scholarly journals Downhill skiing following total knee arthroplasty: a survey of Alberta orthopedic surgeons

2021 ◽  
Vol 64 (4) ◽  
pp. E414-E418
Author(s):  
Andrew Buckley ◽  
Paul Duffy ◽  
Robert Korley
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Full Range ◽  
Evidence Based ◽  
Full Time ◽  
Web Based ◽  
Orthopedic Surgeons ◽  
Downhill Skiing ◽  
Total Knee ◽  
Orthopaedic Society

Background: In older adults facing knee arthroplasty, the ability to resume downhill skiing postoperatively is unclear. This study aimed to determine the perspectives of Alberta orthopedic surgeons and senior residents regarding downhill skiing after total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA). Methods: In May 2019, a Web-based survey was sent through the Alberta Orthopaedic Society to poll orthopedic surgeons performing arthroplasty and senior orthopedic residents (postgraduate year 4 or 5) in Alberta regarding the permissibility of downhill skiing after TKA or UKA. The survey also elicited information regarding under which conditions or restrictions, if any, surgeons would allow patients to return to downhill skiing, whether these recommendations were evidence based, and whether surgeons had seen complications from downhill skiing in their patients who had undergone knee arthroplasty. Results: Of the 41 respondents, 21 (51%) were full-time fellowship-trained orthopedic surgeons, 15 (37%) were specialists with some arthroplasty in their practice, and 5 (12%) were orthopedic residents. Ten of 40 respondents (25%) would allow unrestricted downhill skiing after TKA, and 1 (2%) would not allow any skiing at all. The remaining 29 (72%) indicated that they might allow downhill skiing under specific conditions, with the top 3 being limitations on speed and intensity (29 [71%]), return of full range of motion and strength in the operative knee (26 [63%]), and years of downhill ski experience (23 [56%]). Fourteen respondents (34%) would allow unrestricted downhill skiing after UKA, and 27 (66%) would allow skiing with the same top 3 conditions as for TKA. Thirty-two respondents (78%) reported that their decisions were not evidence based, and 35 (85%) had never seen complications from downhill skiing after TKA or UKA. Conclusion: Alberta orthopedic surgeons and senior residents are cautious regarding skiing after knee arthroplasty. The majority reported that their restrictions were not evidence based, which indicates the need for further investigation to develop an approach for surgeons to consistently and safely address return to downhill skiing after TKA or UKA.

Total Knee Arthroplasty: What to Expect? A Survey of the Members of the Dutch Knee Society on Long-Term Recovery after Total Knee Arthroplasty

2016 ◽  
Vol 30 (06) ◽  
pp. 612-616 ◽  
Author(s):  
Marieke van der Steen ◽  
Rob Janssen ◽  
Max Reijman ◽  
Jaap Tolk
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Dutch Version ◽  
Web Based ◽  
Orthopedic Surgeons ◽  
Special Surgery ◽  
Total Knee ◽  
Hospital For Special Surgery

AbstractThe rate of satisfaction after total knee arthroplasty (TKA) is consistently reported around 80%, leaving one in five patients unsatisfied to some extent. Fulfillment of expectations is reported as the strongest predictor of treatment satisfaction. In this study, we aimed to evaluate what Dutch orthopedic surgeons assume are realistic expectations for recovery 1 year after TKA. We invited the members of the Dutch Knee Society (DKS) to fill out a web-based questionnaire. For expectation measurement, the validated Dutch version of the Hospital for Special Surgery (HSS) knee replacement expectations survey was used. A total of 150 invitations were successfully sent; 84 orthopedic surgeons responded (56%). The overall HSS knee replacement expectation score was 66.0 (standard deviation, 14.0) on a 0 to 100 scale. Most improvement was predicted for the items “pain relief” and “walking short distances.” Expectations related to patients' ability to kneel or squat after TKA were scored poorly. To the opinion of the members of the DKS, after TKA improvement can be expected in domains of pain, function, activities, and psychological wellbeing. Return to normal is not likely to occur, especially in demanding physical activities.

scholarly journals Development, piloting, and evaluation of an evidence-based informed consent form for total knee arthroplasty (EvAb-Pilot): a protocol for a mixed methods study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Alina Weise ◽  
Julia Lühnen ◽  
Stefanie Bühn ◽  
Felicia Steffen ◽  
Sandro Zacher ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Informed Consent ◽  
Adverse Events ◽  
Knee Arthroplasty ◽  
Evidence Based ◽  
Nocebo Effect ◽  
Legal Requirements ◽  
Consent Forms ◽  
Link Type ◽  
Total Knee

Abstract Background Practitioners frequently use informed consent forms to support the physician-patient communication and the informed consent process. Informed consent for surgery often focuses on risk centered information due to high liability risks for treatment errors. This may affect patients’ anxiety of adverse events and the nocebo effect. This study focuses on the optimization of pre-surgical information on risks and complications, and at the same time reconciles these information with legal requirements. Methods The development, piloting, and evaluation of evidence-based informed consent forms for total knee arthroplasty (TKA) and related anesthesia procedures will follow the UK MRC Framework for developing and evaluating complex interventions. Conducting different sub-studies, we will (I) qualitatively explore the information acquisition and decision-making processes, (II) develop and pilot test evidence-based informed consent forms on the example of TKA and related anesthesia procedures, (III) conduct a monocentric interrupted time series (ITS) pilot study to evaluate the effects of evidence-based informed consent forms in comparison with standard consent forms, and (IV) perform a process evaluation to identify barriers and facilitators to the implementation of the intervention and to analyze mechanisms of impact. Discussion The evidence-based and understandable presentation of risks in informed consent forms aims at avoiding distorted risk depiction and strengthening the patients’ competencies to correctly assess the risks of undergoing surgery. This might reduce negative expectations and anxiety of adverse events, which in turn might reduce the nocebo effect. At the same time, the practitioners’ acceptance of evidence-based informed consent forms meeting legal requirements could be increased. Trial registration ClinicalTrials.gov, NCT04669483. Registered 15 December 2020. German Clinical Trials Registry, DRKS00022571. Registered 15 December 2020

scholarly journals Diagnostic algorithm in septic total knee arthroplasty failure – What is evidence-based?

2021 ◽  
Vol 23 ◽  
pp. 208-215
Author(s):  
Christian Suren ◽  
Igor Lazic ◽  
Maximilian Stephan ◽  
Florian Walter Lenze ◽  
Florian Pohlig ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Diagnostic Algorithm ◽  
Evidence Based ◽  
Total Knee ◽  
Arthroplasty Failure

scholarly journals A Dutch Survey on Circumpatellar Electrocautery in Total Knee Arthroplasty

2010 ◽  
Vol 4 (1) ◽  
pp. 201-203 ◽  
Author(s):  
Hans-Peter W. van Jonbergen ◽  
Alexander F.W. Barnaart ◽  
Cees C.P.M. Verheyen
Keyword(s):  
Total Knee Arthroplasty ◽  
The Netherlands ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Patellar Resurfacing ◽  
Orthopedic Surgeons ◽  
Unicompartmental Knee Arthroplasties ◽  
Total Knee ◽  
Anterior Knee

Introduction: Anterior knee pain following total knee arthroplasty is estimated to occur in 4-49% of patients. Some orthopedic surgeons use circumpatellar electrocautery (diathermy) to reduce the prevalence of postsurgical anterior knee pain; however, the extent of its use is unknown. Materials and Methodology: In April 2009, a postal questionnaire was sent to all 98 departments of orthopedic surgery in The Netherlands. The questions focused on the frequency of total knee arthroplasties, patellar resurfacing, and the use of circumpatellar electrocautery. Results: The response rate was 92%. A total of 18,876 TKAs, 2,096 unicompartmental knee arthroplasties, and 215 patellofemoral arthroplasties are performed yearly in The Netherlands by the responding orthopedic surgeons. Of the orthopedic surgeons performing TKA, 13% always use patellar resurfacing in total knee arthroplasty for osteoarthritis, 49% use selective patellar resurfacing, and 38% never use it. Fifty-six percent of orthopedic surgeons use circumpatellar electrocautery when not resurfacing the patella, and 32% use electrocautery when resurfacing the patella. Conclusion: There is no consensus among Dutch orthopedic surgeons on the use of patellar resurfacing or circumpatellar electrocautery in total knee replacement performed for osteoarthritis. A prospective clinical trial is currently underway to fully evaluate the effect of circumpatellar electrocautery on the prevalence of anterior knee pain following total knee arthroplasty.

Tourniquet Use in Total Knee Arthroplasty

2019 ◽  
Vol 32 (08) ◽  
pp. 719-729 ◽  
Author(s):  
Jaymeson R. Arthur ◽  
Mark J. Spangehl
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Wound Complications ◽  
Evidence Based ◽  
Increased Risk ◽  
Negative Effect ◽  
Total Knee ◽  
Controversial Topic ◽  
Antibiotic Delivery

AbstractTourniquet use in total knee arthroplasty has become a controversial topic. There are several benefits of its use including improved visualization, decreased blood loss, shorter operative times, and improved antibiotic delivery. Conversely, there are several significant downsides associated with tourniquet use including postoperative pain, neuromuscular injuries, wound complications, reperfusion injury, increased risk of thrombosis, patellar tracking issues, delayed rehabilitation including decreased postoperative range of motion, and its negative effect on patients with vascular disease. However, objectively, the literature does not definitively push us toward or away from the use of a tourniquet. Furthermore, several alternatives have been developed to help mitigate some of the adverse effects associated with its use. This article summarizes the evidence for and against tourniquet use and provides an evidence-based approach to help guide surgeons in their own practice.

scholarly journals Crystal Arthropathy in the Setting of Total Knee Arthroplasty

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Joseph C. Brinkman ◽  
Kade S. McQuivey ◽  
Justin L. Makovicka ◽  
Joshua S. Bingham
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Ground Level ◽  
Fracture Dislocation ◽  
Acute Gout ◽  
Orthopedic Surgeons ◽  
History Of ◽  
Total Knee ◽  
Gout Flare

We present a case of an 82-year-old female with a history of right total knee arthroplasty 11 years prior. She was admitted after a ground-level fall and developed progressive pain and swelling of her right knee. She had no history of complications with her total knee replacement. Radiographs of the knee and hip were negative for acute fracture, dislocation, or hardware malalignment. Knee aspiration was performed and revealed inflammatory exudate, synovial fluid consistent with crystal arthropathy, and no bacterial growth. She was diagnosed with an acute gout flare, and her symptoms significantly improved with steroids and anti-inflammatory treatment. Orthopedic surgeons should be aware of the potential for crystal arthropathy in the setting of total joint arthroplasty and evaluate for crystals before treating a presumed periprosthetic joint infection.

scholarly journals Variability in Recommendations for Total Knee Arthroplasty Among Rheumatologists and Orthopedic Surgeons

2013 ◽  
Vol 41 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Liana Fraenkel ◽  
Lisa Suter ◽  
Lawrence Weis ◽  
Gillian A. Hawker
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Employment Status ◽  
Functional Limitations ◽  
Knee Oa ◽  
Orthopedic Surgeons ◽  
Physician Characteristics ◽  
Academic Settings ◽  
Total Knee

Objective.The most rapidly growing population of patients undergoing total knee arthroplasty (TKA) is under the age of 65. The objective of our study was to gain insight into the factors influencing physicians’ recommendations for persons in this age group with moderate osteoarthritis (OA).Methods.Rheumatologists and orthopedic surgeons attending national meetings were asked to complete a survey including a standardized scenario of a 62-year-old person with knee OA who has moderate knee pain limiting strenuous activity despite medical management. We used an experimental 2 × 2 × 2 design to examine the effects of sex, employment status, and severity of radiographic OA on physicians’ recommendations. Each physician was asked to rate a single scenario.Results.The percentage of physicians recommending TKA varied from 30% to 55% for scenarios describing a patient with mild radiographic OA, and from 39% to 71% for scenarios describing a patient with moderate radiographic OA. Surgeons were less likely to recommend TKA for women compared to men of the same age, employment status, symptom severity, and functional status, and radiographs. Rheumatologists practicing in academic settings were more likely to recommend TKA compared to those practicing in nonacademic settings, and American surgeons were more likely to recommend TKA compared to their European counterparts.Conclusion.Orthopedic surgeons and rheumatologists vary significantly in their recommendations for patients with moderate knee pain and functional limitations. Both patient and physician characteristics influence physicians’ recommendations, and rheumatologists and orthopedic surgeons display different patterns of decision making.

scholarly journals Web-Based Information on Minimally Invasive Total Knee Arthroplasty

2013 ◽  
Vol 21 (3) ◽  
pp. 305-307 ◽  
Author(s):  
Sanjay Meena ◽  
Aravindh Palaniswamy ◽  
Buddhadev Chowdhury
Keyword(s):  
Total Knee Arthroplasty ◽  
Minimally Invasive ◽  
Knee Arthroplasty ◽  
Web Based ◽  
Total Knee
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