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https://www.readbyqxmd.com/read/28652104/quantifying-pelvic-periprosthetic-bone-remodeling-using-dual-energy-x-ray-absorptiometry-region-free-analysis
#1
Andrew M Parker, Lang Yang, Mohsen Farzi, José M Pozo, Alejandro F Frangi, J Mark Wilkinson
The gold standard tool for measuring periprosthetic bone mineral density (BMD) is dual-energy X-ray absorptiometry (DXA). However, resolution of the method is limited due to the aggregation of pixel data into large regions of interest for clinical and statistical analysis. We have previously validated a region-free analysis method (DXA-RFA) for quantitating BMD change at the pixel level around femoral prostheses. Here, we applied the DXA-RFA method to the pelvis, and quantitated its precision in this setting using repeated DXA scans taken on the same day after repositioning in 29 patients after total hip arthroplasty...
June 23, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28633788/fluoroscopic-and-gait-analyses-for-the-functional-performance-of%C3%A2-a%C3%A2-custom-made-total-talonavicular-replacement
#2
Claudio Belvedere, Matteo Cadossi, Antonio Mazzotti, Sandro Giannini, Alberto Leardini
The present study evaluated the restoration of joint function in a special clinical case: a professional rock climber who underwent an original total talonavicular replacement with a custom-made prosthesis after a complex articular fracture. Full body gait analysis and 3-dimensional joint kinematics using single-plane fluoroscopy were performed on the same day at the 30-month follow-up examination. Gait analysis was performed using stereophotogrammetric, dynamometric, electromyographic, and baropodometric systems...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28629904/perioperative-morbidity-of-same-day-and-staged-bilateral-total-hip-arthroplasty
#3
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Stavros G Memtsoudis, Huong T Do, Michael M Alexiades, Thomas P Sculco
BACKGROUND: Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events. METHODS: We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014...
May 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28607788/a-case-of-fracture-redislocation-of-the-hip-caused-by-a-depressed-fracture-of-the-femoral-head-similar-to-a-hill-sachs-lesion
#4
Yoshihiko Okudera, Hiroaki Kijima, Shin Yamada, Natsuo Konishi, Hitoshi Kubota, Hiroshi Tazawa, Takayuki Tani, Norio Suzuki, Keiji Kamo, Ken Sasaki, Tetsuya Kawano, Yosuke Iwamoto, Naohisa Miyakoshi, Yoichi Shimada
The present case shows a case of fracture-redislocation of the hip caused by a depressed fracture of the femoral head similar to a Hill-Sachs lesion. A 59-year-old man fell from a roof and his left hip joint was dislocated posteriorly. He was admitted to a nearby hospital, and he was referred to our hospital more than 24 hours after injury. Computed tomography (CT) suggested a bone chip from the posterior wall of the acetabulum roof and a depressed femoral head that cut into the posterior margin of the acetabulum roof...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28527684/patient-perceptions-regarding-outpatient-hip-and-knee-arthroplasties
#5
R Michael Meneghini, Mary Ziemba-Davis
BACKGROUND: There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting. METHODS: We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA...
April 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28377154/the-influence-of-activity-based-funding-on-treatment-intensity-and-length-of-stay-of-geriatric-rehabilitation-patients
#6
Hylco Bouwstra, Lizette M Wattel, Aafke J de Groot, Martin Smalbrugge, Cees M Hertogh
AIM: Little is known about the impact of activity-based funding (ABF) to increase treatment intensity and decrease length of stay (LOS) of inpatient geriatric patients. In January 2014, ABF was implemented in The Netherlands with the aim to increase treatment intensity and shorten LOS in geriatric rehabilitation (GR). OBJECTIVES: To describe the influence of ABF on treatment intensity and LOS of inpatient GR patients before and after ABF was implemented. DESIGN: Population-based, retrospective cohort study...
April 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#7
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28244911/effects-of-the-length-of-stay-on-the-cost-of-total-knee-and-total-hip-arthroplasty-from-2002-to-2013
#8
Ilda B Molloy, Brook I Martin, Wayne E Moschetti, David S Jevsevar
BACKGROUND: Utilization of total knee and hip arthroplasty has greatly increased in the past decade in the United States; these are among the most expensive procedures in patients with Medicare. Advances in surgical techniques, anesthesia, and care pathways decrease hospital length of stay. We examined how trends in hospital cost were altered by decreases in length of stay. METHODS: Procedure, demographic, and economic data were collected on 6.4 million admissions for total knee arthroplasty and 2...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27787574/outcome-of-knee-revisions-for-osteoarthritis-and-inflammatory-arthritis-with-postero-stabilized-arthroplasties-a-mean-ten-year-follow-up-with-90-knee-revisions
#9
Philippe Hernigou, Arnaud Dubory, Damien Potage, François Roubineau, Charles Henri Flouzat-Lachaniette
PURPOSE: Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require revision total knee replacement. Few studies have compared post-operative complications, results and risk of re-revision in RA and OA patients. MATERIAL AND METHODS: Forty-five RA patients who had undergone revision TKA from 1998 to 2010 were selected and matched with 45 OA patients who had revision during the same period. Results of the use of a revision postero-stabilized implant in osteoarthritis were compared to results of its use in inflammatory arthritis...
April 2017: International Orthopaedics
https://www.readbyqxmd.com/read/27612756/highly-porous-low-elastic-modulus-316l-stainless-steel-scaffold-prepared-by-selective-laser-melting
#10
Jaroslav Čapek, Markéta Machová, Michaela Fousová, Jiří Kubásek, Dalibor Vojtěch, Jaroslav Fojt, Eva Jablonská, Jan Lipov, Tomáš Ruml
Recently, porous metallic materials have been extensively studied as candidates for use in the fabrication of scaffolds and augmentations to repair trabecular bone defects, e.g. in surroundings of joint replacements. Fabricating these complex structures by using common approaches (e.g., casting and machining) is very challenging. Therefore, rapid prototyping techniques, such as selective laser melting (SLM), have been investigated for these applications. In this study, we characterized a highly porous (87 vol...
December 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/27349628/liposomal-bupivacaine-incisional-injection-in-single-level-lumbar-spine-surgery
#11
Ross C Puffer, Kevin Tou, Rose E Winkel, Mohamad Bydon, Bradford Currier, Brett A Freedman
BACKGROUND CONTEXT: Postsurgical pain control is important in spine surgery as it can lead to earlier mobilization, decreased length of stay, decreased side effects from narcotic medications, and improved patient satisfaction. Liposomal bupivacaine (LB) is an injectable formulation of bupivacaine, providing prolonged local anesthesia, up to 72 hours postinjection. Although, LB has been used with increasing frequency following other musculoskeletal procedures, specifically total joint replacements, its pre-emptive analgesic effect following lumbar microdiscectomy has hitherto not been reported...
November 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27348350/temporomandibular-joint-reconstruction
#12
Mario J Imola, Aaron Liddell
PURPOSE OF REVIEW: Temporomandibular joint (TMJ) reconstruction represents one of the more challenging clinical problems that a head and neck surgeon encounters. Fortunately, the problem is fairly uncommon; however, at the same time, clear clinical guidelines have not been formulated. The goal of this review is to present the established solutions to this difficult reconstructive challenge and highlight key developments that have been recently published. RECENT FINDINGS: Modern-day approaches to TMJ reconstruction include a handful of surgical modalities: costochondral grafting, revascularized tissue transfer, distraction osteogenesis, and alloplastic temporomandibular joint replacement (APTMJR)...
August 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27265559/using-publicly-available-data-to-construct-a-transparent-measure-of-health-care-value-a-method-and-initial-results
#13
William B Weeks, Gregory R Kotzbauer, James N Weinstein
POLICY POINTS: Using publicly available Hospital Compare and Medicare data, we found a substantial range of hospital-level performance on quality, expenditure, and value measures for 4 common reasons for admission. Hospitals' ability to consistently deliver high-quality, low-cost care varied across the different reasons for admission. With the exception of coronary artery bypass grafting, hospitals that provided the highest-value care had more beds and a larger average daily census than those providing the lowest-value care...
June 2016: Milbank Quarterly
https://www.readbyqxmd.com/read/27213284/stacked-modalities-thromboprophylactic-therapy-for-patients-undergoing-total-knee-replacement-surgery
#14
Limin Jiang, Shudong Zhang, Yuchi Zhao
Thromboprophylaxis is a controversial and challenging topic in joint replacement surgery. Mechanical prophylaxis in combination with the use of anticoagulants have been shown to have greater efficacy than single modalities. But the early use of anticoagulants has the potential to increases the risk of postoperative bleeding. The purpose of this study was to evaluate the thromboprophylactic effects of sequential combined method using early-mechanical compression with delayed rivaroxaban in total knee arthroplasty...
March 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27147642/discharge-planning-and-hospital-readmissions
#15
Rachel Mosher Henke, Zeynal Karaca, Paige Jackson, William D Marder, Herbert S Wong
This study examines the association between the quality of hospital discharge planning and all-cause 30-day readmissions and same-hospital readmissions. The sample included adults aged 18 years and older hospitalized in 16 states in 2010 or 2011 for acute myocardial infarction, heart failure, pneumonia, or total hip or joint arthroplasty. Data from the Hospital Consumer Assessment of Healthcare Providers and Systems measured discharge-planning quality at the hospital level. A generalized linear mixed model was used to estimate the contribution of patient and hospital characteristics to 30-day all-cause and same-hospital readmissions...
May 4, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/27130198/cartilage-storage-at-4%C3%A2-%C3%A2-c-with-regular-culture-medium-replacement-benefits-chondrocyte-viability-of-osteochondral-grafts-in-vitro
#16
Jianhong Qi, Zunjie Hu, Hongqiang Song, Bin Chen, Di Xie, Lu Zhou, Yanming Zhang
Maintenance of articular cartilage allografts in culture media is a common method of tissue storage; however, the technical parameters of graft storage remain controversial. In this study, we examined the optimal temperature and culture medium exchange rate for the storage of osteochondral allografts in vitro. Cylindrical osteochondral grafts (n = 120), harvested from the talar joint surface of ten Boer goats, were randomly classified into four groups and stored under the following conditions: Group A1 was maintained at 4 °C in culture medium that was refreshed every 2 days; Group A2 was maintained at 4 °C in the same culture medium, without refreshing; Group B1, was maintained at 37 °C in culture medium that was refreshed every 2 days; Group B2, was maintained at 37 °C in the same culture medium, without refreshing...
September 2016: Cell and Tissue Banking
https://www.readbyqxmd.com/read/27111079/total-joint-arthroplasty-in-a-stand-alone-ambulatory-surgical-center-short-term-outcomes
#17
Bertrand W Parcells, Dean Giacobbe, David Macknet, Amy Smith, Mark Schottenfeld, David A Harwood, Stephen Kayiaros
For decades, the average hospital stay following total joint arthroplasty (TJA) has been getting shorter. The historical standard was several weeks of hospitalization, yet improvements in perioperative care have reduced the average length of stay to a few days. Medicare recognizes a 3-day inpatient stay as the standard of care following hip or knee replacement. Yet continued advances in minimally invasive surgical techniques, short-acting general anesthetics, long-acting local anesthetics, and blood loss management have further improved the safety and recovery for TJA procedures...
July 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/26878539/improvement-in-harris-hip-score-after-cementless-total-hip-arthroplasty-in-young-active-adults-with-secondary-hip-arthritis-a-short-term-follow-up-result
#18
Tariq Siddique, Ranjit Kumar Sah, Faisal Masood, Syed Muhammad Awais
OBJECTIVE: To determine the improvement in Harris Hip Score after non-cemented total hip replacement in younger patients with secondary hip joint arthritis. METHODS: The quasi-experimental study was conducted at Unit I, Department of Orthopaedic Surgery and Traumatology, Mayo Hospital, Lahore, and comprised patients diagnosed clinically and radiologically as secondary hip joint arthritis from September 2009 to December 2014. Harris Hip Score was calculated pre-operatively...
November 2015: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/26878518/short-term-evaluation-of-total-hip-arthroplasty-our-experience-at-tertiary-care-center
#19
Usama Bin Saeed, Rana Dawood Ahmad Khan, Muhammad Zain-Ur-Rehman, Ajmal Yasin
BACKGROUND: Total hip arthroplasty is a common and successful treatment for osteoarthritis of the hip. Demographic trends in Pakistan suggest a significant increase in the demand for total hip replacement surgery. OBJECTIVES: The current study was planned to assess the outcome of THA at our centre in terms of pain relief and functional improvement by using pre and postoperative HHS. It was observed in this study that the functional outcomes were highly encouraging...
November 2015: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/26557232/healthcare-utilization-and-costs-of-knee-or-hip-replacements-versus-pain-relief-injections
#20
Margaret K Pasquale, Anthony M Louder, Raymond Y Cheung, Andrew T Reiners, Jack Mardekian, Robert J Sanchez, Veerainder Goli
BACKGROUND: Given the dramatic increase in total knee and hip replacement procedures among the US population aged 45 years and older, there is a need to compare the downstream healthcare utilization and costs between patients who undergo joint replacement and those who receive intraarticular injections as a low-cost alternative. OBJECTIVE: To compare changes in osteoarthritis (OA)-related healthcare utilization and costs for Medicare members with OA who underwent knee or hip replacement versus those receiving steroid or viscosupplementation injections...
October 2015: American Health & Drug Benefits
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