28,831 results match your criteria Total Knee Arthroplasty


[Imaging study on effect of femoral intramedullary guide on the alignment of femoral prosthesis in unicompartmental knee arthroplasty].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Jan;33(1):8-12

Department of Adult Joint Reconstructive Surgery【?】, Yangpu Hospital, Shanghai Tongji University, Shanghai, 200090, P.R.China.

Objective: To explore the imaging features of intramedullary guide rod and its influence on the alignment of the femoral prosthesis in unicompartmental knee arthroplasty (UKA).

Methods: Between August 2016 and November 2016, 50 patients (50 knees) with primary anteromedial osteoarthritis were treated with UKA by Oxford MicroPlasty minimally invasive replacement system. There were 10 males and 40 females. Read More

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http://dx.doi.org/10.7507/1002-1892.201808045DOI Listing
January 2019

Benchmarks of Duration and Magnitude of Opioid Consumption After Total Hip and Knee Arthroplasty: A Database Analysis of 69,368 Patients.

J Arthroplasty 2018 Dec 24. Epub 2018 Dec 24.

Department of Orthopedic Surgery and Rehabilitative Medicine, University of Chicago Medicine, Chicago, IL.

Background: Opioid prescribing after orthopedic surgeries varies widely, and there is little consensus establishing proper standards of care. This retrospective cohort study examines opioid prescribing trends following total hip (THA) and knee (TKA) arthroplasty and evaluates preoperative opioid use as a predictor of duration and magnitude of postoperative opioid use.

Methods: Patients who underwent THA or TKA in a nationwide insurance database were stratified by preoperative opioid use. Read More

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http://dx.doi.org/10.1016/j.arth.2018.12.023DOI Listing
December 2018

Two-State Comparison of Total Joint Arthroplasty Utilization Following Medicaid Expansion.

J Arthroplasty 2018 Dec 22. Epub 2018 Dec 22.

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO; Division of Infectious Diseases, Department of Medicine, Center for Administrative Data Research, Washington University School of Medicine, St. Louis, MO.

Background: Although Medicaid expansion has improved access to primary care services, its impact on surgical specialty utilization remains unclear. The aim of this study is to determine whether Medicaid expansion is associated with increased utilization rates of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Illinois (which expanded Medicaid) relative to Missouri (which did not expand Medicaid).

Methods: Using administrative data sources, we analyzed 374,877 total hospitalizations (236,333 in Illinois and 138,544 in Missouri) for THA/TKA from 2011 to 2016 (Illinois' Medicaid expansion date: January 1, 2014). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183122
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http://dx.doi.org/10.1016/j.arth.2018.12.019DOI Listing
December 2018
1 Read

Spread of dye injectate in the distal femoral triangle versus the distal adductor canal: a cadaveric study.

Reg Anesth Pain Med 2019 Jan;44(1):39-45

Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, UK.

Background And Objectives: The nerve to vastus medialis (NVM) supplies sensation to important structures relevant to total knee arthroplasty via a medial parapatellar approach. There are opposing findings in the literature about the presence of the NVM within the adductor canal (AC). The objective of this cadaveric study is to compare the effect of injection site (distal femoral triangle (FT) vs distal AC) on injectate spread to the saphenous nerve (SN) and the NVM. Read More

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http://dx.doi.org/10.1136/rapm-2018-000002DOI Listing
January 2019

Neurostructural correlates of strength decrease following total knee arthroplasty: A systematic review of the literature with meta-analysis.

Bosn J Basic Med Sci 2019 Jan 14. Epub 2019 Jan 14.

Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.

Recent literature suggests that alterations in both neural and structural components of the neuromuscular system are major determinants of knee extensor muscle weakness after total knee arthroplasty (TKA). Therefore, the goal of this study was to investigate the maximal voluntary strength (MVS), voluntary muscle activation (VMA), and the cross-sectional area (CSA) of the muscle, up to 33 months after the TKA.  We searched relevant scientific databases and literature for outcomes of interest, including quadriceps MVS, VMA, and CSA. Read More

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http://dx.doi.org/10.17305/bjbms.2019.3814DOI Listing
January 2019

A comparison of the analgesic efficacy of local infiltration analgesia vs. intrathecal morphine after total knee replacement: A randomised controlled trial.

Eur J Anaesthesiol 2019 Jan 10. Epub 2019 Jan 10.

From the Department of Anaesthesiology, Cork University Hospital and University College Cork, Cork, Ireland (DM, JM, JG, FL, GS, GI).

Background: Local infiltration analgesia (LIA) is an effective pain management technique following total knee arthroplasty (TKA).

Objective: To investigate if LIA provides better analgesia for patients undergoing unilateral TKA than intrathecal morphine.

Design: Randomised controlled trial. Read More

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http://dx.doi.org/10.1097/EJA.0000000000000943DOI Listing
January 2019

Changes in postoperative extension angle after total knee arthroplasty: Effect of polyethylene insert thickness.

J Orthop Sci 2019 Jan 10. Epub 2019 Jan 10.

Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori Miyakojima, Osaka City, Osaka, 534-0021, Japan.

Background: Flexion contracture is a serious complication after total knee arthroplasty (TKA). Polyethylene insert (PE) thicker than the extension gap during surgery causes flexion contracture. The purpose of this study was to identify the changes over time in postoperative extension angle and the correlation between extension gap and PE thickness. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09492658183038
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http://dx.doi.org/10.1016/j.jos.2018.12.013DOI Listing
January 2019
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Does bone cement influence soft tissue balancing in total knee arthroplasty?

Knee 2019 Jan 10. Epub 2019 Jan 10.

Department of Orthopedic Surgery, Wollongong Hospital, 252 Loftus St & Locked Bag 8808, South Coast Mail Centre, Wollongong, New South Wales, Australia.

Background: Soft tissue tension significantly affects the function of total knee arthroplasties. This study aims to evaluate if there is a difference in soft tissue tension, comparing trails to cemented definitive components in TKA.

Methods: We prospectively compared femorotibial compartment pressures before and after cement fixation of the components in 40 primary TKA. Read More

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http://dx.doi.org/10.1016/j.knee.2018.12.004DOI Listing
January 2019

Tranexamic acid is effective in lower doses with infusion in total knee arthroplasty.

Acta Orthop Traumatol Turc 2019 Jan 8. Epub 2019 Jan 8.

Kocaeli State Hospital, Department of Orthopedics and Traumatology, Turkey.

Objective: To identify the most effective intravenous regimen with reduced doses of tranexamic acid (TXA).

Methods: We retrospectively evaluated the two most frequently used TXA regimens (infusion and divided-dose regimens) in total knee arthroplasty in comparison with patients not treated with TXA, in three groups. Group NO (n = 134; 19 men and 115 women; mean age: 66. Read More

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http://dx.doi.org/10.1016/j.aott.2018.12.002DOI Listing
January 2019

American Association of Hip and Knee Surgeons Annual Meeting Symposium: Management of the Bariatric Patient. What Are the Implications of Obesity and Total Joint Arthroplasty: The Orthopedic Surgeon's Perspective?

Authors:
Bryan D Springer

J Arthroplasty 2018 Dec 24. Epub 2018 Dec 24.

OrthoCarolina Hip and Knee Center, Charlotte, NC.

Background: Obesity in the United States has reached epidemic proportions. It is associated with multiple higher rates of osteoarthritis of the hip and knee and thus an increasing need for total hip and knee arthroplasty. The demand for total joint arthroplasty among obese patients has increased and outpaces that of a non-obese cohort. Read More

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http://dx.doi.org/10.1016/j.arth.2018.12.021DOI Listing
December 2018

All-polyethylene tibial components in young patients have stable fixation; a comparison RSA study.

Knee 2019 Jan 8. Epub 2019 Jan 8.

Department of Surgical and Perioperative Sciences, Orthopaedics, Umeå University, Umeå, Sweden. Electronic address:

Background: All-polyethylene (AP) tibial components in patients aged greater than 60 years have stable tibial migration patterns and favorable survival rates when compared to identical Metal-backed (MB) designs. Tibial component migration in younger patients has not been reported. The aim of this study was to examine the migration characteristics of patients aged less than 60 years compared to a previous cohort of AP and MB tibial components of identical design in older patients. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09680160183024
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http://dx.doi.org/10.1016/j.knee.2018.12.003DOI Listing
January 2019
1 Read

Mid-term results of impaction bone grafting in tibial bone defects in complex primary knee arthroplasty for severe varus deformity.

SICOT J 2019 14;5. Epub 2019 Jan 14.

Department of Orthopedics, Apollo Hospitals, Sarita Vihar, Delhi 110076, India.

Introduction: Bone defects are a challenging problem encountered occasionally during primary knee arthroplasty. These defects should be meticulously addressed so as to avoid malalignment and premature loosening and failure. Out of the many options available to deal with these defects, impaction bone grafting provides a more biological solution, which is especially important in case of primary knees. Read More

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https://www.sicot-j.org/10.1051/sicotj/2018056
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http://dx.doi.org/10.1051/sicotj/2018056DOI Listing
January 2019
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Feasibility and preliminary effects of a tele-prehabilitation program and an in-person prehablitation program compared to usual care for total hip or knee arthroplasty candidates: a pilot randomized controlled trial.

Disabil Rehabil 2019 Jan 13:1-10. Epub 2019 Jan 13.

a School of Rehabilitation, Faculty of Medicine , University of Montreal , Montréal , Québec , Canada.

Purpose: Prolonged wait times for total hip and knee arthroplasty have deleterious effects on functional status for the awaiting patients. Telerehabilitation interventions can optimize the delivery of perioperative care. This pilot single-blind randomized controlled trial evaluates the feasibility and the potential impact on pain and disability of a telerehabilitation prehabilitation program, compared to in-person prehabilitation or usual care. Read More

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http://dx.doi.org/10.1080/09638288.2018.1515992DOI Listing
January 2019

Factors influencing return to work after hip and knee arthroplasty.

J Orthop Traumatol 2019 Jan 14;20(1). Epub 2019 Jan 14.

The Joint Studio, Hollywood Medical Centre, Suite 1, 85 Monash Avenue, Nedlands, WA, 6009, Australia.

Background: A substantial proportion of patients undergoing lower limb arthroplasty are of working age. This study aims to identify when patients return to work (RTW) and if they return to normal hours and duties, and to identify which factors influence postoperative RTW. The hypothesis is that there is no difference in time of RTW between the different types of surgery, and no difference in time of RTW based on the physical demands of the job. Read More

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https://jorthoptraumatol.springeropen.com/articles/10.1186/s
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http://dx.doi.org/10.1186/s10195-018-0515-xDOI Listing
January 2019
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Knee and Hip Joint Replacement Surgery in a Patient with Ochronotic Arthropathy: Surgical Tips.

Arch Bone Jt Surg 2018 Nov;6(6):577-581

Research performed at Shahid Modarress Hospital, Saveh, Markazi, Iran.

Ochronosis or black joints disorder is a rare autosomal recessive disorder caused by deficiency of homogentisic acid oxidase. Orthopaedic manifestations are common and mostly involve spine and large joints such as knee and hip. Arthropathy is progressive and will eventually leads to arthroplasty. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310191PMC
November 2018

Staphylococcus aureus Colonization in Patients Undergoing Total Hip or Knee Arthroplasty and Cost-effectiveness of Decolonization Programme.

Arch Bone Jt Surg 2018 Nov;6(6):554-559

Research performed at Bone and Joint Reconstruction Center, Vali-Asr Hospital, Arak University of Medical Sciences, Arak, Iran.

Background: Periprosthetic joint infection is a devastating complication of total joint arthroplasty. It seems that the patient's skin, nose, throat, and urine are important sites for microbial colonization. Colonization with staphylococcus aureus, especially methicillin resistant increases the risk of periprosthetic joint infection. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310181PMC
November 2018

Early Regain of Function and Proprioceptive Improvement Following Knee Arthroplasty.

Arch Bone Jt Surg 2018 Nov;6(6):523-531

Research performed at New England Baptist Hospital, Boston, MA, USA Brigham and Women's Hospital, Boston, MA, USA.

Background: Techniques that allow early muscle activation, such as closed kinetic chain (CKC) and open kinetic chain (OKC) exercises, may play a beneficial role in the early rehabilitation of the reconstructed knee. However, current rehabilitation regimens have not been shown to reverse post-operative quadriceps activation failure and weakness. To investigate whether patients who use a continuous active motion (CAM) device that follows closed kinetic chain principles have better early post-operative functional improvements than patients who use a continuous passive motion (CPM) device that follows the principles of open kinetic chain principles. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310182PMC
November 2018

Total joint replacement in sub-Saharan Africa: a systematic review.

Trop Doct 2019 Jan 12:49475518822239. Epub 2019 Jan 12.

5 Consultant Surgeon and Professor, Department of Trauma and Orthopaedics, Countess of Chester Hospital, Chester, UK.

Outcomes of arthroplasty in sub-Saharan Africa are not widely reported. To our knowledge, this systematic review is the first to explore this topic. Scopus, EMBASE, Medline and PubMed databases were searched, utilising MeSH headings and Boolean search strategies. Read More

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http://dx.doi.org/10.1177/0049475518822239DOI Listing
January 2019
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Serum ropivacaine levels after local infiltration analgesia during total knee arthroplasty with and without adductor canal block.

Reg Anesth Pain Med 2019 Jan 11. Epub 2019 Jan 11.

Department of Anesthesiology, University of Utah Hospital, Salt Lake City, Utah, USA.

Background And Objectives: A common analgesic technique for total knee arthroplasty (TKA) is to inject local anesthetic into the periarticular tissue during surgery, known as local infiltration analgesia (LIA). Since the solution used typically contains a large amount of local anesthetic, concerns arise about exceeding the maximum dosage when adding a peripheral nerve block. Little research exists that addresses serum ropivacaine concentrations following LIA combined with peripheral nerve block. Read More

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http://rapm.bmj.com/lookup/doi/10.1136/rapm-2018-100043
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http://dx.doi.org/10.1136/rapm-2018-100043DOI Listing
January 2019
1 Read

RNA expression preoperatively and postoperatively following total knee replacement: a pilot study in patients with and without chronic postsurgical pain.

Reg Anesth Pain Med 2019 Jan 11. Epub 2019 Jan 11.

Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA

Background And Objective: Differences in gene expression may provide insight into the biological pathways involved in chronic postsurgical pain (CPSP). We compared blood RNA microarrays preoperatively and postoperatively following total knee arthroplasty (TKA) in patients with and without CPSP.

Methods: Patients scheduled for primary TKA had whole blood samples obtained preoperatively and at 48 hours and 6 months postsurgery. Read More

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http://rapm.bmj.com/lookup/doi/10.1136/rapm-2018-100118
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http://dx.doi.org/10.1136/rapm-2018-100118DOI Listing
January 2019
1 Read

Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review.

J Orthop Surg Res 2019 Jan 11;14(1):15. Epub 2019 Jan 11.

College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Background: Cardiac complication represents a major cause of morbidity and mortality after total joint arthroplasty, thus necessitating investigation into the associated risks in total hip arthroplasty and total knee arthroplasty. There remains a lack of clarity for many risk factors in the current literature. The aim of this systematic review is to assess the most recent published literature and identify the risk factors associated with cardiac complication in total hip arthroplasty and total knee arthroplasty. Read More

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https://josr-online.biomedcentral.com/articles/10.1186/s1301
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http://dx.doi.org/10.1186/s13018-018-1058-9DOI Listing
January 2019
1 Read

Reliability of patient-reported complications following hip or knee arthroplasty procedures.

BMC Med Res Methodol 2019 Jan 11;19(1):15. Epub 2019 Jan 11.

South Western Sydney Clinical School, UNSW Sydney, Level 2, Clinical Building, Liverpool Hospital, Cnr Elizabeth and Goulburn Sts, Liverpool NSW, 2170, Australia.

Background: Patient reported outcomes are increasingly used to assess the success of surgical procedures. Patient reported complications are often included as an outcome. However, these data must be validated to be accurate and useful in clinical practice. Read More

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https://bmcmedresmethodol.biomedcentral.com/articles/10.1186
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http://dx.doi.org/10.1186/s12874-018-0645-0DOI Listing
January 2019
1 Read

Tibial plateau fractures are associated with a long-lasting increased risk of total knee arthroplasty a matched cohort study of 7,950 tibial plateau fractures.

Osteoarthritis Cartilage 2019 Jan 8. Epub 2019 Jan 8.

Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.

Objective: This study aims to investigate the risk of total knee replacement (TKR) following tibia plateau fractures. Secondary the study aims to investigate the risk of knee arthroscopy following tibial plateau fractures.

Method: The study was designed as a matched cohort study. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10634584193000
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http://dx.doi.org/10.1016/j.joca.2018.12.020DOI Listing
January 2019
1 Read

Association between bone mineral density distribution and various radiographic parameters in patients with advanced medial osteoarthritis of the knee.

J Orthop Sci 2019 Jan 7. Epub 2019 Jan 7.

Niigata University Crisis Management Office, Niigata University Hospital, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata, 951-8520, Japan. Electronic address:

Purpose: Patients with severe osteoarthritis (OA) of the knee have changes in bone mineral density (BMD) of the distal femur and proximal tibia. Correlations between the medial-to-lateral BMD (M/L-BMD) ratio (which normalizes the potentially confounding effects of body size and sex on BMD) and radiographic parameters that indicate OA progression have not been adequately studied. The purpose of this study was to evaluate correlations between radiographic indicators of OA progression and femoral and tibial M/L-BMD ratios. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09492658183039
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http://dx.doi.org/10.1016/j.jos.2018.12.019DOI Listing
January 2019
1 Read

Stance and swing phase knee flexion recover at different rates following total knee arthroplasty: An inertial measurement unit study.

J Biomech 2018 Dec 31. Epub 2018 Dec 31.

Dartmouth College, Thayer School of Engineering, 14 Engineering Drive, Hanover, NH 03755, United States.

Total knee arthroplasty (TKA) is the most common joint replacement in the United States. Range of motion (ROM) monitoring includes idealized clinic measures (e.g. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00219290183092
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http://dx.doi.org/10.1016/j.jbiomech.2018.12.027DOI Listing
December 2018
4 Reads

The safety, efficacy and cost-effectiveness of the Maxm Skate, a lower limb rehabilitation device for use following total knee arthroplasty: study protocol for a randomised controlled trial.

Trials 2019 Jan 10;20(1):36. Epub 2019 Jan 10.

The International Musculoskeletal Research Institute Inc., Adelaide, South Australia, Australia.

Background: Physical rehabilitation is required to enhance functional outcomes and overall recovery following total knee arthroplasty (TKA). However, there are no universally accepted clinical guidelines available to consistently structure rehabilitation for TKA patients. A common method is rehabilitation provided in an outpatient setting, on a one-to-one treatment basis. Read More

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https://trialsjournal.biomedcentral.com/articles/10.1186/s13
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http://dx.doi.org/10.1186/s13063-018-3102-9DOI Listing
January 2019
1 Read

Thirty-Day Unplanned Readmission after Total Knee Arthroplasty at a Teaching Community Hospital: Rates, Reasons, and Risk Factors.

J Knee Surg 2019 Jan 10. Epub 2019 Jan 10.

Department of Orthopedic Surgery, UPMC-Pinnacle, Harrisburg, Pennsylvania.

Unplanned readmission after total knee arthroplasty (TKA) has an increasing prevalence in the United States. Readmissions are now a metric for hospital quality of care, yet there are mixed results and variables associated with unplanned readmission. In this changing healthcare, it is critical for community healthcare institutions to identify risk factors for unplanned readmissions following TKA. Read More

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http://dx.doi.org/10.1055/s-0038-1677510DOI Listing
January 2019
2 Reads

Recovery of knee range of motion after total knee arthroplasty in the first postoperative weeks: poor recovery can be detected early.

Musculoskelet Surg 2019 Jan 9. Epub 2019 Jan 9.

Department of Orthopedic Surgery, St. Anna Hospital, Bogardeind 2, 5664 EH, Geldrop, The Netherlands.

Purpose: The aim of this study was to analyze in detail how knee flexion and extension progress in the first 8 weeks after primary total knee arthroplasty (TKA). The secondary goal was to compare knee range of motion (ROM) recovery patterns between patients with normal and delayed ROM recovery 8 weeks after TKA.

Methods: This prospective clinical trial included all patients who underwent a primary unilateral TKA between February and December 2016 with weekly ROM data documented by the treating outpatient physical therapists (n = 137). Read More

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http://link.springer.com/10.1007/s12306-019-00588-0
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http://dx.doi.org/10.1007/s12306-019-00588-0DOI Listing
January 2019
2 Reads

Patient dissatisfaction following total knee arthroplasty: external validation of a new prediction model.

Eur J Orthop Surg Traumatol 2019 Jan 9. Epub 2019 Jan 9.

Department of Orthopaedic Surgery, University of Illinois Hospital and Health Sciences System, 1801 W. Taylor St., Chicago, IL, 60612, USA.

Tools designed to predict patient satisfaction following total knee arthroplasty (TKA) have the potential to guide patient selection. Our study aimed to validate a model that predicts patient satisfaction following TKA. Phone surveys were administered to 203 patients who underwent TKA between 2009 and 2016 at the University of Illinois. Read More

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http://link.springer.com/10.1007/s00590-019-02375-w
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http://dx.doi.org/10.1007/s00590-019-02375-wDOI Listing
January 2019
1 Read

Aspirin versus rivaroxaban in postoperative bleeding after total knee arthroplasty: a retrospective case-matched study.

Eur J Orthop Surg Traumatol 2019 Jan 9. Epub 2019 Jan 9.

Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.

Background: Venous thromboembolic disease (VTE) is a complication not uncommon following total knee arthroplasty. Postoperative bleeding-related complications are a concern in many guidelines. The authors aimed to compare the amount of postoperative drainage from closed suction drainage, transfusion rate, and postoperative complications between aspirin and rivaroxaban as VTE prophylaxes after total knee arthroplasty. Read More

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http://link.springer.com/10.1007/s00590-019-02365-y
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http://dx.doi.org/10.1007/s00590-019-02365-yDOI Listing
January 2019
4 Reads

Can Machine Learning Methods Produce Accurate and Easy-to-use Prediction Models of 30-day Complications and Mortality After Knee or Hip Arthroplasty?

Clin Orthop Relat Res 2019 Jan 7. Epub 2019 Jan 7.

A. H. S. Harris, T. Bowe, N. J. Giori Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA A. C. Kuo San Francisco Veterans Affairs Medical Center, University of California, San Francisco, CA, USA A H. S. Harris, Y. Weng, A. W. Trickey Stanford-Surgical Policy Improvement Research and Education Center, Stanford, CA, USA N. J. Giori Department of Orthopedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Background: Existing universal and procedure-specific surgical risk prediction models of death and major complications after elective total joint arthroplasty (TJA) have limitations including poor transparency, poor to modest accuracy, and insufficient validation to establish performance across diverse settings. Thus, the need remains for accurate and validated prediction models for use in preoperative management, informed consent, shared decision-making, and risk adjustment for reimbursement.

Questions/purposes: The purpose of this study was to use machine learning methods and large national databases to develop and validate (both internally and externally) parsimonious risk-prediction models for mortality and complications after TJA. Read More

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http://dx.doi.org/10.1097/CORR.0000000000000601DOI Listing
January 2019
1 Read

Management of Extra-articular Deformity in the Setting of Total Knee Arthroplasty.

J Am Acad Orthop Surg 2019 Jan 7. Epub 2019 Jan 7.

From the Adult Reconstruction and Joint Replacement Service (Dr. Sculco), the Department of Orthopaedic Surgery (Dr. Kahlenberg), and Limb Lengthening and Complex Reconstruction Service (Dr. Fragomen and Dr. Rozbruch), Hospital for Special Surgery, New York, NY.

Extra-articular deformities of the femur and tibia in conjunction with advanced knee osteoarthritis pose unique challenges for the arthroplasty surgeon. Careful preoperative planning is needed to evaluate both the intra- and extra-articular deformities and to determine the best route to total knee arthroplasty. An intra-articular compensatory correction can typically be performed if the extra-articular deformity is distant from the joint or if preoperative templating shows that bony cuts do not interfere with ligamentous attachments. Read More

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http://Insights.ovid.com/crossref?an=00124635-900000000-9943
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http://dx.doi.org/10.5435/JAAOS-D-18-00361DOI Listing
January 2019
2 Reads

Postoperative Outcomes in Primary Total Knee Arthroplasty Patients With Preexisting Cognitive Impairment: A Systematic Review.

Geriatr Orthop Surg Rehabil 2018 21;9:2151459318816482. Epub 2018 Dec 21.

Harvard Medical School, Boston, MA, USA.

Introduction: To evaluate the body of evidence on the predictive value of preoperative cognitive impairment on in-hospital, short-term, and midterm postoperative outcomes for elderly patients undergoing total knee arthroplasty (TKA).

Significance: With an aging population, an increasing percentage of the U.S. Read More

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http://dx.doi.org/10.1177/2151459318816482DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304705PMC
December 2018
1 Read

Sciatic nerve block or not for outpatient total knee arthroplasty? Study protocol for a randomized controlled trial.

Trials 2019 Jan 8;20(1):30. Epub 2019 Jan 8.

Department of Orthopedics & Sports, iULS - University Institute of Locomotion & Sports, Pasteur 2 Hospital, 30, Voie Romaine, CS 51069, 06001, Nice, Cedex 1, France.

Background: The number of patients operated on for total knee arthroplasty (TKA) is growing worldwide. Outpatient surgery is defined by a length of stay (LOS) in the hospital of less than 12 h. This can be limited for TKA, with the efficient management of pain and perioperative complications, such as blood loss, affecting a safe hospital discharge. Read More

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http://dx.doi.org/10.1186/s13063-018-3142-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325783PMC
January 2019
3 Reads

Early postoperative complications and discharge time in diabetic patients undergoing total shoulder arthroplasty.

J Orthop Surg Res 2019 Jan 8;14(1). Epub 2019 Jan 8.

Department of Orthopaedics, Stony Brook University Medical Center, HSC T-18, Room 080, Stony Brook, NY, 11794-8181, USA.

Purpose: With the increasing elderly population and obesity epidemic, diabetes is an important factor in arthroplasty planning. Although research suggests diabetes is associated with increased postoperative morbidity after hip and knee replacement, the effect of diabetes and varying management with insulin versus non-insulin agents on total shoulder arthroplasty (TSA) is not established.

Methods: All TSAs from 2015 to 2016 were queried from the American College of Surgeons National Surgical Quality Improvement Program database. Read More

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https://josr-online.biomedcentral.com/articles/10.1186/s1301
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http://dx.doi.org/10.1186/s13018-018-1051-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325881PMC
January 2019
1 Read

Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients-A 12-Year Perspective.

J Knee Surg 2019 Jan 8. Epub 2019 Jan 8.

Department of Orthopaedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, New York.

Despite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Read More

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http://dx.doi.org/10.1055/s-0038-1676372DOI Listing
January 2019
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The Effects of Surgical Technique in Total Knee Arthroplasty for Varus Osteoarthritic Knee on the Rotational Alignment of Femoral Component: Gap Balancing Technique versus Measured Resection Technique.

J Knee Surg 2019 Jan 8. Epub 2019 Jan 8.

Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea.

Few studies have compared the accuracy of femoral component rotation in the measured resection technique according to the preoperative computed tomography (CT) and gap balancing technique. The aim of this study was to evaluate whether there is a difference in accuracy and outlier incidence of femoral component rotation between gap balancing and measured resection techniques with or without preoperative CT and to evaluate the difference in patellofemoral alignment on simple radiographs and clinical outcomes. In this retrospective study, we evaluated femoral component rotation angle on the clinical and surgical transepicondylar axis (FCRA-cTEA and FCRA-sTEA, respectively), patellar tilt angle, lateral patellar displacement, and patient-reported outcomes in the gap balancing technique (Group 1) and in the measured resection technique without (Group 2) and with (Group 3) preoperative CT. Read More

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http://dx.doi.org/10.1055/s-0038-1676766DOI Listing
January 2019

Repurposing Human Osteoarthritic Cartilage as a Bone Graft Substitute in an Athymic Rat Posterolateral Spinal Fusion Model.

Int J Spine Surg 2018 Dec 21;12(6):735-742. Epub 2018 Dec 21.

Orthopaedic Section, Surgical Service, San Francisco VA Medical Center, San Francisco, California.

Background: Spinal fusion involves both endochondral and intramembranous bone formation. We previously demonstrated that endochondral cartilage grafts that were derived from human osteoarthritic (OA) articular cartilage can be used as a bone graft in mouse models. We hypothesized that OA cartilage could also be recycled and repurposed as a bone graft substitute in a posterolateral lumbar spinal fusion model in athymic rats. Read More

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http://ijssurgery.com/lookup/doi/10.14444/5092
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http://dx.doi.org/10.14444/5092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314337PMC
December 2018
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The use of tourniquet may influence the cement mantle thickness under the tibial implant during total knee arthroplasty.

Eur J Orthop Surg Traumatol 2019 Jan 8. Epub 2019 Jan 8.

Department of Orthopaedics, Faculty of Medicine, Democritus University of Thrace, University General Hospital of Alexandroupoli, Alexandroupoli, Greece.

Introduction: It is still unknown whether the creation of blood-free surfaces by the use of tourniquet during total knee arthroplasty (TKA) has an influence on cement penetration and on implant fixation. The aim of this study is to evaluate the cement mantle under tibial component and the occurrence of progressive radiolucent lines (RLLs) according to the use of tourniquet in primary TKA.

Materials And Methods: Fifty patients undergone TKA without the use of tourniquet (group 1) were well matched regarding baseline characteristics with 50 TKAs with the use of tourniquet (group 2). Read More

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http://dx.doi.org/10.1007/s00590-019-02369-8DOI Listing
January 2019

Return to the operating room after patellofemoral arthroplasty versus total knee arthroplasty for isolated patellofemoral arthritis-a systematic review.

Int Orthop 2019 Jan 7. Epub 2019 Jan 7.

Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, 10021, USA.

Purpose: Patellofemoral arthroplasty (PFA) and total knee arthroplasty (TKA) are accepted treatments for end-stage isolated patellofemoral osteoarthritis (PFOA). However, complications and re-operations have historically differed between the two procedures. We performed a systematic review to report on the re-operation rates between TKA and modern PFA for isolated PFOA. Read More

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http://link.springer.com/10.1007/s00264-018-04280-z
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http://dx.doi.org/10.1007/s00264-018-04280-zDOI Listing
January 2019
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Four questions to identify patients with ASA III or higher.

Arch Orthop Trauma Surg 2019 Jan 7. Epub 2019 Jan 7.

Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021, USA.

Background: Increased age, obesity, and American Society of Anesthesiologists (ASA) Physical Status class III and IV have been reported as predictors for mortality and perioperative complications. High-volume institutions rely on central referral services as first contact point for patients. The current study reports on a simple four-step questionnaire to identify patients with ASA-physical status class III and IV to improve referral processes and optimize perioperative work ups. Read More

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http://link.springer.com/10.1007/s00402-018-3078-7
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http://dx.doi.org/10.1007/s00402-018-3078-7DOI Listing
January 2019
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Fixed Distal Femoral Cut of 6° Valgus in Total Knee Arthroplasty: A Radiographic Review of 788 Consecutive Cases.

J Arthroplasty 2018 Dec 19. Epub 2018 Dec 19.

Department of Kinesiology and Rehabilitation Sciences, University of Hawaii, Honolulu, Hawaii.

Background: In place of the mechanical axis (MA), the use of the variable tibiofemoral angle is frequently used to plan measured resection bony cuts during total knee arthroplasty (TKA). This angle, coupled with operator-dependent variability of intramedullary distal femoral cutting guides, has the potential for catastrophic outcomes. Therefore, a simpler, fixed femoral cut of 6° valgus may be more appropriate when direct measurement of the MA is not possible. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183121
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http://dx.doi.org/10.1016/j.arth.2018.12.013DOI Listing
December 2018
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Preoperative Estimated Glomerular Filtration Rate Is a Marker for Postoperative Complications Following Revision Total Knee Arthroplasty.

J Arthroplasty 2018 Dec 8. Epub 2018 Dec 8.

Department of Orthopedics, Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY.

Background: Revision total knee arthroplasty (TKA) is an increasingly common procedure, but complication rates are higher than for primary TKA. A requirement for dialysis has been shown to predict postoperative complications in this patient population, but the impact of less severe, but clinically significant, renal impairment has not been addressed.

Methods: A retrospective cohort study was conducted using the American College of Surgeons National Quality Improvement Program Database. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183118
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http://dx.doi.org/10.1016/j.arth.2018.12.005DOI Listing
December 2018
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Benefits of direct patient discharge to outpatient physical therapy after total knee arthroplasty.

Disabil Rehabil 2019 Jan 7:1-7. Epub 2019 Jan 7.

a Department of Physical Medicine and Rehabilitation , University of Colorado , Aurora , CO , USA.

Purpose: To investigate the effectiveness of home health physical therapy followed by outpatient physical therapy as compared to patients discharged directly to outpatient physical therapy in improving functional performance, strength/activation and residual knee pain outcomes among patients who received a total knee arthroplasty.

Materials And Methods: A secondary analysis of longitudinal data in which patients with total knee arthroplasty underwent home health physical therapy or were discharged directly to outpatient physical therapy. Main outcome measures included the stair climb test, timed up and go, 6-min walk test, quadriceps and hamstring strength, quadriceps activation and residual knee pain. Read More

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https://www.tandfonline.com/doi/full/10.1080/09638288.2018.1
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http://dx.doi.org/10.1080/09638288.2018.1505968DOI Listing
January 2019
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Distal Femur Locking Plates Fit Poorly Before and After Total Knee Arthroplasty.

J Orthop Trauma 2019 Jan 3. Epub 2019 Jan 3.

Department of Orthopaedic Surgery, Stanford University Hospital.

Objective: To evaluate the fit of distal femur locking plates. Secondarily, we sought to compare plate fit among patients with and without a total knee arthroplasty (TKA).

Design: We retrospectively reviewed full-length femur radiographs of patients who underwent primary TKA. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001431DOI Listing
January 2019
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Internal Validation of a Predictive Model for Satisfaction After Primary Total Knee Arthroplasty.

J Arthroplasty 2018 Dec 19. Epub 2018 Dec 19.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Background: As the number of total knee arthroplasty (TKA) procedures continues to rise in the context of bundled payment models, patients dissatisfied postoperatively that require additional care will impose additional cost to the healthcare system. The purpose of this study is to internally validate a predictive model for postoperative patient satisfaction after TKA.

Methods: In total, 484 consecutive primary TKA patients between January 2014 and January 2016 were included. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183122
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http://dx.doi.org/10.1016/j.arth.2018.12.020DOI Listing
December 2018
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Biologic Therapies for the Treatment of Knee Osteoarthritis.

J Arthroplasty 2018 Dec 17. Epub 2018 Dec 17.

Department of Orthopaedic Surgery, Lenox Hill Hospital, New York City, NY.

Background: The use of biologic therapies for the management of knee osteoarthritis has increased, despite insufficient evidence of efficacy. Our aim was to complete a systematic review and analysis of reports utilizing the highest level-of-evidence evaluating: (1) platelet-rich plasma injections (PRPs); (2) bone marrow-derived mesenchymal stem cells (BMSCs); (3) adipose-derived mesenchymal stem cells (ADSCs); and (4) amnion-derived mesenchymal stem cells (AMSCs).

Methods: PubMed, Embase, and Cochrane Library databases were queried for studies evaluating PRP injections, BMSCs, ADSCs, and AMSCs in patients with knee osteoarthritis. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183118
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http://dx.doi.org/10.1016/j.arth.2018.12.001DOI Listing
December 2018
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Normative Values for the Forgotten Joint Score-12 for the US General Population.

J Arthroplasty 2018 Dec 16. Epub 2018 Dec 16.

Department of Orthopaedic Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Background: The Forgotten Joint Score-12 (FJS-12) is a patient-reported outcome questionnaire of joint awareness in patients with hip and knee pathologies. To improve interpretability of values derived from this measure, we collected normative values for the US general population.

Methods: A sample of 2000 participants, representative of US general population, was sought via an online panel. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183121
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http://dx.doi.org/10.1016/j.arth.2018.12.011DOI Listing
December 2018
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Incisional Negative Pressure Wound Therapy Devices Improve Short-Term Wound Complications, but Not Long-Term Infection Rate Following Hip and Knee Arthroplasty.

J Arthroplasty 2018 Dec 15. Epub 2018 Dec 15.

Department of Orthopaedic Surgery, University of Missouri, Columbia, MO.

Background: The potential value of incisional negative pressure wound therapy (iNPWT) on lower extremity total joint arthroplasty (TJA) wound healing has been supported in a few retrospective studies. We performed this prospective, randomized, controlled trial to assess the impact of iNPWT on wound appearance, early complications, and late infection rates following hip and knee TJA compared with a standard surgical dressing.

Methods: Three-hundred ninety-eight patients undergoing primary or revision lower extremity TJA were randomized into iNPWT or conventional wound dressing groups. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183120
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http://dx.doi.org/10.1016/j.arth.2018.12.008DOI Listing
December 2018
1 Read