scholarly journals Early complications of total hip and knee replacement: a comparison of outcomes in a regional orthopaedic hospital and two independent treatment centres

2010 ◽  
Vol 92 (7) ◽  
pp. 610-614 ◽  
Author(s):  
Gordon Bannister ◽  
Mansoor Ahmed ◽  
Miles Bannister ◽  
Rachel Bray ◽  
Paul Dillon ◽  
...  
Keyword(s):  
Private Hospital ◽  
Anecdotal Evidence ◽  
Early Complications ◽  
Total Hip ◽  
Admission Rates ◽  
Orthopaedic Hospital ◽  
Prosthetic Joint ◽  
Audit Rates ◽  
Treatment Centre ◽  
Total Knee

INTRODUCTION There is anecdotal evidence of poorer outcomes from prosthetic joint replacement performed in independent eatment centres but very few comparative studies. PATIENTS AND METHODS We compared the early re-operation, dislocation, re-admission, major wound infection and audit rates of 880 total hip (THA) and 874 total knee (TKA) arthroplasties carried out at a regional orthopaedic hospital (Avon Orthopaedic Centre; AOC) with 368 THAs and 365 TKAs from an NHS (WGH) and 67 THAs and 86 TKAs from a private hospital (CNH) independent treatment centre. RESULTS Early re-operation rates were 9% at CNH, 1.4% at WGH and 0.6% at AOC after THA and 8% at CNH, 1.9% at WGH and 1% at AOC after TKA. After THA, dislocation rates after THA were 6% at CNH and 1.8% at both WGH and AOC. Re-admission rates were 13% at CNH, 0.6% at WGH and 1.2% at AOC. Major wound problems were 20% at CNH, 3.8% at WGH and 0.4% at AOC after THA and 19% at CNH, 1.9% at WGH and AOC (1.1%) after TKA. After TKA, re-admission rates from CNH were 13%, 1% at WGH and 1.1% at AOC. AOC and WGH audited their outcomes. None were available from CNH. CONCLUSIONS Results and audit from independent treatment centres are variable and patients should be warned of this before undergoing treatment at them.

scholarly journals Prevention of early complications following total hip replacement

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 61
Author(s):  
Andreas Fontalis ◽  
Daniel J. Berry ◽  
Andrew Shimmin ◽  
Pablo A. Slullitel ◽  
Martin A. Buttaro ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Joint Infection ◽  
Prevention Measures ◽  
Leg Length ◽  
Early Complications ◽  
Total Hip ◽  
Prosthetic Joint ◽  
Fracture Instability ◽  
Orthopaedic Community

Total hip arthroplasty (THA) has been quoted as “the operation of the century”, owing to its efficacy and the substantial improvements evidenced with respect to functional patient outcomes and quality of life. However, early postoperative complications are often inevitable, hence it is imperative to take every step to prevent them and minimise morbidity and mortality. This manuscript focuses on the most common early complications following THA, namely venous thromboembolism (VTE), prosthetic joint infection, periprosthetic fracture, instability, and leg length inequality. It aims to outline effective risk stratification strategies and prevention measures that could apply to the wider Orthopaedic community.

A Comparative Analysis of Patient Satisfaction following Total Knee Arthroplasty and Total Hip Arthroplasty Using the Forgotten Joint Score

2020 ◽  
Vol 04 (02) ◽  
pp. 084-089
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
Ran Schwarzkopf ◽  
Roy Davidovitch
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Demographic Data ◽  
Demographic Differences ◽  
Total Hip ◽  
Forgotten Joint Score ◽  
Total Knee

AbstractMeasuring patient satisfaction and surgical outcomes following total joint arthroplasty remains controversial with most tools failing to account for both surgeon and patient satisfaction in regard to outcomes. The purpose of this study was to use “The Forgotten Joint Score” questionnaire to assess clinical outcomes comparing patients who underwent a total hip arthroplasty (THA) with those who underwent a total knee arthroplasty (TKA). We conducted a retrospective review of patients who underwent primary THA or TKA between September 2016 and September 2019 and responded to the Forgotten Joint Score-12 (FJS-12) questionnaire at least at one of three time periods (3, 12, and 21 months), postoperatively. An electronic patient rehabilitation application was used to administer the questionnaire. Collected variables included demographic data (age, gender, race, body mass index [BMI], and smoking status), length of stay (LOS), and FJS-12 scores. t-test and chi-square were used to determine significance. Linear regression was used to account for demographic differences. A p-value of less than 0.05 was considered statistically significant. Of the 2,359 patients included in this study, 1,469 underwent a THA and 890 underwent a TKA. Demographic differences were observed between the two groups with the TKA group being older, with higher BMI, higher American Society of Anesthesiologists scores, and longer LOS. Accounting for the differences in demographic data, THA patients consistently had higher scores at 3 months (53.72 vs. 24.96; p < 0.001), 12 months (66.00 vs. 43.57; p < 0.001), and 21 months (73.45 vs. 47.22; p < 0.001). FJS-12 scores for patients that underwent THA were significantly higher in comparison to TKA patients at 3, 12, and 21 months postoperatively. Increasing patient age led to a marginal increase in FJS-12 score in both cohorts. With higher FJS-12 scores, patients who underwent THA may experience a more positive evolution with their surgery postoperatively than those who had TKA.

Outcomes of patients with unexpected diagnosis of infection at total hip or total knee arthroplasty revisions

2021 ◽  
Author(s):  
Mattia Loppini ◽  
Alessandro Pisano ◽  
Marco Di Maio ◽  
Francesco La Camera ◽  
Maddalena Casana ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Total Knee ◽  
Diagnosis Of Infection

scholarly journals Diagnosis and management of the infected total knee replacement: a practical surgical guide

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Akos Zahar ◽  
Martin Sarungi
Keyword(s):  
Surgical Management ◽  
Joint Infection ◽  
Level Of Evidence ◽  
Surgical Guide ◽  
Diagnosis And Management ◽  
Early Revision ◽  
Prosthetic Joint ◽  
Implant Retention ◽  
Total Knee ◽  
Key Steps

Abstract Purpose Prosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a significant burden in health care. Diagnosis and proper management are challenging. A standardised procedure for the diagnostic workup and surgical management provides clear benefits in outcome. Methods Several diagnostic protocols and definitions for PJI were established in recent years. Proper PJI diagnosis remains critical for success and for choosing the optimal treatment option. A distinct workup of diagnostic steps, the evaluation of the results in a multidisciplinary setup and the meticulous surgical management of the infection are the key factors of successful treatment. Results The management of PJI after TKA consists of early revision with debridement and implant retention (DAIR) in early cases or staged revision in late infections beyond 30 days postoperative or after onset of acute symptoms. The revision is performed as a two-stage procedure with the use of a fixed or mobile antibiotic spacer, or in selected cases as a single-stage operation with the use of local and systemic antibiotic treatment. Conclusions This paper reflects the opinion of two revision surgeons who follow the same protocol for diagnosis and treatment of PJI after TKA, highlighting the key steps in diagnosis and management. Level of evidence Expert’s opinion

Skilled Nursing Facility Placement Process After Total Hip and Total Knee Arthroplasty: Revised Rating System and Opportunities for Intervention

2019 ◽  
Vol 34 (6) ◽  
pp. 1066-1071 ◽  
Author(s):  
Daniel J. Snyder ◽  
Thomas R. Kroshus ◽  
Aakash Keswani ◽  
Kevin J. Bozic ◽  
Yale A. Fillingham ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Skilled Nursing Facility ◽  
Rating System ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Total Hip ◽  
Facility Placement ◽  
Total Knee
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