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elective Hip replacement

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https://www.readbyqxmd.com/read/28736863/no-associations-established-between-single-nucleotide-polymorphisms-in-human-toll-like-receptor-2-and-toll-interacting-protein-and-staphylococcus-aureus-bloodstream-infections
#1
Tom Eirik Smeland, Fredrik Müller, Anita Blomfeldt, Knut Stavem, Hege Vangstein Aamot
Staphylococcus aureus bloodstream infections (SABSI) are associated with high morbidity and mortality. The Toll-like receptor 2 (TLR2) and Toll-interacting protein (TOLLIP) are important in recognition and regulation of human innate immunity response to S. aureus. Single nucleotide polymorphisms (SNPs) in the TLR2 and TOLLIP encoding genes have been associated with disease, including BSI. The aim of this study was to examine potential associations between a selection of SNPs in the genes encoding TLR2 and TOLLIP, and predisposition, severity, and outcome of SABSI...
July 24, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28715055/risk-of-surgical-site-infections-following-hip-and-knee-arthroplasty-results-of-the-ischia-gisio-study
#2
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/28690539/neurimmirs-and-postoperative-delirium-in-elderly-patients-undergoing-total-hip-knee-replacement-a-pilot-study
#3
Rui Dong, Lingling Sun, Yayuan Lu, Xi Yang, Mian Peng, Zongze Zhang
Objective: Postoperative delirium (POD) is a frequent complication after surgery and its occurrence is associated with poor outcomes. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The purpose of this study was to investigate the associations between the preoperative expression levels of microRNA (miR)-146a, miR-125b, and miR-181c in cerebrospinal fluid (CSF) and serum and the development and severity of POD. Methods: Forty elderly patients aged 65 years old and older admitted for elective total hip/knee replacement under spinal anesthesia...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28681427/delirium-after-fast-track-hip-and-knee-arthroplasty-a-cohort-study-of-6331-elderly-patients
#4
P B Petersen, C C Jørgensen, H Kehlet
BACKGROUND: Postoperative delirium (PD) is a well-known complication among elderly surgical patients and associated with increased morbidity, mortality and length of stay (LOS). In elective orthopedic surgery, including hip and knee arthroplasty (THA/TKA), most studies report incidences between 5% and 10%. The multimodal optimization of perioperative care (fast-track) aims to enhance recovery and reduce morbidity and LOS, but limited data are available on the effect on PD. Consequently, the study investigated signs of PD associated with LOS > 4 days...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28647838/preoperative-education-for-hip-and-knee-replacement-never-stop-learning
#5
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/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
#6
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#7
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/28567148/hip-abductor-strengthening-improves-physical-function-following-total-knee-replacement-one-year-follow-up-of-a-randomized-pilot-study
#8
Karvannan Harikesavan, Raj D Chakravarty, Arun G Maiya, Sanjay P Hegde, Shivakumar Y Shivanna
BACKGROUND: Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis. OBJECTIVE: To assess the efficacy of hip abductor strengthening exercise on functional outcome using performance based outcome measures following total knee replacement...
2017: Open Rheumatology Journal
https://www.readbyqxmd.com/read/28525512/parecoxib-supplementation-to-morphine-analgesia-decreases-incidence-of-delirium-in-elderly-patients-after-hip-or-knee-replacement-surgery-a-randomized-controlled-trial
#9
Dong-Liang Mu, Da-Zhi Zhang, Dong-Xin Wang, Geng Wang, Chun-Jing Li, Zhao-Ting Meng, Ya-Wei Li, Chao Liu, Xue-Ying Li
BACKGROUND: Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery. METHODS: In a randomized, double-blind, 2-center trial, patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline)...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28524005/rivaroxaban-metabolism-pharmacologic-properties-and-drug-interactions
#10
Tomas Kvasnicka, Ivana Malikova, Zuzana Zenahlikova, Karolína Kettnerova, Radka Brzezkova, Tomas Zima, Jan Ulrych, Jan Briza, Ivan Netuka, Jan Kvasnicka
BACKGROUND: Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action. OBJECTIVE: The absorbtion of rivaroxaban is quick, reaching maximum plasma concentration 2-4 hours following its administration. Peroral bioavailability is high (80-100 %) and pharmacokinetic variability is considered to be moderate (coefficient of variation 30-40 %). This review discusses the properties, drug interactions, pharmacokinetics and clinical indications of rivaroxaban...
May 18, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28509399/association-of-renin-angiotensin-antagonists-with-adverse-perioperative-events-in-patients-undergoing-elective-orthopaedic-surgery-a-case-control-study
#11
Amith Zainudheen, Ian A Scott, Xenia Caney
BACKGROUND: Renin angiotensin antagonists (RAAs) may block protective vasopressor responses during surgery. Evidence linking RAAs with intraoperative hypotension and perioperative adverse events is conflicting. METHODS: Retrospective case-control study of 258 consecutive patients who underwent elective total knee or hip replacement between January 1(st) 2013 and August 31(st) 2016, and who were chronically prescribed a single blood pressure lowering agent up to the time of surgery...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28506775/supervised-or-unsupervised-rehabilitation-after-total-hip-replacement-provides-similar-improvements-for-patients-a-randomised-controlled-trial
#12
Corinne Coulter, Diana M Perriman, Teresa M Neeman, Paul N Smith, Jennifer M Scarvell
OBJECTIVE: To determine do patients do better with unsupervised home PT or in an outpatient setting Are the outcomes after a supervised (centre-based) and an independent (home-based) physical rehabilitation program delivered in the early post-discharge phase (<8weeks) equivalent in an adult THR population. SETTING: Acute care public hospital in the region, supporting a population of almost 540,000. DESIGN: Single blinded randomised controlled trial...
May 12, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28494480/implementation-and-effects-of-enhanced-recovery-after-surgery-for-hip-and-knee-replacements-and-fractured-neck-of-femur-in-new-zealand-orthopaedic-services
#13
Suzanne Proudfoot, Brandon Bennett, Simon Duff, Julie Palmer
AIM: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results. METHOD: ERAS protocols were developed for hip and knee TJA and fractured NOF. Breakthrough Series collaborative methodology was used to implement the ERAS protocols in 18 DHBs...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28456422/validation-of-the-danish-version-of-the-constipation-risk-assessment-scale-cras
#14
Mette Trads, Sasja J Håkonson, Preben U Pedersen
INTRODUCTION: The Constipation Assessment Scale (CRAS) was developed in order to enable the prediction of the risk of developing constipation. The scale needs validation in acute and elective patients with common disorders. MATERIALS AND METHOD: Two hundred and six acute patients with hip fracture and 200 elective patients with total knee or hip replacement were included. They were assessed with CRAS before surgery and their defecation pattern, stool consistency and degree of straining were measured at admission and 30 days after surgery...
December 21, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28439702/a-comparison-of-apixaban-and-dabigatran-etexilate-for-thromboprophylaxis-following-hip-and-knee-replacement-surgery
#15
Adriane Mayer, Philipp Schuster, Bernd Fink
INTRODUCTION: Patients who have undergone hip or knee replacement surgery are exposed to a high risk of developing a post-operative venous thromboembolus and so have a need for an effective, medication-based, thrombosis prophylaxis. New orally active anticoagulants have been available for a few years now. These specific substances directly block either thrombin (e.g., dabigatran etexilate) or Factor Xa (e.g., apixaban). It is not clear whether there are any efficacy differences between these two substances because there have never been any head-to-head studies carried out...
April 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28390883/is-orthopedic-department-teaching-status-associated-with-adverse-outcomes-of-primary-total-hip-arthroplasty
#16
Matthew R Boylan, Dean C Perfetti, Qais Naziri, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
BACKGROUND: Although resident physicians play a vital role in the US health care system, they are believed to create inefficiencies in the delivery of care. Under the regional component of the Comprehensive Care for Joint Replacement model, teaching hospitals are forced to compete on efficiency and outcomes with nonteaching hospitals. METHODS: We identified 86,021 patients undergoing elective primary total hip arthroplasty in New York State between January 1, 2009, and September 30, 2014...
March 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28338589/managing-hip-fracture-and-lower-limb-surgery-in-the-emergency-setting-potential-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#17
William Fisher
Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thrombo-embolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326426/use-of-locking-plates-for-fixation-of-the-greater-trochanter-in-patients-with-hip-replacement
#18
Allison K Tetreault, Brian J McGrory
BACKGROUND: Fixation of the greater trochanter with total hip replacement is challenging and associated with short- and long-term complications. Locking plate technology has been used for fixation of other bones and may be applied successfully in trochanteric fixation. The purpose of this retrospective study was to analyze the utility of the use of trochanteric locking plates in total hip arthroplasty (THA) patients. METHODS: From 2004 to 2014, 32 procedures were performed to fix the greater trochanter in patients with trochanteric fracture, osteotomy, or nonunion in the setting of THA...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28315166/effects-of-thromboprophylactic-doses-of-apixaban-and-rivaroxaban-on-coagulation-and-thrombin-generation-in-association-with-total-hip-replacement
#19
Tuukka A Helin, Lauri Virtanen, Mikko Manninen, Jarkko Leskinen, Juhana Leppilahti, Lotta Joutsi-Korhonen, Riitta Lassila
Factor Xa inhibitors (FXaI) apixaban and rivaroxaban are used for thromboprophylaxis after major elective orthopaedic surgery. Because few patient sample studies exist, we postoperatively assessed patients undergoing unilateral total hip arthroplasty, including 22 treated with apixaban (2.5 mg BID) and 20 treated with rivaroxaban (10 mg OD). We collected blood samples before and 3 h after drug intake at 4 time points, preoperatively, as well as on day 1, week 1 (day 2-8) and day 28 post-operation. APTT and PT were immediately analysed...
May 2017: Journal of Thrombosis and Thrombolysis
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
#20
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
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