Latest & greatest articles for knee replacement

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Top results for knee replacement

181. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults

Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults National Institute for Health and Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation National Institute for Health and Clinical Excellence. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults. London: National Institute for Health and Clinical Excellence (NICE). Technology Appraisal Guidance 170. 2009 Authors' conclusions Rivaroxaban, within its marketing authorisation, is recommended as an option for the prevention of venous thromboembolism in adults having elective total hip

2009 Health Technology Assessment (HTA) Database.

182. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. (Abstract)

Apixaban or enoxaparin for thromboprophylaxis after knee replacement. The optimal strategy for thromboprophylaxis after major joint replacement has not been established. Low-molecular-weight heparins such as enoxaparin predominantly target factor Xa but to some extent also inhibit thrombin. Apixaban, a specific factor Xa inhibitor, may provide effective thromboprophylaxis with a low risk of bleeding and improved ease of use.In a double-blind, double-dummy study, we randomly assigned patients (...) undergoing total knee replacement to receive 2.5 mg of apixaban orally twice daily or 30 mg of enoxaparin subcutaneously every 12 hours. Both medications were started 12 to 24 hours after surgery and continued for 10 to 14 days. Bilateral venography was then performed. The primary efficacy outcome was a composite of asymptomatic and symptomatic deep-vein thrombosis, nonfatal pulmonary embolism, and death from any cause during treatment. Patients were followed for 60 days after anticoagulation therapy

2009 NEJM Controlled trial quality: predicted high

183. Prostheses for primary total knee replacement in Italy

Prostheses for primary total knee replacement in Italy Prostheses for primary total knee replacement in Italy Prostheses for primary total knee replacement in Italy Cerbo M, Fella D, Jefferson T, Migliore A, Paone S, Perrini MR, Velardi L Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Cerbo M, Fella D, Jefferson T, Migliore A, Paone S (...) , Perrini MR, Velardi L. Prostheses for primary total knee replacement in Italy. Rome: Agenzia nazionale per i servizi sanitari regionali. 2009 Authors' objectives We aimed to identify the TKR prostheses currently used in Italy, to retrieve evidence of performance for all the models identified from clinical studies and arthroplasty registers, and to construct a cost-effectiveness model to support the choice for healthcare payers. Authors' conclusions Despite the limitations and constraints of our study

2009 Health Technology Assessment (HTA) Database.

184. After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial Full Text available with Trip Pro

After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient (...) -reported kneeling ability following partial knee replacement (PKR).Sixty adults with medial compartment osteoarthritis, suitable for a PKR, participated.This was a single-blind, prospective randomized controlled trial. Six weeks after PKR, participants randomly received either kneeling advice and education or routine care where no specific kneeling advice was given. Reassessment was at 1 year postoperatively. The primary outcome measure was patient-reported kneeling ability, as assessed by question 7

2008 EvidenceUpdates Controlled trial quality: uncertain

185. Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement Full Text available with Trip Pro

Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement We compared patient-reported outcomes of the Kinemax fixed- and mobile-bearing total knee replacement in a multi-centre randomised controlled trial. Patients were randomised to the fixed- or the mobile-bearing prosthesis via a sealed envelope method after the bone cuts had been made in the operating theatre. Randomisation (...) was stratified by centre and diagnosis. Patients were assessed pre-operatively and at eight to 12 weeks, one year and two years post-operatively. Validated questionnaires were used which included the Western Ontario MacMasters University, Short-Form 12, Mental Health Index-5, Knee Injury and Osteoarthritis Outcome Score for Knee-Related Quality of Life and Function in Sport and Recreation scales and a validated scale of satisfaction post-operatively. In total, 242 patients (250 knees) with a mean age of 68

2008 EvidenceUpdates Controlled trial quality: uncertain

186. Pre-operative injections of epoetin-{alpha} versus post-operative retransfusion of autologous shed blood in total hip and knee replacement Full Text available with Trip Pro

Pre-operative injections of epoetin-{alpha} versus post-operative retransfusion of autologous shed blood in total hip and knee replacement This prospective randomised clinical trial evaluated the effect of alternatives for allogeneic blood transfusions after total hip replacement and total knee replacement in patients with pre-operative haemoglobin levels between 10.0 g/dl and 13.0 g/dl. A total of 100 patients were randomly allocated to the Eprex (pre-operative injections of epoetin (...) ) and 30% (nine of 30 patients) (p = 0.047) respectively, whereas in total knee replacement, the percentages were 0% (0 of 20 patients) and 25% (five of 20 patients) respectively (p = 0.042). Pre-operative epoetin injections are more effective but more costly in reducing the need for allogeneic blood transfusions in mildly anaemic patients than post-operative retransfusion of autologous blood.

2008 EvidenceUpdates Controlled trial quality: uncertain

187. Computer-assisted and conventional total knee replacement Full Text available with Trip Pro

Computer-assisted and conventional total knee replacement After obtaining informed consent, 80 patients were randomised to undergo a navigated or conventional total knee replacement. All received a cemented, unconstrained, cruciate-retaining implant with a rotating platform. Full-length standing and lateral radiographs and CT scans of the hip, knee and ankle joint were carried out five to seven days after operation. No notable differences were found between computer-assisted navigation

2008 EvidenceUpdates Controlled trial quality: uncertain

188. Inpatient compared with home-based rehabilitation following primary unilateral total hip or knee replacement: a randomized controlled trial Full Text available with Trip Pro

Inpatient compared with home-based rehabilitation following primary unilateral total hip or knee replacement: a randomized controlled trial Home-based rehabilitation is increasingly utilized to reduce health-care costs; however, with a shorter hospital stay, the possibility arises for an increase in adverse clinical outcomes. We evaluated the effectiveness and cost of care of home-based compared with inpatient rehabilitation following primary total hip or knee joint replacement.We randomized (...) elective primary total hip or knee replacement as it is the more cost-effective strategy.

2008 EvidenceUpdates Controlled trial quality: predicted high

189. Total knee replacement performed with either a mini-midvastus or a standard approach Full Text available with Trip Pro

Total knee replacement performed with either a mini-midvastus or a standard approach We report the clinical and radiological results of a two- to three-year prospective randomised study which was designed to compare a minimally-invasive technique with a standard technique in total knee replacement and was undertaken between January 2004 and May 2007. The mini-midvastus approach was used on 50 patients (group A) and a standard approach on 50 patients (group B). The mean follow-up in both groups (...) difference in the mean maximum flexion between the groups (p = 0.08). Technical errors were identified in six patients from group A (12%) on radiological evaluation. Based on these results, the authors currently use minimally-invasive techniques in total knee replacement in selected cases only.

2008 EvidenceUpdates Controlled trial quality: uncertain

190. Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up Full Text available with Trip Pro

Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up Approximately 12,000 hip and knee replacements were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, but there is conflicting evidence regarding the effect. We therefore performed an efficacy study of an accelerated perioperative care and rehabilitation intervention (...) in patients receiving primary total hip replacement, and both total and unicompartmental knee replacement.A randomized clinical trial was undertaken in which 87 patients were randomized to either a control group receiving the current perioperative procedure, or an intervention group receiving a new accelerated perioperative care and rehabilitation procedure. Outcome measures were length of stay (LOS) in hospital, and gain in quality of life (QOL) using EQ-5D from baseline to 3-month follow-up.Mean LOS

2008 EvidenceUpdates Controlled trial quality: uncertain

191. Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. (Abstract)

Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. Joint replacements are common procedures and treatment of choice for those with intractable joint pain and disability arising from arthropathy of the hip or knee. Multidisciplinary rehabilitation is considered integral to the outcome of joint replacement.To assess the evidence for effectiveness of multidisciplinary rehabilitation on activity and participation in adults following (...) hip or knee joint replacement for chronic arthropathy.We searched the Cochrane Musculoskeletal Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and CINAHL up to September 2006.Randomised controlled trials (RCTs) that compared organised multidisciplinary rehabilitation with routine services following hip or knee replacement, and included outcome measures of activity and participation in accordance with the International Classification of Functioning, Health

2008 Cochrane

192. A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components Full Text available with Trip Pro

A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components Modifications in the design of knee replacements have been proposed in order to maximise flexion. We performed a prospective double-blind randomised controlled trial to compare the functional outcome, including maximum knee flexion, in patients receiving either a standard or a high flexion version of the NexGen legacy (...) posterior stabilised total knee replacement. A total of 56 patients, half of whom received each design, were assessed pre-operatively and at one year after operation using knee scores and analysis of range of movement using electrogoniometry. For both implant designs there was a significant improvement in the function component of the knee scores (p < 0.001) and the maximum range of flexion when walking on the level, ascending and descending a slope or stairs (all p < 0.001), squatting (p = 0.020

2008 EvidenceUpdates Controlled trial quality: uncertain

193. Total knee replacement with and without patellar resurfacing: A Prospective, randomised trial using the profix total knee system Full Text available with Trip Pro

Total knee replacement with and without patellar resurfacing: A Prospective, randomised trial using the profix total knee system We have examined the differences in clinical outcome of total knee replacement (TKR) with and without patellar resurfacing in a prospective, randomised study of 181 osteoarthritic knees in 142 patients using the Profix total knee system which has a femoral component with features considered to be anatomical and a domed patellar implant. The procedures were carried out (...) between February 1998 and November 2002. A total of 159 TKRs in 142 patients were available for review at a mean of four years (3 to 7). The patients and the clinical evaluator were blinded in this prospective study. Evaluation was undertaken annually by an independent observer using the knee pain scale and the Knee Society clinical rating system. Specific evaluation of anterior knee pain, stair-climbing and rising from a seated to a standing position was also undertaken. No benefit was shown of TKR

2008 EvidenceUpdates Controlled trial quality: uncertain

194. Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults (TA157)

Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults (TA157) Overview | Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults | Guidance | NICE Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults Technology appraisal guidance [TA157] Published date: 24 September 2008 Share Guidance on dabigatran etexilate (Pradaxa (...) ) for preventing venous thromboembolism after hip or knee replacement surgery in adults. Guidance development process Is this guidance up to date? . We found nothing new that affects the recommendations in this guidance. Next review : This guidance will be reviewed if there is new evidence that is likely to change the recommendations. Your responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising

2008 National Institute for Health and Clinical Excellence - Technology Appraisals

195. Impact of hospital volume on the economic value of computer navigation for total knee replacement Full Text available with Trip Pro

Impact of hospital volume on the economic value of computer navigation for total knee replacement Impact of hospital volume on the economic value of computer navigation for total knee replacement Impact of hospital volume on the economic value of computer navigation for total knee replacement Slover JD, Tosteson AN, Bozic KJ, Rubash HE, Malchau H Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The aim was to examine the impact of hospital volume on the cost-effectiveness of computer-assisted surgery (CAS) in elderly patients with end-stage arthritis of the knee, requiring total knee replacement. The authors concluded that CAS was cost-effective for centres with a high volume of joint replacements. Overall, the reporting

2008 NHS Economic Evaluation Database.

196. Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis

Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis March L M, Barcenilla A L, Cross M J, Lapsley H M, Parker D, Brooks P M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods (...) , the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the clinical and economic impact of primary unilateral total knee replacement (TKR) and total hip replacement (THR) in patients with rheumatoid arthritis. The authors concluded that surgery reduced the post-operative costs from the perspective of the patient and the health care system, and improved the health outcomes for both THR and TKR

2008 NHS Economic Evaluation Database.

197. A prospective randomised controlled trial of autologous retransfusion in total knee replacement Full Text available with Trip Pro

A prospective randomised controlled trial of autologous retransfusion in total knee replacement We undertook a prospective randomised controlled trial to investigate the efficacy of autologous retransfusion drains in reducing the need for allogenic blood requirement after unilateral total knee replacement. We also monitored the incidence of post-operative complications. There were 86 patients in the control group, receiving standard care with a vacuum drain, and 92 who received an autologous (...) on this study, the cost-effectiveness and continued use of autologous drains in total knee replacement should be questioned.

2008 EvidenceUpdates Controlled trial quality: uncertain

198. Navigated total knee replacement. A meta-analysis. Full Text available with Trip Pro

Navigated total knee replacement. A meta-analysis. BACKGROUND: Proponents of navigated knee arthroplasty stress its potential to increase the precision of component placement. We conducted a systematic review and meta-analysis to substantiate the validity and relevance of this contention. METHODS: We searched major medical and publishers' databases for randomized trials and any other studies comparing navigated with conventional knee arthroplasty. Major periodicals were searched manually. We (...) interval, -0.2 degrees to 0.5 degrees). Patients managed with navigated surgery had a lower risk of malalignment at critical thresholds of >3 degrees (risk ratio, 0.79; 95% confidence interval, 0.71 to 0.87) and >2 degrees (risk ratio, 0.76; 95% confidence interval, 0.71 to 0.82). No conclusive inferences could be drawn on functional outcomes or complication rates. Navigation lengthened the mean duration of surgery by 23%. CONCLUSIONS: Navigated knee replacement provides few advantages over

2007 EvidenceUpdates

199. Targeted early rehabilitation at home after total hip and knee joint replacement: does it work?

Targeted early rehabilitation at home after total hip and knee joint replacement: does it work? Targeted early rehabilitation at home after total hip and knee joint replacement: does it work? Targeted early rehabilitation at home after total hip and knee joint replacement: does it work? Iyengar K P, Nadkarni J B, Ivanovic N, Mahale A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The study examined two strategies of rehabilitation after total hip replacement (THR) or total knee replacement (TKR). The strategies were conventional inpatient rehabilitation in a hospital ward and the early rehabilitation at home scheme (RAHS). Type of intervention Rehabilitation. Economic study type Cost-effectiveness analysis. Study

2007 NHS Economic Evaluation Database.

200. Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs Full Text available with Trip Pro

Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs Rasanen P, Paavolainen P, Sintonen H, Koivisto A M, Blom M, Ryynanen O P, Roine R P Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED (...) . Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The objective was to undertake a cost-utility analysis of (primary or secondary) hip and primary knee replacement surgery. The authors concluded that both procedures were cost-effective strategies from the perspective of the health care payer in Finland. The study had some methodological limitations

2007 NHS Economic Evaluation Database.