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https://www.readbyqxmd.com/read/28632602/visits-to-the-emergency-department-after-joint-replacement-commentary-on-an-article-by-micaela-a-finnegan-ba-et-al-emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#1
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#2
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28630723/outcome-after-arthroscopic-labral-surgery-in-patients-previously-treated-with-periacetabular-osteotomy-a-follow-up-study-of-43-patients
#3
Charlotte Hartig-Andreasen, Torsten G Nielsen, Bent Lund, Kjeld Søballe, Martin Lind
To identify factors predicting failure after hip arthroscopy in patients with previous periacetabular osteotomy (PAO) defined as a conversion to total hip replacement (THR) and to evaluate the patient reported outcome scores. Of 55 hips treated with hip arthroscopy after PAO from Aug 2008 to 2012 at Aarhus University Hospital, 43 hips were included (median age: 36.1 yrs, range 16.3-56.9 yrs). Indications were unacceptable pain, a positive FABER and impingement test and signs of labral damage on MR-arthrography...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28624294/patient-decision-aids-for-patients-considering-total-joint-replacement-a-cost-effectiveness-analysis-alongside-a-randomised-controlled-trial
#4
Logan Trenaman, Dawn Stacey, Stirling Bryan, Monica Taljaard, Gillian Hawker, Geoff Dervin, Peter Tugwell, Nick Bansback
BACKGROUND: Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether to undergo total joint arthroplasty (TJA). Patient decision aids can support SDM; however, they may incur an upfront cost. We aimed to estimate the health and economic effects of patient decision aids for TJA. METHODS: A cost-effectiveness analysis of a randomised controlled trial with 2-year follow-up. 343 patients were recruited from two orthopedic screening clinics in Ottawa, Canada...
June 14, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28611391/isothiocyanates-are-detected-in-human-synovial-fluid-following-broccoli-consumption-and-can-affect-the-tissues-of-the-knee-joint
#5
Rose Davidson, Sarah Gardner, Orla Jupp, Angela Bullough, Sue Butters, Laura Watts, Simon Donell, Maria Traka, Shikha Saha, Richard Mithen, Mandy Peffers, Peter Clegg, Yongping Bao, Aedin Cassidy, Ian Clark
Osteoarthritis is a major cause of disability and there is no current pharmaceutical treatment which can prevent the disease or slow its progression. Dietary advice or supplementation is clearly an attractive option since it has low toxicity and ease of implementation on a population level. We have previously demonstrated that sulforaphane, a dietary isothiocyanate derived from its glucosinolate precursor which is found in broccoli, can prevent cartilage destruction in cells, in in vitro and in vivo models of osteoarthritis...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28610654/periprosthetic-infection-in-joint-replacement
#6
Christina Otto-Lambertz, Ayla Yagdiran, Franziska Wallscheid, Peer Eysel, Norma Jung
BACKGROUND: The volume of joint replacement surgery has risen steadily in recent years, because the population is aging and increasingly wishes to reserve a high functional status onward into old age. Infection is among the more common complications of joint replacement surgery, arising in 0.2% to 2% of patients, or as many as 9% in special situations such as the implantation of megaprostheses. The associated morbidity and mortality are high. It is thus very important to minimize risk factors for infection and to optimize the relevant diagnostic and therapeutic strategies...
May 26, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28607765/paediatric-bone-and-joint-infection
#7
REVIEW
Alexios D Iliadis, Manoj Ramachandran
Despite advances in understanding and management, paediatric osteoarticular infections continue to pose diagnostic difficulties for clinicians. Delays in diagnosis can lead to potentially devastating morbidity.No single investigation, including joint aspiration, is sufficiently reliable to diagnose conclusively paediatric bone and joint infection. Diagnosis should be based on a combination of clinical signs, imaging and laboratory investigations. Algorithms should supplement, and not replace, clinical decision making in all cases...
January 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28607342/continuous-regional-anesthesia-a-review-of-perioperative-outcome-benefits
#8
Dario Bugada, Daniela Ghisi, Edward R Mariano
Routine use of regional anesthesia for patients having surgery is supported by general safety and proven effectiveness as a targeted modality in the prevention and treatment of acute pain. Recently, perioperative physicians have become much more interested in improving long-term outcomes after surgery rather than focusing on the well-established short-term benefits of regional anesthesia. This interest has raised important questions regarding the potential influence of regional anesthesia on morbidity and mortality, persistent pain and cancer prognosis...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28604090/anesthetic-management-of-a-patient-with-multiple-sclerosis
#9
Naohiro Ohshita, Shoko Gamoh, Masahiko Kanazumi, Masahiro Nakajima, Yoshihiro Momota, Yasuo M Tsutsumi
A 54-year-old woman diagnosed with multiple sclerosis (MS) at the age of 19 years was scheduled to undergo temporomandibular joint mobilization. She was currently in a remission phase from her MS but with persistent sequelae, including impaired eyesight and muscle weakness of the limbs. In addition, the blood vessels in her upper limbs were compromised by the formation of internal shunts secondary to vascular prosthesis replacements for plasma exchange therapy in MS. After a previous joint mobilization surgery, her temporomandibular joint developed adhesions with resultant trismus...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28601245/the-impact-of-discharge-disposition-on-episode-of-care-reimbursement-after-primary-total-hip-arthroplasty
#10
Karim G Sabeh, Samuel Rosas, Leonard T Buller, Martin W Roche, Victor H Hernandez
BACKGROUND: Total joint arthroplasty (TJA) accounts for more Medicare expenditure than any other inpatient procedure. The Comprehensive Care for Joint Replacement model was introduced to decrease cost and improve quality in TJA. The largest portion of episode-of-care costs occurs after discharge. This study sought to quantify the cost variation of primary total hip arthroplasty (THA) according to discharge disposition. METHODS: The Medicare and Humana claims databases were used to extract charges and reimbursements to compare day-of-surgery and 91-day postoperative costs simulating episode-of-care reimbursements...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28599629/dose-dependent-effects-of-intravenous-methoxamine-infusion-during-hip-joint-replacement-surgery-on-postoperative-cognitive-dysfunction-and-blood-tnf-%C3%AE-level-in-elderly-patients-a-randomized-controlled-trial
#11
Shenghui Sun, Defeng Sun, Lin Yang, Jun Han, Ruochuan Liu, Lijie Wang
BACKGROUND: Postoperative cognitive dysfunction (POCD), common in elderly patients, is thought to be closely associated with intraoperative instability of hemodynamics and excessive excretion of tumor necrosis factor-α (TNF-α). Methoxamine is a blood-pressure increasing drug commonly used for maintaining intraoperative hemodynamics. Methoxamine potentially promotes TNF-α expression, leading to an increased risk of POCD. This study aimed to investigate the dose-dependent effect of methoxamine on the incidence of early POCD and blood TNF-α level...
June 9, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28598921/virtual-reality-as-an-adjunctive-nonpharmacological-sedative-during-orthopedic-surgery-under-regional-anesthesia-a-pilot-and-feasibility-study
#12
Peter Y Chan, Simon Scharf
This pilot study assessed the feasibility and potential for any possible sedation sparing effect of immersive virtual reality (IVR) therapy on patients undergoing joint replacement surgery under regional anesthesia. Nine participants were given IVR, regional anesthetic, and sedation. Ten received conventional care. Mean propofol usage was 155 ± 45 mg/h in the conventional care group and 63 ± 21 mg/h in the IVR group (P = .088, mean difference -91.6 mg/h, 95% confidence interval -200 to 16.87 mg/h). There was no significant difference in postoperative satisfaction between the 2 groups...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28597247/pre-operative-predictors-of-post-operative-falls-in-people-undergoing-total-hip-and-knee-replacement-surgery-a-prospective-study
#13
Pazit Levinger, Elin Wee, Soula Margelis, Hylton B Menz, John R Bartlett, Neil R Bergman, Stephen McMahon, Keith D Hill
INTRODUCTION: Pain and disability often persist following hip (THR) and knee replacement (TKR) surgery predisposing patients to increased risk of falling. This study identified pre-operative predictors for post-operative falls in TKR and THR patients, and the incidence and circumstances of falls in the 12 months post-surgery. MATERIALS AND METHODS: A survey was undertaken of patients before THR and TKR, and was repeated 12 months post-operation. The survey included (1) medical history and medications usage, (2) pain and function, (3) health-related and physical activity and (4) fear of falls and history of falls questionnaires...
June 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28587575/comparison-of-multisegmental-foot-and-ankle-motion-between-total-ankle-replacement-and-ankle-arthrodesis-in-adults
#14
Sang Gyo Seo, Eo Jin Kim, Doo Jae Lee, Kee Jeong Bae, Kyoung Min Lee, Dong Yeon Lee
BACKGROUND: Total ankle replacement (TAR) and ankle arthrodesis (AA) are usually performed for severe ankle arthritis. We compared postoperative foot segmental motion during gait in patients treated with TAR and AA. METHODS: Gait analysis was performed in 17 and 7 patients undergoing TAR and AA, respectively. Subjects were evaluated using a 3-dimensional multisegmental foot model with 15 markers. Temporal gait parameters were calculated. The maximum and minimum values and the differences in hallux, forefoot, hindfoot, and arch in 3 planes (sagittal, coronal, transverse) were compared between the 2 groups...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28585185/intercalary-reconstructions-after-bone-tumor-resections-a-review-of-treatments
#15
REVIEW
Georgios N Panagopoulos, Andreas F Mavrogenis, Cyril Mauffrey, Jan Lesenský, Andrea Angelini, Panayiotis D Megaloikonomos, Vasilios G Igoumenou, John Papanastassiou, Olga Savvidou, Pietro Ruggieri, Panayiotis J Papagelopoulos
An intercalary reconstruction is defined as replacement of the diaphyseal portion of a long bone after segmental skeletal resection (diaphysectomy). Intercalary reconstructions typically result in superior function compared to other limb-sparing procedures as the patient's native joints above and below the reconstruction are left undisturbed. The most popular reconstructive options after segmental resection of a bone sarcoma include allografts, vascularized fibula graft, combined allograft and vascularized fibula, segmental endoprostheses, extracorporeal devitalized autograft, and segmental transport using the principles of distraction osteogenesis...
June 5, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28582418/an-in-vivo-comparison-study-in-goats-for-a-novel-motion-preserving-cervical-joint-system
#16
Jie Qin, Chenguang Zhao, Dong Wang, Bo Zhao, Jun Dong, Haopeng Li, Rongxia Sang, Shuang Wang, Jiao Fu, Rangrang Kong, Xijing He
Cervical degenerative disease is one of the most common spinal disorders worldwide, especially in older people. Anterior cervical corpectomy and fusion (ACCF) is a useful method for the surgical treatment of multi-level cervical degenerative disease. Anterior cervical disc replacement (ACDR) is considered as an alternative surgical method. However, both methods have drawbacks, particularly the neck motion decrease observed after arthrodesis, and arthroplasty should only be performed on patients presenting with cervical disc disease but without any vertebral body disease...
2017: PloS One
https://www.readbyqxmd.com/read/28578802/spontaneous-resolution-of-posterior-ankle-joint-loose-bodies-after-total-ankle-replacement-a-case-report
#17
Raymond P Lee, Sally H S Cheng
Late stage ankle osteoarthritis often presents with debilitating pain. It is common to find osteophytes and loose body formation around the joint. Total ankle arthroplasty can preserve joint mobility and pain relieve for such patient. However, when trying to remove the osteophytes and loose bodies at the posterior ankle joint, there is risk of damaging posterior structures such as the neurovascular bundle during the procedure. We are presenting a case where the posterior loose bodies remained untouched during the operation, and patient showed spontaneous resolution of the lesions with time...
June 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28576454/hospital-effect-on-infections-after-four-major-surgeries-outlier-and-volume-outcome-analysis-using-all-inclusive-state-data
#18
Luis Furuya-Kanamori, Suhail A R Doi, Paul N Smith, Nasser Bagheri, Archie C A Clements, Art Sedrakyan
BACKGROUND: Hospital volume is known to have a direct impact on outcomes of major surgeries. However, it is unclear if the evidence applies specifically to surgical site infections. AIMS: To determine if there are procedure-specific hospital outliers (with higher surgical site infection rates [SSIR]) for four major surgical procedures, and to examine if hospital volume is associated with SSIR in the context of outlier performance in New South Wales (NSW), Australia...
May 30, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28576014/surface-characteristics-of-bioactive-ti-fabricated-by-chemical-treatment-for-cartilaginous-integration
#19
Hiroyuki Miyajima, Fusun Ozer, Satoshi Imazato, Francis K Mante
Artificial hip joints are generally expected to fail due to wear after approximately 15years and then have to be replaced by revision surgery. If articular cartilage can be integrated onto the articular surfaces of artificial joints in the same way as osseo-integration of titanium dental implants, the wear of joint implants may be reduced or prevented. However, very few studies have focused on the relationship between Ti surface and cartilage. To explore the possibility of cartilaginous-integration, we fabricated chemically treated Ti surfaces with H2O2/HCl, collagen type II and SBF, respectively...
September 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28567223/reverse-total-shoulder-arthroplasty-salvage-procedure-for-failed-prior-arthroplasty
#20
Seong Hwan Jo, Jung Youn Kim, Nam Su Cho, Yong Girl Rhee
BACKGROUND: To evaluate the clinical outcome of revision of primary shoulder replacement by using reverse total shoulder arthroplasty (RTSA). METHODS: Seven patients underwent revision RTSA with a mean follow-up of 22.1 months (range, 12 to 54 months). Their mean age at the time of operation was 75.5 years (range, 70 to 80 years). Assessments were performed on the preoperative and postoperative visual analogue scale (VAS) score, muscle strength, range of motion, University of California at Los Angeles (UCLA) score, Constant score, subjective satisfaction and the anteroposterior and axillary views of the glenohumeral joint...
June 2017: Clinics in Orthopedic Surgery
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