EPIDEMIOLOGY OF TOTAL KNEE REPLACEMENT IN THE UNITED STATES MEDICARE POPULATION

2005 ◽  
Vol 87 (6) ◽  
pp. 1222-1228 ◽  
Author(s):  
NIZAR N. MAHOMED ◽  
JANE BARRETT ◽  
JEFFREY N. KATZ ◽  
JOHN A. BARON ◽  
JOHN WRIGHT ◽  
...  
Author(s):  
Renee Causey-Upton ◽  
Dana Howell ◽  
Patrick Kitzman ◽  
Melba Custer ◽  
Emily Dressler

Purpose: The structure of pre-operative education programs used nationally for patients prior to total knee replacement (TKR) surgery has not been identified previously, thus hospitals across the United States lack a common standard for this pre-operative education to ensure best patient outcomes. The purpose of this pilot survey study was to describe the content, providers, and delivery methods currently utilized to deliver pre-operative education for total knee replacement in the United States. Method: Data were collected using an online survey developed by the authors based on review of literature and three pre-operative programs, and was distributed through the Research Electronic Data Capture (REDCap). The survey consisted of 16 questions, including 12 closed-ended and four open-ended items. Participants were identified through convenience sampling using contacts of the first author and an internet search of hospitals that provide pre-operative education. Seven professional participants total from nursing, physical therapy, and occupational therapy completed the survey. Descriptive statistics were used for data analysis of the 12 quantitative questions to determine frequency and percentages of responses. Responses on the four open-ended survey items, as well as participant responses of “other” for question items, were recorded and collated from individual survey responses. Results: Pre-operative education provider teams for total knee replacements most frequently consisted of nursing, physical therapy, and occupational therapy staff. Most education programs were provided two weeks prior to surgery in a group format, with the majority of programs being delivered in a single session lasting between 1 and 1.5 hours. Verbal and written instruction were the most commonly utilized methods to deliver education. Individual patient programs included a variety of topics, ranging from what to expect while in the hospital, self-care, adaptive equipment, and home safety being some of the most commonly included content. Conclusions: This pilot study provides a framework to describe the structure of pre-operative total knee replacement education nationally, and can be used to guide a future large scale survey to fully describe the content, providers, and delivery methods of pre-operative education for this population across the United States using a representative sample.


2013 ◽  
Vol 95 (5) ◽  
pp. 385-392 ◽  
Author(s):  
Alexander M Weinstein ◽  
Benjamin N Rome ◽  
William M Reichmann ◽  
Jamie E Collins ◽  
Sara A Burbine ◽  
...  

2000 ◽  
Author(s):  
Michael D. Nowak ◽  
Kenneth Shaw ◽  
Courtland Lewis

Abstract More than 200,000 people in the United States annually undergo knee replacement as a means of diminishing pain and stiffness and restoring mobility, and the number is expected to increase with further advancements in joint replacement procedures [Duke, 1999]. Total knee replacement is performed on people with severe degenerative joint disorder such as osteoarthritis in which the articular surfaces of the knee deteriorate, leading to severe pain, limitation or loss of function and/or deformity of the joint.


Author(s):  
Morshed Khandaker ◽  
Onur Can Kalay ◽  
Fatih Karpat ◽  
Amgad Haleem ◽  
Wendy Williams ◽  
...  

Abstract A method to improve the mechanical fixation of a total knee replacement (TKR) implant is clinically important and is the purpose of this study. More than one million joint replacement procedures are performed in people each year in the United States, and experts predict the number to increase six-fold by the year 2030. Whether cemented or uncemented, joint prostheses may destabilize over time and necessitate revision. Approximately 40,000 hip arthroplasty surgeries have to be revised each year and the rate is expected to increase by approximately 140% (and by 600% for total knee replacement) over the next 25 years. In veterinary surgery, joint replacement has a long history and the phenomenon of surgical revision is also well recognized. For the betterment of both people and animals, improving the longevity of arthroplasty devices is of the utmost clinical importance, and towards that end, several strategies are under investigation. One approach that we explore in the present research is to improve the biomechanical performance of cemented implant systems by altering the implant surface architecture in a way that facilitates its cement bonding capacity. Beginning with the Charnley system, early femoral stems were polished smooth, but a number of subsequent designs have featured a roughened surface — created with bead or grit blasting — to improve cement bonding. Failure at the implant-cement interface remains an issue with these newer designs, leading us to explore in this present research an alternate, novel approach to surface alteration — specifically, laser microgrooving. This study used various microgrooves architectures that is feasible using a laser micromachining process on a tibia tray (TT) for the goat TKR. Developing the laser microgrooving (LM) procedure, we hypothesized feasibility in producing parallel microgrooves of precise dimensions and spacing on both flat and round metallic surfaces. We further hypothesized that laser microgrooving would increase surface area and roughness of the cement interface of test metallic implants and that such would translate into an improved acute mechanical performance as assessed in vitro under both static and cyclic loads. The objective was to develop a computational model to determine the effect of LIM on the tibial tray to the mechanical stimuli distributions from implant to bone using the finite element method. This study designed goat TT 3D solid model from a computer topography (CT) images, out of which three different laser microgrooves were engraved on TT sample by varying depth, height and space between two adjacent grooves. The simulation test results concluded that microgrooves acchitecures positively influence microstrain behavior around the implant/bone interfaces. There is a higher amount of strain observed for microgroove implant/bone samples compared to non-groove implant/bone samples. Thus, the laser-induced microgrooves have the potential to be used clinically in TKR components.


2009 ◽  
Vol 24 (7) ◽  
pp. 1061-1067 ◽  
Author(s):  
Michael Manley ◽  
Kevin Ong ◽  
Edmund Lau ◽  
Steven M. Kurtz

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