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Same day joint replacement.

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...
October 27, 2016: International Orthopaedics
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
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 microdiskectomy has hitherto not been reported...
June 24, 2016: Spine Journal: Official Journal of the North American Spine Society
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
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
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...
May 23, 2016: Journal of Knee Surgery
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
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
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
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
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
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
W Foppen, I C van der Schaaf, K Fischer
INTRODUCTION: Patients with haemophilia tend to bleed in large joints even during prophylactic replacement therapy. Detection of early blood-induced joint changes may improve monitoring of treatment. The aim of this study was to explore the value of routine ultrasound in detecting early joint abnormalities in children with haemophilia on prophylaxis. METHODS: Sixty-four joints in 32 children with haemophilia were examined by one operator using the Haemophilia Early Arthropathy Detection with UltraSound protocol during annual multidisciplinary follow-up...
January 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
Leslie Harrold, Scott Pascal, Courtland Lewis, Regis O'Keefe, Vincent Pellegrini, Jeroan Allison, David Ayers, Patricia Franklin
INTRODUCTION: Current approaches to quantifying total posthospital complications and readmissions following surgical procedures are limited because the United States does not have a single health care payer. Patients seek posthospital care in varied locations, yet hospitals can only quantify those returning to the same facility. Seeking information directly from patients about health care utilization following hospital discharge holds promise to provide data that is missing for surgeons and health care systems...
2014: EGEMS
Anja Schaefer, Thilo Hotfiel, Johannes Pauser, Bernd Swoboda, Hans-Dieter Carl
INTRODUCTION: Limited weight bearing of the lower extremity is a commonly applied procedure in orthopedic rehabilitation following trauma surgery and joint replacement. The compliance of patients with limited weight bearing after cementless total hip arthroplasty has not yet been surveyed using sensor-loaded insoles. The objective of this study was to investigate foot loadings in patients after THA under the assumption of limited weight bearing. METHODS: Peak pressures for the hindfoot, midfoot and forefoot were obtained from 14 patients (10 women, 4 men, age 63 ± 12 years, height 172 ± 9 cm, weight 92 ± 20 kg, BMI 31 ± 6 kg/m(2)) by means of dynamic pedobarography, with full weight bearing preoperatively (baseline) and at 8-10 days after cementless total hip arthroplasty, walking again on even floor, and also walking upstairs and downstairs with a restriction of weight bearing to 10 % body weight, taught by an experienced physiotherapist with a bathroom scale...
February 2015: Archives of Orthopaedic and Trauma Surgery
Ross H Miller, W Brent Edwards, Kevin J Deluzio
Evidence suggests prolonged bouts of sitting are unhealthy, and some public health messages have recently recommended replacing sitting with more standing. However, the relative benefits of replacing sitting with standing compared to locomotion are not known. Specifically, the biomechanical consequences of standing compared to other sitting-alternatives like walking and running are not well known and are usually not considered in studies on sitting. We compared the total knee joint load accumulated (TKJLA) and the total energy expended (TEE) when performing either walking, running, or standing for a common exercise bout duration (30 min)...
January 2015: Gait & Posture
Sun Yunbo, Wang Lei, Shen Xingqin, Zhang Dongliang, Liu Jun, Sun Zhenhui
OBJECTIVE: To evaluate the safety and efficacy of rivaroxaban for prevention of deep vein thrombosis (DVT) in patients with preoperative abnormal D-dimer after total knee arthroplasty (TKA). METHODS: Between August and September 2013, 60 consecutive patients with varus knee osteoarthritis undergoing unilateral TKA were enrolled in the study. According to the preoperative D-dimer level, the patients were divided into 2 groups: D-dimer normal group (control group, n = 41) and D-dimer abnormal group (test group, n = 19)...
August 2014: Chinese Journal of Reparative and Reconstructive Surgery
Anuwat Pongkunakorn, Duangrak Sawatphap
BACKGROUND: There are variations in the type of rehabilitation program and duration of using the continuous passive motion (CPM) machine to increase range of motion (ROM) following total knee arthroplasty (TKA). OBJECTIVE: To compare the outcomes of the 'drop and dangle' (D&D) protocol vs. a 3-hour daily CPM for the purpose of increasing flexion following TKA. MATERIAL AND METHOD: A prospective non-concurrent controlled intervention study was conducted on patients who underwent primary TKA atLampang Hospital from December 2009 to August 2011 (D&D group, n = 36) andfrom September 2011 to December 2012 (CPM group, n = 33)...
September 2014: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Yutaka Morishima, Takashi Mizushima, Katsuya Yamauchi, Mayuko Morikawa, Shizue Masuki, Hiroshi Nose
UNLABELLED: Due to the reduced physical activity of patients who have undergone total hip arthroplasty (THA), there are no home-based exercise training regimens for preventing muscle atrophy and aerobic capacity impairment in these patients. We examined whether interval walking training (IWT) could prevented these issues. Twenty-eight female patients (∼60 years of age) who had undergone THA more than 2 months prior were randomly divided into IWT (n = 14) and control (CNT, n = 14) groups...
2014: PloS One
Yishake Mumingjiang, Xindie Zhou, Rongxin He
BACKGROUND: Total knee arthroplasty (TKA) is a successful and frequently performed procedure in orthopedic surgery. The diagnosis of peri-prosthetic joint infection following TKA remains challenging. The present study estimated the usefulness of knee skin temperature (measured by infrared thermography) and serum soluble intercellular adhesion molecule-1 (sICAM-1) in the diagnosis of post-operative knee peri-prosthetic infection. METHODS: Patients were divided into three groups: 21 patients undergoing uncomplicated TKAs, seven with prosthesis infection, and three undergoing TKA revisions...
2014: Chinese Medical Journal
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