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Total joint arthroplasty

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https://www.readbyqxmd.com/read/28919091/intravenous-acetaminophen-as-an-adjunct-to-multimodal-analgesia-after-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#1
REVIEW
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to investigate the impact of additional intravenous acetaminophen for pain management after total joint arthroplasty (TJA). METHODS: We conducted electronic searches of Medline (1966-2017.07), PubMed (1966-2017.07), Embase (1980-2017.07), ScienceDirect (1985-2017.07) and the Cochrane Library. Randomized controlled trials (RCTs) and non-RCTs were included. The quality assessments were performed according to the Cochrane systematic review method...
September 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28918788/-fast-track-total-knee-arthroplasty
#2
Kirill Gromov, Billy B Kristensen, Christoffer Calov Jørgensen, Torben Bæk Hansen, Henrik Kehlet, Henrik Husted
Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery, thus leading to lower mortality and morbidity as well as high patient satisfaction. All patients are eligible for fast-track TKA, and hence the fast-track concept should be standard at all joint replacement facilities. Future challenges of fast-track TKA include safe introduction of outpatient protocols, acute and chronic pain after surgery and optimal utilization of post-operative physiotherapy...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28918227/bone-remodeling-of-the-distal-femur-after-uncemented-total-knee-arthroplasty-a-2-year-prospective-dxa-study
#3
Mikkel Rathsach Andersen, Nikolaj S Winther, Thomas Lind, Henrik M Schrøder, Michael Mørk Petersen
Loss of bone stock as a response to the bone trauma, immobilization, and stress shielding related to joint replacement surgery increases the risk of fracture of the distal femur after total knee arthroplasty. Previous studies of uncemented femoral components have reported very high levels of bone loss in the distal femur. This study investigates the adaptive bone remodeling of the distal femur after uncemented total knee arthroplasty. We performed a 2-year follow-up of 53 patients (mean age 61.5 [38-70] years, F/M = 27/26, body mass index 29...
September 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28917522/does-physical-activity-change-following-hip-and-knee-replacement-matched-case-control-study-evaluating-physical-activity-scale-for-the-elderly-data-from-the-osteoarthritis-initiative
#4
T O Smith, M Mansfield, J Dainty, G Hilton, C J V Mann, C M Sackley
OBJECTIVES: To determine whether physical activity measured using the Physical Activity Scale for the Elderly (PASE), changes during the initial 24 months post-total hip (THR) or knee replacement (TKR), and how this compares to a matched non-arthroplasty cohort. DESIGN: Case-controlled study analysis of a prospectively collected dataset. SETTING: USA community-based. PARTICIPANTS: 116 people post-THR, 105 people post-TKR compared to 663 people who had not undergone THR or TKR, or had hip or knee osteoarthritis...
September 13, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#5
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28913405/post-acute-care-disparities-in-total-joint-arthroplasty
#6
Roy H Lan, Atul F Kamath
BACKGROUND: Understanding the socioeconomic factors that influence hospitalization and post-discharge metrics after joint replacement is important for identifying key areas of improvement in the delivery of orthopaedic care. METHODS: An institutional administrative data set of 2869 patients from an academic arthroplasty referral center was analyzed to quantify the relationship between socioeconomic factors and post-acute rehabilitation care received, length of stay, and cost of care...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28912417/comparison-of-leukocyte-esterase-testing-of-synovial-fluid-with-synovial-histology-for-the-diagnosis-of-periprosthetic-joint-infection
#7
Rui Li, Xiang Li, Baozhan Yu, Xin Li, Xinggui Song, Heng Li, Chi Xu, Jiying Chen
BACKGROUND Periprosthetic joint infection (PJI) is a complication of total joint arthroplasty (TJA). The leukocyte esterase (LE) strip test and histology are diagnostic methods for PJI. The aims of this study were to determine the sensitivity and specificity of the LE strip test and to compare it with histology in the diagnosis of PJI. MATERIAL AND METHODS Between January and December 2015, 93 patients who underwent TJA with PJI were enrolled in the study. Synovial fluid samples were tested with an LE strip, and three synovial tissue samples from each patient underwent frozen section and formalin-fixed histology...
September 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28910722/analysis-of-in-vivo-articular-cartilage-contact-surface-of-the-knee-during-a-step-up-motion
#8
Peng Yin, Jing-Sheng Li, Willem A Kernkamp, Tsung-Yuan Tsai, Seung-Hoon Baek, Ali Hosseini, Lin Lin, Peifu Tang, Guoan Li
BACKGROUND: Numerous studies have reported on the tibiofemoral articular cartilage contact kinematics, however, no data has been reported on the articular cartilage geometry at the contact area. This study investigated the in-vivo tibiofemoral articular cartilage contact biomechanics during a dynamic step-up motion. METHODS: Ten healthy subjects were imaged using a validated magnetic resonance and dual fluoroscopic imaging technique during a step-up motion. Three-dimensional bone and cartilage models were constructed from the magnetic resonance images...
September 8, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28905107/effect-of-changes-of-femoral-offset-on-abductor-and-joint-reaction-forces-in-total-hip-arthroplasty
#9
Hannes A Rüdiger, Maïka Guillemin, Adeliya Latypova, Alexandre Terrier
BACKGROUND: Anatomical reconstruction in total hip arthroplasty (THA) allows for physiological muscle function, good functional outcome and implant longevity. Quantitative data on the effect of a loss or gain of femoral offset (FO) are scarce. The aim of this study was to quantitatively describe the effect of FO changes on abductor moment arms, muscle and joint reactions forces. METHODS: THA was virtually performed on 3D models built from preoperative CT scans of 15 patients undergoing THA...
September 13, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28902611/accelerated-degenerative-joint-disease-after-staged-hip-arthroscopy-and-periacetabular-osteotomy-in-a-patient-with-hip-dysplasia
#10
Michael Guss, Thomas Youm
Hip dysplasia, when significant, is effectively treated with periacetabular osteotomy. There have been good results reported with hip arthroscopy when dysplasia is mild. However, when dysplasia is significant, hip arthroscopy with labral repair alone has led to poor results and even rapid decline to end stage arthritis. Staged hip arthroscopy and periacetabular osteotomy would potentially treat the labral lesion and correct the underlying bony abnormality that resulted in the labral pathology. Such a staged treatment plan should help prevent progression to degenerative joint disease...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28899856/release-of-the-tourniquet-immediately-after-the-implantation-of-the-components-reduces-the-incidence-of-deep-vein-thrombosis-after-primary-total-knee-arthroplasty
#11
P Zan, M O Mol, J J Yao, L Fan, D Yang, K Liu, G Li
AIMS: The length of the tourniquet time during total knee arthroplasty (TKA) is related to the incidence of post-operative deep vein thrombosis (DVT). Our aim in this study was to investigate the effect of the early release of the tourniquet on the incidence of DVT in patients undergoing TKA. METHODS: A total of 200 patients who underwent TKA between November 2015 and November 2016 were prospectively enrolled. The tourniquet was inflated before surgery and released immediately after the introduction of the components (early release group)...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#12
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28899589/trapeziectomy-with-suspension-interposition-arthroplasty-for-thumb-carpometacarpal-osteoarthritis-a-randomized-controlled-trial-comparing-the-use-of-allograft-versus-flexor-carpi-radialis-tendon
#13
Miriam Marks, Stefanie Hensler, Martina Wehrli, Anne-Gita Scheibler, Stephan Schindele, Daniel B Herren
PURPOSE: The objective of this randomized controlled trial was to compare the 12-month postoperative Michigan Hand Outcomes Questionnaire (MHQ) total score between patients with osteoarthritis (OA) at the first carpometacarpal (CMC I) joint who underwent trapeziectomy with suspension-interposition arthroplasty using the flexor carpi radialis (FCR) tendon and those receiving a human dermal collagen template (allograft). METHODS: We included 60 patients with CMC I OA who met the indications for surgery...
September 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28899386/improved-clinical-outcome-measures-of-knee-pain-and-function-with-concurrent-resolution-of-subchondral-bone-marrow-edema-lesion-and-joint-effusion-in-an-osteoarthritic-patient-following-pentosan-polysulphate-sodium-treatment-a-case-report
#14
Matthew J Sampson, Margie Kabbani, Ravi Krishnan, Michael Nganga, Annika Theodoulou, Jeganath Krishnan
BACKGROUND: At present, there are no registered products for the treatment of subchondral Bone Marrow Edema Lesion (BML) and associated knee pain. Patients who do not respond to current anti-inflammatory therapies are left with limited treatment options, and may resort to operative management with Total Knee Arthroplasty (TKA). We report the use of Pentosan Polysulphate Sodium (PPS) for the treatment of BMLs of the knee. CASE PRESENTATION: We report the case of a 70-year-old female with knee osteoarthritis presenting with a high level of knee pain, scoring 8 on the Numerical Rating Scale (NRS), and functional limitation demonstrating a poor Lysholm Knee Score of 37...
September 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28899328/the-value-of-inpatient-rehabilitation-after-uncomplicated-knee-arthroplasty-a-propensity-score-analysis
#15
Justine Maree Naylor, Andrew Hart, Rajat Mittal, Ian Harris, Wei Xuan
OBJECTIVE: To compare the effectiveness of rehabilitation after total knee arthroplasty (TKA) in models with or without an inpatient rehabilitation component. DESIGN, SETTING AND PARTICIPANTS: A propensity score-matched cohort of privately insured patients with osteoarthritis who underwent primary, unilateral TKA in one of 12 Australian hospitals between August 2013 and January 2015 were included. Those discharged to an inpatient facility because of poor progress or who experienced significant complications within 90 days of surgery were excluded...
September 18, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28898559/changes-in-physical-activity-after-total-hip-or-knee-arthroplasty-a-systematic-review-and-meta-analysis-of-6-and-12-month-outcomes
#16
Thomas Hammett, Aram Simonian, Monica Austin, Robert Butler, Kelli D Allen, Leila Ledbetter, Adam P Goode
OBJECTIVE: Little is known about the extent to which physical activity (PA) changes following total knee or hip joint replacement relative to pain, physical function and quality of life. Our objective was to conduct a systematic review and meta-analysis on changes in PA relative to pain, quality of life and physical function after total knee or hip joint replacement. METHODS: We searched PubMed (Medline), Embase and Cinahl, for peer-reviewed, English-language cohort studies measuring PA with an accelerometer from pre-surgery to post-surgery...
September 12, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28893014/comparison-of-continuous-femoral-nerve-block-versus-local-infiltration-analgesia-as-a-postoperative-analgesia-in-unilateral-total-knee-arthroplasty
#17
Deepika Chaubey, Hari Krishan Mahajan, Parshu Ram Chauhan, Preeti S Govind, Pushpinder Singh, Ravinder Dhanevar, Abhinav Gupta
INTRODUCTION: Local infiltration of knee joint in arthroplasty, provide postoperative analgesia and preserves motor power of quadriceps, which helps in early mobilisation, as compared to femoral nerve block which paralyses vastus medialis. AIM: To compare the quality of postoperative analgesia provided by femoral nerve block and local infiltration in unilateral Total Knee Arthroplasty (TKA). MATERIALS AND METHODS: A prospective study was conducted on 60 patients (25-65 years) of ASA I and II, which were randomly(using random number table) divided into two groups - Group 1-femoral nerve block (FNB) and Group 2-Local Infiltration Analgesia (LIA)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28892670/the-influence-of-sex-and-obesity-on-gait-biomechanics-in-people-with-severe-knee-osteoarthritis-scheduled-for-arthroplasty
#18
K L Paterson, L Sosdian, R S Hinman, T V Wrigley, J Kasza, M Dowsey, P Choong, K L Bennell
BACKGROUND: Sex and body mass may influence knee biomechanics associated with poor total knee arthroplasty (TKA) outcomes for knee osteoarthritis (OA). This study aimed to determine if gait differed between men and women, and overweight and class I obese patients with severe knee OA awaiting TKA. METHODS: 34 patients with severe knee OA (average age 70.0 (SD 7.2) years, body mass index 30.3 (4.1kg/m(2))) were recruited from a TKA waiting list. Three-dimensional gait analysis was performed at self-selected walking speed...
September 5, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28889222/the-predictive-factors-of-secondary-patellar-resurfacing-in-computer-assisted-total-knee-arthroplasty-a-prospective-cohort-study
#19
Florent Franck, Hervé Ouanezar, Alexandre Jacquel, Vincent Pibarot, Julien Wegrzyn
PURPOSE: The decision to resurface the patella during total knee arthroplasty (TKA) remains controversial. This prospective cohort study aimed to evaluate the outcome and survivorship of the native patella in computer-assisted TKA (CAS TKA) implanted for primary knee osteoarthritis, and to determine the predictive factors of secondary patellar resurfacing (SPR). METHODS: A prospective cohort of 273 cementless ultra-congruent mobile-bearing CAS TKA implanted without patellar resurfacing was included in our total joint registry...
September 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28888740/can-the-hip-joint-center-be-estimated-from-pelvic-dimensions-in-dysplastic-hips
#20
Masanori Fujii, Tetsuro Nakamura, Toshihiko Hara, Yasuharu Nakashima
BACKGROUND: We aimed to determine correlations between the hip joint center position and pelvic dimensions and whether the three-dimensional position of the original hip joint center could be estimated from pelvic landmarks in dysplastic and normal hips. METHODS: We reviewed the pelvic CT scans of 70 patients (70 hips) with hip dysplasia. Seventy-seven normal hips were used as controls. The hip joint center coordinates (Cx, Cy, and Cz) and pelvic dimensions were measured with reference to the anterior pelvic plane coordinate system...
September 6, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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