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Latest & greatest articles for knee replacement
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Computer assisted surgery for unicondylar and total kneereplacement Computer assisted surgery for unicondylar and total kneereplacement Computer assisted surgery for unicondylar and total kneereplacement Malaysian Health Technology Assessment (MaHTAS) 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 Malaysian Health Technology (...) Assessment (MaHTAS). Computer assisted surgery for unicondylar and total kneereplacement. Putrajaya: Malaysian Health Technology Assessment (MaHTAS). 2014 Authors' objectives To review evidence on the effectiveness, safety and costeffectiveness of computer assisted surgery for unicondylar and total kneereplacement in patients with osteoarthritis. Authors' conclusions Computer assisted surgery or computer image-based navigation or robotic-assisted procedure has the potential to be used as alternative
Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement: OHTAC Recommendation. March 2014; pp. 1–9 Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement: OHTAC Recommendation Ontario Health Technology Advisory Committee March 2014 Update on Physiotherapy Rehabilitation After Total Knee or Hip Replacement: OHTAC Recommendation. March 2014; pp. 1–9 Suggested Citation This report (...) should be cited as follows: Ontario Health Technology Advisory Committee (OHTAC). Update on physiotherapy rehabilitation after total knee or hip replacement: OHTAC recommendation [Internet]. Toronto: Queen's Printer for Ontario; 2014 March. 9 p. Available from: http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ontario-health- technology-assessment-series/physiotherapy-rehabilitation-after-total-knee-or-hip-replacement. Permission Requests All inquiries regarding permission
A systematic review and meta-regression of mobile-bearing versus fixed-bearing total kneereplacement in 41 studies Mobile-bearing (MB) total kneereplacement (TKR) was introduced to reduce the risk of aseptic loosening and wear of polyethylene inserts. However, no consistent clinical advantages of mobile- over fixed-bearing (FB) TKR have been found. In this study we evaluated whether mobile bearings have an advantage over fixed bearings with regard to revision rates and clinical outcome scores (...) . Furthermore, we determined which modifying variables affected the outcome. A systematic search of the literature was conducted to collect clinical trials comparing MB and FB in primary TKR. The primary outcomes were revision rates for any reason, aseptic loosening and wear. Secondary outcomes included range of movement, Knee Society score (KSS), Oxford knee score (OKS), Short-Form 12 (SF-12) score and radiological parameters. Meta-regression techniques were used to explore factors modifying the observed
Improved fixation in cementless unicompartmental kneereplacement: five-year results of a randomized controlled trial When used for appropriate indications, unicompartmental kneereplacement is associated with fewer complications, faster recovery, and better function than total kneereplacement. However, joint registries demonstrate a higher revision rate for unicompartmental kneereplacement. Currently, most unicompartmental kneereplacements 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 kneereplacements 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
Do modern total kneereplacements offer better value for money? A health economic analysis Do modern total kneereplacements offer better value for money? A health economic analysis Do modern total kneereplacements 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
Analgesia after total kneereplacement: 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 kneereplacement (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
Five-year results of a randomised controlled trial comparing mobile and fixed bearings in total kneereplacement There is conflicting evidence about the merits of mobile bearings in total kneereplacement, 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 kneereplacement functional outcomes, re-operation rates and healthcare costs appear to be the same irrespective of whether a mobile or fixed bearing is used.
Steroid modulation of cytokine release and desmosine levels in bilateral total kneereplacement: 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 kneereplacement 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
Secondary patellar resurfacing following primary total kneereplacement: a systematic review of the literature Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence
A systematic review comparing the accuracy of intramedullary versus extramedullary alignment guides for proximal tibial resection in total kneereplacement Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith
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
Does Exercise Reduce Pain and Improve Physical Function Before Hip or KneeReplacement 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
Cancellation of Hip and KneeReplacement 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 KneeReplacement Surgeries: Guidelines
Does a mobile-bearing, high-flexion design increase knee flexion after total kneereplacement? This prospective randomised controlled double-blind trial compared two types of PFC Sigma total kneereplacement (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
Rationing of total kneereplacement: 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.
The blood-saving effect of tranexamic acid in minimally invasive total kneereplacement: Is an additional pre-operative injection effective? Tranexamic acid (TEA), an inhibitor of fibrinolysis, reduces blood loss after routine total kneereplacement (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
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
Apixaban versus enoxaparin for thromboprophylaxis after hip or kneereplacement: 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