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elective Hip replacement

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https://www.readbyqxmd.com/read/28060228/risk-adjusted-hospital-outcomes-in-medicare-total-joint-replacement-surgical-procedures
#1
Donald E Fry, Michael Pine, Susan M Nedza, David G Locke, Agnes M Reband, Gregory Pine
BACKGROUND: Comparative measurement of hospital outcomes can define opportunities for care improvement and will assume great importance as alternative payment models for inpatient total joint replacement surgical procedures are introduced. The purpose of this study was to develop risk-adjusted models for Medicare inpatient and post-discharge adverse outcomes in elective lower-extremity total joint replacement and to apply these models for hospital comparison. METHODS: Hospitals with ≥50 qualifying cases of elective total hip replacement and total knee replacement from the Medicare Limited Data Set database of 2010 to 2012 were studied...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28052489/preoperative-education-prior-to-elective-knee-arthroplasty-surgery-does-not-change-patient-outcomes
#2
Lawrence Stephen Moulton, Peter A Evans, Ian Starks, Tony Smith
Enhanced recovery programmes have improved outcomes following elective arthroplasty surgery. There are few studies assessing the role of patient education. In our enhanced recovery programme, all patients are offered the chance to attend a preoperative education class. Not all patients attend, enabling a comparison of outcomes. We have published data demonstrating that patients undergoing hip arthroplasty have improved outcomes. In the present article, we present data for total knee arthroplasty. Using a prospectively collected database, we identified all patients undergoing elective primary total knee arthroplasty...
January 4, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28027387/impact-of-smoking-cessation-counseling-prior-to-total-joint-arthroplasty
#3
Sina Akhavan, Long-Co Nguyen, Vanessa Chan, Jamal Saleh, Kevin J Bozic
Perioperative smoking has been linked to surgical complications including poor wound healing, infection, myocardial infarction, prolonged length of stay, need for mechanical ventilation, and death. This study evaluated the effectiveness of preoperative counseling on smoking cessation for patients undergoing elective total joint arthroplasty. Thirty smokers with hip or knee osteoarthritis seeking hip or knee replacement surgery were enrolled prospectively. Interventions included counseling, referrals to smoking cessation programs including the California Smokers' Helpline and the Fontana Tobacco Treatment Program, nicotine replacement therapy (NRT), or instructing patients quit through the "cold turkey" method of abstinence...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/27981344/-characteristics-of-elective-hip-replacement-in-the-elderly
#4
T Claßen, C Scheid, S Landgraeber, M Jäger
Due to demographic changes the number of elderly patients undergoing hip replacement surgery is increasing. In order to ensure safe treatment of elderly patients, age-specific medical factors must be taken into consideration. This article presents an overview of these factors. Furthermore, we evaluated our own patients treated between 2010 and 2015 regarding age-related treatment strategies and complication rates. Out of 3166 patients a total of 439 were over 80 years old (average age 84 years). It can be concluded from the scientific literature and from own data that elective hip replacement surgery in elderly patients is a technically safe procedure; however, the risk profile of each patient must be thoroughly analyzed so that in the event of even minor signs of potential complications countermeasures can be taken in good time...
December 15, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27965248/gender-disparities-in-red-blood-cell-transfusion-in-elective-surgery-a-post-hoc-multicentre-cohort-study
#5
Hans Gombotz, Günter Schreier, Sandra Neubauer, Peter Kastner, Axel Hofmann
OBJECTIVES: A post hoc gender comparison of transfusion-related modifiable risk factors among patients undergoing elective surgery. SETTINGS: 23 Austrian centres randomly selected and stratified by region and level of care. PARTICIPANTS: We consecutively enrolled in total 6530 patients (3465 women and 3065 men); 1491 underwent coronary artery bypass graft (CABG) surgery, 2570 primary unilateral total hip replacement (THR) and 2469 primary unilateral total knee replacement (TKR)...
December 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27931698/the-effectiveness-of-nurse-led-preoperative-assessment-clinics-for-patients-receiving-elective-orthopaedic-surgery-a-systematic-review
#6
Chan Sau-Man Conny, Ip Wan-Yim
PURPOSE: Nurse-led preoperative assessment clinics (POAC) have been introduced in different specialty areas to assess and prepare patients preoperatively in order to avoid last-minute surgery cancellations. Not all patients are referred to POACs before surgery, and the benefits of nurse-led POACs are not well documented in Hong Kong. The purpose of this systemic review was to identify the best available research evidence to inform current clinical practice, guide health care decision making and promote better care...
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27871190/the-significance-of-social-rules-in-group-training-sessions
#7
Line Blixt, Kari Nyheim Solbrække
PURPOSE: To identify what types of social rules are involved in group interventions led by physiotherapists (PTs), and how these rules influence individual recovery. METHODS: Eight patients; six women and two men, which had recently undergone elective hip or knee replacement surgery, were recruited as informants from an intervention group that investigated effect of task specific exercise. The data comprise observational notes from group training sessions and one-on-one semi-structured interviews with the eight patients...
November 21, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27861701/preparing-family-caregivers-to-recognize-delirium-symptoms-in-older-adults-after-elective-hip-or-knee-arthroplasty
#8
Margaret J Bull, Lesley Boaz, Mehdi Maadooliat, Mary E Hagle, Lynn Gettrust, Maureen T Greene, Sue Baird Holmes, Jane S Saczynski
OBJECTIVES: To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers. DESIGN: Mixed-method, pre-post quasi-experimental design. SETTING: A Midwest Veterans Affairs Medical Center and a nonprofit health system. PARTICIPANTS: Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention...
November 11, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27842584/risk-of-infection-in-primary-elective-total-hip-arthroplasty-with-direct-anterior-approach-or-lateral-transgluteal-approach-a-prospective-cohort-study-of-1104-hips
#9
Thomas Ilchmann, Werner Zimmerli, Lilianna Bolliger, Peter Graber, Martin Clauss
BACKGROUND: The direct anterior approach (DAA) is increasingly popular for hip replacement. However, the small incision and the location near to the groin might increase the risk of periprosthetic joint infection (PJI). We asked the questions (i) whether there is an increased risk of infection for this approach, and (ii) whether the spectrum of microorganisms differs between patients with DAA and those with lateral transgluteal approach (LAT). METHODS: All patients operated between 08/2006 and 12/2013 were followed prospectively in an in house register...
November 14, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27832317/influence-of-single-dose-intravenous-tranexamic-acid-on-total-hip-replacement-a%C3%A2-study-on-transfusions-collateral-complications-and-readmissions
#10
A Fígar, S Mc Loughlin, P A Slullitel, W Scordo, M A Buttaro
INTRODUCTION: To determine the effects of tranexamic acid (TXA) on transfusions in patients undergoing hip replacement with a hybrid or cementless prosthesis. METHODS: A group of 172 consecutive patients aged 18 years or older who underwent elective hip replacement with uncemented or hybrid prostheses, undergoing surgery between January 2012 and January 2014 by the same primary surgeon and anesthesiologist, were retrospectively included. TXA (1 g) was administered immediately before incision in the TXA group...
November 10, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#11
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27815950/a-randomized-double-blind-placebo-controlled-study-of-neuromuscular-electrical-stimulation-nmes-use-for-recovery-after-elective-total-hip-replacement-surgery
#12
Jerome J Castellano, Ana-Marie Rojas, Raj Karia, Tracey Hunter, James Slover, Alex Moroz
Early physical activity has been proven to accelerate functional recovery after total hip replacement (THR). Weightbearing intolerance secondary to postoperative pain inhibits participation in physical therapy and limits the achievement of functional independence. Neuromuscular electrical stimulation (NMES) has been shown to improve pain and accelerate recovery. This study focused on the effects of NMES on weightbearing pain. The primary objective of this study was to compare the efficacy of NMES versus placebo in the reduction of pain and the use of opiate medications in the treatment of patients during weightbearing exercises after THR...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27802289/has-metal-on-metal-resurfacing-been-a-cost-effective-intervention-for-health-care-providers-a-registry-based-study
#13
Ruth Pulikottil-Jacob, Martin Connock, Ngianga-Bakwin Kandala, Hema Mistry, Amy Grove, Karoline Freeman, Matthew Costa, Paul Sutcliffe, Aileen Clarke
BACKGROUND: Total hip replacement for end stage arthritis of the hip is currently the most common elective surgical procedure. In 2007 about 7.5% of UK implants were metal-on-metal joint resurfacing (MoM RS) procedures. Due to poor revision performance and concerns about metal debris, the use of RS had declined by 2012 to about a 1% share of UK hip procedures. This study estimated the lifetime cost-effectiveness of metal-on-metal resurfacing (RS) procedures versus commonly employed total hip replacement (THR) methods...
2016: PloS One
https://www.readbyqxmd.com/read/27799243/individual-surgeon-mortality-rates-can-outliers-be-detected-a-national-utility-analysis
#14
Ewen M Harrison, Thomas M Drake, Stephen O'Neill, Catherine A Shaw, O James Garden, Stephen J Wigmore
OBJECTIVES: There is controversy on the proposed benefits of publishing mortality rates for individual surgeons. In some procedures, analysis at the level of an individual surgeon may lack statistical power. The aim was to determine the likelihood that variation in surgeon performance will be detected using published outcome data. DESIGN: A national analysis surgeon-level mortality rates to calculate the level of power for the reported mortality rate across multiple surgical procedures...
October 31, 2016: BMJ Open
https://www.readbyqxmd.com/read/27797404/pentasaccharides-for-the-prevention-of-venous-thromboembolism
#15
REVIEW
Kezhou Dong, Yanzhi Song, Xiaodong Li, Jie Ding, Zhiyong Gao, Daopei Lu, Yimin Zhu
BACKGROUND: Venous thromboembolism (VTE) is a common condition with potentially serious and life-threatening consequences. The standard method of thromboprophylaxis uses an anticoagulant such as low molecular weight heparin (LMWH) or warfarin. In recent years, another type of anticoagulant, pentasaccharide, an indirect factor Xa inhibitor, has shown good anticoagulative effect in clinical trials. Three types of pentasaccharides are available: short-acting fondaparinux, long-acting idraparinux and idrabiotaparinux...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27787880/reducing-hospital-readmission-disparities-of-older-black-and-white-adults-after-elective-joint-replacement-the-role-of-nurse-staffing
#16
Karen B Lasater, Matthew D McHugh
OBJECTIVES: To examine racial differences in readmissions of older adults undergoing elective total hip and knee replacement, to determine the relationship between nurse staffing and readmission, and to study whether the relationship between staffing and readmission differs for older black and white adults. DESIGN: Cross-sectional analysis of multiple linked secondary data sources. SETTING: Nonfederal acute care hospitals in California, Florida, New Jersey, and Pennsylvania (n = 483)...
December 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27766000/location-quality-and-choice-of-hospital-evidence-from-england-2002-2013
#17
Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Hugh Gravelle
We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients in urban and rural locations, (c) the relationship between hospitals' elasticities of demand to quality and the number of local rivals, and how these changed after relaxation of constraints on hospital choice in England in 2006. Using a data set on over 500,000 elective hip replacement patients over the period 2002 to 2013 we find that patients became more likely to travel to a provider with higher quality or lower waiting times, the proportion of patients bypassing their nearest provider increased from 25% to almost 50%, and hospital elasticity of demand with respect to own quality increased...
September 2016: Regional Science and Urban Economics
https://www.readbyqxmd.com/read/27703282/analysis-of-the-blood-consumption-for-surgical-programs
#18
Dzenana Begic, Ermina Mujicic, Jozo Coric, Svjetlana Loga Zec, Lejla Zunic
INTRODUCTION: Transfusion is an activity that assures sufficient supply of blood and blood components to treat the sick and injured. In transfusion departments is necessary to timely provide adequate amounts of blood and blood products for various surgical procedures. MATERIAL AND METHODS: To determine the total amount of preoperative requirements (BT/AB and BT/AB/MT) for blood and blood products in surgical departments of General Hospital "Prim. Dr. Abdulah Nakas" in the period from June 1, 2014 - December 31, 2014 and analyze the requirements for blood in relation to surgical procedures, surgical discipline, period, age and gender of patients...
July 27, 2016: Medical Archives
https://www.readbyqxmd.com/read/27637304/postorthopedic-surgery-joint-replacement-surgery-venous-thromboembolism-prophylaxis
#19
REVIEW
Louis M Kwong, Jon A Kimball
Elective total hip or knee arthroplasty places patients at risk for venous thromboembolism (VTE). As our understanding of the pathophysiology of VTE after joint arthroplasty has increased, pharmacologic strategies have been developed to target different aspects of the coagulation cascade. Various approaches have been used as risk reduction strategies. In 2011 and 2014 the Food and Drug Administration approved rivaroxaban and apixaban as new oral antithrombotic agents. Although controversies remain with regard to the ideal VTE pharmacoprophylactic agent, this class of novel oral anticoagulants has been demonstrated to be safe and to be more effective than enoxaparin...
October 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27623680/exploring-unmet-needs-in-venous-and-arterial-thromboembolism-with-rivaroxaban
#20
Riccardo Cappato, Robert Welsh
The vast clinical research programme for the direct, oral factor Xa inhibitor rivaroxaban has generated a wealth of data since the first rivaroxaban approval in 2008 for the prevention of venous thromboembolism (VTE) in patients undergoing elective hip or knee replacement surgery. While rivaroxaban is widely used across a spectrum of seven indications, there is continuous commitment to investigating its wider benefits in new indications and attempts to refine current evidence. Key data from recently completed randomised controlled trials (RCTs) have shown that rivaroxaban is a feasible anticoagulation option for patients with non-valvular atrial fibrillation (NVAF) undergoing cardioversion or catheter ablation...
September 28, 2016: Thrombosis and Haemostasis
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