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Total joint

J Lock, H Raat, M Peters, M Scholten, M Beijlevelt, R Oostenbrink, F W G Leebeek, H A Moll, M H Cnossen
BACKGROUND: Transmural support by a haemophilia nurse may improve treatment and may empower parents and patients. AIM: To measure the effect of structured home visits by a haemophilia nurse in (parents of) patient on aspects of prophylactic home treatment. METHODS: A multicentre intervention study in two paediatric haemophilia treatment centres was performed. Primary outcome measures were: adherence to prescribed treatment, health-related quality of life and behavioural scores...
October 25, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Se Ang Jang, Young Ho Cho, Young Soo Byun, Tae Hoe Gu
Abductor deficiency in native hip joint may cause severe limping and pain. It is more serious situation in case of arthroplasty due to instability and recurrent dislocation. Well-known causes of abductor deficiency are repeated surgery, chronic trochanteric bursitis, superior gluteal nerve injury, failure of repair of abductor tendon insertion to the greater trochanter. Author had experienced primary abductor deficiency during total hip replacement and treated successfully with the transfer of gluteus maximus...
September 2016: Hip Pelvis
Schneider K Rancy, Samir K Trehan, Angela E Li, Steve K Lee, Hollis G Potter, Scott W Wolfe
Background Previous authors have reported pisotriquetral pain and subsequent pisiform excision following partial or total wrist fusion in patients with scapholunate advanced collapse (SLAC). Prior studies have not considered the potential role of SLAC biomechanics on pisotriquetral osteoarthritis (PT OA) development preoperatively. Purpose To determine the prevalence and severity of PT OA in patients with SLAC as compared with a control population. Patients and Methods Magnetic resonance imaging (MRI) studies of 24 patients with SLAC wrist and 24 sex- and age-matched control patients were analyzed...
November 2016: Journal of Wrist Surgery
Navid Alem, Joseph Rinehart, Brian Lee, Doug Merrill, Safa Sobhanie, Kyle Ahn, Ran Schwarzkopf, Maxime Cannesson, Zeev Kain
BACKGROUND: Efforts to mitigate costs while improving surgical care quality have received much scrutiny. This includes the challenging issue of readmission subsequent to hospital discharge. Initiatives attempting to preclude readmission after surgery require planned and unified efforts extending throughout the perioperative continuum. Patient optimization prior to discharge, enhanced disease monitoring, and seamless coordination of care between hospitals and community providers is integral to this process...
2016: Perioperative Medicine
Matthew J Grosso, Ari Berg, Samuel LaRussa, Taylor Murtaugh, David P Trofa, Jeffrey A Geller
BACKGROUND: Commercial silver-impregnated occlusive dressings (such as Aquacel Ag Surgical wound dressing) have been touted as antimicrobial dressings to be used following total joint arthroplasty. Given the increased cost of an Aquacel dressing over a standard dressing for total joint arthroplasty, the objective of this study was to determine whether Aquacel surgical dressing is effective in reducing the rates of acute periprosthetic joint infection (PJI) compared to standard sterile dressing...
September 28, 2016: Journal of Arthroplasty
Jarrett Williams, Benjamin S Kester, Joseph A Bosco, James D Slover, Richard Iorio, Ran Schwarzkopf
BACKGROUND: To curb the unsustainable rise in health care expenses, health care payers are developing programs to incentivize hospitals and physicians to improve the value of care delivered to patients. Payers are utilizing various metrics, such as length of stay (LOS) and unplanned readmissions, to track progression of quality metrics. Relevant to orthopedic surgeons, the Centers for Medicare and Medicaid Services announced in 2015 the Comprehensive Care for Joint Replacement Payment Model-a program aimed at improving the quality of health care delivered to patients by shifting more of the financial risk of patient care onto providers...
September 28, 2016: Journal of Arthroplasty
P Maxwell Courtney, David C Markel
With renewed focus on achieving value for patients in total hip and knee arthroplasty, payors, hospitals, and physicians strive to provide quality care while minimizing cost. Large registry datasets have gained popularity in the United States to track implant survivorship and outcomes after joint replacement. Partnerships among surgeons, insurers, and health systems have improved on earlier administrative datasets from Medicare to measure quality and outcomes. Participation in state and national registries can help surgeons and hospitals gain a financial advantage in several insurers' quality programs and alternative payment models...
October 24, 2016: Journal of Knee Surgery
B C C Khoo, J K Brown, R L Prince
OBJECTIVES: In recent years quantitative computed tomography (QCT) has allowed precise non-invasive, three dimensional, in vivo measurement of hip structure in large numbers of individuals. The effects of ageing on proximal femur structure are reported and implications for the prevention of hip prosthesis loosening and hip fracture considered. DESIGN, SETTING AND PARTICIPANTS: An observational cross-sectional study of proximal femur QCT in 719 unselected female European descent aged 20 to 89 years recruited from US and Australian populations...
2016: PloS One
Mohamed M Abou Elatta, Foad Assal, Hussam M Basheer, Mazen Mohamed Ibrahim
Volar fracture dislocation is very uncommon, with few series reported in the literature. Patients with such injuries were treated by modified dynamic external fixators. The mean follow-up was 18 months (range, 6 to 92 mo). The mean range of interphalangeal (proximal interphalangeal) joints and distal interphalangeal joints were 90 and 74 degrees, respectively. The total active range of motion (TAM) was excellent (256 degrees). The mean quick disabilities of the arm, shoulder and hand score was 1.2. The advantages of our external fixators are that they are simple, cheap, adjustable, and allow immediate range of motion...
October 21, 2016: Techniques in Hand & Upper Extremity Surgery
Chao Ren, Xiaohai He, Truong Nguyen
Single image super-resolution (SR) is very important in many computer vision systems. However, as a highly ill-posed problem, its performance mainly relies on the prior knowledge. Among these priors, the non-local total variation (NLTV) prior is very popular and has been thoroughly studied in recent years. Nevertheless, technical challenges remain. Because NLTV only exploits a fixed non-shifted target patch in the patch search process, a lack of similar patches is inevitable in some cases. Thus, the non-local similarity cannot be fully characterized, and the effectiveness of NLTV cannot be ensured...
October 19, 2016: IEEE Transactions on Image Processing: a Publication of the IEEE Signal Processing Society
S Møller-Bisgaard, B J Ejbjerg, I Eshed, K Hørslev-Petersen, M L Hetland, A G Jurik, H Thomsen, T Torfing, K Stengaard-Pedersen, P Junker, N S Krogh, T Lottenburger, T Ellingsen, L S Andersen, H Skjødt, A J Svendsen, U Tarp, I T Hansen, J Pødenphant, J K Pedersen, H Lindegaard, L G Hanson, A Vestergaard, D Glinatsi, M Østergaard
OBJECTIVES: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients, and to investigate whether concomitant cyclosporin A (CyA) provides an additional effect. METHOD: In the 2-year randomized, double-blind, treat-to-target trial CIMESTRA, 160 patients with eRA (< 6 months) were randomized to MTX, intra-articular betamethasone and CyA, or placebo CyA...
October 24, 2016: Scandinavian Journal of Rheumatology
Tomokazu Yoshioka, Hisashi Sugaya, Shigeki Kubota, Mio Onishi, Akihiro Kanamori, Yoshiyuki Sankai, Masashi Yamazaki
The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion...
2016: Case Reports in Orthopedics
Shekhar K Gadkaree, Daniel Q Sun, Carol Li, Frank R Lin, Luigi Ferrucci, Eleanor M Simonsick, Yuri Agrawal
Objectives. To investigate whether sensory function declines independently or in parallel with age within a single individual. Methods. Cross-sectional analysis of Baltimore Longitudinal Study of Aging (BLSA) participants who underwent vision (visual acuity threshold), proprioception (ankle joint proprioceptive threshold), vestibular function (cervical vestibular-evoked myogenic potential), hearing (pure-tone average audiometric threshold), and Health ABC physical performance battery testing. Results. A total of 276 participants (mean age 70 years, range 26-93) underwent all four sensory tests...
2016: Journal of Aging Research
P Metais, P Clavert, J Barth, P Boileau, R Broszka, G Nourissat, J Leuzinger, G Walch, L Lafosse
BACKGROUND: The Latarjet-Patte procedure consisting in transfer and screw fixation of the coracoid process to the anterior glenoid is a treatment of reference for anterior shoulder instability. Over time, surgical innovations translated into a number of improvements and, in late 2003, an arthroscopically assisted variant of the procedure was described. OBJECTIVE: To evaluate and compare clinical outcomes of the modified Latarjet-Patte procedure performed by open surgery, arthroscopy with screw fixation, or arthroscopy with endobutton fixation...
October 19, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
H Patel, S Swinson, K Johnson
AIM: To re-assess the content and quality of skeletal surveys performed in the investigation of non-accidental injury following the publication of nationally agreed guidelines produced jointly by the Royal College of Radiologists and the Royal College of Paediatrics and Child Health in 2008. MATERIALS AND METHODS: One hundred consecutive skeletal surveys performed in England, which were sent to a tertiary paediatric hospital for a second opinion, were reviewed for their content and quality...
October 19, 2016: Clinical Radiology
Wei Wang, Gen-Jin Yang, Ju Zhang, Chen Chen, Zhen-Yu Jia, Jia Li, Wei-Dong Xu
BACKGROUND: Ankylosing spondylitis (AS) is an autoimmune rheumatic disease mostly affecting the axial skeleton. Currently, anti-tumour necrosis factor α (anti-TNF-α) represents an effective treatment for AS that may delay the progression of the disease and alleviate the symptoms if the diagnosis can be made early. Unfortunately, effective diagnostic biomarkers for AS are still lacking; therefore, most patients with AS do not receive timely and effective treatment. The intent of this study was to determine several key metabolites as potential biomarkers of AS using metabolomic methods to facilitate the early diagnosis of AS...
October 22, 2016: Arthritis Research & Therapy
Lukas Mangnus, Wouter P Nieuwenhuis, Hanna W van Steenbergen, Tom W J Huizinga, Monique Reijnierse, Annette H M van der Helm-van Mil
BACKGROUND: In the population a high body mass index (BMI) has been associated with slightly increased inflammatory markers. Within rheumatoid arthritis (RA), however, a high BMI has been associated with less radiographic progression; this phenomenon is unexplained. We hypothesized that the phenomenon is caused by an inverse relationship between BMI and inflammation in hand and foot joints with RA. To explore this hypothesis, local inflammation was measured using magnetic resonance imaging (MRI) in early arthritis patients presenting with RA or other arthritides and in asymptomatic volunteers...
October 22, 2016: Arthritis Research & Therapy
Shanyuanye Guan, Hans A Gray, Anthony G Schache, Julian Feller, Richard de Steiger, Marcus G Pandy
No data are available to describe six-degree-of-freedom (6-DOF) knee-joint kinematics for one complete cycle of overground walking subsequent to total knee arthroplasty (TKA). The aims of this study were firstly, to measure 6-DOF knee-joint kinematics and condylar motion for overground walking following TKA; and secondly, to determine whether such data differed between overground and treadmill gait when participants walked at the same speed during both tasks. A unique mobile biplane X-ray imaging system enabled accurate measurement of 6-DOF TKA knee kinematics during overground walking by simultaneously tracking and imaging the joint...
October 22, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Vajara Wilairatana, Peerasit Sinlapavilawan, Sittisak Honsawek, Noppachart Limpaphayom
BACKGROUND: The aim was to compare serum levels of interleukin-6 (SIL6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and joint fluid IL-6 (JIL-6) level between total knee arthroplasty (TKA) that used bone cement (BC group) and antibiotic-loaded bone cement (ALBC group). MATERIALS AND METHODS: Thirty-nine patients (40 TKAs) with a mean age of 69.6 years were non-randomly assigned to the BC or ALBC groups. Samples of SIL6, ESR, and CRP were collected at baseline and at 24 h, 72 h, and 4 weeks after surgery...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Zhenglin Chi, Peng Yang, Dajiang Song, Zan Li, Liang Tang, Weiyang Gao, Yonghuan Song, Tingang Chu
INTRODUCTION: To investigate the results of resurfacing completely degloved digits using bilobed innervated radial artery superficial palmar branch (RASPB) perforator flap in a spiral fashion. METHODS: A detailed anatomic study on 30 adult fresh frozen cadavers preinjected with silicone rubber compound to demarcate arterial anatomy documented locations, numbers, and diameters of arteries and skin perforators with surrounding nerves. The flap-raising procedure was performed using four fresh cadaver specimen...
October 21, 2016: Surgical and Radiologic Anatomy: SRA
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