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https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#1
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28328832/clinico-radiological-diagnosis-and-grading-of-rapidly-progressive-osteoarthritis-of-the-hip
#2
Ancuţa Zazgyva, Simona Gurzu, István Gergely, Ioan Jung, Ciprian O Roman, Tudor S Pop
Due to the current lack of standard definitions for rapidly progressive osteoarthritis of the hip (RPOH) in the literature, this observational study aimed to describe new diagnostic criteria and a grading system for the disease.From a consecutive series of patients undergoing total hip replacement, 2 groups were selected: 1 with RPOH and 1 with primary hip osteoarthritis (POH), and their clinical, paraclinical, and demographic data were compared. The newly proposed clinico-radiological diagnostic criteria are based on characteristics of pain, joint mobility, and radiological assessment...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28326426/use-of-locking-plates-for-fixation-of-the-greater-trochanter-in-patients-with-hip-replacement
#3
Allison K Tetreault, Brian J McGrory
BACKGROUND: Fixation of the greater trochanter with total hip replacement is challenging and associated with short- and long-term complications. Locking plate technology has been used for fixation of other bones and may be applied successfully in trochanteric fixation. The purpose of this retrospective study was to analyze the utility of the use of trochanteric locking plates in total hip arthroplasty (THA) patients. METHODS: From 2004 to 2014, 32 procedures were performed to fix the greater trochanter in patients with trochanteric fracture, osteotomy, or nonunion in the setting of THA...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326419/bilateral-atypical-femoral-fracture-and-end-stage-arthritis-of-the-hip-treated-with-total-hip-arthroplasty
#4
Scott M Sandilands, Jesus M Villa, Carlos J Lavernia
The prolonged use of bisphosphonates has been associated with an increased rate of atypical femoral fracture. A 77-year-old woman with prolonged bisphosphonate use presented to our office with groin pain and end-stage arthritis, She was scheduled for a total hip replacement. Before the surgery and with minimal trauma, the patient then suffered a displaced atypical femoral fracture. She underwent a total hip replacement as a treatment for her fracture and her arthritis. Subsequently, the patient presented with pain in the contralateral thigh with an incomplete atypical femoral fracture...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326404/comparing-contemporary-revision-burden-among-hip-and-knee-joint-replacement-registries
#5
Brian J McGrory, Caryn D Etkin, David G Lewallen
BACKGROUND: Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326400/staged-total-hip-arthroplasty-in-a-patient-with-hip-dysplasia-and-a-large-pertrochanteric-bone-cyst
#6
Joseph R Langston, Alexander M DeHaan, Thomas W Huff
Hip arthroplasty in young patients requires thoughtful preoperative planning. Patients with proximal femoral bone loss complicate this planning and may require a staged procedure to optimize implant insertion. We report on a case of a 26-year-old woman with secondary hip arthritis from developmental dysplasia of the hip and a large pertrochanteric bone cyst that was treated with staged total hip arthroplasty. The cyst was decompressed and filled with an osteoconductive and osteoinductive bone graft substitute called EquivaBone...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28320566/the-utility-of-metal-ion-trends-in-predicting-revision-in-metal-on-metal-total-hip-arthroplasty
#7
Bayard C Carlson, Andrew J Bryan, Nazly T Carrillo-Villamizar, Rafael J Sierra
BACKGROUND: There is a paucity of data examining metal ion levels over time. METHODS: We retrospectively reviewed 59 patients (69 hips) with an articular surface replacement total hip arthroplasty. We reviewed prerevision cobalt and chromium concentrations over time. RESULTS: Seventy-one percent of patients who were revised and had multiple ion measurements (12/17) demonstrated increasing cobalt ion levels or elevated ion levels over time...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-health-care-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#8
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28319091/whole-genome-sequencing-identifies-rare-genotypes-in-comp-and-chadl-associated-with-high-risk-of-hip-osteoarthritis
#9
Unnur Styrkarsdottir, Hannes Helgason, Asgeir Sigurdsson, Gudmundur L Norddahl, Arna B Agustsdottir, Louise N Reynard, Amanda Villalvilla, Gisli H Halldorsson, Aslaug Jonasdottir, Audur Magnusdottir, Asmundur Oddson, Gerald Sulem, Florian Zink, Gardar Sveinbjornsson, Agnar Helgason, Hrefna S Johannsdottir, Anna Helgadottir, Hreinn Stefansson, Solveig Gretarsdottir, Thorunn Rafnar, Ina S Almdahl, Anne Brækhus, Tormod Fladby, Geir Selbæk, Farhad Hosseinpanah, Fereidoun Azizi, Jung Min Koh, Nelson L S Tang, Maryams Danesphour, Jose I Mayordomo, Corrine Welt, Peter S Braund, Nilesh J Samani, Lambertus A Kiemeney, L Stefan Lohmander, Claus Christiansen, Ole A Andreassen, Olafur Magnusson, Gisli Masson, Augustine Kong, Ingileif Jonsdottir, Daniel Gudbjartsson, Patrick Sulem, Helgi Jonsson, John Loughlin, Thorvaldur Ingvarsson, Unnur Thorsteinsdottir, Kari Stefansson
We performed a genome-wide association study of total hip replacements, based on variants identified through whole-genome sequencing, which included 4,657 Icelandic patients and 207,514 population controls. We discovered two rare signals that strongly associate with osteoarthritis total hip replacement: a missense variant, c.1141G>C (p.Asp369His), in the COMP gene (allelic frequency = 0.026%, P = 4.0 × 10(-12), odds ratio (OR) = 16.7) and a frameshift mutation, rs532464664 (p.Val330Glyfs*106), in the CHADL gene that associates through a recessive mode of inheritance (homozygote frequency = 0...
March 20, 2017: Nature Genetics
https://www.readbyqxmd.com/read/28318330/changes-of-bone-mineral-density-and-serum-pentosidine-during-a-27-month-follow-up-of-monthly-minodronate-in-osteoporotic-patients
#10
Tsuyoshi Ohishi, Tomotada Fujita, Daisuke Suzuki, Tatsuya Nishida, Kazufumi Yamamoto, Ryo Okabayashi, Hiroki Ushirozako, Tomohiro Banno, Yukihiro Matsuyama
PURPOSE: Monthly regimen of minodronate for osteoporosis more than two years has not been reported yet. The aim of this study is to elucidate the effect of monthly minodronate (M-MIN) on bone mineral density (BMD) and serum pentosidine (Pen) during 27 months. MATERIALS AND METHODS: The study consisted of 52 newly treated patients (73.3 ± 8.8 years) (new group) and 47 patients (75.9 ± 9.5 years) who were switched from either alendronate or risedronate (switch group)...
March 20, 2017: Endocrine Research
https://www.readbyqxmd.com/read/28317236/rehabilitation-of-revision-total-hip-replacement-a-multi-centre-survey-of-current-practice
#11
Meredith Newman, Karen Barker
BACKGROUND: Demand for revision total hip replacement (RTHR) is increasing. Outcomes after RTHR are varied, with reasonable pain relief but smaller gains in function and mobility. Whether sub-optimal rehabilitation contributes to poorer functional outcomes is unclear. Current rehabilitation is not well defined and there is little research into RTHR rehabilitation. AIMS AND OBJECTIVES: To gather information about the current rehabilitation of patients undergoing planned, single-stage revision or re-revision THR surgery...
March 20, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28316350/peek-and-cfr-peek-as-alternative-bearing-materials-to-uhmwpe-in-a-fixed-bearing-total-knee-replacement-an-experimental-wear-study
#12
Claire L Brockett, Silvia Carbone, John Fisher, Louise M Jennings
New bearing materials for total joint replacement have been explored as the need to improve longevity and enhance performance is driven by the changing demands of the patient demographic. Carbon-reinforced PEEK has demonstrated good wear characteristics in experimental wear simulation in both simple geometry pin-on-plate studies and in total hip joint replacement. Carbon reinforced PEEK CFR-PEEK has the potential to reduce tibial insert thickness and preserve bone in the knee. This study investigated the wear performance of PEEK and CFR-PEEK in a low conformity total knee replacement configuration...
March 15, 2017: Wear: An International Journal on the Science and Technology of Friction Lubrication and Wear
https://www.readbyqxmd.com/read/28315166/effects-of-thromboprophylactic-doses-of-apixaban-and-rivaroxaban-on-coagulation-and-thrombin-generation-in-association-with-total-hip-replacement
#13
Tuukka A Helin, Lauri Virtanen, Mikko Manninen, Jarkko Leskinen, Juhana Leppilahti, Lotta Joutsi-Korhonen, Riitta Lassila
Factor Xa inhibitors (FXaI) apixaban and rivaroxaban are used for thromboprophylaxis after major elective orthopaedic surgery. Because few patient sample studies exist, we postoperatively assessed patients undergoing unilateral total hip arthroplasty, including 22 treated with apixaban (2.5 mg BID) and 20 treated with rivaroxaban (10 mg OD). We collected blood samples before and 3 h after drug intake at 4 time points, preoperatively, as well as on day 1, week 1 (day 2-8) and day 28 post-operation. APTT and PT were immediately analysed...
March 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28314985/the-role-of-new-oral-anticoagulants-in-orthopaedics-an-update-of-recent-evidence
#14
REVIEW
Dimitrios V Papadopoulos, Ioannis Kostas-Agnantis, Ioannis Gkiatas, Andreas G Tsantes, Panagiota Ziara, Anastasios V Korompilias
Rivaroxaban, dabigatran, apixaban and edoxaban are the four available new oral anticoagulants (NOAC) which are currently approved for venous thromboembolism prophylaxis after total hip and knee replacement. Large phase 3 and phase 4 studies comparing NOAC with low molecular weight heparins have shown similar results regarding the efficacy and safety of these two categories of anticoagulants. Management of bleeding complications is a matter of great significance. Three reversal agents have been developed: idarucizumab, andexanet alfa and ciraparantag...
March 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28303384/spinopelvic-parameter-changes-and-low-back-pain-improvement-due-to-femoral-neck-anteversion-in-patients-with-severe-unilateral-primary-hip-osteoarthritis-undergoing-total-hip-replacement
#15
Andrea Piazzolla, Giuseppe Solarino, Davide Bizzoca, Viola Montemurro, Pedro Berjano, Claudio Lamartina, Biagio Moretti
PURPOSE: The study of the interrelation between hip and spine disorders is gaining increasing importance in the last years, but the link between Hip Osteoarthritis (HOA) and Low Back Pain (LBP) remains still unclear. Aim of the study is to assess the relationship between Femoral Neck Anteversion (FNA), LBP, and spinopelvic parameters in patients undergoing Total Hip Replacement (THR) for unilateral severe primary HOA. MATERIALS AND METHODS: 91 patients were recruited...
March 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#16
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28302377/stair-negotiation-as-a-rehabilitation-intervention-for-enhancing-recovery-following-total-hip-and-knee-replacement-surgery
#17
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...
October 20, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28298375/knee-and-hip-intra-articular-adipose-tissues-iaats-compared-with-autologous-subcutaneous-adipose-tissue-a-specific-phenotype-for-a-central-player-in-osteoarthritis
#18
Florent Eymard, Audrey Pigenet, Danièle Citadelle, Joan Tordjman, Louise Foucher, Cindy Rose, Charles-Henri Flouzat Lachaniette, Christine Rouault, Karine Clément, Francis Berenbaum, Xavier Chevalier, Xavier Houard
OBJECTIVES: Compared with subcutaneous adipose tissue (SCAT), infrapatellar fat pad (IFP), the main knee intra-articular adipose tissue (IAAT), has an inflammatory phenotype in patients with osteoarthritis (OA). We phenotyped suprapatellar fat pad (SPFP) and hip acetabular fat pad (AFP), two other IAATs, to determinate the unique signature of IAATs compared with SCAT. METHODS: IFP, SPFP, AFP and autologous SCAT were obtained from patients with OA during total knee (n=38) or hip replacement (n=5)...
March 15, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28298194/patient-endorsement-of-the-outcome-measures-in-rheumatology-omeract-total-joint-replacement-tjr-clinical-trial-draft-core-domain-set
#19
Jasvinder A Singh, Michelle Dowsey, Peter F Choong
BACKGROUND: A patient- and surgeon-Delphi-derived Outcome Measures in Rheumatology (OMERACT) draft core domain set for total joint arthroplasty (TJR) trials was recently developed. Our objective was to obtain further patient stakeholder endorsement of draft core domain set for TJR clinical trials. METHODS: We surveyed two patient groups: (1) OMERACT patient partners; and (2) patients who had undergone hip or knee TJR. Patients received an introductory email with explanations about the core domain set and instructions to rate the core domains, i...
March 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#20
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
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