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https://www.readbyqxmd.com/read/28241434/data-collection-and-analysis-using-wearable-sensors-for-monitoring-knee-range-of-motion-after-total-knee-arthroplasty
#1
Chih-Yen Chiang, Kun-Hui Chen, Kai-Chun Liu, Steen Jun-Ping Hsu, Chia-Tai Chan
Total knee arthroplasty (TKA) is the most common treatment for degenerative osteoarthritis of that articulation. However, either in rehabilitation clinics or in hospital wards, the knee range of motion (ROM) can currently only be assessed using a goniometer. In order to provide continuous and objective measurements of knee ROM, we propose the use of wearable inertial sensors to record the knee ROM during the recovery progress. Digitalized and objective data can assist the surgeons to control the recovery status and flexibly adjust rehabilitation programs during the early acute inpatient stage...
February 22, 2017: Sensors
https://www.readbyqxmd.com/read/28241088/clinical-outcome-of-total-knee-arthroplasty-after-prior-microfracture-a-matched-cohort-study
#2
Mohammad Humza Ansari, Ayoosh Pareek, Nick R Johnson, Matthew P Abdel, Michael J Stuart, Aaron J Krych
Microfracture (MFX) is a common operation for articular cartilage lesions. Data for patients who underwent total knee arthroplasty (TKA) after previous MFX are limited. The purpose of this study was to determine the outcomes, complications, and factors that influence outcomes in patients with previous MFX compared with those without previous MFX. Between 2005 and 2014, twenty-one TKAs were performed at a single tertiary care academic institution in patients with prior history of MFX surgery. These patients were retrospectively reviewed and matched 2:1 to patients who did not undergo previous MFX (n=42)...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28241085/using-accelerometer-based-portable-navigation-to-perform-accurate-total-knee-arthroplasty-bone-resection-in-asian-patients
#3
Hideki Ueyama, Yoshio Matsui, Yukihide Minoda, Masanori Matsuura, Hiroaki Nakamura
Implant alignment is an important factor affecting clinical results associated with total knee arthroplasty (TKA). No report exists showing the utility of an accelerometer-based portable navigation system among patients with marked femoral bowing. The aim of this study was to evaluate the accuracy of a portable navigation system for implant alignment in Asian patients with marked femoral bowing. The authors evaluated 142 consecutive TKAs performed for primary osteoarthritis since July 2013. A portable navigation system was used in 67 knees, and a conventional jig was used in 75 knees...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28240756/assessment-and-therapeutic-choice-in-septic-arthritis-of-the-hip-in-an-intravenous-drug-abuser-case-report-at-14-years-follow-up-and-review-of-literature
#4
P Persiani, F M Ranaldi, O Mazza, A Calistri, M Bove, M Crostelli, C Villani
INTRODUCTION: Osteoarticular infections are found frequently in drug addicted individuals, representing one of the main reasons for their hospitalization. Through inoculation, the pathogenic agents can enter the individual's system directly through the skin or parenterally, transmitted, that is, through syringes and other objects used during such practice. In these particular conditions, or when the medical history is vague, a warranted suspicion and the execution of targeted research can help in the diagnosis of high-risk patients such as addicts...
January 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28238584/perioperative-and-early-postoperative-comparison-of-a-modern-cemented-and-cementless-total-knee-arthroplasty-of-the-same-design
#5
Denis Nam, Judith E Kopinski, Zachary Meyer, Richard D Rames, Ryan M Nunley, Robert L Barrack
BACKGROUND: Cementless total knee arthroplasty (TKA) designs that incorporate a highly porous, titanium surface have the potential to achieve biologic fixation and improve component survivorship. This study's purpose was to compare perioperative and early postoperative outcomes of a cemented vs cementless TKA of the same design. METHODS: This was a retrospective review of a consecutive series of TKAs performed at a single institution using a cemented or cementless TKA of the same design (Triathlon, Stryker Inc, Mahwah, NJ)...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28238583/intra-articular-knee-injections-before-total-knee-arthroplasty-outcomes-and-complication-rates
#6
Brent A Kokubun, Gregory C Manista, P Maxwell Courtney, Sean M Kearns, Brett R Levine
BACKGROUND: The relationship between intra-articular injections and complication rates after total knee arthroplasty (TKA) remains controversial. This study's purpose was to determine the relationship between the number and timing of intra-articular injections with complications and outcomes after TKA from a single surgeon's database. METHODS: We retrospectively reviewed a series of 442 patients who underwent primary TKA from 2008-2015. Patient demographics, comorbidities, number and timing of ipsilateral intra-articular injections, and preoperative and postoperative functional outcome scores were recorded...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28237217/outcomes-of-newer-generation-cementless-total-knee-arthroplasty-beaded-periapatite-coated-vs-highly-porous-titanium-coated-implants
#7
Steven F Harwin, Nirav K Patel, Morad Chughtai, Anton Khlopas, Prem N Ramkumar, Martin Roche, Michael A Mont
BACKGROUND: Newer generation cementless total knee arthroplasty (TKA) designs are available and have novel implant coatings. We evaluated and compared beaded periapatite (PA)-coated vs highly porous titanium-coated cementless TKAs. Specifically, we compared: (1) survivorship, (2) Knee Society Scores (KSSs) and range of motion, (3) complications, and (4) radiographic findings. METHODS: There were 805 TKAs with beaded PA-coated tibial and patellar components (PA group; mean age 67 years; range 41-86 years), and 219 TKAs with highly porous titanium-coated tibial and patella components (mean age 66 years; range 34-88 years)...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28237216/multiple-hip-intra-articular-steroid-injections-increase-risk-of-periprosthetic-joint-infection-compared-with-single-injections
#8
Andrew W Chambers, Kyle W Lacy, Ming Han Lincoln Liow, John Paul M Manalo, Andrew A Freiberg, Young-Min Kwon
BACKGROUND: Patients with hip osteoarthritis often temporize their symptoms with multiple intra-articular steroid hip injections (IASHIs) before undergoing total hip arthroplasty (THA). Although there is recent evidence to suggest that IASHI can lead to an increased risk of future periprosthetic joint infection (PJI), the potential increase in risk of PJI after multiple IASHIs compared with single IASHI remains largely unknown. The aim of the study was to evaluate whether multiple IASHIs are associated with increased risk of PJI compared with single IASHI in THA patients...
January 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28237215/comparison-of-outpatient-vs-inpatient-total-knee-arthroplasty-an-acs-nsqip-analysis
#9
Patawut Bovonratwet, Nathaniel T Ondeck, Stephen J Nelson, Jonathan J Cui, Matthew L Webb, Jonathan N Grauer
BACKGROUND: There has been a recent surge of interest in performing primary total knee arthroplasty (TKA) in the outpatient setting to reduce cost and increase patient satisfaction. Detailed information on the safety of outpatient TKA in large sample sizes is scarce. METHODS: Patients who underwent primary, elective TKA were identified in the 2005-2014 American College of Surgeons National Surgical Quality Improvement Program database. Outpatient procedure was defined as having a hospital length of stay of 0 days, whereas inpatient procedure was defined as having a length of stay ≥1 days...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236553/does-maximal-external-tibial-component-rotation-influence-tibiofemoral-load-distribution-in-the-primary-knee-arthroplasty-setting-a-comparison-of-neutral-vs-maximal-anatomical-external-rotatory-states
#10
William A Manning, Kanishka M Ghosh, Alasdair P Blain, Lee M Longstaff, Steven P Rushton, David J Deehan
BACKGROUND: Tibial component rotation at time of knee arthroplasty can influence conformity, load transmission across the polyethylene surface, and perhaps ultimately determined survivorship. Optimal tibial component rotation on the cut surface is reliant on standard per operative manual stressing. This subjective assessment aims to balance constraint and stability of the articulation through a full arc of movement. METHODS: Using a cadaveric model, computer navigation and under defined, previously validated loaded conditions mimicking the in vivo setting, the influence of maximal tibial component external rotation compared with the neutral state was examined for changes in laxity and tibiofemoral continuous load using 3D displacement measurement and an orthosensor continuous load sensor implanted within the polyethylene spacer in a simulated single radius total knee arthroplasty...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236552/postoperative-impact-of-diabetes-chronic-kidney-disease-hemodialysis-and-renal-transplant-after-total-hip-arthroplasty
#11
Beau J Kildow, Perez Agaba, Brian F Moore, Rhett K Hallows, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: The prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), hemodialysis (HD), and renal transplantation (RT) is increasing. This study assessed postoperative complications among diabetic patients with CKD, HD, or post-RT after total hip arthroplasty (THA). METHODS: Four cohorts were created using a nationwide database: DM&THA, DM&CKD&THA, DM&HD&THA, and DM&RT&THA. Cohorts were matched to a control group by age and gender. Thirty-day medical complications and 90-day and 2-year surgical complications were evaluated...
January 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236551/soft-tissue-releases-in-total-knee-arthroplasty-for-valgus-deformities
#12
Ke Xie, Steven T Lyons
BACKGROUND: Primary total knee arthroplasty (TKA) for valgus knee deformities can be challenging. Soft tissue releases are often necessary to achieve a well-balanced knee. We reviewed the frequency of soft tissue releases including lateral retinacular release (LRR) as it pertains to preoperative limb alignment. Postoperatively, we evaluated limb alignment, knee range of motion, and complications. METHODS: From 2010 to 2016, 214 primary TKAs with valgus deformity were performed by a single surgeon...
January 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236550/complications-after-revision-total-hip-arthroplasty-in-the-medicare-population
#13
Sameer Badarudeen, Albert C Shu, Kevin L Ong, Doruk Baykal, Edmund Lau, Arthur L Malkani
BACKGROUND: The purpose of this study was to identify the incidence and types of complications after revision total hip arthroplasty (THA) within the first year, and determine the relative risk factors for these complications and of re-revision. METHODS: The sample size of 5% Medicare claims data from 1998-2011 was studied. Primary THA patients who underwent subsequent revision were identified using ICD-9-CM codes. Outcomes and complications after revision THA were assessed...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236549/effects-of-resection-of-posterior-condyles-of-femur-on-extension-gap-of-knee-joint-in-total-knee-arthroplasty
#14
Seung-Suk Seo, Chang-Wan Kim, Jin-Hyuk Seo, Do-Hun Kim, Ok-Gul Kim, Chang-Rack Lee
BACKGROUND: When evaluating the effects of the preparation of the flexion gap on the extension gap in total knee arthroplasty (TKA), the effects of posterior condylar resection and osteophyte removal on the extension gap should be differentiated. Although the amount of osteophytes differs between patients, posterior condylar resection is a procedure that is routinely implemented in TKA. The aim of this study was to assess the effects of the resection of the posterior condyle of the femur on the extension gap in posterior-stabilized (PS) TKA...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236548/quantifying-blood-loss-and-transfusion-risk-after-primary-vs-conversion-total-hip-arthroplasty
#15
Jared M Newman, Matthew R Webb, Alison K Klika, Trevor G Murray, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. METHODS: A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41)...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236084/increased-mortality-after-prosthetic-joint-infection-in-primary-tha
#16
Per Hviid Gundtoft, Alma Becic Pedersen, Claus Varnum, Søren Overgaard
BACKGROUND: Revision for prosthetic joint infection (PJI) has a major effect on patients' health but it remains unclear if early PJI after primary THA is associated with a high mortality. QUESTIONS/PURPOSES: (1) Do patients with a revision for PJI within 1 year of primary THA have increased mortality compared with patients who do not undergo revision for any reason within 1 year of primary THA? (2) Do patients who undergo a revision for PJI within 1 year of primary THA have an increased mortality risk compared with patients who undergo an aseptic revision? (3) Are there particular bacteria among patients with PJI that are associated with an increased risk of death? METHODS: This population-based cohort study was based on the longitudinally maintained Danish Hip Arthroplasty Register on primary THA performed in Denmark from 2005 to 2014...
February 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28236080/what-are-the-frequency-associated-factors-and-mortality-of-amputation-and-arthrodesis-after-a-failed-infected-tka
#17
Min-Sun Son, Edmund Lau, Javad Parvizi, Michael A Mont, Kevin J Bozic, Steven Kurtz
BACKGROUND: For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the utilization rate and trend of these measures are not well known. QUESTIONS/PURPOSES: (1) How has the frequency of arthrodesis and AKA after infected TKA changed over the last 10 years? (2) What clinical or institutional factors are associated with patients undergoing arthrodesis or AKA? (3) What is the risk of mortality after arthrodesis or AKA? METHODS: The Medicare 100% National Inpatient Claims Database was used to identify 44,466 patients 65 years of age or older who were diagnosed with an infected TKA and who underwent revision between 2005 and 2014 based on International Classification of Diseases, 9(th) Revision, Clinical Modification codes...
February 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28235575/original-article-epidemiology-and-treatment-of-acetabular-fractures-in-a-level-1-trauma-centre-retrospective-study-of-414-patients-over-10-years
#18
Mehdi Boudissa, Florent Francony, Gael Kerschbaumer, Sebastien Ruatti, Michel Milaire, Philippe Merloz, Jérôme Tonetti
BACKGROUND: Epidemiological studies of acetabular fractures (AFs) are scarce and, to our knowledge, the most recent one from France,by Letournel and Judet,dates back to 1993. Studies have suggested a decrease in high-energy AFs contrasting with an increase in low-energy AFs due to the longer life expectancy. However, a French case-series study failed to confirm these data. We therefore conducted a 10-year retrospective study in a Level-1 trauma centre to: 1) characterise the epidemiological profile of AF, 2) and to describe the treatment strategy...
February 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28235499/dexamethasone-and-perioperative-blood-glucose-in-patients-undergoing-total-joint-arthroplasty-a-retrospective-study
#19
Michael Nurok, Jennifer Cheng, Giulio R Romeo, Stephanie M Vecino, Kara G Fields, Jacques T YaDeau
STUDY OBJECTIVE: Perioperative dexamethasone is commonly used to prevent nausea. It can also increase blood glucose levels, and recent concern about its blood glucose-elevating effect in humans has been raised. This study aimed to demonstrate relationships between dexamethasone administration and elevated perioperative blood glucose in patients undergoing total joint arthroplasty. DESIGN: Retrospective study. SETTING: Academic, orthopedic hospital...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235496/use-of-test-dose-allows-early-detection-of-subdural-local-anesthetic-injection-with-lumbar-plexus-block
#20
Bradley H Lee, Matthias Braehler
A 56year-old woman underwent a lumbar plexus block for a revision of a left total hip arthroplasty. During the block procedure, the needle was advanced over the transverse process and isolated quadriceps twitches were elicited. After administering a test dose of 3ml of 1.5% lidocaine, the patient developed loss of sensation in the L3-4 dermatomal distribution that progressed caudally to involve both legs followed by inability to move the left leg. The patient shortly thereafter became hypotensive and sensory block spread cephalad and peaked at C7 bilaterally suggesting possible subdural spread of local anesthetic...
February 2017: Journal of Clinical Anesthesia
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