Latest & greatest articles for knee replacement

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Top results for knee replacement

21. Low molecular weight heparin versus other anti-thrombotic agents for prevention of venous thromboembolic events after total hip or total knee replacement surgery: a systematic review and meta-analysis Full Text available with Trip Pro

Low molecular weight heparin versus other anti-thrombotic agents for prevention of venous thromboembolic events after total hip or total knee replacement surgery: a systematic review and meta-analysis Venous thromboembolism (VTE) is an important complication following total hip replacement (THR) and total knee replacement (TKR) surgeries. Aim of this study was to comprehensively compare the clinical outcomes of low-molecular-weight heparin (LMWH) with other anticoagulants in patients who

2018 EvidenceUpdates

22. Computer-Assisted Compared with Conventional Total Knee Replacement: A Multicenter Parallel-Group Randomized Controlled Trial (Abstract)

Computer-Assisted Compared with Conventional Total Knee Replacement: A Multicenter Parallel-Group Randomized Controlled Trial We previously reported the short-term radiographic and functional results of a randomized controlled trial (RCT) comparing computer-assisted and conventionally performed total knee replacement. We currently report the 2-year clinical results from this trial.One hundred and ninety patients were randomly allocated to undergo either computer-assisted or conventional total (...) knee replacement. One hundred and seventy-two patients were available for clinical evaluation at 2 years, and 167 (97%) of those answered all patient-reported outcome measures (PROMs), including the Knee Injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Society Score (KSS), visual analog scale (VAS), and EuroQol-5 Dimensions (EQ-5D). Patients and clinical evaluators were blinded to the method of surgery. Surgical outcome

2018 EvidenceUpdates

23. Knee replacement

Knee replacement Top results for knee replacement - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 (...) or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for knee replacement The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other

2018 Trip Latest and Greatest

24. Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial (Abstract)

Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function.A single-blind controlled clinical trial.University Hospital of Rion, Greece.A total of 52 participants following (...) for the experimental group over time were represented by a relative effect size range of 1.3-6.5.Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.

2018 EvidenceUpdates

25. Day-case surgery for total hip and knee replacement: How safe and effective is it? Full Text available with Trip Pro

Day-case surgery for total hip and knee replacement: How safe and effective is it? Multimodal protocols for pain control, blood loss management and thromboprophylaxis have been shown to benefit patients by being more effective and as safe (fewer iatrogenic complications) as conventional protocols.Proper patient selection and education, multimodal protocols and a well-defined clinical pathway are all key for successful day-case arthroplasty.By potentially being more effective, cheaper than

2018 EFORT open reviews

26. Medial subvastus versus the medial parapatellar approach for total knee replacement: A systematic review and meta-analysis of randomized controlled trials Full Text available with Trip Pro

Medial subvastus versus the medial parapatellar approach for total knee replacement: A systematic review and meta-analysis of randomized controlled trials Twenty randomized controlled trials comprising 1893 primary total knee replacements were included in this review.The subvastus approach conferred superior results for mean difference (MD) in time to regain an active straight leg raise (1.7 days, 95% confidence interval [CI] 1.0 to 2.3), visual analogue score for pain on day one (0.8 points (...) on a scale out of 10, 95% CI 0.2 to 1.4) and total range of knee movement at one week (7°, 95% CI 3.2 to 10.7). The subvastus approach also resulted in fewer lateral releases (odds ratio 0.4, 95% CI 0.2 to 0.7) and less peri-operative blood loss (MD 57 mL, 95% CI 10.5 to 106.4) but prolonged surgical times (MD 9.7 min, 95% CI 3.9 to 15.6).There was no difference in Knee Society Score at six weeks or one year, or the rate of adverse events including superficial or deep infection, deep vein thrombosis

2018 EFORT open reviews

27. Sublingual sufentanil tablet system Zalviso® for postoperative analgesia after knee replacement in fast track surgery: a pilot observational study Full Text available with Trip Pro

Sublingual sufentanil tablet system Zalviso® for postoperative analgesia after knee replacement in fast track surgery: a pilot observational study Currently many TKA protocols rely on multimodal analgesic protocols with patient-controlled analgesia systems that administer opioids through a patient controlled IV infusion pump, in addition to concomitant peripheral nerve blocks and local anesthetics. Although effective, PCA IV opioids do not provide optimal results with fast track rehabilitation

2018 Journal of experimental orthopaedics

28. Choosing Between Unicompartmental and Total Knee Replacement: What Can Economic Evaluations Tell Us? A Systematic Review. Full Text available with Trip Pro

Choosing Between Unicompartmental and Total Knee Replacement: What Can Economic Evaluations Tell Us? A Systematic Review. Patients with anteromedial arthritis who require a knee replacement could receive either a unicompartmental knee replacement (UKR) or a total knee replacement (TKR). This review has been undertaken to identify economic evaluations comparing UKR and TKR, evaluate the approaches that were taken in the studies, assess the quality of reporting of these evaluations, and consider

2018 PharmacoEconomics - open

29. No Effect of Acupuncture as Adjunctive Therapy for Patients with Total Knee Replacement: A Randomized Controlled Trial Full Text available with Trip Pro

No Effect of Acupuncture as Adjunctive Therapy for Patients with Total Knee Replacement: A Randomized Controlled Trial Acupuncture is a low risk option in pain management following total knee replacement as an alternative to opioid analgesics. Therefore, the benefit of acupuncture as adjunct to an exercise program was investigated. Furthermore, the modifying effect of previous benefit from acupuncture was explored.Three weeks postoperatively, eligible patients were randomized to acupuncture

2018 EvidenceUpdates

30. Does standing a patient on the day of surgery following a primary unilateral total hip or knee replacement reduce the length of hospital stay?

Does standing a patient on the day of surgery following a primary unilateral total hip or knee replacement reduce the length of hospital stay? Recently Reviewed and Updated CAT: May 2018 Previous CAT Lead: Alison Morris Updated CAT Lead Greg Bicker Date CAT to be reviewed: Insert date Date CAT completed: May 2018 e mail of CAT Lead greg.bicker@mpft.nhs.uk 1 1 Short Question: Specific Question: Does standing a patient on the day of surgery following a primary unilateral total hip or knee (...) replacement reduce the length of hospital stay? Clinical bottom line There is limited, low quality evidence to support reduction in length of stay (LOS) following same day mobilisation in patients undergoing primary Total Hip Replacements (THR) and primary Total Knee Replacements (TKR). However, as the previous CAT concluded, there is evidence to support same day mobilisation as part of a multidisciplinary enhanced recovery protocol, to reduce LOS Clinical bottom line CAT 2010: “There is evidence to show

2018 Public Health England

31. No radiological and clinical advantages with patient-specific positioning guides in total knee replacement Full Text available with Trip Pro

No radiological and clinical advantages with patient-specific positioning guides in total knee replacement Background and purpose - Although the use of patient-specific positioning guides (PSPGs) in total knee replacement (TKR) in theory is promising, the technique has not yet proven its superior- ity compared with the conventional method. We compared radio- logical alignment and clinical outcome between TKR performed with the use of PSPGs and the conventional operation method. Patients (...) and methods - 3 hospitals participated in a prospec- tive trial. 109 patients were randomized to either the conventional method or to the use of PSPGs. Postoperatively a full-length standing anteroposterior radiograph and a postoperative CT scan were taken. On the CT scan the alignments were measured for both the femoral and tibial components in the frontal, sagit- tal, and axial plane. The Knee injury and Osteoarthritis Outcome Score (KOOS), the Eurocol-5D-3L (Eq5D) descriptive system and visual analogue

2018 EvidenceUpdates

32. Effect of the Referencing System on the Posterior Condylar Offset and Anterior Flange-Bone Contact in Posterior Cruciate-Substituting Total Knee Arthroplasty (Abstract)

Effect of the Referencing System on the Posterior Condylar Offset and Anterior Flange-Bone Contact in Posterior Cruciate-Substituting Total Knee Arthroplasty The effect of referencing system on posterior condylar offset (PCO) after total knee arthroplasty (TKA) is still controversial. Moreover, there is a lack of concern about the anterior flange-bone contact according to the referencing system.One hundred four TKAs using the anterior referencing (AR) system and 107 TKAs using the posterior (...) referencing (PR) system were analyzed with 2-year follow-up. The PCO, PCO ratio (PCOR), and contact at the anterior flange-bone interface were compared between the 2 groups. The flexion and extension gaps and the degree of medial release were measured, and clinical outcomes were evaluated. Finally, the correlation between changes in PCO and knee flexion angle was analyzed.The mean postoperative PCO and PCOR were significantly larger in the PR group than in the AR group. Incomplete contact between

2018 EvidenceUpdates

33. A Meta-Analysis of Patellar Replacement in Total Knee Arthroplasty for Patients With Knee Osteoarthritis (Abstract)

A Meta-Analysis of Patellar Replacement in Total Knee Arthroplasty for Patients With Knee Osteoarthritis This meta-analysis (MA) aims at comparing the clinical outcomes of resurfacing and nonresurfacing the patella in patients undergoing total knee arthroplasty in the treatment of knee osteoarthritis.Randomized controlled trials were included by retrieving data from electronic English databases. Both fixed and random-effects models were employed, and standardized mean difference and 95 (...) % confidence intervals were calculated. Stata13.1 software was used for statistical analysis for all the studies included to compare the differences in improving Knee Society Clinical Score and Knee Society Function Score as well as the reduction in rates of infection, reoperation, and anterior knee pain.A total of 394 studies were initially included in this MA. About 20 randomized controlled trials which met the inclusion criteria were finally enrolled in this MA. The results of our MA showed

2018 EvidenceUpdates

34. Effect of bisphosphonates on knee replacement surgery Full Text available with Trip Pro

Effect of bisphosphonates on knee replacement surgery Bone remodelling as a therapeutic target in knee osteoarthritis (OA) has gained much interest, but the effects of antiresorptive agents on knee OA have been conflicting, with no studies to date examining the effects of bisphosphonate use on the clinically relevant endpoint of knee replacement (KR) surgery.We used data from The Health Improvement Network (THIN), a general practitioner electronic medical records representative of the general (...) UK population. We identified older women who had initiated bisphosphonate use after their incident knee OA diagnosis. Each bisphosphonate initiator was propensity score-matched with a non-initiator within each 1-year cohort accrual block. The effect of bisphosphonates on the risk of KR was assessed using Cox proportional hazard regression. Sensitivity analyses to address residual confounding were also conducted.We identified 2006 bisphosphonate initiators, who were matched to 2006 non-initiators

2017 EvidenceUpdates

35. Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial (Abstract)

Parecoxib Supplementation to Morphine Analgesia Decreases Incidence of Delirium in Elderly Patients After Hip or Knee Replacement Surgery: A Randomized Controlled Trial Severe pain and high-dose opioids are both associated with increased risk of postoperative delirium. The authors investigated whether parecoxib-supplemented IV morphine analgesia could decrease the incidence of delirium in elderly patients after total hip or knee replacement surgery.In a randomized, double-blind, 2-center trial (...) , patients of 60 years or older who underwent elective total hip or knee replacement surgery were assigned in a 1:1 ratio to receive either parecoxib (40 mg at the end of surgery and then every 12 hours for 3 days) or placebo (normal saline). All patients received combined spinal-epidural anesthesia during surgery and IV morphine for postoperative analgesia. The primary outcome was the incidence of delirium within 5 days after surgery.Between January 2011 and May 2013, 620 patients were enrolled and were

2017 EvidenceUpdates

36. The Main Cause of Death Following Primary Total Hip and Knee Replacement for Osteoarthritis: A Cohort Study of 26,766 Deaths Following 332,734 Hip Replacements and 29,802 Deaths Following 384,291 Knee Replacements Full Text available with Trip Pro

The Main Cause of Death Following Primary Total Hip and Knee Replacement for Osteoarthritis: A Cohort Study of 26,766 Deaths Following 332,734 Hip Replacements and 29,802 Deaths Following 384,291 Knee Replacements Patients undergoing primary total joint replacement are selected for surgery and thus (other than having a transiently increased mortality rate postoperatively) have a lower mortality rate than age and sex-matched individuals do. Understanding the causes of death following joint (...) replacement would allow targeted strategies to reduce the risk of death and optimize outcome. We aimed to determine the rates and causes of mortality for patients undergoing primary total hip or knee replacement compared with individuals in the general population who were matched for age and sex.We compared causes and rates of mortality between age and sex-matched individuals in the general population (National Joint Registry for England, Wales and Northern Ireland; Hospital Episode Statistics; and Office

2017 EvidenceUpdates

37. Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative. Full Text available with Trip Pro

Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative. Objectives To evaluate the impact of total knee replacement on quality of life in people with knee osteoarthritis and to estimate associated differences in lifetime costs and quality adjusted life years (QALYs) according to use by level of symptoms.Design Marginal structural modeling and cost effectiveness analysis based on lifetime predictions for total knee replacement and death (...) from population based cohort data.Setting Data from two studies-Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST)-within the US health system.Participants 4498 participants with or at high risk for knee osteoarthritis aged 45-79 from the OAI with no previous knee replacement (confirmed by baseline radiography) followed up for nine years. Validation cohort comprised 2907 patients from MOST with two year follow-up.Intervention Scenarios ranging from current practice

2017 BMJ

38. The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Full Text available with Trip Pro

The effect of patient age at intervention on risk of implant revision after total replacement of the hip or knee: a population-based cohort study. Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing (...) for surgery.We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement. These data were adjusted for all-cause mortality with data from the Office for National Statistics and used to generate lifetime risks of revision surgery based on increasing age at the time of primary surgery.We identified 63 158 patients who had undergone total hip replacement and 54 276 who had total knee replacement between Jan 1

2017 Lancet

39. Knee replacement in chronic post-traumatic cases Full Text available with Trip Pro

Knee replacement in chronic post-traumatic cases Post-traumatic knee arthritis is a challenging condition. Prosthetic surgery is demanding and the risk of complications is relatively high.Planning is an essential element of this surgery; correct diagnosis (to exclude latent infection) and adequate considerations regarding approach, axis, bone loss, choice of implant and level of constraint are indispensable.There are two main categories of post-traumatic arthritis: extra-articular deformities (...) and articular deformities.Use of an algorithms can support the surgeon's choice of implant.Correct implant positioning and limb alignment restoration is associated with very good results, similar to those achieved with standard total knee arthroplasty. Cite this article: Benazzo F, Rossi SMP, Combi A, Meena S, Ghiara M. Knee replacement in chronic post-traumatic cases. EFORT Open Rev 2016:1:211-218. DOI: 10.1302/2058-5241.1.000025.

2016 EFORT open reviews

40. Guided Imagery for Total Knee Replacement: A Randomized, Placebo-Controlled Pilot Study. Full Text available with Trip Pro

Guided Imagery for Total Knee Replacement: A Randomized, Placebo-Controlled Pilot Study. To determine the effect of guided imagery (GI) on functional outcomes of total knee replacement (TKR), explore psychological and neuroimmune mediators, and assess feasibility of study implementation.Investigator-blinded, randomized, placebo-controlled pilot study.Hospital, surgeon's office, participant's home.82 persons undergoing TKR.Audiorecordings of TKR-specific GI scripts or placebo-control (...) audiorecordings of audiobook segments.Gait velocity and Western Ontario and McMaster Universities Arthritis Index (WOMAC) Function scale.Outcomes for 58 participants (29 receiving GI and 29 controls) were analyzed at 6 months after surgery. The most frequent reason for noncompletion was protocol-driven exclusion at 6 months for having the contralateral knee replaced before the study endpoint (n = 15). With imaging ability as a moderator, gait velocity, but not WOMAC Function score, was significantly improved

2016 Journal of alternative and complementary medicine (New York, N.Y.) Controlled trial quality: predicted high