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Philippe P Van Overschelde, David A Fitch
BACKGROUND: Patient dissatisfaction following total knee replacement (TKR) has been reported as high as 24%. Most previous studies have focused on satisfaction for TKR overall, with few reporting satisfaction for specific implant designs. The purpose of this study was to assess patient satisfaction for TKRs performed using a second generation medial-pivot system (EVOLUTION(®), MicroPort Orthopedics Inc., Arlington, TN, USA). METHODS: Of a single surgeon's first 250 consecutive TKRs performed using the subject system, 224 completed a patient satisfaction assessment, the Knee Injury and Osteoarthritis Outcome Score (KOOS), range of motion, and radiographs at 2 months follow-up...
September 2016: Annals of Translational Medicine
Mohammad B Hossain, Rehnuma Shifat, David G Johnson, Mark T Bedford, Konrad R Gabrusiewicz, Nahir Cortes-Santiago, Xuemei Luo, Zhimin Lu, Ravesanker Ezhilarasan, Erik P Sulman, Hong Jiang, Shawn S C Li, Frederick F Lang, Jessica Tyler, Mien-Chie Hung, Juan Fueyo, Candelaria Gomez-Manzano
DNA repair pathways enable cancer cells to survive DNA damage induced after genotoxic therapies. Tyrosine kinase receptors (TKRs) have been reported as regulators of the DNA repair machinery. TIE2 is a TKR overexpressed in human gliomas at levels that correlate with the degree of increasing malignancy. Following ionizing radiation, TIE2 translocates to the nucleus, conferring cells with an enhanced nonhomologous end-joining mechanism of DNA repair that results in a radioresistant phenotype. Nuclear TIE2 binds to key components of DNA repair and phosphorylates H4 at tyrosine 51, which, in turn, is recognized by the proto-oncogene ABL1, indicating a role for nuclear TIE2 as a sensor for genotoxic stress by action as a histone modifier...
April 2016: Science Advances
Vikash Kapoor, Daipayan Chatterjee, Sutanu Hazra, Anirban Chatterjee, Parag Garg, Kaustav Debnath, Soham Mandal, Sudipto Sarkar
INTRODUCTION: Patient satisfaction after total knee replacement (TKR) depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana) and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana)...
2016: SICOT-J
Qing-Hang Zhang, Andrew Cossey, Jie Tong
Periprosthetic bone strain distributions in some of the typical cases of total knee replacement (TKR) were studied with regard to the selection of material, design and the alignments of tibial components to examine which conditions are more forgiving than the others to stress shielding post a TKR. Four tibial components with two implant designs (cruciate sacrificing and cruciate retaining) and material properties (metal-backed (MB) and all-polyethylene (AP)) were considered in a specimen-specific finite element tibia bone model loaded in a neutral position...
October 10, 2016: Medical Engineering & Physics
Rebecca N Howie, Timothy L Foutz, Curtis C Cathcart, Jeff S Burmeister, Steve C Budsberg
OBJECTIVE: To investigate the relationship between tibiofemoral kinematics before and after total knee replacement (TKR) in vitro. ANIMALS: Eight canine hemipelves. METHODS: A modified Oxford Knee Rig was used to place cadaveric limbs through a range of passive motion allowing the kinematics of the stifle to be evaluated. Four measurements were performed: a control stage, followed by a cranial cruciate transection stage, then following TKR with the musculature intact stage, and finally TKR with removal of limb musculature stage...
October 14, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Surachai Kotirum, Bunchai Chongmelaxme, Nathorn Chaiyakunapruk
To analyze the cost-utility of oral dabigatran etexilate, enoxaparin sodium injection, and no intervention for venous thromboembolism (VTE) prophylaxis after total hip or knee replacement (THR/TKR) surgery among Thai patients. A cost-utility analysis using a decision tree model was conducted using societal and healthcare payers' perspectives to simulate relevant costs and health outcomes covering a 3-month time horizon. Costs were adjusted to year 2014. The willingness-to-pay threshold of THB 160,000 (USD 4926) was used...
October 4, 2016: Journal of Thrombosis and Thrombolysis
G Avallone, V Pellegrino, P Roccabianca, E Lepri, L Crippa, G Beha, L De Tolla, G Sarli
The expression of tyrosine kinase receptors is attracting major interest in human and veterinary oncological pathology because of their role as targets for adjuvant therapies. Little is known about tyrosine kinase receptor (TKR) expression in canine liposarcoma (LP), a soft tissue sarcoma. The aim of this study was to evaluate the immunohistochemical expression of the TKRs fibroblast growth factor receptor 1 (FGFR1) and platelet-derived growth factor receptor-β (PDGFRβ); their ligands, fibroblast growth factor 2 (FGF2) and platelet-derived growth factor B (PDGFB); and c-kit in canine LP...
October 3, 2016: Veterinary Pathology
Mohammed Shaath, Mohamed Sukeik, Saadallah Mortada, Sean Masterson
Compartment syndrome is a rare complication of total knee replacement (TKR) surgery that needs prompt diagnosis and treatment as it may be associated with high morbidity and mortality. We have found very few reports in the literature describing compartment syndrome after TKRs and therefore, present a relevant case which occurred in the immediate postoperative phase and was treated with fasciotomy and subsequent operations to close the soft tissue defects.
September 18, 2016: World Journal of Orthopedics
Thomas Kurien, Robert Kerslake, Brett Haywood, Richard G Pearson, Brigitte E Scammell
We present our case report using a novel metal artefact reduction magnetic resonance imaging (MRI) sequence to observe resolution of subchondral bone marrow lesions (BMLs), which are strongly associated with pain, in a patient after total knee replacement surgery. Large BMLs were seen preoperatively on the 3-Tesla MRI scans in a patient with severe end stage OA awaiting total knee replacement surgery. Twelve months after surgery, using a novel metal artefact reduction MRI sequence, we were able to visualize the bone-prosthesis interface and found complete resection and resolution of these BMLs...
2016: Case Reports in Orthopedics
C-D Liao, Y-C Huang, Y-S Chiu, T-H Liou
OBJECTIVE: Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. PARTICIPANTS AND SETTING: A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review...
May 9, 2016: Physiotherapy
Ernest R Vina, Di Ran, Erin L Ashbeck, Manjinder Kaur, C Kent Kwoh
OBJECTIVES: Determine if severity of osteoarthritis-related knee pain is associated with willingness to undergo total knee replacement (TKR) and if this association is confounded or modified by components of socioeconomic status and healthcare coverage. METHODS: Cross-sectional analysis was conducted among 3530 Osteoarthritis Initiative study participants. Logistic regression models were used to assess the effect of knee pain severity (0: none, 1-3: mild, 4-7: moderate, 8-10: severe) on willingness to undergo TKR...
September 16, 2016: Arthritis Care & Research
Kuang-Ming Liao, Hsueh-Yi Lu
The incidence and prevalence of chronic obstructive pulmonary disease (COPD) is associated with increasing age. Osteoarthritis is also a growing problem in the aging population, and total knee replacement (TKR) is a common surgical procedure for this population. An increasing number of COPD patients are receiving TKR, but few studies have examined the complications and outcomes after TKR in COPD patients. The purpose of this study was to investigate the complications, including mortality, wound infections, hospitalization readmission, pneumonia (PN), and cerebrovascular accidents (CVAs) in patients with COPD after receiving TKR...
September 2016: Medicine (Baltimore)
Pieter Severijns, Manon Vanslembrouck, John Vermulst, Barbara Callewaert, Bernardo Innocenti, Kaat Desloovere, Hilde Vandenneucker, Lennart Scheys
Knee osteoarthritis is one of the most frequent indications for total knee replacement (TKR). Unfortunately, many patients still have difficulties during daily life activities after TKR. As the underlying causes of these difficulties are still not fully understood, especially with regard to the role of aberrant muscle activation profiles, the purpose of this study was to examine to what extent muscle activation patterns return to normal after TKR. Furthermore, we aimed to further discuss remaining differences by linking them to pre- and post-operative measurements of the knee and hip kinetics and kinematics during multiple functional motor tasks...
September 6, 2016: Gait & Posture
Susan Nedza, Donald E Fry, Susan DesHarnais, Eric Spencer, Patrick Yep
OBJECTIVES: The Center for Medicare and Medicaid Services (CMS) is actively testing bundled payments models. This study sought to identify relevant details for 90-day post-discharge Emergency Department (ED) visits of Medicare beneficiaries following total joint replacement (TJR) surgery meeting eligibility for a CMS bundled payment program. METHODS: The CMS research identifiable file for the State of Texas for 2011-2012 was used to identify patients who underwent TJR...
September 9, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
J D O Barceinas-Sanchez, M Alvarez-Vera, L A Montoya-Santiyanes, I Dominguez-Lopez, A L Garcia-Garcia
The observation of tribological phenomena occurring in total knee replacement (TKR) simulators may be obscured by the intrinsic complexity of their operation: the dynamics and kinematics prescribed by the ISO 14243-3:2014 standard, and the geometry of the surfaces involved. On the other hand, evaluating the individual performance of the tribosystem elements may be carried out in simpler apparatuses. An experimental method is presented here, by means of which the arthrokinematics and loading conditions prescribed by the said standard are adapted to a ball-on-disc configuration in order to observe the behavior of the coefficient of friction along an entire walking cycle, using the contact point of an AISI 316L stainless steel ball rolling/sliding on an ultra-high molecular weight polyethylene (UHMWPE) disc, lubricated by a solution of fetal bovine serum, at 37°C...
August 30, 2016: Journal of the Mechanical Behavior of Biomedical Materials
Nikolai Briffa, Mohamed A Imam, Ravi Mallina, Ashraf Abdelkafy, Ajeya Adhikari
PURPOSE: Accurate component alignment in total knee replacement (TKR) is one of the important factors in determining long-term survivorship. This has been achieved by conventional jigs, computer-assisted technology (CAS) and more recently patient-specific instrumentation (PSI). The purpose of the current study was to investigate the in vivo accuracy of Trumatch™ PSI using validated pin-less computer navigation system. METHOD: Twenty consecutive selected patients that fulfilled our inclusion/exclusion criteria underwent TKR using PSI...
September 7, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Diego A Orozco Villaseñor, Markus A Wimmer
The aim of this study was to determine how representative wear scars of simulator-tested polyethylene (PE) inserts compare with retrieved PE inserts from total knee replacement (TKR). By means of a nonparametric self-organizing feature map (SOFM), wear scar images of 21 postmortem- and 54 revision-retrieved components were compared with six simulator-tested components that were tested either in displacement or in load control according to ISO protocols. The SOFM network was then trained with the wear scar images of postmortem-retrieved components since those are considered well-functioning at the time of retrieval...
2016: BioMed Research International
Adam Daniel Gerrard, Ben Brooks, Peter Asaad, Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Postoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; and the Cochrane Central Register of Controlled Trials (CENTRAL)...
September 3, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Xiaoyu Yan, Xiaohua Gu, Lei Zhou, Houweng Lin, Bin Wu
BACKGROUND AND OBJECTIVES: Apixaban and enoxaparin are indicated for preventing venous thromboembolism (VTE). The aim of this study was to evaluate the cost effectiveness of apixaban versus enoxaparin for the prophylaxis of VTE and associated long-term complications in Chinese patients after total knee replacement (TKR). METHODS: A decision model, which included both acute VTE (represented as a decision tree) and the long-term complications of VTE (represented as a Markov model), was developed to assess the economic outcomes of the two prophylactic strategies for Chinese patients after TKR...
August 31, 2016: Clinical Drug Investigation
Christy Graff, Erik Hohmann, Adam L Bryant, Kevin Tetsworth
BACKGROUND: Although various methods for quantifying outcomes following total knee replacement (TKR) are used, there are few studies of the relationships between patient reported scores and functional tests. This paper aims to assess the relationships between commonly used outcome scores after TKR through a prospective cohort study. METHODS: Twenty-four patients who had undergone unilateral TKR were assessed using four patient-reported outcome scores as well as objective measurements of knee laxity, quadriceps muscle strength and the Timed Up and Go Test...
August 25, 2016: ANZ Journal of Surgery
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