scholarly journals The effects of physiotherapy using proprioceptive neuromuscular facilitation techniques on the gait of patients after hip and knee arthroplasty: a case report.

2021 ◽  
Vol 15 (SUPPLEMENT 2) ◽  
pp. 1-7
Author(s):  
Antonina Kaczorowska ◽  
Jolanta Kaboth ◽  
Ewelina Lepsy ◽  
Agata Mroczek
Keyword(s):  
Case Report ◽  
Knee Arthroplasty ◽  
Sagittal Plane ◽  
Lower Limbs ◽  
Timed Up And Go ◽  
Number Of Patients ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Test Assessment ◽  
Hip And Knee Arthroplasty ◽  
Tinetti Test

Background: Gait disturbances are a major problem for patients after arthroplasty. After the surgery, walking speed, the rhythm of locomotion, and the length of the steps are significantly reduced. One of the therapeutic methods used in gait re-education is proprioceptive neuromuscular facilitation (PNF). Aim of the study: This study aimed to evaluate the effects of physiotherapy using PNF techniques on the gait of patients after hip and knee arthroplasty. Case report: A 60-year-old woman with advanced osteoarthritis that received bilateral hip and right knee arthroplasties was examined. Before and after the therapy, the following tests were performed: measurement of the range of motion (ROM) of hip and knees joints in the sagittal plane using a goniometer, assessment of the symmetry of the lower limbs loading using the two scales test, assessment of the risk of falls using the “Timed Up and Go” test, assessment of balance and gait using the Tinetti test, and assessment of pain intensity using the visual analogue scale (VAS). Rehabilitation was comprised of 15 PNF therapies, including scapular and pelvic PNF patterns. The stabilization of the upper and lower trunk, lifting, shifting of the body’s weight from one foot to another, gait cycle (the stance phase and the swing phase), walking forward, backward, and sideways, and walking up/down the stairs were also used. After the therapy, the flexion ROM in both hip and knees joints was improved. The lower limb symmetry index decreased from 1.167 to 1.121, and the sum of the points obtained in the Tinetti test increased from 22 to 26. Pain in the joints also decreased from 6 on the VAS scale to 4. However, the result obtained in the “Timed Up and Go” test after the therapy was increased by 0.5 s compared to before the therapy. Conclusions: After hip and knee arthroplasties, physiotherapy using PNF techniques improved the gait and functional status of the patient. Continuation of this research using a larger number of patients is needed.

The effects of physiotherapy using proprioceptive neuromuscular facilitation techniques on the gait of patients after hip and knee arthroplasty: a case report

2021 ◽  
Vol 15 (SUPPLEMENT 2) ◽  
pp. 1
Author(s):  
Antonina Kaczorowska ◽  
Jolanta Kaboth ◽  
Ewelina Lepsy ◽  
Agata Mroczek
Keyword(s):  
Case Report ◽  
Knee Arthroplasty ◽  
Sagittal Plane ◽  
Lower Limbs ◽  
Timed Up And Go ◽  
Number Of Patients ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Test Assessment ◽  
Hip And Knee Arthroplasty ◽  
Tinetti Test

Background Gait disturbances are a major problem for patients after arthroplasty. After the surgery, walking speed, the rhythm of locomotion, and the length of the steps are significantly reduced. One of the therapeutic methods used in gait re-education is proprioceptive neuromuscular facilitation (PNF). Aim of the study This study aimed to evaluate the effects of physiotherapy using PNF techniques on the gait of patients after hip and knee arthroplasty. Case report A 60-year-old woman with advanced osteoarthritis that received bilateral hip and right knee arthroplasties was examined. Before and after the therapy, the following tests were performed: measurement of the range of motion (ROM) of hip and knees joints in the sagittal plane using a goniometer, assessment of the symmetry of the lower limbs loading using the two scales test, assessment of the risk of falls using the “Timed Up and Go” test, assessment of balance and gait using the Tinetti test, and assessment of pain intensity using the visual analogue scale (VAS). Rehabilitation was comprised of 15 PNF therapies, including scapular and pelvic PNF patterns. The stabilization of the upper and lower trunk, lifting, shifting of the body’s weight from one foot to another, gait cycle (the stance phase and the swing phase), walking forward, backward, and sideways, and walking up/down the stairs were also used. After the therapy, the flexion ROM in both hip and knees joints was improved. The lower limb symmetry index decreased from 1.167 to 1.121, and the sum of the points obtained in the Tinetti test increased from 22 to 26. Pain in the joints also decreased from 6 on the VAS scale to 4. However, the result obtained in the “Timed Up and Go” test after the therapy was increased by 0.5 s compared to before the therapy. Conclusions After hip and knee arthroplasties, physiotherapy using PNF techniques improved the gait and functional status of the patient. Continuation of this research using a larger number of patients is needed.

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.

scholarly journals BILATERAL TOTAL HIP AND KNEE ARTHROPLASTY IN A PATIENT WITH RHEUMATOID ARTHRITIS. A CASE REPORT

2014 ◽  
pp. 30-36
Author(s):  
Saša Stojanović ◽  
Predrag Stojiljković ◽  
Ivan Golubović ◽  
Ivica Lalić ◽  
Danilo Stojiljković ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

METALLOSIS OF A SILASTIC METACARPOPHALANGEAL JOINT ARTHROPLASTY — A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 429-430
Author(s):  
H. D. Measuria ◽  
T. J. McBride ◽  
S. C. Talwalkar
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Joint Replacements ◽  
Metal On Metal ◽  
Hip And Knee Arthroplasty ◽  
Full Flexion

Metallosis is a well-documented phenomenon in hip and knee arthroplasty from metal on metal bearing joint replacements. However, few cases of metallosis of metacarpophalangeal joint replacements have been reported. We present the case of a 49-year-old lady with rheumatoid arthritis who had previously undergone MCP joint replacements over 20 years ago. The decision was taken to revise her middle MCP joint after she developed pain and ulnar drift. At revision, the joint exhibited severe metallosis presumably arising from the grommet component of the replacement. This required considerable debridement and removal of the components and revision to a new upsized implant without grommets. It is of note that there were no external signs of metallosis with full flexion of the finger and a good roll up.

scholarly journals Elective orthopaedic cancellations due to the COVID-19 pandemic: where are we now, and where are we heading?

2021 ◽  
Vol 2 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Sam Oussedik ◽  
Sam MacIntyre ◽  
Joanne Gray ◽  
Peter McMeekin ◽  
Nick D. Clement ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Financial Burden ◽  
Waiting Lists ◽  
Waiting List ◽  
Joint Registry ◽  
Unmet Demand ◽  
Number Of Patients ◽  
Recovery Strategies ◽  
Hip And Knee Arthroplasty ◽  
The Cost

Aims The primary aim is to estimate the current and potential number of patients on NHS England orthopaedic elective waiting lists by November 2020. The secondary aims are to model recovery strategies; review the deficit of hip and knee arthroplasty from National Joint Registry (NJR) data; and assess the cost of returning to pre-COVID-19 waiting list numbers. Methods A model of referral, waiting list, and eventual surgery was created and calibrated using historical data from NHS England (April 2017 to March 2020) and was used to investigate the possible consequences of unmet demand resulting from fewer patients entering the treatment pathway and recovery strategies. NJR data were used to estimate the deficit of hip and knee arthroplasty by August 2020 and NHS tariff costs were used to calculate the financial burden. Results By November 2020, the elective waiting list in England is predicted to be between 885,286 and 1,028,733. If reduced hospital capacity is factored into the model, returning to full capacity by November, the waiting list could be as large as 1.4 million. With a 30% increase in productivity, it would take 20 months if there was no hidden burden of unreferred patients, and 48 months if there was a hidden burden, to return to pre-COVID-19 waiting list numbers. By August 2020, the estimated deficits of hip and knee arthroplasties from NJR data were 18,298 (44.8%) and 16,567 (38.6%), respectively, compared to the same time period in 2019. The cost to clear this black log would be £198,811,335. Conclusion There will be up to 1.4 million patients on elective orthopaedic waiting lists in England by November 2020, approximate three-times the pre-COVID-19 average. There are various strategies for recovery to return to pre-COVID-19 waiting list numbers reliant on increasing capacity, but these have substantial cost implications. Cite this article: Bone Jt Open 2021;2(2):103–110.

scholarly journals An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 416 ◽  
Author(s):  
Daniel C. Santana ◽  
Ahmed K. Emara ◽  
Melissa N. Orr ◽  
Alison K. Klika ◽  
Carlos A. Higuera ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
High Volume ◽  
Optimal Choice ◽  
Slight Reduction ◽  
Vte Prophylaxis ◽  
Prophylactic Agent ◽  
Total Hip ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty

Patients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6–1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute number of patients. The rate of VTE after total hip arthroplasty has been stable over the past decade, although there has been a slight reduction in the rate of deep venous thrombosis (DVT), but not pulmonary embolism (PE), after total knee arthroplasty. Over this time, there has been significant research into the optimal choice of pharmacologic VTE prophylaxis for individual patients, with the objective to reduce the rate of VTE while minimizing adverse side effects such as bleeding. Recently, aspirin has emerged as a promising prophylactic agent for patients undergoing arthroplasty due to its similar efficacy and good safety profile compared to other pharmacologic agents. However, there is no evidence to date that clearly demonstrates the superiority of any given prophylactic agent. Therefore, this review discusses (1) the current prevalence and trends in VTE after total hip and knee arthroplasty and (2) provides an update on pharmacologic VTE prophylaxis in regard to aspirin usage.

scholarly journals Clinical and radiological outcomes in three-dimensional printing assisted revision total hip and knee arthroplasty: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rui Zhang ◽  
Jiajun Lin ◽  
Fenyong Chen ◽  
Wenge Liu ◽  
Min Chen
Keyword(s):  
3D Printing ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Cochrane Library ◽  
Control Group ◽  
Total Hip ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty

Abstract Background This study investigates whether three-dimensional (3D) printing-assisted revision total hip/knee arthroplasty could improve its clinical and radiological outcomes and assess the depth and breadth of research conducted on 3D printing-assisted revision total hip and knee arthroplasty. Methods A literature search was carried out on PubMed, Web of Science, EMBASE, and the Cochrane Library. Only studies that investigated 3D printing-assisted revision total hip and knee arthroplasty were included. The author, publication year, study design, number of patients, patients’ age, the time of follow-up, surgery category, Coleman score, clinical outcomes measured, clinical outcomes conclusion, radiological outcomes measured, and radiological outcomes conclusion were extracted and analyzed. Results Ten articles were included in our review. Three articles investigated the outcome of revision total knee arthroplasty, and seven investigated the outcome of revision total hip arthroplasty. Two papers compared a 3D printing group with a control group, and the other eight reported 3D printing treatment outcomes alone. Nine articles investigated the clinical outcomes of total hip/knee arthroplasty, and eight studied the radiological outcomes of total hip/knee arthroplasty. Conclusion 3D printing is being introduced in revision total hip and knee arthroplasty. Current literature suggests satisfactory clinical and radiological outcomes could be obtained with the assistance of 3D printing. Further long-term follow-up studies are required, particularly focusing on cost-benefit analysis, resource availability, and, importantly, the durability and biomechanics of customized prostheses using 3D printing compared to traditional techniques.

Artificial intelligence and surgical innovation: lower limb arthroplasty

2020 ◽  
Vol 81 (10) ◽  
pp. 1-7
Author(s):  
AA Magan ◽  
B Kayani ◽  
JS Chang ◽  
M Roussot ◽  
P Moriarty ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Knee Arthroplasty ◽  
Lower Limb ◽  
Computer Assisted Surgery ◽  
Later Life ◽  
Computer Assisted ◽  
Surgical Innovation ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty ◽  
Total Knee

The number of patients requiring hip and knee arthroplasty continues to rise each year. Patients are living longer and expecting to remain active into later life following joint replacement. Developments in computer-assisted surgery and robotic technology may optimise surgical outcomes and patient satisfaction following lower limb arthroplasty. The use of artificial intelligence in healthcare is rapidly growing and has gained momentum in lower limb arthroplasty. This article reviews the use of artificial intelligence and surgical innovation in lower limb arthroplasty, with a particular focus on robotic-assisted surgery in total knee arthroplasty.

Evaluation of the early mobilization effectiveness after total knee and hip artroplasty

2020 ◽  
Author(s):  
Igor Ezhov ◽  
Andrey Abramenkov ◽  
Nusratillo Sotvoldiev
Keyword(s):  
Knee Arthroplasty ◽  
Early Mobilization ◽  
High Tech ◽  
Breathing Exercises ◽  
Early Activation ◽  
Number Of Patients ◽  
Hospitalization Period ◽  
Hip And Knee Arthroplasty ◽  
Total Knee

As a result of the introduction of early mobilization, it was possible to achieve early activation of patients, which includes breathing exercises, verticalization and early activation of the operated limb. The introduction of the method of early activation of patients after hip and knee arthroplasty operations allows to achieve a statistically significant reduction of the hospitalization period and allows to provide qualified high-tech assistance medical help to a greater number of patients.

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