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https://www.readbyqxmd.com/read/28302377/stair-negotiation-as-a-rehabilitation-intervention-for-enhancing-recovery-following-total-hip-and-knee-replacement-surgery
#1
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/28287044/no-effect-of-teriparatide-on-migration-in-total-knee-replacement
#2
Håkan Ledin, Lars Good, Torsten Johansson, Per Aspenberg
Background and purpose - Aseptic loosening is a main cause of late revision in total knee replacement (TKR). Teriparatide, a recombinant parathyroid hormone (PTH), stimulates osteoblasts and has been suggested to improve cancellous bone healing in humans. This might also be relevant for prosthesis fixation. We used radiostereometric analysis (RSA) to investigate whether teriparatide influences prosthesis fixation. Early migration as measured by RSA can predict future loosening. Patients and methods - In a randomized controlled trial with blind evaluation, 50 patients with osteoarthritis of the knee were allocated to a teriparatide treatment group (Forsteo, 20 μg daily for 2 months postoperatively) or to an untreated control group...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28287004/denosumab-reduces-early-migration-in-total-knee-replacement
#3
Håkan Ledin, Lars Good, Per Aspenberg
Background and purpose - Aseptic loosening is a main cause of late revision in total knee replacement (TKR). Migration of implants as measured by radiostereometric analysis (RSA) can predict future loosening. This migration is associated with bone resorption. Denosumab is a human monoclonal antibody that binds to receptors on osteoclast precursors and osteoclasts. This prevents osteoclast formation, resulting in less bone resorption in cortical and trabecular bone. We investigated whether denosumab can reduce migration of TKR, as measured with RSA...
March 13, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28281089/changing-trends-in-total-knee-replacement
#4
Ewan B Goudie, Cal Robinson, Phil Walmsley, Ivan Brenkel
INTRODUCTION: This study evaluates a possible change in the demographics and surgical practice observed in a large cohort of patients undergoing total knee replacement (TKR). PATIENTS AND METHODS: We performed a retrospective analysis of a prospectively collected data on two groups of consecutive patients undergoing primary TKR. Group one consisted of patients who underwent surgery between 1994 and 1998. Group two consisted of patients who had surgery between 2009 and 2012...
March 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28260986/impact-of-remote-ischaemic-preconditioning-on-cerebral-oxygenation-during-total-knee-arthroplasty
#5
Chung-Sik Oh, Seong-Hyop Kim, Jaemoon Lee, Ka Young Rhee
Background: Ischaemic reperfusion injury (IRI) after tourniquet release during total knee arthroplasty (TKR) is related to postoperative cerebral complications. Remote ischaemic preconditioning (RIPC) is known to minimise IRI in previous studies. Thus, we evaluated the effect of RIPC on regional cerebral oxygenation after tourniquet release during TKR. Methods: Patients undergoing TKR were randomly allocated to not receive RIPC (control group) and to receive RIPC (RIPC group). Regional cerebral oxygenation and pulmonary oxygenation were assessed up to 24 h postoperatively...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28252471/balance-training-with-a-dynamometric-platform-following-total-knee-replacement-a-randomized-controlled-trial
#6
Sergio Roig-Casasús, José María Blasco, Laura López-Bueno, María Clara Blasco-Igual
BACKGROUND AND PURPOSE: Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. METHODS: This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group...
March 1, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28249832/supporting-the-delivery-of-total-knee-replacements-care-for-both-patients-and-their-clinicians-with-a-mobile-app-and-web-based-tool-randomized-controlled-trial-protocol
#7
M Sazzad Hussain, Jane Li, Emily Brindal, Yasmin van Kasteren, Marlien Varnfield, Andrew Reeson, Shlomo Berkovsky, Jill Freyne
BACKGROUND: Total knee replacement (TKR) surgeries have increased in recent years. Exercise programs and other interventions following surgery can facilitate the recovery process. With limited clinician contact time, patients with TKR have a substantial burden of self-management and limited communication with their care team, thus often fail to implement an effective rehabilitation plan. OBJECTIVE: We have developed a digital orthopedic rehabilitation platform that comprises a mobile phone app, wearable activity tracker, and clinical Web portal in order to engage patients with self-management tasks for surgical preparation and recovery, thus addressing the challenges of adherence to and completion of TKR rehabilitation...
March 1, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28235533/comparison-of-ropivacaine-with-and-without-fentanyl-vs-bupivacaine-with-fentanyl-for-postoperative-epidural-analgesia-in-bilateral-total-knee-replacement-surgery
#8
Ashish Khanna, Rakesh Saxena, Amitabh Dutta, Neelam Ganguly, Jayashree Sood
STUDY OBJECTIVES: Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.1% with/without fentanyl 2.5 μg/mL vs plain bupivacaine 0.0625% with fentanyl 2.5 μg/mL in patients undergoing bilateral TKR...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28231649/optimal-timing-for-hemoglobin-concentration-determination-after-total-knee-arthroplasty-day-1-versus-day-2
#9
Mahdi Yacine Khalfaoui, Charles Godavitarne, Michael C P Wilkinson
Purpose: Postoperative hemoglobin (Hb) determination remains an essential parameter for quantifying blood loss following total knee replacement (TKR) surgery and guiding transfusion practice. In this study we aimed to ascertain the optimal timing for Hb determination postoperatively and assess its relationship to serum hematocrit (Hct). Materials and Methods: This was a retrospective cohort analysis of 61 consecutive patients undergoing preoperative, day 1 and day 2 Hb and Hct concentration determination following TKR surgery...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28230291/therapeutic-potentials-of-bdnf-trkb-in-breast-cancer-current-status-and-perspectives
#10
Amir Tajbakhsh, Amin Mokhtari-Zaer, Mehdi Rezaee, Fahimeh Afzaljavan, Mehdi Rivandi, Seyed Mahdi Hassanian, Gordon A Ferns, Alireza Pasdar, Amir Avan
Brain-derived neurotrophic factor (BDNF) is a potent neurotrophic factor that has been shown to stimulate breast cancer cell growth and metastasis via tyrosine kinase receptors TrkA, TrkB and the p75(NTR) death receptor. The aberrant activation of BDNF/TrkB pathways can modulate several signaling pathways, including Akt/PI3K, Jak/STAT, NF-kB, UPAR/UPA, Wnt/β-catenin and VEGF pathways as well as the ER receptor. Several microRNAs have been identified that are involved in the modulation of BDNF/TrkB pathways...
February 23, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28228047/visible-glove-perforation-in-total-knee-arthroplasty
#11
Lee Qunn Jid, Mak Wai Ping, Wong Yiu Chung, Wai Yuk Leung
PURPOSE: The risk of superficial surgical site infection (SSI) and periprosthetic joint infection (PJI) after glove perforation is not evident. This study was to identify risk factors for glove perforation in primary TKR (total knee replacement) and the risk of subsequent superficial SSI and PJI. METHODS AND MATERIALS: Results of visible glove perforation of both inner and outer gloves during TKR were reviewed. A case-control analysis was performed on the preoperative and operative variables to identify predictive risk factors for glove perforation...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28217891/a-comprehensive-behavioral-and-exercise-intervention-improves-physical-function-and-activity-participation-after-total-knee-replacement-a-pilot-randomized-study
#12
Sara R Piva, Gustavo J Almeida, Alexandra B Gil, Anthony M DiGioia, Diane L Helsel, Gwendolyn A Sowa
OBJECTIVE: To test the feasibility of a comprehensive behavioral intervention (CBI) program that combines intense exercises with an education program to be implemented at a later stage (3 months) post total knee replacement (TKR), and to get a first impression of the effects of the CBI as compared to a standard of care exercise (SCE) program on the outcomes of physical function and physical activity. METHODS: 44 subjects participated in a 3-month program of either CBI or SCE followed by 3 months of home exercise program...
February 19, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28216311/meniscal-extrusion-and-bone-marrow-lesions-are-associated-with-incident-and-progressive-knee-osteoarthritis
#13
A J Teichtahl, F M Cicuttini, F Abram, Y Wang, J-P Pelletier, P Dodin, J Martel-Pelletier
OBJECTIVE: Whether meniscal extrusion and bone marrow lesions (BMLs) are independently associated with the risk of knee osteoarthritis (OA) is unknown. METHODS: Data was extracted from the Osteoarthritis Initiative (OAI) cohort. Participants were grouped according to the absence (Kellgren-Lawrence (KL) grade ≤ 1, n = 2120) or presence (KL ≥ 2, n = 2249) of radiographic OA (ROA). Baseline meniscal extrusion and tibial BMLs were assessed. Tibial plateau cartilage volume was assessed at baseline and 72 months, while radiographic disease was assessed at baseline and 48 months...
February 13, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28210821/p-f-c-sigma-%C3%A2-cruciate-retaining-fixed-bearing-versus-mobile-bearing-knee-arthroplasty-a-prospective-comparative-study-with-minimum-10-year-follow-up
#14
O Riaz, A Aqil, G Sisodia, G Chakrabarty
AIMS: To prospectively compare long-term clinical and radiological outcomes following a cruciate retaining fixed-bearing (FB) and a mobile-bearing (MB) primary total knee replacement (TKR). METHODS: We prospectively reviewed 113 TKRs in 99 patients (14 bilateral) with a PFC sigma cruciate retaining rotating platform system, at an average follow-up of 11.1 years (range 10-12). Results were contrasted with those from 89 TKRs in 72 patients (17 bilateral) with a PFC sigma cruciate fixed-bearing prosthesis, at an average follow-up of 12...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#15
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
February 10, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28178956/translation-and-validation-of-the-12-item-oxford-knee-score-for-use-in-finland
#16
Aleksi Reito, Anni Järvistö, Esa Jämsen, Eerik Skyttä, Ville Remes, Heini Huhtala, Mika Niemeläinen, Antti Eskelinen
BACKGROUND: The focus in the reporting of results after total knee replacement (TKR) has changed from surgeon/radiologist-based scores to patient-reported outcome measures (PROMs). The questionnaires used in subjective outcome are often originally published in English and need to be validated in different languages. The aim of our study was to investigate the feasibility, validity, reliability, and responsiveness of the Finnish language version of the Oxford Knee Score (OKS-S) questionnaire...
February 8, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28174415/comparison-of-enoxaparin-and-rivaroxaban-in-balance-of-anti-fibrinolysis-and-anticoagulation-following-primary-total-knee-replacement-a-pilot-study
#17
Jinwei Xie, Jun Ma, Qiang Huang, Chen Yue, Fuxing Pei
BACKGROUND This study aimed to assess whether the efficacy of tranexamic acid (TXA) would be altered when rivaroxaban or enoxaparin was used for thromboprophylaxis in primary total knee replacement (TKR). It was hypothesized that the hemostatic effect of TXA would be better with the use of enoxaparin. MATERIAL AND METHODS A randomized clinical trial was conducted on 194 patients undergoing primary TKR for osteoarthritis. An intravenous dose of 15 mg/kg (TXA) and 1 g topical TXA were used. Patients randomly received enoxaparin or rivaroxaban prophylaxis when the drainage was less than 30 ml/h 6-8 h postoperatively...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28168348/insights-into-cellular-signalling-by-g-protein-coupled-receptor-transactivation-of-cell-surface-protein-kinase-receptors
#18
REVIEW
Rebecca Chaplin, Lyna Thach, Morley D Hollenberg, Yingnan Cao, Peter J Little, Danielle Kamato
G protein coupled receptor (GPCR) signalling is mediated by transactivation independent and transactivation dependent pathways. GPCRs transactivate protein tyrosine kinase receptors (PTKRs) and protein serine/threonine kinase receptors (PS/TKR). Since the initial observations of transactivation dependent signalling, there has been an effort to understand the mechanisms behind this phenomena. GPCR signalling has evolved to include biased signalling. Biased signalling, whereby selected ligands can activate the same GPCR that can generate multiple signals, but drive only a unique response...
February 6, 2017: Journal of Cell Communication and Signaling
https://www.readbyqxmd.com/read/28164047/management-of-infected-total-knee-arthroplasty-by-a-new-innovative-customized-articulating-knee-spacer-an-early-experience
#19
Dhiraj P Marothi, Vipin Sharma, Ashish N Sheth, Vikram I Shah, L Bharath, J A Pachore
INTRODUCTION: Management of infected total knee arthroplasty (TKA) is a challenge to patient and surgeon alike. Two-stage exchange is the universally acclaimed method to tackle this problem. Various spacer devices are available for the first stage surgery for local delivery of antibiotics. Here, we report our experience with management of infected TKA patients with our indigenously designed and produced knee spacer. CASE REPORT: Between 2012 and 2013, 28 patients with infected total knee replacement (TKR) have been managed by our indigenous knee spacer...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28160020/diagnosis-of-periprosthetic-joint-infection-using-alpha-defensin-test-or-multiplex-pcr-ideal-diagnostic-test-still-not-found
#20
Arnold J Suda, Marco Tinelli, Nils D Beisemann, Yoram Weil, Amal Khoury, Oliver E Bischel
PURPOSE: Diagnosing periprosthetic infection remains a challenge. Multiplex-PCR and biomarkers such as alpha-defensin are potentially useful and fast methods for detecting periprosthetic infection. This study compared these new methods with clinical assessment, conventional microbiological methods and histo-pathological examination. METHODS: Twenty-eight consecutive patients with 30 joints and a mean age of 67.7 years (range 39 to 88) with removal of total hip arthroplasty (THA) or total knee replacement (TKR) were included in this study...
February 4, 2017: International Orthopaedics
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