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joint replacement surgery

Chun-Hung Chang, Shang-Wen Tsai, Cheng-Fong Chen, Po-Kuei Wu, Wing-Wai Wong, Ming-Chau Chang, Wei-Ming Chen
INTRODUCTION: Evidence about the optimal timing for total hip replacement (THR) in HIV-positive patients is scant. HYPOTHESIS: Preoperative criteria: cluster of differentiation 4 (CD4) counts>200 cells/mm3 and an undetectable HIV virus load before THR, improve infection rates, aseptic loosenings, and functional outcomes. MATERIALS AND METHODS: We recruited 16 HIV-positive patients who had undergone 25 THRs between 2003 and 2015. None had hemophilia, and none were intravenous drug users (IVDUs)...
June 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Nicole Lay Tin Tan, Justin Lindley Hunt, Stella May Gwini
BACKGROUND: Enhanced recovery after surgery programs may improve recovery and reduce duration of hospital stay after joint replacement surgery. However, uptake is incomplete, and the relative importance of program components is unknown. This before-and-after quality improvement study was designed to determine whether adding 'non-surgical' components, to pre-existing 'surgical' components, in an Australian private healthcare setting, would improve patient recovery after total hip replacement...
June 13, 2018: BMC Anesthesiology
Christina Petridou, Lenka Strakova, Ruan Simpson
Introduction: Campylobacter is a common pathogen of the gastrointestinal tract, but invasive disease is rare. Campylobacter fetus can play a role in osteomyelitis, meningitis and joint infection and has a prediliction for the vascular endothelium, causing mycotic aneurysms, thrombophlebitis and endocarditis. Here we present a case of prosthetic valve endocarditis caused by C. fetus and a review of the literature. Case presentation: An 85-year-old woman with a tissue aortic valve replacement and atrial fibrillation was admitted to hospital with tonic-clonic seizures, right-sided hemiparesis, facial droop and hemianopia...
May 2018: JMM Case Reports
Omar Amado, Maria Bautista, Jose Moore, Guillermo Bonilla, Nicolas Jimenez, Adolfo Llinás
Introduction: Joint dislocation is one of the most frequent complications after hip arthroplasty. Multiple strategies have demonstrated ability to prevent instability when used in isolation, but the effect when more than one intervention is implemented has not been measured. The purpose of this study is to assess the rate of dislocation after implementation of a protocol of combined strategies for prevention of instability. Materials and methods: Consecutive patients undergoing primary total hip replacement for hip osteoarthritis between February 2012 and June 2014 were included...
April 2018: Journal of Clinical Orthopaedics and Trauma
Parham Aram, Lea Trela-Larsen, Adrian Sayers, Andrew F Hills, Ashley W Blom, Eugene V McCloskey, Visakan Kadirkamanathan, Jeremy M Wilkinson
Tools that provide personalized risk prediction of the outcomes after surgical procedures help patients to make preference-based decisions amongst the available treatment options. However, it is unclear which modeling approach provides the most accurate risk estimation. We constructed and compared several parametric and non-parametric models for predicting prosthesis survivorship after knee replacement surgery for osteoarthritis. We used 430,455 patient-procedure episodes between April 2003 and September 2015 from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man...
June 11, 2018: American Journal of Epidemiology
Jun Hirose, Hideyuki Takedani, Masanori Nojima, Tomohiko Koibuchi
This study was conducted to investigate the incidence in patients with hemophilia of postoperative complications and risk factors for these complications. Overall, 12 (6.5%) patients developed a postoperative infection. There were 6 (3.4%) postoperative surgical site infections. The presence of an inhibitor was the only risk factor for surgical site infection. Risk factors for delayed wound healing were older age, higher preoperative serum albumin level and procedures other than joint replacement or arthroscopy...
June 2018: Journal of Orthopaedics
Douglas A Zaruta, Bowen Qiu, Andrew Y Liu, Benjamin F Ricciardi
PURPOSE OF REVIEW: Prosthetic joint infection is one the most common causes of revision surgery after hip or knee replacement. Debridement and implant retention (DAIR) is one method of treating these infections; however, significant controversy exists. The purpose of our review was to describe current knowledge about indications, intraoperative/postoperative patient management, and outcomes of DAIR. RECENT FINDINGS: Patient selection affects the success of DAIR...
June 5, 2018: Current Reviews in Musculoskeletal Medicine
Romi Haas, Lisa O'Brien, Kelly-Ann Bowles, Terry Haines
OBJECTIVE: To investigate the effect of an acute weekend physiotherapy service compared to no physiotherapy service on short-term outcomes following lower limb joint replacement. DESIGN: Pre-post intervention (quasi-experimental) study nested within two stepped-wedge cluster randomized controlled trials. SETTING: Public tertiary hospital in Melbourne, Australia. SUBJECTS: Consecutive patients undergoing hip and knee replacement...
June 1, 2018: Clinical Rehabilitation
Jonathan Vela, Kristian Kjær Petersen, Lars Arendt-Nielsen, Mikkel Meyer Andersen, Ole Simonsen
Background Knee osteoarthritis (KOA) was previously considered a degenerative joint disease due to wear and tear. After total Knee replacement (TKR) 13-38% of patients develop persistent post-operative pain. Emerging evidence has shown that the etiology of pain in KOA is multifaceted and may involve different structures including the synovial membrane, musculotendinous structures and neuronal tissue. Current preoperative assessment does not take these into account, thus the current study examines the role of preoperative synovitis on patient reported outcomes one-year post surgery...
December 29, 2017: Scandinavian Journal of Pain
M Marieswaran, Ishita Jain, Bhavuk Garg, Vijay Sharma, Dinesh Kalyanasundaram
The anterior cruciate ligament is one of the six ligaments in the human knee joint that provides stability during articulations. It is relatively prone to acute and chronic injuries as compared to other ligaments. Repair and self-healing of an injured anterior cruciate ligament are time-consuming processes. For personnel resuming an active sports life, surgical repair or replacement is essential. Untreated anterior cruciate ligament tear results frequently in osteoarthritis. Therefore, understanding of the biomechanics of injury and properties of the native ligament is crucial...
2018: Applied Bionics and Biomechanics
Jie Wang, Yahui Tong, Yingqing Jiang, Hongxia Zhu, Hui Gao, Rong Wei, Xianfeng Que, Luoluo Gao
AIMS AND OBJECTIVES: To evaluate the effect of an Internet-based home orthopedic care platform on patients' functional joint recovery, quality of life, and activities of daily living after hip replacement. BACKGROUND: Most of the functional exercises after arthroplasty are performed outside the hospital. At present, the WeChat platform is used mainly in the inland of China for continuous nursing of patients with chronic disease in the Department of Orthopedics. DESIGN: An experimental design was applied...
May 31, 2018: Journal of Clinical Nursing
Piotr Kasina, Anders Enocson, Viktor Lindgren, Lasse J Lapidus
Background and purpose - Patients in Sweden are insured against avoidable patient injuries. Prosthetic joint infections (PJIs) resulting from intraoperative contamination are regarded as compensable by the Swedish public insurance system. According to the Patient Injury Act, healthcare personnel must inform patients about any injury resulting from treatment and the possibility of filing a claim. To analyze any under-reporting of claims and their outcome, we investigated patients' claims of PJI in a nationwide setting Patients and methods - The national cohort of PJI after primary total hip replacement, initially operated between 2005 and 2008, was established through cross-matching of registers and review of individual medical records...
May 29, 2018: Acta Orthopaedica
Ryan S Patton, Robert P Runner, Riley J Lyons, Thomas L Bradbury
BACKGROUND: Direct anterior total hip arthroplasty (THA) is an increasingly utilized and patient-requested approach for arthroplasty carrying a unique set of complications. Injury to the lateral femoral cutaneous nerve (LFCN) can have a wide range of clinical symptoms ranging from hypesthesia to painful paresthesia. Long-term effects of this injury have not been well studied. We describe duration and severity of these symptoms and correlate their relationship with hip functional scores...
April 24, 2018: Journal of Arthroplasty
David Ackland, Dale Robinson, Peter Vee Sin Lee, George Dimitroulis
BACKGROUND: Stock prosthetic temporomandibular joint replacements come in limited sizes, and do not always encompass the joint anatomy that presents clinically. The aims of this study were twofold. Firstly, to design a personalized prosthetic total joint replacement for the treatment of a patient's end-stage temporomandibular joint osteoarthritis, to implant the prosthesis into the patient, and assess clinical outcome 12-months post-operatively; and secondly, to evaluate the influence of changes in prosthetic condyle geometry on implant load response during mastication...
May 11, 2018: Clinical Biomechanics
Justine M Naylor, Natasha Pocovi, Joseph Descallar, Kathryn A Mills
OBJECTIVE: This study aimed to describe the: rates of participation in regular physical activity (PA) pre- and 3-years following knee or hip arthroplasty; factors associated with participation post-surgery; and types of activity undertaken. METHODS: A previously acquired, multicentre, prospective cohort of knee or hip arthroplasty recipients was followed-up 3-years post-surgery. Regular participation in PA was defined as participation in PA ≥1 times/week, excluding incidental activities...
May 25, 2018: Arthritis Care & Research
Vasili Karas, Beau J Kildow, Billy T Baumgartner, Cynthia L Green, David E Attarian, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: The shift toward value-based bundled payment models in total joint arthroplasty highlights the need for identification of modifiable risk factors for increased spending as well as opportunities to mitigate perioperative treatment of chronic disease. The purpose of this study was to identify preoperative comorbidities that result in an increased financial burden using institutional data at a single institution. METHODS: We conducted a retrospective review of total joint arthroplasty patients and collected payment data from the Center for Medicare and Medicaid Services for each patient up to 90 days after surgery in accordance with the regulations of the Comprehensive Care for Joint Replacement initiative...
April 9, 2018: Journal of Arthroplasty
Francesco Muratori, Francesca Totti, Antonio D'Arienzo, Maurizio Scorianz, Guido Scoccianti, Giovanni Beltrami, Francesco Rosario Campo, Carmine Citarelli, Rodolfo Capanna, Domenico Andrea Campanacci
Due to advances in neoadjuvant therapies and preoperative imaging modalities, joint-sparing resections have become appealing in bone tumor surgery. However, the intercalary reconstruction of metadiaphyseal bone defects of the femur and the tibia after juxta-articular tumor resection remains challenging. Both biological and prosthetic reconstructions have been used for joint-sparing resections, but little is known about the long-term outcome of these procedures. The authors reviewed a consecutive series of 64 patients treated with joint-sparing intercalary resection and reconstruction with bone grafts...
June 1, 2018: Surgical Technology International
Ivana Dehorney, Pamela F Ashcraft
Two major cost concerns related to joint replacement surgery are patient length of stay (LOS) and 30-day hospital readmission rates. A quality improvement project was implemented to evaluate the impact of a joint replacement program on patient readmissions and hospital LOS. A total of 1425 patients older than 50 years participated. At the end of the project period, readmission rates decreased from 6.19% to 2.8% and average LOS decreased from 5.87 days to 2.7 days.
July 2018: Journal of Nursing Care Quality
Madhav Chowdhry, Matthew V Dipane, Edward J McPherson
This case report describes in detail an erosive distal diaphyseal pseudotumor that occurred 6 years after a complex endoprosthetic hinge total knee arthroplasty (TKA). A female patient had conversion of a knee fusion to an endoprosthetic hinge TKA at the age of 62. At her scheduled 6-year follow-up, she presented with mild distal thigh pain and radiographs showing a 6-7 cm erosive lytic diaphyseal lesion that looked very suspicious for a neoplastic process. An en bloc resection of the distal femur and femoral endoprosthesis was performed...
May 18, 2018: World Journal of Orthopedics
Andréa Senay, Milanne Trottier, Josée Delisle, Andreea Banica, Benoit Benoit, G Yves Laflamme, Michel Malo, Hai Nguyen, Pierre Ranger, Julio C Fernandes
Background: Low-molecular-weight heparin (LMWH) is a recommended anticoagulant for thromboprophylaxis after major orthopedic surgery. Dabigatran etexilate is an oral anticoagulant recognized as noninferior to LMWH. We aimed to assess the incidence of symptomatic venous thromboembolic events (VTEs) after discharge in patients who underwent joint replacement, using a hospital registry. Patients and methods: Patients who underwent total knee and hip arthroplasty between September 2011 and March 2015 were selected...
2018: Vascular Health and Risk Management
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