Latest & greatest articles for knee replacement

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Top results for knee replacement

61. Improved fixation in cementless unicompartmental knee replacement: five-year results of a randomized controlled trial Full Text available with Trip Pro

Improved fixation in cementless unicompartmental knee replacement: five-year results of a randomized controlled trial When used for appropriate indications, unicompartmental knee replacement is associated with fewer complications, faster recovery, and better function than total knee replacement. However, joint registries demonstrate a higher revision rate for unicompartmental knee replacement. Currently, most unicompartmental knee replacements are cemented; common reasons for revision include (...) aseptic loosening and pain. These problems could potentially be addressed by using cementless implants, with coatings designed to improve fixation. The objectives of this study were to compare the quality of fixation as well as clinical outcomes of cemented and cementless unicompartmental knee replacements at five years of follow-up.A randomized controlled trial was established with sixty-three knees (sixty-two patients) receiving either cemented (thirty-two patients) or cementless Oxford

2013 EvidenceUpdates Controlled trial quality: uncertain

62. Do modern total knee replacements offer better value for money? A health economic analysis Full Text available with Trip Pro

Do modern total knee replacements offer better value for money? A health economic analysis Do modern total knee replacements offer better value for money? A health economic analysis Do modern total knee replacements offer better value for money? A health economic analysis Hamilton DF, Clement ND, Burnett R, Patton JT, Moran M, Howie CR, Simpson AH, Gaston P Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) replacements offer better value for money? A health economic analysis. International Orthopaedics 2013; 37(11): 2147-2152 PubMedID DOI Indexing Status Subject indexing assigned by NLM MeSH Aged; Arthroplasty, Replacement, Knee /economics /instrumentation /methods; Cost-Benefit Analysis; Disability Evaluation; Female; Health Care Costs /statistics & Humans; Knee Joint /physiology /surgery; Knee Prosthesis /economics; Life Expectancy; Male; Middle Aged; Osteoarthritis, Knee /surgery; Quality of Life; Quality

2013 NHS Economic Evaluation Database.

63. Analgesia after total knee replacement: local infiltration versus epidural combined with a femoral nerve blockade: a prospective, randomised pragmatic trial Full Text available with Trip Pro

Analgesia after total knee replacement: local infiltration versus epidural combined with a femoral nerve blockade: a prospective, randomised pragmatic trial In a randomised controlled pragmatic trial we investigated whether local infiltration analgesia would result in earlier readiness for discharge from hospital after total knee replacement (TKR) than patient-controlled epidural analgesia (PCEA) plus femoral nerve block. A total of 45 patients with a mean age of 65 years (49 to 81) received

2013 EvidenceUpdates Controlled trial quality: uncertain

64. Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement (Abstract)

Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement There is conflicting evidence about the merits of mobile bearings in total knee replacement, partly because most randomised controlled trials (RCTs) have not been adequately powered. We report the results of a multicentre RCT of mobile versus fixed bearings. This was part of the knee arthroplasty trial (KAT), where 539 patients were randomly allocated to mobile or fixed bearings (...) difference between trial groups in OKS at five years (-1.12 (95% confidence interval -2.77 to 0.52) or any of the other outcome measures. Furthermore, there was no significant difference in the proportion of patients with knee-related re-operations or in total costs. In this appropriately powered RCT, over the first five years after total knee replacement functional outcomes, re-operation rates and healthcare costs appear to be the same irrespective of whether a mobile or fixed bearing is used.

2013 EvidenceUpdates Controlled trial quality: predicted high

65. Steroid modulation of cytokine release and desmosine levels in bilateral total knee replacement: a prospective, double-blind, randomized controlled trial (Abstract)

Steroid modulation of cytokine release and desmosine levels in bilateral total knee replacement: a prospective, double-blind, randomized controlled trial The perioperative inflammatory response as measured by elevated levels of interleukin-6 (IL-6) has been linked to acute respiratory distress syndrome, postoperative confusion, and fever. Because of the extent of surgery,patients undergoing bilateral total knee arthroplasty may be at high risk of complications. We had found a significant (...) decrease in IL-6 in patients having bilateral total knee replacement who received two doses of 100 mg of hydrocortisone eight hours apart; however, by twenty-four hours, IL-6 levels were equal to those in the group that received a placebo. In the present study, we investigated whether the administration of three doses would reduce IL-6 levels at twenty-four hours and affect other outcomes such as desmosine level, a marker of lung injury.After institutional review board approval, a total of thirty-four

2013 EvidenceUpdates Controlled trial quality: predicted high

66. Quantitative study?other: Movement pain, resting pain and depression prior to total knee replacement predict postoperative pain

Quantitative study?other: Movement pain, resting pain and depression prior to total knee replacement predict postoperative pain Movement pain, resting pain and depression prior to total knee replacement predict postoperative pain | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username (...) and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Movement pain, resting pain and depression prior to total knee replacement predict postoperative pain Article Text Pain management Quantitative study—other Movement

2013 Evidence-Based Nursing

67. Cryotherapy Machines versus Ice Packs for the Post-Operative Management of Anterior Cruciate Ligament Replacement Surgery or Total Knee Arthroplasty: Clinical Evidence and Guidelines

Cryotherapy Machines versus Ice Packs for the Post-Operative Management of Anterior Cruciate Ligament Replacement Surgery or Total Knee Arthroplasty: Clinical Evidence and Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic (...) by the owners’ own terms and conditions. TITLE: Cryotherapy Machines versus Ice Packs for the Post-Operative Management of Anterior Cruciate Ligament Replacement Surgery or Total Knee Arthroplasty: Clinical Evidence and Guidelines DATE: 28 November 2012 RESEARCH QUESTIONS 1. What is the clinical evidence for the use of cyrotherapy machines versus ice packs for the post-operative management of anterior cruciate ligament replacement surgery or total knee arthroplasty? 2. What are the evidence-based guidelines

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

68. Does Exercise Reduce Pain and Improve Physical Function Before Hip or Knee Replacement Surgery? A Systematic Review and Meta-Analysis of Randomized Controlled Trials (Abstract)

Does Exercise Reduce Pain and Improve Physical Function Before Hip or Knee Replacement Surgery? A Systematic Review and Meta-Analysis of Randomized Controlled Trials To investigate the preoperative effects of exercise-based interventions on pain and physical function for people awaiting joint replacement surgery of the hip or knee.Four computer databases (CINAHL, MEDLINE, Embase, and Cochrane Library) were searched until July 4, 2012. Search terms included knee, hip, joint replacement (...) , arthroplasty, physiotherapy, physical therapy, exercise, hydrotherapy, rehabilitation, and preoperative. Reference lists of retrieved articles were also screened.Randomized or quasi-randomized studies comparing an exercise-based intervention with a no-intervention group for people awaiting hip or knee joint replacement surgery were included. Outcomes were pain and physical function including self-reported function, walking speed, and muscle strength. One of 2 reviewers determined that 18 studies met

2013 EvidenceUpdates

69. Cancellation of Hip and Knee Replacement Surgeries: Guidelines

Cancellation of Hip and Knee Replacement Surgeries: Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along (...) . It may not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions. TITLE: Cancellation of Hip and Knee Replacement Surgeries: Guidelines

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

70. Does a mobile-bearing, high-flexion design increase knee flexion after total knee replacement? (Abstract)

Does a mobile-bearing, high-flexion design increase knee flexion after total knee replacement? This prospective randomised controlled double-blind trial compared two types of PFC Sigma total knee replacement (TKR), differing in three design features aimed at improving flexion. The outcome of a standard fixed-bearing posterior cruciate ligament-preserving design (FB-S) was compared with that of a high-flexion rotating-platform posterior-stabilised design (RP-F) at one year after TKR. The study (...) group of 77 patients with osteoarthritis of the knee comprised 37 men and 40 women, with a mean age of 69 years (44.9 to 84.9). The patients were randomly allocated either to the FB-S or the RP-F group and assessed pre-operatively and at one year post-operatively. The mean post-operative non-weight-bearing flexion was 107° (95% confidence interval (CI) 104° to 110°)) for the FB-S group and 113° (95% CI 109° to 117°) for the RP-F group, and this difference was statistically significant (p = 0.032

2012 EvidenceUpdates Controlled trial quality: predicted high

71. Rationing of total knee replacement: a cost-effectiveness analysis on a large trial data set

Rationing of total knee replacement: a cost-effectiveness analysis on a large trial data set Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 NHS Economic Evaluation Database.

72. The blood-saving effect of tranexamic acid in minimally invasive total knee replacement: Is an additional pre-operative injection effective? (Abstract)

The blood-saving effect of tranexamic acid in minimally invasive total knee replacement: Is an additional pre-operative injection effective? Tranexamic acid (TEA), an inhibitor of fibrinolysis, reduces blood loss after routine total knee replacement (TKR). However, controversy persists regarding the dosage and timing of administration of this drug during surgery. We performed a prospective randomised controlled study to examine the optimum blood-saving effect of TEA in minimally invasive TKR

2012 EvidenceUpdates Controlled trial quality: uncertain

73. Review: Factor Xa inhibitors reduce DVT more than LMWH in total knee or hip replacement. Full Text available with Trip Pro

Review: Factor Xa inhibitors reduce DVT more than LMWH in total knee or hip replacement. 22910959 2012 10 19 2012 08 22 1539-3704 157 4 2012 Aug 21 Annals of internal medicine Ann. Intern. Med. ACP Journal Club: review: factor Xa inhibitors reduce DVT more than LMWH in total knee or hip replacement. JC2-5 10.7326/0003-4819-157-4-201208210-02005 Bona Robert R Frank H. Netter School of Medicine at Quinnipiac University Hamden, Connecticut, USA. eng Comment Journal Article United States Ann Intern

2012 Annals of Internal Medicine

74. Dabigatran, rivaroxaban, or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement: systematic review, meta-analysis, and indirect treatment comparisons Full Text available with Trip Pro

Dabigatran, rivaroxaban, or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement: systematic review, meta-analysis, and indirect treatment comparisons Dabigatran, rivaroxaban, or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement: systematic review, meta-analysis, and indirect treatment comparisons Dabigatran, rivaroxaban, or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement: systematic (...) review, meta-analysis, and indirect treatment comparisons Gomez-Outes A, Terleira-Fernandez AI, Suarez-Gea L, Vargas-Castrillon E CRD summary This generally well-conducted review concluded that higher efficacy in prevention of symptomatic venous thromboembolism in new anticoagulants following total knee or hip replacement was associated with a higher risk of bleeding. This conclusion accurately reflects the evidence and is likely to be reliable. Authors' objectives To assess clinical outcomes

2012 DARE.

75. Cognitive stimulation during hospitalization improves global cognition of older Taiwanese undergoing elective total knee and hip replacement surgery Full Text available with Trip Pro

Cognitive stimulation during hospitalization improves global cognition of older Taiwanese undergoing elective total knee and hip replacement surgery   This article is a report on a pilot study conducted to determine the effects of cognitively stimulating activities in older patients undergoing elective hip and/or knee replacement.  Cognitive decline occurs in 16-35·5% of older hospitalized patients. In-hospital interventions, such as cognitively stimulating activities, might combat cognitive (...) for the intervention group (+1·33 points) vs. usual care (-0·26 points) at 1 month after discharge. Group differences in changes were statistically significant both at discharge and 1 month afterwards.  Our cognitive-stimulation intervention benefited global cognitive function among older patients undergoing elective hip and/or knee replacement. The benefit persisted at 1 month after discharge.© 2011 Blackwell Publishing Ltd.

2012 EvidenceUpdates Controlled trial quality: uncertain

76. Apixaban versus enoxaparin for thromboprophylaxis after hip or knee replacement: pooled analysis of major venous thromboembolism and bleeding in 8464 patients from the ADVANCE-2 and ADVANCE-3 trials Full Text available with Trip Pro

Apixaban versus enoxaparin for thromboprophylaxis after hip or knee replacement: pooled analysis of major venous thromboembolism and bleeding in 8464 patients from the ADVANCE-2 and ADVANCE-3 trials In order to compare the effect of oral apixaban (a factor Xa inhibitor) with subcutaneous enoxaparin on major venous thromboembolism and major and non-major clinically relevant bleeding after total knee and hip replacement, we conducted a pooled analysis of two previously reported double-blind (...) randomised studies involving 8464 patients. One group received apixaban 2.5 mg twice daily (plus placebo injection) starting 12 to 24 hours after operation, and the other received enoxaparin subcutaneously once daily (and placebo tablets) starting 12 hours (± 3) pre-operatively. Each regimen was continued for 12 days (± 2) after knee and 35 days (± 3) after hip arthroplasty. All outcomes were centrally adjudicated. Major venous thromboembolism occurred in 23 of 3394 (0.7%) evaluable apixaban patients

2012 EvidenceUpdates

77. Do we need a gender-specific total knee replacement? A randomised controlled trial comparing a high-flex and a gender-specific posterior design (Abstract)

Do we need a gender-specific total knee replacement? A randomised controlled trial comparing a high-flex and a gender-specific posterior design The purpose of this study was to investigate whether a gender-specific high-flexion posterior-stabilised (PS) total knee replacement (TKR) would offer advantages over a high-flex PS TKR regarding range of movement (ROM), 'feel' of the knee, pain and satisfaction, as well as during activity. A total of 24 female patients with bilateral osteoarthritis (...) entered this prospective, blind randomised trial in which they received a high-flex PS TKR in one knee and a gender-specific high-flexion PS TKR in the other knee. At follow-up, patients were assessed clinically measuring ROM, and questioned about pain, satisfaction and daily 'feel' of each knee. Patients underwent gait analysis pre-operatively and at one year, which yielded kinematic, kinetic and temporospatial parameters indicative of knee function during gait. At final follow-up we found

2012 EvidenceUpdates Controlled trial quality: uncertain

78. Long-Term Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Replacements in Patients Younger Than Fifty-one Years of Age with Osteoarthritis (Abstract)

Long-Term Comparison of Fixed-Bearing and Mobile-Bearing Total Knee Replacements in Patients Younger Than Fifty-one Years of Age with Osteoarthritis There is limited information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in patients with osteoarthritis who are younger than fifty-one years and who have a fixed-bearing implant in one knee and a mobile-bearing implant in the other. The purpose of this study was to compare our long-term (...) clinical and radiographic results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in a group of patients from this population.We prospectively compared the results of 108 patients with osteoarthritis who were younger than fifty-one years (mean age, forty-five years) who had received a fixed-bearing prosthesis in one knee and a rotating platform mobile-bearing prosthesis in the other. The mean follow-up was 16.8 years (range, fifteen to eighteen years). The patients

2012 EvidenceUpdates

79. Oral direct factor Xa inhibitors versus low-molecular-weight heparin to prevent venous thromboembolism in patients undergoing total hip or knee replacement: a systematic review and meta-analysis

Oral direct factor Xa inhibitors versus low-molecular-weight heparin to prevent venous thromboembolism in patients undergoing total hip or knee replacement: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

80. Oral Direct Factor Xa Inhibitors Versus Low-Molecular-Weight Heparin to Prevent Venous Thromboembolism in Patients Undergoing Total Hip or Knee Replacement: A Systematic Review and Meta-analysis. (Abstract)

Oral Direct Factor Xa Inhibitors Versus Low-Molecular-Weight Heparin to Prevent Venous Thromboembolism in Patients Undergoing Total Hip or Knee Replacement: A Systematic Review and Meta-analysis. Thromboembolic disease is the most frequent medical complication of arthroplasty.To evaluate the benefits and harms of oral direct factor Xa inhibitors versus low-molecular-weight heparin (LMWH) in patients undergoing total hip or knee replacement.MEDLINE (1966 to December 2011), EMBASE (1980 (...) to December 2011), and the Cochrane Central Register of Controlled Trials (up to December 2011), without language restrictions. References of reviews and abstracts of conferences were hand-searched.Randomized trials in patients undergoing hip or knee replacement that evaluated factor Xa inhibitors versus LMWH.Two reviewers independently evaluated eligibility, abstracted the data, and assessed risk for bias.In 22 trials, high-quality evidence indicated that the absolute effect of factor Xa inhibitors

2012 Annals of Internal Medicine