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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/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#3
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28641330/use-of-shorter-intramedullary-guide-for-ipsilateral-total-knee-arthroplasty-following-prior-total-hip-arthroplasty
#4
Bradley T Webb, Slif D Ulrich, Kenneth G W MacKinlay, Langan S Smith, Arthur L Malkani
No abstract text is available yet for this article.
June 22, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28634094/regional-anesthesia-in-total-joint-arthroplasty-what-is-the-evidence
#5
Dalia H Elmofty, Asokumar Buvanendran
Total joint arthroplasty is one of the most common surgical procedures performed for end-stage osteoarthritis. The increasing demand for knee and hip arthroplasties along with the improvement in life expectancy has created a substantial medical and economic impact on the society. Effective planning of health care for these individuals is vital. The best method for providing anesthesia and analgesia for total joint arthroplasty has not been defined. Yet, emerging evidence suggests that the type of anesthesia can affect morbidity and mortality of patients undergoing these procedures...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633782/factors-predicting-length-of-hospital-stay-and-extended-care-facility-admission-after-hindfoot-arthrodesis-procedures
#6
Jacob Deister, Brian G Cothern, Chad Williams, Andrew W Froehle, Richard T Laughlin
Delayed identification of patients requiring admission to extended care facilities (ECFs) can lead to greater healthcare costs through an increased length of hospital stay (LOHS). Previous studies of hip and knee arthroplasty identified factors associated with a likely discharge to an ECF. These issues have not been extensively studied for major hindfoot procedures. We conducted a retrospective review of 198 cases treated during a 3-year period to identify the risk factors for an extended LOHS and ECF admission after ankle arthrodesis, triple arthrodesis, pantalar arthrodesis, and subtalar arthrodesis...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#7
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/28629906/can-bundled-payments-be-successful-in-the-medicaid-population-for-primary-joint-arthroplasty
#8
P Maxwell Courtney, Tori Edmiston, Brian Batko, Brett R Levine
BACKGROUND: Although some bundled payment models have had success in total joint arthroplasty, concerns exist about access to care for higher cost patients who use more resources. The purpose of this study is to determine whether Medicaid patients have increased hospital costs and more resource utilization in a 90-day episode of care than Medicare or privately insured patients. METHODS: We retrospectively reviewed a consecutive series of 7268 primary hip and knee arthroplasty patients at a single institution...
May 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629905/2017-american-college-of-rheumatology-american-association-of-hip-and-knee-surgeons-guideline-for-the-perioperative-management-of-antirheumatic-medication-in-patients-with-rheumatic-diseases-undergoing-elective-total-hip-or-total-knee-arthroplasty
#9
Susan M Goodman, Bryan Springer, Gordon Guyatt, Matthew P Abdel, Vinod Dasa, Michael George, Ora Gewurz-Singer, Jon T Giles, Beverly Johnson, Steve Lee, Lisa A Mandl, Michael A Mont, Peter Sculco, Scott Sporer, Louis Stryker, Marat Turgunbaev, Barry Brause, Antonia F Chen, Jeremy Gililland, Mark Goodman, Arlene Hurley-Rosenblatt, Kyriakos Kirou, Elena Losina, Ronald MacKenzie, Kaleb Michaud, Ted Mikuls, Linda Russell, Alexander Sah, Amy S Miller, Jasvinder A Singh, Adolph Yates
OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA)...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629903/recording-adverse-events-following-joint-arthroplasty-financial-implications-and-validation-of-an-adverse-event-assessment-form
#10
Matthew J Lee, Khalid M S Mohamed, John C Kelly, John G Galbraith, John Street, Brian J Lenehan
BACKGROUND: In Ireland, funding of joint arthroplasty procedures has moved to a pay-by-results national tariff system. Typically, adverse clinical events are recorded via retrospective chart-abstraction methods by administrative staff. Missed or undocumented events not only affect the quality of patient care but also may unrealistically skew budgetary decisions that impact fiscal viability of the service. Accurate recording confers clinical benefits and financial transparency. The aim of this study was to compare a prospectively implemented adverse events form with the current national retrospective chart-abstraction method in terms of pay-by-results financial implications...
April 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28629423/understanding-consumer-and-clinician-preferences-and-decision-making-for-rehabilitation-following-arthroplasty-in-the-private-sector
#11
Mark A Buhagiar, Justine M Naylor, Grahame Simpson, Ian A Harris, Friedbert Kohler
BACKGROUND: To understand private consumer and clinician preferences towards different rehabilitation modes following knee or hip arthroplasty, and identify factors which influence the chosen rehabilitation pathway. METHODS: Mixed methods cross-sectional study involving 95 semi-structured interviews of consumers (patients and carers) and clinicians (arthroplasty surgeons, physiotherapists and rehabilitation physicians) in Sydney, Australia, during 2014-2015. Participants were asked about the acceptability of different modes of rehabilitation provision, and factors influencing their chosen rehabilitation pathway...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28622969/probability-of-undiagnosed-obstructive-sleep-apnea-does-not-correlate-with-adverse-pulmonary-events-nor-length-of-stay-in-hip-and-knee-arthroplasty-using-intrathecal-opioid
#12
Matthew J Thompson, Bryce N Clinger, Robert M Simonds, Camille J Hochheimer, Laura A Lahaye, Gregory J Golladay
BACKGROUND: Recent emphasis on bundled payments and outcomes tracking has increased the focus on preoperative optimization in patients undergoing elective lower extremity arthroplasty. Since patients with obstructive sleep apnea (OSA) have an increased risk of adverse perioperative pulmonary events, screening for undiagnosed OSA is sometimes included as part of preoperative risk assessment. However, there are limited data regarding quantification of OSA risk in lower extremity arthroplasty patients, and little is known about the utility of quantitative OSA screening and the risk of pulmonary complications in hip and knee arthroplasty patients who receive intrathecal morphine anesthetic...
April 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28622817/prevalence-and-risk-factors-for-postoperative-delirium-in-total-joint-arthroplasty-patients-a-prospective-study
#13
Wenliang Chen, Xiurong Ke, Xiaoqing Wang, Xiaoliang Sun, Juncheng Wang, Guojing Yang, Haijie Xia, Lei Zhang
BACKGROUND: The aim of this prospective study was to investigate the incidence and clinical features of delirium after total joint arthroplasty, and to establish the potential risk factors for postoperative delirium. METHODS: A total of 212 consecutive patients undergoing hip or knee arthroplasty, who met the inclusion and exclusive criteria were enrolled. The general characteristics, preoperative and postoperative hematological variables were documented respectively...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28620968/clinical-practice-guidelines-incorporating-input-from-a-patient-panel
#14
Susan M Goodman, Amy S Miller, Marat Turgunbaev, Gordon Guyatt, Adolph Yates, Bryan Springer, Jasvinder A Singh
OBJECTIVE: To describe the integral role of a Patient Panel in the development of the 2017 American College of Rheumatology (ACR)/American Association of Hip and Knee Surgeons (AAHKS) clinical practice guideline. METHODS: We convened a Panel of 11 patients with rheumatoid arthritis and juvenile idiopathic arthritis, all of whom had undergone 1 or more arthroplasties, to review the evidence and provide guidance on recommendations for the 2017 ACR/AAHKS guideline to address the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty...
June 16, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28620948/2017-american-college-of-rheumatology-american-association-of-hip-and-knee-surgeons-guideline-for-the-perioperative-management-of-antirheumatic-medication-in-patients-with-rheumatic-diseases-undergoing-elective-total-hip-or-total-knee-arthroplasty
#15
Susan M Goodman, Bryan Springer, Gordon Guyatt, Matthew P Abdel, Vinod Dasa, Michael George, Ora Gewurz-Singer, Jon T Giles, Beverly Johnson, Steve Lee, Lisa A Mandl, Michael A Mont, Peter Sculco, Scott Sporer, Louis Stryker, Marat Turgunbaev, Barry Brause, Antonia F Chen, Jeremy Gililland, Mark Goodman, Arlene Hurley-Rosenblatt, Kyriakos Kirou, Elena Losina, Ronald MacKenzie, Kaleb Michaud, Ted Mikuls, Linda Russell, Alexander Sah, Amy S Miller, Jasvinder A Singh, Adolph Yates
OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA)...
June 16, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28620917/2017-american-college-of-rheumatology-american-association-of-hip-and-knee-surgeons-guideline-for-the-perioperative-management-of-antirheumatic-medication-in-patients-with-rheumatic-diseases-undergoing-elective-total-hip-or-total-knee-arthroplasty
#16
Susan M Goodman, Bryan Springer, Gordon Guyatt, Matthew P Abdel, Vinod Dasa, Michael George, Ora Gewurz-Singer, Jon T Giles, Beverly Johnson, Steve Lee, Lisa A Mandl, Michael A Mont, Peter Sculco, Scott Sporer, Louis Stryker, Marat Turgunbaev, Barry Brause, Antonia F Chen, Jeremy Gililland, Mark Goodman, Arlene Hurley-Rosenblatt, Kyriakos Kirou, Elena Losina, Ronald MacKenzie, Kaleb Michaud, Ted Mikuls, Linda Russell, Alexander Sah, Amy S Miller, Jasvinder A Singh, Adolph Yates
OBJECTIVE: This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA)...
June 16, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28616704/metallic-ion-release-after-knee-prosthesis-implantation-a-prospective-study
#17
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/28614232/the-efficiency-and-safety-of-dexamethasone-for-pain-control-in-total-joint-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#18
Jian Meng, Lin Li
BACKGROUND: This meta-analysis aimed to evaluate the efficiency and safety of dexamethasone administration in total knee and hip arthroplasties. METHODS: Two researchers search the relevant studies independently including Embase (1980-017.04), PubMed (1966-017.04), ScienceDirect (1985-017.04), Web of Science (1950-2017.03), and Cochrane Library for potential relevant studies. After testing for heterogeneity between studies, data were aggregated for random-effects models when necessary...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614226/tranexamic-acid-plus-diluted-epinephrine-versus-tranexamic-acid-alone-for-blood-loss-in-total-joint-arthroplasty-a-meta-analysis
#19
Zhanxia Yu, Lulan Yao, Qin Yang
BACKGROUND: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)). METHODS: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28612028/chronic-kidney-dysfunction-can-increase-the-risk-of-deep-vein-thrombosis-after-total-hip-and-knee-arthroplasty
#20
Qiangqiang Li, Bingyang Dai, Yao Yao, Kai Song, Dongyang Chen, Qing Jiang
BACKGROUND: Deep vein thrombosis (DVT) is one of the major complications of total joint arthroplasty (TJA). Chronic kidney dysfunction (CKD) has proven to promote a proinflammatory and prothrombotic state and is prevalent among patients undergoing TJA. The purpose of this study is to identify whether CKD increase the risk of DVT following TJA. METHODS: In a retrospective study, 1274 patients who underwent primary TJA were studied. CKD is graded in 5 stages. Univariate and multivariate analysis were used to identify the association of CKD and its severity with postoperative DVT...
2017: BioMed Research International
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