Backwards Walking Programme Following Hip and Knee Arthroplasty

2020 ◽  
Author(s):  
Keyword(s):  
Knee Arthroplasty ◽  
Hip And Knee Arthroplasty ◽  
Walking Programme

scholarly journals Perioperative Management of Chronic Antithrombotic Agents in Elective Hip and Knee Arthroplasty

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 188
Author(s):  
Daniel C. Santana ◽  
Matthew J. Hadad ◽  
Ahmed Emara ◽  
Alison K. Klika ◽  
Wael Barsoum ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Perioperative Management ◽  
Recent Literature ◽  
Patient Specific ◽  
Antithrombotic Agents ◽  
Coronary Syndrome ◽  
Risk Of Bleeding ◽  
Post Operative Period ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty

Total hip and knee arthroplasty are common major orthopedic operations being performed on an increasing number of patients. Many patients undergoing total joint arthroplasty (TJA) are on chronic antithrombotic agents due to other medical conditions, such as atrial fibrillation or acute coronary syndrome. Given the risk of bleeding associated with TJAs, as well as the risk of thromboembolic events in the post-operative period, the management of chronic antithrombotic agents perioperatively is critical to achieving successful outcomes in arthroplasty. In this review, we provide a concise overview of society guidelines regarding the perioperative management of chronic antithrombotic agents in the setting of elective TJAs and summarize the recent literature that may inform future guidelines. Ultimately, antithrombotic regimen management should be patient-specific, in consultation with cardiology, internal medicine, hematology, and other physicians who play an essential role in perioperative care.

Predictors of Successful Early Discharge for Total Hip and Knee Arthroplasty in Octogenarians

2021 ◽  
pp. 155633162110306
Author(s):  
Andrew B. Kay ◽  
Danielle Y. Ponzio ◽  
Courtney D. Bell ◽  
Fabio Orozco ◽  
Zachary D. Post ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Early Discharge ◽  
Readmission Rates ◽  
Patients Âgés ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Student’S T ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Decreased length of stay after total joint arthroplasty (TJA) is becoming a more common way to contain healthcare costs and increase patient satisfaction. There is little evidence to support “early” discharge in elderly patients. Purpose: We sought to identify preoperative factors that correlated with early discharge (by postoperative day [POD] 1) in comparison to late discharge (after POD2) in octogenarians after TJA. Methods: In a retrospective cohort study from a single institution, we identified 482 patients ages 80 to 89 who underwent primary TJA from January 2014 to December 2017; 319 had total knee arthroplasty (TKA) and 163 had total hip arthroplasty (THA). Data collected included preoperative knee range of motion (ROM), demographics, and comorbidities; 90-day readmission and mortality rates were also evaluated. P values for continuous data were calculated using student’s t test and for categorical data using χ2 testing. Results: Of octogenarian patients, 30.9% were discharged by POD1. Early discharge was associated with being male, married, and nonsmoking, as well as having an American Society of Anesthesiologists (ASA) score of 2, independent preoperative ambulation, and a postoperative caregiver. Type of procedure (TKA vs THA), body mass index, laterality, preoperative range of motion (ROM) for TKA, and single vs multilevel home did not affect the probability of early discharge. Discharge on POD1 was not associated with increased 90-day readmission rates. There were no deaths. Conclusion: Early discharge for octogenarians can be successfully implemented in a select subset of patients without increasing 90-day readmission or death rates. There are multiple factors that predict successful early discharge.

Tranexamic acid in patients with current or former cancer undergoing hip and knee arthroplasty

2021 ◽  
Author(s):  
Nathan H. Varady ◽  
Antonia F. Chen ◽  
Nicholas J. Drayer ◽  
John Ready ◽  
Santiago A. Lozano‐Calderon ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Hip And Knee Arthroplasty

scholarly journals Trends and developments in hip and knee arthroplasty technology

2021 ◽  
Vol 8 ◽  
pp. 205566832095204
Author(s):  
Martin Marsh ◽  
Simon Newman
Keyword(s):  
Knee Arthroplasty ◽  
Standard Of Care ◽  
Hip Resurfacing ◽  
Implant Survival ◽  
Dual Mobility ◽  
Joint Replacements ◽  
Robotic Assisted Surgery ◽  
Hip And Knee Arthroplasty ◽  
Hip Stems ◽  
Hip And Knee Surgery

The developments in hip and knee arthroplasty over recent years have aimed to improve outcomes, reduce complications and improve implant survival. This review describes some of the most interesting trends and developments in this important and fast-moving field. Notable developments have included ceramic hip resurfacing, mini hip stems, cementless knee replacement and the wider adoption of the dual mobility articulation for hip arthroplasty. Advances in additive manufacturing and the surface modification of joint replacements offer increasing options for more challenging arthroplasty cases. Robotic assisted surgery is one of the most interesting developments in hip and knee surgery. The recent growth in the use of this technology is providing data that will help determine whether this approach should become the standard of care for hip and knee arthroplasty in the future.

scholarly journals Protocol for systematic review: patient decision aids for total hip and knee arthroplasty decision-making

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Lissa Pacheco-Brousseau ◽  
Marylène Charette ◽  
Dawn Stacey ◽  
Stéphane Poitras
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Decision Aids ◽  
Risk Of Bias ◽  
Decision Making Process ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Hip And Knee Arthroplasty

Abstract Background Total hip and knee arthroplasty are a highly performed surgery; however, patient satisfaction with surgery results and patient involvement in the decision-making process remains low. Patient decision aids (PtDAs) are tools used in clinical practices to facilitate active patient involvement in healthcare decision-making. Nonetheless, PtDA effects have not been systematically evaluated for hip and knee total joint arthroplasty (TJA) decision-making. The aim of this systematic review is to determine the effect of patient decision aids compared to alternative of care on quality and process of decision-making when provided to adults with hip and knee osteoarthritis considering primary elective TJA. Methods This systematic review will follow the Cochrane Handbook for Systematic Reviews. This protocol was reported based on the PRISMA-P checklist guidelines. Studies will be searched in CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science. Eligible studies will be randomized control trial (RCT) evaluating the effect of PtDA on TJA decision-making. Descriptive and meta-analysis of outcomes will include decision quality (knowledge and values-based choice), decisional conflict, patient involvement, decision-making process satisfaction, actual decision made, health outcomes, and harm(s). Risk of bias will be evaluated with Cochrane’s risk of bias tool for RCTs. Quality and strength of recommendations will be appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Discussion This review will provide a summary of RCT findings on PtDA effect on decision-making quality and process of adults with knee and hip osteoarthritis considering primary elective TJA. Further, it will provide evidence comparing different types of PtDA used for TJA decision-making. This review is expected to inform further research on joint replacement decision-making quality and processes and on ways PtDAs facilitate shared decision-making for orthopedic surgery. Systematic review registration PROSPERO CRD42020171334

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