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https://www.readbyqxmd.com/read/27932262/the-coach-program-a-joint-approach-to-patient-education-and-support
#1
Yael Shaked, Patricia Dickson, Kathy Workman
Hospital lengths of stay for orthopaedic procedures are declining internationally. Discharge home from hospital following total joint replacement surgery can be stressful due to pain and physical restrictions. Thus, many patients report experiencing increased anxiety and feeling a sudden withdrawal of support from their medical team. The Coach Program maximizes human resources and family-centred care by formally integrating an individual whom the patient identifies as their primary support into their health care team...
December 5, 2016: Healthcare
https://www.readbyqxmd.com/read/27931702/peripheral-nerve-blocks-causing-increased-risk-for-fall-and-difficulty-in-ambulation-for-the-hip-and-knee-joint-replacement-patient
#2
Bonnie L Crumley Aybar, Michael J Gillespie, Sean F Gipson, Caitlin E Mullaney, Melissa Tommasino-Storz
A systematic review of the literature was completed by the Evidence-Based Practice Group for the Patient population, Intervention/Issue, Comparison Intervention, Outcomes, Timing (PICOT) question: "Does the use of a peripheral nerve block increase the risk for falls and difficulty ambulation in patients after lower extremity surgery through postoperative day 2?" A search of multiple databases using specified key terms resulted in 258 articles for total knee arthroplasty or total hip arthroplasty. These were reduced to 13 with exclusion criteria and became primary evidence...
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#3
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27925193/systemic-and-local-adipose-tissue-in-knee-osteoarthritis
#4
REVIEW
Elisa Belluzzi, Hamza El Hadi, Marnie Granzotto, Marco Rossato, Roberta Ramonda, Veronica Macchi, Raffaele De Caro, Roberto Vettor, Marta Favero
Osteoarthritis is a common chronic joint disorder affecting older people. The knee is the major joint affected. The symptoms of osteoarthritis include limited range of motion, joint swelling, and pain causing disability. There are no disease modifying drugs available, and treatments are mainly focused on pain management. Total knee replacement performed at the end stage of the disease is considered the only cure available. It has been found that obese people have an increased risk to develop not only knee but also hand osteoarthritis...
December 7, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27922951/anatomic-and-ultrasonographic-evaluation-of-the-knee-sensory-innervation-a-cadaveric-study-to-determine-anatomic-targets-in-the-treatment-of-chronic-knee-pain
#5
Jorge M Orduña Valls, Ricardo Vallejo, Pablo López Pais, Eliezer Soto, Daniel Torres Rodríguez, David L Cedeño, Carlos Tornero Tornero, Maximino Quintáns Rodríguez, Aurora Baluja González, Julián Álvarez Escudero
BACKGROUND AND OBJECTIVES: Osteoarthrosis is a main cause of knee pain in the elderly. Pain associated with this condition is often refractory to conservative treatment. Total knee replacement may be the best option for severe pathologies; however, the occurrence of a chronic pain state after knee replacement has been well documented in the literature. The previous descriptions of the genicular nerves have been considered somewhat inaccurate. This innervation is complex and exhibits significant interindividual variability...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27922946/patient-reported-outcome-measurement-for-patients-with-total-knee-arthroplasty
#6
Stephen Lyman, Kaitlyn L Yin
Total knee arthroplasty is a large contributor to Medicare costs. In an effort to lower costs and improve outcomes, the Centers for Medicaid and Medicare Services has implemented the Comprehensive Care for Joint Replacement model, which incentivizes surgeons to submit both general health and joint-specific patient-reported outcome measures (PROMs). However, in addition to using PROMs for reporting purposes, surgeons should also consider incorporating PROMs into clinical practice. Currently, PROMs are not widely implemented in the clinical setting despite their value in measuring factors such as patients' expectations and mental state, which impact outcomes...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27920813/densitometric-evaluation-of-bone-prosthetic-counterface-in-hip-and-knee-arthroplasty-with-modern-implants
#7
Andrea Cozzi Lepri, Marco Giorgini, Carla Signorini, Christian Carulli, Roberto Civinini, Maria Luisa Brandi, Massimo Innocenti
INTRODUCTION: Recent acquisitions of the complex mechanisms of osseointegration between implants and host bone have gained attention, accordingly to the methods of evaluation of these interactions. DEXA analysis is considered an useful tool to assess such phenomena, in order to analyse in a quantitative manner the local metabolic activity of the bone, and to evaluate over the time the integration between host bone and prosthetic components. The purpose of the present study is to report about a preliminary experience in the analysis of osseointegration processes of patients undergoing a primary Total Hip Arthroplasty (THA) or a revision Total Knee Arthroplasty (rTKA)...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#8
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27918885/mutant-ccl2-protein-coating-mitigates-wear-particle-induced-bone-loss-in-a-murine-continuous-polyethylene-infusion-model
#9
Akira Nabeshima, Jukka Pajarinen, Tzu-Hua Lin, Xinyi Jiang, Emmanuel Gibon, Luis A Córdova, Florence Loi, Laura Lu, Eemeli Jämsen, Kensuke Egashira, Fan Yang, Zhenyu Yao, Stuart B Goodman
Wear particle-induced osteolysis limits the long-term survivorship of total joint replacement (TJR). Monocyte/macrophages are the key cells of this adverse reaction. Monocyte Chemoattractant Protein-1 (MCP-1/CCL2) is the most important chemokine regulating trafficking of monocyte/macrophages in particle-induced inflammation. 7ND recombinant protein is a mutant of CCL2 that inhibits CCL2 signaling. We have recently developed a layer-by-layer (LBL) coating platform on implant surfaces that can release biologically active 7ND...
November 24, 2016: Biomaterials
https://www.readbyqxmd.com/read/27914722/poor-expectations-of-knee-replacement-benefit-are-associated-with-modifiable-psychological-factors-and-influence-the-decision-to-have-surgery-a-cross-sectional-and-longitudinal-study-of-a-community-based-sample
#10
Daniel L Riddle, Gregory J Golladay, Amanda Hayes, Hassan M K Ghomrawi
BACKGROUND: Total knee arthroplasty (TKA) is a highly effective surgery, but is underutilized by some patient groups. This study determined factors associated with a person's expectations with respect to pain and walking function following a TKA procedure, should they elect to undergo a TKA. METHODS: A total of 3542 people were studied with or at risk of knee osteoarthritis and enrolled in the community-based Osteoarthritis Initiative (OAI). Multivariable logistic regression analyses identified demographic, socioeconomic, osteoarthritis-related, joint replacement awareness, and psychological correlates as poor outcome expectations...
November 30, 2016: Knee
https://www.readbyqxmd.com/read/27906096/biological-and-functional-evaluation-of-a-novel-pyrolytic-carbon-implant-for-the-treatment-of-focal-osteochondral-defects-in-the-medial-femoral-condyle-assessment-in-a-canine-model
#11
Samantha L Salkeld, Laura P Patron, Joan C Lien, Stephen D Cook, Deryk G Jones
BACKGROUND: Osteochondral defects continue to be a clinical treatment challenge, and when left untreated, may cause pain and functional impairment. Pyrolytic carbon is a unique isotropic biomaterial used in heart valve and small joint replacements due to its excellent wear properties and biocompatibility with bone and articular cartilage. Therefore, a proposed solution is to utilize a focal pyrolytic carbon hemiarthroplasty implant as an alternative resurfacing treatment strategy for isolated cartilage lesions...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27906065/dystrophin-deficient-dogs-with-reduced-myostatin-have-unequal-muscle-growth-and-greater-joint-contractures
#12
Joe N Kornegay, Daniel J Bogan, Janet R Bogan, Jennifer L Dow, Jiahui Wang, Zheng Fan, Naili Liu, Leigh C Warsing, Robert W Grange, Mihye Ahn, Cynthia J Balog-Alvarez, Steven W Cotten, Monte S Willis, Candice Brinkmeyer-Langford, Hongtu Zhu, Joe Palandra, Carl A Morris, Martin A Styner, Kathryn R Wagner
BACKGROUND: Myostatin (Mstn) is a negative regulator of muscle growth whose inhibition promotes muscle growth and regeneration. Dystrophin-deficient mdx mice in which myostatin is knocked out or inhibited postnatally have a less severe phenotype with greater total mass and strength and less fibrosis and fatty replacement of muscles than mdx mice with wild-type myostatin expression. Dogs with golden retriever muscular dystrophy (GRMD) have previously been noted to have increased muscle mass and reduced fibrosis after systemic postnatal myostatin inhibition...
April 4, 2016: Skeletal Muscle
https://www.readbyqxmd.com/read/27900699/the-anconeus-triceps-lateral-flap-approach-for-total-elbow-arthroplasty-in-rheumatoid-arthritis
#13
A Celli, P Bonucci
BACKGROUND: The posterior approaches to the elbow are considered as to allow an excellent joint exposure for total elbow arthroplasty. One complication that is well recognized is the insufficiency of the extensor mechanism in particular with the patients with poor tendon quality as in the rheumatoid diseases. The purpose of this paper is to present a new triceps-splitting exposure for total elbow arthroplasty used in rheumatoid patients with their preliminary results. METHODS: Fifteen consecutive patients with rheumatoid disease at grades III to V of the Larsen grading scale underwent total elbow replacement using the new triceps-splitting exposure called anconeus-triceps lateral flap and it preserves the integrity of the medial proper triceps tendon...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27898194/inflammatory-cell-induced-corrosion-in-total-knee-arthroplasty-a-retrieval-study
#14
Arianna Cerquiglini, Johann Henckel, Harry S Hothi, Anna Di Laura, John A Skinner, Alister J Hart
Metal release in patients with joint replacements is associated with local tissue reactions, pain, and ultimately revision of implants. One of the causes of this metal loss is speculated to be due to a mechanism of inflammatory cell-induced corrosion (ICIC). In this knee retrieval study, we aimed to: (1) identify the extent and location of ICI corrosion patterns on our femoral and tibial components and (2) correlate our findings with implant and clinical information. We investigated 28 femoral and 9 tibial components made of polished CoCr for presence of ICIC, using macroscopic and microscopic screening and statistical analyses to identify any significant correlations between our results and clinical information...
November 29, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27896037/functional-evaluation-of-patients-undergoing-multiple-joint-replacements-a-retrospective-study-of-50-patients-with-a-minimum-of-six-months-of-follow-up
#15
Shubhranshu S Mohanty, Nandan Mishra, Prateek Patil, Ajinkya Desale
INTRODUCTION:  Polyarthritis is a challenging condition that an orthopedic surgeon faces in day-to-day practice. Some of the conditions where multiple joints are affected are rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Multiple joint afflictions can cause severe impairment in the quality of life, which leads to a significant socioeconomic burden on the family and society. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by conservative management...
October 15, 2016: Curēus
https://www.readbyqxmd.com/read/27894147/reliability-concurrent-validity-and-minimal-detectable-change-for-iphone-goniometer-app-in-assessing-knee-range-of-motion
#16
Saurabh P Mehta, Katherine Barker, Brett Bowman, Heather Galloway, Nicole Oliashirazi, Ali Oliashirazi
Much of the published works assessing the reliability of smartphone goniometer apps (SG) have poor generalizability since the reliability was assessed in healthy subjects. No research has established the values for standard error of measurement (SEM) or minimal detectable change (MDC) which have greater clinical utility to contextualize the range of motion (ROM) assessed using the SG. This research examined the test-retest reproducibility, concurrent validity, SEM, and MDC values for the iPhone goniometer app (i-Goni; June Software Inc...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27893033/effect-of-a-decision-aid-on-access-to-total-knee-replacement-for-black-patients-with-osteoarthritis-of-the-knee-a-randomized-clinical-trial
#17
Said A Ibrahim, Marissa Blum, Gwo-Chin Lee, Pekka Mooar, Elina Medvedeva, Aliya Collier, Diane Richardson
Importance: Black patients with advanced osteoarthritis (OA) of the knee are significantly less likely than white patients to undergo surgery. No strategies have been proved to improve access to surgery for black patients with end-stage OA of the knee. Objective: To assess whether a decision aid improves access to total knee replacement (TKR) surgery for black patients with OA of the knee. Design, Setting, and Participants: In a randomized clinical trial, 336 eligible participants who self-identified as black and 50 years or older with chronic and frequent knee pain, a Western Ontario McMaster Universities Osteoarthritis Index score of at least 39, and radiographic evidence of OA of the knee were recruited from December 1, 2010, to May 31, 2014, at 3 medical centers...
November 23, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27891054/patellofemoral-joint-arthroplasty-our-experience-in-isolated-patellofemoral-and-bicompartmental-arthritic-knees
#18
L Sabatini, M Schirò, F Atzori, G Ferrero, A Massè
INTRODUCTION: Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27890891/mid-term-clinical-results-of-versys-hip-system-zimmer-uncemented-total-hip-replacement-arthroplasty
#19
Hidemi Kawaji, Takuya Uematsu, Naoya Hoshikawa, Hiroshi Watanabe, Shinro Takai
: Recent reports suggest that uncemented total hip replacement arthroplasty (THR) results in favorable short- to mid-term clinical results. In the present study, we assessed the mid-term clinical results of VerSys Hip System uncemented THR at our hospital. MATERIALS AND METHODS: We studied patients who received THR using VerSys Hip System and who could be followed-up more than 3 years. Clinical records were used to retrospectively identify patient characteristics, which included age, gender, disease requiring THR, preoperative and postoperative pain score of the Japan Orthopaedic Association scoring system, range of motion in flexion and abduction, operating time, intraoperative complication, and additional operation or revision surgery...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27890309/patterns-of-ninety-day-readmissions-following-total-joint-replacement-in-a-bundled-payment-initiative
#20
Omar A Behery, Benjamin S Kester, Jarrett Williams, Joseph A Bosco, James D Slover, Richard Iorio, Ran Schwarzkopf
BACKGROUND: Alternative payment models aim to improve quality and decrease costs associated with total joint replacement. Postoperative readmissions within 90 days are of interest to clinicians and administrators as there is no additional reimbursement beyond the episode bundled payment target price. The aim of this study is to improve the understanding of the patterns of readmission which would better guide perioperative patient management affecting readmissions. We hypothesize that readmissions have different timing, location, and patient health profile patterns based on whether the readmission is related to a medical or surgical diagnosis...
November 1, 2016: Journal of Arthroplasty
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