40,635 results match your criteria Total Knee Arthroplasty

Characterization and Potential Relevance of Randomized Controlled Trial Patient Populations in Total Joint Arthroplasty in the United States: A Systematic Review.

J Arthroplasty 2022 Jun 21. Epub 2022 Jun 21.

Weill Cornell Medicine, New York, NY 10021.

Background: A substantial number of randomized controlled trial (RCT) studies in total joint arthroplasty (TJA) are published each year in the United States (US). However, it is unknown how closely the demographic and clinical characteristics of these cohorts resemble that of the US patient population undergoing TJA. Thus, the purpose of this systematic review was to evaluate the patient characteristics of published RCTs in TJA in the US and to compare these characteristics against patient cohorts from national patient databases. Read More

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The Role of Stability and Alignment in Improving Patient Outcomes After Total Knee Arthroplasty.

JBJS Rev 2022 May 2;10(5). Epub 2022 May 2.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

»: Total knee arthroplasty (TKA) is an effective treatment option for many patients, but a small group of patients are dissatisfied following TKA.

»: Alignment, in combination with balance, stability, and knee kinematics, is an important modifiable surgical factor that can affect patient outcomes.

»: Driven by the subset of dissatisfied patients after TKA, new techniques have evolved in the search for a more anatomic reconstruction of individual knee morphology and a more accurate approximation of the individual lower-extremity alignment. Read More

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Same-day discharge after early mobilisation and increased frequency of physiotherapy following hip and knee arthroplasty.

S Afr J Physiother 2022 31;78(1):1755. Epub 2022 May 31.

Department of Physiotherapy, Faculty of Health Science, University of the Witwatersrand, Parktown, South Africa.

Background: Advanced rehabilitation pathway (ARP) after hip and knee arthroplasties is popular globally and is gaining ground in South Africa (SA). A multidisciplinary team in Rustenburg, SA, has implemented an ARP with the first same-day discharge (SDD) from hospital. The lack of evidence of physiotherapy protocols within an ARP determined our study. Read More

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Conversion Total Knee Arthroplasty After Tibial Plateau Fixation Is Associated With Lower Reimbursement, Greater Complication Rates, and Similar Opioid Use.

Cureus 2022 May 20;14(5):e25171. Epub 2022 May 20.

Orthopedics, University of Texas Southwestern Medical Center, Dallas, USA.

Objective Total knee replacement after previous open reduction and internal fixation for tibial plateau fracture (conversion total knee) increases the complexity of the procedure and the complication rate. However, very little research exists to report on opioid use and cost associated with total knee arthroplasty (TKA) following tibial plateau fracture fixation as compared to primary TKA patients with no history of tibial plateau fracture. The aim of this study is to compare the differences in opioid use, reimbursements, and complication rates between patients with and without a history of tibial plateau fracture undergoing TKA. Read More

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Does Application of Lymphatic Drainage with Kinesiology Taping Have Any Effect on the Extent of Edema and Range of Motion in Early Postoperative Recovery following Primary Endoprosthetics of the Knee Joint?

J Clin Med 2022 Jun 16;11(12). Epub 2022 Jun 16.

Department of Sports Medicine, Faculty of Health Sciences, Medical University of Lublin, 20-093 Lublin, Poland.

Background: The surgery of knee replacement due to degenerative changes is the last step of the treatment. After surgery, a major problem in patients is pain, swelling, intraarticular hematoma, and the restriction of the mobility of the joint. The aim of this work was to determine the effect of Kinesio Taping (KT) on reducing edema of the subcutaneous tissue and improving the range of motion in the joint. Read More

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Effectiveness of ERAS (Enhanced Recovery after Surgery) Protocol via Peripheral Nerve Block for Total Knee Arthroplasty.

J Clin Med 2022 Jun 10;11(12). Epub 2022 Jun 10.

Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea.

Peripheral nerve block (PNB) for patients with total knee arthroplasty (TKA) is one of the recommended interventions in ERAS protocols. However, most existing studies involved unilateral TKA (UTKA). As such, this study aimed to evaluate the effectiveness of PNB in terms of immediate postoperative analgesia, length of hospital stays (LOS), and early functional outcomes in both UTKA and simultaneous bilateral TKAs (BTKAs). Read More

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Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol.

J Clin Med 2022 Jun 8;11(12). Epub 2022 Jun 8.

Surgery Department, Hôpital Maisonneuve-Rosemont, Montreal University, 5415 Boulevard de l'Assomption, Montreal, QC H1T 2M4, Canada.

Pressure to reduce healthcare costs, limited hospital availability along with improvements in surgical technique and perioperative care motivated many centers to focus on outpatient pathway implementation. However, in many short-stay protocols, the focus has shifted away from aiming to reduce complications and improved rehabilitation, to using length of stay as the main factor of success. To improve patient outcomes and maintain safety, the best way to implement a successful outpatient program would be to combine it with the principles of enhanced recovery after surgery (ERAS), and to improve patient recovery to a level where the patient is able to leave the hospital sooner. Read More

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Online Crowdsourcing Survey of United States Population Preferences and Perceptions Regarding Outpatient Hip and Knee Arthroplasty.

J Arthroplasty 2022 Jun 20. Epub 2022 Jun 20.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.

Introduction: Outpatient total joint arthroplasty (TJA) has been shown to be both safe and cost-effective in appropriately selected patients and continues to expand substantially across the United States. Using online crowdsourcing, we aimed to assess population perceptions regarding outpatient TJA and to determine factors associated with preference for outpatient vs. inpatient arthroplasty. Read More

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Computer-Navigated and Robotic-Assisted Total Knee Arthroplasty: Increasing in Popularity without Increasing Complications.

J Arthroplasty 2022 Jun 20. Epub 2022 Jun 20.

Keck School of Medicine of USC, Los Angeles, California. Electronic address:

Introduction: Data on the clinical impact of computer navigation (CN) and robotic assistance (RA) in total knee arthroplasty (TKA) are mixed. This study aims to describe modern utilization trends in CN-TKA, RA-TKA, and conventional (CON) TKA and to assess for differences in postoperative complications and opioid consumption by procedure type.

Methods: A national database was queried to identify primary, elective TKA patients from 2015 to 2020. Read More

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Modifiable factors influencing length of stay after total knee arthroplasty.

Eur J Orthop Surg Traumatol 2022 Jun 23. Epub 2022 Jun 23.

Department of Trauma Surgery, Privatklinik Hochrum, Laerchenstr. 41, 6063, Rum, Austria.

Purpose: This cohort study aims to investigate the current Rapid-Recovery-(RR)-pathway at an orthopaedic surgery hospital centre and to identify preoperative, intraoperative, and postoperative factors that are significantly associated with prolonged hospital Length of Stay (LOS) after total knee arthroplasty (TKA).

Method: A total of 194 patients undergoing primary TKA were included in this retrospective study. Sociodemographic data documented were age, gender, body mass index, living situation, and the clinical diagnosis. Read More

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Biomechanical Analysis of the Use of Stems in Revision Total Knee Arthroplasty.

Bioengineering (Basel) 2022 Jun 19;9(6). Epub 2022 Jun 19.

BEAMS Department, Université Libre de Bruxelles, Av. F. Roosevelt, 50 CP165/56, 1050 Bruxelles, Belgium.

Adequate fixation is fundamental in revision total knee arthroplasty; consequently, surgeons must determine the correct set-up for each patient, choosing from numerous stem solutions. Several designs are currently available on the market, but there are no evidence-based quantitative biomechanical guideline yet. Therefore, several stems were designed and analyzed using a previously-validated finite-element model. Read More

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The Role of Prophylactic Peroneal Nerve Decompression in Patients with Severe Valgus Deformity at the Time of Primary Total Knee Arthroplasty.

Strategies Trauma Limb Reconstr 2022 Jan-Apr;17(1):38-43

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, United States of America.

Background: Common peroneal nerve (PN) palsy after total knee arthroplasty (TKA) is a serious complication. Although many authors suggest delayed or immediate PN decompression after TKA in these patients, little is known about the role of prophylactic peroneal nerve decompression (PPND) at the time of TKA. The aim is to report the results of PPND in high-risk patients at the time of TKA. Read More

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Bone Hook Reduction Technique Combined with Lateral Parapatellar Arthrotomy for Periprosthetic Distal Femoral Fractures Following Total Knee Arthroplasty: A Technical Note.

Orthop Surg 2022 Jun 22. Epub 2022 Jun 22.

Department of Orthopaedic Surgery, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea.

Objective: To report a bone hook reduction technique combined with lateral parapatellar arthrotomy for periprosthetic distal femoral fractures following total knee arthroplasty (TKA).

Methods: From April 2012 to June 2018, a total of 31 knees who underwent this technique for the treatment of periprosthetic distal femoral fractures following TKA were retrospectively reviewed. Through a lateral parapatellar arthrotomy, the vastus lateralis fascia was dissected from the muscle belly to allow anteromedial mobilization of the muscles. Read More

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Higher risk of knee arthroplasty during ten-year follow-up if baseline radiographic osteoarthritis involves the patellofemoral joint: a CHECK Cohort Study.

BMC Musculoskelet Disord 2022 Jun 22;23(1):600. Epub 2022 Jun 22.

Department of General Practice, Erasmus University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Netherlands.

Background: Patellofemoral OA is a strong risk factor for progression to generalized whole knee OA, but it is unknown whether involvement of the patellofemoral joint in early radiographic OA (ROA) is associated with risk of undergoing future knee arthroplasty. This is clinically relevant because patellofemoral OA likely requires a different treatment approach than tibiofemoral OA, and identifying prognostic factors for future arthroplasty might assist clinicians with prioritizing and guiding early interventions that could improve long-term outcomes. Therefore, we evaluated association of baseline patellofemoral or tibiofemoral ROA with undergoing knee arthroplasty over 10 years. Read More

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A radiographic model predicting the status of the anterior cruciate ligament in varus knee with osteoarthritis.

BMC Musculoskelet Disord 2022 Jun 22;23(1):603. Epub 2022 Jun 22.

Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

Purpose: The study aims to investigate the accuracy of different radiographic signs for predicting functional deficiency of anterior cruciate ligament (ACL) and test whether the prediction model constructed by integrating multiple radiographic signs can improve the predictive ability.

Methods: A total number of 122 patients from January 1, 2018, to September 1, 2021, were enrolled in this study. Among them, 96 patients were classified as the ACL-functional (ACLF) group, while 26 patients as the ACL-deficient (ACLD) group after the assessment of magnetic resonance imaging (MRI) and the Lachman's test. Read More

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Pharmacological thromboprophylaxis as a risk factor for early periprosthetic joint infection following primary total joint arthroplasty.

Sci Rep 2022 Jun 22;12(1):10579. Epub 2022 Jun 22.

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.

Venous thromboembolism (VTE) prophylaxis has been suggested for patients who underwent total join arthroplasty (TJA). However, the morbidity of surgical site complications (SSC) and periprosthetic joint infection (PJI) has not been well evaluated. We aimed to evaluate the impact of VTE prophylaxis on the risk of early postoperative SSC and PJI in a Taiwanese population. Read More

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2022 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.

J Arthroplasty 2022 Jun 17. Epub 2022 Jun 17.

University of Alabama at Birmingham and Veterans Affairs Medical Center, Birmingham, Alabama.

Objective: To develop updated American College of Rheumatology/American Association of Hip and Knee Surgeons guidelines for the perioperative management of disease-modifying medications for patients with rheumatic diseases, specifically those with inflammatory arthritis (IA) and those with systemic lupus erythematosus (SLE), undergoing elective total hip arthroplasty (THA) or elective total knee arthroplasty (TKA).

Methods: We convened a panel of rheumatologists, orthopedic surgeons, and infectious disease specialists, updated the systematic literature review, and included currently available medications for the clinically relevant population, intervention, comparator, and outcomes (PICO) questions. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence and the strength of recommendations using a group consensus process. Read More

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Effectiveness of a multifaceted quality improvement intervention to improve patient outcomes after total hip and knee arthroplasty: a registry nested cluster randomised controlled trial.

BMJ Qual Saf 2022 Jun 22. Epub 2022 Jun 22.

Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.

Objective: To assess the effectiveness of a prospective multifaceted quality improvement intervention on patient outcomes after total hip and knee arthroplasty (THA and TKA).

Design: Cluster randomised controlled trial nested in a national registry. From 1 January 2018 to 31 May 2020 routinely submitted registry data on revision and patient characteristics were used, supplemented with hospital data on readmission, complications and length of stay (LOS) for all patients. Read More

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Learning curve for robotic assisted total knee arthroplasty: our experience with imageless hand-held Navio system.

J Robot Surg 2022 Jun 22. Epub 2022 Jun 22.

Department of Orthopaedics, Lokmanya Hospital, Pune, India.

The main purpose of this study was to determine the learning curve of Robotic assisted Total Knee Arthroplasty surgery through assessment of operative time and comparison with that of conventional jig based Total Knee Arthroplasty. The study included our first 75 Robotic assisted Total Knee Arthroplasty and 25 randomly selected conventional jig-based Total knee arthroplasty from June 2017 to December 2017. The 75 cases were divided into 3 groups of 25 consecutive cases. Read More

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[Bone cement implantation syndrome in total knee arthroplasty:a case report].

Zhongguo Gu Shang 2022 Jun;35(6):586-8

Department of Orthopaedics Center, the 940th Hospital of PLA Joint Logistics Support Force, Lanzhou 730050, Gansu, China.

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Impact of keel saw blade design and thickness on the incidence of tibial plateau fracture and tibial implant-loosening in cementless medial UKR.

BMC Musculoskelet Disord 2022 Jun 21;23(1):597. Epub 2022 Jun 21.

Klinikum Garmisch-Partenkirchen, Endogap, Joint Replacement Institute, Auenstraße 6, 82467, Garmisch-Partenkirchen, Germany.

Background: Tibial plateau fractures and tibial implant- loosening are severe complications in cementless unicompartmental knee replacement (UKR). The tibial keel preparation is particularly demanding and different saw blades can be used. It was hypothesized that different blade designs and thickness have an influence on the frequency of tibial plateau fractures and implant-loosening in cementless medial UKR. Read More

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The use of intrathecal morphine for acute postoperative pain in lower limb arthroplasty surgery: a survey of practice at an academic hospital.

J Orthop Surg Res 2022 Jun 21;17(1):323. Epub 2022 Jun 21.

Department of Anaesthesiology, University of the Witwatersrand, Johannesburg, South Africa.

Background And Purpose Of The Study: Intrathecal morphine (ITM) provides optimal postoperative analgesia in patients who are scheduled for total knee and hip operation with spinal anaesthesia. However, the ideal dose at which maximal analgesic effect occurs with minimal side effects is not known. This study aimed to describe the use of two doses of ITM and side effect profile in patients undergoing elective hip and knee arthroplasty. Read More

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Increasing trend of radiographic features of knee osteoarthritis in rheumatoid arthritis patients before total knee arthroplasty.

Sci Rep 2022 Jun 21;12(1):10452. Epub 2022 Jun 21.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

To investigate the trend and factors related to the occurrence of osteoarthritis (OA)-like features on knee radiographs of rheumatoid arthritis (RA) patients undergoing total knee arthroplasty (TKA) in the recent decades. To classify antero-posterior knee radiographs into 'RA' and 'OA-like RA' groups, a deep learning model was developed by training the network using knee radiographs of end-stage arthropathy in RA patients obtained during 2002-2005 and in primary OA patients obtained during 2007-2009. We used this model to categorize 796 knee radiographs, which were recorded in RA patients before TKA during 2006-2020, into 'OA-like RA' and 'RA' groups. Read More

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Risk factors differ for Gram-negative surgical site infection following hip and knee arthroplasty: an observational study from a national surveillance system.

N Z Med J 2022 Feb 25;135(1550):47-61. Epub 2022 Feb 25.

Clinical Microbiologist, Department of Microbiology, Auckland District Health Board, Auckland City Hospital, Auckland; Clinical Lead New Zealand Surgical Site Infection Improvement Programme, Health Quality & Safety Commission, Wellington.

Aim: To describe risk factors for surgical site infection (SSI) caused by aerobic Gram-negative organisms after hip and knee arthroplasty.

Method: Publicly funded hip and knee arthroplasties (performed between 1 July 2013 and 31 December 2017) that developed SSIs were compared to those that did not. SSIs were grouped by causative organism: Gram-negative (Pseudomonas spp. Read More

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February 2022

Designing and testing of a novel patient-specific total knee prosthesis using the probabilistic approach.

Biomed Tech (Berl) 2022 May 9. Epub 2022 May 9.

Department of Mechanical Engineering, Atatürk University, Erzurum, Turkey.

In order to prevent failure as well as ensure comfort, patient-specific modelling for prostheses has been gaining interest. However, deterministic analyses have been widely used in the design process without considering any variation/uncertainties related to the design parameters of such prostheses. Therefore, this study aims to compare the performance of patient-specific anatomic Total Knee Arthroplasty (TKA) with off-the-shelf TKA. Read More

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Large variability in recommendations for return to daily life activities after knee arthroplasty among Dutch hospitals and clinics: a cross-sectional study.

Acta Orthop 2022 Jun 20;93:568-573. Epub 2022 Jun 20.

Academic Medical Center, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam.

Background And Purpose: Recommendations concerning the return to daily life activities, including work and sport, after knee arthroplasty (KA) are essential for setting realistic patient expectations. Fulfillment of these expectations contributes to more satisfaction and enhanced recovery after KA. However, scientific evidence for such recommendations is limited, and recommendations are often based only on healthcare professionals' expert opinions. Read More

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Manipulation under anesthesia after total knee arthroplasty: a retrospective study of 145 patients.

Acta Orthop 2022 Jun 21;93:583-587. Epub 2022 Jun 21.

Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio; Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland.

Background And Purpose: Manipulation under anesthesia (MUA) is considered to be effective in treating stiffness after total knee arthroplasty (TKA). However, not all patients achieve a satisfactory range of motion (ROM) after MUA. This retrospective study determined the outcome of MUA and identified the factors affecting it. Read More

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Revision Risk for Total Knee Arthroplasty Polyethylene Designs in Patients 65 Years of Age or Older: An Analysis from the American Joint Replacement Registry.

J Bone Joint Surg Am 2022 Jun 20. Epub 2022 Jun 20.

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

Background: Polyethylene bearing design may influence the risk of revision after total knee arthroplasty (TKA). Previous investigations from outside of the United States have suggested the potential for an increased risk of all-cause revision and revision for infection with the use of posterior-stabilized bearings. We examine the risk of revision based on the polyethylene bearing design selection for primary TKA. Read More

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An Enhanced Understanding of Culture-Negative Periprosthetic Joint Infection with Next-Generation Sequencing: A Multicenter Study.

J Bone Joint Surg Am 2022 Jun 20. Epub 2022 Jun 20.

Rothman Institute at Thomas Jefferson, Philadelphia, Pennsylvania.

Background: The challenges of culture-negative periprosthetic joint infection (PJI) have led to the emergence of molecular methods of pathogen identification, including next-generation sequencing (NGS). While its increased sensitivity compared with traditional culture techniques is well documented, it is not fully known which organisms could be expected to be detected with use of NGS. The aim of this study was to describe the NGS profile of culture-negative PJI. Read More

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Effect of Painless Rehabilitation Nursing for Hip Replacement Patients.

Comput Math Methods Med 2022 11;2022:5164973. Epub 2022 Jun 11.

Nursing College of Shanxi Medical University, Shanxi, China.

Objective: To analyze the effect of painless rehabilitation nursing for hip replacement patients.

Method: 124 elderly patients who underwent total knee arthroplasty in our hospital from June 2019 to June 2020 were selected as study subjects. They were randomly divided into observation group and control group. Read More

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