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https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#1
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28642665/osteoporosis-in-brazilian-patients-awaiting-knee-arthroplasty
#2
David Sadigursky, Luiz Alberto Barretto, Diogo Maciel Vieira Lobão, Rogério Jamil Fernandes Carneiro, Paulo Oliveira Colavolpe
OBJECTIVE: The primary objective of this study was to determine the prevalence of osteoporosis and osteopenia prior to total knee arthroplasty (TKA) in female patients. As a secondary objective, we evaluated the incidence of hip fractures, types of drugs to treat osteoporosis and serum vitamin D levels. METHOD: This is a transversal, descriptive and observational study which evaluated 60 women above age 55 prior to total knee replacement. RESULTS: Mean patient age was 71...
May 2017: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28634320/comparison-of-2-analgesia-modalities-in-total-knee-replacement-surgery-is-there-an-effect-on-knee-function-rehabilitation
#3
Janis Zinkus, Lina Mockutė, Arūnas Gelmanas, Ramūnas Tamošiūnas, Arūnas Vertelis, Andrius Macas
BACKGROUND We compared the effects of continuous femoral nerve block (CFNB) and continuous intraarticular block (CIAB) on pain, functional recovery and adverse effects after total knee arthroplasty (TKA). MATERIAL AND METHODS We prospectively randomized 54 patients undergoing TKA into 2 groups: CFNB (Group F) and CIAB (Group I). Surgery was performed under spinal anesthesia. All patients received patient-controlled analgesia (PCA) with morphine, diclofenac, and acetaminophen for the first 72 h postoperatively...
June 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#4
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
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
#5
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#6
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/28630749/imaging-in-peri-prosthetic-assessment-an-orthopaedic-perspective
#7
Christoph H Lohmann, Sanjiv Rampal, Martin Lohrengel, Gurpal Singh
As imaging techniques are ever-evolving, this article aims to provide a brief overview of the various modalities including their limitations. The ability of imaging for evaluation of implant osseo-integration will be addressed and also the role of imaging in assessing septic and aseptic loosening, with a particular focus on adverse tissue reactions, will be discussed. Specific features when imaging the big joints such as shoulder, hip, knee and ankle joint will also be outlined.Overall, a lack of standardisation and validity was noted and despite the gross variety of imaging modalities, there is no technique covering all aspects required for evaluation of implant fixation and septic and aseptic loosening...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28626383/an-alternative-approach-to-the-terminal-management-of-ogilvie-syndrome
#8
Daniel Galban, Joshua J Baiel
Ogilvie syndrome is defined as colonic pseudo-obstruction due to nonmechanical causes. Mortality of nearly 50% is associated with perforation of the distended, pseudo-obstructed colon. While conservative medical therapy has proven to be beneficial in a majority of cases, >3% of patients have significant distention or perforation of the colon that warrants surgical resection. The case of a 48-year-old male with progressive abdominal discomfort and distention 12 days following knee replacement surgery is presented...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626303/the-comparison-of-clinical-features-and-quality-of-life-after-total-knee-replacement
#9
Jiyeon Lee, Jung-Hee Kim, Eun-Jung Jung, Byoung-Hee Lee
[Purpose] The purpose of this study is to provide fundamental information for efficient management of patients after a total knee replacement (TKR) through the evaluation of changes of range of motion, pain, functional level, and quality of life. [Subjects and Methods] For a total of 63 knee osteoarthritis patients, VAS, KSKS, KSFS, HSS, WOMAC scores and quality of life were evaluated for functional levels at pre-operation, post-operation, six months after operation, and 12 months after operation. [Results] After the TKR operations, participants showed significant improvement in KSKS, KSFS, WOMAC, and SF-36 scores when compared to pre-operation...
June 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28622843/fatal-pulmonary-embolism-following-elective-total-knee-replacement-using-aspirin-in-multi-modal-prophylaxis-a-12year-study
#10
C Quah, E Bayley, N Bhamber, P Howard
BACKGROUND: The National Institute for Health and Clinical Excellence (NICE) has issued guidelines on which thromboprophylaxis regimens are suitable following lower limb arthroplasty. Aspirin is not a recommended agent despite being accepted in orthopaedic guidelines elsewhere. We assessed the incidence of fatal pulmonary embolism (PE) and all-cause mortality following elective primary total knee replacement (TKR) with a standardised multi-modal prophylaxis regime in a large teaching district general hospital...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28616704/metallic-ion-release-after-knee-prosthesis-implantation-a-prospective-study
#11
Adrien Lons, Sophie Putman, Gilles Pasquier, Henri Migaud, Elodie Drumez, Julien Girard
INTRODUCTION: Metal-on-metal (MoM) hip replacement bearings produce metallic ions that can cause health complications. Metallic release also occurs with other materials, but data on metallic ion levels after knee arthroplasty are sparse. We postulate that knee replacement generates elevating metallic ions (chromium (Cr), cobalt (Co) and titanium (Ti)) during the first year after implantation. PATIENTS AND METHODS: This ongoing prospective study included all patients who underwent the same type of knee arthroplasty between May and December 2013...
June 14, 2017: International Orthopaedics
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
#12
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/28610776/two-stage-late-reconstruction-with-a-fresh-large-osteochondral-shell-allograft-transplantation-flocsat-for-a-large-ostechondral-defect-in-a-non-union-after-a-lateral-tibia-plateau-fracture-2-year-follow-up
#13
C Krettek, J Clausen, M Omar, S Noack, C Neunaber
This is the description of a 58-year-old female patient presenting 8 months after a horse riding accident with significant pain and inability to walk independently. Imaging revealed a large osseous defect of the lateral tibia plateau which was not united posteriorly. The patient refused knee replacement and we developed a patient specific two-step procedure for her. Step 1: Filling of the defect with a large cortico-cancellous autograft from the posterior iliac crest; step 2: Transplantation of a fresh large osteochondral shell allograft (FLOCSAT)...
May 17, 2017: Injury
https://www.readbyqxmd.com/read/28609474/effects-of-perceptions-of-care-medical-advice-and-hospital-quality-on-patient-satisfaction-after-primary-total-knee-replacement-a-cross-sectional-study
#14
Tom Schaal, Tonio Schoenfelder, Joerg Klewer, Joachim Kugler
INTRODUCTION: The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction...
2017: PloS One
https://www.readbyqxmd.com/read/28608283/geometric-morphometric-analysis-reveals-age-related-differences-in-the-distal-femur-of-europeans
#15
Etienne Cavaignac, Frederic Savall, Elodie Chantalat, Marie Faruch, Nicolas Reina, Philippe Chiron, Norbert Telmon
BACKGROUND: Few studies have looked into age-related variations in femur shape. We hypothesized that three-dimensional (3D) geometric morphometric analysis of the distal femur would reveal age-related differences. The purpose of this study was to show that differences in distal femur shape related to age could be identified, visualized, and quantified using three-dimensional (3D) geometric morphometric analysis. METHODS: Geometric morphometric analysis was carried out on CT scans of the distal femur of 256 subjects living in the south of France...
December 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/28607784/use-of-nonvascularized-autologous-fibular-strut-graft-in-the-treatment-of-major-bone-defect-after-periprosthetic-knee-fracture
#16
Vincenzo Giordano, Bruno Parilha Coutinho, Mateus Kenji Miyahira, Felipe Serrão Mendes de Souza, Ney Pecegueiro do Amaral
We present the case of a patient who suffered a comminuted supracondylar periprosthetic femur fracture. The patient was an 86-year-old lady who suffered a minor fall at home and presented at our hospital with a right comminuted distal femur fracture around a total knee arthroplasty. The patient was submitted to a cruciate-sacrificing total knee replacement 6 years before at the same institution. Despite severe metaphyseal fragmentation and short distal fragment, the prosthesis was stable; thus, open fracture reduction and stabilization with internal fixation were performed...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28606159/thresholds-for-oxford-knee-score-after-total-knee-replacement-surgery-a-novel-approach-to-post-operative-evaluation
#17
Christian Lund Petersen, Jonas Bruun Kjærsgaard, Nicolai Kjærgaard, Michael Ulrich Jensen, Mogens Berg Laursen
BACKGROUND: In a prospective cohort study, we wanted to detect thresholds distinguishing between patients with a satisfactory and an unsatisfactory outcome after total knee replacement (TKR) based on Patient-Reported Outcome Measures (PROMs), namely the Oxford Knee Score (OKS), using patient satisfaction and patient-perceived function as global transition items. METHODS: Seventy-three TKR patients completed the OKS questionnaire before surgery and were invited to complete the same questionnaire again 6 (4 to 9) months after surgery...
June 12, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28602641/a-novel-flexible-capacitive-load-sensor-for-use-in-a-mobile-unicompartmental-knee-replacement-bearing-an-in-vitro-proof-of-concept-study
#18
M J A Mentink, B H Van Duren, D W Murray, H S Gill
Instrumented knee replacements can provide in vivo data quantifying physiological loads acting on the knee. To date instrumented mobile unicompartmental knee replacements (UKR) have not been realised. Ideally instrumentation would be embedded within the polyethylene bearing. This study investigated the feasibility of an embedded flexible capacitive load sensor. A novel flexible capacitive load sensor was developed which could be incorporated into standard manufacturing of compression moulded polyethylene bearings...
June 8, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28602534/bilateral-total-hip-and-knee-arthroplasties-average-10-year-follow-up
#19
John B Meding, Philip M Faris, Ken E Davis
BACKGROUND: The present study investigates the clinical and radiographic outcomes in patients with all 4 major lower extremity joints replaced. METHODS: A retrospective review of our institution's database identified 125 patients in whom both hips and both knees were replaced. The mean time between the first and last arthroplasty was 6.6 years. Preoperative diagnoses included osteoarthritis in 80% and rheumatoid arthritis in 20%. The average age at the time of the first arthroplasty was 63...
May 22, 2017: Journal of Arthroplasty
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
#20
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
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