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https://www.readbyqxmd.com/read/29775187/body-mass-index-is-associated-with-all-cause-mortality-after-tha-and-tka
#1
Michelle M Dowsey, Peter F M Choong, Elizabeth W Paxton, Tim Spelman, Robert S Namba, Maria C S Inacio
BACKGROUND: Both obesity and underweight are associated with a higher risk of mortality in adulthood, but the association between mortality after arthroplasty and extreme ranges of body mass index (BMI) have not been evaluated beyond the first year. QUESTIONS/PURPOSES: The purpose of this study was to investigate the association between BMI and all-cause mortality after TKA and THA. METHODS: Data from two arthroplasty registries, the St Vincent's Melbourne Arthroplasty (SMART) Registry from Australia and the Kaiser Permanente Total Joint Replacement Registry (KPTJRR) from the United States, were used to identify patients aged ≥ 18 years undergoing elective TKAs and THAs between January 1, 2002, and December 31, 2013...
June 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29773405/gender-differences-in-knee-morphology-and-the-prospects-for-implant-design-in-total-knee-replacement
#2
Malte Asseln, Christoph Hänisch, Fabian Schick, Klaus Radermacher
BACKGROUND: Morphological differences between female and male knees have been reported in the literature, which led to the development of so-called gender-specific implants. However, detailed morphological descriptions covering the entire joint are rare and little is known regarding whether gender differences are real sexual dimorphisms or can be explained by overall differences in size. METHODS: We comprehensively analysed knee morphology using 33 features of the femur and 21 features of the tibia to quantify knee shape...
May 14, 2018: Knee
https://www.readbyqxmd.com/read/29772190/serum-metal-levels-in-maxillofacial-reconstructive-surgery-patients-a-pilot-study
#3
Louis G Mercuri, Michael Miloro, Anastasia K Skipor, Divya Bijukumar, Cortino Sukotjo, Mathew T Mathew
PURPOSE: The aim of this pilot study was to assay metal concentrations in the serum of patients who had undergone dental implant placement, orthognathic surgery using rigid metal fixation plates and screws, and total temporomandibular joint replacement (TMJ TJR). MATERIALS AND METHODS: Thirty patients were identified and included in this pilot study. Sixteen patients (9 men and 8 women), with an average age of 44 years (range, 19 to 79 yr), provided informed consent to participate and were divided into 3 study groups with 4 patients in each (group 1, orthognathic surgery; group 2, TMJ TJR; and group 3, dental implant placement)...
April 21, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29768985/effects-of-monoclonal-antibodies-against-nerve-growth-factor-on-healthy-bone-and-joint-tissues-in-mice-rats-and-monkeys-histopathologic-biomarker-and-microcomputed-tomographic-assessments
#4
Kathryn E Gropp, Cathy S Carlson, Mark G Evans, Cedo M Bagi, William J Reagan, Susan I Hurst, David L Shelton, Mark A Zorbas
Tanezumab, an anti-nerve growth factor (NGF) antibody, is in development for management of chronic pain. During clinical trials of anti-NGF antibodies, some patients reported unexpected adverse events requiring total joint replacements, resulting in a partial clinical hold on all NGF inhibitors. Three nonclinical toxicology studies were conducted to evaluate the effects of tanezumab or the murine precursor muMab911 on selected bone and joint endpoints and biomarkers in cynomolgus monkeys, Sprague-Dawley rats, and C57BL/6 mice...
January 1, 2018: Toxicologic Pathology
https://www.readbyqxmd.com/read/29762447/gastrocnemius-myocutaneous-flaps-for-knee-joint-coverage
#5
Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29759905/analysis-of-4063-complications-of-shoulder-arthroplasty-reported-to-the-us-food-and-drug-administration-from-2012-to-2016
#6
Jeremy S Somerson, Jason E Hsu, Moni B Neradilek, Frederick A Matsen
BACKGROUND: Most of the literature on shoulder arthroplasty failure comes from high-volume centers. These reports tend to exclude the experience of community orthopedic surgeons, who perform most of the shoulder joint replacements. METHODS: We analyzed the failure reports mandated by the US Food and Drug Administration for all hospitals. Each reported event from 2012 to 2016 was characterized by implant, failure mode, and year of surgery. RESULTS: For the 1673 anatomic arthroplasties, the most common failure modes were glenoid component failure (20...
May 11, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29758587/regional-vs-general-anesthesia-for-total-knee-and-hip-replacement-an-analysis-of-postoperative-pain-perception-from-the-international-pain-out-registry
#7
Katharina Donauer, Hagen Bomberg, Stefan Wagenpfeil, Thomas Volk, Winfried Meissner, Alexander Wolf
BACKGROUND: Total hip and knee replacements are common surgeries, and an optimal pain treatment is essential for early rehabilitation. Since data from randomized controlled trails on the use of regional anesthesia in joint replacements of the lower extremities are conflicting, we analyzed the international PAIN OUT registry for comparison of regional anesthesia vs. general anesthesia regarding pain and morphine consumption on the first postoperative day. METHODS: International Classification of Diseases-9 (ICD-9) codes were used to identify 2,346 cases for knee and 2,315 for hip arthroplasty between 2010 and 2016 from the PAIN OUT registry...
May 14, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29757957/arthroprotective-effects-of-cf-02-sharing-structural-similarity-with-quercetin
#8
Feng-Cheng Liu, Jeng-Wei Lu, Chiao-Yun Chien, Hsu-Shan Huang, Chia-Chung Lee, Shiu-Bii Lien, Leou-Chyr Lin, Liv Weichien Chen, Yi-Jung Ho, Min-Chung Shen, Ling-Jun Ho, Jenn-Haung Lai
In this study, we synthesized hundreds of analogues based on the structure of small-molecule inhibitors (SMIs) that were previously identified in our laboratory with the aim of identifying potent yet safe compounds for arthritis therapeutics. One of the analogues was shown to share structural similarity with quercetin, a potent anti-inflammatory flavonoid present in many different fruits and vegetables. We investigated the immunomodulatory effects of this compound, namely 6-(2,4-difluorophenyl)-3-(3-(trifluoromethyl)phenyl)-2 H -benzo[ e ][1,3]oxazine-2,4(3 H )-dione (Cf-02), in a side-by-side comparison with quercetin...
May 14, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29757058/outcomes-following-hip-and-knee-replacement-in-diabetic-versus-nondiabetic-patients-and-well-versus-poorly-controlled-diabetic-patients-a-prospective-cohort-study
#9
Erik Lenguerrand, Andrew D Beswick, Michael R Whitehouse, Vikki Wylde, Ashley W Blom
Background and purpose - The impact of diabetes and glycemic control before joint replacement on clinical and patient-reported outcomes is unclear. We compared pain, function, complications, and length of hospital stay in diabetic and nondiabetic patients receiving primary total hip (THR) or knee replacement (TKR) and compared these outcomes in patients with poorly controlled versus well-controlled diabetes. Patients and methods - We conducted a prospective cohort study of patients undergoing primary THR (n = 300) or TKR (n = 287) for osteoarthritis...
May 14, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29753618/predictors-and-cost-of-readmission-in-total-knee-arthroplasty
#10
Kenneth L Urish, Yongmei Qin, Benjamin Y Li, Tudor Borza, Michael Sessine, Peter Kirk, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus, Bruce L Jacobs
BACKGROUND: The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. However, there is a lack of national representative sample of all-payer hospital admissions to direct strategy, identify risk factors for readmission, and understand actual readmission cost. METHODS: We used the Nationwide Readmission Database to examine national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures...
April 17, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29752509/current-concepts-and-future-perspectives-in-computer-assisted-navigated-total-knee-replacement
#11
REVIEW
Tomoyuki Matsumoto, Naoki Nakano, John E Lawrence, Vikas Khanduja
BACKGROUND: Total knee replacements (TKR) aim to restore stability of the tibiofemoral and patella-femoral joints and provide relief of pain and improved quality of life for the patient. In recent years, computer-assisted navigation systems have been developed with the aim of reducing human error in joint alignment and improving patient outcomes. METHODS: We examined the current body of evidence surrounding the use of navigation systems and discussed their current and future role in TKR...
May 12, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29752179/the-effect-of-eicosapentaenoic-and-docosahexaenoic-acids-on-physical-function-exercise-and-joint-replacement-in-patients-with-coronary-artery-disease-a-secondary-analysis-of-a-randomized-clinical-trial
#12
Abdulhamied Alfaddagh, Tarec K Elajami, Mohamad Saleh, Mohamad Elajami, Bruce R Bistrian, Francine K Welty
BACKGROUND: Poor physical function impairs fitness and exercise and is associated with worse cardiovascular outcomes and all-cause mortality. Joint pain and stiffness limit physical function. OBJECTIVE: To determine if eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation improves physical function and exercise in coronary artery disease (CAD) patients. METHODS: A total of 291 subjects with stable CAD were randomized to either Lovaza (1...
March 14, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29752154/cementless-versus-cemented-glenoid-components-in-conventional-total-shoulder-joint-arthroplasty-analysis-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#13
Richard S Page, Vishal Pai, Kevin Eng, Gregory Bain, Stephen Graves, Michelle Lorimer
BACKGROUND: Glenoid loosening is a common mode of failure after total shoulder arthroplasty (TSA). Newer cementless glenoid components have been introduced to promote biological fixation with the aim to decrease glenoid loosening. Limited data are available comparing revision rates between cemented and cementless glenoid fixation in TSA. The study aim was to compare the revision rates of cemented and cementless design glenoid components used in conventional TSA performed for the diagnosis of osteoarthritis...
May 8, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29748122/the-tipping-point-for-931-elective-shoulder-arthroplasties
#14
Jeremy S Somerson, Jason E Hsu, Moni B Neradilek, Frederick A Matsen
BACKGROUND: A patient with arthritis usually experiences the progression of symptoms over time. At some stage, the patient may decide that the symptoms have reached a level of severity that leads him or her to elect to proceed with joint replacement; we refer to this degree of symptom severity as the "tipping point." Our goal was to study the factors that influenced the tipping point for patients undergoing elective shoulder arthroplasty. METHODS: We analyzed the characteristics of 931 patients undergoing shoulder arthroplasty to determine the factors affecting the tipping point as characterized by the patients' comfort and function at the time they determined their symptoms had progressed to the point when this elective surgery was merited...
May 7, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29744425/preliminary-focus-on-the-mechanical-and-antibacterial-activity-of-a-pmma-based-bone-cement-loaded-with-gold-nanoparticles
#15
T Russo, A Gloria, R De Santis, U D'Amora, G Balato, A Vollaro, O Oliviero, G Improta, M Triassi, L Ambrosio
In total knee arthroplasty (TKA) and total hip replacement (THR) the restoration of the normal joint function represents a fundamental feature. A prosthetic joint must be able to provide motions and to transmit functional loads. As reported in the literature, the stress distribution may be altered in bones after the implantation of a total joint prosthesis. Some scientific works have also correlated uncemented TKA to a progressive decrease of bone density below the tibial component. Antibiotic-loaded bone cements are commonly employed in conjunction with systemic antibiotics to treat infections...
September 2017: Bioactive Materials
https://www.readbyqxmd.com/read/29726671/the-ethics-of-bundled-payments-in-total-joint-replacement-cherry-picking-and-lemon-dropping
#16
Casey Jo Humbyrd
The Centers for Medicare & Medicaid Services has initiated bundled payments for hip and knee total joint replacement in an effort to decrease healthcare costs and increase quality of care. The ethical implications of this program have not been studied. This article considers the ethics of patient selection to improve outcomes; specifically, screening patients by body mass index to determine eligibility for total joint replacement. I argue that this type of screening is not ethically defensible, and that the bundled payment program as structured is likely to lead to unfair restrictions on who receives total joint replacements...
2018: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/29725971/a-comprehensive-review-of-stem-cells-for-cartilage-regeneration-in-osteoarthritis
#17
Gauthaman Kalamegam, Adnan Memic, Emma Budd, Mohammed Abbas, Ali Mobasheri
Osteoarthritis (OA) is an age related joint disease associated with degeneration and loss of articular cartilage. Consequently, OA patients suffer from chronic joint pain and disability. Weight bearing joints and joints that undergo repetitive stress and excessive 'wear and tear' are particularly prone to developing OA. Cartilage has a poor regenerative capacity and current pharmacological agents only provide symptomatic pain relief. OA patients that respond poorly to conventional therapies are ultimately treated with surgical procedures to promote cartilage repair by implantation of artificial joint structures (arthroplasty) or total joint replacement (TJR)...
May 4, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29721359/acute-cauda-equina-syndrome-following-orthopedic-procedures-as-a-result-of-epidural-anesthesia
#18
Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields
Background: Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction. Case Description: The first patient underwent a hip replacement and received 5 mL of 1% lidocaine epidural anesthesia. Postoperatively, when the patient developed an acute CES, the lumbar magnetic resonance imaging (MRI) scan demonstrated clumping/posterior displacement of nerve roots of the cauda equina consistent with adhesive arachnoiditis attributed to the patient's previous L4-L5 lumbar decompression/fusion...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29719874/reducing-the-rate-of-post-surgical-urinary-tract-infections-in-orthopedic-patients
#19
Amit Thakker, Natasha Briggs, Azusa Maeda, Julie Byrne, John Roderick Davey, Timothy D Jackson
Urinary tract infection (UTI) is the fourth leading cause of healthcare-associated infections, with approximately 70%-80% being attributed to the inappropriate use of indwelling catheters. In many cases, indwelling catheters are used inappropriately without any valid indication, creating potentially avoidable and significant patient distress, discomfort, pain and activity restrictions, together with substantial care burden, cost and hospitalisation. In the Division of Orthopedic Surgery at Toronto Western Hospital (TWH), we identified UTI rate reduction as a quality improvement priority...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29716723/experimental-evaluation-of-current-and-novel-approximations-of-articular-surfaces-of-the-ankle-joint
#20
Claudio Belvedere, Sorin Siegler, Andrea Ensini, Jason Toy, Paolo Caravaggi, Ramya Namani, Luca Giuseppe Princi, Stefano Durante, Alberto Leardini
Kinematics and flexibility properties of both natural and replaced ankle joints are affected by the geometry of the articulating surfaces. Recent studies proposed an original saddle-shaped, skewed, truncated cone with laterally oriented apex, as tibiotalar contact surfaces for ankle prosthesis. The goal of this study was to compare in vitro this novel design with traditional cylindrical or medially centered conic geometries in terms of their ability to replicate the natural ankle joint mechanics. Ten lower limb cadaver specimens underwent a validated process of custom design for the replacement of the natural ankle joint...
April 24, 2018: Journal of Biomechanics
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