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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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

BMC Musculoskelet Disord 2022 Jun 17;23(1):587. Epub 2022 Jun 17.

The First Clinical College of Zhejiang Chinese Medical University, The First Affiliated Hospital of Zhejiang Chinese Medical University, 548# BinWen Road, HangZhou, ZheJiang Province, People's Republic of China.

Background: Total knee arthroplasty is the leading way to treat hemophilia arthritis. At present, there is a lack of research on the influencing factors of blood loss in total knee arthroplasty for hemophilia arthritis. This study comprehensively explores the definite factors affecting the hidden blood loss in total knee arthroplasty for hemophilia patients. Read More

Zhonghua Yi Xue Za Zhi 2022 Jun;102(24):1833-1838

Department of Orthopedics, Peking University Third Hospital, Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China.

To evaluate tourniquet effect on the morphology and stiffness of quadriceps in patients receiving total knee arthroplasty (TKA). Total of 80 patients with primary knee osteoarthritis receiving unilateral primary TKA from August 2020 to June 2021 in Peking University Third Hospital were enrolled in this randomized controlled trial. The patients were randomly divided into tourniquet group and non-tourniquet group (40 cases in each group). Read More

Orthop Clin North Am 2022 Jul 27;53(3):277-286. Epub 2022 May 27.

Orthopaedic Institute at Northwell Health, 210 East 64th Street, 4th Floor, New York, NY 10065, USA.

Extensor mechanism disruptions following total knee arthroplasty are devastating injuries with complication rates following surgical intervention ranging from 25% to 45%. Primary repair with and without augmentation is appropriate in certain limited clinical settings. Allograft reconstruction has been a popular option; however, synthetic grafts are showing promise and good results. Read More

Orthop Clin North Am 2022 Jul;53(3):267-276

Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.

In the multiply operated on knee replacement, no one soft tissue procedure is vastly superior to another. The most extensive literature available is in relation to muscle flaps, which will continue to be the workhorse technique for orthopedic and plastic reconstructive surgeons for the foreseeable future. Closed incision negative pressure wound therapy may prove to be a superior method in time but further large-scale studies are required to expand our understanding of this technique. Read More

Adv Biomed Res 2022 29;11:34. Epub 2022 Apr 29.

Department of Orthopedic Surgery and Traumatology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Severe varus deformity of the knee poses a technical challenge in balancing the flexion-extension gaps. The use of a varus-valgus constrained prosthesis is a solution to achieve coronal plane stability. The results of constrained condylar knee (CCK) implants in primary total knee arthroplasty are not well known. Read More

Knee Surg Sports Traumatol Arthrosc 2022 Jun 18. Epub 2022 Jun 18.

Gelenkpunkt - Sports and Joint Surgery, FIFA Medical Centre of Excellence, Olympiastraße 39, 6020, Innsbruck, Austria.

Purpose: The purpose of this systematic review is to describe the complications and downsides of robotic systems in total knee arthroplasty (TKA).

Methods: A comprehensive search according to the PRISMA guidelines was performed across PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, and Google Scholar from inception until December 2021. All articles of any study design directly reporting on complications and downsides of the robotic system in TKA were considered for inclusion. Read More

ANZ J Surg 2022 Jun 18. Epub 2022 Jun 18.

Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.

Backgrounds: We intended to identify the incidence and risk factors (RFs) for Postoperative urinary retention (POUR) after applying a risk-stratified catheterization optimization method in enhanced recovery after surgery (ERAS)-total joint arthroplasty (TJA).

Methods: A total of 381 patients were prospectively monitored for POUR. POUR diagnosis was done by a perioperative specialist. Read More

BMC Musculoskelet Disord 2022 Jun 15;23(1):579. Epub 2022 Jun 15.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

Background: The coronal whole-leg radiograph is generally used for preoperative planning in total knee arthroplasty. The distal femoral valgus angle (DFVA) is measured for distal femoral bone resection using an intramedullary guide rod. The effect of coronal and sagittal femoral shaft bowing on DFVA measurement in the presence of malrotation or knee flexion contracture has not been well reported. Read More

BMC Musculoskelet Disord 2022 Jun 15;23(1):576. Epub 2022 Jun 15.

Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pecs, Pécs, Hungary.

Background: The knee replacement (KR) surgery aims to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery are evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question. Read More

BMJ Open 2022 Jun 16;12(6):e058316. Epub 2022 Jun 16.

Department of Applied Health Research, University College London, London, UK.

Objective: To evaluate the impact of the 'Getting it Right First Time' (GIRFT) national improvement programme in orthopaedics, which started in 2012.

Design: Mixed-methods study comprising statistical analysis of linked national datasets (National Joint Registry; Hospital Episode Statistics; Patient-Reported Outcomes); economic analysis and qualitative case studies in six National Health Service (NHS) Trusts.

Setting: NHS elective orthopaedic surgery in England. Read More

Cureus 2022 May 12;14(5):e24941. Epub 2022 May 12.

Orthopaedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, USA.

A 63-year-old woman with ankylosis of the left knee due to severe heterotopic ossification (HO) following total knee arthroplasty (TKA) underwent right TKA with preoperative radiation and postoperative chemical prophylaxis for HO. At the one-year follow-up, the patient had no evidence of HO in the right knee. To our knowledge, there are no reports of successful arthroplasty in patients with a history of ankylosis due to severe HO. Read More

Am J Phys Med Rehabil 2022 Jul 4;101(7):666-673. Epub 2021 Oct 4.

From the Department of Physiotherapy, Singapore General Hospital, Singapore (Y-HP, JW-MT, CL-LP, ES-XC, E-LW); Medicine Academic Programme, Duke-NUS Graduate Medical School, Singapore (Y-HP, JT); Department of Physiotherapy, Seng Kang General Hospital, Singapore (FJ-TS); Department of Rheumatology and Immunology, Singapore General Hospital, Singapore (JT); Health Services Research and Evaluation, Singhealth Office of Regional Health, Singapore (JT); Department of Orthopaedic Surgery, Singapore General Hospital, Singapore (S-JY); and Research Health Institute, University of the Sunshine Coast, Sunshine Coast, Australia (RAC).

Objective: After total knee arthroplasty, the ability to weight bear symmetrically during the sit-to-stand task provides important information regarding altered movement patterns. Despite this, comprehensive recovery curves and validity data for sit-to-stand weight-bearing symmetry are lacking in the total knee arthroplasty population. Our study aimed to (1) develop recovery curves with reference ranges, (2) identify the correlates of standard and constrained sit-to-stand weight-bearing symmetry, and (3) evaluate their predictive validity with gait speed. Read More

J Am Acad Orthop Surg Glob Res Rev 2022 Jun 15;6(6). Epub 2022 Jun 15.

New York University Langone Orthopedic Hospital, New York, NY.

Introduction: The purpose of this study was to identify common complications and the rates of readmission and revision in total knee arthroplasty (TKA) patients younger than 65 years.

Methods: Using the American Joint Replacement Registry, we conducted a retrospective review of all TKAs done in patients aged 18 to 65 years from 2012 to 2020. Demographic factors such as age, sex, Charlson Comorbidity Index (CCI), and preoperative Veterans RAND 12-Item Health Survey Physical Component Summary (VR-12 PCS) scores were collected. Read More

J Clin Nurs 2022 Jun 15. Epub 2022 Jun 15.

School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.

Objective: The objective of the study was to comprehensively synthesise the components of integrated clinical pathways (ICPs) and post-operative outcomes of patients undergone total hip and knee arthroplasty (THA & TKA) and hip fracture surgeries.

Background: Previous systematic reviews examined components and effectiveness of ICPs for lower limb joint replacement and hip fracture surgeries.

Design And Methods: An updated systematic review guided by the Whittemore and Knafl (2005) framework. Read More