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Fast-track arthroplasty

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https://www.readbyqxmd.com/read/29102512/ninety-day-morbidity-and-mortality-in-risk-screened-and-optimized-patients-undergoing-two-team-fast-track-simultaneous-bilateral-tka-compared-with-unilateral-tka-a-prospective-study
#1
Vikas Kulshrestha, Santhosh Kumar, Barun Datta, V K Sinha, Gaurav Mittal
BACKGROUND: Simultaneous bilateral total knee arthroplasty (SBTKA) offers significant socioeconomic benefits. However, retrospective studies and public health data show increased mortality and morbidity rates in patients undergoing SBTKA compared with those undergoing unilateral TKA (UTKA), and there have been recommendations against the use of SBTKA. High-volume centers, which feature careful patient selection and fast-tracked surgery, continue to perform SBTKA and have published their results in favor of the procedure...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29022751/prospective-psychometric-characterization-of-hip-and-knee-arthroplasty-patients
#2
Silas Hinsch Gylvin, Anders Fink-Jensen, Henrik Kehlet, Christoffer Calov Jørgensen, Mogens Berg Laursen, Kirill Gromov, Henrik Morville Schroder, Susanne Jung Høvsgaard, Heidi Raahauge Wede, Phillip Raphael Kyle, Per Bech
BACKGROUND: Psychiatric conditions and psychopharmacological treatments have been demonstrated to be important risk-factors for prolonged hospital length of stay, readmission and morbidity, following fast-track total hip (THA) and total knee arthroplasty (TKA). AIMS: The aim of the study was to provide a detailed description of the preoperative psychiatric characteristics of a well-defined patient population undergoing THA and TKA, using the 90-item Symptom Checklist (SCL-90-R)...
October 12, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28985252/age-and-sex-based-recovery-curves-to-track-functional-outcomes-in-older-adults-with-total-knee-arthroplasty
#3
Yong-Hao Pua, Felicia Jie-Ting Seah, Cheryl Lian-Li Poon, John Wei-Ming Tan, Ross Alan Clark, Jennifer Suet-Ching Liaw, Hwei-Chi Chong
Background: older adults with total knee arthroplasty (TKA) frequently undergo rehabilitation to address limited knee flexion range-of-motion, quadriceps weakness and gait speed limitations. This study aimed to develop age- and sex-specific recovery curves of knee flexion range-of-motion, quadriceps strength and fast gait speed post-TKA. Methods: a population-based sample of 2,987 patients undergoing primary TKA participated, of whom 2015 (68%) were 65 years of age or older...
August 30, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28933332/the-impact-of-caregivers-anxiety-on-patients-anxiety-before-fast-track-knee-arthroplasty
#4
P Zietek, B Zarzycka, J Zietek, M Stepien-Slodkowska, E Sienko-Awierianow, D Kotrych, K Dobiecki
PURPOSE OF THE STUDY Anxiety may have negative repercussions on the surgery including poorer outcomes. On the other hand, the majority of patients reporting preoperative anxiety fear not receiving enough attention from a caregiver. In patients undergoing fast-track knee arthroplasty, we determined the relationship between patients' preoperative anxiety and the anxiety the patient's caregiver. We also analyzed the influence of selected psychosocial and demographic variables on the relationship between caregivers' and patients' anxiety...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28918788/-fast-track-total-knee-arthroplasty
#5
Kirill Gromov, Billy B Kristensen, Christoffer Calov Jørgensen, Torben Bæk Hansen, Henrik Kehlet, Henrik Husted
Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery, thus leading to lower mortality and morbidity as well as high patient satisfaction. All patients are eligible for fast-track TKA, and hence the fast-track concept should be standard at all joint replacement facilities. Future challenges of fast-track TKA include safe introduction of outpatient protocols, acute and chronic pain after surgery and optimal utilization of post-operative physiotherapy...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28914103/the-first-6-weeks-of-recovery-after-primary-total-hip-arthroplasty-with-fast-track
#6
Lisette C M Klapwijk, Nina M C Mathijssen, Jeroen C van Egmond, Bianca M Verbeek, Stephan B W Vehmeijer
No abstract text is available yet for this article.
September 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28900757/low-incidence-of-postoperative-urinary-retention-with-the-use-of-a-nurse-led-bladder-scan-protocol-after-hip-and-knee-arthroplasty-a-retrospective-cohort-study
#7
N P Kort, Y Bemelmans, R Vos, M G M Schotanus
PURPOSE: Postoperative urinary retention (POUR), defined as the inability to empty the bladder voluntary after surgery, is a commonly reported complication. This study reports the incidence and possible risk factors for POUR after elective fast-track hip or knee arthroplasty when using a nurse-led bladder scan protocol. METHODS: This retrospective cohort study included data from 803 patients who underwent unilateral hip or knee arthroplasty. Patients' digital clinical records were reviewed for eligibility...
September 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28880108/reduced-length-of-uninterrupted-institutional-stay-after-implementing-a-fast-track-protocol-for-primary-total-hip-replacement
#8
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-track protocols have been successfully implemented in many hospitals as they have been shown to result in shorter length of stay (LOS) without compromising results. We evaluated the effect of fast-track implementation on the use of institutional care and results after total hip replacement (THR). Patients and methods - 3,193 THRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register...
September 7, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28854533/safety-aspects-of-preoperative-high-dose-glucocorticoid-in-primary-total-knee-replacement
#9
C C Jørgensen, F T Pitter, H Kehlet
Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation Database for Fast-track Hip and Knee Replacement introduced preoperative methylprednisolone (MP) 125 mg as part of a multimodal analgesic protocol in TKA. We analysed the risk of length of hospital stay (LOS) >4 days, 30 and 90 day readmissions in patients with MP vs patients having TKA before the use of MP and adjusted for comorbidity and place of surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28836971/which-patient-specific-and-surgical-characteristics-influence-postoperative-pain-after-tha-in-a-fast-track-setting
#10
Yvon M den Hartog, Gerjon Hannink, Nick T van Dasselaar, Nina M Mathijssen, Stephan B Vehmeijer
BACKGROUND: In our hospital a fast-track setting including a multimodal pain protocol is used for total hip arthroplasty (THA). Despite this multimodal pain protocol there is still a large range in reported postoperative pain between patients, which hinders mobilization and rehabilitation postoperatively. The goal of this study was to identify which patient-specific and surgical characteristics influence postoperative pain after THA in a fast-track setting. METHODS: All 74 patients with osteoarthritis of the hip who underwent primary THA procedure by anterior supine intermuscular approach between November 2012 and January 2014 were included in this prospective cohort study...
August 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28833302/patient-experience-with-early-discharge-after-total-knee-arthroplasty-a-focus-group-study
#11
Lise Husby Høvik, Bjørg Aglen, Vigdis Schnell Husby
BACKGROUND: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast-track pathway aims at improving patient outcome, and patients are now discharged 2-3 days after surgery. Little is known about how the patients cope with pain, exercise or daily activities at home. AIM: To explore the experience of patients undergoing total knee arthroplasty in a fast-track pathway during the first 2 weeks after surgery...
August 23, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28831572/fast-track-and-outpatient-surgery-in-total-knee-arthroplasty-beneficial-for-patients-doctors-and-hospitals
#12
EDITORIAL
Michael T Hirschmann, Nanne Kort, Sebastian Kopf, Roland Becker
No abstract text is available yet for this article.
September 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28801413/effectiveness-of-rehabilitation-after-a-total-hip-arthroplasty-a-protocol-for-an-observational-study-for-the-comparison-of-usual-care-in-the-netherlands-versus-germany
#13
Gesine H Seeber, Annet Wijnen, Djordje Lazovic, Sjoerd K Bulstra, Günter Dietz, Christiaan P van Lingen, Martin Stevens
INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800859/the-role-of-psychiatric-diagnoses-for-outcome-after-hip-and-knee%C3%A2-arthroplasty
#14
Silas H Gylvin, Christoffer C Jørgensen, Anders Fink-Jensen, Gunnar H Gislason, Henrik Kehlet
BACKGROUND: Surgical patients receiving psychopharmacologic treatment have been associated with adverse outcomes in total hip and knee arthroplasty (THA and TKA). The purpose of this study was to investigate whether a specific high-risk group of patients receiving psychopharmacologic treatment could be identified based upon a nationwide psychiatric diagnosis register. METHODS: From 7 different orthopedic centers, 8288 THA and TKA patients were included from January 2010 to November 2012 of which 943 (11...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28751437/enhanced-recovery-after-surgery-for-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#15
Shibai Zhu, Wenwei Qian, Chao Jiang, Canhua Ye, Xi Chen
OBJECTIVES: To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Relevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones...
July 27, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#16
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28682892/in-patients-undergoing-fast-track-total-knee-arthroplasty-addition-of-buprenorphine-to-a-femoral-nerve-block-has-no-clinical-advantage-a-prospective-double-blinded-randomized-placebo-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Rienk van Beek, Harry J Zonneveldt, Tjeerd van der Ploeg, Jeroen Steens, Phillip Lirk, Marcus W Hollmann
BACKGROUND: Several adjuvants have been proposed to prolong the effect of peripheral nerve blocks, one of which is buprenorphine. In this randomized double blinded placebo controlled trial we studied whether the addition of buprenorphine to a femoral nerve block prolongs analgesia in patients undergoing total knee arthroplasty in a fast track surgery protocol. METHODS: The treatment group (B) was given an ultrasound-guided femoral nerve block with ropivacaine 0...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28681427/delirium-after-fast-track-hip-and-knee-arthroplasty-a-cohort-study-of-6331-elderly-patients
#18
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/28657575/perioperative-pain-management-in-fast-track-knee-arthroplasty
#19
Chiara Caparrini, Irene Miniati, Marco Ponti, Andrea Baldini
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June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657396/preoperative-methylprednisolone-does-not-reduce-loss-of-knee-extension-strength-after-total-knee-arthroplastya-randomized-double-blind-placebo-controlled-trial-of-61-patients
#20
RANDOMIZED CONTROLLED TRIAL
Viktoria Lindberg-Larsen, Thomas Q Bandholm, Camilla K Zilmer, Jens Bagger, Mette Hornsleth, Henrik Kehlet
Background and purpose - Patients undergoing total knee arthroplasty (TKA) face challenges related to postoperative reduction in knee-extension strength. We evaluated whether inhibition of the inflammatory response by a single preoperative dose of methylprednisolone (MP) reduces the pronounced loss of knee-extension strength at discharge after fast-track TKA. Patients and methods - 70 patients undergoing elective unilateral TKA were randomized (1:1) to preoperative intravenous (IV) MP 125 mg (group MP) or isotonic saline IV (group C)...
October 2017: Acta Orthopaedica
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