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https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#1
REVIEW
Paul K Edwards, Simon C Mears, C Lowry Barnes
PURPOSE OF REVIEW: Participation in alternative payment models has focused efforts to improve outcomes and patient satisfaction while also lowering cost for elective hip and knee replacement. The purpose of this review is to determine if preoperative education classes for elective hip and knee replacement achieve these goals. RECENT FINDINGS: Recent literature demonstrates that patients who attend education classes prior to surgery have decreased anxiety, better post-operative pain control, more realistic expectations of surgery, and a better understanding of their surgery...
June 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28647139/impact-of-raised-serum-cobalt-levels-from-recalled-articular-surface-replacement-hip-prostheses-on-the-visual-pathway
#2
Timothy Unsworth-Smith, Jane C Khan, Riaz J K Khan, Enid Chelva, Caroline Ann Lim, Samantha Haebich, Michelle L Trevenen
BACKGROUND: The articular surface replacement (ASR) was recalled in 2010 because of higher than expected revision rates. Patients reported symptoms of neurologic dysfunction including poor vision. This cohort study, using objective measurements, aimed to establish whether a higher incidence of visual function defects exists in ASR patients. METHODS: Thirty-three ASR patients and 33 non-ASR controls (control 1) were recruited. Data were compared with normative population data from the visual electrophysiology database (control 2)...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28643347/off-resonance-based-assessment-of-metallic-wear-debris-near-total-hip-arthroplasty
#3
Kevin M Koch, Matthew F Koff, Thomas W Bauer, Parina H Shah, Andrew S Nencka, S Sivaram Kaushik, Hollis G Potter
PURPOSE: The presence of metallic debris near total hip arthroplasty can have a significant impact on longitudinal patient management. Methods for magnetic resonance imaging-based quantification of metallic debris near painful total hip replacements are described and applied to cohorts of symptomatic and control subject cases. METHODS: A combination of metal artifact reduction, off-resonance mapping, off-resonance background removal, and spatial clustering methods are utilized to quantify off-resonance signatures in cases of suspected metallosis...
June 22, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#4
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28642665/osteoporosis-in-brazilian-patients-awaiting-knee-arthroplasty
#5
David Sadigursky, Luiz Alberto Barretto, Diogo Maciel Vieira Lobão, Rogério Jamil Fernandes Carneiro, Paulo Oliveira Colavolpe
OBJECTIVE: The primary objective of this study was to determine the prevalence of osteoporosis and osteopenia prior to total knee arthroplasty (TKA) in female patients. As a secondary objective, we evaluated the incidence of hip fractures, types of drugs to treat osteoporosis and serum vitamin D levels. METHOD: This is a transversal, descriptive and observational study which evaluated 60 women above age 55 prior to total knee replacement. RESULTS: Mean patient age was 71...
May 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28640672/consistency-in-patient-reported-outcomes-after-total-hip-replacement
#6
Albin Bengtsson, Gabrielle S Donahue, Szilard Nemes, Göran Garellick, Ola Rolfson
Purpose - The primary objective in this study was to describe the patient-reported outcome measures (PROMs) of total hip replacement (THR) patients 6 years after index surgery. Second, we sought to analyze how the preoperative, 1- and 6-year outcomes were associated. Patients and methods - By assessing the Swedish Hip Arthroplasty Register (SHAR), 15,755 patients with complete follow-up were included in the study group. 1-year and 6-year response rates were 93% and 87%. PROMs used by the SHAR include the EQ-5D instrument, and 2 modified visual analogue scales, 1 for pain and 1 for satisfaction...
June 22, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28636252/influence-of-analyzed-lubricant-volumes-on-the-amount-and-characteristics-of-generated-wear-particles-from-three-different-types-of-polyethylene-liner-materials
#7
Jana Markhoff, Carmen Zietz, Christian Fabry, Gerhard Fulda, Rainer Bader
The articulating components of artificial joints consist mainly of metals, ceramics, or polymers. Resulting abrasive wear particles can promote osteolysis and aseptic loosening of the endo-prosthetic implants. Ultra-high-molecular-weight-polyethylene is the material used most for bearing couples in total hip replacement. In the present study, three types of polyethylene (PE) liners varying in material composition, i.e., (1) conventional PE (C-PE), (2) sequentially cross-linked PE (SX-PE), (3) cross-linked PE blended with vitamin E (EX-PE) articulating with two types of femoral heads were used...
June 21, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28632602/visits-to-the-emergency-department-after-joint-replacement-commentary-on-an-article-by-micaela-a-finnegan-ba-et-al-emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#8
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#9
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28630749/imaging-in-peri-prosthetic-assessment-an-orthopaedic-perspective
#10
Christoph H Lohmann, Sanjiv Rampal, Martin Lohrengel, Gurpal Singh
As imaging techniques are ever-evolving, this article aims to provide a brief overview of the various modalities including their limitations. The ability of imaging for evaluation of implant osseo-integration will be addressed and also the role of imaging in assessing septic and aseptic loosening, with a particular focus on adverse tissue reactions, will be discussed. Specific features when imaging the big joints such as shoulder, hip, knee and ankle joint will also be outlined.Overall, a lack of standardisation and validity was noted and despite the gross variety of imaging modalities, there is no technique covering all aspects required for evaluation of implant fixation and septic and aseptic loosening...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28630723/outcome-after-arthroscopic-labral-surgery-in-patients-previously-treated-with-periacetabular-osteotomy-a-follow-up-study-of-43-patients
#11
Charlotte Hartig-Andreasen, Torsten G Nielsen, Bent Lund, Kjeld Søballe, Martin Lind
To identify factors predicting failure after hip arthroscopy in patients with previous periacetabular osteotomy (PAO) defined as a conversion to total hip replacement (THR) and to evaluate the patient reported outcome scores. Of 55 hips treated with hip arthroscopy after PAO from Aug 2008 to 2012 at Aarhus University Hospital, 43 hips were included (median age: 36.1 yrs, range 16.3-56.9 yrs). Indications were unacceptable pain, a positive FABER and impingement test and signs of labral damage on MR-arthrography...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28629904/perioperative-morbidity-of-same-day-and-staged-bilateral-total-hip-arthroplasty
#12
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Stavros G Memtsoudis, Huong T Do, Michael M Alexiades, Thomas P Sculco
BACKGROUND: Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events. METHODS: We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014...
May 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28626592/diffuse-b-cell-non-hodgkin-s-lymphoma-presenting-atypically-as-periprosthetic-joint-infection-in-a-total-hip-replacement
#13
Aysha Rajeev, Angela Ralte, Nameer Choudhry, Faizan Jabbar, Paul Banaszkiewicz
The occurrence of extranodal primary B cell non-Hodgkin's lymphoma is rare. Total hip replacement is one of the most common orthopaedic procedures performed. There has been an increased incidence of primary lymphomas involving periprosthetic sites. Chronic inflammation due to metal debris arising from the prosthetic implants has been evidenced as one of the causes for the development of soft tissue lymphomas albeit rarely. We describe a case report of a 77-year-old patient who had underwent a cemented total hip replacement in the past who further developed large B cell primary non-Hodgkin's lymphoma...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28625602/frax-score-can-be-used-to-avoid-superfluous-dxa-scans-in-detecting-osteoporosis-in-celiac-disease-accuracy-of-the-frax-score-in-celiac-patients
#14
Raffaella Tortora, Nicola Imperatore, Pietro Capone, Nicolò Gerbino, Matilde Rea, Giovanna Affinito, Nicola Caporaso, Antonio Rispo
The Fracture Risk Assessment (FRAX) tool has been developed to estimate patients' 10-yr probability of fracture, thus establishing which patients should undergo dual-energy X-ray Absorptiometry (DXA) scan. This study aimed to evaluate if the FRAX tool can replace or optimize the use of DXA scan in celiac disease (CD). We prospectively enrolled all CD patients aged over 40 yr diagnosed at our third-level unit. At time of CD diagnosis, all patients underwent FRAX score calculation for risk of major osteoporotic and hip fractures and DXA scan (used as gold standard) to assess the accuracy of the FRAX score...
June 15, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28623889/surgical-accuracy-function-and-quality-of-life-of-simultaneous-versus-staged-bilateral-total-hip-arthroplasty-in-patients-with-osteonecrosis-of-the-femoral-head
#15
Seung-Chan Kim, Young-Wook Lim, Woo-Lam Jo, Dong-Chul Park, Jin-Woo Lee, Won-Woo Kang, Yong-Sik Kim
BACKGROUND: The optimal surgical option for patients requiring bilateral hip replacement remains controversial. The purpose of this study was to compare surgical accuracy; functional outcome and health-related quality of life; and prosthetic-related complications and revision surgery of a simultaneous bilateral total hip arthroplasty (THA) with those of a staged bilateral THA with an interval between procedures <12 months. METHODS: A total of 123 unselected consecutive patients (mean age, 43...
June 17, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28616704/metallic-ion-release-after-knee-prosthesis-implantation-a-prospective-study
#16
Adrien Lons, Sophie Putman, Gilles Pasquier, Henri Migaud, Elodie Drumez, Julien Girard
INTRODUCTION: Metal-on-metal (MoM) hip replacement bearings produce metallic ions that can cause health complications. Metallic release also occurs with other materials, but data on metallic ion levels after knee arthroplasty are sparse. We postulate that knee replacement generates elevating metallic ions (chromium (Cr), cobalt (Co) and titanium (Ti)) during the first year after implantation. PATIENTS AND METHODS: This ongoing prospective study included all patients who underwent the same type of knee arthroplasty between May and December 2013...
June 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28607788/a-case-of-fracture-redislocation-of-the-hip-caused-by-a-depressed-fracture-of-the-femoral-head-similar-to-a-hill-sachs-lesion
#17
Yoshihiko Okudera, Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Ken Sasaki, Tetsuya Kawano, Yosuke Iwamoto, Naohisa Miyakoshi, Yoichi Shimada
The present case shows a case of fracture-redislocation of the hip caused by a depressed fracture of the femoral head similar to a Hill-Sachs lesion. A 59-year-old man fell from a roof and his left hip joint was dislocated posteriorly. He was admitted to a nearby hospital, and he was referred to our hospital more than 24 hours after injury. Computed tomography (CT) suggested a bone chip from the posterior wall of the acetabulum roof and a depressed femoral head that cut into the posterior margin of the acetabulum roof...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28602534/bilateral-total-hip-and-knee-arthroplasties-average-10-year-follow-up
#18
John B Meding, Philip M Faris, Ken E Davis
BACKGROUND: The present study investigates the clinical and radiographic outcomes in patients with all 4 major lower extremity joints replaced. METHODS: A retrospective review of our institution's database identified 125 patients in whom both hips and both knees were replaced. The mean time between the first and last arthroplasty was 6.6 years. Preoperative diagnoses included osteoarthritis in 80% and rheumatoid arthritis in 20%. The average age at the time of the first arthroplasty was 63...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28601245/the-impact-of-discharge-disposition-on-episode-of-care-reimbursement-after-primary-total-hip-arthroplasty
#19
Karim G Sabeh, Samuel Rosas, Leonard T Buller, Martin W Roche, Victor H Hernandez
BACKGROUND: Total joint arthroplasty (TJA) accounts for more Medicare expenditure than any other inpatient procedure. The Comprehensive Care for Joint Replacement model was introduced to decrease cost and improve quality in TJA. The largest portion of episode-of-care costs occurs after discharge. This study sought to quantify the cost variation of primary total hip arthroplasty (THA) according to discharge disposition. METHODS: The Medicare and Humana claims databases were used to extract charges and reimbursements to compare day-of-surgery and 91-day postoperative costs simulating episode-of-care reimbursements...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28599629/dose-dependent-effects-of-intravenous-methoxamine-infusion-during-hip-joint-replacement-surgery-on-postoperative-cognitive-dysfunction-and-blood-tnf-%C3%AE-level-in-elderly-patients-a-randomized-controlled-trial
#20
Shenghui Sun, Defeng Sun, Lin Yang, Jun Han, Ruochuan Liu, Lijie Wang
BACKGROUND: Postoperative cognitive dysfunction (POCD), common in elderly patients, is thought to be closely associated with intraoperative instability of hemodynamics and excessive excretion of tumor necrosis factor-α (TNF-α). Methoxamine is a blood-pressure increasing drug commonly used for maintaining intraoperative hemodynamics. Methoxamine potentially promotes TNF-α expression, leading to an increased risk of POCD. This study aimed to investigate the dose-dependent effect of methoxamine on the incidence of early POCD and blood TNF-α level...
June 9, 2017: BMC Anesthesiology
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