scholarly journals Use of Enoxaparin and Dabigatran for Thrombosis Prevention After Total Knee Replacement

2012 ◽  
Vol 19 (2) ◽  
pp. 61-64
Author(s):  
V. Yu Murylev ◽  
Y. A Rukin ◽  
P. M Elizarov ◽  
A. G Zhuchkov ◽  
D. I Terentiev
Keyword(s):  
Total Knee Replacement ◽  
Enoxaparin Sodium ◽  
Knee Replacement ◽  
Vena Cava ◽  
Preventive Measure ◽  
Early Postoperative Period ◽  
Peroral Administration ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Total Knee

Comparative analysis of dabigatran etaxilate and enoxaparin sodium use for prevention of vena cava inferior system thrombosis in patients after total knee replacement in early postoperative period was performed. In 74 patients (1 st group) dabigatran etaxilate and in 127 (2 nd group) enoxaparin sodium was used as a preventive measure. The rate of thrombosis made up 1.35% and 2.4% in the first and second groups, respectively. No significant difference in the volume of perioperative blood loss between the groups was noted. No other hemorrhagic complications were observed. It was shown that in more convenient peroral administration the dabigatran etaxilate efficacy and safety was comparable to enoxaparin sodium.

scholarly journals The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rongguo Yu ◽  
Youguang Zhuo ◽  
Eryou Feng ◽  
Wulian Wang ◽  
Wentao Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Continuous Passive Motion ◽  
Cochrane Library ◽  
Short Term ◽  
Significant Difference ◽  
Pain Outcomes ◽  
Total Knee

Abstract Background A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention. Methods A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software. Results Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability). Conclusions Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.

scholarly journals Platypnoea–orthodeoxia after left total knee replacement

2019 ◽  
Vol 12 (10) ◽  
pp. e230771
Author(s):  
Taha Almufti ◽  
Franz Eversheim ◽  
Brett Johnson ◽  
Gabriel Ayonmigbesimi Akra
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Unusual Case ◽  
Medical Intervention ◽  
Colour Doppler ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference ◽  
Severe Hypoxaemia ◽  
Total Knee

Platypnoea–orthodeoxia syndrome (POS) is a rare disorder characterised by both dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position, with improvement in the supine position. We report an unusual case in which an 82-year-old woman developed severe hypoxaemia with POS after left total knee replacement. A significant difference in alveolar–arterial blood gas oxygen tension was demonstrated, and hypoxaemia failed to respond to 100% oxygen supply. A patent foramen ovale with a right-to-left shunt was evident on transoesophageal echocardiogram employing colour Doppler and agitated normal saline studies. Interestingly, the patient’s symptoms resolved within 6 months with ongoing chest physiotherapy, without surgical or medical intervention.

scholarly journals Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Markus A. Wimmer ◽  
William Nechtow ◽  
Thorsten Schwenke ◽  
Kirsten C. Moisio
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Daily Activities ◽  
Wear Testing ◽  
Significant Difference ◽  
Flexion Extension ◽  
Total Knee ◽  
Stair Walking ◽  
The Many

Walking is only one of many daily activities performed by patients following total knee replacement (TKR). The purpose of this study was to examine the hypotheses (a) that subject activity characteristics are correlated with knee flexion range of motion (ROM) and (b) that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857) walking cycles including 65 (range: 0–319) stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

scholarly journals Comparison of simultaneous bilateral versus unilateral total knee replacement on pain levels and functional recovery

2020 ◽  
Author(s):  
Ahmad H Alghadir ◽  
Zaheen A Iqbal ◽  
Shahnawaz Anwer ◽  
Dilshad Anwar
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Knee Replacement ◽  
Functional Capacity ◽  
Recovery Of Function ◽  
Significant Difference ◽  
Reduction Of Pain ◽  
Total Knee ◽  
Bilateral Total Knee Replacement

Abstract Background Total knee replacement is a common operative procedure to improve pain, function, and quality of life in patients with end stage knee osteoarthritis. The current study aimed to compare simultaneous bilateral versus unilateral total knee replacement on pain intensity and recovery of function. Methods A total of 80 patients (bilateral 50, unilateral 30) aged 63.28 (9.4) years undergone total knee replacement participated in the current study. The participants were admitted for 5-7 days in the hospital. Participants in both the group received similar inpatient and outpatient physiotherapy sessions. Pain intensity and function capacity were assessed at baseline, day 7, and day 30 post-operatively using visual analogue scale and lower extremity functional scale, respectively. Repeated measures analysis of variance was used to analyze the data. Results Both groups showed a significant reduction of pain intensity (Day 0, mean 8.9, SD 1.0; Day 30, mean 2.2, SD 1.3 in bilateral total knee replacement; Day 0, mean 8.8, SD 1.1; Day 30, mean 2.0, SD 1.5 in unilateral total knee replacement; p<0.001) and improvement in the functional capacity (Day 0, mean 16.2, SD 10.1; Day 30, mean 55.6, SD 14.6 in bilateral total knee replacement; Day 0, mean 19.1, SD 9.1; Day 30, mean 56.7, SD 15.8 in unilateral total knee replacement; p<0.001) following total knee replacement at 30 days post-operatively. However, there was a non-significant difference noted between bilateral versus unilateral total knee replacement on the reduction of pain intensity (mean changes, 6.9 versus 6.8) and improvement in the functional capacity (mean changes, 39.4 versus 37.6) at 30 days post-operatively (p>0.05). Conclusion Simultaneous bilateral total knee replacement was associated with a similar reduction of pain intensity and recovery of function compared to unilateral total knee replacement, suggesting the use of simultaneous bilateral total knee replacement in patients with bilateral knee osteoarthritis since its costs and rehabilitation process could be reduced compared to staged bilateral total knee replacement.

scholarly journals Bariatric Orthopaedics: Impact of Obesity on Total Knee Replacement

2020 ◽  
Author(s):  
Ahsan Butt ◽  
Muhammad Zain-ur-Rehman ◽  
Adeel Nawab ◽  
Ahmad Hafeez ◽  
Ali Amjad
Keyword(s):  
Body Mass Index ◽  
Patient Satisfaction ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Body Mass ◽  
Knee Replacement ◽  
Osteoarthritis Of The Knee ◽  
Significant Difference ◽  
Total Knee ◽  
The Impact

Abstract Introduction: Total knee replacement is a reliable operation for reducing pain and improving function in severe osteoarthritis of the knee. As incidence of obesity is increasing worldwide, there is a debate about the role of Body Mass Index (BMI) in selection of patients requiring total knee replacement. The aim of the study was to evaluate the impact of body mass index on total knee replacement in terms of post-operative improvement in knee range of motion, patient satisfaction and complications.Material and methods: Out of 175 patients who suffered from advance knee osteoarthritis and were candidates for primary total knee replacement from January 2016 to March 2018, 155 patients fit the inclusion criteria. Group 1 included 66 patients who were overweight and class 1 obese while group 2 included 89 patients who were class 2 and 3 obese according to WHO Body Mass Index classification. All patients underwent total knee replacement according to the hospital guidelines. Pre and post-operative range of motion, patient satisfaction and complications were assessed and documented. Results: There was no statistically significant difference in improvements in post-operative knee range of motion between the two groups up to 2 years of follow up. [Mann-Whitney U test p= 0.069]. Similarly, Mann-Whitney U test showed that there is no significant difference between patient satisfaction levels (SF-12 scores) of the two groups (p= 0.09). Conclusion: There is no significant impact of obesity on outcomes after total knee replacement and BMI should not be used as a factor in selecting patients who qualify for total knee replacement.Level of Evidence: Level III

scholarly journals Patient specific instrumentation influences hemoglobin decrease after total knee replacement.

10.29007/f8h2 ◽  
2018 ◽  
Author(s):  
Davide Cucchi ◽  
Beatrice Zanini ◽  
Paolo Ferrua ◽  
Riccardo Compagnoni ◽  
Alessandra Menon ◽  
...  
Keyword(s):  
Blood Loss ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Medullary Canal ◽  
Patient Specific ◽  
Reduce Blood Loss ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Conventional Instrumentation ◽  
Total Knee

Patient Specific Instrumentation (PSI) may contribute to reduce blood loss after total knee replacement (TKR) by avoiding violation of the medullary canal. The purpose of the study was to compare the hemoglobin (Hb) decrease in two groups of patients undergoing TKR with PSI and conventional instrumentation.Pre- and post-operative blood samples were collected for twenty-two patients randomly assigned to receive a PSI-assisted or conventional TKR. Post- to preoperative Hb difference was calculated.A significant difference in Hb reduction in favor of the PSI group was registered on the last day of stay but not on the previous post-operative days: these promising results suggest a beneficial effect of PSI in blood loss reduction. PSI may hence be considered among the strategies available to control and reduce blood loss related to TKR.

scholarly journals A Portable System for Remote Rehabilitation Following a Total Knee Replacement: A Pilot Randomized Controlled Clinical Study

Sensors ◽  
2020 ◽  
Vol 20 (21) ◽  
pp. 6118
Author(s):  
Kevin M. Bell ◽  
Chukwudi Onyeukwu ◽  
Clair N. Smith ◽  
Adrianna Oh ◽  
Annette Devito Dabbs ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Physical Therapists ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Training System ◽  
Outpatient Rehabilitation ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Total Knee

Rehabilitation has been shown to improve functional outcomes following total knee replacement (TKR). However, its delivery and associated costs are highly variable. The authors have developed and previously validated the accuracy of a remote (wearable) rehabilitation monitoring platform (interACTION). The present study’s objective was to assess the feasibility of utilizing interACTION for the remote management of rehabilitation after TKR and to determine a preliminary estimate of the effects of the interACTION system on the value of rehabilitation. Specifically, we tested post-operative outpatient rehabilitation supplemented with interACTION (n = 13) by comparing it to a standard post-operative outpatient rehabilitation program (n = 12) using a randomized design. Attrition rates were relatively low and not significantly different between groups, indicating that participants found both interventions acceptable. A small (not statistically significant) decrease in the number of physical therapy visits was observed in the interACTION Group, therefore no significant difference in total cost could be observed. All patients and physical therapists in the interACTION Group indicated that they would use the system again in the future. Therefore, the next steps are to address the concerns identified in this pilot study and to expand the platform to include behavioral change strategies prior to conducting a full-scale randomized controlled trial. Trial registration: ClinicalTrials.gov NCT02646761 “interACTION: A Portable Joint Function Monitoring and Training System for Remote Rehabilitation Following TKA” 6 January 2016.

Comparison of bilateral versus unilateral total knee replacement on pain levels and functional recovery

2019 ◽  
Author(s):  
Ahmad H Alghadir ◽  
Zaheen A Iqbal ◽  
Shahnawaz Anwer ◽  
Dilshad Anwar
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Knee Replacement ◽  
Functional Capacity ◽  
Recovery Of Function ◽  
Co Morbidity ◽  
Significant Difference ◽  
Reduction Of Pain ◽  
Total Knee

Abstract Background: Total knee replacement (TKR) is a common operative procedure to improve pain, function, and quality of life in patients with severe grade knee osteoarthritis. The current study aimed to compare bilateral versus unilateral total knee replacement (TKR) on pain intensity and recovery of function.Methods: A total of 80 patients (bilateral 50, unilateral 30) aged 63.28 (9.4) years undergone TKR participated in the current study. The participants were admitted for 5-7 days in the hospital. Participants in both the group received similar inpatient and outpatient physiotherapy sessions. Pain intensity and function capacity were assessed at baseline, day 7, and day 30 postoperatively using visual analogue scale (VAS) and lower extremity functional scale (LEFS), respectively. Repeated measures analysis of variance was used to analyze the data. Results: Both the group showed a significant reduction of pain intensity and improvement in the functional capacity following TKR at 30 days post-operatively (p<0.001). However, there was a non-significant difference noted between bilateral versus unilateral TKR on the reduction of pain intensity and improvement in the functional capacity at 30 days postoperatively (p>0.05).Conclusion: Bilateral TKR was associated with a similar reduction of pain intensity and recovery of function compared to unilateral TKR, suggesting the use of Bilateral TKR in patients with bilateral knee osteoarthritis to reduce costs and co-morbidity related to staged bilateral TKR.

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