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https://www.readbyqxmd.com/read/29792786/imageless-navigation-total-hip-arthroplasty-an-evaluation-of-operative-time
#1
Epaminondas Markos Valsamis, David Ricketts, Adnan Hussain, Amir-Reza Jenabzadeh
INTRODUCTION: Imageless navigation has been successfully integrated in knee arthroplasty but its effectiveness in total hip arthroplasty (THA) has been debated. It has consistently been shown that navigation adds significant time and cost to the operation. Further, the relative success of traditional hip replacements has impeded the adoption of new techniques. METHODS: We compared the operative time between fifty total hip replacements with and without the use of imageless navigation by a single senior surgeon in a retrospective study...
2018: SICOT-J
https://www.readbyqxmd.com/read/29792279/can-intraoperative-measurement-of-bone-quality-help-in-decision-making-for-cementless-unicompartmental-knee-arthroplasty
#2
Johannes A Eckert, Sebastian Jaeger, Matthias C Klotz, Martin Schwarze, Rudi G Bitsch
BACKGROUND: In uncemented total hip arthroplasty (THA), low bone mineral density (BMD) is associated with aseptic loosening. BMD is usually assessed via dual-energy X-ray absorptiometry (DXA) or quantitative computed tomography, which takes time and exposes patients to radiation. Due to its low risk profile, intraoperative measurement of the trabecular stability might be a useful alternative to DXA. METHODS: In 24 human femora, BMD was analysed using DXA at the femoral necks and the knees...
May 20, 2018: Knee
https://www.readbyqxmd.com/read/29792206/is-the-cup-orientation-different-in-bilateral-total-hip-arthroplasty-with-right-handed-surgeons-using-posterolateral-approach
#3
Xinggui Song, Ming Ni, Heng Li, Xin Li, Xiang Li, Jun Fu, Jiying Chen
BACKGROUND: The impact of surgeon handedness on acetabular cup orientation in total hip arthroplasty (THA) is not well studied. The aim of our study is to investigate the difference of cup orientation in bilateral THA performed by right-handed surgeons using posterolateral approach and which cup could be fitter to Lewinneck's safe zone. METHODS: The study consisted of 498 patients that underwent bilateral THA by three right-handed surgeons in our hospital. Postoperative acetabular cup anteversion and abduction on an anteroposterior pelvic radiograph were measured by Orthoview software (Orthoview LLC, Jacksonville, Florida)...
May 23, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29792086/risk-of-further-surgery-on-the-same-or-opposite-side-and-mortality-after-primary-total-hip-arthroplasty-a-multi-state-analysis-of-133-654-patients-from-the-swedish-hip-arthroplasty-register
#4
Peter H J Cnudde, Szilard Nemes, Erik Bülow, A John Timperley, Sarah L Whitehouse, Johan Kärrholm, Ola Rolfson
Background and purpose - The hip-related timeline of patients following a total hip arthroplasty (THA) can vary. Ideally patients will live their life without need for further surgery; however, some will undergo replacement on the contralateral hip and/or reoperations. We analyzed the probability of mortality and further hip-related surgery on the same or contralateral hip. Patients and methods - We performed a multi-state survival analysis on a prospectively followed cohort of 133,654 Swedish patients undergoing an elective THA between 1999 and 2012...
May 23, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29791928/the-impact-of-medical-comorbidities-on-primary-total-knee-arthroplasty-reimbursements
#5
Karim G Sabeh, Samuel Rosas, Leonard T Buller, Andrew A Freiberg, Cynthia L Emory, Martin W Roche
Medical comorbidities have been shown to cause an increase in peri-and postoperative complications following total knee arthroplasty (TKA). However, the increase in cost associated with these complications has yet to be determined. Factors that influence cost have been of great interest particularly after the initiation of bundled payment initiatives. In this study, we present and quantify the influence of common medical comorbidities on the cost of care in patients undergoing primary TKA. A retrospective level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary TKA between 2007 and 2015...
May 23, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29791925/patient-specific-instrumentation-affects-perioperative-blood-loss-in-total-knee-arthroplasty
#6
Davide Cucchi, Alessandra Menon, Beatrice Zanini, Riccardo Compagnoni, Paolo Ferrua, Pietro Randelli
Patient-specific instrumentation (PSI) may contribute to reduced blood loss related to total knee arthroplasty (TKA). The purpose of this study was to compare the estimated hemoglobin (Hb) and red blood cell volume (RBC) losses in two groups of patients undergoing TKA with PSI and conventional instrumentation. Pre- and postoperative blood samples were collected from 22 patients randomly assigned to receive a PSI-assisted or conventional TKA. Post- to preoperative Hb difference was calculated and RBC loss was estimated according to Sehat et al...
May 23, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29791704/use-of-neuromuscular-electrical-stimulation-during-physical-therapy-may-reduce-the-incidence-of-arthrofibrosis-after-total-knee-arthroplasty
#7
Chukwuweike U Gwam, Tanner McGinnis, Jennifer I Etcheson, Nicole E George, Assem A Sultan, Ronald E Delanois, Anil Bhave, Steven F Harwin, Michael A Mont
INTRODUCTION: Arthrofibrosis remains a major complication following total knee arthroplasty (TKA) that negatively impacts patient outcomes and exhausts healthcare resources. The use of neuromuscular electrical stimulation (NMES) has demonstrated the ability to facilitate quadriceps muscle recovery and reduce pain. Therefore, the purpose of this study was to compare TKA patients who received physical therapy (PT) and adjuvant NMES therapy versus physical therapy alone in terms of: 1) rates of manipulation under anesthesia (MUA) to treat arthrofibrosis; and 2) post-therapy range of motion (ROM)...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791699/a-comparative-effectiveness-study-for-non-operative-treatment-methods-for-knee-osteoarthritis
#8
Frank R Kolisek, Charles Jaggard, Anton Khlopas, Assem A Sultan, Nipun Sodhi, Michael A Mont
A number of non-operative treatment options are commonly prescribed for patients presenting with degenerative osteoarthritis of the knee, where surgery is not yet recommended. However, there is a paucity of studies evaluating the comparative effectiveness of these treatment options to best inform both patients and providers. This study examined the comparative effectiveness of a home exercise program versus bracing or a combination of the two (brace-only, exercise-only, and brace and exercise cohorts) on the following: 1) objective functional measures (quadriceps muscle strength, Self-Paced Walk Test [SPWT], and Timed "Up & Go" [TUG] Test); 2) subjective functional measures (Lower Extremity Function Scale [LEFS] and Health Survey [VR-12] outcomes); 3) pain using Visual Analog Scale [VAS-10]; 4) patient metrics (patient treatment preference, perceptions, and compliance); and 5) progression to total knee arthroplasty (TKA) over a 12-week period...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791698/stryker-orthopaedic-modeling-and-analytics-soma-a-review
#9
Walter Schmidt, Sally LiArno, Anton Khlopas, Andreas Petersik, Michael A Mont
Due to the differences in bone morphology between demographics such as age, gender, body mass index, and ethnicity, the development of orthopaedic implants requires a large number of anatomical data from various patient populations. In an effort to assess these demographic variations, Stryker Orthopaedic Modeling and Analytics (SOMA) has been developed. SOMA is a suite of tools which utilizes a comprehensive database of computed tomography scans (CT-scans), plus associated three-dimensional (3D) bone models, allowing the user to assess population differences in bone morphology, bone density, and implant fit for the purposes of research and development...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29790397/higher-cartilage-wear-in-unipolar-than-bipolar-hemiarthroplasties-of-the-hip-at-2-years-a-randomized-controlled-radiostereometric-study-in-19-fit-elderly-patients-with-femoral-neck-fractures
#10
Wender Figved, Stian Svenøy, Stephan M Röhrl, Jon Dahl, Lars Nordsletten, Frede Frihagen
Background and purpose - The use of unipolar hemi-arthroplasties for femoral neck fractures is increasing in some countries due to reports of higher reoperation rates in bipolar prostheses. On the other hand, it has been proposed that bipolar hemiarthroplasties have clinical advantages and less cartilage wear than unipolar hemiarthroplasties. We compared cartilage wear between bipolar and unipolar hemiarthroplasties using radiostereometric analyses (RSA), in patients aged 70 years or older. Patients and methods - 28 ambulatory, lucid patients were randomized to treatment with a unipolar or a bipolar hemiarthroplasty for an acute femoral neck fracture...
May 23, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29789904/revision-knee-arthroplasty-with-rotating-hinge-systems-in-patients-with-gross-ligament-instability
#11
Sebastian P Boelch, Joerg Arnholdt, Boris M Holzapfel, Axel Jakuscheit, Maximilian Rudert, Maik Hoberg
PURPOSE: The clinical and radiographic outcomes after revision total knee arthroplasty (TKA) for instability with two rotating hinge knee prostheses were compared. METHODS: Fifty-one patients revised for TKA instability were prospectively randomized to either the Link Endo-Model (N = 26) or the EnduRo (N = 25). Clinical and radiographic outcome scores were compared pre-operatively and at 12 months' follow-up. Failure mechanisms were recorded. RESULTS: Age, BMI, operation, and tourniquet-time did not differ significantly between groups...
May 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29789406/ranking-hospitals-do-we-gain-reliability-by-using-composite-rather-than-individual-indicators
#12
Stefanie N Hofstede, Iris E Ceyisakar, Hester F Lingsma, Dionne S Kringos, Perla J Marang-van de Mheen
BACKGROUND: Despite widespread use of quality indicators, it remains unclear to what extent they can reliably distinguish hospitals on true differences in performance. Rankability measures what part of variation in performance reflects 'true' hospital differences in outcomes versus random noise. OBJECTIVE: This study sought to assess whether combining data into composites or including data from multiple years improves the reliability of ranking quality indicators for hospital care...
May 22, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29788969/psychosocial-predictors-for-outcome-after-total-joint-arthroplasty-a-prospective-comparison-of-hip-and-knee-arthroplasty
#13
Marion Lindner, Olaf Nosseir, Anett Keller-Pliessnig, Per Teigelack, Martin Teufel, Sefik Tagay
BACKGROUND: As findings regarding predictors for good outcome after total joint arthroplasty are highly inconsistent, aim of this study was to investigate the influence of the psychosocial variables sense of coherence and social support as well as mental distress on physical outcome after surgery. It should be investigated if different predictors are important in patients after total hip arthroplasty (THA) compared to patients after total knee arthroplasty (TKA). METHODS: In a prospective design, 44 patients undergoing THA and 61 patients undergoing TKA were examined presurgery and 6 and 12 weeks after surgery using WOMAC (disease-specific outcome), SF-36 (health-related quality of life), BSI (psychological distress), SOC-13 (sense of coherence), and F-SozU (social support)...
May 22, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29788949/range-of-motion-after-total-knee-arthroplasty-in-hemophilic-arthropathy
#14
Radovan Kubeš, Peter Salaj, Rastislav Hromádka, Josef Včelák, Aleš Antonín Kuběna, Monika Frydrychová, Štěpán Magerský, Michal Burian, Martin Ošťádal, Jan Vaculik
BACKGROUND: Outcomes of total knee replacement in cases of hemophilic patients are worse than in patients who undergo operations due to osteoarthritis. Previous publications have reported varying rates of complications in hemophilic patients, such as infection and an unsatisfactory range of motion, which have influenced the survival of prostheses. Our retrospective study evaluated the data of hemophilic patients regarding changes in the development of the range of motion. METHODS: The data and clinical outcomes of 72 total knee replacements in 45 patients with hemophilia types A and B were reviewed retrospectively...
May 22, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29788680/two-sequential-free-flaps-for-coverage-of-a-total-knee-implant
#15
Siew Weng Ng, Hui Chai Fong, Bien-Keem Tan
Knee revision arthroplasty following peri-prosthetic joint infections is a formidable challenge. Patients are at a high risk of recurrent infection, and the soft tissue over the revised implant is often of questionable quality. Flap reconstruction has improved the salvage rates of infected arthroplasties, and should be considered in all cases of revision arthroplasty. We present a challenging case requiring staged reconstruction with two free latissimus dorsi flaps after the initial use of a medial gastrocnemius flap...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29788284/military-service-and-decision-quality-in-the-management-of-knee-osteoarthritis
#16
Eric R Henderson, Alexander J Titus, Benjamin J Keeney, Philip P Goodney, Jon D Lurie, Said A Ibrahim
Background: Decision quality measures the degree to which care decisions are knowledge-based and value-aligned. Because military service emphasizes hierarchy, command, and mandates some healthcare decisions, military service may attenuate patient autonomy in healthcare decisions and lower decision quality. VA is the nation's largest provider of orthopedic care. We compared decision quality in a sample of VA and non-VA patients seeking care for knee osteoarthritis. Methods: Our study sample consisted of patients newly referred to our orthopedic clinic for the management of knee osteoarthritis...
May 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29787389/liposomal-bupivacaine-does-not-reduce-inpatient-opioid-prescription-or-related-complications-after-knee-arthroplasty-a-database-analysis
#17
Lukas Pichler, Jashvant Poeran, Nicole Zubizarreta, Crispiana Cozowicz, Eric C Sun, Madhu Mazumdar, Stavros G Memtsoudis
BACKGROUND: Although some trials suggest benefits of liposomal bupivacaine, data on real-world use and effectiveness is lacking. This study analyzed the impact of liposomal bupivacaine use (regardless of administration route) on inpatient opioid prescription, resource utilization, and opioid-related complications among patients undergoing total knee arthroplasties with a peripheral nerve block. It was hypothesized that liposomal bupivacaine has limited clinical influence on the studied outcomes...
May 21, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29785589/a-novel-technology-for-3d-knee-prosthesis-planning-and-treatment-evaluation-using-2d-x-ray-radiographs-a-clinical-evaluation
#18
Guoyan Zheng, Hagen Hommel, Alper Akcoltekin, Benedikt Thelen, Jan Stifter, Geert Peersman
PURPOSE:  To present a clinical validation of a novel technology called "3X" which allows for 3D prosthesis planning and treatment evaluation in total knee arthroplasty (TKA) using only 2D X-ray radiographs. MATERIALS AND METHODS:  After local institution review board approvals, 3X was evaluated on 43 cases (23 for preoperative planning and 20 for postoperative treatment evaluation). All the patients underwent CT scans according to a standard protocol...
May 21, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29785450/light-intensity-physical-activity-increases-and-sedentary-behavior-decreases-following-total-knee-arthroplasty-in-patients-with-osteoarthritis
#19
Emmanuel Frimpong, Joanne A McVeigh, Dick van der Jagt, Lipalo Mokete, Yusuf S Kaoje, Mohammed Tikly, Rebecca M Meiring
PURPOSE: To describe objectively measured changes in the volume and pattern of physical activity and sedentary behavior in patients undergoing total knee arthroplasty for osteoarthritis. METHODS: Physical activity and sedentary behavior were measured in patients (13 males, 76 females) with a mean age of 64 years (range 55-80) and end-stage osteoarthritis of the knee, using an accelerometer (ActiGraph GT3X+) for seven consecutive days (24 h/day) prior to, 6 weeks and 6 months after total knee arthroplasty...
May 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29785449/parkinson-s-disease-increases-the-risk-of-perioperative-complications-after-total-knee-arthroplasty-a-nationwide-database-study
#20
Jared M Newman, Nipun Sodhi, Alyeesha B Wilhelm, Anton Khlopas, Alison K Klika, Qais Naziri, Thomas J Kryzak, Carlos A Higuera, Michael A Mont
PURPOSE: Therefore, the purpose of this study was to evaluate the short-term perioperative outcomes of PD patients who underwent total knee arthroplasty (TKA). We specifically evaluated: (1) perioperative surgical and medical complications; (2) lengths of stay (LOS); and (3) total hospital charges. METHODS: The Nationwide Inpatient Sample was used to identify PD patients who underwent TKA between 2002 and 2013. To control for potential confounders, PD TKA and non-PD TKA patients were propensity score matched (1:3) based on age, sex, ethnicity, Charlson Comorbidity Index, and insurance type...
May 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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