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Knee arthroplasty

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https://www.readbyqxmd.com/read/28738430/postoperative-stiffening-after-bicruciate-retaining-total-knee-arthroplasty
#1
Frédéric Lavoie, Fidaa Al-Shakfa, James Reuben Moore, Lydia Mychaltchouk, Khaled Iguer
No abstract text is available yet for this article.
July 24, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28737635/reducing-length-of-stay-direct-cost-and-readmissions-in-total-joint-arthroplasty-patients-with-an-outcomes-manager-led-interprofessional-team
#2
Melissa Arana, Licia Harper, Huanying Qin, Jay Mabrey
The purpose of this quality improvement project was to determine whether an outcomes manager-led interprofessional team could reduce length of stay and direct cost without increasing 30-day readmission rates in the total joint arthroplasty patient population. The goal was to promote interprofessional relationships combined with collaborative practice to promote coordinated care with improved outcomes. Results from this project showed that length of stay (total hip arthroplasty [THA] reduced by 0.4 days and total knee arthroplasty [TKA] reduced by 0...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737615/acute-wound-complications-after-total-knee-arthroplasty-prevention-and-management
#3
Matthew J Simons, Nirav H Amin, Giles R Scuderi
Normal wound healing with avoidance of early wound complications is critical to the success of total knee arthroplasty. The severity of acute complications includes less morbid problems, such as quickly resolved drainage and small superficial eschars, to persistent drainage and full-thickness tissue necrosis, which may require advanced soft-tissue coverage. To achieve proper healing, surgeons must respond to persistent drainage by addressing modifiable patient risk factors, using meticulous surgical technique, and implementing an algorithmic approach to treatment...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#4
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735805/impact-of-definition-and-timeframe-on-capturing-surgery-related-readmissions-after-primary-joint-arthroplasty
#5
Brian P Chen, Johanna Dobransky, Stephane Poitras, Alan Forster, Paul E Beaulé
BACKGROUND: Readmission rate has emerged as an important metric to measure quality, but varying definitions and timeframes are used. We aimed to evaluate the impact of different readmission definitions (postoperative vs postdischarge) and timeframes (30 vs 90-day) on capturing surgery-related readmissions after primary total joint arthroplasty. METHODS: Patients who underwent primary total hip or knee arthroplasty between January 1, 2013 and December 31, 2015 were included...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735804/effect-of-type-2-diabetes-on-in-hospital-postoperative-complications-and-mortality-after-primary-total-hip-and-knee-arthroplasty
#6
Maria A Martínez-Huedo, Rodrigo Jiménez-García, Isabel Jiménez-Trujillo, Valentín Hernández-Barrera, Benito Del Rio Lopez, Ana López-de-Andrés
BACKGROUND: We aimed to compare in-hospital postoperative complications (IHPC) and in-hospital mortality between patients with and without type 2 diabetes mellitus (T2DM) undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: We analyzed data from the Spanish National Hospital Discharge Database, 2010-2014. We selected patients who had undergone THA (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 81...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735803/transfusion-thresholds-for-major-orthopedic-surgery-a-systematic-review-and-meta-analysis
#7
Matthew D Mitchell, Joel S Betesh, Jaimo Ahn, Eric L Hume, Samir Mehta, Craig A Umscheid
BACKGROUND: More than a million surgeries are performed annually in the United States for hip or knee arthroplasty or hip fracture stabilization. One-fifth of these patients have blood transfusions during their hospital stay. Increases in transfusion rates have caused concern about increased adverse events from unnecessary transfusions. METHODS: We systematically reviewed randomized trials examining the effect of restrictive vs liberal transfusion thresholds on patients having major orthopedic surgery...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735802/correction-of-patellofemoral-malalignment-with-patellofemoral-arthroplasty
#8
Marco Valoroso, Mo Saffarini, Giuseppe La Barbera, Cécile Toanen, Gerjon Hannink, Luca Nover, David H Dejour
BACKGROUND: The goal of patellofemoral arthroplasty (PFA) is to replace damaged cartilage and correct underlying deformities to reduce pain and prevent maltracking. We aimed to determine how PFA modifies patellar height, tilt, and tibial tuberosity-trochlear groove (TT-TG) distance. The hypothesis was that PFA would correct trochlear dysplasia or extensor mechanism malalignment. METHODS: The authors prospectively studied a series of 16 patients (13 women and 3 men) aged 64...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735799/prior-knee-arthroscopy-does-not-influence-long-term-total-knee-arthroplasty-outcomes-and-survivorship
#9
Anthony Viste, Matthew P Abdel, Matthieu Ollivier, Kristin C Mara, Aaron J Krych, Daniel J Berry
BACKGROUND: Arthroscopic knee surgery frequently precedes total knee arthroplasty (TKA). There have been mixed data on the effect of prior arthroscopic surgery on results of TKA. The purpose of this study was to compare the 10-year Knee Society Score (KSS), survivorship, and complications of TKA in a cohort of patients who had a previous knee arthroscopy to a control cohort. METHODS: A retrospective review of 1315 TKAs who underwent a primary TKA between 2003 and 2004 was performed...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734614/correlation-of-the-caprini-score-and-venous-thromboembolism-incidence-following-primary-total-joint-arthroplasty-results-of-a-single-institution-protocol
#10
Dexter K Bateman, Robert W Dow, Andrzej Brzezinski, Howard Y Bar-Eli, Stephen T Kayiaros
BACKGROUND: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis, is a serious complication after total joint arthroplasty (TJA). Risk assessment models are increasingly used to provide patient-specific risk stratification. A recently implemented protocol mandates calculation of a Caprini Score for all surgical patients at our institution. We investigated the accuracy of the Caprini Score in predicting VTE events following TJA. METHODS: A retrospective review of patients undergoing primary total hip (THA) and total knee arthroplasty (TKA) over a 1-year time period was performed...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734613/obesity-does-not-affect-outcomes-in-hybrid-versus-cemented-total-knee-arthroplasty-in-asians
#11
Jin-Guang Ernest Ang, Hamid Rahmatullah Bin Abd Razak, Tet-Sen Howe, Boon-Keng Tay, Seng-Jin Yeo
BACKGROUND: This study aims to evaluate patient reported and functional outcomes following hybrid versus cemented total knee arthroplasty (TKA) in patients, stratified by body mass index (BMI). METHODS: Registry data of patients undergoing primary TKA between January 2004 and January 2013 were collected. Baseline interviews were conducted preoperatively to assess sociodemographic characteristics, BMI, and knee arthritis severity, using the Knee Society Score which consists of the Knee Society Knee Score and the Knee Society Function Score (KSFS) and Oxford Knee Score (OKS)...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734612/primary-total-knee-arthroplasty-how-does-residual-patellar-thickness-affect-patient-oriented-outcomes
#12
Jose C Alcerro, Mark D Rossi, Carlos J Lavernia
BACKGROUND: Maintenance of the native patellar thickness has been deemed important for proper clinical outcomes after total knee arthroplasty (TKA). Our objective was to study the effects of the change in patellar thickness on patient-perceived outcomes (PPOs) after TKA. We hypothesized that reestablishing native patellar thickness after TKA results in better PPOs. METHODS: 819 consecutive patients undergoing primary TKA were studied. Patients were classified according to their postoperative patellar thickness into: (1) less than native patella thickness; (2) equal to native patella thickness; and (3) greater than native patella thickness...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28733296/a-unified-multi-level-model-approach-to-assessing-patient-responsiveness-including-return-to-normal-minimally-important-differences-and-minimal-clinically-important-improvement-for-patient-reported-outcome-measures
#13
Adrian Sayers, Vikki Wylde, Erik Lenguerrand, Rachael Gooberman-Hill, Jill Dawson, David Beard, Andrew Price, Ashley W Blom
OBJECTIVE: This article reviews and compares four commonly used approaches to assess patient responsiveness with a treatment or therapy (return to normal (RTN), minimal important difference (MID), minimal clinically important improvement (MCII), OMERACT-OARSI [Outcome Measures in Rheumatology-Osteoarthris Reseach Society International] (OO)) and demonstrates how each of the methods can be formulated in a multilevel modelling (MLM) framework. DESIGN: Cohort study...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28733109/reconstructing-the-chronically-disrupted-knee-extensor-mechanism-after-total-knee-arthroplasty-hourglass-variant-of-the-original-partial-allograft-technique
#14
C Fiquet, A Schneider, R Ballis, E Servien, P Neyret, S Lustig
Allograft reconstruction is a valuable treatment option for patients with chronic extensor mechanism disruption after total knee arthroplasty. Here, an hourglass variant of the original partial allografttechnique is described. An hourglass-shaped patellar bone block is press-fit into the native patella. The graft is fixed to both the patella and the tibia then sutured with the knee fully extended. Outcomes of this technique were assessed in 5 patients after at least 24 months' follow-up. The mean knee and function Knee Society Score values were 77...
July 18, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28732754/what-is-the-quality-of-online-resources-about-pain-control-after-total-knee-arthroplasty
#15
William W Schairer, Cynthia A Kahlenberg, Peter K Sculco, Benedict U Nwachukwu
BACKGROUND: With the growing opioid crisis in the United States, there has been a push to reduce the utilization of opioids in favor of multimodal analgesia options. The purpose of this study was to evaluate the quality of online resources that patients may use to learn about pain control after total knee arthroplasty (TKA). METHODS: We identified websites using a combination of search terms about TKA and pain control. A novel grading rubric was created with 25 maximum points, consisting of items that were deemed important for patients to know about the subject...
June 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28731957/longitudinal-postoperative-course-of-pain-and-dysfunction-following-total-knee-arthroplasty
#16
Katherine Hadlandsmyth, M Bridget Zimmerman, Roohina Wajid, Kathleen A Sluka, Keela Herr, Charles R Clark, Nicolas O Noiseux, John J Callaghan, Barbara A Rakel
OBJECTIVES: While the majority of patients undergoing Total Knee Arthroplasty report substantial improvement in pain and function, a significant subset experience persistent post-surgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6 weeks post-TKA, to six month outcomes. This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6 weeks and 6 months post-TKA...
July 20, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28729762/combination-of-bone-marrow-mesenchymal-stem-cells-and-cartilage-fragments-contribute-to-enhanced-repair-of-osteochondral-defects
#17
Mohammed Abbas
Cartilage tissue engineering using stem cells and biomaterials is considered a promising approach despite poor outcomes. We hypothesise that articular cartilage fragments provides native environmental cues to enhance stem cell differentiation. As such we evaluated the chondrogenic differentiation and repair of critical size defect in a human explant osteochondral model (OD) using bone marrow derived mesenchymal stem cells (BM-MSCs) and homogenised cartilage. BM-MSCs were established from the bone-marrow plugs of patients undergoing total knee arthroplasty and characterized...
2017: Bioinformation
https://www.readbyqxmd.com/read/28729306/hospital-variation-in-allogeneic-transfusion-and-extended-length-of-stay-in-primary-elective-hip-and-knee-arthroplasty-a-cross-sectional-study
#18
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Cynthia So-Osman, M Elske van den Akker-van Marle, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
OBJECTIVES: Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. DESIGN: Cross-sectional medical record review study...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728882/variation-in-the-cost-of-5-common-operations-in-the-united-states
#19
Elliot Wakeam, George Molina, Neel Shah, Stuart R Lipsitz, David C Chang, Atul A Gawande, Alex B Haynes
BACKGROUND: Health care costs are an important policy focus in the United States. The magnitude and drivers of variation in the costs of common operative procedures are not well understood. We sought to characterize variation in costs across hospitals. METHODS: We used data from the Nationwide Inpatient Sample from 2001-2011 for 5 elective operations: colectomy, coronary artery bypass graft, total knee arthroplasty, cesarean section, and lung resection. Hospitals were benchmarked for each using hierarchical risk- and reliability-adjustment methods to generate an observed-to-expected cost ratio, which was adjusted for patient demographics, comorbidity, wage index, and procedure complexity...
July 17, 2017: Surgery
https://www.readbyqxmd.com/read/28728444/determinants-of-pain-disability-health-related-quality-of-life-and-physical-performance-in-patients-with-knee-osteoarthritis-awaiting-total-joint-arthroplasty
#20
Véronique Lowry, Philippe Ouellet, Pascal-André Vendittoli, Lisa C Carlesso, Timothy H Wideman, François Desmeules
PURPOSE: In patients suffering from knee osteoarthritis awaiting knee arthroplasty, to measure associations between several selected determinants and pain, disability, health-related quality of life and physical performance. MATERIAL AND METHODS: Validated self-reported measures were collected: (1) Western Ontario and McMaster Universities Osteoarthritis Index, (2) Lower Extremity Functional Scale (LEFS) and (3) Short-Form 36 (SF-36). Physical performance was also assessed with four validated performance tests...
July 20, 2017: Disability and Rehabilitation
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