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https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#1
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28091768/total-hip-arthroplasty-instability-treatment-without-dual-mobility-cups-brief-overview-and-experience-of-other-options
#2
REVIEW
Luigi Zagra, Eleonora Caboni
Dual mobility cups are getting increasing interest for the prevention, but also in the treatment of THA instability. Nevertheless when a dislocation occurs the main issue remains the knowledge and the correction of the causes of dislocation, including reorientation of the components and soft tissues treatment. There are several options of alternative implants to DMCs including upsizing of the head, and constrained liners. The Authors present how to evaluate patients with THA instability, the advantages and the disadvantages of each procedure and their experience in the treatment of cases without DMCs during a five years' time period...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28091766/pre-operative-intra-articular-deep-tissue-sampling-with-novel-retrograde-forceps-improves-the-diagnostics-in-periprosthetic-joint-infection
#3
Matthias D Wimmer, Milena M Ploeger, Max J Friedrich, Thomas Hügle, Sascha Gravius, Thomas M Randau
BACKGROUND: Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28091739/survival-of-uncemented-cups-from-a-single-manufacturer-implanted-from-1985-to-2013-finnish-arthroplasty-register-data
#4
Antton Palomäki, Lasse Lempainen, Markus Matilainen, Antti Eskelinen, Ville Remes, Petri Virolainen, Keijo T Mäkelä
INTRODUCTION: Total hip arthroplasty (THA) with uncemented implants has been a relatively common procedure in Finland during the recent decades. The most common brand of uncemented implants was chosen for further analysis to study the survivorship of this uncemented cup design in comparison to cemented references. PATIENTS, MATERIALS AND METHODS: Since 1980, The Finnish Arthroplasty Register has collected information on THAs on a national level. This study was based on information of THAs recorded in the Finnish Arthroplasty Register from 1985 to 2013...
January 13, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28089827/plication-of-the-posterior-capsule-for-intraoperative-posterior-instability-during-anatomic-total-shoulder-arthroplasty
#5
Eduard Alentorn-Geli, Andrew T Assenmacher, John W Sperling, Robert H Cofield, Joaquín Sánchez-Sotelo
BACKGROUND: Restoration of soft tissue balance for intraoperative posterior instability during anatomic total shoulder arthroplasty (TSA) is particularly difficult. The effectiveness of posterior capsular plication (PCP) in restoring soft tissue balance is largely unknown. The purpose of this study was to report the outcomes, complications, and reoperations of primary TSA in which a PCP was performed to correct excessive intraoperative posterior subluxation. METHODS: Thirty-eight shoulders (37 patients) underwent PCP for intraoperative posterior instability during anatomic TSA...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089825/clinical-and-radiographic-outcome-of-revision-surgery-of-total-elbow-prosthesis-midterm-results-in-19-cases
#6
Jetske Viveen, Ante Prkic, Koen L M Koenraadt, Izaäk F Kodde, Bertram The, Denise Eygendaal
BACKGROUND: The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty. METHODS: All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089667/periprosthetic-fractures-of-the-distal-femur-after-total-knee-arthroplasty-plate-versus-nail-fixation
#7
REVIEW
Sara Shippee Wallace, Daniel Bechtold, Adam Sassoon
: The incidence of periprosthetic fractures about a TKA is increasing. Traditionally these fractures are classified by their location and prosthesis integrity. In the setting of a supracondyar fracture about a well-fixed prosthesis, both plate and nail fixation of the fracture present themselves as options, each with unique benefits and pitfalls. Through review and discussion of the literature, we aim to describe some of the patient, fracture, and implant related factors that should be considered when planning fixation of periprosthetic fractures about a TKA...
January 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28089470/conversion-hip-arthroplasty-in-failed-fixation-of-intertrochanteric-fracture-a-propensity-score-matching-study
#8
Young-Kyun Lee, Jung Taek Kim, Awad Abdalla Alkitaini, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Conversion hip arthroplasty is a salvage procedure for failed internal fixation of intertrochanteric fractures. However, the technical difficulties and perioperative morbidity of conversion arthroplasty are uncertain. METHODS: We compared the type of arthroplasty (total hip arthroplasty or hemiarthroplasty), operative parameters, perioperative morbidity, 1-year mortality, implant stability, and clinical results of 33 conversion hip arthroplasties due to a failed internal fixation of intertrochanteric fracture with those of a matched control group of 33 primary hip arthroplasties due to the same fracture...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#9
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089468/obtain-a-outcome-benefits-of-tranexamic-acid-in-hip-arthroplasty-a%C3%A2-randomized-double-blinded-controlled-trial
#10
Andrew Fraval, Peter Effeney, Lena Fiddelaers, Belinda Smith, Ben Towell, Phong Tran
BACKGROUND: We examined whether the blood conserving effect of tranexamic acid (TXA) in total hip arthroplasty using the direct anterior approach, translates to an effect on functional outcomes in the perioperative period. METHODS: We conducted a single-center, randomized, double-blinded, placebo-controlled trial. One hundred one patients were randomized to receive either TXA or an equivalent volume of normal saline. The primary outcome measure was thigh swelling...
December 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089467/the-evolution-of-implant-design-decreases-the-incidence-of-lateral-release-in-primary-total-knee-arthroplasty
#11
Jonathan E Webb, Heidi Y Yang, Jamie E Collins, Elena Losina, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Appropriate balancing of the patellofemoral joint (PFJ) using a lateral release can help to prevent patellar instability in total knee arthroplasty (TKA). Contemporary total knee implant designs are characterized by enhanced trochlear geometry more similar to native knee anatomy to minimize instability and reduce utilization of a lateral release. METHODS: We retrospectively reviewed consecutive TKA cases from a single senior surgeon's practice with 3 successive total knee designs: the Press-Fit Condylar (PFC), the Sigma, and the ATTUNE (DePuy, Warsaw, IN)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089261/is-previous-nonarthroplasty-surgery-a-risk-factor-for-periprosthetic-infection-in-primary-shoulder-arthroplasty
#12
Jean-David Werthel, Taku Hatta, Bradley Schoch, Robert Cofield, John W Sperling, Bassem T Elhassan
BACKGROUND: The purpose of this study was to determine the risk of periprosthetic infection after primary shoulder arthroplasty (SA) in patients undergoing previous nonarthroplasty shoulder surgery compared with those without previous surgery. MATERIALS AND METHODS: All patients undergoing primary SA at our institution between 1970 and 2012 were included in this study. The cohort consisted of 4577 patients treated with 2890 total SAs, 1233 hemiarthroplasties, and 454 reverse SAs; 813 (18%) patients had undergone prior nonarthroplasty shoulder surgery on the operative side...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089256/a-comparative-analysis-of-work-related-outcomes-after-humeral-hemiarthroplasty-and-reverse-total-shoulder-arthroplasty
#13
Daniel J Hurwit, Joseph N Liu, Grant H Garcia, Gregory Mahony, Hao-Hua Wu, David M Dines, Russell F Warren, Lawrence V Gulotta
BACKGROUND: The return to work of young patients undergoing shoulder arthroplasty is increasingly important. Whereas studies have shown superior outcomes of reverse total shoulder arthroplasty (RTSA) compared with humeral hemiarthroplasty (HHA), no prior literature has compared RTSA with HHA in regard to return to work. METHODS: A retrospective review of a prospectively collected shoulder arthroplasty registry was performed to analyze all patients who underwent RTSA or HHA at a single institution...
January 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#14
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089186/predictors-of-same-day-discharge-in-primary-total-joint-arthroplasty-patients-and-risk-factors-for-post-discharge-complications
#15
Alex Sher, Aakash Keswani, Dong-Han Yao, Michael Anderson, Karl Koenig, Calin S Moucha
BACKGROUND: Same-day (<24 h) discharge total joint arthroplasty (TJA) may be a safe and effective option for certain patients with end-stage osteoarthritis. Given the growing pressure to improve quality and lower TJA episode costs, surgeons must identify which TJA patients can be appropriately discharged home quickly and safely. This study identifies characteristics associated with same-day discharge post-TJA as well as assesses risk factors for complications in this select patient population...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089185/joint-replacement-volume-positively-correlates-with-improved-hospital-performance-on-centers-for-medicare-and-medicaid-services-quality-metrics
#16
Rachel A Sibley, Vanessa Charubhumi, Lorraine H Hutzler, Albit R Paoli, Joseph A Bosco
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089184/bone-wax-is-effective-in-reducing-blood-loss-after-total-knee-arthroplasty
#17
Ing H Moo, Jerry Y Q Chen, Eric H Pagkaliwaga, See W Tan, Kein B Poon
BACKGROUND: Total knee arthroplasty (TKA) is associated with major blood loss and blood transfusion is often required. This study aimed to evaluate the efficacy of bone wax in reducing blood loss and transfusion rates after TKA. METHODS: A prospective randomized controlled study that included 100 patients undergoing primary unilateral TKA with cement was conducted in a tertiary center between March 2014 and June 2014. The bone wax group received 2.5 g of bone wax, applied onto the uncovered bone around the prostheses and the nail holes before the tourniquet was released, whereas the control group had hemostasis achieved using electrocautery only...
December 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28088603/hospital-readmissions-after-surgery-how-important-are-hospital-and-specialty-factors
#18
Robert H Hollis, Laura A Graham, Joshua S Richman, Melanie S Morris, Hillary J Mull, Tyler S Wahl, Edith Burns, Laurel A Copeland, Gordon L Telford, Amy K Rosen, Kamal F Itani, Jeffrey Whittle, Todd H Wagner, Mary T Hawn
BACKGROUND: Hospital readmission rates after surgery may represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. STUDY DESIGN: For general, orthopedic, and vascular specialties at Veterans Affairs hospitals during 2008-2014, 30-day risk-adjusted readmission rates were estimated for six high-volume procedures and each specialty...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28088378/antimicrobial-coated-implants-in-trauma-and-orthopaedics-a-clinical-review-and-risk-benefit-analysis
#19
REVIEW
Volker Alt
Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed...
December 21, 2016: Injury
https://www.readbyqxmd.com/read/28088227/simplified-chinese-version-of-the-forgotten-joint-score-fjs-for-patients-who-underwent-joint-arthroplasty-cross-cultural-adaptation-and-validation
#20
Shiqi Cao, Ning Liu, Wuxiang Han, Yunpeng Zi, Fan Peng, Lexiang Li, Qiwei Fu, Yi Chen, Weijie Zheng, Qirong Qian
BACKGROUND: The Forgotten Joint Score (FJS) is a newly developed health-related quality of life (HRQoL) questionnaire designed to evaluate the awareness after total knee arthroplasty (TKA). This study cross-culturally adapted and psychometrically validated a simplified Chinese version of the FJS (SC-FJS). METHODS: Cross-cultural adaptation was performed according to the internationally recognized guidelines. One-hundred and fifty participants who underwent primary TKA were recruited in this study...
January 14, 2017: Journal of Orthopaedic Surgery and Research
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