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Monica Teng, Hui Jun Zhou, Liang Lin, Pang Hung Lim, Doreen Yeo, Suzanne Goh, Soon Yin Tjan, Boon Peng Lim
Background: The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore. Methods: A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR)...
March 9, 2018: Journal of Public Health
Barbara L Conner-Spady, Deborah A Marshall, Eric Bohm, Michael J Dunbar, Tom W Noseworthy
PURPOSE: (1) To assess responsiveness of the EQ-5D-5L compared to Oxford hip and knee scores and the SF-12 in osteoarthritis patients undergoing total hip (THR) or knee (TKR) replacement surgery; (2) to compare distribution and anchor-based methods of assessing responsiveness. METHODS: Questionnaires were mailed to consecutive patients following surgeon referral for primary THR or TKR and 1 year post-surgery. We assessed effect size (ES), standardized response mean (SRM), and standard error of measurement (SEM)...
February 8, 2018: Quality of Life Research
Anne R Bass, Jackie D Szymonifka, Matthew T Rondina, Margaret Bogardus, Mitchell G Scott, Scott C Woller, Scott M Stevens, Charles Eby, Kerri Merritt, Alejandro Gonzalez Della Valle, Gerard Moskowitz, Eva Flores, Brian F Gage
Background: Orthopedic patients are at risk for adverse postoperative cardiovascular outcomes. Questions/Purposes: This pilot randomized controlled trial (RCT) of atorvastatin vs. placebo in orthopedic surgery patients was performed in order to assess: (1) the prevalence of perioperative myocardial injury; (2) the effect of atorvastatin on perioperative inflammation; and (3) the feasibility of performing a large RCT of statin therapy in orthopedic patients. Methods: Hip fracture (hip Fx) and total hip and knee replacement (THR and TKR) patients were randomized 1:1 to atorvastatin 40 mg daily vs...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Alf Inge Hellevik, Marianne Bakke Johnsen, Arnulf Langhammer, Valborg Baste, Ove Furnes, Kjersti Storheim, John Anker Zwart, Gunnar Birkeland Flugsrud, Lars Nordsletten
Objective: Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. Design: In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR...
2018: Clinical Epidemiology
Edward Burn, Christopher J Edwards, David W Murray, Alan Silman, Cyrus Cooper, Nigel K Arden, Rafael Pinedo-Villanueva, Daniel Prieto-Alhambra
OBJECTIVES: To measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in patient profiles. DESIGN: Cross-sectional study using routinely collected data. SETTING: National Health Service primary care records from 1995 to 2014 in the Clinical Practice Research Datalink were linked to hospital inpatient data from 1997 to 2014 in Hospital Episode Statistics Admitted Patient Care...
January 27, 2018: BMJ Open
Marianne Bakke Johnsen, Alf Inge Hellevik, Milada Cvancarova Småstuen, Arnulf Langhammer, Ove Furnes, Gunnar Birkeland Flugsrud, Lars Nordsletten, John Anker Zwart, Kjersti Storheim
To investigate the total effect of smoking on total hip or knee replacement (THR/TKR) due to primary osteoarthritis (OA) and to quantify the indirect effect of smoking through body mass index (BMI). Participants from the Nord-Trøndelag Health Study (the HUNT Study) were linked to the Norwegian Arthroplasty Register to detect the first THR or TKR due to primary OA. A mediation analysis was used to decompose the total effect of smoking into a direct and indirect effect. BMI was considered a mediator in the analysis...
2017: PloS One
M C S Inacio, K Cashman, N L Pratt, M H Gillam, G Caughey, S E Graves, E E Roughead
OBJECTIVES: To evaluate the prevalence and change in analgesic medications use prior to joint replacement in older patients between 2001 and 2012. METHODS: A population based epidemiological study was conducted. Opioids, non-steroidal anti-inflammatories (NSAIDs), paracetamol, corticosteroid injections, medications for neuropathic pain, hypnotics, and muscle relaxants supplied 1 year prior to total knee replacement (TKR, n = 15,517) and hip replacement (THR, n = 10,018) were assessed...
December 16, 2017: Osteoarthritis and Cartilage
René Lindholm Cordtz, Samuel Hawley, Daniel Prieto-Alhambra, Pil Højgaard, Kristian Zobbe, Søren Overgaard, Anders Odgaard, Lars Erik Kristensen, Lene Dreyer
OBJECTIVES: To study the impact of the introduction of biological disease-modifying anti-rheumatic drugs (bDMARDs) and associated rheumatoid arthritis (RA) management guidelines on the incidence of total hip (THR) and knee replacements (TKR) in Denmark. METHODS: Nationwide register-based cohort and interrupted time-series analysis. Patients with incident RA between 1996 and 2011 were identified in the Danish National Patient Register. Patients with RA were matched on age, sex and municipality with up to 10 general population comparators (GPCs)...
December 15, 2017: Annals of the Rheumatic Diseases
Sharon Brennan-Olsen, Sara Vogrin, Kara L Holloway, Richard S Page, Muhammad A Sajjad, Mark A Kotowicz, Patricia M Livingston, Mustafa Khasraw, Sharon Hakkennes, Trish L Dunning, Susan Brumby, Daryl Pedler, Alasdair Sutherland, Svetha Venkatesh, Lana J Williams, Gustavo Duque, Julie A Pasco
Compared to urban residents, those in rural/regional areas often experience inequitable healthcare from specialist service providers. Independent of small between-area differences in utilisation, socially advantaged groups had the greatest uptake of joint replacement. These data suggest low correlation between 'need' vs. 'uptake' of surgery in rural/regional areas. BACKGROUND AND PURPOSE: Compared to urban residents, those in rural and regional areas often experience inequitable healthcare from specialist service providers, often due to geographical issues...
November 6, 2017: Archives of Osteoporosis
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
Mary E Jones, Madeleine A M Davies, Kirsten M Leyland, Antonella Delmestri, Angus Porter, Jason Ratcliffe, Nick Peirce, Julia L Newton, Nigel K Arden
OBJECTIVES: This study aimed to describe the prevalence and risk of chronic conditions in former elite cricketers compared to a normal population, and describe wellbeing in former elite cricketers. DESIGN: Cross-sectional study. METHODS: Former elite cricketers, recruited from the Professional Cricketers' Association, completed a self-report cross-sectional questionnaire. The English Longitudinal Study of Ageing (ELSA) served as the normal population...
October 18, 2017: Journal of Science and Medicine in Sport
Qianpeng Zheng, Hong Chen
After total hip replacement and total knee replacement, patients are highly recommended to take walking rehabilitation, during which time, the weight loads on the limb should be limited to a certain range, which is difficult for patients to control on their own. To improve the accuracy and reliability of the traditional method for walking rehabilitation, we proposed a monitoring system comprised of pressure sensors, an analog digital converter, a micro-control unit, Bluetooth modules and a smart-phone application...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Samuel Hawley, René Cordtz, Lene Dreyer, Christopher J Edwards, Nigel K Arden, Antonella Delmestri, Alan Silman, Cyrus Cooper, Andrew Judge, Daniel Prieto-Alhambra
OBJECTIVE: To estimate the impact of NICE approval of tumor necrosis factor inhibitor (TNFi) therapies on the incidence of total hip replacement (THR) and total knee replacement (TKR) among rheumatoid arthritis (RA) patients in England and Wales. METHODS: Primary care data [Clinical Practice Research Datalink (CPRD)] for the study period (1995-2014) were used to identify incident adult RA patients. The age and sex-standardised 5-year incidence of THR and TKR was calculated separately for RA patients diagnosed in each six-months between 1995-2009...
September 23, 2017: Seminars in Arthritis and Rheumatism
Aladdin H Shadyab, Wenjun Li, Charles B Eaton, Andrea Z LaCroix
OBJECTIVE: To investigate associations of body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) with survival to age 85 with mobility limitation or death before age 85 among older women with total knee (TKR) or total hip (THR) replacement for osteoarthritis. METHODS: This was a prospective study of women (aged 65-79 years at baseline) from the Women's Health Initiative recruited during 1993-1998 and followed through 2012. Women's Health Initiative data were linked to Medicare claims data to determine TKR (n=1,867) and THR (n=944) for osteoarthritis...
October 3, 2017: Arthritis Care & Research
Dirk Holten, Peter Zaar, Stefan Kessler
Introduction We implemented a hospital-wide mandatory RBC transfusion trigger checklist based on the haemoglobin level transfusion thresholds recommended by the German federal physicians board. Transfusion triggers, transfusion rates and hospital LOS in orthopaedic lower limb arthroplasty were compared before and after implementation of the transfusion trigger checklist. The goal was to evaluate the effect of this single and easy-to-implement intervention on transfusion rates in orthopaedic lower limb arthroplasty...
December 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
T O Smith, M Mansfield, J Dainty, G Hilton, C J V Mann, C M Sackley
OBJECTIVES: To determine whether physical activity measured using the Physical Activity Scale for the Elderly (PASE), changes during the initial 24 months post-total hip (THR) or knee replacement (TKR), and how this compares to a matched non-arthroplasty cohort. DESIGN: Case-controlled study analysis of a prospectively collected dataset. SETTING: USA community-based. PARTICIPANTS: 116 people post-THR, 105 people post-TKR compared to 663 people who had not undergone THR or TKR, or had hip or knee osteoarthritis...
September 13, 2017: Physiotherapy
Wenjun Li, David C Ayers, Courtland G Lewis, Thomas R Bowen, Jeroan J Allison, Patricia D Franklin
BACKGROUND: Obesity has been associated with lower function and more pain before and after total hip or knee replacement (THR or TKR). We examined the changes between preoperative and postoperative function and pain in a large representative U.S. cohort to determine if there was a relationship to obesity status. METHODS: Preoperative and 6-month postoperative data on function (Short Form-36 Physical Component Summary [PCS] score), joint pain (Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score), and body mass index (BMI) were collected from a national sample of 2,040 patients who had undergone THR and 2,964 who had undergone TKR from May 2011 to March 2013...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
A I Hellevik, L Nordsletten, M B Johnsen, A M Fenstad, O Furnes, K Storheim, J A Zwart, G Flugsrud, A Langhammer
OBJECTIVE: To investigate whether parity, age at menarche, menopausal status, age at menopause, use of oral contraceptives (OC) or use of hormone replacement therapy (HRT) were associated with total knee replacement (TKR) or total hip replacement (THR) due to primary osteoarthritis. METHOD: In a prospective cohort study of 30,289 women from the second and third surveys of the Nord-Trøndelag Health Study, data were linked to the Norwegian Arthroplasty Register (NAR) in order to identify TKR or THR due to primary osteoarthritis...
July 10, 2017: Osteoarthritis and Cartilage
Louis M Kwong, Alexander G G Turpie, Sally Tamayo, W Frank Peacock, Zhong Yuan, Nicholas Sicignano, Kathleen Pillsbury Hopf, Manesh R Patel
BACKGROUND: Rivaroxaban is a novel oral anticoagulant indicated for prophylaxis against deep vein thrombosis and pulmonary embolism in patients undergoing total hip replacement (THR) or total knee replacement (TKR) surgery. OBJECTIVE: To evaluate major bleeding (MB) in THR/TKR patients receiving post-operative rivaroxaban. METHODS: Electronic medical records of nearly 10 million US Department of Defense (DoD) beneficiaries were queried from 1 January 2013 through 30 June 2015...
July 20, 2017: Current Medical Research and Opinion
Pazit Levinger, Elin Wee, Soula Margelis, Hylton B Menz, John R Bartlett, Neil R Bergman, Stephen McMahon, Keith D Hill
INTRODUCTION: Pain and disability often persist following hip (THR) and knee replacement (TKR) surgery predisposing patients to increased risk of falling. This study identified pre-operative predictors for post-operative falls in TKR and THR patients, and the incidence and circumstances of falls in the 12 months post-surgery. MATERIALS AND METHODS: A survey was undertaken of patients before THR and TKR, and was repeated 12 months post-operation. The survey included (1) medical history and medications usage, (2) pain and function, (3) health-related and physical activity and (4) fear of falls and history of falls questionnaires...
August 2017: Archives of Orthopaedic and Trauma Surgery
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