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replacement of the hip and knee

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https://www.readbyqxmd.com/read/28733296/a-unified-multi-level-model-approach-to-assessing-patient-responsiveness-including-return-to-normal-minimally-important-differences-and-minimal-clinically-important-improvement-for-patient-reported-outcome-measures
#1
Adrian Sayers, Vikki Wylde, Erik Lenguerrand, Rachael Gooberman-Hill, Jill Dawson, David Beard, Andrew Price, Ashley W Blom
OBJECTIVE: This article reviews and compares four commonly used approaches to assess patient responsiveness with a treatment or therapy (return to normal (RTN), minimal important difference (MID), minimal clinically important improvement (MCII), OMERACT-OARSI [Outcome Measures in Rheumatology-Osteoarthris Reseach Society International] (OO)) and demonstrates how each of the methods can be formulated in a multilevel modelling (MLM) framework. DESIGN: Cohort study...
July 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728303/-enhancing-soft-tissue-reattachment-with-artificial-mesh-in-joint-endoprosthetic-reconstruction-for-bone-tumors
#2
J S Lin, R Chen, W Yan, D D Chen
Objective: To investigate the operative method and clinical application of the BARD(®) Mesh in enhancing joint stability and function of endoprosthetic reconstruction for bone tumors. Methods: From Jan 2013 to Jun 2015, the clinical data of 51 patients aged (44.75±23.18) years underwent wide resection of tumor and endoprosthetic reconstruction using the BARD(®) Mesh were collected. Among them, 27 were male and 24 were female. The surgical treatments received by these patients included 5 shoulder arthroplasties, 12 elbow replacements, 12 hip replacements and 32 knee replacements (including 24 femoral tumors and 8 tibial tumors)...
July 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#3
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28719557/functional-gain-and-pain-relief-after-total-joint-replacement-according-to-obesity-status
#4
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
https://www.readbyqxmd.com/read/28715055/risk-of-surgical-site-infections-following-hip-and-knee-arthroplasty-results-of-the-ischia-gisio-study
#5
A Agodi, F Auxilia, M Barchitta, M L Cristina, D D'Alessandro, I Mura, M Nobile, C Pasquarella, Gisio Gisio-SItI
BACKGROUND: Surgical Site Infection (SSI) is one of the major complications following insertion of hip or knee prosthesis. The aim of the present study was to describe rates of SSIs and associated risk factors during hip and knee prosthesis procedures in Italian hospitals. METHODS: Italian hospitals were invited to join the ISChIA (Surgical Site Infections in Arthroplasty Surgery) project and participated in the study on a voluntary basis. SSI surveillance was performed according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS) -SSI protocol...
September 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28706379/plasma-level-of-osteopontin-does-not-respond-to-total-replacement-surgery-in-patients-with-severe-primary-knee-hip-osteoarthritis
#6
Ramy Abdelnaby, Sameh El Deeb, Ali Khachab, Klaus Bläsius, Markus Tingart, Björn Rath
OBJECTIVE: To test the response of Osteopontin levels in patients with knee/hip Osteoarthritis undergoing a replacement surgery. METHOD: Plasma samples of 30 (16 with knee Osteoarthritis and 14 with hip Osteoarthritis) patients have been collected before and 3 month after a knee/hip replacement in order to investigate the above stated aim of this study. RESULT: Osteopontin levels did not decrease after 3 months of the surgery. CONCLUSION: Osteopontin levels showed no significant reduction and therefore do not respond to replacement treatment...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28705605/age-of-menarche-is-associated-with-knee-joint-replacement-due-to-primary-osteoarthritis-the-hunt-study-and-the-norwegian-arthroplasty-register
#7
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
https://www.readbyqxmd.com/read/28705547/closed-incision-negative-pressure-therapy-effects-on-postoperative-infection-and-surgical-site-complication-after-total-hip-and-knee-arthroplasty
#8
Roberta E Redfern, Claire Cameron-Ruetz, Simone K O'Drobinak, John T Chen, Karl J Beer
BACKGROUND: The aim of this study is to determine whether negative pressure wound therapy, used prophylactically in clean surgical incisions, reduces surgical site infection, hematoma, and seroma after total joint replacement. METHODS: A single center, open-label study with a prospective cohort of patients undergoing primary total knee arthroplasty or total hip arthroplasty treated with closed incision negative pressure therapy (ciNPT) of clean surgical wounds was conducted...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28704193/rehabilitation-of-patients-with-hip-joint-arthroplasty-late-post-surgery-period-hospital-rehabilitation
#9
Maya S Krastanova, Elena M Ilieva, Danelina E Vacheva
BACKGROUND: Hip joint replacement (endoprosthesis, alloplasty) has become one of the most frequent surgery interventions of the 20th century. AIM: To conduct rehabilitation therapy in the late post-surgery period of hospital rehabilitation (45 days after surgery), to track patients' progress and measure the results. MATERIALS AND METHODS: One hundred and fifty-two patients with hip joint endoprosthesis were included in the study. All underwent surgery and rehabilitation at the Department of Clinical Rehabilitation of the Physical and Rehabilitation Medicine Clinic at Doctor G...
June 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28695187/infection-burden-in-total-hip-and-knee-arthroplasties-an-international-registry-based-perspective
#10
Bryan D Springer, September Cahue, Caryn D Etkin, David G Lewallen, Brian J McGrory
BACKGROUND: Infection remains a leading cause of failure of hip and knee replacements. Infection burden is the ratio of implants revised for infection to the total number of arthroplasties in a specific period, measuring the steady state of infection in a registry. We hypothesized infection burden would be similar among arthroplasty registries. METHODS: We evaluated publicly reported data from 6 arthroplasty registries (Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR], New Zealand Joint Registry, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, National Joint Registry of England, Wales, Northern Ireland, and the Isle of Man, and the American Joint Replacement Registry) for revisions performed with an infection diagnosis over the last 6 years...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28695185/prospective-quality-of-life-assessment-after-hip-and-knee-arthroplasty-short-and-mid-term-follow-up-results
#11
Juan Pablo Martinez-Cano, Juan Pablo Herrera-Escobar, Ana Sofía Arango Gutierrez, Alfredo Sanchez Vergel, Alfredo Martinez-Rondanelli
BACKGROUND: Hip and knee arthroplasty aims to restore the joint function and to improve health-related quality of life (HRQoL) in patients with articular damage. It is important to quantify the HRQoL improvement and when this is achieved. The Oxford knee score and the Oxford hip score were developed to evaluate patients after knee and hip arthroplasty. We sought to evaluate HRQoL changes in the short and mid term following either primary or revision hip and knee arthroplasty. METHODS: Prospective cohort study during a 20-month period (August 2013 to March 2015) in a tertiary referral hospital...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28690539/neurimmirs-and-postoperative-delirium-in-elderly-patients-undergoing-total-hip-knee-replacement-a-pilot-study
#12
Rui Dong, Lingling Sun, Yayuan Lu, Xi Yang, Mian Peng, Zongze Zhang
Objective: Postoperative delirium (POD) is a frequent complication after surgery and its occurrence is associated with poor outcomes. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The purpose of this study was to investigate the associations between the preoperative expression levels of microRNA (miR)-146a, miR-125b, and miR-181c in cerebrospinal fluid (CSF) and serum and the development and severity of POD. Methods: Forty elderly patients aged 65 years old and older admitted for elective total hip/knee replacement under spinal anesthesia...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28689828/influence-of-humeral-head-material-on-wear-performance-in-anatomic-shoulder-joint-arthroplasty
#13
Ulrike Mueller, Steffen Braun, Stefan Schroeder, Mark Schroeder, Robert Sonntag, Sebastian Jaeger, Jan Philippe Kretzer
BACKGROUND: The number of total shoulder arthroplasties has increased in the past years, with encouraging results. However, the survival of anatomic total shoulder arthroplasty (aTSA) is lower compared with that of knee and hip replacements. Wear-associated problems like loosening are well-known causes of long-term failure of aTSA. The main purpose of this study was to investigate the wear behavior of ceramic-polyethylene bearings compared with the standard metal-polyethylene bearings...
July 6, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28681427/delirium-after-fast-track-hip-and-knee-arthroplasty-a-cohort-study-of-6331-elderly-patients
#14
P B Petersen, C C Jørgensen, H Kehlet
BACKGROUND: Postoperative delirium (PD) is a well-known complication among elderly surgical patients and associated with increased morbidity, mortality and length of stay (LOS). In elective orthopedic surgery, including hip and knee arthroplasty (THA/TKA), most studies report incidences between 5% and 10%. The multimodal optimization of perioperative care (fast-track) aims to enhance recovery and reduce morbidity and LOS, but limited data are available on the effect on PD. Consequently, the study investigated signs of PD associated with LOS > 4 days...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28678604/a-post-marketing-assessment-of-major-bleeding-in-total-hip-and-total-knee-replacement-surgery-patients-receiving-rivaroxaban
#15
Louis M Kwong, Alexander G G Turpie, Capt Sally Tamayo, W Frank Peacock, Zhong Yuan, Nicholas Sicignano, Kathleen Pillsbury Hopf, Manesh 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 U.S. Department of Defense (DoD) beneficiaries were queried from January 1, 2013 through June 30, 2015...
July 5, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28673804/modeling-learning-in-surgical-practice
#16
Epaminondas Markos Valsamis, Rajna Golubic, Thomas E Glover, Henry Husband, Adnan Hussain, Amir-Reza Jenabzadeh
OBJECTIVE: Methods that model surgical learning curves are frequently descriptive and lack the mathematical rigor required to extract robust, meaningful, and quantitative information. We aimed to formulate a method to model learning that is tailored to dealing with the high variability seen in surgical data and can readily extract important quantitative information such as learning rate, length of learning, and learnt level of performance. METHODS: We developed a method where progressively more complex models are fitted to learning data...
June 30, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28671393/top-20-research-studies-of-2016-for-primary-care-physicians
#17
Mark H Ebell, Roland Grad
This article summarizes the top 20 original research studies and four practice guidelines of 2016, based on regular literature surveillance and as selected by members of the Canadian Medical Association. The studies, known as POEMs (patient-oriented evidence that matters), were rated highly because of their relevance, validity, and potential to change practice. Key hypertension treatment findings include reduced mortality (a benefit not demonstrated in lower-risk persons or persons with diabetes mellitus) but also an increase in harms with a more aggressive blood pressure target in high-risk persons with hypertension and without diabetes...
May 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28664450/factors-that-affect-outcome-following-total-joint-arthroplasty-a-review-of-the-recent-literature
#18
REVIEW
Forrest H Schwartz, Jeffrey Lange
PURPOSE OF REVIEW: It is well established that certain patient-specific risk factors affect outcomes following total joint arthroplasty. The goal of this paper is to summarize the latest data on several variables that have been investigated in the last 3 years and to characterize the effects these factors have on the success of hip and knee replacement. RECENT FINDINGS: Preoperative diagnoses of depression and anxiety, liver disease, hypoalbuminemia, vitamin D deficiency, and diabetes mellitus are associated with increased risk of postoperative complications and can lead to worse outcomes after joint replacement surgery...
June 29, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28660479/nerve-growth-factor-antagonists-is-the-future-of-monoclonal-antibodies-becoming-clearer
#19
Bernard Bannwarth, Marie Kostine
Although there is an unmet need for pain medications that are both effective and safe, virtually no novel analgesics have been approved over the past two decades. In view of both experimental and clinical evidence of a major role for nerve growth factor (NGF) in the generation and maintenance of a wide range of pain states, the clinical development of humanised anti-nerve growth factor monoclonal antibodies (anti-NGF mAbs) aroused particular interest. However, the US Food and Drug Administration (FDA) placed a clinical hold on anti-NGF mAb clinical studies in late 2010, first because of reports of serious joint-related adverse events, and afterwards because of sympathetic nervous system safety concerns...
June 28, 2017: Drugs
https://www.readbyqxmd.com/read/28657948/impact-of-the-hospital-readmission-reduction-program-on-surgical-readmissions-among-medicare-beneficiaries
#20
Andrew M Ibrahim, Hari Nathan, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To understand the impact of the Hospital Readmission Reduction Program on both future targeted and nontargeted surgical procedures. BACKGROUND: The Hospital Readmission Reduction Program, established under the Affordable Care Act in March of 2010, placed financial penalties on hospitals with higher than expected rates of readmission beginning in 2012 for targeted medical conditions. Multiple studies have suggested a "spill-over" effect into other conditions, but the extent of that effect for specific surgical procedures is unknown...
June 27, 2017: Annals of Surgery
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