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pain TKA THA

Dermot P Maher, Pauline Woo, Waylan Wong, Xiao Zhang, Roya Yumul, Charles Louy
OBJECTIVE: To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses among patients who undergo total hip arthroplasties (THAs) and total knee arthroplasties (TKAs). DESIGN: Retrospective analysis. SETTING: Single tertiary care, academic, urban, level 1 trauma center. PARTICIPANTS: Final cohort represents 301 consecutive surgical inpatients meeting criteria for evaluation by HCAHPS survey...
November 2016: Journal of Clinical Anesthesia
Joshua C Rozell, P Maxwell Courtney, Jonathan R Dattilo, Chia H Wu, Gwo Chin Lee
BACKGROUND: Improved pain management and early mobilization protocols have increased interest in the feasibility of short stay (<24 hours) or outpatient total hip (THA) and total knee (TKA) arthroplasty. However, concerns exist regarding patient safety and readmissions. The purposes of this study were to determine the incidence of in-hospital complications following THA/TKA, to create a model to identify comorbidities associated with the risk of developing major complications >24 hours postoperatively, and to validate this model against another consecutive series of patients...
September 1, 2016: Journal of Arthroplasty
Patricia Ribinik, Ahcene Aimar, Antoinette Ngonde Njoh
OBJECTIVE: To evaluate the interest of social insurance preliminary agreement to enter PRM ward for patients after orthopedic surgery in Gonesse hospital. MATERIAL/PATIENTS AND METHODS: From 01/01/15 to 06/30/15 went to PRM ward (inpatient or day hospital rehabilitation) 16 patients after TKA, 20 patients including 3 femoral neck fracture after THA, 3 patients after anterior cruciate knee ligamentoplasty and 3 patients with cuff tear surgery. At entrance, we assess patient's pain, mobility, personal and environmental factors upon Sofmer-Fedmer, MSAP and HAS standards...
September 2016: Annals of Physical and Rehabilitation Medicine
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
September 14, 2016: Revista Brasileira de Anestesiologia
Adam Tucker, Darren McCusker, Nidhi Gupta, Jonathon Bunn, Mark Murnaghan
INTRODUCTION: Arthroplasty is commonplace in orthopaedic practice, and post operative pain has been shown to substantially hinder recovery and discharge from hospital. OBJECTIVES: The current study assessed a multidisciplinary, multimodal Orthopaedic ERP in terms of its effect on patient perceived post operative pain in hip and knee arthroplasty. Secondary outcome was in the form of a cost analysis. METHODS: A prospective study was performed on consecutive arthroplasty patients across a 6 week period in a district orthopaedic unit...
May 2016: Ulster Medical Journal
Jakob Kjellberg, Henrik Kehlet
INTRODUCTION: Total hip and knee replacement (THA and TKA) are successful operations based on patient-reported outcomes and short-term socioeconomic evaluations. However, other data have shown problems regarding persistent pain and function. No detailed large-scale, long-term socioeconomic data exist on income and total health expenses before and after THA and TKA compared with a matched reference population (RP). METHODS: From the unique nationwide Danish registers, a total of 128,109 patients undergoing primary THA and TKA were followed from up to 12 years before to up to 12 years after surgery...
August 2016: Danish Medical Journal
Natalie A Glass, Neil A Segal, John J Callaghan, Charles R Clark, Nicolas O Noiseux, Yubo Gao, Richard Johnston
OBJECTIVE: To evaluate the extent to which elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) for osteoarthritis (OA) restore normal patient-reported physical function in men and women. METHODS: Pain and physical function (WOMAC-PF) were prospectively measured pre- and post-operatively. The relationship between surgical procedure and achieving physical function equivalent to age and sex-matched adults with no hip or knee joint problems was modeled using sex-specific logistic regression...
June 24, 2016: Osteoarthritis and Cartilage
James Cyriac, Leslie Garson, Ran Schwarzkopf, Kyle Ahn, Joseph Rinehart, Shermeen Vakharia, Maxime Cannesson, Zeev Kain
BACKGROUND: Previously, our group successfully established one of the nation's first Perioperative Surgical Homes (PSHs) aimed at coordinating services to patients undergoing primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). As we now focus on extending the PSH to other service lines within the hospital, the long-term sustainability of this practice model is an important factor to consider moving forward. METHODS: We prospectively collected data from all patients who underwent elective primary TKA and THA at our institution between October 1, 2012, and September 30, 2014...
July 2016: Anesthesia and Analgesia
J Lošťák, J Gallo, J Zapletalová
UNLABELLED: PURPOSE OF THE STUDY The aim of the study was, first, to assess satisfaction of our patients after primary total knee arthroplasty (TKA) at various intervals of follow-up. Second, a list of pre- and peri-operative factors with potential effects on patient satisfaction was analysed. The third objective was to identify conditions under which a result of replacement could be considered definite with a little probability of further unexpected development. A more detailed knowledge of unsatisfied patients may provide valuable information for use in pre-operative evaluation, indication for surgery, as well as in the surgery itself...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Aluane Silva Dias, Tathyana Rinaldi, Luciana Gardin Barbosa
INTRODUCTION: The currently common musculoskeletal disorders have been increasingly treated surgically, and the pain can be a limiting factor in postoperative rehabilitation. RATIONALE: Patient controlled analgesia (PCA) controls pain, but its adverse effects can interfere with rehabilitation and in the patient discharge process. This study becomes important, since there are few studies evaluating this correlation. OBJECTIVES: To compare the outcomes of patients who used and did not use patient controlled analgesia in postoperative orthopedic surgery with respect to pain, unscheduled need for O2 (oxygen), and time of immobility and in-hospital length of stay...
May 2016: Brazilian Journal of Anesthesiology
T Blikman, W Rienstra, T M van Raaij, A J ten Hagen, B Dijkstra, W P Zijlstra, S K Bulstra, I van den Akker-Scheek, M Stevens
INTRODUCTION: Residual pain is a major factor in patient dissatisfaction following total hip arthroplasty or total knee arthroplasty (THA/TKA). The proportion of patients with unfavourable long-term residual pain is high, ranging from 7% to 34%. There are studies indicating that a preoperative degree of central sensitisation (CS) is associated with poorer postoperative outcomes and residual pain. It is thus hypothesised that preoperative treatment of CS could enhance postoperative outcomes...
2016: BMJ Open
Jenna Goesling, Stephanie E Moser, Bilal Zaidi, Afton L Hassett, Paul Hilliard, Brian Hallstrom, Daniel J Clauw, Chad M Brummett
Few studies have assessed postoperative trends in opioid cessation and predictors of persistent opioid use after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Preoperatively, 574 TKA and THA patients completed validated, self-report measures of pain, functioning, and mood and were longitudinally assessed for 6 months after surgery. Among patients who were opioid naive the day of surgery, 8.2% of TKA and 4.3% of THA patients were using opioids at 6 months. In comparison, 53.3% of TKA and 34...
June 2016: Pain
S R Kingsbury, B Dube, C M Thomas, P G Conaghan, M H Stone
AIMS: Increasing demand for total hip and knee arthroplasty (THA/TKA) and associated follow-up has placed huge demands on orthopaedic services. Feasible follow-up mechanisms are therefore essential. METHODS: We conducted an audit of clinical follow-up decision-making for THA/TKA based on questionnaire/radiograph review compared with local practice of Arthroplasty Care Practitioner (ACP)-led outpatient follow-up. In all 599 patients attending an ACP-led THA/TKA follow-up clinic had a pelvic/knee radiograph, completed a pain/function questionnaire and were reviewed by an ACP...
February 2016: Bone & Joint Journal
Salvatore J Frangiamore, Marcelo B P Siqueira, Anas Saleh, Thomas Daly, Carlos A Higuera, Wael K Barsoum
BACKGROUND: Diagnosing periprosthetic joint infection (PJI) requires a combination of clinical and laboratory parameters, which may be expensive and difficult to interpret. Synovial fluid cytokines have been shown to accurately differentiate septic from aseptic failed total knee (TKA) and hip (THA) arthroplasties. However, after first-stage explantation, there is still no reliable test to rule out PJI before a second-stage reimplantation procedure. QUESTIONS/PURPOSES: (1) Which synovial fluid cytokines have the highest diagnostic accuracy for PJI? (2) Which cytokine shows the greatest decrease associated with the resolution of infection in the same patient between explantation and subsequent reimplantation of an infected arthroplasty? (3) What is the accuracy of synovial fluid cytokines and the Musculoskeletal Infection Society (MSIS) criteria to rule out PJI after first-stage explantation? (4) What are the most studied synovial fluid cytokines for diagnosing PJI as reported in the literature and what are their cumulative diagnostic accuracy? METHODS: Between May 2013 and March 2014, 104 patients with painful THA and TKA evaluated for possible PJI were included in our study...
July 2016: Clinical Orthopaedics and related Research
Maria C S Inacio, Nicole L Pratt, Elizabeth E Roughead, Stephen E Graves
BACKGROUND: Joint arthroplasty patients have a high prevalence of co-morbidities and this impacts their surgical outcomes. There are different ways to ascertain co-morbidities and appropriate measurement is necessary. The purpose of this study was to: (1) describe the prevalence of co-morbidities in a cohort of total hip arthroplasty (THA) and knee arthroplasty (TKA) patients using two diagnoses-based measures (Charlson and Elixhauser) and one prescription-based measure (RxRisk-V); (2) compare the agreement of co-morbidities amongst the measures...
2015: BMC Musculoskeletal Disorders
Zoe H Dailiana, Ippolyti Papakostidou, Sokratis Varitimidis, Lycurgos Liaropoulos, Elias Zintzaras, Theofilos Karachalios, Emmanuel Michelinakis, Konstantinos N Malizos
BACKGROUND: To investigate and compare the impact of primary hip (THA) and knee (TKA) arthroplasty on quality of life in patients with osteoarthritis, to determine patients' satisfaction with total joint arthroplasty, and to detect the effect of patients' demographic and clinical characteristics on outcome. METHODS: Three hundred seventy eight (378) patients with hip (174) and knee (204) osteoarthritis undergoing total joint arthroplasty (174 THA-204 TKA) were assessed pre- and post-operatively (6 weeks, 3, 6, and 12 months) using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and Centre for Epidemiological Studies Depression Scale (CES-D10)...
2015: BMC Musculoskeletal Disorders
M K Urban, T Chiu, S Wolfe, S Magid
OBJECTIVES: The authors investigated the impact of computerized provider order entry (CPOE) on the delivery times of analgesia and subsequent patient outcomes. We hypothesized that patients would report less pain and use less pain medications compared with the previous paper-based system. METHODS: Two groups of patients after a total hip (THA) or knee arthroplasty (TKA) were retrospectively compared: one comprising 106 patients when the paper-based ordering system was in effect (conventional group), and one comprising 96 patients after CPOE was installed (electronic group)...
2015: Applied Clinical Informatics
Jeroen C van Egmond, Hennie Verburg, Stephan B W Vehmeijer, Nina M C Mathijssen
Rapid recovery protocols reduce the length of hospital stay after Total Knee Arthroplasty (TKA) and Total Hip Arthroplasty (THA). However, little is known about the early postoperative phase. The purpose of this study was to examine which problems patients encountered during the first six weeks after primary TKA or THA surgery with rapid recovery. We invited twenty patients for a focus group meeting which discussed various subjects regarding the first six weeks after hospital discharge. The focus group meetings were analysed qualitatively...
September 2015: Acta Orthopaedica Belgica
Toby O Smith, Sarah Latham, Vivienne Maskrey, Annie Blyth
BACKGROUND: It has been perceived that people following total hip arthroplasty (THA) or total knee arthroplasty (TKA) have the capability, with reduced pain, to increase their levels of physical activity. OBJECTIVES: To determine the attitudes and perceptions of people awaiting or having undergone THA or TKA to physical activity post-arthroplasty and to identify potential facilitators or barriers to engage in active living and physical activity pursuits. METHODS: Systematic review of published and unpublished databases was undertaken from their inception to November 2014...
September 2015: Postgraduate Medical Journal
Torsten Pohl, Torsten Brauner, Scott Wearing, Knut Stamer, Thomas Horstmann
BACKGROUND: Sensorimotor function is degraded in patients after lower limb arthroplasty. Sensorimotor training is thought to improve sensorimotor skills, however, the optimal training stimulus with regard to volume, frequency, duration, and intensity is still unknown. The aim of this study, therefore, was to firstly quantify the progression of sensorimotor function after total hip (THA) or knee (TKA) arthroplasty and, as second step, to evaluate effects of different sensorimotor training volumes...
2015: BMC Musculoskeletal Disorders
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