7,905 results match your criteria Total Joint Replacement Rehabilitation

Rest-activity daily rhythm and physical activity levels after hip and knee joint replacement: the role of actigraphy in orthopedic clinical practice.

Chronobiol Int 2021 Jun 14:1-10. Epub 2021 Jun 14.

IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.

Elective hip and knee joint replacement for osteoarthritis are cost-effective surgical procedures requiring specific rehabilitation programs. Actigraphy is widely used in both research and clinical practice to study activity patterns with great accuracy and validity but it has never been utilized in orthopedic patients. Therefore, the aim of this study was to objectively assess, through actigraphy, physical activity (PA) levels and rest-activity daily rhythm (RAR) in patients undergoing hip or knee joint replacement and hospitalized for ten days after surgery. Read More

View Article and Full-Text PDF

The Impact of Room-Sharing on Length of Stay After Total Hip or Knee Arthroplasty: A Retrospective Study.

Arthroplast Today 2021 Apr 22;8:289-294.e2. Epub 2021 Apr 22.

Department of Orthopaedics, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Background: Prolonged length of stay (LOS) after elective total hip (THA) and knee (TKA) arthroplasty is often associated with worse patient outcomes. Social support through room-sharing has been identified as a factor that may reduce LOS in a hospital setting, but has not yet been examined in an orthopedic population. The aim of this study was to evaluate the effect of single- vs shared-room accommodation after elective TKA or THA on hospital LOS. Read More

View Article and Full-Text PDF

Health literacy and clinical outcomes in patients with total knee arthroplasty in different rehabilitation settings: An exploratory prospective observational study.

Int J Orthop Trauma Nurs 2021 May 5;42:100865. Epub 2021 May 5.

UMIT-Private University for Health Sciences, Medical Informatics and Technology, Department of Nursing Science and Gerontology, Division of Integrated Care, Hall in Tirol, Austria.

Background: Limited health literacy is associated with negative clinical outcomes. Although research on health literacy has increased in recent years, there is still a lack of evidence for orthopaedic patients undergoing joint replacement and in the rehabilitation sector.

Objectives: The aims of this study were to assess health literacy of patients undergoing total knee arthroplasty (TKA) and to observe its course during rehabilitation. Read More

View Article and Full-Text PDF

Post-operative management after total ankle arthroplasty: A systematic review of the literature.

Foot Ankle Surg 2021 May 28. Epub 2021 May 28.

1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123, Bologna, Italy.

Background: Currently, there is no consensus on the most appropriate post-operative management for patients undergoing total ankle arthroplasty. The aim of this study is therefore to offer a systematic review of the pertaining literature to identify current post-operative protocols and describe possible differences.

Methods: A systematic review to identify recent studies concerning the post-operative management after total ankle arthroplasty was conducted. Read More

View Article and Full-Text PDF

Analgesia effects of IPACK block added to multimodal analgesia regiments after total knee replacement: A systematic review of the literature and meta-analysis of 5 randomized controlled trials.

Medicine (Baltimore) 2021 Jun;100(22):e25884

Department of Orthopedics, The First People's Hospital of Changzhou, Changzhou, Jiangsu, China.

Background: Currently, no meta-analysis exists elucidate the analgesic effect of adding IPACK block to our current multimodal analgesia regimen after total knee replacement (TKR). The purpose of this study is to systematically review the level I evidence in the literature to ascertain whether IPACK block can bring additional analgesic benefits to existing multimodal analgesia regimens.

Methods: The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Read More

View Article and Full-Text PDF

Specific knowledge and resilience affect short-term outcome in patients following primary total hip arthroplasty.

Arch Orthop Trauma Surg 2021 Jun 3. Epub 2021 Jun 3.

Sonderkrankenanstalt Zicksee, Otto Pohanka Platz, 7161, Sankt Andrä am Zicksee, Austria.

Purpose: The aim of the present study was to investigate the potential associations between specific knowledge, resilience and patient-reported outcome measures (PROMS) following primary total hip arthroplasty (THA).

Methods: In a cross-sectional prospective study, consecutive patients following primary THA were included at a rehabilitation center. A novel knowledge score and the validated Connor Davidson Resilience Scale (CD-RISC) were utilized to assess patients' specific knowledge and resilience, respectively. Read More

View Article and Full-Text PDF

The effect of care transition pathway implementation on patients undergoing joint replacement during the COVID-19 pandemic: a quasi-experimental study from a tertiary care hospital orthopedic department in Beijing, China.

J Orthop Surg Res 2021 Jun 1;16(1):356. Epub 2021 Jun 1.

Department of Orthopedics, China-Japan Friendship Hospital, Beijing, China.

Background: The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Read More

View Article and Full-Text PDF

Identification of Patients with Similar Gait Compensating Strategies Due to Unilateral Hip Osteoarthritis and the Effect of Total Hip Replacement: A Secondary Analysis.

J Clin Med 2021 May 17;10(10). Epub 2021 May 17.

Department of Orthopedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, 60528 Frankfurt/Main, Germany.

Despite good clinical functional outcome, deficits in gait biomechanics exist 2 years after total hip replacement surgery. The aims of this research were (1) to group patients showing similar gait adaptations to hip osteoarthritis and (2) to investigate the effect of the surgical treatment on gait kinematics and external joint moments. In a secondary analysis, gait data of 51 patients with unilateral hip osteoarthritis were analyzed. Read More

View Article and Full-Text PDF

The Direct Anterior Approach to Primary Total Hip Replacement: Radiological Analysis in Comparison to Other Approaches.

J Clin Med 2021 May 21;10(11). Epub 2021 May 21.

Department of Orthopaedics and Rehabilitation, Medical University of Warsaw, 02-091 Warszawa, Poland.

Total hip arthroplasty (THA) is currently considered the most effective treatment for end-stage hip osteoarthritis (OA). The surgery can be performed via a number of different approaches, including direct anterior (DAA; Smith-Petersen; Hueter), anterolateral (ALA; Watson-Jones), direct lateral (LA; Bauer), posterior (PA; Kocher-Langenbeck), and posterolateral (PLA). There is still a dispute over the optimal technique. Read More

View Article and Full-Text PDF

Robotic arm-assisted versus conventional medial unicompartmental knee arthroplasty: five-year clinical outcomes of a randomized controlled trial.

Bone Joint J 2021 Jun;103-B(6):1088-1095

Department of Trauma and Orthopaedics, Glasgow Royal Infirmary, Glasgow, UK.

Aims: Unicompartmental knee arthroplasty (UKA) is a bone-preserving treatment option for osteoarthritis localized to a single compartment in the knee. The success of the procedure is sensitive to patient selection and alignment errors. Robotic arm-assisted UKA provides technological assistance to intraoperative bony resection accuracy, which is thought to improve ligament balancing. Read More

View Article and Full-Text PDF

Patients follow three distinct outcome trajectories following total knee arthroplasty.

Bone Joint J 2021 Jun;103-B(6):1096-1102

Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.

Aims: Although total knee arthroplasty (TKA) is a highly successful procedure, about 20% of patients remain dissatisfied postoperatively. This proportion is derived from dichotomous models of the assessment of surgical success or failure, which may not reflect the spectrum of outcomes. The aim of this study was to explore differing responses to surgery, and assess whether there are distinct groups of patients with differing patterns of outcome. Read More

View Article and Full-Text PDF

In the dark about physical activity - exploring patient perceptions of physical activity after elective total knee joint replacement: a qualitative study.

Arthritis Care Res (Hoboken) 2021 May 31. Epub 2021 May 31.

School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.

Objective: The study aimed to explore patient perceptions of and motivations for physical activity after total knee joint replacement.

Methods: Participants were purposively sampled after completing a public outpatient rehabilitation exercise group. Semi-structured interviews were completed with 22 participants (mean age 70 years, 45% women) 6 to 12 months after total knee joint replacement. Read More

View Article and Full-Text PDF

An assessment of the return to professional activity of patients aged ≤30 years after hip replacement surgery?

Int J Occup Med Environ Health 2021 May 26. Epub 2021 May 26.

Medical University of Lodz, Łódź, Poland (Orthopedics and Pediatrics Orthopedics Department).

Objectives: The study evaluated the professional activity of patients after a total cementless hip replacement surgery performed at the age of ≤30 years.

Material And Methods: The study group comprised 87 patients, with 95 total cementless hip replacements. The mean age was 25. Read More

View Article and Full-Text PDF

Complications After Anatomic Shoulder Arthroplasty: Revisiting Leading Causes of Failure.

Orthop Clin North Am 2021 Jul 6;52(3):269-277. Epub 2021 May 6.

Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA. Electronic address:

For practicing shoulder arthroplasty surgeons, it is advisable to consider a breadth of data sources concerning complications and outcomes. Although published series from high-volume centers are the primary source of data, these results may not be generalizable to a wide range of practice settings. National or health system-specific registry and medical device databases are useful adjuncts to assess the changing complication profile of shoulder arthroplasty, as well as to understand the complications specific to certain implants or implant types. Read More

View Article and Full-Text PDF

Preoperative risk stratification minimizes 90-day complications in morbidly obese patients undergoing primary total knee arthroplasty.

Bone Joint J 2021 Jun;103-B(6 Supple A):45-50

Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Aims: It has been shown that the preoperative modification of risk factors associated with obesity may reduce complications after total knee arthroplasty (TKA). However, the optimal method of doing so remains unclear. The aim of this study was to investigate whether a preoperative Risk Stratification Tool (RST) devised in our institution could reduce unexpected intensive care unit (ICU) transfers and 90-day emergency department (ED) visits, readmissions, and reoperations after TKA in obese patients. Read More

View Article and Full-Text PDF

Are surgeons still performing primary total knee arthroplasty in the morbidly obese?

Bone Joint J 2021 Jun;103-B(6 Supple A):38-44

Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA.

Aims: The purpose of this study was to assess total knee arthroplasty (TKA) volume and rates of early complications in morbidly obese patients over the last decade, where the introduction of quality models influencing perioperative care pathways occurred.

Methods: Patients undergoing TKA between 2011 to 2018 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Patients were stratified by BMI < 40 kg/m and ≥ 40 kg/m and evaluated by the number of cases per year. Read More

View Article and Full-Text PDF

Manipulation under anaesthesia after primary total knee arthroplasty : minimal differences in intravenous sedation alone versus neuraxial anaesthesia.

Bone Joint J 2021 Jun;103-B(6 Supple A):126-130

Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York, USA.

Aims: Manipulation under anaesthesia (MUA) remains an effective intervention to address restricted range of motion (ROM) after total knee arthroplasty (TKA) and occurs in 2% to 3% of primary TKAs at our institution. Since there are few data on the outcomes of MUA with different anaesthetic methods, we sought to compare the outcomes of patients undergoing MUA with intravenous (IV) sedation and neuraxial anaesthesia.

Methods: We identified 548 MUAs after primary TKA (136 IV sedation, 412 neuraxial anaesthesia plus IV sedation) from March 2016 to July 2019. Read More

View Article and Full-Text PDF

Increased risk of periprosthetic joint infection after acute, traumatic wound dehiscence following primary total knee arthroplasty.

Bone Joint J 2021 Jun;103-B(6 Supple A):191-195

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Aims: To describe the risk of periprosthetic joint infection (PJI) and reoperation in patients who have an acute, traumatic wound dehiscence following total knee arthroplasty (TKA).

Methods: From January 2002 to December 2018, 16,134 primary TKAs were performed at a single institution. A total of 26 patients (0. Read More

View Article and Full-Text PDF

Differences in time to return to work among patients undergoing simultaneous versus staged bilateral total knee arthroplasty.

Bone Joint J 2021 Jun;103-B(6 Supple A):108-112

Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, New York, USA.

Aims: Many patients undergoing total knee arthroplasty (TKA) have severe osteoarthritis (OA) in both knees and may consider either simultaneous or staged bilateral TKA. The implications of simultaneous versus staged bilateral TKA for return to work are not well understood. We hypothesized that employed patients who underwent simultaneous bilateral TKA would have significantly fewer days missed from work compared with the sum of days missed from each operation for patients who underwent staged bilateral TKA. Read More

View Article and Full-Text PDF

Results of debridement, antibiotics, and implant retention for periprosthetic knee joint infection supplemented with the use of intraosseous antibiotics.

Bone Joint J 2021 Jun;103-B(6 Supple A):185-190

OrthoCarolina Hip and Knee Center, OrthoCarolina, Charlotte, North Carolina, USA.

Aims: Debridement, antibiotics, and implant retention (DAIR) remains one option for the treatment of acute periprosthetic joint infection (PJI) despite imperfect success rates. Intraosseous (IO) administration of vancomycin results in significantly increased local bone and tissue concentrations compared to systemic antibiotics alone. The purpose of this study was to evaluate if the addition of a single dose of IO regional antibiotics to our protocol at the time of DAIR would improve outcomes. Read More

View Article and Full-Text PDF

2021 Mark Coventry Award: Use of a smartphone-based care platform after primary partial and total knee arthroplasty: a prospective randomized controlled trial.

Bone Joint J 2021 Jun;103-B(6 Supple A):3-12

Joint Implant Surgeons, New Albany, Ohio, USA.

Aims: The purpose is to determine the non-inferiority of a smartphone-based exercise educational care management system after primary knee arthroplasty compared with a traditional in-person physiotherapy rehabilitation model.

Methods: A multicentre prospective randomized controlled trial was conducted evaluating the use of a smartphone-based care management system for primary total knee arthroplasty (TKA) and partial knee arthroplasty (PKA). Patients in the control group (n = 244) received the respective institution's standard of care with formal physiotherapy. Read More

View Article and Full-Text PDF

Clinical-Instrumental Results and Analysis of Functional Activity Restoration in Professional Athletes After Lumbar Total Disk Replacement.

World Neurosurg 2021 May 27. Epub 2021 May 27.

University of Sheffield department Neuroscience, Royal Hallamshire Hospital, Sheffield, United Kingdom.

Objective: To analyze the clinical and biomechanical outcome of professional athletes after lumbar total disk replacement, with a focus on restoration of the functional activity.

Methods: This nonrandomized retrospective single-center study included 11 professional athletes who underwent lumbar disc replacement surgery using the prosthesis M6-L (Spinal Kinetics, Schaffhausen, Switzerland). The average postoperative follow-up was 3. Read More

View Article and Full-Text PDF

Disagreement in Readmission Rates After Total Hip and Knee Arthroplasty Across Data Sets.

Arthroplast Today 2021 Jun 17;9:73-77. Epub 2021 May 17.

Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.

Background: In 2014, the Affordable Care Act Hospital Readmissions Reduction Program began penalizing hospitals for excessive readmission rates 30 days after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Various data sets with nonstandardized validation processes report readmission data, which may provide conflicting outcome values for the same patient populations.

Methods: We queried 4 separate data sets: the American Joint Replacement Registry, Centers for Medicare and Medicaid Services billing data, the Vizient data set, and an advanced analytics integration (Cognos) report from our electronic medical record. Read More

View Article and Full-Text PDF

Three-dimensional-printed custom-made hemipelvic endoprosthesis for the revision of the aseptic loosening and fracture of modular hemipelvic endoprosthesis: a pilot study.

BMC Surg 2021 May 26;21(1):262. Epub 2021 May 26.

Department of Orthopaedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, People's Republic of China.

Background: The aims of this pilot study were (1) to assess the efficacy of 3D-printed custom-made hemipelvic endoprosthesis in restoring the natural location of acetabulum for normal bodyweight transmission; (2) to evaluate the short-term function of the revision with this endoprosthesis and (3) to identify short-term complications associated with the use of this endoprosthesis.

Methods: Between February 2017 and December 2017, seven patients received revision with 3D-printed custom-made hemipelvic endoprosthesis. The body weight moment arm (BWMA) and cup height discrepancy (CHD) after primary and revisional surgery were analyzed to assess acetabulum location with plain radiography. Read More

View Article and Full-Text PDF

Calcaneal insufficiency fractures following ipsilateral total knee arthroplasty.

Injury 2021 May 15. Epub 2021 May 15.

Department of Rehabilitation, Nagoya Joint Replacement Orthopaedic Clinic, 7 Iponbashi, Takadaji, Kita-Nagoya, Aichi 481-0011, Japan.

Introduction: Only a few reports have described calcaneal insufficiency fractures (IFs) following total knee arthroplasty (TKA). Herein, we describe nine cases of calcaneal IFs following ipsilateral TKA. The purpose of this study was to investigate the incidence of calcaneal fractures following TKA and determine the characteristics of patients with IFs. Read More

View Article and Full-Text PDF

Total hip replacement in patient with residual poliomyelitis with neglected femoral neck fracture.

BMJ Case Rep 2021 May 21;14(5). Epub 2021 May 21.

Orthopaedic, Benghazi Medical Center, Benghazi, Libya

A 71-year-old man with residual poliomyelitis was referred to the orthopaedic surgeons with a neglected left femoral neck fracture of the paralytic limb. He had presented at another hospital with left groin pain and inability to weight bear 4 weeks earlier after a fall from standing height, but had delayed treatment due to his insistence on waiting until he returned to his home country.Successful treatment of residual poliomyelitis fractures requires early union as well as early mobilisation and rehabilitation. Read More

View Article and Full-Text PDF

Development and ex-vivo assessment of a novel patient specific guide and instrumentation system for minimally invasive total shoulder arthroplasty.

PLoS One 2021 21;16(5):e0251880. Epub 2021 May 21.

Department of Mechanical Engineering, Imperial College London, London, United Kingdom.

Objective: To develop and assess a novel guidance technique and instrumentation system for minimally invasive short-stemmed total shoulder arthroplasty that will help to reduce the complications associated with traditional open replacement such as poor muscle healing and neurovascular injury. We have answered key questions about the developed system including (1) can novel patient-specific guides be accurately registered and used within a minimally invasive environment?; (2) can accuracy similar to traditional techniques be achieved?

Methods: A novel intra-articular patient-specific guide was developed for use with a new minimally invasive posterior surgical approach that guides bone preparation without requiring muscle resection or joint dislocation. Additionally, a novel set of instruments were developed to enable bone preparation within the minimally invasive environment. Read More

View Article and Full-Text PDF

Medial femoral condyle fracture during an Oxford unicompartmental knee replacement surgery: case report.

J ISAKOS 2021 May 15;6(3):182-184. Epub 2020 Dec 15.

Knee Fellow, Clinica Alemana de Santiago SA, Vitacura, Metropolitan Region, Chile.

Oxford unicompartmental knee arthroplasty has been used as a good alternative for medial unicompartmental osteoarthritis due to its association with early rehabilitation and a low rate of intraoperative complications. This case describes a rare complication during the procedure of an intraoperative fracture of the medial condyle that was treated with osteosynthesis with 6.5 mm cannulated screws and a compression technique. Read More

View Article and Full-Text PDF

The Effect of a Discharge Disposition Algorithm on Patient Outcomes and Satisfaction.

Orthop Nurs 2021 May-Jun 01;40(3):125-133

Jessica L. Heligman, DNP, Florida Gulf Coast University, Las Vegas, FL.

Total joint arthroplasties are one of the most common procedures performed in the United States. As changes have occurred in the surgical techniques of these procedures, postoperative recovery time has decreased and patients have been able to safely transition to home rather than a post-acute care facility. The demand for total joint arthroplasty (TJA) is expected to grow 44% as the prevalence of lower extremity osteoarthritis continues to rise (Sher et al. Read More

View Article and Full-Text PDF

Comparison of a fast track protocol and standard care after hip arthroplasty in the reduction of the length of stay and the early weight-bearing resumption: study protocol for a randomized controlled trial.

Trials 2021 May 17;22(1):348. Epub 2021 May 17.

Reconstructive Orthopaedic Surgery and Innovative Techniques - Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136, Bologna, Italy.

Background: To date, hip arthroplasty is one of the most commonly performed surgical procedures, with growing worldwide demand. In recent decades, major progress made in terms of surgical technique, biomechanics, and tribology knowledge has contributed to improve the medical and functional management of the patient. This study aims to assess if the application of a fast track protocol, consisting of a preoperative educational intervention, adequate postoperative pain control, and intensive rehabilitation intervention, reduces the length of stay (LOS) and allows the early functional recovery compared to standard clinical practice for patients undergoing hip arthroplasty. Read More

View Article and Full-Text PDF