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William Wynell-Mayow, Muhammad Zahid Saeed
BACKGROUND: The WHO includes osteoarthritis as a disease of priority, owing to its significant impact on quality of life, and globally increasing prevalence. Hospital budgets are under pressure to ration knee replacements and shorten inpatient stays. Prolonged tourniquet application has been hypothesised to extend recovery through pain and reduced mobility. PATIENTS AND METHODS: A total of 123 elective total knee replacements meeting inclusion criteria took place from July 2015 to October 2017 at the Royal Free Hospital...
March 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Monica Teng, Hui Jun Zhou, Liang Lin, Pang Hung Lim, Doreen Yeo, Suzanne Goh, Soon Yin Tjan, Boon Peng Lim
Background: The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore. Methods: A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR)...
March 9, 2018: Journal of Public Health
Christopher J Vertullo, Stephen E Graves, Yi Peng, Peter L Lewis
Background and purpose - Recent direct comparative reports suggest that hybrid fixation may have a similar or superior outcome to cemented fixation in total knee replacement (TKR); however, a paucity of long-term data exists. To minimize the confounders of a direct comparison, we performed an instrumental variable analysis examining the revision rate of 2 cohorts of patients based on their surgeon's preference for cemented or hybrid fixation. Methods - Registry data were obtained from 1999 until 2015 for 2 cohorts of patients who received minimally stabilized TKR, defined as those treated by high-volume hybrid fixation preferring surgeons, designated routinely hybrid (RH), and those treated by high-volume cemented fixation preferring surgeons, designated routinely cemented (RC)...
March 12, 2018: Acta Orthopaedica
Bart G Pijls, José W M Plevier, Rob G H H Nelissen
Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies. Methods - Migration pattern was defined as at least 2 postoperative RSA follow-up moments. Maximal total point motion (MTPM) at 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were considered. Results - The literature search yielded 1,167 hits of which 53 studies were included, comprising 111 study groups and 2,470 knees...
March 6, 2018: Acta Orthopaedica
Vikki Wylde, Jane Dennis, Rachael Gooberman-Hill, Andrew David Beswick
OBJECTIVE: Approximately 20% of patients experience chronic pain after total knee replacement (TKR). The aim of this systematic review was to evaluate the effectiveness of postdischarge interventions commenced in the first 3 months after surgery in reducing the severity of chronic pain after TKR. DESIGN: The protocol for this systematic review was registered on PROSPERO (registration number: CRD42017041382). MEDLINE, Embase, CINAHL, PsycINFO and The Cochrane Library were searched from inception to November 2016...
February 28, 2018: BMJ Open
Hua Tian, Min-Wei Zhao, Xiao Geng, Qi-Yun Zhou, Yang Li
Background: Restoring good alignment after total knee replacement (TKR) is still a challenge globally, and the clinical efficiency of patient-specific instruments (PSIs) remains controversial. In this study, we aimed to explore the value and significance of three-dimensional printing PSIs based on knee joint computed tomography (CT) and full-length lower extremity radiography in TKR. Methods: Between June 2013 and October 2014, 31 TKRs were performed using PSIs based on knee joint CT and full-length lower extremity radiography in 31 patients (5 males and 26 females; mean age: 67...
March 5, 2018: Chinese Medical Journal
S W F Middleton, A D Toms, P J Schranz, V I Mandalia
BACKGROUND: We present the largest series of Avon patellofemoral joint (PFJ) replacements outside of the design centre. There is discussion over its efficacy and usefulness. We report an independent opinion of its indications, survivorship and outcomes. METHODS: We prospectively collected demographic data and patient reported outcome measures (PROM's) on our cohort of Avon Patellofemoral replacements since its adoption in our unit in 2003 until 2014. We performed a retrospective review of radiographs...
February 20, 2018: Knee
Klemens Trieb, David Ullmann, Katharina Metzinger, Reinhard Kramar, Andreas Mauerer, Stefan Hofstätter, Rainer Fiala
AIMS: The aim of this open-label, prospective, short-term study was to carry out an initial comparison of a completely metal-free ceramic with a geometrically identical metallic arthroplasty over a 1-year follow-up period. METHODS: This study investigates a completely metal-free system using a composite matrix material containing aluminum oxide (Al2 O3 , BPK-S Integration, Peter Brehm GmbH, Weisendorf, Germany) or zirconium oxide (ZrO2 , BPK-S Integration Ceramic, Biolox Delta-CeramTec GmbH, Plochingen, Germany)...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Imran Ahmed, Vlad Paraoan, Dveej Bhatt, Bhanu Mishra, Chetan Khatri, Damian Griffin, Andrew Metcalfe, Tim Barlow
OBJECTIVES: Total knee replacement (TKR) is an effective means of alleviating the symptoms of end stage osteoarthritis. However, 20% of patients report dissatisfaction one year post-operatively. Previous literature has demonstrated contradictory evidence regarding the relationship between alignment and tibial component sizing with patient reported outcome measures (PROMs). We aim to investigate the association between alignment of TKR components and effect of tibial component sizing on PROMs...
February 19, 2018: International Journal of Surgery
M T Sanchez-Santos, C Garriga, A Judge, R N Batra, A J Price, A D Liddle, M K Javaid, C Cooper, D W Murray, N K Arden
To develop and validate a clinical prediction model of patient-reported pain and function after undergoing total knee replacement (TKR). We used data of 1,649 patients from the Knee Arthroplasty Trial who received primary TKR across 34 centres in the UK. The external validation included 595 patients from Southampton University Hospital, and Nuffield Orthopaedic Centre (Oxford). The outcome was the Oxford Knee Score (OKS) 12-month after TKR. Pre-operative predictors including patient characteristics and clinical factors were considered...
February 21, 2018: Scientific Reports
Cesar Garriga, Maria T Sanchez-Santos, Andrew Judge, Thomas Perneger, Didier Hannouche, Anne Lübbeke, Nigel K Arden
We aimed to develop a predictive model for non-satisfaction following primary total knee replacement (TKR) and to assess its transportability to another health care system. Data for model development were obtained from two UK tertiary hospitals. Model transportation data were collected from Geneva University Hospitals in Switzerland. Participants were individuals undergoing primary TKR with non-satisfaction with surgery after one year the outcome of interest. Multiple imputation and logistic regression modelling with bootstrap backward selection were used to identify predictors of outcome...
February 21, 2018: Scientific Reports
Xavier Paredes-Carnero, Manuel Leyes, Francisco Forriol, Ana Belén Fernández-Cortiñas, Jesús Escobar, Javier G Babé
PURPOSE: Sometimes, total knee replacement (TKR) is performed after a tibial osteotomy. It is not known if the osteotomy influences the clinical process of a TKR. The aim of this study was to look at the clinical outcome of a TKR after high tibial osteotomy (HTO) compared to a TKR with no HTO. METHODS: Between 1995 and 2005, 41 post-HTO TKRs (group A) with a minimum follow-up of ten years were selected. In parallel, it was selected a control group undergoing simple TKR, consisting of 41 patients (group B) matched with group A...
February 20, 2018: International Orthopaedics
George E Naoum, Michael Morkos, Brian Kim, Waleed Arafat
Thyroid cancer is a frequently encountered endocrine malignancy. Despite the favorable prognosis of this disease, 15-20% of differentiated thyroid cancer (DTC) cases and most anaplastic types, remain resistant to standard treatment options, including radioactive iodine (RAI). In addition, around 30% of medullary thyroid cancer (MTC) cases show resistance after surgery. The evolving understanding of disease-specific molecular therapeutic targets has led to the approval of two targeted therapies (Sorafenib and Lenvatinib) for RAI refractory DTC and another two drugs (Vandetanib and Cabozantinib) for MTC...
February 19, 2018: Molecular Cancer
Edward Burn, Alexander D Liddle, Thomas W Hamilton, Sunil Pai, Hemant G Pandit, David W Murray, Rafael Pinedo-Villanueva
BACKGROUND AND OBJECTIVE: Patients with anteromedial arthritis who require a knee replacement could receive either a unicompartmental knee replacement (UKR) or a total knee replacement (TKR). This review has been undertaken to identify economic evaluations comparing UKR and TKR, evaluate the approaches that were taken in the studies, assess the quality of reporting of these evaluations, and consider what they can tell us about the relative value for money of the procedures. METHODS: A search of MEDLINE, EMBASE and the Centre for Reviews and Dissemination National Health Service Economic Evaluation Database was undertaken in January 2016 to identify relevant studies...
December 2017: PharmacoEconomics Open
Siti Maisarah Mattap, Dawn Aitken, Karen Wills, Laura Laslett, Changhai Ding, Jean-Pierre Pelletier, Johanne Martel-Pelletier, Stephen E Graves, Michelle Lorimer, Flavia Cicuttini, Graeme Jones
The aim of this study is to describe the association of bone marrow lesions (BMLs) present on two different MRI sequences with clinical outcomes, cartilage defect progression, cartilage volume loss over 2.7 years, and total knee replacement (TKR) over 13.3 years. 394 participants (50-80 years) were assessed at baseline and 2.7 years. BML presence at baseline was scored on T1-weighted fat-suppressed 3D gradient-recalled acquisition (T1) and T2-weighted fat-suppressed 2D fast spin-echo (T2) sequences. Knee pain, function, and stiffness were assessed using WOMAC...
February 13, 2018: Calcified Tissue International
Francesca Gattino, Lorella Maniscalco, Selina Iussich, Ilaria Biasato, Marina Martano, Emanuela Morello, Cecilia Gola, Yolanda Millán Ruiz, Nobuo Saeki, Paolo Buracco, Juana Martín de Las Mulas, Raffaella De Maria
Canine mammary tumours (CMTs) are one of the most common malignancies in bitches. Platelet-derived growth factor receptor (PDGFR) α and β, vascular endothelial growth factor receptor-2 (VEGFR-2) and CD117 are tyrosine kinase receptors involved in several tumours and represent suitable targets for specific therapy with toceranib phosphate. The purpose of this study was to evaluate the expression of these receptors in the pathogenesis and progression of CMTs. PDGFRα, PDGFRβ, VEGFR-2 and CD117 were expressed in 46/83 (55...
February 9, 2018: Veterinary Record
Haroon Rehman, David R W MacDonald, Matthew Smith, Syaza Zainudin, Graham Robertson, Martin Mitchell
INTRODUCTION: Intra-operative assessment of total knee arthroplasty (TKA) components is performed with manufacturer specific jigs. Pre-operative templating, patient specific knee cutting blocks and computer-assisted surgeries have also been used to improve alignment and sizing; although the literature shows marginal improvement in functional scores. We propose pre-operative shoe size as a simple measurement tool for estimating the component sizes required for TKA. We investigate the relationship between TKA implant sizes, height, body weight and shoe size...
February 7, 2018: International Journal of Surgery
Barbara L Conner-Spady, Deborah A Marshall, Eric Bohm, Michael J Dunbar, Tom W Noseworthy
PURPOSE: (1) To assess responsiveness of the EQ-5D-5L compared to Oxford hip and knee scores and the SF-12 in osteoarthritis patients undergoing total hip (THR) or knee (TKR) replacement surgery; (2) to compare distribution and anchor-based methods of assessing responsiveness. METHODS: Questionnaires were mailed to consecutive patients following surgeon referral for primary THR or TKR and 1 year post-surgery. We assessed effect size (ES), standardized response mean (SRM), and standard error of measurement (SEM)...
February 8, 2018: Quality of Life Research
Anne R Bass, Jackie D Szymonifka, Matthew T Rondina, Margaret Bogardus, Mitchell G Scott, Scott C Woller, Scott M Stevens, Charles Eby, Kerri Merritt, Alejandro Gonzalez Della Valle, Gerard Moskowitz, Eva Flores, Brian F Gage
Background: Orthopedic patients are at risk for adverse postoperative cardiovascular outcomes. Questions/Purposes: This pilot randomized controlled trial (RCT) of atorvastatin vs. placebo in orthopedic surgery patients was performed in order to assess: (1) the prevalence of perioperative myocardial injury; (2) the effect of atorvastatin on perioperative inflammation; and (3) the feasibility of performing a large RCT of statin therapy in orthopedic patients. Methods: Hip fracture (hip Fx) and total hip and knee replacement (THR and TKR) patients were randomized 1:1 to atorvastatin 40 mg daily vs...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Cynthia A Kahlenberg, Myra Trivellas, Yuo-Yu Lee, Douglas E Padgett
Background: Preoperative valgus deformity is present in an estimated 10-20% of patients undergoing total knee replacement (TKR). Questions/Purposes: The objective of this study was to compare the Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores after TKR in a matched cohort of patients with preoperative valgus and varus deformities. Methods: This is a matched cohort study of 162 patients with varus native knees and 162 patients with valgus native knees who underwent TKR and were prospectively followed in our institutional registry...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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