scholarly journals Psychosocial predictors for outcome after total joint arthroplasty: a prospective comparison of hip and knee arthroplasty

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Marion Lindner ◽  
Olaf Nosseir ◽  
Anett Keller-Pliessnig ◽  
Per Teigelack ◽  
Martin Teufel ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Psychosocial Predictors ◽  
Prospective Comparison ◽  
Hip And Knee Arthroplasty

scholarly journals The impact of enhanced recovery after surgery on total joint arthroplasty: A protocol for systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Siddharth Rele ◽  
Cade Shadbolt ◽  
Chris Schilling ◽  
Nicholas F Taylor ◽  
Michelle M Dowsey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Joint Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

BACKGROUND The number of total joint arthroplasty being performed is increasing worldwide. To match this increasing demand, there has been focus on hastening patients’ recovery of function. This effort has culminated in formulation of enhanced recovery for surgery (ERAS) strategies. However, with evolving ERAS programs and new recommendations, a review of current evidence is required to provide clinicians with up-to-date information about its effect on outcomes for total joint arthroplasty. OBJECTIVE This study outlines the protocol for a systematic review and meta-analysis that aims to assess the utility of enhanced recovery after surgery programs on patient, health services and economic outcomes for primary, elective total hip and knee arthroplasty. METHODS A systematic search will be conducted in Medline (OVID), EMCARE (OVID), Web of Science, CINAHL, National Health Service Economic Evaluations Database and the Cochrane Library. Analytical, observational and experimental designs will be included in this systematic review. Only studies including patients undergoing primary, total knee and hip arthroplasty comparing ERAS programs with conventional surgery and postoperative care will be included. Data related to patient outcomes, health service outcomes, safety and economic evaluation will be extracted. RESULTS The search terms have been finalized, and the final primary database search will be completed in November 2020. The results of this systematic review will be disseminated in a peer-reviewed journal. CONCLUSIONS This protocol will guide a systematic review assessing outcomes associated with ERAS surgery in primary, total hip and knee arthroplasty CLINICALTRIAL Open Science Framework. Doi: 10.17605/OSF.IO/Y4BHS

scholarly journals Patient-reported quality of life after primary major joint arthroplasty: a prospective comparison of hip and knee arthroplasty

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Zoe H. Dailiana ◽  
Ippolyti Papakostidou ◽  
Sokratis Varitimidis ◽  
Lycurgos Liaropoulos ◽  
Elias Zintzaras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Arthroplasty ◽  
Joint Arthroplasty ◽  
Prospective Comparison ◽  
Patient Reported ◽  
Hip And Knee Arthroplasty

scholarly journals Comprehensive Operative Note Templates for Primary and Revision Total Hip and Knee Arthroplasty

2016 ◽  
Vol 10 (1) ◽  
pp. 725-731 ◽  
Author(s):  
Ali J. Electricwala ◽  
Derek F. Amanatullah ◽  
Rapeepat I. Narkbunnam ◽  
James I. Huddleston ◽  
William J. Maloney ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Revision Thas ◽  
Total Hip ◽  
Operative Note ◽  
Hip And Knee Arthroplasty ◽  
Operative Notes ◽  
Revision Total Joint Arthroplasty ◽  
Revision Tkas

Background: Adequate preoperative planning is the first and most crucial step in the successful completion of a revision total joint arthroplasty. The purpose of this study was to evaluate the availability, adequacy and accuracy of operative notes of primary surgeries in patients requiring subsequent revision and to construct comprehensive templates of minimum necessary information required in the operative notes to further simplify re-operations, if they should become necessary. Methods: The operative notes of 144 patients (80 revision THA’s and 64 revision TKA’s) who underwent revision total joint arthroplasty at Stanford Hospital and Clinics in the year 2013 were reviewed. We assessed the availability of operative notes and implant stickers prior to revision total joint arthroplasty. The availability of implant details within the operative notes was assessed against the available surgical stickers for adequacy and accuracy. Statistical comparisons were made using the Fischer-exact test and a P-value of less than 0.05 was considered statistically significant. Results: The primary operative note was available in 68 of 144 revisions (47%), 39 of 80 revision THAs (49%) and 29 of 66 revision TKAs (44%, p = 0.619). Primary implant stickers were available in 46 of 144 revisions (32%), 26 of 80 revision THAs (32%) and 20 of 66 revision TKAs (30%, p = 0.859). Utilizing the operative notes and implant stickers combined identified accurate primary implant details in only 40 of the 80 revision THAs (50%) and 34 of all 66 revision TKAs (52%, p = 0.870). Conclusion: Operative notes are often unavailable or fail to provide the necessary information required which makes planning and execution of revision hip and knee athroplasty difficult. This emphasizes the need for enhancing the quality of operative notes and records of patient information. Based on this information, we provide comprehensive operative note templates for primary and revision total hip and knee arthroplasty.

scholarly journals Management of von Willebrand disease in patients undergoing total hip and knee arthroplasty

2019 ◽  
Vol 29 (9) ◽  
pp. 266-269
Author(s):  
Khaled M. Yaghmour ◽  
Yuhan Peng ◽  
Emanuele Chisari ◽  
Wasim Khan ◽  
Stephen M. McDonnell
Keyword(s):  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Perioperative Management ◽  
Functional Limitation ◽  
Joint Arthroplasty ◽  
Von Willebrand Disease ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Surgical Field ◽  
Von Willebrand

Von Willebrand disease is the commonest bleeding disorder encountered in the medical and surgical field. As a result of the repetitive bleeding into the joints many patients suffer from arthropathy that can cause a significant amount of pain and functional limitation. Total joint arthroplasty is being utilised as the last resort in managing these patients; however, the presence of von Willebrand disease raises a number of dilemmas. In this review, we look at the effects of von Willebrand disease on joints and the perioperative management of von Willebrand disease patients undergoing total joint arthroplasty.

Impact of Weight-Band Dosing of Tinzaparin for Venous Thromboembolism Prophylaxis on Persistent Wound Drainage in Adult Patients Undergoing Hip and Knee Arthroplasty

2021 ◽  
pp. 106002802110242
Author(s):  
Cassandra Cooper ◽  
Ouida Antle ◽  
Jennifer Lowerison ◽  
Deonne Dersch-Mills ◽  
Ashley Kenny
Keyword(s):  
Body Weight ◽  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Thromboembolism Prophylaxis ◽  
Wound Drainage ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact

Background: Persistent wound drainage and venous thromboembolism (VTE) are potential complications of total joint arthroplasty, and these risks can be challenging to balance in clinical practice. Anecdotal observation has suggested that following joint arthroplasty, persistent wound drainage occurs more frequently with higher body weight and higher doses of tinzaparin when compared with lower body weight and lower doses of tinzaparin. Objective: The overall purpose of this study was to describe the impact of a tinzaparin weight-band dosing table for VTE prophylaxis on wound healing, thrombosis, and bleeding outcomes in patients undergoing total joint arthroplasty. Methods: This retrospective chart review included patients who underwent total hip or knee arthroplasty and received tinzaparin for thromboprophylaxis per their weight-banding category. The primary outcome was the incidence of persistent wound drainage. Secondary outcomes include the occurrence of VTE and clinically important bleeding during hospital admission. Results: A total of 231 patients were included in the analysis. There was no significant difference in persistent wound drainage between the 3 weight categories, and there were no differences in rates of VTE or clinically important bleeding. Concurrent use of low-dose acetylsalicylic acid was associated with a 3-fold increased risk of persistent wound drainage (risk ratio = 3.35; 95% CI = 2.14-5.24; P = 0.00003). Conclusion and Relevance: In joint arthroplasty patients, we observed no significant difference in rates of persistent wound drainage between various weight categories receiving different weight-banded doses of tinzaparin. Our results do not suggest that the current weight-band dosing table for tinzaparin needs to be adjusted to optimize patient outcomes.

METALLOSIS OF A SILASTIC METACARPOPHALANGEAL JOINT ARTHROPLASTY — A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 429-430
Author(s):  
H. D. Measuria ◽  
T. J. McBride ◽  
S. C. Talwalkar
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Joint Replacements ◽  
Metal On Metal ◽  
Hip And Knee Arthroplasty ◽  
Full Flexion

Metallosis is a well-documented phenomenon in hip and knee arthroplasty from metal on metal bearing joint replacements. However, few cases of metallosis of metacarpophalangeal joint replacements have been reported. We present the case of a 49-year-old lady with rheumatoid arthritis who had previously undergone MCP joint replacements over 20 years ago. The decision was taken to revise her middle MCP joint after she developed pain and ulnar drift. At revision, the joint exhibited severe metallosis presumably arising from the grommet component of the replacement. This required considerable debridement and removal of the components and revision to a new upsized implant without grommets. It is of note that there were no external signs of metallosis with full flexion of the finger and a good roll up.

Ceforanide vs. Cephalothin Concentrations in Total Joint Arthroplasty

1983 ◽  
Vol 17 (9) ◽  
pp. 645-648 ◽  
Author(s):  
William J. Cady ◽  
Bradley G. Wulf ◽  
Michael T. O'Neil ◽  
Dwight W. Burney ◽  
William R. Hamsa
Keyword(s):  
Total Knee Arthroplasty ◽  
Synovial Fluid ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Plasma Concentrations ◽  
Prophylactic Antibiotic ◽  
Joint Arthroplasty ◽  
Total Hip ◽  
Orthopedic Procedure ◽  
Total Knee

Total joint arthroplasty is a common orthopedic procedure and requires prophylactic antibiotic coverage to prevent infections in the operated joint. The antibiotics routinely used for prophylaxis are the cephalosporins. This study compared bone, synovial fluid, and plasma concentrations of ceforanide with cephalothin concentrations in 30 patients undergoing elective total hip or total knee arthroplasty. Ceforanide provided significantly higher plasma concentrations for 61–110 minutes postdose than did cephalothin (p < 0.025 and p < 0.005). No difference was noted between the two antibiotics for the bone concentrations in the total hip arthroplasty group; however, cephalothin concentrated to a greater degree in the bone of patients undergoing total knee arthroplasty (p < 0.05). Cephalothin achieved higher concentrations in the synovial fluid than did ceforanide (p < 0.05). Both antibiotics were well tolerated and no postoperative infections were noted in either group.

scholarly journals Neuraxial and general anesthesia for outpatient total joint arthroplasty result in similarly low rates of major perioperative complications: a multicentered cohort study

2022 ◽  
pp. rapm-2021-103189
Author(s):  
Edward Yap ◽  
Julia Wei ◽  
Christopher Webb ◽  
Kevin Ng ◽  
Matthias Behrends
Keyword(s):  
Cohort Study ◽  
General Anesthesia ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Outpatient Surgery ◽  
Joint Arthroplasty ◽  
Neuraxial Anesthesia ◽  
General Anesthesia Group ◽  
Increased Risk ◽  
Same Day Discharge

BackgroundNeuraxial anesthesia when compared with general anesthesia has shown to improve outcomes following lower extremity total joint arthroplasty. It is unclear whether these benefits are present in outpatient surgery given the selection of healthier patients.ObjectiveTo compare the effects of neuraxial versus general anesthesia on outcomes following ambulatory hip and knee arthroplasty.MethodsMulticentered retrospective cohort study in ambulatory hip or knee arthroplasty patients between January 2017 and December 2019. Primary endpoint examined 30-day major postoperative complications (mortality, myocardial infarction, deep venous thromboembolism, pulmonary embolism, stroke, and acute renal failure).ResultsOf 11 523 eligible patients identified, 10 003 received neuraxial anesthesia, while 1520 received general anesthesia. 30-day major complications did not differ between neuraxial anesthesia and general anesthesia groups (1.8% vs 2.3%; aOR=0.85, CI: 0.56 to 1.27, p=0.39). There was no difference in 30-day minor complications (surgical site infection, pneumonia, urinary tract infection; 3.3% vs 4.1%; aOR=0.83, CI: 0.62 to 1.14, p=0.23). The neuraxial group demonstrated reduced pain and analgesia requirements and had less postoperative nausea and vomiting (PONV). Median recovery room length of stay was shorter by 52 min in the general anesthesia group, but these patients were more likely to fail same day discharge (33% vs 23.4%; p<0.01).ConclusionAnesthesia type was not associated with an increased risk for complications. However, neuraxial anesthesia improved outcomes that predict readiness for discharge: patients had less pain, required less opioids, and had a lower incidence of PONV, thus improving the rate of same day discharge.Trial registration numberNCT04203732.

scholarly journals Predictors for readmission following primary total hip and total knee arthroplasty

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902095916
Author(s):  
Ong-art Phruetthiphat ◽  
Jesse E Otero ◽  
Biagio Zampogna ◽  
Sebastiano Vasta ◽  
Yubo Gao ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Multivariate Regression ◽  
The United States ◽  
Joint Arthroplasty ◽  
Hospital Length Of Stay ◽  
Common Cause ◽  
Total Hip ◽  
Total Knee

Background: Readmission following total joint arthroplasty has become a closely watched metric for many hospitals in the United States due to financial penalties imposed by Centers for Medicare and Medicaid Services. The purpose of this study was to identify both preoperative and postoperative reasons for readmission within 30 days following primary total hip and total knee arthroplasty (TKA). Methods: Retrospective data were collected for patients who underwent elective primary total hip arthroplasty (THA; CPT code 27130) and TKA (27447) from 2008 to 2013 at our institution. The sample was separated into readmitted and nonreadmitted cohorts. Demography, comorbidities, Charlson comorbidity index (CCI), operative parameters, readmission rates, and causes of readmission were compared between the groups using univariate and multivariate regression analysis. Results: There were 42 (3.4%) and 28 (2.2%) readmissions within 30 days for THA and TKA, respectively. The most common cause of readmission within 30 days following total joint arthroplasty was infection. Trauma was the second most common reason for readmission of a THA while wound dehiscence was the second most common cause for readmission following TKA. With univariate regression, there were multiple associated factors for readmission among THA and TKA patients, including body mass index, metabolic equivalent (MET), and CCI. Multivariate regression revealed that hospital length of stay was significantly associated with 30-day readmission after THA and TKA. Conclusion: Patient comorbidities and preoperative functional capacity significantly affect 30-day readmission rate following total joint arthroplasty. Adjustments for these parameters should be considered and we recommend the use of CCI and METs in risk adjustment models that use 30-day readmission as a marker for quality of patient care. Level of Evidence: Level III/Retrospective cohort study

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