scholarly journals Patients with Knee Osteoarthritis Undergoing Total Knee Arthroplasty Have a Lower Risk of Subsequent Severe Cardiovascular Events: Propensity Score and Instrumental Variable Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0127454 ◽  
Author(s):  
Wen-Yan Lin ◽  
Ching-Chih Lee ◽  
Chia-Wen Hsu ◽  
Kuang-Yung Huang ◽  
Shaw-Ruey Lyu
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Instrumental Variable ◽  
Lower Risk ◽  
Cardiovascular Events ◽  
Instrumental Variable Analysis ◽  
Total Knee ◽  
Variable Analysis

scholarly journals Impact of Preoperative Opioid Use on Patient-Reported Outcomes after Revision Total Knee Arthroplasty: A Propensity Matched Analysis

2021 ◽  
Author(s):  
Eitan Ingall ◽  
Christian Klemt ◽  
Christopher M. Melnic ◽  
Wayne B. Cohen-Levy ◽  
Venkatsaiakhil Tirumala ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Opioid Use ◽  
Absolute Increase ◽  
Patient Reported ◽  
Total Knee ◽  
Opioid Users ◽  
Revision Tka

AbstractThis is a retrospective study. Prior studies have characterized the deleterious effects of narcotic use in patients undergoing primary total knee arthroplasty (TKA). While there is an increasing revision arthroplasty burden, data on the effect of narcotic use in the revision surgery setting remain limited. Our aim was to characterize the effect of active narcotic use at the time of revision TKA on patient-reported outcome measures (PROMs). A total of 330 consecutive patients who underwent revision TKA and completed both pre- and postoperative PROMs was identified. Due to differences in baseline characteristics, 99 opioid users were matched to 198 nonusers using the nearest-neighbor propensity score matching. Pre- and postoperative knee disability and osteoarthritis outcome score physical function (KOOS-PS), patient reported outcomes measurement information system short form (PROMIS SF) physical, PROMIS SF mental, and physical SF 10A scores were evaluated. Opioid use was identified by the medication reconciliation on the day of surgery. Propensity score–matched opioid users had significantly lower preoperative PROMs than the nonuser for KOOS-PS (45.2 vs. 53.8, p < 0.01), PROMIS SF physical (37.2 vs. 42.5, p < 0.01), PROMIS SF mental (44.2 vs. 51.3, p < 0.01), and physical SF 10A (34.1 vs. 36.8, p < 0.01). Postoperatively, opioid-users demonstrated significantly lower scores across all PROMs: KOOS-PS (59.2 vs. 67.2, p < 0.001), PROMIS SF physical (43.2 vs. 52.4, p < 0.001), PROMIS SF mental (47.5 vs. 58.9, p < 0.001), and physical SF 10A (40.5 vs. 49.4, p < 0.001). Propensity score–matched opioid-users demonstrated a significantly smaller absolute increase in scores for PROMIS SF Physical (p = 0.03) and Physical SF 10A (p < 0.01), as well as an increased hospital length of stay (p = 0.04). Patients who are actively taking opioids at the time of revision TKA report significantly lower preoperative and postoperative outcome scores. These patients are more likely to have longer hospital stays. The apparent negative effect on patient reported outcomes after revision TKA provides clinically useful data for surgeons in engaging patients in a preoperative counseling regarding narcotic use prior to revision TKA to optimize outcomes.

Circulating surgery-induced gene signatures are associated with recovery from total knee arthroplasty for knee osteoarthritis

2021 ◽  
Vol 29 ◽  
pp. S355-S356
Author(s):  
M.A. Kirksey ◽  
S.G. Lessard ◽  
M. Khan ◽  
G.A. Birch ◽  
D. Oliver ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Gene Signatures ◽  
Total Knee

scholarly journals Age and Sex Differences in Knee Osteoarthritis Patients’ Expectations of Total Knee Arthroplasty

2017 ◽  
Vol 25 ◽  
pp. S346 ◽  
Author(s):  
G.A. Hawker ◽  
D. Marshall ◽  
A. Jones ◽  
L. Woodhouse ◽  
B. Ravi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Sex Differences ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Total Knee ◽  
Age And Sex

Thromboembolic and bleeding complications following primary total knee arthroplasty

2021 ◽  
Vol 103-B (10) ◽  
pp. 1571-1577
Author(s):  
Astrid Blicher Schelde ◽  
Janne Petersen ◽  
Thomas Bo Jensen ◽  
Kirill Gromov ◽  
Søren Overgaard ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Knee Arthroplasty ◽  
Major Bleeding ◽  
Multivariable Analysis ◽  
Primary Total Knee Arthroplasty ◽  
Bleeding Complications ◽  
All Cause Mortality ◽  
Total Knee ◽  
Primary Total Knee

Aims The aim of this study is to compare the effectiveness and safety of thromboprophylactic treatments in patients undergoing primary total knee arthroplasty (TKA). Methods Using nationwide medical registries, we identified patients with a primary TKA performed in Denmark between 1 January 2013 and 31 December 2018 who received thromboprophylactic treatment. We examined the 90-day risk of venous thromboembolism (VTE), major bleeding, and all-cause mortality following surgery. We used a Cox regression model to compute hazard ratios (HRs) with 95% confidence intervals (CIs) for each outcome, pairwise comparing treatment with dalteparin or dabigatran with rivaroxaban as the reference. The HRs were both computed using a multivariable and a propensity score matched analysis. Results We identified 27,736 primary TKA patients who received thromboprophylactic treatment (rivaroxaban (n = 18,846); dalteparin (n = 5,767); dabigatran (n = 1,443); tinzaparin (n = 1,372); and enoxaparin (n = 308)). In the adjusted multivariable analysis and compared with rivaroxaban, treatment with dalteparin (HR 0.68 (95% CI 0.49 to 0.92)) or dabigatran (HR 0.31 (95% CI 0.13 to 0.70)) was associated with a decreased risk of VTE. No statistically significant differences were observed for major bleeding or all-cause mortality. The propensity score matched analysis yielded similar results. Conclusion Treatment with dalteparin or dabigatran was associated with a decreased 90-day risk of VTE following primary TKA surgery compared with treatment with rivaroxaban. Cite this article: Bone Joint J 2021;103-B(10):1571–1577.

scholarly journals Knee osteoarthritis with patellar dislocation treated by total knee arthroplasty using a lateral parapatellar approach—ingenuity of exposure and closure

2021 ◽  
Vol 11 ◽  
pp. 173-177
Author(s):  
Mitsuhiko Kubo ◽  
Kosuke Kumagai ◽  
Tsutomu Maeda ◽  
Yasutaka Amano ◽  
Hitomi Fujikawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Patellar Dislocation ◽  
Total Knee

scholarly journals Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

2021 ◽  
Vol 10 (19) ◽  
pp. 4475
Author(s):  
Hong Jin Kim ◽  
Jae Hyuk Yang ◽  
Dong-Gune Chang ◽  
Seung Woo Suh ◽  
Hoon Jo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Spinal Fusion ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Spinal Diseases ◽  
Spinal Disease ◽  
Spinopelvic Alignment ◽  
Total Knee ◽  
Lumbar Spinal

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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