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Partial knee replacement

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https://www.readbyqxmd.com/read/29777717/analysis-of-the-postoperative-periarticular-environment-and-influence-on-sustained-drug-delivery-from-a-gel-formulation
#1
Darren Svirskis, Waldron Martis, Prabhat Bhusal, Manisha Sharma, Renus Stowers, Simon W Young
Regional intraarticular delivery of local anaesthetics is effective in treating postoperative pain following total knee or hip replacement. Recent research efforts have been only partially successful in achieving sustained release of the analgesic agent, in part due to limited understanding of the biological environment into which these formulations are administered. This study aimed to detail the composition and properties of postoperative periarticular fluid (PO-PAF). PO-PAF was collected from 8 patients and the composition and physicochemical properties determined...
May 16, 2018: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29757137/reversal-of-apixaban-induced-alterations-in-haemostasis-by-different-coagulation-factor-concentrates-in-patients-after-hip-or-knee-replacement-surgery
#2
Katrin Schmidt, Kerstin Krüger, Elisabeth Langer, Martin Schmutzler, Elke Johnen, Klaus D Wernecke, Christian Von Heymann, Mareike K Körber
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) with a specific inhibition of activated factor X (FXa). In case of bleeding or need of urgent surgery a direct antidote is not yet available. Off-label application of non-specific haemostatic agents, such as prothrombin complex concentrate (PCC) and recombinant FVIIa (rFVIIa), has been reported to reverse the effects of apixaban in in vitro and animal studies. The aim of this study is to measure the reversal potential of PCC and rFVIIa in patients with prophylactic apixaban concentrations...
May 11, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29731320/the-largest-survivorship-and-clinical-outcomes-study-of-the-fixed-bearing-stryker-triathlon-partial-knee-replacement-a-multi-surgeon-single-centre-cohort-study-with-a-minimum-of-two-years-of-follow-up
#3
S W F Middleton, P J Schranz, V I Mandalia, A D Toms
BACKGROUND: The surgical management of isolated medial compartment degenerative disease of the knee causes debate. Unicompartmental arthroplasty options include fixed and mobile bearing implant designs with fixed bearing becoming increasingly popular. We present the largest cohort of a fixed bearing single radius design, Stryker Triathlon Partial Knee Replacement (PKR). METHODS: We prospectively collected demographic data and patient reported outcome measures (PROMs) on our cohort of PKR implants since its adoption in our unit, 2009 until March 2015...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29663192/human-knee-meniscus-regeneration-strategies-a-review-on-recent-advances
#4
REVIEW
Mamatha M Pillai, J Gopinathan, R Selvakumar, Amitava Bhattacharyya
PURPOSE OF REVIEW: Lack of vascularity in the human knee meniscus often leads to surgical removal (total or partial meniscectomy) in the case of severe meniscal damage. However, complete recovery is in question after such removal as the meniscus plays an important role in knee stability. Thus, meniscus tissue regeneration strategies are of intense research interest in recent years. RECENT FINDINGS: The structural complexity and inhomogeneity of the meniscus have been addressed with processing technologies for precisely controlled three dimensional (3D) complex porous scaffold architectures, the use of biomolecules and nanomaterials...
April 16, 2018: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/29657460/a-quality-improvement-project-decreases-incidence-of-pulmonary-embolism-following-arthroplasty
#5
Iyad Eid, Dane Moran, Lynn Morrison, Eyad HajHussein, Hanna Hill, Rasha Ansari, Tammy Williams, Mojieb Manzary
Objective: To develop a quality improvement initiative to reduce the incidence of pulmonary embolism (PE) following elective lower extremity joint replacement surgery. Methods: 866 Patients undergoing a total knee or total or partial hip replacement surgery at a from 2014 to 2016 were included in this prospective pre-post interventional study. Results: There were 13 PE's before the intervention and 2 after the intervention. The incidence of PE was significantly higher prior to the intervention (2...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29560397/biarticular-total-femur-spacer-for-massive-femoral-bone-loss-the-mobile-solution-for-a-big-problem
#6
Pablo Sanz-Ruiz, Jose Antonio Calvo-Haro, Manuel Villanueva-Martinez, Jose Antonio Matas-Diez, Javier Vaquero-Martín
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29559252/targeting-%C3%AE-catenin-dependent-wnt-signaling-via-peptidomimetic-inhibitors-in-murine-chondrocytes-and-oa-cartilage
#7
A Held, A Glas, L Dietrich, M Bollmann, K Brandstädter, T N Grossmann, C H Lohmann, T Pap, J Bertrand
OBJECTIVE: The canonical Wnt signaling pathway has been shown to be involved in regulating chondrocyte hypertrophic differentiation during OA. The aim of this study was to test the therapeutic potential of two stapled peptide canonical Wnt inhibitors - SAH-Bcl9 and StAx-35R - in preventing Wnt induced cartilage changes in OA. METHODS: Primary neonatal murine chondrocytes and cartilage explants from OA patients undergoing total joint replacement for knee OA, were used for microscopy to determine matrix and cell penetrating capacity of FITC-tagged SAH-Bcl9 and StAx-35R peptides...
March 17, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29548618/outpatient-focused-joint-arthroplasty-is-the-future-the-midwest-center-for-joint-replacement-experience
#8
Michael E Berend, Wesley G Lackey, Joshua L Carter
BACKGROUND: Perhaps, the most significant developments in joint arthroplasty in the past decade have been in the area of multimodal perioperative management reducing pain, nausea, and length of stay leading to outpatient arthroplasty. METHODS: Over a 2-year period, we performed 1230 arthroplasty cases including partial knee, total hip, total knee, and selected revision cases. RESULTS: Patient satisfaction ranged from 98% to 100% great/good...
June 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29386912/safety-and-efficacy-of-subcutaneous-tanezumab-in-patients-with-knee-or-hip-osteoarthritis
#9
Charles Birbara, Eugene J Dabezies, Aimee M Burr, Robert J Fountaine, Michael D Smith, Mark T Brown, Christine R West, Rosalin H Arends, Kenneth M Verburg
Background/objective: The objective of this study was to investigate the safety and efficacy of subcutaneous (SC) and intravenous (IV) tanezumab administration in osteoarthritis (OA) patients. Materials and methods: Study 1027 (NCT01089725), a placebo-controlled trial, evaluated the efficacy of SC tanezumab (ie, 2.5, 5, and 10 mg) and the therapeutic equivalence of 10 mg tanezumab given subcutaneously versus intravenously every 8 weeks in the symptomatic treatment of OA...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29298664/the-prevention-of-delirium-in-elderly-with-obstructive-sleep-apnea-podesa-study-protocol-for-a-multi-centre-prospective-randomized-controlled-trial
#10
Jean Wong, David Lam, Stephen Choi, Mandeep Singh, Naveed Siddiqui, Sanjeev Sockalingam, Frances Chung
BACKGROUND: Delirium is a common problem that occurs in 5-50% of elderly individuals following surgery. Patients who develop delirium after surgery are at increased risk for serious complications. Recent studies suggest that patients with obstructive sleep apnea (OSA), a sleep disorder characterized by repeated episodes of complete or partial blockage of the upper airway - are at greater risk to develop delirium. OSA is more common in elderly individuals but is often undiagnosed. Identification and treatment of unrecognized OSA may reduce the incidence of postoperative delirium...
January 3, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29154233/objective-assessment-of-knee-proprioception-and-sensorimotor-function-in-patients-with-primary-gonarthrosis-before-and-after-knee-replacement
#11
Anna Hadamus, Dariusz Białoszewski
The sensorimotor system is a complicated tool allowing for maintaining body balance and responding to changing environmental conditions to prevent injury. It is difficult to objectively assess the function of balance control mechanisms due to the multidimensional nature of the sensorimotor system and multitude of variables that may interfere with the measurement. The function of the sensorimotor system is considerably compromised in osteoarthritis, including gona-rthro-sis. The knee is the second most common location of osteoarthritis, after the hip, and total or partial replacement surgery of the knee joint represents the therapy of choice in advanced stages of the condition...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/29138892/-partial-and-complete-joint-transplantation-with-fresh-osteochondral-allografts-the-flocsat-concept
#12
REVIEW
C Krettek, J-D Clausen, N Bruns, C Neunaber
Cartilage defects in adult patients do not heal well. Fresh osteochondral allograft (OCA) transplantation is based on mature, living, mechanically sound hyaline cartilage attached to a bone interface, which is brought into an osteochondral defect, where it becomes osseointegrated. According to current knowledge, intact hyaline cartilage tissue is immune privileged and does not, in contrast to bone, meniscus or ligaments, cause an immune reaction. The technique has the unique advantage of transplanting viable, mature and mechanically stable hyaline cartilage into the affected area...
November 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29119286/no-effect-of-topical-application-of-tranexamic-acid-on-articular-cartilage
#13
Luiz Felipe Ambra, Laura de Girolamo, Wanting Niu, Amy Phan, Myron Spector, Andreas H Gomoll
PURPOSE: The objective of this study was to evaluate potential cytotoxicity of TXA on articular cartilage by assessing chondrocyte viability of osteochondral explants after exposure to different concentrations and durations of TXA. METHODS: Thirty-nine osteochondral plugs (OCPs) were harvested from three adult Yucatan minipigs immediately after their death. OCPs were divided into 13 groups exposed to different concentrations of TXA (1, 2 and 4 mg/ml in saline solution) for 1, 3 and 6 h...
November 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29109026/a-low-friction-biphasic-and-boundary-lubricating-hydrogel-for-cartilage-replacement
#14
Piers E Milner, Maria Parkes, Jennifer L Puetzer, Robert Chapman, Molly M Stevens, Philippa Cann, Jonathan R T Jeffers
Partial joint repair is a surgical procedure where an artificial material is used to replace localised chondral damage. These artificial bearing surfaces must articulate against cartilage, but current materials do not replicate both the biphasic and boundary lubrication mechanisms of cartilage. A research challenge therefore exists to provide a material that mimics both boundary and biphasic lubrication mechanisms of cartilage. In this work a polymeric network of a biomimetic boundary lubricant, poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC), was incorporated into an ultra-tough double network (DN) biphasic (water phase + polymer phase) gel, to form a PMPC triple network (PMPC TN) hydrogel with boundary and biphasic lubrication capability...
January 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/28974402/up-to-10-year-follow-up-of-the-oxford-domed-lateral-partial-knee-replacement-from-an-independent-centre
#15
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...
December 2017: Knee
https://www.readbyqxmd.com/read/28887704/-indication-and-limitations-of-meniscus-replacement
#16
REVIEW
C Stärke, S Kopf, R Becker
BACKGROUND: Meniscal lesions are among the most important musculoskeletal disorders and are the most common indication for knee joint arthroplasty. However, the structural integrity and function is rarely retained, and a loss of tissue results. Thus, there is a huge demand for meniscal replacement options. CURRENT PROCEDURES: Autografts were used in the past but did not fulfill expectations. Meniscus allografts have been developed to be a viable treatment option...
October 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28805136/-the-ovine-model-for-meniscus-tissue-engineering-considerations-of-anatomy-function-implantation-and-evaluation
#17
Andrzej Brzezinski, Salim A Ghodbane, Jay M Patel, Barbara A Perry, Charles J Gatt, Michael G Dunn
Meniscus injuries represent one of the most-common intra-articular knee injuries. The current treatment options include meniscectomy and allograft transplantation, both with poor long-term outcomes. Therefore, there is a need for regenerative techniques to restore meniscal function. To preclinically test scaffolds for meniscus replacement, large animal models need to be established and standardized. This review establishes the anatomical and compositional similarities between human and sheep menisci and provides guidance for implantation and evaluation of such devices...
December 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28681269/a-retrospective-assessment-of-prognostication-in-456-685-patients-undergoing-elective-major-non-cardiac-surgery
#18
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...
September 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28610776/two-stage-late-reconstruction-with-a-fresh-large-osteochondral-shell-allograft-transplantation-flocsat-for-a-large-ostechondral-defect-in-a-non-union-after-a-lateral-tibia-plateau-fracture-2-year-follow-up
#19
C Krettek, J Clausen, M Omar, S Noack, C Neunaber
This is the description of a 58-year-old female patient presenting 8 months after a horse riding accident with significant pain and inability to walk independently. Imaging revealed a large osseous defect of the lateral tibia plateau which was not united posteriorly. The patient refused knee replacement and we developed a patient specific two-step procedure for her. Step 1: Filling of the defect with a large cortico-cancellous autograft from the posterior iliac crest; step 2: Transplantation of a fresh large osteochondral shell allograft (FLOCSAT)...
July 2017: Injury
https://www.readbyqxmd.com/read/28609474/effects-of-perceptions-of-care-medical-advice-and-hospital-quality-on-patient-satisfaction-after-primary-total-knee-replacement-a-cross-sectional-study
#20
MULTICENTER STUDY
Tom Schaal, Tonio Schoenfelder, Joerg Klewer, Joachim Kugler
INTRODUCTION: The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction...
2017: PloS One
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