Latest & greatest articles for knee replacement

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Top results for knee replacement

1. Technology-assisted rehabilitation following total knee or hip replacement for people with osteoarthritis: a systematic review and meta-analysis Full Text available with Trip Pro

Technology-assisted rehabilitation following total knee or hip replacement for people with osteoarthritis: a systematic review and meta-analysis Technology-assisted Rehabilitation Following Total Knee or Hip Replacement for People With Osteoarthritis: A Systematic Review and Meta-Analysis - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History (...) be less than 100 characters Choose a collection: Unable to load your collection due to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation BMC Musculoskelet Disord Actions , 20 (1), 506 2019 Nov 3 Technology-assisted Rehabilitation Following Total Knee or Hip Replacement for People With Osteoarthritis: A Systematic Review and Meta-Analysis , , , , Affiliations Expand Affiliations 1 Level

2020 EvidenceUpdates

2. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations Full Text available with Trip Pro

Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: Acta Orthopaedica: Vol 0, No 0 | Search in: Journal 6,974 Views 0 CrossRef citations to date Altmetric Articles Consensus statement for perioperative care in total (...) hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS ® ) Society recommendations , , , , , , & Published online: 30 Oct 2019 In this article Articles Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS ® ) Society recommendations Ljungqvist O , Scott M , Fearon K C . Enhanced Recovery After Surgery: a review . JAMA Surg 2017 ; 152(3): 292 – 8 . , , , ). For total hip (THR

2019 ERAS Society

3. The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial (Abstract)

The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial To assess the effects of preoperative balance training on the early postoperative balance and functional outcomes after total knee replacement surgery and to test whether an outpatient intervention may be as effective as a domiciliary intervention.This is a three-arm randomized controlled trial.University hospital.Eighty-six individuals were recruited (...) showed no between-group differences and a small effect size (d < 0.5; P = 0.937). Secondary assessments suggested non-significant between-group differences.Preoperative balance training, conducted either as domiciliary or as an outpatient, is an effective approach to enhance early postoperative balance outcome but not the perceived functionality of individuals undergoing total knee replacement.

2019 EvidenceUpdates

4. Comparison of Topical and Intravenous Tranexamic Acid for Total Knee Replacement: A Randomized Double-Blinded Controlled Study of Effects on Tranexamic Acid Levels and Thrombogenic and Inflammatory Marker Levels (Abstract)

Comparison of Topical and Intravenous Tranexamic Acid for Total Knee Replacement: A Randomized Double-Blinded Controlled Study of Effects on Tranexamic Acid Levels and Thrombogenic and Inflammatory Marker Levels Tranexamic acid (TXA) is an antifibrinolytic drug. Topical administration of TXA during total knee arthroplasty (TKA) is favored for certain patients because of concerns about thrombotic complications, despite a lack of supporting literature. We compared local and systemic levels

2019 EvidenceUpdates

5. Self-Warming Blanket Versus Forced-Air Warming in Primary Knee or Hip Replacement: A Randomized Controlled Non-Inferiority Study. (Abstract)

Self-Warming Blanket Versus Forced-Air Warming in Primary Knee or Hip Replacement: A Randomized Controlled Non-Inferiority Study. After primary total knee/hip replacement (TKR or THR respectively) a prosthetic joint infection (PJI) could develop. Hypothermia could raise the risk of infection. Heating by forced-air can disrupt laminar airfl ow in the operation room (OR), potentially raising the risk of infection. We aimed to study non-inferiority of an active self-heating blanket (SHB) compared

2019 Asian journal of anesthesiology Controlled trial quality: uncertain

6. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Full Text available with Trip Pro

The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Late-stage isolated medial knee osteoarthritis can be treated with total knee replacement (TKR) or partial knee replacement (PKR). There is high variation in treatment choice and little robust evidence to guide selection. The Total or Partial Knee Arthroplasty Trial (TOPKAT) therefore aims to assess (...) the clinical effectiveness and cost-effectiveness of TKR versus PKR in patients with medial compartment osteoarthritis of the knee, and this represents an analysis of the main endpoints at 5 years.Our multicentre, pragmatic randomised controlled trial was done at 27 UK sites. We used a combined expertise-based and equipoise-based approach, in which patients with isolated osteoarthritis of the medial compartment of the knee and who satisfied general requirements for a medial PKR were randomly assigned (1:1

2019 Lancet Controlled trial quality: predicted high

7. Addition of Adductor Canal Block to Periarticular Injection for Total Knee Replacement: A Randomized Trial (Abstract)

Addition of Adductor Canal Block to Periarticular Injection for Total Knee Replacement: A Randomized Trial Periarticular injection is a popular method to control postoperative pain after total knee replacement. An adductor canal block is a sensory block that can also help to alleviate pain after total knee replacement. We hypothesized that the combination of adductor canal block and periarticular injection would allow patients to reach discharge criteria 0.5 day faster than with periarticular

2019 EvidenceUpdates

8. Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up (Abstract)

Radiofrequency ablation of genicular nerves prior to total knee replacement has no effect on postoperative pain outcomes: a prospective randomized sham-controlled trial with 6-month follow-up Refractory chronic knee pain from osteoarthritis (OA) is commonly treated with total knee arthroplasty (TKA). TKA can be associated with severe postoperative pain and persistent postsurgical knee pain. Poorly controlled postoperative pain can negatively effect functional outcomes following TKA (...) , and effective opioid-sparing analgesia is key to the ideal recovery. Genicular nerve radiofrequency ablation (GN-RFA) has been shown in several trials to be clinically effective in patients with severe refractory knee pain from OA. We aimed to assess if preoperative GN-RFA would improve postoperative pain outcomes following TKA.This was a sham-control prospective clinical trial in which blinded participants were randomized to image-guided GN-RFA or a simulated sham procedure 2-6 weeks prior to elective TKA

2019 EvidenceUpdates

9. Diagnostic Accuracy of Serum, Synovial, and Tissue Testing for Chronic Periprosthetic Joint Infection After Hip and Knee Replacements: A Systematic Review (Abstract)

Diagnostic Accuracy of Serum, Synovial, and Tissue Testing for Chronic Periprosthetic Joint Infection After Hip and Knee Replacements: A Systematic Review Chronic periprosthetic joint infection (PJI) is a devastating complication that can occur following total joint replacement. Patients with chronic PJI report a substantially lower quality of life and face a higher risk of short-term mortality. Establishing a diagnosis of chronic PJI is challenging because of conflicting guidelines, numerous (...) involving the diagnosis of chronic PJI in patients with hip or knee replacement. Eligible studies were assessed for quality and bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Meta-analyses were performed on tests with sufficient data points. Summary estimates and hierarchical summary receiver operating characteristic (HSROC) curves were obtained using a bivariate model.A total of 12,616 citations were identified, and 203 studies met the inclusion criteria

2019 EvidenceUpdates

10. Perioperative Dietary Restriction of Carbohydrates in the Management of Blood Glucose Levels in Patients Undergoing Total Knee Replacement (Abstract)

Perioperative Dietary Restriction of Carbohydrates in the Management of Blood Glucose Levels in Patients Undergoing Total Knee Replacement Approximately 75% of the US population over 65 years has prediabetes or diabetes. Despite current evidence for the efficacy of carbohydrate restriction in managing blood glucose, this practice has not been implemented as part of routine perioperative blood sugar management. We hypothesize that a carbohydrate reduced hospital diet (CRD) of 135 g/d may improve (...) blood sugar levels following total knee arthroplasty (TKA) compared to a non-carbohydrate reduced hospital diet (NCRD).We randomized non-insulin-dependent prediabetic and diabetic patients undergoing TKA to either an NCRD or a CRD. Sixty-four patients were enrolled in the study and 2 were excluded, leading to 62 patients in the final analysis. The NCRD group included 14 females (47%) and 16 males (53%), with mean age of 68.5 years (±6.3 years). The CRD group included 16 females (50%) and 16 males

2019 EvidenceUpdates

11. Effectiveness of Later-Stage Exercise Programs vs Usual Medical Care on Physical Function and Activity After Total Knee Replacement: A Randomized Clinical Trial Full Text available with Trip Pro

Effectiveness of Later-Stage Exercise Programs vs Usual Medical Care on Physical Function and Activity After Total Knee Replacement: A Randomized Clinical Trial Several functional limitations persist after total knee replacement (TKR). Intensive exercise programs could resolve these limitations but are not well tolerated by many patients until a later stage (>2 months) after surgery. Evidence for exercise at a later stage after TKR is limited.To compare the effectiveness of later-stage exercise (...) germane to knee replacement and additional surveys of physical function. Data were analyzed by linear mixed models and responder analysis.A total of 240 participants (mean [SD] age, 70 [7] years; 61.7% female) were allocated to physical therapy (n = 96), community exercise (n = 96), or control (n = 48). All 3 arms demonstrated clinically important improvement. At 3 months, between-arm analyses for the WOMAC-PF demonstrated no differences between physical therapy and community (-2.2; 98.3% CI, -4.5

2019 EvidenceUpdates

12. What is the evidence to support early supervised exercise therapy after primary total knee replacement? A systematic review and meta-analysis Full Text available with Trip Pro

What is the evidence to support early supervised exercise therapy after primary total knee replacement? A systematic review and meta-analysis Total knee replacement (TKR) patients participate in early supervised exercise therapy programs, despite a lack of evidence for such programs or the optimal type, duration or frequency to provide the best clinical outcomes. As hospital stay rates decrease worldwide, the first days after joint replacement surgery are of increasing clinical importance (...) postoperatively, and the Modified Quadriceps Setting group showed greater hamstring and gluteal muscle strength. Results of the methodological quality assessment showed included studies were of moderate quality. The meta-analysis included 3 of the 4 trials and found no significant differences between groups in maximum knee flexion (MD = 1.34; 95% CI, - 5.55-8.24) or knee society scores (MD = - 1.17; 95% CI, - 4.32-1.98) assessed at 6 weeks post-operatively.The paucity and heterogeneity of existing studies

2019 EvidenceUpdates

13. Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis. Full Text available with Trip Pro

Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis. To present a clear and comprehensive summary of the published data on unicompartmental knee replacement (UKA) or total knee replacement (TKA), comparing domains of outcome that have been shown to be important to patients and clinicians to allow informed decision making.Systematic review using data from randomised controlled trials, nationwide databases or joint registries, and large

2019 BMJ

14. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Full Text available with Trip Pro

How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Knee replacements are the mainstay of treatment for end-stage osteoarthritis and are effective. Given time, all knee replacements will fail and knowing when this failure might happen is important. We aimed to establish how long a knee replacement lasts.In this systematic review and meta-analysis, we searched MEDLINE and Embase for case (...) series and cohort studies published from database inception until July 21, 2018. Articles reporting 15 year or greater survival of primary total knee replacement (TKR), unicondylar knee replacement (UKR), and patellofemoral replacements in patients with osteoarthritis were included. Articles that reviewed specifically complex primary surgeries or revisions were excluded. Survival and implant data were extracted, with all-cause survival of the knee replacement construct being the primary outcome. We

2019 Lancet

15. One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements

One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements Discover Portal Discover Portal One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements Published on 30 August 2016 doi: A one-stage knee replacement procedure to treat an infected prosthetic knee may offer similar outcomes for most people as the more commonly used two (...) replacement surgery. Using one-stage revision surgery to treat suitable patients would reduce hospital time and improve patient experience. Patient selection will remain important and patient registries could be used to monitor outcomes. Share your views on the research. Why was this study needed? Knee replacement surgery (arthroplasty) replaces a damaged or diseased knee with an artificial joint. More than 70,000 knee replacements are carried out in England and Wales each year, and the number is rising

2019 NIHR Dissemination Centre

16. Partial knee replacements may save costs compared with total knee replacements

Partial knee replacements may save costs compared with total knee replacements Partial and total knee replacement costs compared Discover Portal Discover Portal Partial knee replacements may save costs compared with total knee replacements Published on 27 November 2018 doi: Partial knee replacements, when performed by experienced surgeons, can save costs and improve quality of life compared with total knee replacements. Partial replacements for selected patients improve quality of life and save (...) between £600 and £2,000 over the patient’s lifetime, depending on age and gender. Knee replacements are commonly performed for people with ongoing pain and poor function. If the damage is limited to one side of the knee, it may be suitable to replace just the affected side (unicompartmental replacement) rather than replacing the entire knee joint. This study compared costs and quality of life associated with both procedures using the National Joint Registry for England and Wales, with patients matched

2019 NIHR Dissemination Centre

17. Nexgen found to be best value for total knee replacement

Nexgen found to be best value for total knee replacement Nexgen found to be best value for total knee replacement Discover Portal Discover Portal Nexgen found to be best value for total knee replacement Published on 28 June 2016 doi: This economic analysis, using routinely collected National Joint Registry data from 2003 to 2012, found that Nexgen was the most cost-effective brand of prosthesis for total knee replacement. The cheapest brand was AGC Biomet, but Nexgen gave greater quality (...) of life improvement, and the additional cost for the benefit - £2,300 per quality-adjusted life-year - was well within usual willingness to pay thresholds. Nexgen also had the lowest rates of revision surgery. The study is the first to compare commonly-used prostheses for patient outcomes, costs and revision rates (how soon the replacement knee needed replacing). The comparisons relied on non-randomised, routinely collected data, and although the authors made every effort to correct for possible bias

2019 NIHR Dissemination Centre

18. Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours

Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours Discover Portal Discover Portal Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours Published on 15 March 2016 doi: Neuraxial anaesthesia, administered around the nerves (...) in the spine, was found to be as safe as general anaesthesia for people undergoing total hip or knee replacements. This review found a similar risk of dying, infection, nerve damage and blood clots in people regardless of the type of anaesthesia. Hospital stay was reduced on average by 0.4 days in the neuraxial anaesthesia group, though the significance to patients or impact on costs was not explored. Using neuraxial anaesthesia took no longer to perform than general anaesthesia. Hip and knee replacements

2019 NIHR Dissemination Centre

19. The Effect of Prosthetic Design and Polyethylene Type on the Risk of Revision for Infection in Total Knee Replacement: An Analysis of 336,997 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry (Abstract)

The Effect of Prosthetic Design and Polyethylene Type on the Risk of Revision for Infection in Total Knee Replacement: An Analysis of 336,997 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry Periprosthetic infection following total knee replacement remains alarmingly frequent, is devastating for patients, and is an increasingly substantial public health burden. While both the prosthetic design elements and type of polyethylene used in total knee (...) replacement can independently affect survivorship of the prosthesis, their influence on the risk of revision for infection is unknown. Therefore, we examined the effects of total knee prosthetic design and type of polyethylene bearing on the long-term revision risk for nonacute infection following total knee replacement by comparing 4 different cohorts: patients who had minimally stabilized total knee prostheses with crosslinked polyethylene (XLPE) bearing surfaces, minimally stabilized total knee

2019 EvidenceUpdates

20. Knee replacement. (Abstract)

Knee replacement. Knee replacement surgery is one of the most commonly done and cost-effective musculoskeletal surgical procedures. The numbers of cases done continue to grow worldwide, with substantial variation in utilisation rates across regions and countries. The main indication for surgery remains painful knee osteoarthritis with reduced function and quality of life. The threshold for intervention is not well defined, and is influenced by many factors including patient and surgeon (...) preference. Most patients have a very good clinical outcome after knee replacement, but multiple studies have reported that 20% or more of patients do not. So despite excellent long-term survivorship, more work is required to enhance this procedure and development is rightly focused on increasing the proportion of patients who have successful pain relief after surgery. Changing implant design has historically been a target for improving outcome, but there is greater recognition that improvements can

2018 Lancet