Evaluation and Management of Metal Hypersensitivity in Total Joint Arthroplasty: A Systematic Review

2014 ◽  
Vol 24 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Michael Amini ◽  
Wesley H Mayes ◽  
Alice Tzeng ◽  
Tony H Tzeng ◽  
Khaled J. Saleh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Metal Hypersensitivity

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

scholarly journals The Effect of Bariatric Surgery Prior to Lower-Extremity Total Joint Arthroplasty: A Systematic Review

2019 ◽  
Vol 15 (2) ◽  
pp. 190-200 ◽  
Author(s):  
Alex Gu ◽  
Jordan S. Cohen ◽  
Michael-Alexander Malahias ◽  
Danny Lee ◽  
Peter K. Sculco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Lower Extremity ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty

Return to Golfing Activity After Joint Arthroplasty

2016 ◽  
Vol 45 (1) ◽  
pp. 243-249 ◽  
Author(s):  
Dean N. Papaliodis ◽  
Christos D. Photopoulos ◽  
Nima Mehran ◽  
Michael B. Banffy ◽  
James E. Tibone
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Total Joint Arthroplasty ◽  
Shoulder Arthroplasty ◽  
Return To Sport ◽  
Joint Arthroplasty ◽  
Review Of The Literature ◽  
Shoulder Replacement ◽  
Web Based ◽  
Practice Recommendations

Background: Many patients who are considering total joint arthroplasty, including hip, knee, and shoulder replacement, are concerned with their likelihood of returning to golf postoperatively as well as the effect that surgery will have on their game. Purpose: To review the existing literature on patients who have undergone major joint arthroplasty (hip, knee, and shoulder), to examine the effects of surgery on performance in golf, and to provide surgeon recommendations as related to participation in golf after surgery. A brief review of the history and biomechanics of the golf swing is also provided. Study Design: Systematic review. Methods: We performed a systematic review of the literature in the online Medline database, evaluating articles that contained the terms “golf” and “arthroplasty.” Additionally, a web-based search evaluating clinical practice recommendations after joint arthroplasty was performed. The research was reviewed, and objective and anecdotal guidelines were formulated. Results: Total joint arthroplasty provided an improvement in pain during golfing activity, and most patients were able to return to sport with variable improvements in sport-specific outcomes. Conclusion: In counseling patients regarding the return to golf after joint arthroplasty, it is our opinion, on the basis of our experience and those reported from others in the literature, that golfers undergoing total hip, knee, and shoulder arthroplasty can safely return to sport.

scholarly journals Impact of Prior Intra-articular Injections on the Risk of Prosthetic Joint Infection Following Total Joint Arthroplasty: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Fei Nie ◽  
Wei Li
Keyword(s):  
Systematic Review ◽  
Prosthetic Joint Infection ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
Joint Arthroplasty ◽  
Injection Group ◽  
Prosthetic Joint ◽  
Increased Risk ◽  
The Impact

Objective: The current review was designed to assess the impact of prior intra-articular injections on the risk of prosthetic joint infection (PJI) in patients undergoing total joint arthroplasty (TJA) with a focus on the timing of injection before surgery.Methods: The databases of PubMed, Embase and Google Scholar were searched up to 15th June 2021. All studies comparing the incidence of PJI with and without prior intra-articular injections were included. Risk ratios (RR) with 95% confidence intervals were calculated for PJI.Results: Nineteen studies were included. Both corticosteroids and hyaluronic acid injections were used before TJA in the included studies. Overall, comparing 127,163 patients with prior intra-articular injections and 394,104 patients without any injections, we noted a statistically significant increased risk of PJI in the injection group (RR 1.24 95% CI: 1.11, 1.38 I2 = 48% p = 0.002). On subgroup analysis, there was a statistically significant increased risk of PJI in the injection group in studies where intra-articular injections were administered <12 months before surgery (RR 1.18 95% CI: 1.10, 1.27 I2 = 7% p < 0.00001). Furthermore, on meta-analysis, we noted non-significant but increased risk of PJI when injections were administered 1 month (RR 1.47 95% CI: 0.88, 2.46 I2 = 77% p = 0.14), 0–3 months (RR 1.22 95% CI: 0.96, 1.56 I2 = 84% p = 0.11), and 3–6 months (RR 1.16 95% CI: 0.99, 1.35 I2 = 49% p = 0.06) before surgery.Conclusion: Our results indicate that patients with prior intra-articular injections have a small but statistically significant increased risk of PJI after TJA. Considering that PJI is a catastrophic complication with huge financial burden, morbidity and mortality; the clinical significance of this small risk cannot be dismissed. The question of the timing of injections and the risk of PJI still remains and can have a significant impact on the decision making.Systematic Review Registration: PROSPERO: CRD42021258297.

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