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Total arthroplasty in ankylosed knees: a case series

CAMANHO, Gilberto Luiz
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica
ENG
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36.94%
OBJECTIVE: To present nine patients with ankylosis in their knees that were submitted to a total arthroplasty to lessen their pain and improve their functional limitation. For these patients, arthrodesis remained a possibility in the event of arthroplasty failure. INTRODUCTION: Ankylosis of the knee is a severe functional limitation that becomes worse when pain is present. Arthrodesis of the knee is a classical indication for such patients, since it resolves the pain; however, the severe functional limitation remains. METHODS: In the present study, we evaluated the clinical course of nine patients who underwent total arthroplasty of the knee, and were followed up for at least five years. RESULTS: The results demonstrate that all of the patients experienced a significant reduction in pain and some improvement in the degree of knee flexion and extension. CONCLUSION: Based on the latest follow-up, there has been no need to perform arthrodesis for any of our patients, showing that a total arthroplasty could be a option for treatment in knee ankylosis.

ISOKINETIC EVALUATION OF PATIENTS SUBMITTED TO TOTAL KNEE ARTHROPLASTY

DEMANGE, Marco Kawamura; CAMANHO, Gilberto Luis; PECORA, Jose Ricardo; GREVE, Julia Maria; SILVA, Adriana Lucia Pastore e; REGINATO, Thiago Jose Buer
Fonte: ATHA COMUNICACAO & EDITORA Publicador: ATHA COMUNICACAO & EDITORA
Tipo: Artigo de Revista Científica
ENG
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Objective: In total knee arthroplasty, the minimally-invasive approach has been claimed to enable earlier rehabilitation because it spares the femoral quadriceps muscle. To check the influence of preserving the extensor apparatus during surgery, the strength of knee extension and flexion muscles was evaluated in patients submitted to total knee arthroplasty with different approaches. Materials and Methods: The values of maximum torque and total work obtained by isokinetic dynamometry six months after surgery were compared for the Minimally invasive surgery group constituted of 12 individuals submitted to total knee arthroplasty by the minimally invasive surgical approach and the Control group, constituted of eight patients submitted to total knee arthroplasty by the transquadricipital approach, between January 2005 and July 2006. Results: Statistical analysis of the absolute values for maximum torque and total work adjusted for body weights did not show differences between both groups. Conclusion: There was no difference in the extension and flexion strength of the knee muscles six months after surgery.

Sonographic Evaluation of the Abductor Mechanism After Total Hip Arthroplasty

GARCIA, Flavio Luis; PICADO, Celso Herminio Ferraz; NOGUEIRA-BARBOSA, Marcello Henrique
Fonte: AMER INST ULTRASOUND MEDICINE Publicador: AMER INST ULTRASOUND MEDICINE
Tipo: Artigo de Revista Científica
ENG
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36.94%
Objective. The purpose of this series was to determine the frequency of abductor mechanism avulsion by sonography after total hip arthroplasty with the Hardinge approach (J Bone Joint Surg Br 1982; 64:17-19) and its relationship to the presence of insufficiency of this musculature in the postoperative period. Methods. Thirty-four consecutive patients were prospectively accessed in the postoperative period of hip arthroplasty by the Trendelenburg test, hip sonography, and abductor muscle electromyography. In patients who were found to have clinical insufficiency of the abductor musculature, we also measured the femoral offset in the preoperative and postoperative radiographs. Hip sonography was performed by an experienced musculoskeletal radiologist blinded to the other tests, and the tendons of the gluteus medius and gluteus minimus were visualized on longitudinal and transverse sections with a 7- to 10-MHz linear transducer. Results. Eight patients presented clinical insufficiency of the abductor musculature as detected by the Trendelenburg test. Four of these 8 patients with abductor insufficiency presented tendinous avulsion detected by sonography. One of the 4 patients with abductor insufficiency and normal sonographic findings had a decrease in the femoral offset caused by the arthroplasty itself. Two patients presented electromyographic changes of the abductor musculature...

Resultados funcionais em pacientes com artrose patelofemoral submetidos à artroplastia de interposição retinacular; Functional outcomes with retinacular interposition arthroplasty in patients with patellofemoral arthrosis

Kersz, Ilana Henkin
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Dissertação Formato: application/pdf
POR
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Introdução: A degeneração da articulação patelofemoral é uma patologia relativamente comum, ocorrendo em 5% a 9% dos pacientes com artrose isolada do joelho. Avanço progressivo do processo degenerativo acompanhado de dor, rigidez articular e considerável limitação funcional são achados comumente presentes, tornando-se, muitas vezes, necessária a adoção de intervenções cirúrgicas. O tratamento cirúrgico para pacientes jovens, apresentando estágio avançado de artrose isolada da articulação patelofemoral, permanece controverso. Diversas técnicas cirúrgicas, incluindo liberação do retináculo lateral, avanço da tuberosidade tibial, implante autólogo de condrócitos, patelectomia, artroplastia patelofemoral e artroplastia total do joelho têm sido empregadas, apresentando ampla variação nos índices de sucesso. Além disso, a rotina pós-operatória e a necessidade de imobilização e proteção do reparo, após alguns procedimentos, tendem a repercutir nos resultados funcionais finais e no retorno às atividades de vida diária. Não há solução perfeita para o tratamento cirúrgico da artrose patelofemoral isolada. As opções terapêuticas disponíveis até proporcionam resultados funcionais aceitáveis...

Fatores de risco para infecção em cirurgias de prótese total de quadril e de joelhos; Risk factors infection in total hip and knee arthroplasty

Neide Sumie Yamada
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 30/01/2012 PT
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Introdução: As infecções são uma das complicações mais temidas nas artroplastias de quadril e joelho. A falta de um registro nacional de artroplastias e a escassez de publicações nacionais sobre o tema leva ao desconhecimento sobre os fatores de risco desta complicação na população brasileira. Objetivo: O objetivo deste trabalho é identificar a incidência e os fatores de risco para infecções relacionadas com as artroplastias de quadril (PTQ) e joelho (PTJ) em pacientes do hospital das clínicas da Unicamp. Métodos: Foi realizado um estudo tipo caso-controle, retrospectivo, das PTQs e PTJs feitas no período de 2005 a 2009, onde foi revisado os prontuários e coletados estes dados: idade, sexo, peso, altura,tipo de cirurgia, tempo de duração da cirurgia, número de doses de antibioticoterapia profilática, tempo de internação pré e pós-operatório, tempo de sondagem vesical de demora, presença de comorbidades como hipertensão e diabetes, história de etilismo e tabagismo, infecções recentes e tardias. Resultados: Foram incluídas neste estudo 173 artroplastias, sendo 109 (63%) de quadril e 64 (37%) de joelho. A incidência de infecções nas PTQs foi de 6,4% e nas PTJs foi de 20,3%. Dentre os fatores de risco para infecção...

Persistent pain after total knee or hip arthroplasty : differential study of prevalence, nature, and impact

Pinto, Patrícia; Almeida, Armando; McIntyre, Teresa; Soares, Vera Araújo; Ferrero, Ramón
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em //2013 ENG
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36.94%
This study compares the incidence, nature, and impact of persistent post-surgical pain after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and investigates differences between these procedures, with the focus on potential presurgical and post-surgical issues that could be related to the distinct persistent post-surgical pain outcomes between these two groups. A consecutive sample of 92 patients was assessed prospectively 24 hours before, 48 hours, and 4-6 months after surgery. The data show that TKA patients had a higher likelihood of developing persistent post-surgical pain, of reporting higher pain levels, and of using more neuropathic descriptors when classifying their pain. In addition, TKA patients more often reported interference from pain on functional domains, including general activity, walking ability, and normal work. Demographic factors, like gender and age, along with presurgical clinical factors like disease onset, existence of medical comorbidities, and other pain problems, may have contributed to these differences, whereas baseline psychologic factors and functionality levels did not seem to exert an influence. Heightened acute post-surgical pain experience among TKA patients could also be related to distinct outcomes for persistent post-surgical pain. Future prospective studies should therefore collect TKA and THA samples wherein patients are homogeneous for demographic and presurgical clinical issues. Overall...

Infected primary knee arthroplasty: Risk factors for surgical treatment failure

Pradella,Joao Gabriel Duarte Paes; Bovo,Miguel; Salles,Mauro Jose Costa; Klautau,Giselle Burlamaqui; Camargo,Osmar Arbix Pedro de; Cury,Ricardo de Paula Leite
Fonte: Sociedade Brasileira de Ortopedia e Traumatologia Publicador: Sociedade Brasileira de Ortopedia e Traumatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 EN
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OBJECTIVE: To present epidemiological data and risk factors associated with surgical out-comes favorable or unfavorable for the treatment of infection in infected total knee arthroplasty. METHODS: We reviewed medical records of 48 patients who underwent treatment of primary total knee arthroplasty for infection between January 1994 and December 2008, in the Orthopedics and Traumatology Department of the Santa Casa de Misericórdia de São Paulo. The variables associated with favorable outcome of surgical treatment (debridement and retention or exchange arthroplasty in two days) or unfavorable (arthrodesis or death) infection. RESULTS: A total of 39 cases of infection after primary total knee arthroplasty, 22 progressed to 17 for a favorable outcome and unfavorable outcome. Early infections (OR: 14.0, 95% CI 1.5-133.2, p = 0.016) and diabetes (OR: 11.3, 95% CI 1.4-89.3, p = 0.032) were associated with arthrodesis joint and death respectively. CONCLUSION: Patients with early infection had a higher risk of developing surgical procedure with unfavorable outcome (arthrodesis) and diabetics had higher odds of death after infection of primary knee arthroplasties.

Urinary retention and the role of indwelling catheterization following total knee arthroplasty

Kumar,P.; Mannan,K.; Chowdhury,A.M.; Kong,K.C.; Pati,J.
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2006 EN
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INTRODUCTION: We aimed to investigate the rate of urinary retention after knee arthroplasty, the various factors involved in predicting those at risk for retention and to assess the impact of retention and catheterization on joint sepsis. MATERIALS AND METHODS: A retrospective review was conducted of all available case notes of patients undergoing total knee arthroplasty in a consecutive 2-year period (2000-2002). Adequate data was available for 142 patients. RESULTS: 142 patients underwent total knee arthroplasty. 19 patients were catheterized preoperatively for monitoring urine output. 123 patients were not catheterized. Urinary retention occurred in 19.7% (28/142). The mean day of catheterization for retention was 0.66. The mean duration of catheterization in patients developing retention was 3.58 days and was 3 days in the patients catheterized pre - or perioperatively. Deep joint sepsis occurred in 2.1% (3/142) - only one had been catheterized and that was preoperatively. No case of infection had urinary retention or had a symptomatic urinary tract infection. The only factors predicting those at significant risk of retention following knee arthroplasty was a past medical history of urinary retention (p = 0.049) and postoperative morphine requirement (p = 0.035). No patients required urological surgical intervention at mean follow up of 1.97 years. CONCLUSIONS: This study supports the use of indwelling urinary catheterization for patients developing urinary retention after total knee arthroplasty.

Muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty

Ciolac,Emmanuel Gomes; Greve,Júlia Maria D’Andréa
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2011 EN
Relevância na Pesquisa
36.99%
OBJECTIVES: To analyze muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. METHODS: Twenty-three community-dwelling women were divided into the following groups: older, with knee osteoarthritis and total knee arthroplasty in the contralateral limb (OKG; N= 7); older, without symptomatic osteoarthritis (OG; N= 8); and young and healthy (YG; N= 8). Muscle strength (1-repetition maximum strength test) and exercise intensity progression (workload increases of 5%-10% were made whenever adaptation occurred) were compared before and after 13 weeks of a twice-weekly progressive resistance-training program. RESULTS: At baseline, OKG subjects displayed lower muscle strength than those in both the OG and YG. Among OKG subjects, baseline muscle strength was lower in the osteoarthritic leg than in the total arthroplasty leg. Muscle strength improved significantly during follow-up in all groups; however, greater increases were observed in the osteoarthritic leg than in the total knee arthroplasty leg in OKG subjects. Greater increases were also seen in the osteoarthritic leg of OKG than in OG and YG. The greater muscle strength increase in the osteoarthritic leg reduced the interleg difference in muscle strength in OKG subjects...

Is Recovery Faster for Mobile-bearing Unicompartmental than Total Knee Arthroplasty?

Lombardi, Adolph V.; Berend, Keith R.; Walter, Christopher A.; Aziz-Jacobo, Jorge; Cheney, Nicholas A.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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37.03%
How does unicompartmental compare with total knee arthroplasty in durability, incidence of complications and manipulations, recovery, postoperative function, and return to sport and work? We matched 103 patients (115 knees) treated with a mobile-bearing unicompartmental device through July 2005 to a selected group of 103 patients (115 knees) treated with cruciate retaining total knee arthroplasty for bilaterality, age, gender and body mass index. Patients who underwent a unicompartmental surgery had better range of motion at discharge and shorter hospital stay than those who had a total knee arthroplasty (77° versus 67° and 1.4 versus 2.2 days). At 6 weeks, Knee Society functional scores and range of motion were higher for unicompartmental than total knees (63 versus 55 and 115° versus 110°). Patient-perceived Oxford scores were similar between groups (unicompartmental 5.4 versus total 4.1). Average times to return to work and sport were similar for both groups. Minimally invasive unicompartmental knee arthroplasty demonstrated better early ROM, shorter hospital stays, and improved functional scores. No advantage was seen in terms of return to work, return to sport, or Oxford scores. The data suggest minimally invasive unicompartmental arthroplasty using a rapid recovery protocol allows patients a faster return to a more functional level than total knee arthroplasty.

The AViKA (Adding Value in Knee Arthroplasty) postoperative care navigation trial: rationale and design features

Losina, Elena; Collins, Jamie E; Daigle, Meghan E; Donnell-Fink, Laurel A; Prokopetz, Julian JZ; Strnad, Doris; Lerner, Vladislav; Rome, Benjamin N; Ghazinouri, Roya; Skoniecki, Debra J; Katz, Jeffrey N; Wright, John
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
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Background: Utilization of total knee arthroplasty is increasing rapidly. A substantial number of total knee arthroplasty recipients have persistent pain after surgery. Our objective was to design a randomized controlled trial to establish the efficacy of a motivational-interviewing-based telephone intervention aimed at improving patient outcomes and satisfaction following total knee arthroplasty. Methods/Design The study was conducted at Brigham and Women’s Hospital in Boston, Massachusetts. The study focused on individuals 40 years or older with a primary diagnosis of osteoarthritis who were scheduled for total knee arthroplasty. The study compared two management strategies over the first six months postoperatively: 1) enhanced postoperative care with frequent follow-up by a care navigator; 2) usual postoperative care. Those who were randomized into the enhanced postoperative care arm received ten calls from a trained non-clinician care navigator over the first six postoperative months. The navigator used motivational interviewing techniques to engage patients in discussions related to their rehabilitation goals, including patient’s plans for and confidence in achieving those goals. Patients in the usual care arm received standard postoperative management and received no navigator phone calls. Patients in both arms were assessed at baseline...

Poor outcome of revised resurfacing hip arthroplasty: 397 cases from the Australian Joint Replacement Registry

de Steiger, R.; Miller, L.; Prosser, G.; Graves, S.; Davidson, D.; Stanford, T.
Fonte: Taylor & Francis Publicador: Taylor & Francis
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
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Background and purpose: Recent years have seen a rapid increase in the use of resurfacing hip arthroplasty despite the lack of literature on the long-term outcome. In particular, there is little evidence regarding the outcome of revisions of primary resurfacing. The purpose of this analysis was to examine the survivorship of primary resurfacing hip arthroplasties that have been revised. Patients and methods: Over 12,000 primary resurfacing hip arthroplasties were recorded by the Australian Orthopaedic Association National Joint Replacement Registry between September 1, 1999 and December 31, 2008. During this time, 397 revisions for reasons other than infection were reported for these primary resurfacings and classified as acetabular, femoral, or both acetabular and femoral revisions. The survivorship of the different types of revisions was estimated using the Kaplan-Meier method and compared using proportional hazard models. Additionally, the outcome of a femoral-only revision was compared to that of primary conventional total hip arthroplasty. Results: Acetabular-only revision had a high risk of re-revision compared to femoral-only and both acetabular and femoral revision (5-year cumulative per cent revision of 20%, 7%, and 5% respectively). Femoral-only revision had a risk of re-revision similar to that of revision of both the acetabular and femoral components. Femoral-only revision had over twice the risk of revision of primary conventional total hip arthroplasty. Interpretation: Revision of a primary resurfacing arthroplasty is associated with a major risk of re-revision. The best outcome is achieved when either the femoral-only or both the acetabular and femoral components are revised. Technically straightforward femoral-only revisions generally have a worse outcome than a primary conventional total hip arthroplasty.; Richard N. de Steiger...

Centralization and the relationship between volume and outcome in knee arthroplasty procedures

Marlow, N.; Barraclough, B.; Collier, N.; Dickinson, I.; Fawcett, J.; Graham, J.; Maddern, G.
Fonte: Blackwell Science Asia Publicador: Blackwell Science Asia
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
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37.05%
BACKGROUND: Centralization aims to reduce adverse patient outcomes by concentrating complex surgical procedures in specified hospitals. OBJECTIVES: This review assessed the efficacy of centralization for knee arthroplasty by examining the relationship between hospital and surgeon volume and patient outcomes. DATA SOURCES AND REVIEW METHODS: The systematic review identified studies using multiple databases, including Medline and Embase. Two independent researchers ensured studies met the inclusion criteria. Morbidity, mortality, length of stay, financial outcomes and statistical rigour were examined. Correlations between volume and outcome were reported. RESULTS: Twelve primary knee arthroplasty studies examined hospital volume, which was significantly associated with decreased morbidity (five of seven studies), mortality (two of five studies) and length of stay (two of three studies). Three primary knee arthroplasty studies examined surgeon volume, which was significantly associated with decreased morbidity (two of three studies), mortality (zero of two studies) and length of stay (one of one study). Two revision knee arthroplasty studies examined hospital volume. One study examined but did not test for significance between hospital volume and patient morbidity; both studies examined volume and patient mortality reporting inconclusive results; and one study reported no significant association between volume and length of stay. None of the revision knee arthroplasty studies examined surgeon volume. CONCLUSIONS: Significant associations between increased hospital and surgeon volume and improved patient outcomes were reported. However...

Multi-state models and arthroplasty histories after unilateral total hip arthroplasties: Introducing the Summary Notation for Arthroplasty Histories

Gillam, M.; Ryan, P.; Salter, A.; Graves, S.
Fonte: Taylor & Francis Publicador: Taylor & Francis
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
37.17%
Background and purpose: An increasing number of patients have several joint replacement procedures during their lifetime. We investigated the use and suitability of multi-state model techniques in providing a more comprehensive analysis and description of complex arthroplasty histories held in arthroplasty registries than are allowed for with traditional survival methods. Patients and methods: We obtained data from the Australian Orthopaedic Association National Joint Replacement Registry on patients (n = 84,759) who had undergone a total hip arthroplasty for osteoarthritis in the period 2002–2008. We set up a multi-state model where patients were followed from their first recorded arthroplasty to several possible states: revision of first arthroplasty, either a hip or knee as second arthroplasty, revision of the second arthroplasty, and death. The Summary Notation for Arthroplasty Histories (SNAH) was developed in order to help to manage and analyze this type of data. Results: At the end of the study period, 12% of the 84,759 patients had received a second hip, 3 times as many as had received a knee. The estimated probabilities of having received a second arthroplasty decreased with age. Males had a lower transition rate for receiving a second arthroplasty...

Large femoral heads decrease the incidence of dislocation after total hip arthroplasty: A randomized controlled trial

Howie, D.; Holubowycz, O.; Middleton, R.
Fonte: Journal Bone Joint Surgery Inc Publicador: Journal Bone Joint Surgery Inc
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
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BACKGROUND: The use of larger femoral heads has been proposed to reduce the risk of dislocation after total hip arthroplasty, but there is a lack of evidence to support this proposal. The aim of this multicenter randomized controlled trial was to determine whether the incidence of dislocation one year after total hip arthroplasty is significantly lower in association with the use of a 36-mm femoral head articulation as compared with a 28-mm articulation. METHODS: Six hundred and forty-four middle-aged and elderly patients undergoing primary or revision arthroplasty were randomized intraoperatively to receive either a 36 or 28-mm metal femoral head on highly cross-linked polyethylene. Patients who were at high risk of dislocation (including those with dementia and neuromuscular disease) and those undergoing revision for the treatment of recurrent hip dislocation or infection were excluded. Patients were stratified according to other potential risk factors for dislocation, including diagnosis and age. Diagnosis of hip dislocation required confirmation by a physician and radiographic evidence of a dislocation. RESULTS: Overall, at one year of follow-up, hips with a 36-mm femoral head articulation had a significantly lower incidence of dislocation than did those with a 28-mm articulation (1.3% [four of 299] compared with 5.4% [seventeen of 316]; difference...

Time to event analysis of arthroplasty registry data.

Gillam, Marianne Knarberg Hansen
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2013
Relevância na Pesquisa
37.13%
Background: Arthroplasty registry data are traditionally analysed using standard survival methods, that is, Kaplan-Meier survival curves and the Cox proportional hazards model. The outcome of interest is usually the time from the primary procedure until occurrence of a single event – revision of the prosthesis. Other outcomes may also be of interest, for example, time to death, time to receiving another arthroplasty and the association between covariates and these events. The rise in life expectancy of the population combined with an increasing number of joint replacements being performed has resulted in many patients experiencing several joint replacement procedures during their lifetime. The analyses of registry data such as these require the use of more sophisticated statistical methods. Application and evaluation of statistical methods to analyse registry data containing complex arthroplasty histories are lacking. Aim: The aim of this thesis was to investigate the use of statistical methods in the analysis of multiple event data contained in arthroplasty registries. Within this broad aim the objectives were to investigate the use of competing risks methods in estimating the risk and rate of revision, investigate methods for handling covariates with time-varying effect...

Association of low birth weight and preterm birth with the incidence of knee and hip arthroplasty for osteoarthritis

Hussain, S.M.; Wang, Y.; Wluka, A.E.; Shaw, J.E.; Magliano, D.J.; Graves, S.; Cicuttini, F.M.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
37.08%
Objective: Low birth weight (LBW) and preterm birth have been associated with adverse adult outcomes, including hypertension, insulin resistance, cardiovascular disease, and reduced bone mass. It is unknown whether LBW and preterm birth affect the risk of osteoarthritis (OA). This study aims to examine whether LBW and preterm birth were associated with the incidence of knee and hip arthroplasty for OA. Methods: A total of 3,604 participants of the Australian Diabetes, Obesity and Lifestyle Study who reported their birth weight and history of preterm birth and were age >40 years at the commencement of arthroplasty data collection comprised the study sample. The incidence of knee and hip replacement for OA during 2002–2011 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. Results: One hundred and sixteen participants underwent knee arthroplasty and 75 underwent hip arthroplasty for OA. LBW (yes versus no; hazard ratio [HR] 2.04, 95% confidence interval [95% CI] 1.11–3.75, P = 0.02) and preterm birth (yes versus no; HR 2.50, 95% CI 1.29–4.87, P = 0.007) were associated with increased incidence of hip arthroplasty independent of age, sex, body mass index, education level...

Factors Affecting the Stability of Reverse Shoulder Arthroplasty

Clouthier, Allison
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
36.99%
Reverse shoulder arthroplasty is a relatively new procedure that is used to treat shoulders with massive rotator cuff tears combined with arthritis, a condition that is not well managed using conventional shoulder arthroplasty. By reversing the ‘ball-and-socket’ anatomy of the shoulder, the constraint of the joint can be increased. Despite the success of this prosthesis in improving pain and function, complication rates remain high and instability is often reported as the most commonly occurring complication. The mechanism of dislocation as well as factors that can be modified to decrease the risk of dislocation are not well understood for reverse shoulder arthroplasty. Therefore, the purpose of this study was to create a platform for examining the stability of reverse shoulder arthroplasty and use this to investigate factors affecting stability, including shoulder orientation (abduction and abduction plane angles), loading direction, glenosphere eccentricity and diameter, and humeral socket constraint. An anatomical shoulder simulator was developed using a synthetic bone model and pneumatically actuated cables to represent the three heads of the deltoid. A displacing force was applied to the humeral head by a material testing machine in an anterior...

Reverse arthroplasty of the shoulder for treating rotator cuff arthropathy

Amaral,Marcus Vinicius Galvão; Faria,José Leonardo Rocha de; Siqueira,Gláucio; Cohen,Marcio; Brandão,Bruno; Moraes,Rickson; Monteiro,Martim; Motta,Geraldo
Fonte: Sociedade Brasileira de Ortopedia e Traumatologia Publicador: Sociedade Brasileira de Ortopedia e Traumatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 EN
Relevância na Pesquisa
36.99%
OBJECTIVE: to present a retrospective analysis on the clinical-functional results and complications among patients with rotator cuff arthropathy (RCA) who underwent reverse arthroplasty of the shoulder. METHODS: patients with a diagnosis of RCA associated with pseudoparalysis of anterior elevation who underwent reverse arthroplasty of the shoulder with a minimum follow-up of one year were selected. RESULTS: preoperative information was gathered from our shoulder and elbow arthroplasty register, comprising age, sex, laterality, history of previous procedures, Constant's functional scores and the preoperative range of motion as described in the protocol of the American Academy of Shoulder and Elbow Surgery (ASES). After a mean follow-up of 44 months, 17 patients (94%) were satisfied with the result from the procedure. CONCLUSION: reverse arthroplasty for treating RCA in patients with pseudoparalysis of the shoulder was shown to be effective in achieving a statistically significant improvement in range of motion regarding anterior flexion and abduction. However, in this series, there was no improvement in range of motion regarding external and internal rotation. Reverse arthroplasty is a procedure that reestablishes shoulder joint function in patients who previously did not present any therapeutic possibilities.

Muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty

Ciolac, Emmanuel Gomes; Greve, Júlia Maria D’Andréa
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2011 ENG
Relevância na Pesquisa
36.99%
OBJECTIVES: To analyze muscle strength and exercise intensity adaptation to resistance training in older women with knee osteoarthritis and total knee arthroplasty. METHODS: Twenty-three community-dwelling women were divided into the following groups: older, with knee osteoarthritis and total knee arthroplasty in the contralateral limb (OKG; N= 7); older, without symptomatic osteoarthritis (OG; N= 8); and young and healthy (YG; N= 8). Muscle strength (1-repetition maximum strength test) and exercise intensity progression (workload increases of 5%-10% were made whenever adaptation occurred) were compared before and after 13 weeks of a twice-weekly progressive resistance-training program. RESULTS: At baseline, OKG subjects displayed lower muscle strength than those in both the OG and YG. Among OKG subjects, baseline muscle strength was lower in the osteoarthritic leg than in the total arthroplasty leg. Muscle strength improved significantly during follow-up in all groups; however, greater increases were observed in the osteoarthritic leg than in the total knee arthroplasty leg in OKG subjects. Greater increases were also seen in the osteoarthritic leg of OKG than in OG and YG. The greater muscle strength increase in the osteoarthritic leg reduced the interleg difference in muscle strength in OKG subjects...