprosthetic joint infection (PJI) restrict the role of NM scintigraphy. On the other hand, several studies suggest that NM imaging plays an important role in the evaluation of patients with painful prosthesis, but its specificity in differentiating aseptic loosening from infection is low...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28655354/perioperative-systemic-steroid-for-rapid-recovery-in-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis-of-randomized-trials
#11
REVIEW
Chen Yue, Rong Wei, Youwen Liu
BACKGROUND: Perioperative systemic steroid administration for rapid recovery in total knee and hip arthroplasty (TKA/THA) is an important and controversial topic. We conducted this systematic review and meta-analysis to evaluate the overall benefits and harms of perioperative systemic steroid in patients undergoing TKA and THA. METHODS: A comprehensive search was performed on PubMed, OVID, and Web of Science databases, and a systematic approach was carried out starting from the PRISMA recommendations...
June 27, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28583060/impact-of-social-support-and-pain-coping-abilityon-length-of-stay-and-discharge-disposition-following-hip-and-knee-arthroplasty-a-prospective-study
#12
Emmanuel Edusei, Kelsey Grossman, Ashley Payne, Brian Perez, Ifeoma Inneh, Charles Nelson, James Slover
INTRODUCTION: While there are many factors known to predict the outcomes of hip and knee arthroplasty procedures, there is a growing interest in predictors that take into consideration the social and psychological preparedness of patients prior to surgery. This study's aim was to determine whether patients' preoperative social support and pain catastrophizing characteristics are independently associated with the outcomes of postoperative length of stay or discharge disposition following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
April 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28558112/mid-term-results-of-total-hip-and-total-knee-arthroplasty-in-patients-with-human-immunodeficiency-virus
#13
Brian P Chalmers, Matthew P Abdel, Michael J Taunton, Robert T Trousdale, Mark W Pagnano
With antiretroviral therapy, patients who are human immunodeficiency virus (HIV)-positive are increasingly becoming candidates for total hip arthroplasty (THA) and total knee arthroplasty (TKA). Prior reports focus on perioperative complications, but longer-term outcomes remain unclear. The authors specifically analyzed clinical outcomes, perioperative complications, and survivorship free of periprosthetic joint infection (PJI) of THAs and TKAs in HIV-positive patients who had extended follow-up. A total of 21 HIV-positive patients who underwent 29 primary arthroplasties (14 THAs, 15 TKAs) from 1992 to 2012 were retrospectively reviewed...
July 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28533697/a-comparison-of-predictors-and-intensity-of-acute-postsurgical-pain-in-patients-undergoing-total-hip-and-knee-arthroplasty
#14
Patrícia R Pinto, Teresa McIntyre, Vera Araújo-Soares, Patrício Costa, Ramón Ferrero, Armando Almeida
BACKGROUND: Acute pain is an expected result after surgery. Nevertheless, when not appropriately controlled, acute pain has a very negative impact on individual clinical outcomes, impairing healing and recovery, and has clear consequences on health care system costs. Augmenting knowledge on predictors and potentially modifiable determinants of acute postsurgical pain can facilitate early identification of and intervention in patients at risk. However, only a few studies have examined and compared acute pain after total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28503200/a-retrospective-cohort-study-of-adverse-events-in-patients-undergoing-orthopaedic-surgery
#15
Joel J Gagnier, Hal Morgenstern, Patrick Kellam
BACKGROUND: This study's objective was to identify adverse events following common orthopaedic procedures, and to estimate the incidence rates and risks of these events and their associations with age, sex, and comorbidities. METHODS: This retrospective cohort study manually reviewed and extracted electronic medical data on the incidence and predictors of adverse events that occurred within 90 days of the 50 most frequent orthopaedic surgeries at an academic hospital in 2010...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28473962/associations-among-pain-catastrophizing-muscle-strength-and-physical-performance-after-total-knee-and-hip-arthroplasty
#16
Kazuhiro Hayashi, Masato Kako, Kentaro Suzuki, Keiko Hattori, Saori Fukuyasu, Koji Sato, Izumi Kadono, Tadahiro Sakai, Yukiharu Hasegawa, Yoshihiro Nishida
AIM: To investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty (TKA) or total hip arthroplasty (THA). METHODS: The study group of 46 participants underwent TKA or THA. The participants were evaluated within 7 d before the operation and at 14 d afterwards. Physical performance was measured by the Timed Up and Go (TUG) test, and 10-m gait time was measured at comfortable and maximum speeds...
April 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28442852/perioperative-systemic-glucocorticoids-in-total-hip-and-knee-arthroplasty-a-systematic-review-of-outcomes
#17
REVIEW
Jeffrey Hartman, Vickas Khanna, Anthony Habib, Forough Farrokhyar, Muzammil Memon, Anthony Adili
BACKGROUND: Perioperative systemic glucocorticoids are frequently included in multimodal analgesia and antiemetic regimens administered to patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this systematic review was to evaluate the available randomized controlled trials (RCTs) to determine the effect of perioperative systemic glucocorticoids on postoperative nausea and vomiting (PONV), pain, narcotic consumption, antiemetic consumption, length of stay in hospital, and major complications in patients undergoing elective THA or TKA...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28353050/do-surgeon-expectations-predict-clinically-important-improvements-in-womac-scores-after-tha-and-tka
#18
Hassan M K Ghomrawi, Carol A Mancuso, Allison Dunning, Alejandro Gonzalez Della Valle, Michael Alexiades, Charles Cornell, Thomas Sculco, Matthias Bostrom, David Mayman, Robert G Marx, Geoffrey Westrich, Michael O'Dell, Alvin I Mushlin
BACKGROUND: Failure of THA or TKA to meet a patient's expectations may result in patient disappointment and litigation. However, there is little evidence to suggest that surgeons can consistently anticipate which patients will benefit from those interventions. QUESTIONS/PURPOSES: To determine the ability of surgeons to identify, in advance of surgery, patients who will benefit from THA or TKA and those who will not, where 'benefit' is defined as a clinically important improvement in a validated patient-reported outcomes score...
September 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28340617/the-efficacy-of-pregabalin-for-the-management-of-postoperative-pain-in-primary-total-knee-and-hip-arthroplasty-a-meta-analysis
#19
Fei Li, Jianxiong Ma, Mingjie Kuang, Xuan Jiang, Ying Wang, Bin Lu, Xingwen Zhao, Lei Sun, Xinlong Ma
OBJECTIVE: A systematic review of randomized controlled trials (RCTs) was conducted to evaluate the efficacy of pregabalin for the management of postoperative pain in patients undergoing primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA). METHOD: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. RevMan 5.3 software was selected to conduct the meta-analysis...
March 24, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28301858/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#20
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain...
April 2017: Pain
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