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Knee Exam

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341. Midterm Effect of Mental Factors on Pain, Function, and Patient Satisfaction 5 Years After Uncomplicated Total Knee Arthroplasty. Full Text available with Trip Pro

Midterm Effect of Mental Factors on Pain, Function, and Patient Satisfaction 5 Years After Uncomplicated Total Knee Arthroplasty. The effects of psychological factors on the short-term outcome after uncomplicated total knee arthroplasty (TKA) have been described in several studies. However, the effects of mental factors on the midterm (5-year) outcome have not been described in the literature. This study was performed to examine the influence of pain catastrophizing, anxiety, depression (...) the Knee Injury and Osteoarthritis Outcome Score and patient satisfaction. Intergroup differences were tested using an independent t-test. Odds ratios were calculated to determine the probability of an unsatisfactory outcome.At the 5-year follow-up, only depressive symptoms and somatization dysfunction had a significant effect on postoperative pain (numerical rating scale score). This significant effect was also observed for the different Knee Injury and Osteoarthritis Outcome Score subscales

2019 Journal of Arthroplasty

342. Vancomycin-Gentamicin Prefabricated Spacers in 2-Stage Revision Arthroplasty for Chronic Hip and Knee Periprosthetic Joint Infection: Insights Into Reimplantation Microbiology and Outcomes. Full Text available with Trip Pro

. The associations of second-stage positive cultures with treatment failures and patient-associated factors were analyzed.We conducted a retrospective cohort study, examining patients managed with 2-stage revision arthroplasty due to knee or hip chronic periprosthetic joint infection between 2010 and 2017. Prefabricated vancomycin-gentamicin cement spacers were used during the spacer stage. Intraoperative microbiological culture results after the first and second stages were evaluated. The primary end point (...) Vancomycin-Gentamicin Prefabricated Spacers in 2-Stage Revision Arthroplasty for Chronic Hip and Knee Periprosthetic Joint Infection: Insights Into Reimplantation Microbiology and Outcomes. Second-stage positive cultures in 2-stage revision arthroplasty are a matter of concern, as their influence in outcomes is not clearly defined. We sought to study reimplantation microbiology when using vancomycin-gentamicin prefabricated cement spacers in hip and knee periprosthetic joint infection

2019 Journal of Arthroplasty

343. Surgeon Mean Operative Times in Total Knee Arthroplasty in a Variety of Settings in a Health System. (Abstract)

Surgeon Mean Operative Times in Total Knee Arthroplasty in a Variety of Settings in a Health System. High-quality care is essential in total joint arthroplasty. Multiple initiatives such as centers of excellence, patient optimization, and alternative payment models have demonstrated improved outcomes and decreased cost. Many studies have shown that longer operative times (OTs) are associated with increased frequency of postoperative complications. These findings often come from large data sets (...) and may not accurately represent the average OT of individual surgeons. The purpose of this study was to determine the hospital and patient-related factors that influence OT.This retrospective study reviewed OT of 6003 total knee arthroplasty cases performed by 41 surgeons at 4 hospitals in a single health-care system. Mean OT was calculated for each surgeon. The effect of surgeon, hospital-, and patient-related factors on OT was assessed.Among the 41 surgeons, the mean OT was 105 ± 25 minutes. Two

2019 Journal of Arthroplasty

344. Bilateral Simultaneous vs Staged Total Knee Arthroplasty: Minimal Difference in Perioperative Risks. Full Text available with Trip Pro

Bilateral Simultaneous vs Staged Total Knee Arthroplasty: Minimal Difference in Perioperative Risks. With the rising utilization of total joint arthroplasty, the role of simultaneous-bilateral surgery will have an expanding impact. The purpose of this study is to examine the risks of perioperative complications with this approach in total knee arthroplasty (TKA), to inform shared decision-making.We reviewed national hospital discharge data from 2005 to 2014 to compare outcomes between (...) simultaneous-bilateral TKAs (sim-BTKAs) and staged-bilateral TKAs (staged-BTKAs). Hierarchical logistic regression analyses were used to adjust for confounders. Outcomes analyzed included mortality, various medical complications, knee infection, and mechanical complications.This study analyzed 27,301 sim-BTKAs and 45,419 staged-BTKAs. Patients who underwent simultaneous surgery had a statistically significant higher adjusted odds of mortality, cardiac events, thromboembolic events, and complications

2019 Journal of Arthroplasty

345. Tibial Tubercle Osteotomy vs the Extensile Medial Parapatellar Approach in Revision Total Knee Arthroplasty: Is Tibial Tubercle Osteotomy a Harmful Approach? (Abstract)

with a ROM above 60°. The TTO approach was applied to patients with knee flexion limited to 0°-30°. We clinically assessed knee ROM, Knee Society scores, and Hospital for Special Surgery scores at the time of the last follow-up. We radiographically measured femorotibial alignment and patellar height. We also examined the complication rates. The average length of the TTO was 1.0 × 2.5 cm × 10 cm. We used 3 or more 3.5-mm half-threaded screws.The mean postoperative ROM of the knee joint at the time (...) Tibial Tubercle Osteotomy vs the Extensile Medial Parapatellar Approach in Revision Total Knee Arthroplasty: Is Tibial Tubercle Osteotomy a Harmful Approach? As the frequency of total knee arthroplasty (TKA) is increasing, long-term follow-up of patients has become essential, and the frequency of revision total knee arthroplasty (R-TKA) due to the occurrence of various complications has also increased. There is controversy regarding which approach has minimal complications and an adequate

2019 Journal of Arthroplasty

346. Activity Impairment and Work Productivity Loss After Total Knee Arthroplasty: A Prospective Study. (Abstract)

Activity Impairment and Work Productivity Loss After Total Knee Arthroplasty: A Prospective Study. Total knee arthroplasty (TKA) is increasingly performed among working-aged individuals, highlighting the importance of work-related outcomes. Therefore, the aim is to examine the extent of both activity impairment outside work and work productivity (absenteeism, presenteeism, at-work productivity loss) at 6 and 24 months post-TKA surgery. Additionally, associated risk factors with these outcomes (...) age, gender, education, pain catastrophizing, pain, function, psychological distress, and knee-related and health-related quality of life. Linear and logistic regression was used to assess associations between covariates and Work Productivity and Activity Impairment scores at follow-up.At 6 months, the mean activity impairment was 22.8% (standard deviation [SD] 23.5) dropping to 17.1% (23.1) by 24 months. Among workers, presenteeism was 18.4% (24.6) and at-work productivity loss was 20.8% (26.1

2019 Journal of Arthroplasty

347. Impact of Resilience on Outcomes of Total Knee Arthroplasty. (Abstract)

Impact of Resilience on Outcomes of Total Knee Arthroplasty. Resilience, defined as the ability to bounce back from stress, has been suggested as a predictor of surgical outcomes. The purpose of this study is to examine the relationship between resilience and patient-reported outcomes following primary elective total knee arthroplasty (TKA). We hypothesized that patients exhibiting greater preoperative resilience would report better outcome scores.A prospective cohort of 153 patients (74 male (...) , 79 female) undergoing primary elective TKA completed questionnaires preoperatively and at 3 and 12 months following their index procedure. The validated Brief Resilience Scale was used to evaluate resilience. Hierarchical multiple linear regression was used to analyze the effect of resilience on KOOS-JR (Knee Injury and Osteoarthritis Outcome Score JR) and PROMIS-10 (Patient-Reported Outcomes Measurement Information System) outcome scores.At 12 months, the change in the coefficient

2019 Journal of Arthroplasty

348. The Influence of Preoperative Radiographic Patellofemoral Degenerative Changes and Malalignment on Patellofemoral-Specific Outcome Scores Following Fixed-Bearing Medial Unicompartmental Knee Arthroplasty. (Abstract)

The Influence of Preoperative Radiographic Patellofemoral Degenerative Changes and Malalignment on Patellofemoral-Specific Outcome Scores Following Fixed-Bearing Medial Unicompartmental Knee Arthroplasty. There is controversy as to whether the presence of degenerative changes and malalignment of the patellofemoral joint is a contraindication to medial unicompartmental knee arthroplasty. Therefore, the aim of the present study was to examine the influence of preoperative radiographic (...) patellofemoral joint osteoarthritis and alignment on intermediate-term knee and patellofemoral joint-specific patient-reported outcomes following fixed-bearing medial unicompartmental knee arthroplasty.We performed a retrospective review of the records on a consecutive series of patients who had undergone robotic arm-assisted fixed-bearing onlay medial unicompartmental knee arthroplasty and had a minimum duration of follow-up of 2 years. All records were collected from a single surgeon's arthroplasty

2019 The Journal of Bone and Joint Surgery. American Volume

349. The Effect of Surgeon Preference for Selective Patellar Resurfacing on Revision Risk in Total Knee Replacement: An Instrumental Variable Analysis of 136,116 Procedures from the Australian Orthopaedic Association National Joint Replacement Registry. (Abstract)

The Effect of Surgeon Preference for Selective Patellar Resurfacing on Revision Risk in Total Knee Replacement: An Instrumental Variable Analysis of 136,116 Procedures from the Australian Orthopaedic Association National Joint Replacement Registry. The optimum strategy regarding resurfacing the patella in total knee replacement (TKR) remains debated, with wide national and international variability. To minimize the confounders of a direct comparison of cases with or without resurfacing, we (...) performed an instrumental variable analysis examining revision risk on the basis of surgeon preference for patellar resurfacing in TKR, specifically examining the subsequent patellar revision risk and all-cause revision risk among cases of surgeons preferring to perform resurfacing on a selective basis compared with those whose preference is to routinely resurface or who infrequently perform resurfacing.Data from the Australian Orthopaedic Association National Joint Replacement Registry from 1999

2019 The Journal of Bone and Joint Surgery. American Volume

350. Peritoneal Dialysis Does Not Carry the Same Risk as Hemodialysis in Patients Undergoing Hip or Knee Arthroplasty. (Abstract)

Peritoneal Dialysis Does Not Carry the Same Risk as Hemodialysis in Patients Undergoing Hip or Knee Arthroplasty. Dialysis has been associated with increased complication rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The current literature on this issue is limited and does not distinguish between hemodialysis and peritoneal dialysis. The purpose of this study was to determine (1) the differences in the infection and other complication rates after THA or TKA (...) were not receiving either form of dialysis. Multivariate regression analysis was performed to examine several adverse events, including the prevalence of infection at 1 year and hospital readmission at 30 days.The infection rates at 1 year after THA were significantly lower in the peritoneal dialysis group than in the hemodialysis group: 1.57% (95% confidence interval [CI] = 0.7% to 3.0%) and 4.20% (95% CI = 2.7% to 6.2%), respectively, with an odds ratio (OR) of 0.30 (95% CI = 0.12 to 0.71

2019 The Journal of Bone and Joint Surgery. American Volume

351. Efficacy, Safety, and Tolerability of ONO-4474, an Orally Available Pan-Tropomyosin Receptor Kinase Inhibitor, in Japanese Patients With Moderate to Severe Osteoarthritis of the Knee: A Randomized, Placebo-Controlled, Double-Blind, Parallel-Group Comparat Full Text available with Trip Pro

Efficacy, Safety, and Tolerability of ONO-4474, an Orally Available Pan-Tropomyosin Receptor Kinase Inhibitor, in Japanese Patients With Moderate to Severe Osteoarthritis of the Knee: A Randomized, Placebo-Controlled, Double-Blind, Parallel-Group Comparat We examined the efficacy, safety, and tolerability of ONO-4474 in Japanese patients with osteoarthritis (OA) of the knee. In this multicenter, placebo-controlled, randomized, double-blind, parallel-group comparative study, patients (...) with moderate to severe OA who were refractory to nonsteroidal anti-inflammatory drugs were orally administered 100 mg of ONO-4474 twice daily for 28 days. The primary end point was knee pain during walking, assessed by visual analog scale over 24 hours (VAS24 ). Treatment-emergent adverse events (TEAEs) and adverse drug reactions were reported for safety. In total, 110 patients were randomized (1:1) to receive placebo or ONO-4474. The mean (standard deviation) change in VAS24 scores at week 4 was -26.9

2019 Journal of clinical pharmacology Controlled trial quality: predicted high

352. The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis. (Abstract)

The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis. Transcranial direct current stimulation (tDCS) has demonstrated effectiveness in reducing clinical and experimental measures of pain in patients with chronic pain; however, research examining the mechanisms of action for the effects of tDCS has been lacking. The present study investigated the effect of active tDCS on measures of inflammation (...) and stress. Older adults (aged 50-70 years) with knee osteoarthritis (OA) were randomly assigned to receive daily 20-min sessions of either tDCS (n = 20) or sham tDCS (n = 20) for 5 consecutive days. Participants provided blood samples at baseline and the end of treatment. The following measures of immune function and stress were collected: interleukin (IL)-6 and 10, tumor necrosis factor-α (TNF-α), C-reactive protein, cortisol, and β-endorphin. Generalized linear modeling evaluated each posttreatment

2019 Biological research for nursing Controlled trial quality: uncertain

353. Densitometric changes of the patella in patients undergoing unilateral knee arthroplasty. (Abstract)

Densitometric changes of the patella in patients undergoing unilateral knee arthroplasty. Although the intervention of knee arthroplasty became routine, there is no standard reference on the densitometric characteristics of the patella before and after surgery. Scope of this work is the evaluation of patellar bone density before and after unilateral knee arthroplasty.BMD was assessed by DEXA examination in 146 individuals, who have been divided into three distinct groups. Group I: 68 subjects (...) with a mean age of 70.6 years, with an unilateral femoral-tibial knee prothesis. Group II: healthy subjects of similar age (average: 64) and without implants. Group III: healthy adults with a mean age of 26.6 years. The follow-up was performed at 6 months to a maximum of 2 years post surgery.The results were obtained from 68 subjects examined with the DEXA software dedicated to the forearm, which turned out to be the most appropriate for our purpose. The follow-up performed every 6 months after surgery

2019 Il Giornale di chirurgia Controlled trial quality: uncertain

354. Gene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial. (Abstract)

on gene expression within the human skeletal muscle cells are barely examined. The purpose of the present study was to analyze the gene expression within the skeletal muscle cells after tourniquet-induced ischemia to identify differential expressed genes (DEGs) and pathways.As part of a randomized, controlled, monocentric trial (Clinical-Trials.gov NCT02475603) 20 patients, scheduled to undergo primary total knee arthroplasty (TKA), were included. Written informed consent was received and the patients (...) Gene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial. Postoperative quadriceps muscle strength was lowered after tourniquet application during total knee arthroplasty (TKA). Furthermore, tourniquet application results in higher proteolytic activity within vastus medialis cells, without influence on the amount and function of mitochondria. The effects of the commonly utilized intraoperative tourniquet

2019 European journal of trauma and emergency surgery : official publication of the European Trauma Society Controlled trial quality: uncertain

355. Stair climbing ability in patients with early knee osteoarthritis: Defining the clinical hallmarks of early disease. (Abstract)

the SCT is better than ascending stair time for the identification of these patients.This study was a secondary, cross-sectional analysis of baseline data from a randomized controlled trial. Adults with moderate to severe knee pain were enrolled (n = 57; mean age 58.9 years; 71.9% women). Each participant performed an 11-step SCT (11-SCT) while wearing shoes with a pressure sensor insole. A receiver operating characteristic analysis was used to examine the discriminative power of 11-SCT (...) Stair climbing ability in patients with early knee osteoarthritis: Defining the clinical hallmarks of early disease. A growing clinical interest has been shown towards identifying knee osteoarthritis (OA) patients at earlier stages. The early detection of knee OA may allow for more effective interventions.The aim of this study was to determine the discriminative ability of a stair-climb test (SCT) in identifying patients with early knee OA, and to determine if descending stair time during

2019 Gait & posture Controlled trial quality: uncertain

356. Role of the PERK-eIF2<i>α</i>-CHOP Signaling Pathway in the Effect of Needle Knife Therapy on Knee Joint Chondrocyte Apoptosis. Full Text available with Trip Pro

knee joint chondrocyte apoptosis. Apoptosis and ultrastructural changes in the articular cartilage were examined by pathological study and transmission electron microscopy, and PERK, eIF2α, and CHOP mRNA and protein levels were detected by qRT-PCR and western blot, respectively. PERK, eIF2α, and CHOP protein levels were significantly higher in the model group than in the normal group (P < 0.01) and were considerably downregulated in the needle knife and the medicine groups compared to the model (...) Role of the PERK-eIF2α-CHOP Signaling Pathway in the Effect of Needle Knife Therapy on Knee Joint Chondrocyte Apoptosis. Needle knife therapy, a form of acupuncture and moxibustion, has been widely used in the clinical treatment of knee osteoarthritis (KOA). However, the mechanism is not clear. Therefore, we studied the mechanisms of action of needle knife intervention on KOA in rabbits, with the PERK-eIF2α-CHOP pathway as a starting point, in order to determine the mechanism underlying

2019 Evidence-based Complementary and Alternative Medicine (eCAM)

357. A Double-Blind, Randomized Controlled 12-Week Follow-Up Trial to Evaluate the Efficacy and Safety of Polycan in Combination with Glucosamine for the Treatment of Knee Osteoarthritis. Full Text available with Trip Pro

A Double-Blind, Randomized Controlled 12-Week Follow-Up Trial to Evaluate the Efficacy and Safety of Polycan in Combination with Glucosamine for the Treatment of Knee Osteoarthritis. The aim of the present study was to examine the efficacy and safety of Polycan, a β-glucan produced from the black yeast Aureobasidium pullulans SM-2001, in combination with glucosamine in reducing knee osteoarthritis-associated symptoms.This was a double-blind, randomized controlled trial of a formulated product

2019 Evidence-based Complementary and Alternative Medicine (eCAM) Controlled trial quality: predicted high

358. Psychosocial Factors and Knee Pain among Older People in Japan: The JAGES Cross-sectional Study. (Abstract)

municipalities to collect cross-sectional data. Functionally independent community-dwelling adults aged ≥65 (n=26,037) were eligible for the study. Self-reported knee pain in the past year was used as the dependent variable. Past occupation and equivalized household income were separately added to the models as independent variables. Poisson regression analysis was used to examine the associations between SES and knee pain, adjusting for covariates. Mediation analysis was applied to estimate how depression (...) Psychosocial Factors and Knee Pain among Older People in Japan: The JAGES Cross-sectional Study. Psychosocial factors are known to affect knee pain. However, the magnitude of depression on the associations between socioeconomic status (SES) and knee pain in older individuals remains unknown. This study aimed to determine (1) the associations between SES and knee pain and (2) how depression mediates the associations between SES and knee pain.We conducted a survey across 30 Japanese

2019 Clinical Journal of Pain

359. Clinical Course and Impact of Complex Regional Pain Syndrome Confined to the Knee. (Abstract)

-center study.Patients with CRPS of the knee.Patients self-reported their past and current CRPS symptoms, HR-QoL, and work status; all underwent a physical examination. A comparison was made of changes in symptoms over time between patients with CRPS of the knee and those with CRPS of more distal locations.In total, 32 patients were enrolled. The follow-up time was 11.5 ± 6.29 years since diagnosis, and symptoms and signs showed a significant decrease over time. Twelve patients (37.5%) rated (...) Clinical Course and Impact of Complex Regional Pain Syndrome Confined to the Knee. Although complex regional pain syndrome (CRPS) of the knee is comparable to CRPS of the ankle/foot at time of diagnosis, no reports are available concerning the course of knee CRPS. Therefore, this study investigated the clinical course in terms of the symptoms and signs, health-related quality of life (HR-QoL), and work status of patients diagnosed with CRPS of the knee.Observational, descriptive study.Single

2019 Pain Medicine

360. The effect of morphine added to periarticular multimodal drug injection or spinal anesthesia on pain management and functional recovery after total knee arthroplasty. (Abstract)

The effect of morphine added to periarticular multimodal drug injection or spinal anesthesia on pain management and functional recovery after total knee arthroplasty. The efficacy of morphine added to periarticular multimodal drug injection (PMDI) for pain management after total knee arthroplasty (TKA) is controversial. Adding morphine to spinal anesthesia has reportedly improved pain relief for the first 24 h. We examined the effect of morphine added to PMDI or spinal anesthesia on pain (...) . The adverse effects of morphine were assessed by counting the numbers of times vomiting occurred and antiemetics were used. Functional recovery was evaluated by recording the range of motion of the knee and the date of ability to walk.Rest pain was the least in Group B at 6 and 12 h after operation. The number of times analgesics were used was the least in Group B. The time period until the first analgesic use was the longest in Group B. The number of vomiting episodes was the least in Group C. The number

2019 Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association Controlled trial quality: uncertain

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