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https://www.readbyqxmd.com/read/28209371/the-effect-of-patient-age-at-intervention-on-risk-of-implant-revision-after-total-replacement-of-the-hip-or-knee-a-population-based-cohort-study
#1
Lee E Bayliss, David Culliford, A Paul Monk, Sion Glyn-Jones, Daniel Prieto-Alhambra, Andrew Judge, Cyrus Cooper, Andrew J Carr, Nigel K Arden, David J Beard, Andrew J Price
BACKGROUND: Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing for surgery. METHODS: We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement...
February 13, 2017: Lancet
https://www.readbyqxmd.com/read/28202056/normal-gastric-emptying-time-of-a-carbohydrate-rich-drink-in-elderly-patients-with-acute-hip-fracture-a-pilot-study
#2
Per M Hellström, Bodil Samuelsson, Amer N Al-Ani, Margareta Hedström
BACKGROUND: Guidelines for fasting in elderly patients with acute hip fracture are the same as for other trauma patients, and longer than for elective patients. The reason is assumed stress-induced delayed gastric emptying with possible risk of pulmonary aspiration. Prolonged fasting in elderly patients may have serious negative metabolic consequences. The aim of our study was to investigate whether the preoperative gastric emptying was delayed in elderly women scheduled for surgery due to acute hip fracture...
February 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28196043/measures-of-the-appropriateness-of-elective-orthopaedic-joint-and-spine-procedures
#3
Jeffrey N Katz, Amelia R Winter, Gillian Hawker
Total knee arthroplasty and total hip arthroplasty are 2 of the most commonly performed elective orthopaedic procedures. They are remarkably successful in relieving pain and improving function in individuals with advanced, symptomatic arthritis. Since, in addition to providing benefits, these procedures pose risks, it is important to provide clinicians with guidance in determining which patients should undergo total joint replacement surgery. The development of the RAND approach in 1986 and its application to total hip and knee replacement have enabled clinicians, payers, and others to assess the appropriateness of past and current procedures for particular patients...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28195304/association-between-psychological-health-and-wound-complications-after-surgery
#4
P Britteon, N Cullum, M Sutton
BACKGROUND: Surgical wound complications remain a major cause of morbidity, leading to higher costs and reduced quality of life. Although psychological health is widely considered to affect wound healing, the evidence on wound outcomes after surgery is mixed. Studies generally focus on small samples of patients undergoing a specific procedure and have limited statistical power. METHODS: This study investigated the relationship between three different measures of anxiety and/or depression and seven adverse surgical outcomes using observational data collected before and after surgery between 2009 and 2011...
February 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28193498/a-prospective-cohort-study-examining-medical-and-social-factors-associated-with-engagement-in-life-activities-following-total-hip-replacement
#5
Crystal MacKay, Fiona Webster, Viji Venkataramanan, Jessica Bytautas, Anthony V Perruccio, Rosalind Wong, Lisa Carlesso, Aileen M Davis
OBJECTIVES: Studies show limited improvement in the frequency of engaging in life activities after joint replacement. However, there is a paucity of research that has examined factors, including other life events, which influence engagement following total hip replacement (THR). This research sought to identify factors associated with engaging in life activities following THR. METHODS: A prospective cohort study was conducted with 376 people who had a THR for osteoarthritis...
February 10, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28185755/the-james-a-rand-young-investigator-s-award-administrative-claims-vs-surgical-registry-capturing-outcomes-in-total-joint-arthroplasty
#6
Joseph T Patterson, David Sing, Erik N Hansen, Bobby Tay, Alan Zhang
BACKGROUND: Administrative claims in total joint arthroplasty are used for observational studies and payment adjustments under the Comprehensive Care for Joint Replacement (CJR) legislation. Claims data have not been validated against prospective surgical outcome registries for primary total hip (THA) or knee arthroplasty (TKA). We hypothesized that significant differences in reported comorbidity and adverse event measures exist between administrative claims and prospective registry data relevant to payment adjudication under the CJR reimbursement model...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28185753/predicting-the-incremental-hospital-cost-of-adverse-events-among-medicare-beneficiaries-in-the-comprehensive-joint-replacement-program-during-fiscal-year-2014
#7
Steven D Culler, David S Jevsevar, Kevin J McGuire, Kevin G Shea, Kenneth M Little, Michael J Schlosser
BACKGROUND: The Medicare program's Comprehensive Care for Joint Replacement (CJR) payment model places hospitals at financial risk for the treatment cost of Medicare beneficiaries (MBs) undergoing lower extremity joint replacement (LEJR). METHODS: This study uses Medicare Provider Analysis and Review File and identified 674,777 MBs with LEJR procedure during fiscal year 2014. Adverse events (death, acute myocardial infarction, pneumonia, sepsis or shock, surgical site bleeding, pulmonary embolism, mechanical complications, and periprosthetic joint infection) were studied...
January 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#8
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
February 10, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28184362/uncemented-total-hip-replacement-after-two-years-of-neglected-hip-dislocation-with-fracture-of-posterior-column-and-wall-of-the-acetabulum
#9
Sundaresh Dc, Sharath K Ramanath, Amit Grover, Daksh Gadi
INTRODUCTION: Posterior hip dislocation of the hip with acetabular fracture is a challenging problem to treat. Such dislocations are associated with avascular necrosis of the femoral head if neglected. Managing such conditions with total hip replacement (THR) is very difficult because of associated altered anatomy. CASE PRESENTATION: We hereby report a two-year neglected hip dislocation with associated acetabular fracture successfully treated with uncemented THR...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28184276/segregation-for-reduction-of-regulated-medical-waste-in-the-operating-room-a-case-report
#10
Helen Ki Shinn, Youngyoen Hwang, Byung-Gun Kim, Chunwoo Yang, WonJu Na, Jang-Ho Song, Hyun Kyoung Lim
One-third of all hospital-regulated medical waste (RMW) comes from the operating room (OR), and it considerably consists of disposable packaging and wrapping materials for the sterilization of surgical instruments. This study sought to identify the amount and type of waste produced by ORs in order to reduce the RMW so as to achieve environmentally-friendly waste management in the OR. We performed an initial waste segregation of 4 total knee replacement arthroplasties (TKRAs) and 1 total hip replacement arthroplasty, and later of 1 extra TKRA, 1 laparoscopic anterior resection of the colon, and 1 pelviscopy (with radical vaginal hysterectomy), performed at our OR...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28180913/-surgical-hip-dislocation-current-status-in-the-treatment-of-femoral-acetabular-impingement
#11
F Sitterlee, S Kirschbaum, C Perka, M Müller
INTRODUCTION: Surgical hip dislocation (SHD) in the therapy of femoral acetabular impingement (FAI) has been mostly replaced by minimally invasive techniques. Nevertheless, in the circumstances of complex FAI types and combined impingement located in inaccessible areas of the hip, SHD is an option to reach those deformities. The advantage of the complete overview of the hip joint enables the circumferential therapy of bony deformity, but at the expense of higher invasivity. In the literature there is still a lack of mid to long-term studies of SHD to determine the overall treatment outcome...
February 8, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28176355/strain-shielding-inspired-re-design-of-proximal-femoral-stems-for-total-hip-arthroplasty
#12
Myriam Cilla, Sara Checa, Georg N Duda
A large number of hip prosthesis with different designs have been developed. However, the influence of hip implant design changes on the strains induced in the bone remains unclear. The purpose of this study is to better understand the mechanics of short stem total hip arthroplasty. Specifically, it investigates whether strain shielding can be avoided by changing implant shape and/or material properties. It is hypothesized that the re-design of existing implant designs can result in further reduction of strain shielding and thus keep bone loss minimal following total hip replacement...
February 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28173689/evaluation-of-geographic-indices-describing-health-care-utilization
#13
Agnus M Kim, Jong Heon Park, Sungchan Kang, Yoon Kim
Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea...
January 2017: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
https://www.readbyqxmd.com/read/28171843/gait-kinetics-of-total-hip-replacement-patients-a-large-scale-long-term-follow-up-study
#14
Damien Bennett, Paul Ryan, Seamus O'Brien, David E Beverland
BACKGROUND: It is not known if lower limb gait kinetics of total hip replacement (THR) patients reach normal levels at long term follow-up post-operatively. METHODS: Three-dimensional gait analysis was performed on 134 THR patients with identical implants 10-years post-operatively. Lower limb moments and powers were compared between different age strata (54-64 years, 65-69 years, 70-74 years, 75-79 years and over 80 years) and a normal elderly control group. RESULTS: Hip extensor moment and hip power generation were significantly reduced in all age groups compared to normal...
January 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28169136/in-vitro-wear-of-ultrahigh-molecular-weight-polyethylene-and-vitamin-e-blended-highly-cross-linked-polyethylene-in-linked-semiconstrained-total-elbow-replacement-prostheses
#15
Oludele O Popoola, Brian L Kincaid, Kimberly Mimnaugh, Mark Marqueling
BACKGROUND: The objectives of this study were to develop a clinically relevant in vitro elbow wear test and to compare the polyethylene wear of 2 total elbow replacement prostheses, one that uses conventional gamma-irradiated polyethylene (CPE) and one that uses vitamin E blended and cross-linked polyethylene (VE-HXPE) bushings. MATERIALS AND METHODS: The test protocol applied 0° to 85° flexion-extension motions and imposed a constant 4.5° varus malalignment of the ulnar relative to the humeral implant under a variable joint load profile at a frequency of 1 Hz...
February 3, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28167881/poor-prognosis-of-patients-treated-for-periprosthetic-joint-infection
#16
REVIEW
Cynthia A Kahlenberg, Alexia Hernandez-Soria, Michael B Cross
The study by Gomez et al., "The Fate of Spacers in the Treatment of Periprosthetic Joint Infection," evaluates the clinical course and success rate of treatment of periprosthetic joint infection with two-stage revision with spacer placement in the interim period. The current review critically analyzes the findings of this study and examines how these findings may influence patient care in the field of hip and knee replacement. Gomez et al. report sobering results of two-stage revision with spacer placement for periprosthetic joint infection...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167869/bearings-in-hip-arthroplasty-joint-registries-vs-precision-medicine-review-article
#17
REVIEW
Mark J Pearson, Liam M Grover, Janet M Lord, Simon W Jones, Edward T Davis
BACKGROUND: Precision medicine has been adopted in a range of clinical settings where omics data have led to greater characterisation of disease and stratification of patients into subcategories of phenotypes and pathologies. However, in orthopaedics, precision medicine lags behind other disciplines such as cancer. Joint registries have now amassed a huge body of data pertaining to implant performance which can be broken down into performance statistics for different material types in different cohorts of patients...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28165602/outcome-of-revision-arthroplasty-for-failed-metal-on-metal-total-hip-replacements-is-there-a-relation-with-metal-ions
#18
Hafiz J Iqbal, Waheeb A K Al-Azzani, Esther Jackson-Taylor, Elizabeth Clatworthy, Alun John
PURPOSE: We aimed to assess the early outcome following revision arthroplasty for failed metal-on-metal (MoM) total hip replacements (THR) due to adverse reaction to metal debris (ARMD). METHODS: We reviewed 106 consecutive revision arthroplasties. Case notes and radiological investigations were reviewed to assess the complications. Oxford Hip Score (OHS) and Euroqol (EQ-5D-3L) scores were used to assess the functional outcome and improvement of quality of life...
February 3, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28165601/bikini-versus-traditional-incision-direct-anterior-approach-is-there-any-difference-in-soft-tissue-damage
#19
Brent A Lanting, Kirk C Hartley, Adam J Raffoul, Timothy A Burkhart, Lyndsay Sommerville, Glynn R Martin, James L Howard, Marjorie Johnson
INTRODUCTION: The direct anterior approach for total hip replacements has reported advantages of improved early function and muscle preservation. In an effort to improve healing and cosmesis, a change in the orientation of the incision has been proposed. Traditionally, the skin incision is in-line with the tensor fasciae latae muscle belly. The bikini incision is orthogonal to this orientation. The hypothesis was that muscle damage would be increased by using the bikini incision. METHODS: A traditional or bikini incision was performed on 18 cadaveric hips...
February 6, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28165596/screws-are-not-needed-when-secure-interference-fit-of-uncemented-acetabular-components-is-adequate-a-5-to-15-year-follow-up-with-clinical-and-radiological-analysis
#20
Eduardo García-Rey
PURPOSE: Even with good surgical preparation, adequate primary stability of the acetabular component is not always achieved after primary total hip replacement (THR). We hypothesise that adequate bone preparation for appropriate cortical loading would allow us to avoid screw use. METHODS: A total of 791 uncemented cups were analysed to compare the need for screws to obtain primary fixation in 5 different designs. Arthritic hips with inflammatory arthritis or severe congenital hip disease were excluded...
January 31, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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