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https://www.readbyqxmd.com/read/28597247/pre-operative-predictors-of-post-operative-falls-in-people-undergoing-total-hip-and-knee-replacement-surgery-a-prospective-study
#1
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...
June 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28539693/quality-based-procedures-for-knee-replacement-hip-replacement-and-hip-fracture-physiotherapists-perceptions-of-adherence-barriers-and-facilitators
#2
Kirsti J E Reinikka, Denise Taylor, Sylvia Daniel, Stacey Burns-Hogan, Brittany DePass, Laura McGill, Michael McLeod, Susan Safadi, Sandy Veit
Purpose: This mixed-methods study examined the perceived barriers to and facilitators of implementing best-practice guidelines (BPGs) and adhering to provincial Quality-Based Procedures (QBPs) by Ontario physiotherapists working with patients after total knee replacement (TKR), total hip replacement (THR), and hip fracture (HF). Method: Using snowball sampling, 93 hospital and home care physiotherapists working with patients after TKR, THR, or HF completed a Web-based survey. A subset of these participated in follow-up semi-structured telephone interviews...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/28521834/incidence-of-total-hip-or-knee-replacement-due-to-osteoarthritis-in-relation-to-thyroid-function-a-prospective-cohort-study-the-nord-tr%C3%A3-ndelag-health-study
#3
Alf Inge Hellevik, Marianne Bakke Johnsen, Arnulf Langhammer, Anne Marie Fenstad, Ove Furnes, Kjersti Storheim, John Anker Zwart, Gunnar Flugsrud, Lars Nordsletten
BACKGROUND: To study whether thyroid function was associated with risk of hip or knee replacement due to primary osteoarthritis. METHODS: In a prospective cohort study, data from the second and third survey of the Nord-Trøndelag Health Study were linked to the Norwegian Arthroplasty Register in order to identify total hip or knee replacement as a result of primary osteoarthritis. RESULTS: Among 37 891 participants without previously known thyroid disease we recorded 978 total hip replacements (THRs) and 538 total knee replacements (TKRs) during a median follow-up time of 15...
May 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28302377/stair-negotiation-as-a-rehabilitation-intervention-for-enhancing-recovery-following-total-hip-and-knee-replacement-surgery
#4
REVIEW
James P Gavin, Tikki Immins, Thomas Wainwright
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) are common orthopaedic procedures. However, an optimal programme for post-operative rehabilitation has yet to be established. Stair negotiation is a challenging, habitual task, regularly used as a post-operative functional outcome measure; yet as a physical rehabilitation intervention it appears to be rarely used. AIM: The review purpose was to investigate the effectiveness of stair climbing as a rehabilitation intervention for THR and TKR patients...
May 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#5
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
May 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28118530/current-risk-adjustment-and-comorbidity-index-underperforms-in-predicting-post-acute-utilization-and-hospital-readmissions-after-joint-replacements-implications-for-comprehensive-care-for-joint-replacement-model
#6
Amit Kumar, Amol Karmarkar, Brian Downer, Amit Vashist, Deepak Adhikari, Soham Al Snih, Kenneth Ottenbacher
OBJECTIVE: Compare the performances of comorbidity indices: Charlson, Elixhauser, and the Centers for Medicare & Medicaid Services (CMS) risk adjustment model Hierarchical Condition Category (HCC), in predicting post-acute discharge settings and hospital readmission for patients after joint replacement. METHODS: Retrospective study of Medicare beneficiaries with total knee replacement (TKR) or total hip replacement (THR) discharged from hospitals in 2009-2011 (N=607,349)...
January 24, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28102615/comparative-effectiveness-of-venous-thromboembolism-prophylaxis-options-for-the-patient-undergoing-total-hip-and-knee-replacement-a-network-meta-analysis
#7
A Kapoor, A Ellis, N Shaffer, J Gurwitz, A Chandramohan, J Saulino, A Ishak, T Okubanjo, F Michota, E Hylek, T A Trikalinos
Essentials Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options. We provide profiles of venous thromboembolism and hemorrhage risk for 12 options. Direct oral Xa inhibitors had a favorable profile compared with low-molecular-weight heparin. Other options did not have favorable profiles compared with low-molecular-weight heparin. SUMMARY: Background There are numerous trials and several meta-analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR)...
February 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28089984/achieving-consensus-on-total-joint-replacement-trial-outcome-reporting-using-the-omeract-filter-endorsement-of-the-final-core-domain-set-for-total-hip-and-total-knee-replacement-trials-for-endstage-arthritis
#8
Jasvinder A Singh, Michelle M Dowsey, Michael Dohm, Susan M Goodman, Amye L Leong, Marieke M J H Scholte Voshaar, Peter F Choong
OBJECTIVE: Discussion and endorsement of the OMERACT total joint replacement (TJR) core domain set for total hip replacement (THR) and total knee replacement (TKR) for endstage arthritis; and next steps for selection of instruments. METHODS: The OMERACT TJR working group met at the 2016 meeting at Whistler, British Columbia, Canada. We summarized the previous systematic reviews, the preliminary OMERACT TJR core domain set and results from previous surveys. We discussed preliminary core domains for TJR clinical trials, made modifications, and identified challenges with domain measurement...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28073671/fast-track-recovery-technique-applied-to-primary-total-hip-and-knee-replacement-surgery-analysis-of-costs-and-complications
#9
C Wilches, J D Sulbarán, J E Fernández, J M Gisbert, J M Bausili, X Pelfort
PURPOSE: To determine the cost reduction and complication rates of using an enhanced recovery pathway (Fast-track) when compared to traditional recovery in primary total hip replacement (THR) and total knee replacement (TKR), as well as to determine if there were significant differences in complication rates. MATERIAL AND METHODS: Retrospective review of 100 primary total arthroplasties using the Fast-track recovery system and another 100 using conventional recovery...
January 7, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28061841/supervised-neuromuscular-exercise-prior-to-hip-and-knee-replacement-12-month-clinical-effect-and-cost-utility-analysis-alongside-a-randomised-controlled-trial
#10
Linda Fernandes, Ewa M Roos, Søren Overgaard, Allan Villadsen, Rikke Søgaard
BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery...
January 6, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27996342/sick-leave-in-sweden-before-and-after-total-joint-replacement-in-hip-and-knee-osteoarthritis-patients
#11
Kjerstin Stigmar, Leif E Dahlberg, Caddie Zhou, Helena Jacobson Lidgren, Ingemar F Petersson, Martin Englund
Background and purpose - Little is know about patterns of sick leave in connection with total hip and knee joint replacement (THR and TKR) in patients with osteoarthritis (OA). Patients and methods - Using registers from southern Sweden, we identified hip and knee OA patients aged 40-59 years who had a THR or TKR in the period 2004-2012. Patients who died or started on disability pension were excluded. We included 1,307 patients with THR (46% women) and 996 patients with TKR (56% women). For the period 1 year before until 2 years after the surgery, we linked individual-level data on sick leave from the Swedish Social Insurance Agency...
April 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/27965248/gender-disparities-in-red-blood-cell-transfusion-in-elective-surgery-a-post-hoc-multicentre-cohort-study
#12
Hans Gombotz, Günter Schreier, Sandra Neubauer, Peter Kastner, Axel Hofmann
OBJECTIVES: A post hoc gender comparison of transfusion-related modifiable risk factors among patients undergoing elective surgery. SETTINGS: 23 Austrian centres randomly selected and stratified by region and level of care. PARTICIPANTS: We consecutively enrolled in total 6530 patients (3465 women and 3065 men); 1491 underwent coronary artery bypass graft (CABG) surgery, 2570 primary unilateral total hip replacement (THR) and 2469 primary unilateral total knee replacement (TKR)...
December 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27704332/a-cost-utility-analysis-of-dabigatran-enoxaparin-and-usual-care-for-venous-thromboprophylaxis-after-hip-or-knee-replacement-surgery-in-thailand
#13
Surachai Kotirum, Bunchai Chongmelaxme, Nathorn Chaiyakunapruk
To analyze the cost-utility of oral dabigatran etexilate, enoxaparin sodium injection, and no intervention for venous thromboembolism (VTE) prophylaxis after total hip or knee replacement (THR/TKR) surgery among Thai patients. A cost-utility analysis using a decision tree model was conducted using societal and healthcare payers' perspectives to simulate relevant costs and health outcomes covering a 3-month time horizon. Costs were adjusted to year 2014. The willingness-to-pay threshold of THB 160,000 (USD 4926) was used...
February 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27611713/emergency-department-visits-following-joint-replacement-surgery-in-an-era-of-mandatory-bundled-payments
#14
Susan M Nedza, Donald E Fry, Susan DesHarnais, Eric Spencer, Patrick Yep
OBJECTIVES: The Center for Medicare & Medicaid Services (CMS) is actively testing bundled payments models. This study sought to identify relevant details for 90-day postdischarge emergency department (ED) visits of Medicare beneficiaries following total joint replacement (TJR) surgery meeting eligibility for a CMS bundled payment program. METHODS: The CMS research identifiable file for the State of Texas for 2011-2012 was used to identify patients who underwent TJR...
February 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27558412/central-sensitization-as-a-determinant-of-patients-benefit-from-total-hip-and-knee-replacement
#15
V Wylde, A Sayers, A Odutola, R Gooberman-Hill, P Dieppe, A W Blom
BACKGROUND: Discrepancies exist between osteoarthritic joint changes and pain severity before and after total hip (THR) and knee (TKR) replacement. This study investigated whether the interaction between pre-operative widespread hyperalgesia and severity of radiographic osteoarthritis (OA) was associated with pain severity before and after joint replacement. METHODS: Data were analysed from 232 patients receiving THR and 241 receiving TKR. Pain was assessed pre-operatively and at 12 months post-operatively using the WOMAC Pain Scale...
February 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27531085/national-trends-in-deep-vein-thrombosis-following-total-knee-and-total-hip-replacement-in-the-united-states
#16
Anahita Dua, Sapan S Desai, Cheong J Lee, Jennifer A Heller
BACKGROUND: Total knee replacement (TKR) and total hip replacement (THR) are associated with an increased risk of deep vein thrombosis (DVT). Advances in DVT prophylaxis over the past decade have led to a decrease in DVT-related morbidity, but gender, racial, and other demographic factors that contribute to a higher risk of DVT are incompletely characterized. This study aimed to determine the incidence of DVT over the past decade and identify factors that were associated with an increased risk of DVT...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27513792/venous-thromboembolism-after-total-knee-replacement-or-total-hip-replacement-what-can-be-learnt-from-root-cause-analysis
#17
S Benjamin, D Warwick
INTRODUCTION Because of the high risk of venous thromboembolism (VTE) in total hip replacement (THR) and total knee replacement (TKR), guidelines are used widely to enhance effective (yet safe) prophylaxis. If patients develop VTEs despite use of such guidelines, then the reasons are that the guidelines were: (i) followed but the VTE occurred anyway; (ii) not implemented appropriately. All VTEs are assessed routinely by root-cause analysis (RCA). METHODS The records and subsequent RCA reports for each patient who experienced clinically significant VTE after THR or TKR were reviewed...
November 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27497697/cross-cultural-validation-of-the-icoap-and-physical-function-short-forms-of-the-hoos-and-koos-in-a-multi-country-study-of-patients-with-hip-and-knee-osteoarthritis
#18
S P Mehta, A Sankar, V Venkataramanan, L S Lohmander, J N Katz, G A Hawker, L Gossec, E M Roos, J-F Maillefert, M Kloppenburg, M Dougados, A M Davis
OBJECTIVE: To evaluate the internal consistency and construct validity of the Physical Function short-forms for the Hip and Knee Injury Osteoarthritis Outcome Scores (HOOS-PS/KOOS-PS) and the Intermittent and Constant Osteoarthritis Pain (ICOAP) in a nine country study of patients consulting for total hip or knee replacement (THR or TKR). METHODS: Patients completed HOOS-PS or KOOS-PS, ICOAP and Western Ontario and McMaster Universities' Osteoarthritis Index (WOMAC) pain and physical function subscales at their consultation visit...
August 4, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/27356253/rationing-of-hip-and-knee-replacement-effect-on-the-severity-of-patient-reported-symptoms-and-the-demand-for-surgery-in-otago
#19
David Gwynne-Jones, Ella Iosua
AIM: A key Government health target has been to increase access to elective surgery. Despite this, there is a growing concern about unmet demand and increasing numbers of patients are being declined elective surgery. This study aims to determine whether there has been an increase in the severity of osteoarthritis of the hip and knee in patients undergoing publicly-funded elective total joint replacement (TJR) and any increase in demand for TJR in Otago. METHOD: Demographic details and preoperative patient reported outcome scores (Oxford hip or knee score (OHS,OKS) and a reduced Western Ontario and McMaster Osteoarthritis Index (WOMAC) score (RWS) were collected prospectively in an historical cohort of patients undergoing total hip and knee replacement (THR, TKR) between 2006-2010...
April 1, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27352238/an-open-label-study-of-the-pharmacokinetics-and-pharmacodynamics-of-dabigatran-etexilate-150mg-once-daily-in-caucasian-patients-with-moderate-renal-impairment-undergoing-primary-unilateral-elective-total-knee-or-hip-replacement-surgery
#20
MULTICENTER STUDY
Bengt I Eriksson, Zsolt Mikuska, Martin Feuring, Jean Amiral, Sebastian Haertter, Joachim Stangier, Gerhard Nehmiz, Jeffrey I Weitz
BACKGROUND: In adults with moderate renal impairment (creatinine clearance [CrCl] 30-50mL/min) undergoing total hip or knee replacement (THR/TKR), the recommended dose of dabigatran etexilate is 150mg once daily (qd). We investigated the steady state pharmacokinetics, pharmacodynamics and safety in these patients. METHODS: Single-arm, open-label phase 4 study (NCT01184989) in Caucasian patients receiving dabigatran etexilate 75mg 1-4h after surgery and 150mg qd on days 2-10 (TKR) or days 2-35 (THR)...
August 2016: Thrombosis Research
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