Factors related to the indecision of older adults with knee osteoarthritis about receiving physician-recommended total knee arthroplasty

2016 ◽  
Vol 39 (22) ◽  
pp. 2302-2307 ◽  
Author(s):  
Wen-Ling Yeh ◽  
Yun-Fang Tsai ◽  
Kuo-Yao Hsu ◽  
Dave Weichih Chen ◽  
Ching-Yen Chen
2021 ◽  
Vol 29 ◽  
pp. S355-S356
Author(s):  
M.A. Kirksey ◽  
S.G. Lessard ◽  
M. Khan ◽  
G.A. Birch ◽  
D. Oliver ◽  
...  

2017 ◽  
Vol 25 ◽  
pp. S346 ◽  
Author(s):  
G.A. Hawker ◽  
D. Marshall ◽  
A. Jones ◽  
L. Woodhouse ◽  
B. Ravi ◽  
...  

2012 ◽  
Vol 303 (4) ◽  
pp. R376-R386 ◽  
Author(s):  
Ashley N. Bailey ◽  
Austin D. Hocker ◽  
Benjamin R. Vermillion ◽  
Keith Smolkowski ◽  
Steven N. Shah ◽  
...  

Total knee arthroplasty (TKA) is the most common and a cost-effective surgical remediation for older adults with long-standing osteoarthritis. In parallel with the expanding population of older adults, the number of TKAs performed annually is projected to be 3.48 million by 2030. During this surgery, a tourniquet is used to stop blood flow to the operative leg. However, the molecular pathways that are affected by tourniquet use during TKA continue to be elucidated. We hypothesized that components of the catabolic FoxO3a (i.e., MuRF1, MAFbx, and Bnip3) pathway, as well as the cellular stress pathways [i.e., stress-activated protein kinase (SAPK)/JNK and MAPKs], are upregulated during TKA. The purpose of this study was to measure changes in transcripts and proteins involved in muscle cell catabolic and stress-activated pathways. We obtained muscle biopsies from subjects, 70 ± 1.3 yr, during TKA, from the vastus lateralis at baseline (before tourniquet inflation), during maximal ischemia (just before tourniquet release), and during reperfusion. Total tourniquet time was 43 ± 2 min and reperfusion time was 16 ± 1. Significant increases in FoxO3a downstream targets, MAFbx and MuRF1, were present for mRNA levels during ischemia (MAFbx, P = 0.04; MuRF1, P = 0.04), and protein expression during ischemia (MAFbx, P = 0.002; MuRF1, P = 0.001) and reperfusion (MuRF1, P = 0.002). Additionally, stress-activated JNK gene expression ( P = 0.01) and protein were elevated during ischemia ( P = 0.001). The results of this study support our hypothesis that protein degradation pathways are stimulated during TKA. Muscle protein catabolism is likely to play a role in the rapid loss of muscle volume measured within 2 wk of this surgery.


2021 ◽  
Vol 11 ◽  
pp. 173-177
Author(s):  
Mitsuhiko Kubo ◽  
Kosuke Kumagai ◽  
Tsutomu Maeda ◽  
Yasutaka Amano ◽  
Hitomi Fujikawa ◽  
...  

2021 ◽  
Vol 10 (19) ◽  
pp. 4475
Author(s):  
Hong Jin Kim ◽  
Jae Hyuk Yang ◽  
Dong-Gune Chang ◽  
Seung Woo Suh ◽  
Hoon Jo ◽  
...  

Concurrent knee osteoarthritis (KOA) and degenerative lumbar spinal disease (LSD) has increased, but the total knee arthroplasty (TKA) effect on degenerative LSD remains unclear. The aim of this study was to retrospectively analyze to compare radiological and clinical outcomes between spinal fusion only and preoperative TKA with spinal fusion for the patients with concurrent KOA and degenerative LSD. A total of 72 patients with concurrent KOA and degenerative LSDs who underwent spinal fusion at less than three levels were divided in two groups: non-TKA group (n = 50) and preoperative TKA group (n = 22). Preoperative lumbar lordosis (LL) was significantly lower in the preoperative TKA group than the non-TKA group (p < 0.05). Significantly higher preoperative pelvic incidence (PI), PI/LL mismatch, and pelvic tilt (PT) occurred in preoperative TKA group than non-TKA group (all p < 0.05). There was significant improvement of postoperative Oswestry Disability Index and leg Visual Analog Scale in the preoperative TKA group (all p < 0.01). Preoperative TKA could be a benefit for in proper correction of sagittal spinopelvic alignment by spinal fusion. Therefore, preoperative TKA could be considered a preceding surgical option for patients with severe sagittal spinopelvic parameters in concurrent KOA and degenerative LSD.


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