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921. One-year mortality and Periprosthetic infection rates after Total knee Arthroplasty in Cancer patients: a population-based cohort study. Full Text available with Trip Pro

One-year mortality and Periprosthetic infection rates after Total knee Arthroplasty in Cancer patients: a population-based cohort study. Knowledge on periprosthetic infection and mortality rate following total knee arthroplasty (TKA) is essential for justifying this treatment in patients with cancer; however, relevant data from population-based studies are lacking. Therefore, we examined 1-year periprosthetic infection, mortality, and 5-year relative survival rates in cancer patients who (...) underwent TKA.This is a population-based cohort study based on analysis of the Taiwan National Health Insurance Research Database. We enrolled a total of 2294 cancer patients and 131,849 patients without cancer (control group) who underwent TKA between January 1, 1997, and December 31, 2011. All patients were followed until death, infection, withdrawal from the National Health Insurance, or December 31, 2012.The periprosthetic knee joint infection rate in cancer patients (1.73%) was not significantly

2018 BMC Cancer

922. Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function. (Abstract)

Combined distal femoral osteotomy (DFO) in genu valgum leads to reliable patellar stabilization and an improvement in knee function. Valgus deformities of the lower extremity influence patellofemoral joint kinematics. However, studies examining the clinical outcome after treatment of patellar instability and maltracking due to valgus deformity are rare in recent literature. This study's purpose is to analyze the clinical results after combined distal femoral osteotomy (DFO) for treatment (...) ), apprehension sign, Zohlen sign, and J-sign were physically examined. Pain level and knee function were objectified on a visual analogue scale (VAS). The Lysholm, Kujala, and Tegner scores, re-dislocation rate, and patient satisfaction were also examined.20 combined DFOs on 18 patients with a median age of 23 years (15-55 years) were performed. The preoperative mechanical leg axis was 6.5° ± 2.0° valgus, and the mean tibial tuberosity to trochlear groove (TT-TG) distance was 19.1 ± 4.8 mm. All patients

2018 Knee Surgery, Sports Traumatology, Arthroscopy

923. Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis. Full Text available with Trip Pro

Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis. The social impact of degenerative diseases is steadily increasing, because of the continued rise in the mean age of the active population. Articular cartilage lesions are generally associated with disability and symptoms such as joint pain and reduced function, and remain a challenge for the orthopaedic surgeon. Several non-invasive solution have been proposed (...) , but the results achieved to date are far from being completely satisfactory. Recently, new therapeutic approaches, such as the use of mesenchymal stem cells, have been developed. Among the many sources, the adipose tissue is nowadays considered one of the smartest, due to its abundance and easy access. The aim of this retrospective study is to explore whether patients affected by symptomatic knee osteoarthritis treated with micro-fragmented adipose tissue associated with a chondral shaving procedure

2018 BMC Musculoskeletal Disorders

924. Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees. Full Text available with Trip Pro

treatment of an isolated cartilage knee injury and (b) to evaluate the predictive value of dGEMRIC. Patients and methods - 16 knees with an isolated traumatic cartilage injury of the medial femoral condyle had cartilage repair surgery either by microfracture or autologous cartilage implantation. dGEMRIC of the injured knee was performed 2 years after surgery and radiographic examinations were performed 17 years after the operation. Results - Radiographic OA was present in 12 of 16 knees. Irrespective (...) Poor outcome after a surgically treated chondral injury on the medial femoral condyle: early evaluation with dGEMRIC and 17-year radiographic and clinical follow-up in 16 knees. Background and purpose - The optimal treatment for traumatic cartilage injuries remains unknown. Contrast-enhanced MRI of cartilage (dGEMRIC) evaluates cartilage quality and a low dGEMRIC index may predict radiographic osteoarthritis (OA). The purpose of this study was (a) to explore the results 17 years after surgical

2018 Acta Orthopaedica

925. Favourable long-term functional and radiographical outcome after osteoautograft transplantation surgery of the knee: a minimum 10-year follow-up. (Abstract)

- and postoperative cartilage changes were estimated based on standardised radiographs. The extent of osteoarthritis (OA) was graded according to the Kellgren-Lawrence scale. Clinical outcomes were evaluated with the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire.A total of 60 patients (64 knees) with a median age of 30 years (range 14-62) were included. The median follow-up was 140 months (range 47-205). Of the 64 knees examined, 14 (22%) had a traumatic chondral lesion and 50 (78%) had (...) Favourable long-term functional and radiographical outcome after osteoautograft transplantation surgery of the knee: a minimum 10-year follow-up. The aim of this study was to assess the progression of radiological cartilage changes and to document the functional, long-term results during a follow-up of 10 years after osteoautograft transplantation (OAT) knee surgery.The study was a retrospective analysis of all patients who underwent OAT at Turku University Hospital from 1999 to 2007. Pre

2018 Knee Surgery, Sports Traumatology, Arthroscopy

926. Primary Hip and Knee Arthroplasty in a Safety Net Hospital: Substance Abuse and Other Factors Affecting Short-term Complications. (Abstract)

Primary Hip and Knee Arthroplasty in a Safety Net Hospital: Substance Abuse and Other Factors Affecting Short-term Complications. Arthroplasty outcomes and patient risk factors have not been studied in detail in safety net hospital settings. This study examines the relationship between selected risk factors and short-term complications in such a population, including a large subgroup with treated substance abuse.This retrospective cohort study contains 486 consecutive patients after primary hip (...) and knee arthroplasty. One hundred three of these had a history of substance abuse and completed a 1-year sobriety pathway preoperatively. Primary outcomes included the presence of any complication, deep infection, and reoperation. Bivariable analyses were used to compare outcomes with demographic and health risk factors. A multivariate analysis was performed to identify independent risk factors.Adverse outcomes were more common in patients with higher rates of substance abuse, mental illness

2018 Journal of Arthroplasty

927. Outcomes and early revision rate after medial unicompartmental knee arthroplasty: prospective results from a non-designer single surgeon. Full Text available with Trip Pro

assessment and radiological evaluation. 91 patients had extended clinical outcomes. Post-operative assessment included functional scoring with the Oxford Knee Score (OKS) and radiographic review. Survivorship curves were constructed using the life-table method, with 95% confidence intervals calculated using Rothman's equation. Separate endpoints were examined: revision for any reason and revision for confirmed loosening.The mean follow-up was 3.5 years. The pre-operative OKS improved from a mean of 21.2 (...) Outcomes and early revision rate after medial unicompartmental knee arthroplasty: prospective results from a non-designer single surgeon. This prospective study evaluates outcomes and reoperation rates for unicompartmental knee arthroplasty (UKA) from a single non-designer surgeon using relatively extended criteria of degenerative changes of grade 2 or above in either or both non-operated compartments.187 consecutive medial mobile bearing UKA implants were included after history, clinical

2018 BMC Musculoskeletal Disorders

928. Knee dGEMRIC at 7 T: comparison against 1.5 T and evaluation of T<sub>1</sub>-mapping methods. Full Text available with Trip Pro

Knee dGEMRIC at 7 T: comparison against 1.5 T and evaluation of T1-mapping methods. dGEMRIC (delayed Gadolinium Enhanced Magnetic Resonance Image of Cartilage) is a well-established technique for cartilage quality assessment in osteoarthritis at clinical field strengths. The method is robust, but requires injection of contrast agent and a cumbersome examination procedure. New non-contrast-agent-based techniques for cartilage quality assessment are currently being developed at 7 T (...) . However, dGEMRIC remains an important reference technique during this development. The aim of this work was to compare T1 mapping for dGEMRIC at 7 T and 1.5 T, and to evaluate three T1-mapping methods at 7 T.The knee of 10 healthy volunteers and 9 patients with early signs of cartilage degradation were examined at 1.5 T and 7 T after a single (one) contrast agent injection (Gd-(DTPA)2-). Inversion recovery (IR) sequences were acquired at both field strengths, and at 7 T variable flip angle (VFA

2018 BMC Musculoskeletal Disorders

929. A controlled before-after study to evaluate the effect of a clinician led policy to reduce knee arthroscopy in NSW. Full Text available with Trip Pro

for patients aged 50 years or over.Trends in rates and volume of knee arthroscopy for patients 50 years or over in NSW between 2004 and 2015 by district were examined. Changes at four hospitals that adopted the policy were assessed by a quasi-experimental before and after study design with control groups, using the generalised estimating equations (GEE) Poisson model. Each case hospital was matched with four control hospitals in terms of the volume of knee arthroscopy surgeries performed in the five years (...) A controlled before-after study to evaluate the effect of a clinician led policy to reduce knee arthroscopy in NSW. Clinical evidence shows knee arthroscopy has little benefit for degenerative conditions and considerable variation in the incidence of knee arthroscopy in Australia has been identified. This study aimed to evaluate a clinician-led evidence-based policy which was implemented in one local health district in New South Wales (NSW) in 2012 to reduce the use of knee arthroscopy

2018 BMC Musculoskeletal Disorders

930. Prospective Associations of C-Reactive Protein (CRP) Levels and CRP Genetic Risk Scores with Risk of Total Knee and Hip Replacement for Osteoarthritis in a Diverse Cohort. Full Text available with Trip Pro

Prospective Associations of C-Reactive Protein (CRP) Levels and CRP Genetic Risk Scores with Risk of Total Knee and Hip Replacement for Osteoarthritis in a Diverse Cohort. To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA.This study included a cohort of postmenopausal white, African American

2018 Osteoarthritis and Cartilage

931. The Reliability of Sensor-Assisted Soft Tissue Measurements in Primary Total Knee Arthroplasty. (Abstract)

The Reliability of Sensor-Assisted Soft Tissue Measurements in Primary Total Knee Arthroplasty. In pursuit to improve soft tissue balancing in total knee arthroplasties (TKAs), a wireless device was introduced to assess femorotibial pressures. The aim of this study was to evaluate the reliability of this device.After 33 TKAs were balanced by conventional techniques, contact pressures were measured using a wireless sensor 3 times in a row; twice while the examiner was blinded for the result (n (...)  = 29); and once while the examiner was able to see the result as visual feedback (n = 32). Femorotibial pressures were measured in the medial and lateral compartments with the knee in 10°, 45°, and 90° of flexion (6 measurements per TKA). Furthermore, both the combined pressure and the difference in pressure between the compartments was calculated throughout the 3 positions (together another 6 measurements per TKA).The intraclass correlation coefficient between the blind measurements was poor in 2

2018 Journal of Arthroplasty

932. Associations between the chemokine biomarker CCL2 and knee osteoarthritis outcomes: The Johnston County Osteoarthritis Project. Full Text available with Trip Pro

. Baseline CCL2 serum concentrations were assessed by multiplex assay and associated with presence or progression of individual radiographic features at 5-year follow-up. Separate multiple logistic regression models were used to examine adjusted associations between baseline CCL2 and each of the knee OA variables at follow-up. CCL2 at baseline was modeled as an explanatory variable, whereas each of the knee OA variables at follow-up served as the response variables. Models were adjusted for age, BMI (...) Associations between the chemokine biomarker CCL2 and knee osteoarthritis outcomes: The Johnston County Osteoarthritis Project. Our study analyzes the association between chemokine-ligand-2 (CCL2) serum concentrations at baseline and knee radiographic osteoarthritis (OA) (knee-rOA), knee-rOA progression, individual radiographic features and knee symptomatic OA at 5-year follow-up.OA outcomes were analyzed in a community-based cohort including a baseline enrollment and a 5-year follow-up

2018 Osteoarthritis and Cartilage

933. Subchondral Bone Circulation in Osteoarthritis of the Human Knee. Full Text available with Trip Pro

to examine initial uptake and washout of the contrast agent in the lateral tibial plateau.Arterial and venous perfusion kinetics were abnormal in subchondral OA bone compared to those of normal controls. Time-intensity curves (TIC) exhibited delayed contrast clearance in OA knees compared to normal. Quantitatively, changes were observed in the kinetic parameters, kep, Akep, and kel. The mean kep and Akep were reduced in OA, compared to normal bone, indicating a reduction of arterial inflow and delayed (...) Subchondral Bone Circulation in Osteoarthritis of the Human Knee. The hypothesis of this study is that human subchondral bone exhibits abnormal patterns of perfusion in osteoarthritis (OA) that can be characterized by kinetic parameters of blood flow using dynamic contrast enhanced (DCE) MRI.Fifteen subjects with advanced OA of the knee and seven control subjects without OA were studied at 1.5 T with DCE-MRI. Region of interest (ROIs) analysis of pharmacokinetic perfusion parameters were used

2018 Osteoarthritis and Cartilage

934. Level of participation in physical therapy or an internet-based exercise training program: associations with outcomes for patients with knee osteoarthritis. Full Text available with Trip Pro

Level of participation in physical therapy or an internet-based exercise training program: associations with outcomes for patients with knee osteoarthritis. To examine whether number of physical therapy (PT) visits or amount of use of an internet-based exercise training (IBET) program is associated with differential improvement in outcomes for participants with knee osteoarthritis (OA).A secondary analysis was performed using data from participants in 2 arms of a randomized control trial (...) for individuals with symptomatic knee OA: PT (N = 135) or IBET (N = 124). We examined associations of number of PT visits attended (up to 8) or number of days the IBET website was accessed during the initial 4-month study period with changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, pain and function subscales, as well as a 2-min Step Test, at 4-month and 12-month follow-up.Participants with more PT visits experienced greater improvement in WOMAC total score (estimate

2018 BMC Musculoskeletal Disorders

935. The Association Between Daily Physical Activity and Pain Among Patients with Knee Osteoarthritis: The Moderating Role of Pain Catastrophizing. Full Text available with Trip Pro

The Association Between Daily Physical Activity and Pain Among Patients with Knee Osteoarthritis: The Moderating Role of Pain Catastrophizing. The primary objective of this study was to examine the day-to-day association between physical activity and pain intensity among a sample of patients with knee osteoarthritis (KOA) and the potential moderation of this association by negative cognitive processes.In this micro-longitudinal daily diary study, KOA patients (N = 121) completed questionnaires (...) analyses indicated that day-to-day increases in physical activity were associated with heightened levels of pain intensity (B = 0.13 SE = 0.03, P < 0.001). In addition, it was revealed that the association between physical activity and pain intensity was moderated by catastrophizing (B = -0.01 SE = 0.002, P < 0.05), with patients scoring higher in catastrophizing showing a relatively stronger link between day-to-day physical activity and increased knee pain. This effect was specific to catastrophizing

2018 Pain Medicine

936. Sinew acupuncture for knee osteoarthritis: study protocol for a randomized sham-controlled trial. Full Text available with Trip Pro

to examine whether sinew acupuncture can safely relieve pain and symptoms of knee osteoarthritis (KOA) and improve patients' functional movement and quality of life.A randomized, sham-controlled, patient- and assessor-blinded trial will be conducted to compare the efficacy of sinew acupuncture and sham acupuncture. Subjects will be assessed by the physician and acupuncturists. A sample of eighty-six eligible subjects will be randomized into either the sinew acupuncture group or the sham acupuncture group (...) Sinew acupuncture for knee osteoarthritis: study protocol for a randomized sham-controlled trial. Sinew acupuncture is a new modality of acupuncture in which needles are inserted into acupoints, ashi points or spasm points of sinew and muscles along the meridian sinew pathway. A previous observational study revealed that sinew acupuncture has immediate analgesic effects on various soft tissue injuries, including knee injuries. However, no rigorous trials have been conducted. This study aims

2018 BMC Complementary and Alternative Medicine Controlled trial quality: predicted high

937. Narcotics and Knee Arthroscopy: Trends in Use and Factors Associated With Prolonged Use and Postoperative Complications. (Abstract)

Narcotics and Knee Arthroscopy: Trends in Use and Factors Associated With Prolonged Use and Postoperative Complications. To (1) examine trends in the prevalence of preoperative and prolonged postoperative narcotic use in patients undergoing knee arthroscopy, (2) characterize factors associated with prolonged narcotic use after knee arthroscopy, and (3) explore the association of preoperative and prolonged postoperative narcotic use with complications after knee arthroscopy.The PearlDiver (...) database was reviewed for patients who underwent knee arthroscopy from 2007 to 2015 with a minimum of 6 months' follow up. Patients with preoperative or prolonged postoperative narcotic use were identified and analyzed for trends. Predictors for prolonged postoperative use were identified, and regression analysis was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).A total of 75,372 patients were included, of which 23.9% used narcotics preoperatively and 22.6% used narcotics

2018 Arthroscopy

938. Association of childhood adiposity measures with adulthood knee cartilage defects and bone marrow lesions: a 25-year cohort study. Full Text available with Trip Pro

) were collected in 1985. Body mass index (BMI), overweight status and fat mass were calculated. Participants underwent 1.5 T knee magnetic resonance imaging (MRI) during 2008-2010, and cartilage defects and BMLs were scored from knee MRI scans. Log binomial regressions were used to examine the associations.Among 327 participants (47.1% females), 21 (6.4%) were overweight in childhood. Childhood adiposity measures were associated with the increased risk of adulthood patellar cartilage defects (Weight (...) Association of childhood adiposity measures with adulthood knee cartilage defects and bone marrow lesions: a 25-year cohort study. To describe the associations between childhood adiposity measures and adulthood knee cartilage defects and bone marrow lesions (BMLs) measured 25 years later.327 participants from the Australian Schools Health and Fitness Survey (ASHFS) of 1985 (aged 7-15 years) were followed up 25 years later (aged 31-41 years). Childhood measures (weight, height and skinfolds

2018 Osteoarthritis and Cartilage

939. Predictors and Cost of Readmission in Total Knee Arthroplasty. Full Text available with Trip Pro

Predictors and Cost of Readmission in Total Knee Arthroplasty. The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. However, there is a lack of national representative sample of all-payer hospital admissions to direct strategy, identify risk factors for readmission, and understand actual readmission cost.We used the Nationwide Readmission Database to examine (...) national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures. We fit a multivariable logistic regression model to examine factors associated with readmission. Then, we determined mean readmission costs and calculated the readmission cost when distributed across the entire TKA population.We identified 224,465 patients having TKA across all states participating in the Nationwide Readmission Database. The mean unadjusted 30-day TKA readmission rate

2018 Journal of Arthroplasty

940. Mechanism and influencing factors of proximal fibular osteotomy for treatment of medial compartment knee osteoarthritis: A prospective study Full Text available with Trip Pro

obtained preoperatively and postoperatively. Knee function and OA severity were evaluated using the Hospital for Special Surgery (HSS) knee score and the Kellgren-Lawrence (KL) score. Multivariable linear regression models were used to examine associations between increases in the HSS score and selected factors influencing knee OA. Results Sixty-seven knee joints of 45 patients undergoing PFO were included. The HSS scores were significantly better at the final follow-up than preoperatively. Regression (...) Mechanism and influencing factors of proximal fibular osteotomy for treatment of medial compartment knee osteoarthritis: A prospective study Objectives This study was performed to explore the mechanism of proximal fibular osteotomy (PFO) for treatment of medial compartment knee osteoarthritis (OA) and evaluate the relevant factors influencing the treatment outcome. Methods Fifty-two patients with medial compartment knee OA with varus deformities were prospectively selected. Radiographs were

2018 The Journal of international medical research

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