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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
#1
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
#2
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
#3
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/27919671/supracondylar-femoral-osteotomy-and-knee-joint-replacement-during-the-same-surgical-procedure-in-a-type-a-haemophiliac-patient-with-knee-flexion-deformity-and-ankylosis
#4
Jose Luis Osma Rueda, Alejandra Oliveros Vargas, Cristian David Sosa
BACKGROUND: Haemophilia A is the cause of diverse musculoskeletal disorders such as ankylosis, arthritis and associated angular deformity. There are few reported cases in patients with haemophilia A in which simultaneous supracondylar femoral osteotomy and knee joint replacement has been performed to treat knee angular deformity and ankylosis. Here we present the case of an 18year old male patient, with an evolution of two years, who was unable to walk due to the presence of an untreated supracondylar fracture in the left femur and ipsilateral haemophilic arthropathy which led him to develop an ankylosis in flexion close to 70°...
December 2, 2016: Knee
https://www.readbyqxmd.com/read/27919372/does-extended-cpoe-use-reduce-patient-length-of-stay
#5
Darryl Romanow, Arun Rai, Mark Keil, Steven Luxenberg
OBJECTIVE: This study compares use of Computerized Provider Order Entry (CPOE) and related clinical systems (i.e., extended CPOE) across 796 clinical teams caring for five distinct patient conditions. Our focus is the relationship between clinical teams' extended CPOE use and extent of prolonged stay (EPS), defined as the deviation in patients' observed length of stay from expected risk-adjusted length of stay. MATERIALS AND METHODS: Using archival data from two affiliated hospitals in the Southeastern United States, we focused on five different patient conditions of varying mortality risk (vaginal birth, knee/hip replacement, cardiovascular surgery, organ transplant and pneumonia)...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27916580/annual-revision-rates-of-partial-versus-total-knee-arthroplasty-a-comparative-meta-analysis
#6
REVIEW
Harshvardhan Chawla, Jelle P van der List, Alexander B Christ, Maximiliano R Sobrero, Hendrik A Zuiderbaan, Andrew D Pearle
BACKGROUND: Utilization of unicompartmental knee arthroplasty (UKA) and patellofemoral arthroplasty (PFA) as alternatives to total knee arthroplasty (TKA) for unicompartmental knee osteoarthritis (OA) has increased. However, no single resource consolidates survivorship data between TKA and partial resurfacing options for each variant of unicompartmental OA. This meta-analysis compared survivorship between TKA and medial UKA (MUKA), lateral UKA (LUKA) and PFA using annual revision rate as a standardized metric...
December 1, 2016: Knee
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
#7
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/27914627/comparison-of-in-vivo-measured-loads-in-knee-hip-and-spinal-implants-during-level-walking
#8
Philipp Damm, Ines Kutzner, Georg Bergmann, Antonius Rohlmann, Hendrik Schmidt
Walking is a task that we seek to understand because it is the most relevant human locomotion. Walking causes complex loading patterns and high load magnitudes within the human body. This work summarizes partially published load data collected in earlier in vivo measurement studies on 9 patients with telemeterized knee endoprostheses, 10 with hip endoprostheses and 5 with vertebral body replacements. Moreover, for the 19 endoprosthesis patients, additional simultaneously measured and previously unreported ground reaction forces are presented...
November 28, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27913813/-rehabilitation-after-hip-and-knee-endoprosthetic-treatment-in-the-elderly
#9
H Bork
Due to current demographic developments with a continuous increase in average life expectancy and improved medical treatment, the number of elderly patients with joint replacement of the lower extremities also has increased in recent years. Most of these patients have not only one but several chronic diseases requiring treatment and medication. Drug-drug interaction and functional restrictions of the elderly additionally reduce the postoperative psychophysical capacity; therefore, special knowledge in rehabilitative treatment and pain management is necessary...
December 2, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27912929/survival-failure-modes-and-function-of-combined-distal-femur-and-proximal-tibia-reconstruction-following-tumor-resection
#10
F Sevelda, W Waldstein, J Panotopoulos, C Stihsen, A Kaider, P T Funovics, R Windhager
BACKGROUND: Tumor spread to the knee joint or skip metastasis to the adjacent bones of the knee require reconstruction with combined distal femur and proximal tibia replacements. The literature on implant survival and failure modes with this type of reconstruction is sparse. The goals of this study were to determine the implant survival, the different failure modes and the functional outcome of this megaendoprosthetic reconstruction. PATIENTS AND METHODS: Thirty-nine patients with combined distal femur and proximal tibia reconstruction were retrospectively reviewed...
November 23, 2016: European Journal of Surgical Oncology
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/27904225/the-inferior-medial-genicular-artery-and-its-vascularization-of-the-pes-anserinus-superficialis-a-cadaveric-study
#12
Lena Hirtler, Manuel Ederer, Mike Faber, Patrick Weninger
BACKGROUND: A common method for reconstruction of the anterior cruciate ligament (ACL) is it's replacement by a free avascular graft, using the gracilis and/or semitendinosus tendons. These grafts pass a vulnerable phase in the ligamentization-process during the 1(st) year after reconstruction. The aims of this study were first to evaluate the vascularization of the pes anserinus superficialis (PAS) by the inferior medial genicular artery (IMGA) and second to develop a pedunculated surgical technique for ACL reconstruction, to preserve a maximal amount of natural vascularization of the tendons inserting at the PAS...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27904224/estimation-of-drug-absorption-in-antibiotic-soaked-bone-grafts
#13
Manish Ramesh Shah, Rukesh R Patel, Randhirsinh V Solanki, Shailendra H Gupta
INTRODUCTION: There is paucity of literature about antibiotic uptake in bone grafts soaked in antibiotic solutions at room temperature in the operation theatre. We hypothesized that if bone grafts are dipped in different strengths of antibiotic solutions for sufficient period, their utilization at the target site helps in localized release of antibiotics in adequate inhibitory concentration to achieve the bacterial regression. The purpose of the study was to find out: (1) Optimum duration, strength, and volume of antibiotic solution required for dipping bone grafts at room temperature prior to the use...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27900474/bone-scan-usefulness-in-patients-with-painful-hip-or-knee-prosthesis-10-situations-that-can-cause-pain-other-than-loosening-and-infection
#14
REVIEW
Sofia Vaz, Teresa C Ferreira, Lucília Salgado, Frédéric Paycha
In recent years, with the higher median life expectancy, the number of hip and knee replacements has increased. Clinical examination and morphological studies are essential to evaluate patients with a painful arthroplasty. Nuclear medicine examinations also play an important role, their main usefulness being the exclusion of prosthesis complications. Nevertheless, conventional examinations, namely bone scan and white blood cell scintigraphy, can also identify complications, such as loosening and infection. This study describes the normal and pathologic patterns of a bone scan and exemplifies ten common situations that can cause pain in patients with hip or knee arthroplasty, other than loosening and infection, which can be disclosed on a bone scintigraphy...
November 30, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27899003/dietary-intake-of-fiber-in-relation-to-knee-pain-trajectories
#15
Zhaoli Dai, Na Lu, Jingbo Niu, David T Felson, Yuqing Zhang
Objective Dietary fiber may reduce knee pain in part by lowering body weight and inflammation. In this study, we assessed whether fiber intake was associated with knee pain development patterns. Methods In a prospective, multicenter cohort of 4,796 men and women aged 45-79 years with or at risk of knee osteoarthritis in Osteoarthritis Initiative, participants were followed up annually for 8 years. Dietary fiber was estimated using a validated food frequency questionnaire at baseline. Group-based trajectory modeling was used to identify WOMAC pain trajectories, which were assessed for the associations with dietary fiber intake using polytomous regression models...
November 29, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27898194/inflammatory-cell-induced-corrosion-in-total-knee-arthroplasty-a-retrieval-study
#16
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/27895368/does-obesity-affects-early-infection-after-total-knee-arthroplasty-a-comparison-of-obese-vs-non-obese-patients
#17
Waseem Ahmed, Riaz Hussain Lakdawala, Yasir Mohib, Aurangzeb Qureshi, Rizwan Haroon Rashid
Surgical site infection (SSI) is a disastrous complication after total knee arthroplasty (TKA) which can cause prosthesis loosening and may end up in septicaemia. The incidence of infection reported to be in the range of 0.3-12.4% for primary TKA. Significantly higher infection rate is found in the morbidly obese patients. The current study compared the immediate rate of post-total knee replacement wound infection in the obese versus non-obese population. The cross-sectional study was conducted at Aga Khan University Hospital (AKUH) and comprised patients undergoing TKA for primary knee osteoarthritis...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27895006/patients-need-for-tailored-comparative-health-care-information-a-qualitative-study-on-choosing-a-hospital
#18
Nicolien C Zwijnenberg, Michelle Hendriks, Evelien Bloemendal, Olga C Damman, Judith D de Jong, Diana Mj Delnoij, Jany Jd Rademakers
BACKGROUND: The Internet is increasingly being used to provide patients with information about the quality of care of different health care providers. Although online comparative health care information is widely available internationally, and patients have been shown to be interested in this information, its effect on patients' decision making is still limited. OBJECTIVE: This study aimed to explore patients' preferences regarding information presentation and their values concerning tailored comparative health care information...
November 28, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27894148/catastrophic-failure-of-regenerex-tibial-components-a-case-series
#19
Gavin Stormont, Daniel Stormont
The aim of this study was to analyze short-term metal failures in well-placed Signature-guided Regenerex (Zimmer Biomet, Warsaw, IN) tibial components in a limited patient series. A retrospective, consecutive, nonrandomized, unblinded study from a limited cohort of young active osteoarthritis patients was conducted. All cases received a Regenerex tibial component which we evaluated for metal failure. Patients met the then current indications from the Center for Medicare and Medicaid Services Guidelines for knee replacement...
November 28, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27894147/reliability-concurrent-validity-and-minimal-detectable-change-for-iphone-goniometer-app-in-assessing-knee-range-of-motion
#20
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
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