scholarly journals The influence of anesthesia and analgesia on the formation of chronic pain syndrome in patients undergoing total knee or hip arthroplasty. Article

2020 ◽  
pp. 25-32
Author(s):  
Mikhail E. Politov ◽  
N. V Panov ◽  
A. M Ovechkin ◽  
S. V Sokologorsky
Keyword(s):  
Chronic Pain ◽  
Hip Arthroplasty ◽  
Pain Syndrome ◽  
Womac Score ◽  
Early Postoperative Period ◽  
Functional Rehabilitation ◽  
Hip Joint Replacement ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee

Introduction. Total knee and hip replacement surgery for stages 3-4 of osteoarthritis often complicated by chronic postoperative pain syndrome (CPOP). Obj'ectives. The aim of the study was to choosing anesthesia that lid to decries the incidence of CPOP. Materials and methods. The study included 104 patients over 65 years old who underwent total knee or hip arthroplasty. Patients were divided into two groups: combined spinal-epidural anesthesia and extended epidural analgesia (CSEA) - 53 patients; general anesthesia and multicomponent postoperative analgesia (GA) - 51 patients. The Western Ontario MacMaster (WOMAC) scale and The Douleur Neuropathique 4 Questions (DN4) scale was used. Indicators were evaluated in 3, 6 and 12 months after surgery. We also assess the area of the hyperalgesia zone in the early postoperative period. Results. The WOMAC score was 85.7 9.99 points in the CSEA group and 99.0 11.68 in the GA group 3 months after surgery (p 0.01), 81.3 10.19 versus 93, 8 11.31 after 6 months (p 0.01) and 78.7 10.48 versus 89.9 10.77 after a year (p 0.01). The formation of CPOP was observed in 16 (15.4 %) patients, 4 (7.5 %) patients in the CSEA group and 12 (23.53 %) patients in the GA group (p 0.05). The neuropathic component of chronic pain was observed in 10 (62.5 %) patients, somewhat less often in the CSEA group (p 0.05). In patients with advanced CPOP, it was noted that the area of the secondary hyperalgesia zone in the first two days after surgery was significantly larger. The hyperalgesia zone was significantly smaller in patients with CSEA. Conclusions. Performing knee or hip joint replacement using CSEA compared with GA without a regional component is associated with a lower risk of developing CPOP syndrome and better functional rehabilitation.

Hip arthroplasty in haemophilia: a systematic review

2018 ◽  
Vol 28 (5) ◽  
pp. 459-467 ◽  
Author(s):  
Ali Parsa ◽  
Mohammad Azizbaig Mohajer ◽  
Maryam Mirzaie
Keyword(s):  
Hip Arthroplasty ◽  
Case Reports ◽  
Femoral Stem ◽  
World Federation ◽  
Complication Rates ◽  
Precise Control ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Number Of Patients ◽  
Uncemented Acetabular Component

Background: Rigorous haemostatic control and careful rehabilitation are essential for haemophilic patients undergoing total hip arthroplasty (THA). Aim: to examine the current literature regarding THA in patients with haemophilia in order to determine clinical outcomes and complication rates. Methods: We included 11 case reports/series and 9 original articles. There was a total of 206 patients who underwent 226 THAs. Findings: The number of patients enrolled in the selected articles varied from 1 in case reports to 34 in the original articles. Gender was documented in 10. Mean age at surgery was 41 years. Mean follow-up was 73 months (standard deviation [SD] 35 months). All but 4 articles specified whether implants were cemented or uncemented, with 95% being uncemented, 3.5% being cemented, and 1.5% being hybrid (uncemented acetabular component, cemented femoral stem). Conclusion: Controlled hypotensive anaesthesia (to reduce preoperative blood loss), consult with haematologist, precise control of haemostasis status per the guidelines defined by the World Federation joint replacement, can improve the success rate and hip replacement surgery can be performed safely.

scholarly journals Risk of Venous Thromboembolic Events in Patients with Osteonecrosis of the Femoral Head Undergoing Primary Hip Arthroplasty

2019 ◽  
Vol 8 (12) ◽  
pp. 2158
Author(s):  
Pei-Hsun Sung ◽  
Yao-Hsu Yang ◽  
Hsin-Ju Chiang ◽  
John Y. Chiang ◽  
Hon-Kan Yip ◽  
...  
Keyword(s):  
Femoral Head ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Thromboembolic Events ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Post Surgery ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

Previous data have shown patients with osteonecrosis of the femoral head (ONFH) have increased lifelong risk of unprovoked venous thromboembolic events (VTE) as compared with the general population, according to sharing common pathological mechanism of endothelial dysfunction. However, whether the risk of VTE increases in those ONFH patients undergoing major hip replacement surgery remains unclear. This is a retrospective nationwide Asian population-based study. From 1997 to 2013, a total of 12,232 ONFH patients receiving partial or total hip replacement for the first time and revision surgeries were retrospectively selected from Taiwan Health Insurance surgical files. By 1:1 matching on age, sex, surgical types, and socioeconomic status, 12,232 subjects without ONFH undergoing similar hip surgery were selected as non-ONFH group. The incidence and risk of post-surgery VTE, including deep venous thrombosis (DVT) and pulmonary embolism (PE), were compared between the ONFH and non-ONFH groups. Results showed that 53.8% of ONFH patients were male and the median age was 61.9 years old. During the mean follow-up period of 6.4 years, the incidences of VTE (1.4% vs. 1.2%), DVT (1.1% vs. 0.9%), and PE (0.4% vs. 0.4%) were slightly but insignificantly higher in the ONFH than in the non-ONFH group undergoing the same types of major hip replacement surgery (all p-values > 0.250). Concordantly, we found no evidence that the risk of VTE was increased in the ONFH patients as compared with the non-ONFH counterparts (adjusted HR 1.14; 95% CI 0.91–1.42; p = 0.262). There were also no increased risks for DVT and PE in the ONFH subgroups stratified by comorbidities, drug exposure to pain-killer or steroid, and follow-up duration after surgery, either. In conclusion, hip arthroplasty in Asian patients with ONFH is associated with similar rates of VTE as compared to patients with non-ONFH diagnoses.

scholarly journals Variation in age and physical status prior to total knee and hip replacement surgery: A comparison of centers in Australia and Europe

2009 ◽  
Vol 61 (2) ◽  
pp. 166-173 ◽  
Author(s):  
Ilana N. Ackerman ◽  
Paul A. Dieppe ◽  
Lyn M. March ◽  
Ewa M. Roos ◽  
Anna K. Nilsdotter ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Physical Status ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee

scholarly journals Neutrophil to lymphocyte ratio as a predictor for diagnosis of early Periprosthetic joint infection

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Bao-Zhan Yu ◽  
Jun Fu ◽  
Wei Chai ◽  
Li-Bo Hao ◽  
Ji-Ying Chen
Keyword(s):  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Predictive Value ◽  
Joint Infection ◽  
Early Postoperative Period ◽  
Infected Group ◽  
Neutrophil To Lymphocyte Ratio ◽  
Musculoskeletal Infection ◽  
Lymphocyte Ratio ◽  
Total Knee

Abstract Background Periprosthetic joint infection (PJI) is a catastrophic complication after total knee or hip arthroplasty. The diagnosis of PJI is very difficult, especially in the early postoperative period. The value of the neutrophil to lymphocyte ratio (NLR) is useful for diagnosing infectious diseases. The objective of this study was to investigate the accuracy of the NLR for the diagnosis of early PJI after total knee or hip arthroplasty. Methods We retrospectively evaluated consecutive primary total knee or hip arthroplasty and identified the patients who readmitted within the first 90 days postoperatively between January 2011 and October 2018.There were 20 cases diagnosed early PJI and 101 uninfected cases on the basis of the modified Musculoskeletal Infection Society (MSIS) criteria. The serum parameters including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood-cell (WBC) count, NLR and interleukin-6 (IL-6) were compared between the two groups. Receiver operating characteristic curves were generated to estimate the optimal cutoff values for each parameter. The sensitivity, specificity, positive predictive value and negative predictive value for each parameter were calculated. Results The CRP, ESR, WBC, NLR and IL-6 values were all significally higher in the infected group than the uninfected group. The median of CRP was 66.6 mg/l in the infected group and 8.6 mg/l in the uninfected group (p < 0.001). The median of ESR was 34.8 mm/hr. in the infected group and 17.4 mm/hr. in the uninfected group (p < 0.001). In the infected group and uninfected group, the median of WBC was 8.2X109 /L and 6.1 X109 /L (p = 0.002), respectively; while the median of NLR was 5.2 and 2.1 (p < 0.001). The median of IL-6 was 46 pg/ml and 6.4 pg/ml (p < 0.001),respectively. The best parameter for the diagnosis of early PJI was IL-6 (AUC = 0.814) followed by the NLR (AUC =0.802), CRP (AUC =0.793), ESR (AUC =0.744) and WBC (AUC = 0.632). Conclusions This study is the first to show that NLR values are more accurate than CRP and may be considered as useful parameters for the diagnosis of early PJI because it is a cheap and convenient parameter to be calculated in daily practice without extra costs.

Red cell transfusions in total knee and total hip replacement surgery

Transfusion ◽  
1991 ◽  
Vol 31 (6) ◽  
pp. 531-537 ◽  
Author(s):  
DM Surgenor ◽  
EL Wallace ◽  
WH Churchill ◽  
SH Hao ◽  
RH Chapman ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Red Cell ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee

Red Cell Transfusions in Total Knee and Total Hip Replacement Surgery

1992 ◽  
Vol 36 (3) ◽  
pp. 186-187
Author(s):  
D. M. Surgenor ◽  
E. L. Wallace ◽  
W. H. Churchill ◽  
S. H. S. Hao ◽  
R. H. Chapman ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Red Cell ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee

Functional mobility on discharge day after total knee and hip replacement surgery

2014 ◽  
Vol 25 (1) ◽  
Author(s):  
Gizem İrem Kinikli ◽  
Hande Güney ◽  
Ayşenur Karaman ◽  
Kamil Yilmaz ◽  
Ömür Çağlar ◽  
...  
Keyword(s):  
Hip Replacement ◽  
Functional Mobility ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee

Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism after total knee and hip replacement surgery

2009 ◽  
Vol 31 (1) ◽  
pp. 194-212 ◽  
Author(s):  
Sorrel E. Wolowacz ◽  
Neil S. Roskell ◽  
Fiona Maciver ◽  
Stephen M. Beard ◽  
Paul A. Robinson ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Venous Thromboembolism ◽  
Hip Replacement ◽  
Dabigatran Etexilate ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Total Knee

Features of preoperative planning for hip arthroplasty

2021 ◽  
Vol 2 (2) ◽  
pp. 59-64
Author(s):  
B.P. Buryachenko ◽  
◽  
D.I. Vartholomew ◽  
Keyword(s):  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Preoperative Planning ◽  
X Rays ◽  
X Ray ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Digital Planning ◽  
Speed Up

Relevance. Preoperative planning is an integral stage of hip replacement surgery, which reduces the number of complications and improves the accuracy of the installation of endoprosthesis components. Goal. Assess the accuracy of digital preoperative planning using mediCAD® v.6. Material and methods. The study included data from 276 patients with idiopathic coxarthrosis who were treated at the orthopedic department of the Center of Traumatology and Orthopedics of the Main Military Clinical Hospital named after N.N. Burdenko in the period from 2018 to 2020.The patients had X-rays of the pelvis and hip joint in two projections. All patients underwent total hip arthroplasty with cementless endoprostheses. Before surgery, all patients underwent preoperative planning using the mediCAD® v.6 software. After the operation, a control X-ray was performed, followed by an assessment of the obtained images in the same software. The planning accuracy was evaluated by comparing the parameters that were calculated in the program before the operation with the parameters of the installed implants. The results. The conducted study demonstrated the high accuracy of digital preoperative planning. The coincidence of the planned sizes of the acetabular component of the endoprosthesis and a deviation within +/- one size was observed in 93% of patients, femoral — in 84% of patients. Conclusion. Preoperative planning is an integral stage of hip replacement surgery, which allows you to perform the necessary preparation for the intervention. Digital planning allows you to simplify and speed up the process of preparing for an operation and improve the quality of its execution.

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