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Total joint arthroplasty

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https://www.readbyqxmd.com/read/27931702/peripheral-nerve-blocks-causing-increased-risk-for-fall-and-difficulty-in-ambulation-for-the-hip-and-knee-joint-replacement-patient
#1
Bonnie L Crumley Aybar, Michael J Gillespie, Sean F Gipson, Caitlin E Mullaney, Melissa Tommasino-Storz
A systematic review of the literature was completed by the Evidence-Based Practice Group for the Patient population, Intervention/Issue, Comparison Intervention, Outcomes, Timing (PICOT) question: "Does the use of a peripheral nerve block increase the risk for falls and difficulty ambulation in patients after lower extremity surgery through postoperative day 2?" A search of multiple databases using specified key terms resulted in 258 articles for total knee arthroplasty or total hip arthroplasty. These were reduced to 13 with exclusion criteria and became primary evidence...
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#2
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27922987/total-joint-arthroplasty-in-patients-with-human-immunodeficiency-virus
#3
Kalpit N Shah, Jeremy N Truntzer, Francine Touzard Romo, Lee E Rubin
No abstract text is available yet for this article.
November 1, 2016: JBJS Reviews
https://www.readbyqxmd.com/read/27922947/microbiology-and-antimicrobial-challenges-of-prosthetic-joint-infection
#4
Douglas R Osmon
Research that leads to better strategies to diagnose and treat prosthetic joint infection (PJI) is critical because PJI is a devastating complication of total knee arthroplasty. A key to the diagnosis and management of PJI is defining the microbiology of PJI and improving the medical management of PJI utilizing both systemic and local antimicrobial therapy. In this review, the author will present his opinions on future research needs as they relate to the microbiology of PJI, including antimicrobial resistance and the antimicrobial treatment of PJI...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27922946/patient-reported-outcome-measurement-for-patients-with-total-knee-arthroplasty
#5
Stephen Lyman, Kaitlyn L Yin
Total knee arthroplasty is a large contributor to Medicare costs. In an effort to lower costs and improve outcomes, the Centers for Medicaid and Medicare Services has implemented the Comprehensive Care for Joint Replacement model, which incentivizes surgeons to submit both general health and joint-specific patient-reported outcome measures (PROMs). However, in addition to using PROMs for reporting purposes, surgeons should also consider incorporating PROMs into clinical practice. Currently, PROMs are not widely implemented in the clinical setting despite their value in measuring factors such as patients' expectations and mental state, which impact outcomes...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27920813/densitometric-evaluation-of-bone-prosthetic-counterface-in-hip-and-knee-arthroplasty-with-modern-implants
#6
Andrea Cozzi Lepri, Marco Giorgini, Carla Signorini, Christian Carulli, Roberto Civinini, Maria Luisa Brandi, Massimo Innocenti
INTRODUCTION: Recent acquisitions of the complex mechanisms of osseointegration between implants and host bone have gained attention, accordingly to the methods of evaluation of these interactions. DEXA analysis is considered an useful tool to assess such phenomena, in order to analyse in a quantitative manner the local metabolic activity of the bone, and to evaluate over the time the integration between host bone and prosthetic components. The purpose of the present study is to report about a preliminary experience in the analysis of osseointegration processes of patients undergoing a primary Total Hip Arthroplasty (THA) or a revision Total Knee Arthroplasty (rTKA)...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27920583/intellijoint-hip-%C3%A2-a-3d-mini-optical-navigation-tool-for-improving-intraoperative-accuracy-during-total-hip-arthroplasty
#7
Wayne G Paprosky, Jeffrey M Muir
Total hip arthroplasty is an increasingly common procedure used to address degenerative changes in the hip joint due to osteoarthritis. Although generally associated with good results, among the challenges associated with hip arthroplasty are accurate measurement of biomechanical parameters such as leg length, offset, and cup position, discrepancies of which can lead to significant long-term consequences such as pain, instability, neurological deficits, dislocation, and revision surgery, as well as patient dissatisfaction and, increasingly, litigation...
2016: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/27919672/a-study-of-pre-operative-presence-of-micro-organisms-in-affected-knee-joints-of-rheumatoid-arthritis-patients-who-need-total-knee-arthroplasty
#8
Jiang-Ming Luo, Lin Guo, Hao Chen, Peng-Fei Yang, Ran Xiong, Yang Peng, Liu Yang
BACKGROUND: To evaluate, by way of intraoperative tissue culture and pathological study, the pre-operative presence of micro-organisms in knee joints of patients with rheumatoid arthritis (RA) who need total knee arthroplasty (TKA). METHODS: From November 2012 to January 2014, 47 patients with RA (53 knees) who needed TKA were included in this study. Patients received routine pre-operative examination and joint fluid routine and culture. Each RA patient was match-paired with one osteoarthritis (OA) patient...
December 2, 2016: Knee
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#9
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27919578/is-the-commercial-antibiotic-loaded-bone-cement-useful-in-prophylactic-and-cost-saving-after-knee-and-hip-joint-arthroplasty-the-transatlantic-paradox
#10
Pablo Sanz-Ruiz, Jose Antonio Matas-Diez, Mar Sanchez-Somolinos, Manuel Villanueva-Martinez, Javier Vaquero-Martín
BACKGROUND: The use of antibiotic-loaded bone cement (ALBC) has proven to be effective in preventing periprosthetic infection (PPI) after total hip (THA) and knee arthroplasty (TKA). However, the economic benefit of using ALBC routinely remains controversial. METHODS: A total of 2518 patients subjected to THA, partial hip arthroplasty, and TKA between 2009 and 2012 were identified in our prospectively collected registry. Two groups were defined: before (2009-2010) and after the introduction of ALBC (2011-2012)...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27919200/bony-ankylosis-of-the-facet-joint-of-the-cervical-spine-in-rheumatoid-arthritis-its-characteristics-and-relationship-to-the-clinical-findings
#11
Haku Iizuka, Yoichi Iizuka, Koichi Okamura, Yukio Yonemoto, Tokue Mieda, Kenji Takagishi
OBJECTIVES: The purpose of this study was to clarify the characteristics of bony ankylosis of the facet joint of the cervical spine in RA patients who required cervical spine surgery, and its relationship to the clinical findings. METHODS: Eighty consecutive RA patients with cervical spine disorder who received initial surgery were reviewed. The occurrence of bony ankylosis of the facet joint of the cervical spine was investigated using computed tomography (CT) before surgery...
December 6, 2016: Modern Rheumatology
https://www.readbyqxmd.com/read/27914722/poor-expectations-of-knee-replacement-benefit-are-associated-with-modifiable-psychological-factors-and-influence-the-decision-to-have-surgery-a-cross-sectional-and-longitudinal-study-of-a-community-based-sample
#12
Daniel L Riddle, Gregory J Golladay, Amanda Hayes, Hassan M K Ghomrawi
BACKGROUND: Total knee arthroplasty (TKA) is a highly effective surgery, but is underutilized by some patient groups. This study determined factors associated with a person's expectations with respect to pain and walking function following a TKA procedure, should they elect to undergo a TKA. METHODS: A total of 3542 people were studied with or at risk of knee osteoarthritis and enrolled in the community-based Osteoarthritis Initiative (OAI). Multivariable logistic regression analyses identified demographic, socioeconomic, osteoarthritis-related, joint replacement awareness, and psychological correlates as poor outcome expectations...
November 30, 2016: Knee
https://www.readbyqxmd.com/read/27913237/combined-use-of-intravenous-and-topical-versus-intravenous-tranexamic-acid-in-primary-total-joint-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#13
REVIEW
Xue-Qin Zhang, Jie Ni, Wei-Hong Ge
OBJECTIVE: To compare the safety and efficacy of combined use of intravenous and topical (combined group) tranexamic acid (TXA) with that of intravenous tranexamic acid (IV group) in primary total joint arthroplasty (TJA). METHODS: Literature was searched in PubMed, Cochrane Library, Embase, Medline, and China National Knowledge Infrastructure (CNKI) databases. Only randomized controlled trials (RCTs) were included in our study. Data were using fixed-effects or random-effects models with standard mean differences and risk ratios for continuous and dichotomous variables, respectively...
November 29, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27912753/radiographic-evaluation-of-early-periprosthetic-acetabular-bone-contrast-and-prosthetic-head-acetabular-coverage-after-uncemented-and-cemented-total-hip-prosthesis-in-dogs
#14
Ayman A Mostafa, Karin Lucas, Ingo Nolte, Patrick Wefstaedt
BACKGROUND: Coxofemoral osteoarthritis is a chronic, disabling condition affecting people and dogs, with THA providing an excellent return to function in severely affected joints. The principal role of THA is to restore an adequate range of motion to the hip joint while transferring load from the acetabulum in order to improve the survival of the implant and enhance the limb function in the short and long terms. The objectives of the study reported here were, therefore, to radiographically evaluate periprosthetic acetabular bone GV and to assess prosthetic head acetabular coverage after 4 months of uncemented and cemented THA in dogs...
December 3, 2016: BMC Veterinary Research
https://www.readbyqxmd.com/read/27911455/functional-outcomes-of-infected-hip-arthroplasty-a-comparison-of-different-surgical-treatment-options
#15
Benjamin V Herman, Mark Nyland, Lyndsay Somerville, Steven J MacDonald, Brent A Lanting, James L Howard
BACKGROUND: Periprosthetic joint infection (PJI) following total hip arthroplasty (THA) can be treated with irrigation and debridement with head and polyethylene exchange (IDHPE) or 2-stage revision (2SR). Few studies have compared patient-reported outcome measures (PROMs) in patients managed with these treatments. METHODS: A retrospective review identified 137 patients who had an infected primary THA between 1986-2013. Control cohorts were matched according to age and Charlton Comorbidity Index (CCI)...
November 28, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27910817/on-the-molecular-interaction-between-femoral-heads-and-polyethylene-liners-in-artificial-hip-joints-phenomenology-and-molecular-scale-phenomena
#16
Giuseppe Pezzotti, B Sonny Bal, Elisa Casagrande, Nobuhiko Sugano, Bryan J McEntire, Wenliang Zhu, Leonardo Puppulin
The chemical interaction of femoral heads with polyethylene liners is an important new area of research in total hip arthroplasty (THA) as a consequence of an unabating quest for elongated artificial joint lifetimes. It is a topic that goes beyond simple mechanical behavior or wear. It seeks to describe the prosthetic device as a whole by adding chemical considerations to mechanics and abrasion. One of the poorly understood chemical interactions is oxygen affinity of the femoral heads. While oxygen unavoidably diffuses into the non-crystalline enclaves of the polyethylene liner as a result of its contact with the tribolayer, a ceramic femoral head can either attract or release oxygen due to its tribochemical interactions...
December 2, 2016: Biomedical Materials
https://www.readbyqxmd.com/read/27909213/hammertoe-correction-with-k-wire-fixation-compared-with-percutaneous-correction
#17
Mustafa Yassin, Avraham Garti, Eyal Heller, Dror Robinson
BACKGROUND: Kirschner wire (K-wire) fixation for correction of hammertoe deformity is the gold standard for hammertoe surgery fixation, the current study compares it to percutaneous surgery with 3M Coban dressings. METHODS: All hammertoe corrections performed were retrospectively reviewed. For the K-wire fixation group: resection arthroplasty of the proximal interphalangeal joint was performed and fixed with a K-wire. The percutaneous technique used involved percutaneous diaphyseal osteotomy of the middle and proximal phalanges combined with tendon release...
November 30, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27909126/medium-term-outcomes-of-the-universal-2-total-wrist-arthroplasty-in-patients-with-rheumatoid-arthritis
#18
R Badge, K Kailash, D R Dickson, S Mahalingam, A Raza, A Birch, D Nuttall, S R Murali, M J Hayton, S Talwalkar, A C Watts, I A Trail
AIMS: The aims of this study were to evaluate the clinical and radiological outcomes of the Universal-2 total wrist arthroplasty (TWA) in patients with rheumatoid arthritis. PATIENTS AND METHODS: This was a retrospective review of all 95 Universal-2 TWAs which were performed in our institution between 2003 to 2012 in patients with rheumatoid arthritis. A total of six patients were lost to follow-up and two died of unrelated causes. A total of ten patients had bilateral procedures...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909124/predicting-dissatisfaction-following-total-knee-arthroplasty-in-patients-under-55-years-of-age
#19
C E H Scott, W M Oliver, D MacDonald, F A Wade, M Moran, S J Breusch
AIMS: Risk of revision following total knee arthroplasty (TKA) is higher in patients under 55 years, but little data are reported regarding non-revision outcomes. This study aims to identify predictors of dissatisfaction in these patients. PATIENTS AND METHODS: We prospectively assessed 177 TKAs (157 consecutive patients, 99 women, mean age 50 years; 17 to 54) from 2008 to 2013. Age, gender, implant, indication, body mass index (BMI), social deprivation, range of movement, Kellgren-Lawrence (KL) grade of osteoarthritis (OA) and prior knee surgery were recorded...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909123/comparative-study-of-computer-assisted-total-knee-arthroplasty-after-opening-wedge-osteotomy-versus-after-unicompartmental-arthroplasty
#20
R Pailhé, J Cognault, J Massfelder, A Sharma, R-C Rouchy, B Rubens-Duval, D Saragaglia
AIMS: The role of high tibial osteotomy (HTO) is being questioned by the use of unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment femorotibial osteoarthritis. Our aim was to compare the outcomes of revision HTO or UKA to a total knee arthroplasty (TKA) using computer-assisted surgery in matched groups of patients. PATIENTS AND METHODS: We conducted a retrospective study to compare the clinical and radiological outcome of patients who underwent revision of a HTO to a TKA (group 1) with those who underwent revision of a medial UKA to a TKA (group 2)...
December 2016: Bone & Joint Journal
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