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Total joint arthroplasty

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https://www.readbyqxmd.com/read/28728205/-predictability-of-postoperative-pain-and-satisfaction-how-precise-are-we-and-what-is-the-role-of-professional-experience
#1
Ulf Krister Hofmann, Cosima Dobler, Marco Gesicki, Torsten Kluba, Sebastian Scheidt
Background The indication for surgery is justified by an expected improvement for the patient. To evaluate the probability and extent of individual postoperative patient benefit, the surgeon needs to elaborate numerous parameters of potential relevance for the outcome beyond his key competence, that is the technical dimension of the operation. Despite the highest medical standards, individual postoperative satisfaction with surgery is highly variable, even in cases with a technically good result. The aim of the present study was to investigate the individual predictability of postoperative pain and satisfaction in patients with elective musculoskeletal surgery...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28728076/age-explains-limited-hip-extension-recovery-at-one-year-from-total-hip-arthroplasty
#2
Davide Mazzoli, Erika Giannotti, Maria Longhi, Paolo Prati, Stefano Masiero, Andrea Merlo
BACKGROUND: To investigate the dependency of the one-year recovery in gait after total hip arthroplasty on age and preoperative conditions. METHODS: Longitudinal retrospective study on 20 elderly patients with unilateral total hip arthroplasty consequent to hip osteoarthritis, assessed by gait analysis before surgery (T0), 2weeks (T1), 6 (T2) and 12months (T3) post-surgery. A set of variables assessing primary gait deviations and compensatory mechanisms were extracted from gait analysis data...
July 5, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28727583/serum-bupivacaine-concentration-after-periarticular-injection-with-a-mixture-of-liposomal-bupivacaine-and-bupivacaine-hcl-during-total-knee-arthroplasty
#3
Michael J Buys, Marian F Murphy, Christine M Warrick, Nathan L Pace, Jeremy M Gililland, Christopher E Pelt, Byron R Bankhead, John L Patzkowsky, Ken B Johnson
BACKGROUND AND OBJECTIVES: A relatively new technique to reduce postoperative pain for total knee arthroplasty is to inject a mixture of 266 mg of liposomal bupivacaine and 125 mg of 0.25% bupivacaine HCl with epinephrine 1:300,000 around the knee joint at the time of surgery. Currently, no publications report serum bupivacaine concentrations over time after periarticular injection of liposomal mixed with free bupivacaine. This information is important to ensure safe serum bupivacaine concentrations are maintained especially when considering supplemental or rescue peripheral nerve blocks...
July 20, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28725502/universal-2-wrist-arthroplasty-in-rheumatoid-arthritis
#4
Sandra Pfanner, Giovanni Munz, Giulia Guidi, Massimo Ceruso
Purpose  The aim of this study was to evaluate the mid- to long-term outcomes and complications in patients affected by rheumatic diseases treated with the Universal 2 (U2) total wrist arthroplasty (TWA). Methods  We reviewed, in a retrospective, noncontrolled cohort study, 22 patients affected by rheumatoid arthritis (RA), who underwent U2 total wrist replacement between March 2003 and January 2014 for the treatment of 23 rheumatoid wrists with the aim of obtaining the remission of pain and a range of motion (ROM) useful for daily activities, according to the patients' demands, as an alternative to total wrist arthrodesis...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725499/the-effect-of-metacarpophalangeal-joint-hyperextension-on-outcomes-in-the-surgical-treatment-of-carpometacarpal-joint-arthritis
#5
David M Brogan, Rose M van Hogezand, Nikola Babovic, Brian Carlsen, Sanjeev Kakar
Purpose  In the surgical treatment of thumb carpometacarpal (CMC) joint arthritis, the effect of mild preoperative metacarpophalangeal (MCP) hyperextension on postoperative functional outcomes is unknown. We sought to examine outcomes after surgical treatment of CMC arthritis in patients with and without mild preexisting MCP deformity. Methods  A retrospective review was conducted to analyze the functional outcomes of patients treated for CMC arthritis at a single institution from March 1998 to May 2009...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#6
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28719994/giant-cell-tumor-of-the-metacarpal-case-report
#7
Laura W Lewallen, Eric R Wagner, Steven L Moran
BACKGROUND: Giant cell tumor (GCT) of bone is a benign, though locally aggressive tumor, classically described as an eccentric lytic lesion, often with cortical expansion and destruction. It typically involves the metaphysis or epiphysis of long bones in skeletally mature patients, with a slight female predominance. The incidence in the small bones of the hand has been reported to be 2% to 5%. METHODS: Treatment options have evolved in recent years, and currently include intralesional curettage with or without adjuvant therapy, wide resection, and occasionally amputation...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28715928/lack-of-evidence-the-anti-stepwise-introduction-of-metal-on-metal-hip-replacements
#8
Aleksi Reito, Lari Lehtovirta, Olli Lainiala, Keijo Mäkelä, Antti Eskelinen
Background and purpose - Orthopedics and especially joint replacement surgery have had more than their fair share of unsuccessful innovations that have violated widely endorsed principles for the introduction of new surgical innovations. We aimed to investigate (1) the trends in the use of the Birmingham Hip Resurfacing (BHR), the ASR hip resurfacing (ASR HRA) and the ASR XL total hip replacement (ASR XL THR) system with very different market approval processes and (2) whether their use was corroborated by clinical trials published in the peer-reviewed literature...
July 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28715055/risk-of-surgical-site-infections-following-hip-and-knee-arthroplasty-results-of-the-ischia-gisio-study
#9
A Agodi, F Auxilia, M Barchitta, M L Cristina, D D'Alessandro, I Mura, M Nobile, C Pasquarella, Gisio Gisio-SItI
BACKGROUND: Surgical Site Infection (SSI) is one of the major complications following insertion of hip or knee prosthesis. The aim of the present study was to describe rates of SSIs and associated risk factors during hip and knee prosthesis procedures in Italian hospitals. METHODS: Italian hospitals were invited to join the ISChIA (Surgical Site Infections in Arthroplasty Surgery) project and participated in the study on a voluntary basis. SSI surveillance was performed according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS) -SSI protocol...
September 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28713612/in-vivo-magnetic-resonance-imaging-morphometry-of-the-patella-bone-in-south-indian-population
#10
Reshma Muhamed, Vasudha V Saralaya, B V Murlimanju, Ganesh Kumar Chettiar
Racial differences exist in the dimensions of structures and the commercially available prostheses are designed based on the Caucasians. In this context, the goal of the present investigation was to determine the gender wise measurements of patella bone in South Indians. The present study included axial magnetic resonance images of the knee joint from 140 South Indian adults (70 males, 70 females; aged between 20-70 years). The angle, width, thickness, lateral facet width, facet thickness, ratio of the lateral facet, the relative thickness and ratio of facet thickness were measured in the patella by using the digital ruler...
June 2017: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/28712796/electrosurgery-induced-damage-to-ti-6al-4v-and-cocrmo-alloy-surfaces-in-orthopedic-implants-in%C3%A2-vivo-and-in%C3%A2-vitro
#11
Gregory W Kubacki, Shiril Sivan, Jeremy L Gilbert
BACKGROUND: Recent observations of specific metal damage patterns on retrieved total joint implants implied a cellular origin and was termed inflammatory cell-induced (ICI) corrosion. Although ICI corrosion continues to present a potential damage source for metallic biomaterials surfaces, an alternate source of some damage patterns may arise from electrosurgery instruments in total joint arthroplasty. METHODS: To characterize electrosurgically-induced damage patterns on metal implants, a model system of highly polished CoCrMo and Ti-6Al-4V disks and commercial electrosurgical generator was evaluated in various modes and power settings using monopolar and bipolar configurations...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28712028/internal-femoral-component-rotation-adversely-influences-load-transfer-in-total-knee-arthroplasty-a-cadaveric-navigated-study-using-the-verasense-device
#12
William A Manning, Kanishka M Ghosh, Alasdair Blain, Lee Longstaff, Steven P Rushton, David J Deehan
PURPOSE AND HYPOTHESIS: Correct femoral component rotation at knee arthroplasty influences patellar tracking and may determine function at extremes of movement. Additionally, such malrotation may deleteriously influence flexion/extension gap geometry and soft tissue balancing kinematics. Little is known about the effect of subtle rotational change upon load transfer across the tibiofemoral articulation. Our null hypothesis was that femoral component rotation would not influence load across this joint in predictable manner...
July 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28711342/birmingham-hip-resurfacing-vs-total-hip-arthroplasty-a-matched-pair-comparison-of-clinical-outcomes
#13
Victor R Ortiz-Declet, David A Iacobelli, Leslie C Yuen, Itay Perets, Austin W Chen, Benjamin G Domb
BACKGROUND: Birmingham hip resurfacing (BHR) has proven to be a good alternative for younger patients with osteoarthritis. Some have asserted that BHR may yield outcomes which are superior to total hip arthroplasty (THA), and that some studies which failed to show a difference were plagued by ceiling effects and lack of sensitivity of outcome measures. The purpose of this study is to compare outcomes of BHR and THA using the "Forgotten Joint" Score-12 (FJS), a more sensitive score with lesser vulnerability to the ceiling effect...
June 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28711157/ma%C3%A3-a-trapeziometacarpal-joint-arthroplasty-clinical%C3%A2-and-radiological-outcomes-of-80-patients-with%C3%A2-more-than-6-years-of-follow-up
#14
Adriano Toffoli, Jacques Teissier
PURPOSE: Trapeziometacarpal (TMC) total joint replacement is increasingly being performed in Europe. MAÏA TMC total joint arthroplasty is a modular uncemented ball-and-socket hydroxyapatite-coated implant. This study assessed the midterm clinical and radiological results of the MAÏA TMC prosthesis. METHODS: This single-center retrospective study involved 80 patients who underwent 96 MAÏA TMC prosthesis implantations from February 2006 to April 2009, and who had a minimum of 5 years' follow-up...
July 13, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28709759/total-hip-arthroplasty-outcomes-an-18-year-experience-in-a-single-center-is-systemic-lupus-erythematosus-a-potential-risk-factor-for-adverse-outcomes
#15
Javier Merayo-Chalico, Marco Gónzalez-Contreras, Rigoberto Ortíz-Hernández, Jorge Alcocer-Varela, David Marcial, Diana Gómez-Martín
BACKGROUND: In patients with systemic lupus erythematosus (SLE), persistent joint activity and treatment with glucocorticoids are associated with musculoskeletal complications. About 30% of these patients become candidates for surgical treatment. The aim of this study was to evaluate postoperative outcomes after total hip arthroplasty (THA) in SLE patients. METHODS: We performed a retrospective cohort study at a tertiary care center in Mexico City between 1995 and 2013...
June 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28709659/in-vivo-hip-joint-loads-and-pedal-forces-during-ergometer-cycling
#16
P Damm, J Dymke, A Bender, G Duda, G Bergmann
The rising prevalence of osteoarthritis and an increase in total hip replacements calls for attention to potential therapeutic activities. Cycling is considered as a low impact exercise for the hip joint and hence recommended. However, there are limited data about hip joint loading to support this claim. The aim of this study was to measure synchronously the in vivo hip joint loads and pedal forces during cycling. The in vivo hip joint loads were measured in 5 patients with instrumented hip implants. Data were collected at several combinations of power and cadence, at two saddle heights...
July 5, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28708763/day-to-day-experience-in-resolution-of-pain-after-surgery
#17
Timothy T Houle, Scott Miller, Jason E Lang, Jessica L Booth, Regina S Curry, Lynnette Harris, Carol A Aschenbrenner, James C Eisenach
We know little about the individual pain experience of patients recovering from surgery in the first weeks after hospital discharge. Here we examine individual differences in the day-to-day experience after two major surgeries: lower limb total major joint arthroplasty (TJA) and cesarean delivery (CD). Fifty-five TJA patients and 157 CD patients were recruited to complete questionnaires and record their daily pain experiences after surgery. After hospital discharge, patients recorded their pain intensity once daily for 60 days (CD) or twice daily for 2 weeks, once daily for two weeks, weekly for 8 weeks and monthly for 3 months (TJA)...
July 11, 2017: Pain
https://www.readbyqxmd.com/read/28707831/-prevention-of-perioperative-infections-in-orthopaedic-surgery-role-of-general-practitioner
#18
Olivier Borens, Éric Thein, Christophe Tissot, Anne-Sophie Brunel
Total joint replacement comes with a high success rate and has been shown to have a very positive impact on our patients suffering from arthritis. Against all efforts about 2 % of our patients will suffer an implant related infection. As the treatment of infected arthroplasties is difficult and expensive the knowledge of risk factors is becoming more and more important for the treatment team in order to improve our preventive measures. Prevention must be performed pre-, intra- and postoperatively. Preoperative optimization of blood sugar levels, nutritional status and correction of general anaemia for example are paramount and the general practitioner as well as the surgeon should be aware of these and other modifiable risk factors in order to operate on the patient in the best possible conditions...
December 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28707110/what-factors-are-associated-with-90-day-episode-of-care-payments-for-younger-patients-with-total-joint-arthroplasty
#19
Shweta Pathak, Cecilia M Ganduglia, Samir S Awad, Wenyaw Chan, John M Swint, Robert O Morgan
BACKGROUND: Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inpatient and postdischarge care service-component differences across 90-day episodes of care and factors associated with payments for younger patients is crucial for successful implementation of bundled payments in TJA in non-Medicare populations...
July 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28706395/salmonella-typhimurium-infection-in-total-knee-arthroplasty-a-case-report-with-review-of-literature
#20
Sujeesh Sebastian, Benu Dhawan, Rajesh Malhotra, Deepak Gautam, Arti Kapil
Salmonella enterica serotype Typhimurium is a rare cause of prosthetic joint infection (PJI). The recognized predisposing risk factors for Salmonella septic arthritis include diabetes mellitus, renal failure, human immunodeficiency virus infection and chronic corticosteroid use. We describe a case of PJI of the knee in a 74-year-old lady who was on antitubercular treatment. The patient presented with discharging sinus and raised inflammatory markers. She was successfully treated by the removal of prosthesis and debridement followed by ciprofloxacin therapy for 6 weeks...
July 2017: Journal of Laboratory Physicians
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