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https://www.readbyqxmd.com/read/28737635/reducing-length-of-stay-direct-cost-and-readmissions-in-total-joint-arthroplasty-patients-with-an-outcomes-manager-led-interprofessional-team
#1
Melissa Arana, Licia Harper, Huanying Qin, Jay Mabrey
The purpose of this quality improvement project was to determine whether an outcomes manager-led interprofessional team could reduce length of stay and direct cost without increasing 30-day readmission rates in the total joint arthroplasty patient population. The goal was to promote interprofessional relationships combined with collaborative practice to promote coordinated care with improved outcomes. Results from this project showed that length of stay (total hip arthroplasty [THA] reduced by 0.4 days and total knee arthroplasty [TKA] reduced by 0...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737077/systematic-screening-of-adverse-reactions-to-metal-debris-after-recap-m2a-magnum-metal-on-metal-total-hip-arthroplasty
#2
H Mäntymäki, M Junnila, P Lankinen, M Seppänen, T Vahlberg, K T Mäkelä
BACKGROUND AND AIMS: An adverse reaction to metal debris is a known complication after large diameter head metal-on-metal total hip arthroplasty. However, the failure rate varies depending on the implant design. Therefore, we investigated the prevalence of adverse reaction to metal debris, as well as the symptoms and risk factors after undergoing a ReCap-M2a-Magnum large diameter head metal-on-metal total hip arthroplasty. MATERIALS AND METHODS: Between 2005 and 2012, 1188 patients (1329 hips) underwent ReCap-M2a-Magnum total hip arthroplasty at our institution...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#3
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735805/impact-of-definition-and-timeframe-on-capturing-surgery-related-readmissions-after-primary-joint-arthroplasty
#4
Brian P Chen, Johanna Dobransky, Stephane Poitras, Alan Forster, Paul E Beaulé
BACKGROUND: Readmission rate has emerged as an important metric to measure quality, but varying definitions and timeframes are used. We aimed to evaluate the impact of different readmission definitions (postoperative vs postdischarge) and timeframes (30 vs 90-day) on capturing surgery-related readmissions after primary total joint arthroplasty. METHODS: Patients who underwent primary total hip or knee arthroplasty between January 1, 2013 and December 31, 2015 were included...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735804/effect-of-type-2-diabetes-on-in-hospital-postoperative-complications-and-mortality-after-primary-total-hip-and-knee-arthroplasty
#5
Maria A Martínez-Huedo, Rodrigo Jiménez-García, Isabel Jiménez-Trujillo, Valentín Hernández-Barrera, Benito Del Rio Lopez, Ana López-de-Andrés
BACKGROUND: We aimed to compare in-hospital postoperative complications (IHPC) and in-hospital mortality between patients with and without type 2 diabetes mellitus (T2DM) undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: We analyzed data from the Spanish National Hospital Discharge Database, 2010-2014. We selected patients who had undergone THA (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code 81...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735803/transfusion-thresholds-for-major-orthopedic-surgery-a-systematic-review-and-meta-analysis
#6
Matthew D Mitchell, Joel S Betesh, Jaimo Ahn, Eric L Hume, Samir Mehta, Craig A Umscheid
BACKGROUND: More than a million surgeries are performed annually in the United States for hip or knee arthroplasty or hip fracture stabilization. One-fifth of these patients have blood transfusions during their hospital stay. Increases in transfusion rates have caused concern about increased adverse events from unnecessary transfusions. METHODS: We systematically reviewed randomized trials examining the effect of restrictive vs liberal transfusion thresholds on patients having major orthopedic surgery...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735801/prior-arthroscopy-leads-to-inferior-outcomes-in-total-hip-arthroplasty-a-match-controlled-study
#7
Itay Perets, Yosif Mansor, Brian H Mu, John P Walsh, Victor Ortiz-Declet, Benjamin G Domb
BACKGROUND: Total hip arthroplasty (THA) is one of the most common reoperations after hip arthroscopy. Although arthroscopy causes changes in the hip joint and the surrounding soft tissues that can make THA more challenging, previous reports on arthroscopy before THA have not demonstrated any significant effect on clinical outcomes. METHODS: Patients who underwent a THA following an ipsilateral hip arthroscopy were matched to a control group of THA patients with no history of ipsilateral hip surgery...
July 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735800/durability-of-hemiarthroplasty-for-pathologic-proximal-femur-fractures
#8
Matthew T Houdek, Cody C Wyles, Joshua R Labott, Peter S Rose, Michael J Taunton, Franklin H Sim
BACKGROUND: The hip is a common location for metastatic tumors. Due to the high loads placed through the proximal femur, surgery is often indicated to provide pain relief and restore function. Historically, these lesions are reconstructed with a hemiarthroplasty; however, there are few reports on the outcome of these reconstructions. The purpose of this study is to evaluate the outcome of hemiarthroplasty for the treatment of proximal femur metastatic disease, with a specific focus on the rates of conversion to total hip arthroplasty (THA)...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735470/staged-reimplantation-of-a-total-hip-prosthesis-after-co-infection-with-candida-tropicalis-and-staphylococcus-haemolyticus-a-case-report
#9
Sujeesh Sebastian, Rajesh Malhotra, Ashish Pande, Deepak Gautam, Immaculata Xess, Benu Dhawan
Fungal prosthetic joint infection is a rare complication in total joint arthroplasty. There are no established guidelines for management of these infections. We present a case of a 53-year-old male with a hip joint prosthesis co-infected with Candida tropicalis and Staphylococcus haemolyticus. A two-stage exchange arthroplasty was performed. The patient underwent implant removal, debridement, irrigation with saline solution and application of cement spacer impregnated with vancomycin followed by aggressive antimicrobial treatment in first stage...
July 22, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28735246/nurses-reports-of-staffing-adequacy-and-surgical-site-infections-a-cross-sectional-multi-centre-study
#10
Christine Tvedt, Ingeborg Strømseng Sjetne, Jon Helgeland, Hege Line Løwer, Geir Bukholm
BACKGROUND: It is indicated that healthcare personnel's perceptions of the work environment may reflect the clinical outcomes for the patients they care for. However, the body of evidence is inconsistent when it comes to the association between work environment and surgical site infection. OBJECTIVES: The aim of this study is to examine the associations between nurse-reported characteristics of the work environment and incidence of surgical site infections after total hip arthroplasty...
July 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28734615/highly-cross-linked-polyethylene-reduces-osteolysis-incidence-and%C3%A2-wear-related-reoperation-rate-in-cementless-total-hip-arthroplasty%C3%A2-compared-with-conventional-polyethylene-at%C3%A2-a%C3%A2-mean%C3%A2-12-year-follow-up
#11
Manabu Tsukamoto, Toshiharu Mori, Hideo Ohnishi, Soshi Uchida, Akinori Sakai
BACKGROUND: A number of studies on total hip arthroplasty have compared highly cross-linked polyethylene (HXLPE) with conventional polyethylene (CPE) liners beyond 10 years. However, the impact of HXLPE on the wear-related reoperation rate is unclear. The purpose of this study was to evaluate the clinical advantage of using a single manufacturer's HXLPE in terms of reducing the reoperation rate. METHODS: The study was a follow-up retrospective cohort study over a mean of 12 years that examined patients aged 45-70 years with cementless total hip arthroplasty using a 26-mm-diameter cobalt-chromium head...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734614/correlation-of-the-caprini-score-and-venous-thromboembolism-incidence-following-primary-total-joint-arthroplasty-results-of-a-single-institution-protocol
#12
Dexter K Bateman, Robert W Dow, Andrzej Brzezinski, Howard Y Bar-Eli, Stephen T Kayiaros
BACKGROUND: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis, is a serious complication after total joint arthroplasty (TJA). Risk assessment models are increasingly used to provide patient-specific risk stratification. A recently implemented protocol mandates calculation of a Caprini Score for all surgical patients at our institution. We investigated the accuracy of the Caprini Score in predicting VTE events following TJA. METHODS: A retrospective review of patients undergoing primary total hip (THA) and total knee arthroplasty (TKA) over a 1-year time period was performed...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734611/survivorship-of-a-porous-tantalum-monoblock-acetabular-component-in-primary-hip-arthroplasty-with-a-mean-follow-up-of-18-years
#13
George A Macheras, Panagiotis Lepetsos, Andreas O Leonidou, Panagiotis P Anastasopoulos, Spyridon P Galanakos, Lazaros A Poultsides
BACKGROUND: The use of porous tantalum for the acetabular component in primary total hip arthroplasty (THA) has demonstrated excellent short-term and midterm results. However, long-term data are scarce. The purpose of this prospective study is to report the long-term clinical and radiologic outcome following use of an uncemented porous tantalum acetabular component in primary THA with a minimum follow-up of 17.5 years, in a previously studied cohort of patients. METHODS: We prospectively followed 128 consecutive primary THAs in 140 patients, between November 1997 and June 1999...
July 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28733672/trainee-surgeons-affect-operative-time-but-not-outcome-in-minimally-invasive-total-hip-arthroplasty
#14
Markus Weber, Achim Benditz, Michael Woerner, Daniela Weber, Joachim Grifka, Tobias Renkawitz
Training of young surgeons in total hip arthroplasty (THA) is crucial, but might affect operative time and outcome especially in minimally invasive (MIS) THA. We asked whether the learning curve of orthopaedic residents trained on MIS THA has an impact on (1) operative time (2) complication rates and (3) early postoperative outcome. In a retrospective analysis of over 1000 MIS THAs from our institutional joint registry, operative time, complication rates, patient reported outcome measures (Western Ontario and McMaster Universities Arthritis Index [WOMAC] and Euro-Qol 5D-5L [EQ-5D]) within the first year and responder rates for positive outcome as defined by the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus responder (OMERACT-OARSI) criteria were compared between trainee and senior surgeons...
July 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28733296/a-unified-multi-level-model-approach-to-assessing-patient-responsiveness-including-return-to-normal-minimally-important-differences-and-minimal-clinically-important-improvement-for-patient-reported-outcome-measures
#15
Adrian Sayers, Vikki Wylde, Erik Lenguerrand, Rachael Gooberman-Hill, Jill Dawson, David Beard, Andrew Price, Ashley W Blom
OBJECTIVE: This article reviews and compares four commonly used approaches to assess patient responsiveness with a treatment or therapy (return to normal (RTN), minimal important difference (MID), minimal clinically important improvement (MCII), OMERACT-OARSI [Outcome Measures in Rheumatology-Osteoarthris Reseach Society International] (OO)) and demonstrates how each of the methods can be formulated in a multilevel modelling (MLM) framework. DESIGN: Cohort study...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28731779/arthroscopic-labral-base-repair-in-the-hip-5-year-minimum-clinical-outcomes
#16
Benjamin G Domb, Leslie C Yuen, Victor Ortiz-Declet, Jody Litrenta, Itay Perets, Austin W Chen
BACKGROUND: Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28731488/contamination-risk-of-synovial-biopsy-cultures-in-total-hip-arthroplasty-a-prospective-review-of-100-cases
#17
Christophe Pattyn, Thomas De Bo, Joris Anthonissen, Philippe Willekens, Geert Claeys, Emmanuel A Audenaert
INTRODUCTION: Cultures of deep synovial biopsies remain an important tool in diagnosing periprosthetic joint infection, a devastating complication following total hip arthroplasty (THA). Recent reports of unexpected positive intraoperative cultures in aseptic revision arthroplasty, however, challenge the validity and interpretation of these cultures. The aim of this study was to evaluate the contamination risk of synovial biopsy cultures collected intraoperatively during primary THA of healthy subjects...
July 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28731487/intraoperative-fluoroscopy-with-a-direct-anterior-approach-reduces-variation-in-acetabular-cup-abduction-angle
#18
Gens P Goodman, Nitin Goyal, Nancy L Parks, Robert H Hopper, William G Hamilton
INTRODUCTION: The purpose of this study was to compare acetabular cup position for 2 cohorts of total hip arthroplasty (THA) patients who had a direct anterior approach. METHODS: 100 THA cases were performed with an anterior approach using intraoperative fluoroscopy (IF) to aid in cup positioning. Another group of 100 cases underwent THA with an anterior approach without the use of any fluoroscopy. Postoperative abduction and anteversion angles were measured using Martell's hip analysis software...
July 19, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28730395/dynamic-hip-screw-and-fibular-strut-graft-for-fixation-of-fresh-femoral-neck-fracture-with-posterior-comminution
#19
Adham Elgeidi, Abed El Negery, M Serry Abdellatif, Nabil El Moghazy
INTRODUCTION: Posterior comminution of the femoral neck fracture is a major cause of delayed and non-union owing to the loss of the buttressing effect against the posterior rotation. When a femoral neck fracture with posterior comminution is anatomically reduced, only the anterior portions of the femoral neck fracture surfaces are brought into contact leaving a posterior defect. The purpose of this study was to evaluate the use of fibular strut grafting and dynamic hip screw (DHS) for fresh femoral neck fractures with posterior comminution in young patient less than 50 years...
July 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28729306/hospital-variation-in-allogeneic-transfusion-and-extended-length-of-stay-in-primary-elective-hip-and-knee-arthroplasty-a-cross-sectional-study
#20
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Cynthia So-Osman, M Elske van den Akker-van Marle, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
OBJECTIVES: Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. DESIGN: Cross-sectional medical record review study...
July 20, 2017: BMJ Open
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