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elective Knee replacement

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https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#1
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29316598/s-orthopaedic-department-teaching-status-associated-with-adverse-outcomes-of-primary-total-knee-arthroplasty
#2
Dean C Perfetti, Nipun Sodhi, Anton Khlopas, Assem A Sultan, Suela Lamaj, Mathew R Boylan, Jared M Newman, Qais Naziri, William A Cantrell, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
INTRODUCTION: Although resident physicians have a critical role in the daily management of patients, based on their limited experiences, they are thought to potentially create inefficiencies in the hospital. With changes set forth by the Comprehensive Care for Joint Replacement (CJR) program, both teaching and non-teaching hospitals are directly compared on efficiency and outcomes. Therefore, the purpose of this study was to compare outcomes between teaching and non-teaching hospitals in the state of New York...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29303906/the-efficacy-of-pre-operative-preparation-with-intravenous-iron-and-or-erythropoietin-in-anaemic-patients-undergoing-orthopaedic-surgery-an-observational-study
#3
Martina Heschl, Hans Gombotz, Bettina Haslinger-Eisterer, Axel Hofmann, Nikolaus Böhler, Jens Meier
BACKGROUND: Pre-operative anaemia and transfusion are common among patients undergoing elective orthopaedic surgery. Application of 'patient blood management' might be the most effective way to reduce both anaemia and transfusion. Pre-operative administration of iron and/or erythropoietin (EPO) is one of the cornerstones of the first pillar of patient blood management, but in a daily clinical setting, efficacy and long-term safety of this measure have not been analysed thoroughly to date...
January 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29298664/the-prevention-of-delirium-in-elderly-with-obstructive-sleep-apnea-podesa-study-protocol-for-a-multi-centre-prospective-randomized-controlled-trial
#4
Jean Wong, David Lam, Stephen Choi, Mandeep Singh, Naveed Siddiqui, Sanjeev Sockalingam, Frances Chung
BACKGROUND: Delirium is a common problem that occurs in 5-50% of elderly individuals following surgery. Patients who develop delirium after surgery are at increased risk for serious complications. Recent studies suggest that patients with obstructive sleep apnea (OSA), a sleep disorder characterized by repeated episodes of complete or partial blockage of the upper airway - are at greater risk to develop delirium. OSA is more common in elderly individuals but is often undiagnosed. Identification and treatment of unrecognized OSA may reduce the incidence of postoperative delirium...
January 3, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#5
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29248360/balancing-training-and-outcomes-in-total-knee-replacement-a-ten-year-review
#6
A Faulkner, M J Reidy, P S E Davies, W Wang, N Buddhadev, L Johnston, B Clift
INTRODUCTION: 10-year study examining differences in total knee arthroplasty (TKA) functional outcomes and survivorship in patients operated on by consultant and trainee orthopaedic surgeons. METHOD: Data was prospectively collected from all elective TKAs performed at our three linked institutions. Patient demographics, surgeon grade, and length of hospital stay were recorded. Outcomes pre-operatively and at 1, 3, 5, 7 and 10 years included mortality, need for revision surgery and function as documented by the patients' Knee Society Score...
December 13, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29224190/metabolic-surgery-for-the-treatment-of-type-2-diabetes-in-obese-individuals
#7
REVIEW
David E Cummings, Francesco Rubino
Several bariatric operations originally designed to promote weight loss have been found to powerfully treat type 2 diabetes, causing remission in most cases, through diverse mechanisms additional to the secondary consequences of weight loss. These observations have prompted consideration of such operations as 'metabolic surgery', used expressly to treat diabetes, including among patients who are only mildly obese or merely overweight. Large, long-term observational studies consistently demonstrate that bariatric/metabolic surgery is associated with reductions in all cardiovascular risk factors, actual cardiovascular events, microvascular diabetes complications, cancer and death...
December 9, 2017: Diabetologia
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#8
Gueorgui Dubrocq, Andrea Estrada, Shannon Kelly, Natella Rakhmanina
An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29078245/-antiembolic-stockings-great-effects-in-edoxaban-approval-studies
#9
Knut Kroeger, Peter Kujath
In this age of evidence-based medicine, the use of medical thrombosis prophylaxis stockings (AES) as a physical strategy for the prevention of lower limb venous thrombosis has been questioned. The current German S3 guidelines even state that their non-application is, in the vast majority of cases, explicitly covered by the recommendations of this guideline. Low molecular weight heparins (NMH) and direct oral anticoagulants (DOAK) have received approval for thrombosis prophylaxis in elective knee and hip joint replacement, but the use of AES is absent from these approval studies...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28974402/up-to-10-year-follow-up-of-the-oxford-domed-lateral-partial-knee-replacement-from-an-independent-centre
#10
Simon D S Newman, Altay Altuntas, Helen Alsop, Justin P Cobb
BACKGROUND: The Oxford Domed Lateral Partial Knee Replacement (ODLPKR) was designed specifically for the lateral compartment in response to the unacceptable dislocation rate seen with the Oxford Partial Knee. This paper presents the up to 10-year follow-up of an independent, single surgeon series using this implant. The aim of this study is to assess the medium term outcome of the ODLPKR. The primary outcome measures were 13 revision surgery, re-operation and functional outcome. METHODS: Sixty-four knees in 58 patients were performed between 2005 and 2009...
September 30, 2017: Knee
https://www.readbyqxmd.com/read/28960546/early-recovery-following-lower-limb-arthroplasty-qualitative-interviews-with-patients-undergoing-elective-hip-and-knee-replacement-surgery-initial-phase-in-the-development-of-a-patient-reported-outcome-measure-prom
#11
Louise H Strickland, Laura Kelly, Thomas W Hamilton, David W Murray, Hemant G Pandit, Crispin Jenkinson
AIMS AND OBJECTIVES: The aim of this study was to explore the patients' perspective of surgery and early recovery when undergoing lower limb (hip or knee) arthroplasty. BACKGROUND: Lower limb arthroplasty is a commonly performed procedure for symptomatic arthritis which has not responded to conservative medical treatment. Each patients' perspective of the surgical process and early recovery period impacts on their quality of life. DESIGN: Open, semi-structured qualitative interviews were utilised to allow for a deeper understanding of the patient perspective when undergoing a hip or knee arthroplasty...
September 27, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28951054/recent-trends-in-blood-utilization-after-revision-hip-and-knee-arthroplasty
#12
Robert A Burnett, Nicholas A Bedard, David E DeMik, Yubo Gao, Steve S Liu, John J Callaghan
BACKGROUND: Blood transfusion guidelines in elective surgery have been implemented over the last decade to minimize risk and cost related to transfusion without sacrificing patient outcomes. Blood utilization in primary total hip (THA) and total knee arthroplasty (TKA) has been extensively studied but there is a paucity of studies evaluating utilization in revision THA and TKA. The purpose of this study is to evaluate current trends in transfusion following revision THA and TKA. METHODS: The Humana dataset was reviewed for transfusion trends from 2007 to 2015 for patients undergoing revision THA and TKA...
September 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28891828/poor-performance-on-a-preoperative-cognitive-screening-test-predicts-postoperative-complications-in-older-orthopedic-surgical-patients
#13
Deborah J Culley, Devon Flaherty, Margaret C Fahey, James L Rudolph, Houman Javedan, Chuan-Chin Huang, John Wright, Angela M Bader, Bradley T Hyman, Deborah Blacker, Gregory Crosby
BACKGROUND: The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. METHODS: We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement...
November 2017: Anesthesiology
https://www.readbyqxmd.com/read/28838614/implementation-of-preoperative-screening-criteria-lowers-infection-and-complication-rates-following-elective-total-hip-arthroplasty-and-total-knee-arthroplasty-in-a-veteran-population
#14
Fernando D Nussenbaum, David Rodriguez-Quintana, Sara M Fish, David M Green, Catherine W Cahill
BACKGROUND: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures with a risk of complications. Attempting to minimize complications, our institution implemented preoperative screening criteria for patients undergoing elective total joint replacement. Our study aimed to determine if screening criteria lowered total complications and/or surgical site infections (SSI). METHODS: Two groups of consecutive patients undergoing TKA and THA at a single Veterans Affairs facility were evaluated prior to and after implementation of screening criteria, 520 and 475 respectively...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28828124/radiological-difficulty-in-identifying-unicompartmental-knee-replacement-dislocation
#15
Oruaro Adebayo Onibere, Iain Stevenson, Fraser Jonathan Gill
Unicondylar knee replacement is a relatively common elective orthopedic procedure but is not often seen in the Emergency Department setting. Familiarity with normal clinical and radiological appearances is difficult to gain. Dislocation of the mobile bearing component "spacer" is a known complication of unicondylar knee replacements, and these patients will initially present to the accident and Emergency Department. In this setting, an accurate and prompt diagnosis is necessary to appropriately manage the patient's condition...
September 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/28768430/multi-and-univariate-analyses-of-the-weekend-effect-for-elective-lower-limb-joint-replacements
#16
Wte Briggs, Blt Guevel, A W McCaskie, S M McDonnell
Introduction The weekend effect is a perceived difference in outcome between medical care provided at the weekend when compared to that of a weekday. Clearly multifactorial, this effect remains incompletely understood and variable in different clinical contexts. In this study we analyse factors relevant to the weekend effect in elective lower-limb joint replacement at a large NHS multispecialty academic healthcare centre. Materials and Methods We reviewed the electronic medical records of 352 consecutive patients who received an elective primary hip or knee arthroplasty...
August 3, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28765504/does-early-return-to-theatre-add-value-to-rates-of-revision-at-3-years-in-assessing-surgeon-performance-for-elective-hip-and-knee-arthroplasty-national-observational-study
#17
Alex Bottle, Helen E Chase, Paul P Aylin, Mark Loeffler
BACKGROUND: Joint replacement revision is the most widely used long-term outcome measure in elective hip and knee surgery. Return to theatre (RTT) has been proposed as an additional outcome measure, but how it compares with revision in its statistical performance is unknown. METHODS: National hospital administrative data for England were used to compare RTT at 90 days (RTT90) with revision rates within 3 years by surgeon. Standard power calculations were run for different scenarios...
August 1, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28760710/the-impact-of-preoperative-bacteriuria-on-the-risk-of-periprosthetic-joint-infection-after-primary-knee-or-hip-replacement-a-retrospective-study-with-a-1-year-follow-up
#18
M Honkanen, E Jämsen, M Karppelin, R Huttunen, H Huhtala, A Eskelinen, J Syrjänen
OBJECTIVES: Patients who undergo elective joint replacement are traditionally screened and treated for preoperative bacteriuria to prevent periprosthetic joint infection (PJI). More recently, this practice has been questioned. The purpose of this study was to determine whether preoperative bacteriuria is associated with an increased risk of PJI. METHODS: Patients who had undergone a primary hip or knee replacement in a tertiary care hospital between September 2002 and December 2013 were identified from the hospital database (23 171 joint replacements, 10 200 hips, and 12 971 knees)...
July 29, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28756546/thromboprophylaxis-with-enoxaparin-and-direct-oral-anticoagulants-in-major-orthopedic-surgery-and-acutely-ill-medical-patients-a-meta-analysis
#19
Claudio Cimminiello, Paolo Prandoni, Giancarlo Agnelli, Giovanni Di Minno, Hernan Polo Friz, Francesco Scaglione, Patrizia Boracchi, Giuseppe Marano, Job Harenberg
Subjects undergoing major orthopedic surgery and acutely ill hospitalized medical patients represent a population at medium-high risk for venous thromboembolism (VTE). They are treated with low molecular weight heparin (LMWH) and direct oral anticoagulants [DOACs] for VTE prevention. We conducted a meta-analysis of phase III randomized clinical trials evaluating LMWH enoxaparin versus DOACs for prophylaxis of VTE by combining studies including patients undergoing elective total hip and knee replacement surgery, and acutely ill hospitalized medical subjects...
December 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28746022/mortality-after-total-knee-and-total-hip-arthroplasty-in-a-large-integrated-health-care-system
#20
Maria C S Inacio, Mark T Dillon, Alex Miric, Ronald A Navarro, Elizabeth W Paxton
CONTEXT: The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. OBJECTIVE: To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. DESIGN: A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry...
2017: Permanente Journal
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