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https://www.readbyqxmd.com/read/29913844/systematic-review-of-neuropathic-component-in-persistent-post-surgical-pain
#1
S Haroutiunian, L Nikolajsen, N B Finnerup, T S Jensen
Background/aim The aim of the current study was to assess the neuropathic component of persistent post-surgical pain (PPSP) following eleven types of surgery. Methods We performed a systematic PubMed, CENTRAL and EMBASE search to identify studies on PPSP following (i) thoracic surgery, (ii) breast surgery, (iii) groin hernia repair, (iv) prostatectomy, (v) major abdominal surgery, (vi) gynecologic surgery, (vii) iliac crest bone harvest, (viii) total hip arthroplasty (THA) or knee arthroplasty (TKA), (ix) varicose vein stripping or ablation, (x) mandibular sagittal split osteotomy and (xi) donor nephrectomy, and assessed the prevalence of Probable/Definite neuropathic pain using the recently published neuropathic pain probability grading criteria [1]...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29794270/patients-pre-operative-general-and-specific-outcome-expectations-predict-postoperative-pain-and-function-after-total-knee-and-total-hip-arthroplasties
#2
Claire Tilbury, Tsjitske M Haanstra, Suzan H M Verdegaal, Rob G H H Nelissen, Henrica C W de Vet, Thea P M Vliet Vlieland, Raymond W Ostelo
BACKGROUND AND AIMS: Previous studies have suggested there is an association between preoperative expectations about the outcome and outcomes of total knee and total hip arthroplasty (TKA/THA). However, expectations have been rarely examined on their clinical relevance relative to other well-known predictive factors. Furthermore expectations can be measured on a more generic level (e.g. does one expect their symptoms to improve after surgery) or on a more specific level (e.g. does one expect to be able to squat again after surgery)...
April 30, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29657477/evaluation-of-the-multi-attribute-prioritisation-tool-for-total-joint-replacement
#3
Michael Nganga, Donald Bramwell, Jenifer Monaghan, Christine Doerr, Graham Mercer, Jeganath Krishnan
Rationale aims and objectives: The demand for arthroplasty is increasing and will continue to rise with an ageing population. Obesity and lengthy waiting time for Total Joint Replacement (TJR) have been associated with poorer outcomes postoperatively. This study aimed to evaluate the Multi-Attribute Prioritisation Tool (MAPT) for TJR patients. The primary objective was to explore if patients prioritised by the MAPT had an improvement in score post-operative. Further to identify any relationship between MAPT score and length of time on the waiting list or obesity...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29642914/development-of-the-italian-version-of-the-high-activity-arthroplasty-score-haas-i-following-hip-and-knee-total-arthroplasty-cross-cultural-adaptation-reliability-validity-and-sensitivity-to-change
#4
Marco Monticone, Antonio Capone, Luca Frigau, Giuseppe Marongiu, Paola Abelli, Francesco Mola, Nicola Maffulli, Calogero Foti
BACKGROUND: The number of physically active individuals who develop knee and hip arthritis and who undergo arthroplasties of these joints ie ever increasing. It has become necessary to develop evaluation scales which address the specific issues raised by such individuals. The High Activity Arthroplasty Score is one such scales, originally developed in English. METHODS: The HAAS-I was developed by means of forward-backward translation, a final review by an expert committee and a test of the pre-final version to establish its correspondence with the original English version...
April 11, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29578248/incidence-and-related-factors-for-intraoperative-failed-spinal-anaesthesia-for-lower-limb-arthroplasty
#5
E K Aasvang, M B Laursen, J Madsen, M Krøigaard, S Solgaard, P Kjaersgaard-Andersen, H Mandøe, T B Hansen, J U Nielsen, N Krarup, A E Skøtt, H Kehlet
BACKGROUND: Spinal anaesthesia is the preferred choice for total hip- and knee arthroplasty (THA/TKA), due to the claimed superior outcome profile, relative simple technique and without the need for advanced airway support. However, choosing and informing about spinal anaesthesia should also include the risk for intraoperative failed spinal anaesthesia with associated pain, discomfort and suboptimal settings for airway management. Small-scale studies suggest incidences from 1 to 17%; however, no multi-institutional large data exists on failed spinal incidence and related factors during THA/TKA, hindering evidence-based information and potential anaesthesia stratification...
March 26, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29567002/how-much-pain-is-significant-defining-the-minimal-clinically-important-difference-for-the-visual-analog-scale-for-pain-after-total-joint-arthroplasty
#6
Jonathan R Danoff, Rahul Goel, Ryan Sutton, Mitchell G Maltenfort, Matthew S Austin
BACKGROUND: The ability to detect changes in patient-perceived pain after total joint arthroplasty (TJA) is critical to manage postoperative pain. The minimal clinically important difference (MCID) for visual analog scale for pain (VAS-P) has not been investigated in this population. This study investigated the MCID for VAS-P in the TJA population. METHODS: Postoperative pain scores were collected on 139 total hip arthroplasty (THA) and 165 total knee arthroplasty (TKA) patients...
February 22, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29567001/the-james-a-rand-young-investigator-s-award-battling-the-opioid-epidemic-with-prospective-pain-threshold-measurement
#7
Brian T Nickel, Mitchell R Klement, William A Byrd, David E Attarian, Thorsten M Seyler, Samuel S Wellman
BACKGROUND: Responsible analgesic prescribing is paramount in the opioid epidemic era, yet no standardized protocol exists. We aim to (1) quantify and correlate outpatient opioid need after total knee and hip arthroplasties (TKA and THA) with preoperative objective pain pressure thresholds (PPTs) and subjective pain measures and (2) report incidence of nonsurgical opioid prescriptions 6 weeks postoperatively. METHODS: Prospectively, PPTs were measured using an algometer with a maximum force of 20 pounds in 160 consecutive patients (90 TKA and 70 THA)...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29566421/the-role-of-virtual-rehabilitation-in-total-knee-and-hip-arthroplasty
#8
Morad Chughtai, Jared M Newman, Assem A Sultan, Anton Khlopas, Sergio M Navarro, Anil Bhave, Michael A Mont
Virtual rehabilitation therapies have been developed to focus on improving care for those suffering from various musculoskeletal disorders. There has been evidence suggesting that real-time virtual rehabilitation may be equivalent to conventional methods for adherence, improvement of function, and relief of pain seen in these conditions. This study specifically evaluated the use of a virtual physical therapy/rehabilitation platform for use during the postoperative period after total hip arthroplasty (THA) and total knee arthroplasty (TKA)...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29545451/flares-in-patients-with-rheumatoid-arthritis-after-total-hip-and-total-knee-arthroplasty-rates-characteristics-and-risk-factors
#9
Susan M Goodman, Vivian P Bykerk, Edward DiCarlo, Ryan W Cummings, Laura T Donlin, Dana E Orange, Annie Hoang, Serene Mirza, Michael McNamara, Kayte Andersen, Susan J Bartlett, Jackie Szymonifka, Mark P Figgie
OBJECTIVE: Rates of total knee arthroplasty (TKA) and total hip arthroplasty (THA) remain high for patients with rheumatoid arthritis (RA), who are at risk of flaring after surgery. We aimed to describe rates, characteristics, and risk factors of RA flare within 6 weeks of THA and TKA. METHODS: Patients with RA were recruited prior to elective THA and TKA surgery and prospectively followed. Clinicians evaluated RA clinical characteristics 0-2 weeks before and 6 weeks after surgery...
May 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29529667/late-reinfection-may-recur-more-than-5-years-after-reimplantation-of-tha-and-tka-analysis-of-pathogen-factors
#10
Kevin L Garvin, Ryan E Miller, Todd M Gilbert, Anthony M White, Elizabeth R Lyden
BACKGROUND: Two-stage reimplantation has consistently yielded high rates of success for patients with chronic prosthetic joint infection, although results more than 5 years after reimplantation are not commonly reported. Numerous factors may contribute to the risk of reinfection, although these factors-as well as the at-risk period after reimplantation-are not well characterized. QUESTIONS/PURPOSES: (1) What is the risk of reinfection after reimplantation for prosthetic joint infection at a minimum of 5 years? (2) Is the bacteriology of the index infection associated with late reinfection? (3) Is the presence of bacteria at the time of reimplantation associated with late reinfection? METHODS: Between 1995 and 2010, we performed 97 two-stage revisions in 93 patients for prosthetic joint infection of the hip or knee, and all are included in this retrospective study...
February 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29523446/reasons-for-ninety-day-emergency-visits-and-readmissions-after-elective-total-joint-arthroplasty-results-from-a-us-integrated-healthcare-system
#11
Matthew P Kelly, Heather A Prentice, Wei Wang, Brian H Fasig, Dhiren S Sheth, Elizabeth W Paxton
BACKGROUND: Previous studies evaluating reasons for 30-day readmissions following total joint arthroplasty (TJA) may underestimate hospital-based utilization of healthcare resources during a patient's episode-of-care. We sought to identify common reasons for 90-day emergency department (ED) visits and hospital readmissions following primary elective unilateral TJA. METHODS: Patients from July 1, 2012 through June 30, 2015 having primary elective TJA and at least one 90-day postoperative ED-only visit and/or readmission for any reason were identified using the Kaiser Permanente Total Joint Replacement Registry...
February 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29499692/the-influence-of-preoperative-determinants-on-quality-of-life-functioning-and-pain-after-total-knee-and-hip-replacement-a-pooled-analysis-of-dutch-cohorts
#12
Stefanie N Hofstede, Maaike G J Gademan, Theo Stijnen, Rob G H H Nelissen, Perla J Marang-van de Mheen
BACKGROUND: Previous research has identified preoperative determinants that predict health related quality of life (HRQoL), functioning and pain after total knee or hip arthroplasty (TKA/THA), but these differed between studies and had opposite directions. This may be due to lack of power and not adjusting for confounders. The present study aims to identify the preoperative determinants that influence health related quality of life (HRQoL), functioning and pain after total knee or hip arthroplasty (TKA/THA)...
March 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29485516/the-impact-of-advanced-age-on-the-outcomes-of-primary-total-hip-and-knee-arthroplasty-for-osteoarthritis-a-systematic-review
#13
Benjamin P d'S Murphy, Michelle M Dowsey, Peter F M Choong
BACKGROUND: Elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective options for the management of osteoarthritis that has not responded to conservative therapy, and they are increasing in utilization worldwide. Therefore, we sought to investigate how older age influences the outcomes of THA and TKA through a review of the current literature. METHODS: The Embase and MEDLINE databases were examined for relevant studies that assessed the role of older age in determining the outcomes of THA and TKA...
February 2018: JBJS Reviews
https://www.readbyqxmd.com/read/29359322/evolution-of-bias-and-sample-size-in-postoperative-pain-management-trials-after-hip-and-knee-arthroplasty
#14
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)...
May 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
#15
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 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
#16
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
#17
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...
April 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29080048/total-knee-arthroplasty-in-patients-with-prior-ipsilateral-hip-arthrodesis
#18
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...
April 2018: 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
#19
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
#20
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
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