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Joint replacement hip and knee

Felix Stief, André Schmidt, Stefan van Drongelen, Katharina Lenarz, Dara Froemel, Timur Tarhan, Frederick Lutz, Andrea Meurer
A total hip replacement (THR) is a common and routine procedure to reduce pain and restore normal activity. Gait analysis can provide insights into functional characteristics and dynamic joint loading situation not identifiable by clinical examination or static radiographic measures. The present prospective longitudinal study tested whether two years after surgery a THR would restore dynamic loading of the knee and hip joints in the frontal plane to normal. Instrumented gait analysis was performed shortly before surgery and approximately two years after THR on 15 unilateral hip osteoarthritis patients...
March 14, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Fernando Domínguez-Navarro, Celedonia Igual-Camacho, Antonio Silvestre-Muñoz, Sergio Roig-Casasús, José María Blasco
BACKGOUND: Balance and proprioceptive deficits are frequently persistent after total joint replacement, limiting functionality and involving altered movement patterns and difficulties in walking and maintaining postural control among patients. RESEARCH QUESTION: The goal of this systematic review was to evaluate the short- and mid-term effects of proprioceptive and balance training for patients undergoing total knee and hip replacement. METHODS: This is a systematic review of literature...
March 5, 2018: Gait & Posture
Matthew P Kelly, Heather A Prentice, Wei Wang, Brian H Fasig, Dhiren S Sheth, Elizabeth W Paxton
BACKGROUND: Previous studies evaluating reasons for 30-day readmissions following total joint arthroplasty (TJA) may underestimate hospital-based utilization of healthcare resources during a patient's episode-of-care. We sought to identify common reasons for 90-day emergency department (ED) visits and hospital readmissions following primary elective unilateral TJA. METHODS: Patients from July 1, 2012 through June 30, 2015 having primary elective TJA and at least one 90-day postoperative ED-only visit and/or readmission for any reason were identified using the Kaiser Permanente Total Joint Replacement Registry...
February 12, 2018: Journal of Arthroplasty
I P Munugoda, K Wills, F Cicuttini, S E Graves, M Lorimer, G Jones, M L Callisaya, D Aitken
OBJECTIVE: To examine the association between ambulatory activity (AA), body composition measures and hip or knee joint replacement (JR) due to osteoarthritis. DESIGN: At baseline, 1082 community-dwelling older-adults aged 50 - 80 years were studied. AA was measured objectively using pedometer and body composition by dual-energy x-ray absorptiometry. The incidence of primary (first-time) JR was determined by data linkage to the Australian Orthopaedic Association National Joint Replacement Registry...
February 20, 2018: Osteoarthritis and Cartilage
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
John A Palsis, Thomas S Brehmer, Vincent D Pellegrini, Jacob M Drew, Barton L Sachs
BACKGROUND: In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. METHODS: We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
Anne F Mannion, Franco M Impellizzeri, Michael Leunig, Dezsö Jeszenszy, Hans-Jürgen Becker, Daniel Haschtmann, Stefan Preiss, Tamas F Fekete
PURPOSE: Studies comparing the outcome of spine surgery with that of large-joint replacement report equivocal findings. The patient-reported outcome measures (PROMs) used in such studies are typically generic and may not be sufficiently sensitive to the successes/failures of treatment. This study compared different indices of "success" in patients undergoing surgery for degenerative disorders of the lumbar spine, hip, or knee, using a validated, multidimensional, and joint-specific PROM...
February 19, 2018: European Spine Journal
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Jie Shi, Wei Wang, Xiao-le He, Xu-Sheng Li
Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Elisabetta Casalone, Ioanna Tachmazidou, Eleni Zengini, Konstantinos Hatzikotoulas, Sophie Hackinger, Daniel Suveges, Julia Steinberg, Nigel William Rayner, arcOGEN Consortium, Jeremy Mark Wilkinson, Kalliope Panoutsopoulou, Eleftheria Zeggini
OBJECTIVES: Osteoarthritis (OA) is a complex disease, but its genetic aetiology remains poorly characterised. To identify novel susceptibility loci for OA, we carried out a genome-wide association study (GWAS) in individuals from the largest UK-based OA collections to date. METHODS: We carried out a discovery GWAS in 5414 OA individuals with knee and/or hip total joint replacement (TJR) and 9939 population-based controls. We followed-up prioritised variants in OA subjects from the interim release of the UK Biobank resource (up to 12 658 cases and 50 898 controls) and our lead finding in operated OA subjects from the full release of UK Biobank (17 894 cases and 89 470 controls)...
February 7, 2018: Annals of the Rheumatic Diseases
Hussein Abdelaziz, Akos Zahar, Christian Lausmann, Thorsten Gehrke, Helmut Fickenscher, Eduardo M Suero, Matthias Gebauer, Mustafa Citak
PURPOSE: The aim of the study was to quantify the bacterial contamination rate of electrocautery tips during primary total joint replacement (TJR), as well as during aseptic and septic revision TJR. METHODS: A total of 150 electrocautery tips were collected between April and July 2017. TJR surgeries were divided into three groups: (1) primary, (2) aseptic and (3) septic revisions. In each group, a total of 50 electrocautery tips were collected. A monopolar electrocautery with a reusable stainless-steel blade tip was used in all cases...
February 12, 2018: International Orthopaedics
Deborah A Marshall, Ken Deal, Barbara Conner-Spady, Eric Bohm, Gillian Hawker, Lynda Loucks, Karen V MacDonald, Tom Noseworthy
OBJECTIVE: Patients face significant waiting times for hip and knee total joint replacement (TJR) in publicly funded healthcare systems. We aimed to assess how surgeon selection and reputation affect patients' willingness to wait for TJR. DESIGN: We assessed patient preferences using a discrete choice experiment questionnaire with 12 choice scenarios administered to patients referred for TJR. Based on qualitative research, pre- and pilot-testing, we characterized each scenario by five attributes: surgeon reputation, surgeon selection, waiting time to surgeon visit (initial consultation), waiting time to surgery, and travel time to hospital...
February 6, 2018: Osteoarthritis and Cartilage
Barbara L Conner-Spady, Deborah A Marshall, Eric Bohm, Michael J Dunbar, Tom W Noseworthy
PURPOSE: (1) To assess responsiveness of the EQ-5D-5L compared to Oxford hip and knee scores and the SF-12 in osteoarthritis patients undergoing total hip (THR) or knee (TKR) replacement surgery; (2) to compare distribution and anchor-based methods of assessing responsiveness. METHODS: Questionnaires were mailed to consecutive patients following surgeon referral for primary THR or TKR and 1 year post-surgery. We assessed effect size (ES), standardized response mean (SRM), and standard error of measurement (SEM)...
February 8, 2018: Quality of Life Research
Wei-Min Chu, Hsin-En Ho, Jiaan-Der Wang, Wei-Cheng Chan, Yi-Sheng Liou, Wen-Chao Ho, Sung-Yuan Hu, Yu-Tse Tsan
Multiple comorbidities, especially musculoskeletal dysfunction and cerebrovascular disease, remain barriers to normal social participation among persons with hemophilia (PWH). However, the relative health effects of such comorbidities on workers with hemophilia have seldom been explored. In this study, we investigated the incidence of comorbidities and their risk factors among workers with hemophilia.The study compared the incidence and risk factors of the major comorbidities of 411 workers with hemophilia enrolled in Taiwan's National Health Insurance Research Database between 1997 and 2010 with an age- and sex-matched general population...
February 2018: Medicine (Baltimore)
Jennifer M Woods, Anecita Gigi Lim
Aims and objectives: The aim of this article was to determine whether the incidence of intrathecal morphine-induced pruritus (ITMI) was influenced by ethnicity, age or gender in relation to orthopaedic versus caesarean surgeries. Background: The use of intrathecal morphine for patients undergoing total hip and knee joint replacements and for lower segment caesarean sections (LSCS) has gained popularity worldwide since its introduction over 30 years ago. Several international studies show that morphine delivered via the intrathecal route is an effective and safe method of pain relief...
February 2018: British Journal of Pain
Karthikeyan Kallidaikurichi Srinivasan, Anne-Marie Leo, Gabriella Iohom, Frank Loughnane, Peter J Lee
Background and Aims: Routine use of pre-procedural ultrasound guided midline approach has not shown to improve success rate in administering subarachnoid block. The study hypothesis was that the routine use of pre-procedural (not real time) ultrasound-guided paramedian spinals at L5-S1 interspace could reduce the number of passes (i.e., withdrawal and redirection of spinal needle without exiting the skin) required to enter the subarachnoid space when compared to the conventional landmark-guided midline approach...
January 2018: Indian Journal of Anaesthesia
Charles Birbara, Eugene J Dabezies, Aimee M Burr, Robert J Fountaine, Michael D Smith, Mark T Brown, Christine R West, Rosalin H Arends, Kenneth M Verburg
Background/objective: The objective of this study was to investigate the safety and efficacy of subcutaneous (SC) and intravenous (IV) tanezumab administration in osteoarthritis (OA) patients. Materials and methods: Study 1027 (NCT01089725), a placebo-controlled trial, evaluated the efficacy of SC tanezumab (ie, 2.5, 5, and 10 mg) and the therapeutic equivalence of 10 mg tanezumab given subcutaneously versus intravenously every 8 weeks in the symptomatic treatment of OA...
2018: Journal of Pain Research
Edward Burn, Christopher J Edwards, David W Murray, Alan Silman, Cyrus Cooper, Nigel K Arden, Rafael Pinedo-Villanueva, Daniel Prieto-Alhambra
OBJECTIVES: To measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in patient profiles. DESIGN: Cross-sectional study using routinely collected data. SETTING: National Health Service primary care records from 1995 to 2014 in the Clinical Practice Research Datalink were linked to hospital inpatient data from 1997 to 2014 in Hospital Episode Statistics Admitted Patient Care...
January 27, 2018: BMJ Open
Pablo S Corona, Matias Vicente, Mireia Lalanza, Carles Amat, Luis Carrera
BACKGROUND: Bone loss is a common problem in periprosthetic joint infection (PJI) scenarios. Modular megaprosthesis (MP) could offer a limb salvage solution in such situations. Concerns about risk of infection relapse, reinfection and implant longevity exist regarding MP use in cases of chronic PJI, rather than standard implants. We therefore sought to analyze our results with MP use in chronic PJI cases. METHODS: We performed a retrospective analysis of 29 MP patients...
January 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
A Saleh, J George, M Faour, A K Klika, C A Higuera
OBJECTIVES: The diagnosis of periprosthetic joint infection (PJI) is difficult and requires a battery of tests and clinical findings. The purpose of this review is to summarize all current evidence for common and new serum biomarkers utilized in the diagnosis of PJI. METHODS: We searched two literature databases, using terms that encompass all hip and knee arthroplasty procedures, as well as PJI and statistical terms reflecting diagnostic parameters. The findings are summarized as a narrative review...
January 2018: Bone & Joint Research
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