Factors associated with pressure ulcer onset after knee replacement

2021 ◽  
Vol 30 (11) ◽  
pp. 924-929
Author(s):  
Cristiana Forni ◽  
Nicola Cerantola ◽  
Gianfranco Ferrarelli ◽  
Luana Lombrosi ◽  
Andrea Bolzon ◽  
...  
Keyword(s):  
Knee Replacement ◽  
Predictive Factors ◽  
Conflicts Of Interest ◽  
Area Under The Curve ◽  
Factors Associated ◽  
Replacement Surgery ◽  
Braden Scale ◽  
Combined Use ◽  
Number Of Patients ◽  
Knee Replacements

Objective: The aim of this study was to find the rate of pressure ulcers (PUs) in patients with knee replacements and identify predictive factors. The ability of the Braden scale to predict the onset of PUs was also investigated. Method: A retrospective prognostic cohort study was carried out involving all consecutive patients undergoing knee replacement surgery. The data were collected from patient records. The variables collected were grouped into two categories: those connected to the patient's own characteristics; and those linked to the care methods used. Results: The total number of patients included in the study was 565. Of these, 2.3% had developed a PU: 0.5% at the heel and 1.8% at the sacrum. Multivariate analysis showed that the variables actually correlated to the outcome were age (p=0.074; odds ratio (OR)=1.08), body mass index (BMI, p=0.037; OR=1.13) and Braden scale (p=0.029; OR=0.72). A combination of these three parameters showed better predictivity of PUs (area under the curve (AUC) 84%). Conclusion: Age, BMI and preoperative Braden score were shown to be independent predictive factors of the onset of PUs in patients with knee replacements. The combined use of all three variables increased the ability to identify the patients at most risk of developing a PU. Declaration of interest: The study was financed by the Professional Nurse Register of Bologna as winner of a competition for research projects in the province of Bologna. The authors declare no conflicts of interest.

Participation in Sports After Total Knee Replacement

1998 ◽  
Vol 26 (4) ◽  
pp. 530-535 ◽  
Author(s):  
Neil Bradbury ◽  
David Borton ◽  
Geoff Spoo ◽  
Mervyn J. Cross
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Retrospective Review ◽  
High Impact ◽  
Regular Exercise ◽  
Sports Activity ◽  
Replacement Surgery ◽  
Knee Replacements ◽  
Total Knee

Return to regular sports activity was evaluated in a retrospective review of 160 patients who had undergone total knee replacement surgery by a single surgeon (208 knee replacements). Mean age of the patients was 68 years (range, 27 to 87) at surgery and 73 years (range, 33 to 91) at review at a mean follow-up of 5 years (range, 3 to 7). Seventy-nine patients regularly participated in sports, at least once per week, before surgery, and 51 patients regularly participated in sports after surgery. Only eight patients took up sports after surgery who were not regularly involved in sports in the year before surgery. Patients were more likely to return to low-impact activities such as bowls (29 of 32, or 91%) than to high-impact activities such as tennis (6 of 30, or 20% returned). Forty-three of 56 patients (77%) who had participated in regular exercise in the year before surgery returned to sports. Eighty patients did not participate in sports before surgery and 54 of these had coexisting disease that prevented sports. None of these patients returned to sports.

All-Polyethylene Tibial Components in Total Knee Replacement: Early Failures

2018 ◽  
Vol 32 (09) ◽  
pp. 919-923
Author(s):  
Zaki Suliman Alhifzi ◽  
Yousef Tawfik Khoja ◽  
Gavin C. Wood
Keyword(s):  
Knee Replacement ◽  
Unit Cost ◽  
Primary Total Knee Arthroplasty ◽  
Functional Results ◽  
Replacement Surgery ◽  
Physical Status Classification ◽  
Knee Replacements ◽  
Early Failures ◽  
Total Knee ◽  
American Society

AbstractIn total primary knee replacement surgery, the use of all-polyethylene tibial (APT) components has many advantages, including no backside wear and no linear dissociation. In addition, the greater polyethylene thickness permits more conservative bone resection compared with that for metal-backed components, with a lower unit cost and similar functional results. Thus, the use of an APT in primary total knee arthroplasty remains an attractive option. This is a review of 158 patients who underwent primary knee replacement using APT components from a single manufacturer. Data collection included age, American Society of Anesthesiology physical status classification, body mass index (BMI), type of deformity, the presence of diabetes mellitus, rate of revision, and characteristics associated with early failure of the components. Average follow-up time was 40 months. The revision rate for any reason was 5.6%, and the average BMI in revision cases was 37.6. Patients with a higher BMI (≥ 37.6) were significantly more likely to require revision surgery than patients with a lower BMI (p = 0.04). In our sample, high BMI was a contributing factor for early failures in total knee replacements using an APT component. Generally, polyethylene tibial components used for primary knee replacements are safe and effective, with good outcomes and subsequent lower costs to the health care system.

Hip and knee arthroplasty

2017 ◽  
Vol 11 (1) ◽  
pp. 20-27
Author(s):  
Dominic Marley ◽  
Nomaan Sheikh ◽  
John Taylor ◽  
Amit Kumar
Keyword(s):  
Primary Care ◽  
Knee Pain ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
National Joint Registry ◽  
Knee Replacement Surgery ◽  
Joint Registry ◽  
Replacement Surgery ◽  
Knee Replacements ◽  
Hip And Knee Arthroplasty

The incidence of hip and knee replacement surgery has risen dramatically in recent years. The latest National Joint Registry figures indicate that almost 190 000 total hip and knee replacements were performed in 2015. The aim of this article is to discuss the management of hip and knee pain in primary care, the indications for hip and knee arthroplasty and surgical considerations.

scholarly journals 1064 Extra-Articular Tibial Deformity Management in Total Knee Replacement

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S M Choi ◽  
R Kumar ◽  
R Morgan-Jones ◽  
S Agarwal
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Mechanical Axis ◽  
Corrective Osteotomy ◽  
Oxford Knee Score ◽  
Coronal Plane ◽  
Replacement Surgery ◽  
Tibial Resection ◽  
Knee Replacements ◽  
Total Knee

Abstract Aim In knee replacements, restoration of mechanical alignment is essential. Patients with extra-articular deformities (EAD) pose challenges in planning knee replacements. We present a method, based on our experience and review of literature on planning knee replacement surgery, in the presence of extra-articular coronal plane deformity of the tibia. Method Retrospective analysis was made of six patients with EAD of the tibia who underwent knee replacement at our centre. Mechanical axis of the tibia is considered and positioning of the tibia component is planned perpendicular to the mechanical axis of the tibia. The integrity of the collaterals determines the need for correction. Tibial resection >15mm from medial or lateral aspect of the tibia is an indication for corrective osteotomy prior to replacement surgery. The hip knee ankle angle (HKA) was noted. Pre-operative, post-operative clinical score, degree of constraints and post-operative complications were recorded. A post-operative long leg alignment radiograph was obtained. Result All patients had total knee replacement without correction of deformity. Adequate alignment of the limb and restoration of mechanical axis was achieved in all six patients without the need for correction of tibial deformity. All patients had improvement in their HKA angle and Oxford knee score. No re-operations were required, and no complications recorded. Conclusions Our study will help provide guidance on operative planning and decisions making for patients with extra-articular coronal plane tibial deformities.

Balance Confidence and Function after Knee-Replacement Surgery

2006 ◽  
Vol 14 (2) ◽  
pp. 181-191 ◽  
Author(s):  
Kate E. Webster ◽  
Julian A. Feller ◽  
Joanne E. Wittwer
Keyword(s):  
Knee Replacement ◽  
Self Efficacy ◽  
Functional Performance ◽  
Knee Replacement Surgery ◽  
Balance Confidence ◽  
Replacement Surgery ◽  
Knee Replacements ◽  
And Function ◽  
The Relationship ◽  
General Self Efficacy

This study examined the relationship between balance confidence and function in older adults after knee-replacement surgery. Thirty-six adults (20 men and 16 women age 58–84 years) completed measures of balance confidence, general self-efficacy, and function. Results showed that participants with greater balance confidence had better functional performance and reported fewer difficulties with activities of daily living. General self-efficacy and age were not related to any of the functional measures. Women scored lower than men for all balance-confidence and function measures. These findings highlight the potential value of studying balance-related self-efficacy beliefs in people with knee replacements. Longitudinal studies are now needed to determine whether a change in balance confidence is associated with a change in function and to further explore gender differences.

scholarly journals Assessing the non-inferiority of prosthesis constructs used in total and unicondylar knee replacements using data from the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man: a benchmarking study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026736 ◽  
Author(s):  
Kevin C Deere ◽  
Michael R Whitehouse ◽  
Martyn Porter ◽  
Ashley W Blom ◽  
Adrian Sayers
Keyword(s):  
Relative Risk ◽  
Knee Replacement ◽  
National Joint Registry ◽  
Joint Registry ◽  
Replacement Surgery ◽  
Kaplan Meier ◽  
Knee Replacements ◽  
Total Knee ◽  
The Difference ◽  
Using Data

ObjectivesTo investigate the relative performance of knee replacement constructs compared with the best performing construct and illustrate the substantial variability in performance.DesignA non-inferiority study.SettingEngland and Wales.ParticipantsAll primary total and unicondylar knee replacements performed and registered in the National Joint Registry between 1 April 2003 and 31 December 2016.Main outcome measuresKaplan-Meier failure function for knee replacement constructs. Failure difference between best performing construct (the benchmark) and other constructs.MethodsUsing a non-inferiority analysis, the performance of knee replacement constructs by brand were compared with the best performing construct. Construct failure was estimated using the 1-Kaplan Meier method, that is, an estimate of net failure. The difference in failure between the contemporary benchmark construct and all other constructs were tested.ResultsOf the 449 different knee replacement constructs used, only 27 had ≥500 procedures at risk at 10 years postprimary, 18 of which were classified as inferior to the benchmark by at least 20% relative risk of failure. Two of these 18 were unicondylar constructs that were inferior by at least 100% relative risk. In men, aged 55–75 years, 12 of 27 (44%) constructs were inferior by at least 20% to the benchmark at 7 years postprimary. In women, aged 55–75 years, 8 of 32 (25%) constructs were inferior at 7 years postprimary. Very few constructs were classified as non-inferior to the contemporary benchmark.ConclusionsThere are few knee replacement constructs that can be shown to be non-inferior to a contemporary benchmark. Unicondylar knee constructs have, almost universally, at least 100% worse revision outcomes compared with the best performing total knee replacement. These results will help to inform patients, clinicians and commissioners when considering knee replacement surgery.

scholarly journals Total hip and knee arthoplasty: on the issue of indications for surgery

2020 ◽  
Vol 8 (3) ◽  
pp. 355-364
Author(s):  
Alim A. Vorokov ◽  
Pavel I. Bortulev ◽  
Valery M. Khaydarov ◽  
Stanislav A. Linnik ◽  
Aleksandr N. Tkachenko
Keyword(s):  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Subjective Experience ◽  
Hip Osteoarthritis ◽  
Total Hip ◽  
Aged People ◽  
Number Of Patients ◽  
Keywords And Phrases ◽  
Knee Replacements ◽  
Hip And Knee Arthroplasty

Background. Both in Russia and across the world, the annual frequency of total hip and knee replacement has increased, which has inevitably led to an increase in the number of patients with unsatisfactory treatment outcomes. This failure can primarily be attributed to the complications that arise, some of which arise due to the wrong choice of treatment approach. Aim. To analyze the publications on the results of treatment of patients with hip osteoarthritis and knee osteoarthritis by total hip and knee replacements. Materials and methods. The literature data were searched in open electronic databases of scientific literature PubMed and eLibrary using the following keywords and phrases: total hip/knee replacement, complications, patient satisfaction, age, obesity. The search depth was 20 years. Results. The data indicated a rise in the total number of such patients recorded annually. A significant number of publications, both in Russian and foreign literature, are devoted to the analysis of complications that mainly determine the patients satisfaction with an operation. In addition, these articles analyze the issues of determining the indications and contraindications in applying these methods of treatment. However, it is not uncommon for orthopedists to form a decision for performing an operation based on their subjective experience. At the same time, one of the circumstances that influences the decision-making is the lack of a stable system in the conservative treatment of degenerative joint diseases. According to the data from health care organizations, hip and knee replacements are the only available method for treating osteoarthritis. This circumstance may lead to an unjustified expansion of indications for arthroplasty, which would definitely affect the outcomes of treatment. In this situation, it is critical to search for precise criteria to identify the indication for total hip and knee arthroplasty. Conclusion. Unjustified expansion of indications for endoprosthesis leads to an increase in the number of complications, which in turn leads to an increase in the number of patients who remain unsatisfied with the outcomes of hip and knee arthroplasty in the long term. This circumstance encourages special scientific research to clarify the indications and contraindications for hip and knee replacements, especially in young and middle-aged people.

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