scholarly journals Differences in total knee arthroplasty goals by age group in osteoarthritis patients referred to orthopaedic surgery

2015 ◽  
Vol 23 ◽  
pp. A342
Author(s):  
G.A. Hawker ◽  
B. Spady ◽  
A.-M. Adachi ◽  
S. Rahman ◽  
J. Squire Howden ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Orthopaedic Surgery ◽  
Age Group ◽  
Total Knee

scholarly journals Total cement knee arthroplasty in patients of 85–95 years old with terminal stage of degenerative knee disease

2018 ◽  
Vol 177 (6) ◽  
pp. 49-53 ◽  
Author(s):  
V. Yu. Murylev ◽  
P. M. Elizarov ◽  
A. V. Muzychenkov ◽  
Ya. A. Rukin ◽  
A. A. Dering ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Charlson Comorbidity Index ◽  
Surgical Intervention ◽  
Age Group ◽  
Old Patients ◽  
Terminal Stage ◽  
Knee Arthrosis ◽  
Comorbidity Index ◽  
Total Knee

The objectiveof the study is to make the analysis of the results of total cement knee arthroplasty in the most difficult age group of 85–95 years old patients.Material and methods.40 patients with terminal knee arthrosis were selected based on their comorbidity.Results.Patients with the Charlson comorbidity index of 5–8 points need hospitalization for the treatment of aggravating somatic pathology, as preparation for a future knee arthroplasty. In the operated patients, the result on the KOOS was (76±7.19), and on the WOMAC was (151±4.83) a year after the arthroplasty.Сonclusion.Surgical intervention – total knee arthroplasty in patients of 85–95 years old is possible only if its risk is minimized.

scholarly journals Optimal Age Group Selection and Development of a Nomogram To Predict Complications in Patients Undergoing Simultaneous Bilateral Total Knee Arthroplasty

2021 ◽  
Author(s):  
Kui-shuai XU ◽  
Liang ZHANG ◽  
Zhongkai REN ◽  
Tianrui WANG ◽  
Xia ZHAO ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Calibration Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Area Under The Curve ◽  
Operation Time ◽  
Age Group ◽  
Bilateral Total Knee Arthroplasty ◽  
Actual Observation ◽  
Total Knee

Abstract Purpose By comparing the occurrence of complications at 30 days after Simultaneous bilateral total knee arthroplasty (SBTKA) for each age group, the optimal age range of patients receiving SBTKA was determined.An individualized histogram model was established to predict complications within 30 days after SBTKA. Methods The general data of 861 patients who received SBTKA in our hospital on January 1, 2012 and March 31, 2017 were retrospectively analyzed. According to the age of the patients, they were divided into four ages: less than 60 years old, 60 to 64 years old, 65 to 69 years old and over 70 years old. The incidence of complications in different ages was studied.According to the occurrence of complications, 96 cases were included in the complication group and 765 cases in the non-complication group. Univariate and multivariate Logistic regression analysis was conducted to determine and screen out the independent risk factors for complications after SBTKA, and then R software was used to construct the prediction model of the nomogram.The area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were selected to evaluate the nomogram. Results Patients aged 60 to 64 years had the lowest overall postoperative complication rate (7.17%).Five independent predictors were identified by multivariate analysis and were used to establish the nomogram.The AUC of the nomogram was 0.851(95%CI:0.819–0.883).The calibration curve showed that the prediction of nomogram was highly consistent with the actual observation, and DCA showed that nomogram had good clinical usefulness. Conclusion The optimal age group for SBTKA is between 60 and 64 years of age, where the incidence of complications is lowest.Older age, lower preoperative hemoglobin levels, higher preoperative blood urea nitrogen(BUN) levels, longer operation time, and ASA grade ≥ III were identified as independent predictors of complications within 30 days after SBTKA.A nomogram containing the above five predictors could accurately predict the risk of complications within 30 days after SBTKA.

Trends in Periprosthetic Knee Infection and Associated Costs: A Population-Based Study Using National Data

2020 ◽  
Author(s):  
Robert Brochin ◽  
Jashvant Poeran ◽  
Khushdeep S. Vig ◽  
Aakash Keswani ◽  
Nicole Zubizarreta ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Trend Test ◽  
Strong Impact ◽  
Hospitalization Costs ◽  
Teaching Status ◽  
Increasing Trend ◽  
Total Knee ◽  
Increasing Trends

AbstractGiven increasing demand for primary knee arthroplasties, revision surgery is also expected to increase, with periprosthetic joint infection (PJI) a main driver of costs. Recent data on national trends is lacking. We aimed to assess trends in PJI in total knee arthroplasty revisions and hospitalization costs. From the National Inpatient Sample (2003–2016), we extracted data on total knee arthroplasty revisions (n = 782,449). We assessed trends in PJI prevalence and (inflation-adjusted) hospitalization costs (total as well as per-day costs) for all revisions and stratified by hospital teaching status (rural/urban by teaching status), hospital bed size (≤299, 300–499, and ≥500 beds), and hospital region (Northeast, Midwest, South, and West). The Cochran–Armitage trend test (PJI prevalence) and linear regression determined significance of trends. PJI prevalence overall was 25.5% (n = 199,818) with a minor increasing trend: 25.3% (n = 7,828) in 2003 to 28.9% (n = 19,275) in 2016; p < 0.0001. Median total hospitalization costs for PJI decreased slightly ($23,247 in 2003–$20,273 in 2016; p < 0.0001) while median per-day costs slightly increased ($3,452 in 2003–$3,727 in 2016; p < 0.0001), likely as a function of decreasing length of stay. With small differences between hospitals, the lowest and highest PJI prevalences were seen in small (≤299 beds; 22.9%) and urban teaching hospitals (27.3%), respectively. In stratification analyses, an increasing trend in PJI prevalence was particularly seen in larger (≥500 beds) hospitals (24.4% in 2003–30.7% in 2016; p < 0.0001), while a decreasing trend was seen in small-sized hospitals. Overall, PJI in knee arthroplasty revisions appears to be slightly increasing. Moreover, increasing trends in large hospitals and decreasing trends in small-sized hospitals suggest a shift in patients from small to large volume hospitals. Decreasing trends in total costs, alongside increasing trends in per-day costs, suggest a strong impact of length of stay trends and a more efficient approach to PJI over the years (in terms of shorter length of stay).

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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