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https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#1
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29126382/analysis-of-medical-service-use-of-knee-osteoarthritis-and-knee-meniscal-and-ligament-injuries-in-korea-a-cross-sectional-study-of-national-patient-sample-data
#2
Chang Yong Suh, Yoon Jae Lee, Joon-Shik Shin, Jinho Lee, Me-Riong Kim, Wonil Koh, Yun-Yeop Cha, Byung-Cheul Shin, Eui-Hyoung Hwang, Kristin Suhr, Mia Kim, In-Hyuk Ha
BACKGROUND: Osteoarthritis (OA) and meniscal and ligament injuries of the knee are the two most common knee disorders in Korea. The aim of this study was to analyze the demographic characteristics, medical service use and related costs for these disorders, and the results are expected to help inform practitioners, researchers, and policy-makers. METHODS: The present study aimed to evaluate incidence and patient characteristics, and to assess current medical service use, usual care, and medical expenses of knee disorders by analyzing 2014 national patient sample data from the Korean Health Insurance Review and Assessment Service...
November 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29123665/the-characterisation-of-unexplained-pain-after-knee-replacement
#3
Jonathan Ra Phillips, Beverley Hopwood, Rowenna Stroud, Paul A Dieppe, Andrew D Toms
Background: The aims of this study were to characterise the pain experienced by patients with chronic pain after knee replacement (KR), in whom no apparent 'orthopaedic' problem could be identified, and to establish how many have pain sensitisation problems (including neuropathic pain). Methods: A total of 44 patients were prospectively evaluated at a multidisciplinary tertiary referral clinic by an orthopaedic surgeon, pain specialist, rheumatologist and physiotherapist...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29114630/unicompartmental-knee-arthroplasty-modes-of-failure-and-conversion-to-total-knee-arthroplasty
#4
REVIEW
Michele Vasso, Katia Corona, Rocco D'Apolito, Giuseppe Mazzitelli, Alfredo Schiavone Panni
Despite the excellent success rates of the modern unicompartmental knee arthroplasty (UKA), results of knee replacement registries still shows a relatively high revision and failure rate for UKA, especially when compared with traditional total knee arthroplasty (TKA). Bearing dislocation continues to be advocated as the predominant mechanism of failure in mobile UKA, whereas polyethylene wear and aseptic loosening remains the main cause of failure of fixed UKA. Degeneration of the unreplaced compartments has been reported in both mobile and fixed designs...
March 2017: Joints
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#5
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107492/is-rapid-recovery-hip-and-knee-replacements-possible-and-safe-in-the-octogenarian-patient
#6
Paul K Edwards, James R Kee, Simon C Mears, C Lowry Barnes
BACKGROUND: Rapid recovery programs are now aimed to reduce costs of hip and knee arthroplasties by discharging patients directly home, shortening hospital length of stay (LOS), and reducing readmission rates. Although patients aged 80 years and older are included in the Medicare bundle, little work has been performed to determine if older patients can safely participate in rapid recovery programs. METHODS: We retrospectively reviewed 2482 patients undergoing primary and revision total hip and knee arthroplasties (THA and TKA) who all participated in a multifaceted rapid recovery program...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29105532/early-aseptic-loosening-of-a-mobile-bearing-total-knee-replacement
#7
Ines Kutzner, Geir Hallan, Paul Johan Høl, Ove Furnes, Øystein Gøthesen, Wender Figved, Peter Ellison
Background and purpose - Registry-based studies have reported an increased risk of aseptic tibial loosening for the cemented Low Contact Stress (LCS) total knee replacement compared with other cemented designs; however, the reasons for this have not been established. We made a retrieval analysis with the aim of identifying the failure mechanism. Patients and methods - We collected implants, cement, tissue, blood, and radiographs from 32 failed LCS Complete cases. Damage to the tibial baseplate and insert was assessed...
November 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29102502/total-knee-replacement-cementless-tibial-fixation-with-screws-10-year-results
#8
Önder Ersan, Alper Öztürk, Mehmet Faruk Çatma, Serhan Ünlü, Mutlu Akdoğan, Yalım Ateş
BACKGROUND: The aim of this study was to evaluate the long term clinical and radiological results of cementless total knee replacement. METHODS: A total of 51 knees of 49 patients (33 female and 16 male; mean age: 61.6 years (range, 29-66 years)) who underwent TKR surgery with a posterior stabilized hydroxyapatite coated knee implant were included in this study. All of the tibial components were fixed with screws. The HSS scores were examined preoperatively and at the final follow-up...
November 1, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29101982/acr-appropriateness-criteria-%C3%A2-imaging-after%C3%A2-total%C3%A2-knee-arthroplasty
#9
Mary G Hochman, Yulia V Melenevsky, Darlene F Metter, Catherine C Roberts, Jenny T Bencardino, R Carter Cassidy, Michael G Fox, Mark J Kransdorf, Douglas N Mintz, Nehal A Shah, Kirstin M Small, Stacy E Smith, Kathy M Tynus, Barbara N Weissman
Total knee arthroplasty (TKA) is the most commonly performed joint replacement procedure in the United States and annual demand for primary TKA is expected to grow by 673% by 2030. The first part provides an overview of imaging modalities (radiographs, CT, MRI, ultrasound, and various nuclear medicine studies) and discusses their usefulness in the imaging evaluation of TKA. The second part focuses on evidence-based imaging and imaging-guided intervention algorithms for the workup of TKA and its complications, including routine follow-up, component wear, periprosthetic infection, aseptic loosening, granulomas/osteolysis, conventional and rotational instability, periprosthetic fracture, patellar complications, and a variety of periprosthetic soft tissue abnormalities...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29096686/vaso-vitamin-d-and-arthroplasty-surgery-outcomes-study-supplementation-of-vitamin-d-deficiency-to-improve-outcomes-after-total-hip-or-knee-replacement-study-protocol-for-a-randomised-controlled-feasibility-trial
#10
Rory J M Morrison, Deborah Bunn, William K Gray, Paul N Baker, Craig White, Amar Rangan, Kenneth S Rankin, Mike R Reed
BACKGROUND: Vitamin D deficiency has been linked to poor outcomes after total hip replacement (THR) or total knee replacement (TKR), including lower patient-reported outcome measures (PROMs), peri-prosthetic infection and longer hospital stay. We present a randomised feasibility trial protocol designed to prospectively investigate the influence of vitamin D testing, and subsequent supplementation for deficiency, prior to THR/TKR. METHODS/DESIGN: One hundred adult patients undergoing primary THR/TKR for osteoarthritis at two NHS hospital trusts in North East England will be recruited...
November 2, 2017: Trials
https://www.readbyqxmd.com/read/29094006/neuropathic-pain-like-symptoms-and-pre-surgery-radiographic-severity-contribute-to-patient-satisfaction-4-8-years-post-total-joint-replacement
#11
Sophie C Warner, Helen Richardson, Wendy Jenkins, Thomas Kurien, Michael Doherty, Ana M Valdes
AIM: To investigate a comprehensive range of factors that contribute to long-term patient satisfaction post-total joint replacement (TJR) in people who had undergone knee or hip replacement for osteoarthritis. METHODS: Participants (n = 1151) were recruited from Nottinghamshire post-total hip or knee replacement. Questionnaire assessment included medication use, the pain-DETECT questionnaire (PDQ) to assess neuropathic pain-like symptoms (NP) and TJR satisfaction measured on average 4...
October 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29083362/periprosthetic-knee-infection-two-stage-revision-surgery
#12
Tommaso Bonanzinga, Giuseppe Tanzi, Francesco Iacono, Matteo Carlo Ferrari, Maurilio Marcacci
Periprosthetic joint infection (PJI) remains a serious complication following a total joint replacement.  Diagnosis and management of PJI is challenging for surgeons since there is no "gold standard". This challenging condition requires a coordinated management approach to achieve good patient outcomes. Further difficulties involve choosing the optimal method to treat the periprosthetic joint infection. In this article, it is stressed the role of the two-stage revision: implant removal, debridement and placement of an antibiotic spacer, and antibiotic therapy with cessation prior to reimplantation...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29083348/cementless-knee-arthroplasty
#13
Lorenzo Ponziani, Francesco Di Caprio, Renato Meringolo
Total knee replacement is a common treatment for advanced knee osteoarthritis. The most common and widespread method is cemented arthroplasty. As in the prosthetic hip a gradual transition from cemented to uncemented fixation techniques occurred over time, increasing interest is growing also around cementless knee fixation, with the theoretical advantages of preserving the bone stock and obtaining a biological fixation avoiding cement fragmentation. On the basis of the actual knowledge, the uncemented knee prosthesis represents an interesting alternative especially for the patient under 65 years of age, with viable bone quality, in which a biological bone-prosthesis fixation is desirable, while avoiding the drawbacks of cement fragmentation and of the possible future revision of a cemented implant...
October 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29032861/patellar-resurfacing-in-total-knee-arthroplasty-systematic-review-and-meta-analysis
#14
REVIEW
Umile G Longo, Mauro Ciuffreda, Nicholas Mannering, Valerio D'Andrea, Matteo Cimmino, Vincenzo Denaro
BACKGROUND: Patellar resurfacing in total knee arthroplasty remains controversial. The aim of this study is to evaluate this technique through an analysis of comparative studies in the current literature. METHODS: We performed a comprehensive search of PubMed, MEDLINE, Cochrane, CINAHL, and EMBASE databases using various combinations of the keywords "Knee," "Replacement," "Prosthesis," "Patella," "Resurfacing," and "Arthroplasty." All articles relevant to the subject were retrieved, and their bibliographies were hand searched for further references relevant to primary patellar resurfacing in total knee arthroplasty...
September 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28983214/factors-associated-with-choice-and-success-of-one-versus-two-stage-revision-arthroplasty-for-infected-hip-and-knee-prostheses
#15
Lucas Castellani, Nick Daneman, Samira Mubareka, Richard Jenkinson
BACKGROUND: Prosthetic joint infections (PJI) of hip and knee arthroplasties are becoming increasingly common with an aging population and an increasing demand for these procedures. Despite attempts at standardization, medical and surgical approaches vary widely among practitioners. QUESTIONS/PURPOSES: We first sought to determine if there were specific factors associated with choice of one- versus two-stage revision. Then we investigated whether the type of revision approach influenced clinical treatment success...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28974402/up-to-10-year-follow-up-of-the-oxford-domed-lateral-partial-knee-replacement-from-an-independent-centre
#16
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/28974377/persistent-opioid-use-following-total-knee-arthroplasty-a-signal-for-close-surveillance
#17
Robert S Namba, Maria C S Inacio, Nicole L Pratt, Stephen E Graves, Elizabeth E Roughead, Elizabeth W Paxton
BACKGROUND: Prolonged opioid use following total knee arthroplasty (TKA) has not been extensively studied. METHODS: A cohort study of primary TKA for osteoarthritis using an integrated healthcare system and Total Joint Replacement Registry (January 2008-December 2011) was conducted. Opioid use during the first year after TKA was the exposure of interest and cumulative daily oral morphine equivalent (OME) amounts were calculated. Total postsurgical OME per 90-day exposure periods were categorized into quartiles...
September 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28951054/recent-trends-in-blood-utilization-after-revision-hip-and-knee-arthroplasty
#18
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/28929828/increased-risk-of-aseptic-loosening-for-43-525-rotating-platform-vs-fixed-bearing-total-knee-replacements
#19
MULTICENTER STUDY
Oystein Gothesen, Stein Hakon L Lygre, Michelle Lorimer, Stephen Graves, Ove Furnes
Background and purpose - Given similar functional outcomes with mobile and fixed bearings, a difference in survivorship may favor either. This study investigated the risk of aseptic loosening for the most used subtypes of mobile-bearing rotating-platform knees, in Norway and Australia. Patients and methods - Primary TKRs reported to the Norwegian and Australian joint registries, between 2003 and 2014, were analyzed with aseptic loosening as primary end-point and all revisions as secondary end-point. We hypothesized that no difference would be found in the rate of revision between rotating-platform and the most used fixed-bearing TKRs, or between keeled and non-keeled tibia...
December 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28878516/enhanced-recovery-principles-applied-to-revision-hip-and-knee-arthroplasty-reduces-length-of-stay-and-blood-transfusion
#20
Michael Kent, Nick Calvert, Kevin Blades, Alex Swann, Piers Yates
INTRODUCTION: This is the first study reporting the application of Enhanced Recovery Principles (ERP) to revision arthroplasty. METHOD: Retrospective series of 132 revision hip and knee replacements treated with ERP. RESULTS: Infiltration was associated with reduced LOS in knees (6 vs 8.5 days), lower PCA usage and incidence of transfusion in knees (2 vs 3 days) and hips (1 vs 6 days). Revisions for infection had a longer LOS (5.4 vs 11...
December 2017: Journal of Orthopaedics
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