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Arthroplasty fast-track

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https://www.readbyqxmd.com/read/27903009/temperature-controlled-continuous-cold-flow-device-after-total-knee-arthroplasty-a-randomized-controlled-trial-study
#1
Alberto Ruffilli, Francesco Castagnini, Francesco Traina, Isabella Corneti, Domenico Fenga, Sandro Giannini, Cesare Faldini
Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain, edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy to improve the postoperative results, acting on pain, edema, and blood loss. This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany)...
November 30, 2016: Journal of Knee Surgery
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
#2
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/27791240/feasibility-of-day-case-total-hip-arthroplasty-a-single-centre-observational-study
#3
Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R Mikkelsen, Malene Laursen, Mette T Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen
INTRODUCTION: Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge. METHODS: Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study...
October 24, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27776372/early-removal-of-drainage-tube-after-fast-track-primary-total-knee-arthroplasty
#4
Shaoyun Zhang, Bin Xu, Qiang Huang, Huan Yao, Jinwei Xie, Fuxing Pei
There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups...
October 24, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27759465/thromboembolic-and-major-bleeding-events-in-relation-to-perioperative-bridging-of-vitamin-k-antagonists-in-649-fast-track-total-hip-and-knee-arthroplasties
#5
Christoffer C Jørgensen, Henrik Kehlet
Background - The benefit of preoperative bridging in surgical patients with continuous anticoagulant therapy is debatable, and drawing of meaningful conclusions may have been limited by mixed procedures with different thromboembolic and bleeding risks in most published studies. Patients and methods - This was an observational cohort treatment study in consecutive primary unilateral total hip and knee arthroplasty patients between January 2010 and November 2013 in 8 Danish fast-track departments. Data were collected prospectively on preoperative comorbidity and anticoagulants in patients with preoperative vitamin K antagonist (VKA) treatment...
October 19, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27660489/relationship-between-self-reported-pain-sensitivity-and-pain-after-total-knee-arthroplasty-a-prospective-study-of-71-patients-8-weeks-after-a-standardized-fast-track-program
#6
Berit T Valeberg, Lise H Høvik, Kari H Gjeilo
BACKGROUND AND PURPOSE: This was a prospective cohort study assessing data from 71 adult patients undergoing total knee arthroplasty (TKA) following a standardized fast-track program between January and July 2013. The objective was to examine the relationship between self-rated pain sensitivity, as measured by the Pain Sensitivity Questionnaire (PSQ), and postoperative pain after TKA. METHODS: The baseline questionnaires, PSQ and Brief Pain Inventory, were given to the patients for self-administration at the presurgical evaluation (1-2 weeks prior to surgery)...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27658640/24%C3%A2-hours-stay-after-hip-replacement
#7
Yannick N T Van Den Eeden, Bruno J G De Turck, Frank M C Van Den Eeden
Background and purpose - The length of stay after total hip arthroplasty has been reduced to 2-4 days after implementing fast-track surgery. We investigated whether a new time-based patient-centered primary direct anterior approach (DAA) total hip arthroplasty (THA) treatment protocol in a specialized clinic, with a planned length of stay of about 24 hours, could be achieved in all patients or only in a selected group of patients. Patients and methods - We analyzed prospectively collected data in a cohort of 378 consecutive patients who underwent a primary direct anterior THA as a patient-centered time-based procedure between March 1, 2012 and December 31, 2015...
September 23, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27634599/tnf-%C3%AE-concentrations-in-pre-operative-synovial-fluid-for-predicting-early-post-operative-function-and-pain-after-fast-track-total-knee-arthroplasty
#8
Pawel Zietek, Violetta Dziedziejko, Krzysztof Safranow, Joanna Zietek, Marta Stępień-Słodkowska, Monika Bialecka, Maciej Zietek, Daniel Kotrych, Adam Kamiński, Aleksandra Kowalska
BACKGROUND: Tumor necrosis factor-alpha (TNF-α) helps regulate neuroinflammation and anxiety and could conceivable predict early post-operative pain and function after fast-track total knee arthroplasty (TKA). METHODS: In patients with severe osteoarthritic knees undergoing TKA, we assessed: the correlations between pre-operative concentrations of TNF-α in synovial fluid; pre- and six-week post-operative knee function and pain; pre- and post-operative anxiety; pre- and post-operative synovial fluid concentrations of cartilage oligomeric matrix protein (COMP); age and body mass index (BMI)...
December 2016: Knee
https://www.readbyqxmd.com/read/27554781/no-effect-of-a-bipolar-sealer-on-total-blood-loss-or-blood-transfusion-in-nonseptic-revision-knee-arthroplasty-a-prospective-study-with-matched-retrospective-controls
#9
Christian Skovgaard Nielsen, Kirill Gromov, Øivind Jans, Anders Troelsen, Henrik Husted
BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. METHODS: In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet...
July 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27537753/practice-and-outcomes-of-the-perioperative-surgical-home-in-a-california-integrated-delivery-system
#10
Chunyuan Qiu, Maxime Cannesson, Atef Morkos, Vu T Nguyen, Diana LaPlace, Narendra S Trivedi, Armond Khachatourians, Joseph Rinehart, Zeev N Kain
BACKGROUND: In this article, we report on the implementation and impact of a Perioperative Surgical Home (PSH) model for the total knee arthroplasty at an integrated delivery system (Kaiser Permanente). METHODS: A multidisciplinary committee developed and implemented a series of PSH protocols that included the entire continuum of care from the decision for surgery until 30 days after surgery. Five hundred forty-six subjects were included in the preimplementation phase (Fast Track [T-fast]), and 518 patients were included in the postimplementation phase (PSH)...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27378634/is-outpatient-arthroplasty-as-safe-as-fast-track-inpatient-arthroplasty-a-propensity-score-matched-analysis
#11
Francis Lovecchio, Hasham Alvi, Shawn Sahota, Matthew Beal, David Manning
BACKGROUND: In the emerging fiscal climate of value-based decision-making and shared risk and remuneration, outpatient total joint arthroplasty is attractive provided the incidence of costly complications is comparable to contemporary "fast-track" inpatient pathways. METHODS: All patients undergoing total hip arthroplasty or total knee arthroplasty between 2011 and 2013 were selected from the American College of Surgeons-National Surgical Quality Improvement Program database...
September 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27347785/does-bmi-influence-hospital-stay-and-morbidity-after-fast-track-hip-and-knee-arthroplasty
#12
Henrik Husted, Christoffer C Jørgensen, Kirill Gromov, Henrik Kehlet
Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality in such patients who were operated with the fast-track methodology and compared the levels with those in patients with normal BMI. Patients and methods - This was a prospective observational study involving 13,730 procedures (7,194 THA and 6,536 TKA operations) performed in a standardized fast-track setting...
October 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27229729/the-psychosocial-effect-of-web-based-information-in-fast-track-surgery
#13
Lene Bastrup Jørgensen, Lone Ramer Mikkelsen, Bodil Bjørnshave Noe, Martin Vesterby, Maria Uhd, Bengt Fridlund
The psychosocial effects of web-based information have yet to be tested for patients joining a fast-track total hip arthroplasty programme. This study compared and evaluated the psychosocial impact of standard total hip arthroplasty programme, with and without supplementation with a web-based information platform (E-total hip arthroplasty programme). Totally, 299 patients were enrolled in an un-controlled, before-and-after study, 117 in the S-total hip arthroplasty programme group and 182 in the E-total hip arthroplasty programme group...
May 26, 2016: Health Informatics Journal
https://www.readbyqxmd.com/read/27195631/postoperative-morbidity-and-discharge-destinations-after-fast-track-hip-and-knee-arthroplasty-in-patients-older-than-85-years
#14
Frederik T Pitter, Christoffer C Jørgensen, Martin Lindberg-Larsen, Henrik Kehlet
BACKGROUND: Elderly patients are at risk of increased length of hospital stay (LOS), postoperative complications, readmission, and discharge to destinations other than home after elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Recent studies have found that enhanced recovery protocols or fast-track surgery can be safe for elderly patients undergoing these procedures and may result in reduced LOS. However, detailed studies on preoperative comorbidity and differentiation between medical and surgical postoperative morbidity in elderly patients are scarce...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27054365/postoperative-urinary-catheterization-thresholds-of-500-versus-800-ml-after-fast-track-total-hip-and-knee-arthroplasty-a-randomized-open-label-controlled-trial
#15
Lars S Bjerregaard, Ulla Hornum, Charlotte Troldborg, Stina Bogoe, Per Bagi, Henrik Kehlet
BACKGROUND: No evidence-based threshold exists for postoperative urinary bladder catheterization. The authors hypothesized that a catheterization threshold of 800 ml was superior to 500 ml in reducing postoperative urinary catheterization and urological complications after fast-track total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: This was a randomized, controlled, open-label trial that included patients greater than or equal to 18 yr who underwent THA or TKA in three Danish, fast-track, orthopedic departments...
June 2016: Anesthesiology
https://www.readbyqxmd.com/read/27052271/length-of-stay-after-shoulder-arthroplasty-the-effect-of-an-orthopedic-specialty-hospital
#16
Eric M Padegimas, Benjamin M Zmistowski, Corey T Clyde, Camilo Restrepo, Joseph A Abboud, Mark D Lazarus, Matthew L Ramsey, Gerald R Williams, Surena Namdari
BACKGROUND: One potential avenue for the realization of health care savings is reduction in hospital length of stay (LOS). Initiatives to reduce LOS may also reduce infection and improve patient satisfaction. We compare LOS after shoulder arthroplasty at an orthopedic specialty hospital (OSH) and a tertiary referral center (TRC). METHODS: A single institutional database was used to retrospectively identify all primary shoulder arthroplasties performed between January 1, 2013, and July 1, 2015, at the OSH and TRC...
September 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27034841/a-trend-for-increased-risk-of-revision-surgery-due-to-deep-infection-following-fast-track-hip-arthroplasty
#17
Einar Amlie, Anners Lerdal, Caryl L Gay, Øystein Høvik, Lars Nordsletten, Sigbjørn Dimmen
Rates of revision surgery due to deep infection following total hip arthroplasty (THA) increased at a Norwegian hospital following implementation of fast-track procedures. The purpose of this study was to determine whether selected demographic (age and sex) and clinical (body mass index, American Society of Anesthesiologists (ASA) classification, surgery duration, length of hospital stay, cemented versus uncemented prosthesis, and fast-track procedures) factors were associated with higher risk of revision surgery due to deep infection following THA...
2016: Advances in Orthopedics
https://www.readbyqxmd.com/read/27028450/serious-renal-and-urological-complications-in-fast-track-primary-total-hip-and-knee-arthroplasty-a-detailed-observational-cohort-study
#18
Lars S Bjerregaard, Christoffer C Jorgensen, Henrik Kehlet
BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs...
March 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/26968693/feasibility-and-safety-of-2-day-discharge-after-fast-track-total-hip-arthroplasty-a-chinese-experience
#19
Guojing Yang, Wanchen Chen, Wenliang Chen, Xiaojun Tang, Yijiang Huang, Lei Zhang
BACKGROUND: A fast-track program (FT) can shorten hospital stay after total hip arthroplasty. The aim of this prospective randomized study was to investigate the feasibility and safety of 2-day discharge after fast-track total hip arthroplasty in a Chinese population. METHODS: A total of 258 selected patients who underwent unilateral primary total hip arthroplasty were enrolled into the final cohort and were randomized into the FT (n = 126) and standard program group (n = 132)...
August 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/26945552/postoperative-anemia-and-early-functional-outcomes-after-fast-track-hip-arthroplasty-a-prospective-cohort-study
#20
Øivind Jans, Thomas Bandholm, Sorel Kurbegovic, Søren Solgaard, Per Kjaersgaard-Andersen, Pär I Johansson, Henrik Kehlet
BACKGROUND: Postoperative anemia is prevalent in fast-track hip arthroplasty (THA) where patients are mobilized and discharged early, but whether anemia impairs functional recovery after discharge has not been adequately evaluated previously. This study aimed to evaluate whether postoperative anemia influenced recovery of mobility and quality of life (Qol) during the first 2 weeks after discharge from THA. STUDY DESIGN AND METHODS: This was a prospective observational study in 122 THA patients more than 65 years of age...
April 2016: Transfusion
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