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elective Knee replacement

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https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
July 29, 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
#13
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
https://www.readbyqxmd.com/read/28739626/patient-reported-outcome-measures-proms-enhancing-decision-making-and-follow-up
#14
Robert Walker, Anthony Thomas Gough, Dan H Williams
A case presentation of patient undergoing elective total knee replacement. Patient-reported outcome measures prospectively collected electronically pre and postoperatively allowed real-time review, aiding follow-up and reducing the need for clinical, face-to-face follow-up.
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28739308/risk-of-surgical-site-infection-in-elective-hip-and-knee-replacements-after-confirmed-eradication-of-mrsa-in-chronic-carriers
#15
Tarang Tandon, Baha J Tadros, Harold Akehurst, Adhish Avasthi, Richard Hill, Madhu Rao
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is globally endemic and is a leading cause of surgical site infection (SSI). The purpose of this study was to evaluate the incidence of SSI in MRSA carriers undergoing elective hip or knee arthroplasty, who had confirmed eradication and to compare it with incidence of SSI in non-MRSA carriers. METHODS: This is a retrospective analysis of 6613 patients who underwent elective total hip arthroplasty (THA; n = 3347) and total knee arthroplasty (TKA; n = 3266) at our institution...
June 29, 2017: Journal of Arthroplasty
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
#16
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...
October 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
#17
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
#18
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
#19
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/28681269/a-retrospective-assessment-of-prognostication-in-456-685-patients-undergoing-elective-major-non-cardiac-surgery
#20
Daniel McIsaac, Luke T Lavallée, Carl van Walraven
BACKGROUND: The accuracy of patient prognostication varies extensively in studies of select populations. Prognostication is an important component of patient selection for elective surgery. This retrospective study assessed patient prognostication prior to elective surgery by comparing the observed with the expected number of deaths in such patients. STUDY DESIGN: We used population-based administrative data to identify all adults undergoing one of 13 most common elective major non-cardiac gender-neutral surgeries in Ontario, Canada from 2002-2014...
July 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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