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https://www.readbyqxmd.com/read/29151014/consent-in-elective-hip-arthroplasty-what-has-changed-over-the-last-15-years
#1
Rohit Singh, George Evans, Amit Patel, Richard Jones
PURPOSE: It is regular practice that patients undergoing orthopaedic procedures particularly those related to arthroplasty are given both verbal and written information prior to their surgery. The aim of this study was to complete a 15 year audit cycle by assessing the patient understanding of the consent process in elective orthopaedic surgery following the introduction of patient information booklets, DVDs, web links, and "joint school." METHODS: 150 patients (50 patients in each cycle of the study) undergoing primary total hip arthroplasty were counselled about the audit and prospectively enrolled...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#2
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29146507/impact-of-osteoarthritis-and-total-joint-arthroplasty-on-the-kinematics-of-the-trapeziometacarpal-joint-a-pilot-study
#3
Priscilla D'Agostino, Benjamin Dourthe, Faes Kerkhof, Evie E Vereecke, Filip Stockmans
PURPOSE: To quantify the effect of osteoarthritis (OA) and total trapeziometacarpal (TMC) joint replacement on thumb kinematics during the primary physiological motions of the thumb. METHODS: We included 4 female patients with stage III TMC OA. A computed tomography-based markerless method was used to quantify the 3-dimensional thumb kinematics in patients before and after TMC joint replacement surgery with the Arpe implant. RESULTS: Trapeziometacarpal OA led to a marked decrease of internal rotation and abduction of the first metacarpal (MC1) during thumb flexion and a decrease of MC1 adduction during thumb adduction...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29145982/impact-of-outpatient-total-joint-replacement-on-postoperative-outcomes
#4
REVIEW
Danielle Lovett-Carter, Zain Sayeed, Leila Abaab, Vinay Pallekonda, William Mihalko, Khaled J Saleh
Total joint arthroplasty (TJA) has demonstrated tremendous benefits to patients with osteoarthritis. Health care reform has influenced surgeons to optimize TJA care pathways as well as playing a role in the formation of outpatient TJA protocols. Understanding the outcomes of outpatient TJA is imperative to surgical predicate decision making. The aim of this review is to compare outcomes of outpatient TJA patients to standard-stay inpatients. Postoperative outcomes assessed include pain, complications, readmissions, reoperation, patient satisfaction, and cost...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145978/outpatient-management-of-ankle-fractures
#5
REVIEW
Charles Qin, Robert G Dekker, Mia M Helfrich, Anish R Kadakia
Interest in outpatient orthopedic surgery has been fueled by provider desire to control costs and development of rapid recovery protocols. Open reduction and internal fixation (ORIF) is a commonly elected treatment strategy for ankle fracture that may be performed in an outpatient setting. Lessons on cost-savings of the outpatient model in orthopedics can be learned in total joint replacement and spine surgery. Moreover, in properly selected patients, outpatient ORIF has been shown to be comparably safe. Reasons for admission of the surgically managed patient with ankle fractures, including concern for surgical delay and additional social factors, warrant further investigation...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145340/open-repair-of-intraoperative-popliteal-artery-injury-during-total-knee-arthroplasty-in-a-patient-with-severe-hemophilia-a-a-case-report-and-literature-review
#6
Bin Feng, Ke Xiao, Jiang Shao, Yu Fan, Xisheng Weng
RATIONALE: Arterial injuries during total knee arthroplasty (TKA) though rare may occur. Hemophilia may further challenge the management of such injury. PATIENT CONCERNS: A 48-year-old male patient with severe hemophilia type A and stiff knee arthropathy underwent bilateral TKAs. Left popliteal artery injury was detected at the end of the left TKA. DIAGNOSES: Urgent angiography confirmed the diagnosis of the left popliteal artery transection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145334/concurrent-one-stage-total-knee-and-hip-arthroplasty-due-to-sequel-of-juvenile-rheumatoid-arthritis-a-case-report
#7
Afshin Taheriazam, Amin Saeidinia
RATIONALE: Rheumatoid arthritis is a chronic systemic connective tissue disease. Total hip and knee arthroplasties are common major orthopaedic procedures worldwide. PATIENT CONCERNS: To date, no studies have presented 1-stage concurrent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA). We reported a case which is, to our knowledge, the first description of both THA and TKA in a patient with RA simultaneously...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143404/tool-for-osteoarthritis-risk-prediction-toarp-over-8-years-using-baseline-clinical-data-x-ray-and-mri-data-from-the-osteoarthritis-initiative
#8
Gabby B Joseph, Charles E McCulloch, Michael C Nevitt, Jan Neumann, Alexandra S Gersing, Martin Kretzschmar, Benedikt J Schwaiger, John A Lynch, Ursula Heilmeier, Nancy E Lane, Thomas M Link
BACKGROUND: Osteoarthritis (OA), a multifactorial disease causing joint degeneration, often leads to severe disability. The rising rates of disability highlight the need for implementing preventative measures at early stages of the disease, which would especially benefit subjects at high risk for OA development. PURPOSE: To develop a risk prediction tool for moderate-severe OA (TOARP) over 8 years based on subject characteristics, knee radiographs, and MRI data at baseline using data from the Osteoarthritis Initiative (OAI)...
November 16, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29139570/distribution-of-segmental-foot-kinematics-in-patients-with-degenerative-joint-disease-of-the-ankle
#9
Karl Canseco, Karen M Kruger, Jessica M Fritz, Katherine A Konop, Sergey Tarima, Richard M Marks, Gerald F Harris
Degenerative joint disease (DJD) of the ankle is a debilitating chronic disease associated with severe pain and dysfunction resulting in antalgic gait alteration. Little information is available about segmental foot and ankle motion distribution during gait in ankle osteoarthritis. The aim of the current study was to dynamically characterize segmental foot and ankle kinematics of patients with severe ankle arthrosis requiring total ankle replacement. This was a prospective study involving 36 (19 M, 17 F) adult patients with a clinical diagnosis of ankle arthrosis ("DJD" group) and 36 (23 M, 13 F) healthy subjects ("Control" group)...
November 15, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29135720/clinical-outcome-following-total-joint-replacement-and-arthrodesis-for-hallux-rigidus-a-systematic-review
#10
Jasper Stevens, Robin T A L de Bot, Joris P S Hermus, Lodewijk W van Rhijn, Adhiambo M Witlox
BACKGROUND: Hallux rigidus is a common cause of foot pain in the elderly and has a negative impact on quality of life. Several operative treatment options are available for feet that are refractory to conservative treatment. Of these, total joint replacement and arthrodesis of the first metatarsophalangeal joint are the most commonly performed interventions. Nevertheless, it is still not known which intervention results in the best clinical outcome and the fewest complications. METHODS: PubMed/MEDLINE, Embase, and the Cochrane Library were systematically searched for studies assessing outcome with the American Orthopaedic Foot & Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) score, Foot Function Index (FFI), visual analog scale (VAS) for pain, or Short Form-36 (SF-36) in patients who underwent an arthrodesis or total joint replacement for the treatment of symptomatic hallux rigidus...
November 14, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/29135673/myocardial-cobalt-levels-are-elevated-in-the-setting-of-total-hip-arthroplasty
#11
Cody C Wyles, T Carson Wright, Melanie C Bois, Md Shahrier Amin, Ahmed Fayyaz, Sarah M Jenkins, Saranya P Wyles, Patrick L Day, David L Murray, Robert T Trousdale, Nandan S Anavekar, William D Edwards, Joseph J Maleszewski
BACKGROUND: Arthroplasty implants commonly contain elemental metal that may undergo wear-related release. Recently, cases of hip implant-associated myocardial injury have been reported. However, we are not aware of any previous study that has systematically measured myocardial metal levels or examined the relationship with total hip arthroplasty (THA). METHODS: Archives of our institution were queried for autopsies of individuals who had undergone THA between 1990 and 2013...
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29135529/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#12
Kathryn H Bridges, Sylvia H Wilson
Tranexamic Acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29129614/mid-term-clinical-functional-and-radiographic-outcomes-of-105-gender-specific-patellofemoral-arthroplasties-with-or-without-the-association-of-medial-unicompartmental-knee-arthroplasty
#13
Sergio Romagnoli, Matteo Marullo
BACKGROUND: The purpose of this study is to evaluate clinical and radiographic outcomes after gender-specific patellofemoral arthroplasty (PFA) either isolated or combined with unicompartmental knee arthroplasty (UKA). METHODS: A total of 105 PFAs in 85 patients were reviewed: 64 knees had isolated patellofemoral osteoarthritis and received an isolated PFA, and 41 knees with bicompartmental osteoarthritis were treated with medial UKA and PFA. Preoperative and postoperative clinical and functional assessment included knee range of motion, Knee Society Score, University of California Los Angeles Activity Score, Tegner Activity Level Scale, and visual analogue scale pain...
October 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29126692/biomaterials-in-temporomandibular-joint-replacement-current-status-and-future-perspectives-a-narrative-review
#14
REVIEW
N De Meurechy, A Braem, M Y Mommaerts
The alloplastic total temporomandibular joint (TMJ) prosthesis has a long history, with many different materials and designs used. While several of these materials have proven valuable over time, many others have not been suitable for implantation, resulting in failure and the need for explantation of the implant. Because of the failure of several of these systems, the use of alloplastic prostheses has reduced dramatically, despite their advantages over autogenous restoration. The aim of this narrative review is to discuss the criteria that must be met by a biomaterial in order for it to be considered suitable for implantation, as well as the common complications that can occur...
November 7, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29122388/pelvic-tilt-displacement-before-and-after-artificial-hip-joint-replacement-surgery
#15
Toru Nishiwaki, Ryosuke Hata, Akihito Oya, Masaya Nakamura, Morio Matsumoto, Arihiko Kanaji
BACKGROUND: Prediction of pelvic displacement before total hip arthroplasty (THA) is important for accurate acetabular implant placement. This study aimed to evaluate the effect of contralateral joint conditions on pelvic displacement after THA. METHODS: A total of 355 cases that underwent computed tomography before and after THA for osteoarthritis due to developmental dysplasia were assessed. The pelvic plane was based on preoperative and postoperative day 1 computed tomography images...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29121296/are-perioperative-therapeutic-doses-of-statins-associated-with-postoperative-pain-and-opioid-consumption-after-hip-surgery-under-spinal-anaesthesia
#16
W Saasouh, S Leung, H O Yilmaz, O Koyuncu, J You, N M Zimmerman, K Ruetzler, A Turan
Background: The anti-inflammatory effects of statins have been suggested to relieve postoperative pain. This retrospective study tested the association between the perioperative routine use of statins in therapeutic doses, and opioid requirements and pain scores, after hip replacement surgery. Methods: With IRB approval, data was obtained for adult patients who had elective hip replacement surgery under spinal anaesthesia at Cleveland Clinic between 2005 and 2015...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29116495/mandibular-kinematics-and-maximum-voluntary-bite-force-following-segmental-resection-of-the-mandible-without-or-with-reconstruction
#17
Sabine S Linsen, Annina Oikonomou, Markus Martini, Marcus Teschke
OBJECTIVES: The purpose was to analyze mandibular kinematics and maximum voluntary bite force in patients following segmental resection of the mandible without and with reconstruction (autologous bone, alloplastic total temporomandibular joint replacement (TMJ TJR)). MATERIALS AND METHODS: Subjects operated from April 2002 to August 2014 were enrolled in the study. Condylar (CRoM) and incisal (InRoM) range of motion and deflection during opening, condylar retrusion, incisal lateral excursion, mandibular rotation angle during opening, and maximum voluntary bite force were determined on the non-affected site and compared between groups...
November 7, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29113159/treatment-of-osteosarcoma-around-the-knee-in-skeletally-immature-patients
#18
Weitao Yao, Qiqing Cai, Jiaqiang Wang, Songtao Gao
Limb sparing surgery in growing young patients with malignant tumors is difficult as invasion of the physis by the tumor or surgical resection through the metaphysis may cause significant limb discrepancy following surgery. At present, hinged tumor prosthesis or biological reconstructions are the main methods following tumor resection in these patients. The aim of the present study was to assess different procedures for the treatment of osteosarcoma around knee joints in immature patients. A retrospective study of 56 patients (<15 years old, open physis) who had been treated for osteosarcoma around the knee joint between January 2007 and December 2015 was performed...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29110097/geographic-region-socioeconomic-position-and-the-utilisation-of-primary-total-joint-replacement-for-hip-or-knee-osteoarthritis-across-western-victoria-a-cross-sectional-multilevel-study-of-the-australian-orthopaedic-association-national-joint-replacement-registry
#19
Sharon Brennan-Olsen, Sara Vogrin, Kara L Holloway, Richard S Page, Muhammad A Sajjad, Mark A Kotowicz, Patricia M Livingston, Mustafa Khasraw, Sharon Hakkennes, Trish L Dunning, Susan Brumby, Daryl Pedler, Alasdair Sutherland, Svetha Venkatesh, Lana J Williams, Gustavo Duque, Julie A Pasco
Compared to urban residents, those in rural/regional areas often experience inequitable healthcare from specialist service providers. Independent of small between-area differences in utilisation, socially advantaged groups had the greatest uptake of joint replacement. These data suggest low correlation between 'need' vs. 'uptake' of surgery in rural/regional areas. BACKGROUND AND PURPOSE: Compared to urban residents, those in rural and regional areas often experience inequitable healthcare from specialist service providers, often due to geographical issues...
November 6, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29105561/failure-of-an-accis-metal-on-metal-hip-resurfacing-prosthesis-a-case-report
#20
Martin C Bone, Andrew Naylor
The introduction of coatings on joint replacements was intended to reduce wear volumes, prevent corrosion and reduce metal ion release. However, retrieval analysis to confirm their in vivo performance has been limited. The aim of study was to examine the coating on a retrieved hip prosthesis to determine whether substantial damage or wear had occurred. A single advanced ceramic-coated implant systems titanium niobium nitride-coated hip resurfacing prosthesis was retrieved for examination. Wear volumes and surface roughness were measured to quantify the damage to the articulating surfaces...
November 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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