Latest & greatest articles for knee replacement

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Top results for knee replacement

101. Inflammation related to synovectomy during total knee replacement in patients with primary osteoarthritis: a prospective, randomised study (PubMed)

Inflammation related to synovectomy during total knee replacement in patients with primary osteoarthritis: a prospective, randomised study We compared inflammation in the knee after total knee replacement (TKR) for primary osteoarthritis between two groups of patients undergoing joint replacement with and without synovectomy. A total of 67 patients who underwent unilateral TKR were randomly divided into group I, TKR without synovectomy, and group II, TKR with synovectomy. Clinical outcomes (...) , serial serum inflammatory markers (including interleukin-6 (IL-6), CRP and ESR) and the difference in temperature of the skin of the knee, compared with the contralateral side, were sequentially evaluated until 26 weeks after surgery. Pre-operatively, there were no statistically different clinical parameters between groups I and II. At the 26-week follow-up, both groups had a similarly significantly improved American Knee Society clinical score (p < 0.001) and functional score (p < 0.001

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2011 EvidenceUpdates

102. Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery

Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery (...) Ringerike T, Hamidi V, Hagen G, Reikvam A, Klemp M 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 Ringerike T, Hamidi V, Hagen G, Reikvam A, Klemp M. Thromboprophylactic treatment with rivaroxaban or dabigatran compared with enoxaparin or dalteparin in patients undergoing elective hip- or knee replacement surgery. Oslo: Norwegian Knowledge Centre

2011 Health Technology Assessment (HTA) Database.

103. Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model

Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model Cost-effectiveness of total hip and knee replacements for the Australian population with osteoarthritis: discrete-event simulation model Higashi H, Barendregt JJ 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 evaluate the cost-effectiveness of total hip or knee replacements, in Australia, accounting for left and right joint replacements in each patient. The authors concluded that both hip and knee replacements were cost-effective

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2011 NHS Economic Evaluation Database.

104. Equity in access to total joint replacement of the hip and knee in England: cross sectional study. (PubMed)

Equity in access to total joint replacement of the hip and knee in England: cross sectional study. To explore geographical and sociodemographic factors associated with variation in equity in access to total hip and knee replacement surgery.Combining small area estimates of need and provision to explore equity in access to care.English census wards.Patients throughout England who needed total hip or knee replacement and numbers who received surgery.Predicted rates of need (derived from (...) % confidence interval 0.65 to 0.72) and less total knee replacement (0.87, 0.82 to 0.93). Compared with women, men received more provision relative to need for total hip replacement (1.08, 1.05 to 1.10) and total knee replacement (1.31, 1.28 to 1.34). Compared with the least deprived, residents in the most deprived areas got less provision relative to need for total hip replacement (0.31, 0.30 to 0.33) and total knee replacement (0.33, 0.31 to 0.34). For total knee replacement, those in urban areas got

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2010 BMJ

105. Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement (PubMed)

Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area.Randomized controlled trial.Research laboratory and hospital rehabilitation pool.Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial.Twelve (...) =.018) and that of the nonoperated leg 2% (P=.019) after training compared with controls.Progressive aquatic resistance training had favorable effects on mobility limitation by increasing walking speed and decreasing stair ascending time. In addition, training increased lower limb muscle power and muscle CSA. Resistance training in water is a feasible mode of rehabilitation that has wide-ranging positive effects on patients after knee replacement surgery.Copyright 2010 American Congress

2010 EvidenceUpdates

106. Measurement of joint effusion and haematoma formation by ultrasound in assessing the effectiveness of drains after total knee replacement: A prospective randomised study (PubMed)

Measurement of joint effusion and haematoma formation by ultrasound in assessing the effectiveness of drains after total knee replacement: A prospective randomised study We prospectively randomised 78 patients into two groups, 'drains' or 'no drains' to assess the effectiveness of suction drains in reducing haematoma and effusion in the joint and its effect on wound healing after total knee replacement. Ultrasound was used to measure the formation of haematoma and effusion on the fourth post

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2010 EvidenceUpdates

107. Surface neuromuscular electrical stimulation for quadriceps strengthening pre and post total knee replacement. (PubMed)

Surface neuromuscular electrical stimulation for quadriceps strengthening pre and post total knee replacement. Total knee replacement has been demonstrated to be one of the most successful procedures in the treatment of osteoarthritis. However quadriceps weakness and reductions in function are commonly reported following surgery. Recently Neuromuscular Electrical Stimulation (NMES) has been used as an adjunct to traditional strengthening programmes. This review considers the effectiveness (...) in each group was unclear.The studies found in this review do not permit any conclusions to be made about the application of neuromuscular stimulation for the purposes of quadriceps strengthening before or after total knee replacement. At this time the evidence for the use of neuromuscular stimulation for the purposes of quadriceps strengthening in this patient group is unclear.

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2010 Cochrane

109. Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. (PubMed)

Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. Low-molecular-weight heparins such as enoxaparin are preferred for prevention of venous thromboembolism after major joint replacement. Apixaban, an orally active factor Xa inhibitor, might be as effective, have lower bleeding risk, and be easier to use than is enoxaparin. We assessed efficacy and safety of these drugs after elective total knee replacement.In ADVANCE-2 (...) , a multicentre, randomised, double-blind phase 3 study, patients undergoing elective unilateral or bilateral total knee replacement were randomly allocated through an interactive central telephone system to receive oral apixaban 2.5 mg twice daily (n=1528) or subcutaneous enoxaparin 40 mg once daily (1529). The randomisation schedule was generated by the Bristol-Myers Squibb randomisation centre and stratified by study site and by unilateral or bilateral surgery with a block size of four. Investigators

2010 Lancet

110. Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism in patients aged over 75 years or with moderate renal impairment undergoing total knee or hip replacement

Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism in patients aged over 75 years or with moderate renal impairment undergoing total knee or hip replacement Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism in patients aged over 75 years or with moderate renal impairment undergoing total knee or hip replacement Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism in patients aged (...) over 75 years or with moderate renal impairment undergoing total knee or hip replacement Wolowacz SE, Roskell NS, Plumb JM, Clemens A, Noack H, Robinson PA, Dolan G, Brenkel IJ 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

2010 NHS Economic Evaluation Database.

111. Is longer waiting time for total knee replacement associated with health outcomes and medication costs? Randomized clinical trial

Is longer waiting time for total knee replacement associated with health outcomes and medication costs? Randomized clinical trial 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.

2010 NHS Economic Evaluation Database.

112. Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review

Is a tourniquet beneficial in total knee replacement surgery? A meta-analysis and systematic review 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.

2010 DARE.

113. Mini-incision surgery for total knee replacement (IPG345)

Mini-incision surgery for total knee replacement (IPG345) Overview | Mini-incision surgery for total knee replacement | Guidance | NICE Mini-incision surgery for total knee replacement Interventional procedures guidance [IPG345] Published date: May 2010 Share Save Guidance The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Mini-incision surgery for total knee replacement. It replaces (...) the previous guidance on Mini-incision surgery for total knee replacement (NICE interventional procedures guidance 117, September 2004). Description The most common indication for a total knee replacement is osteoarthritis of the knee joint. The mini-incision total knee replacement involves an incision 10 to 12 cm long over the knee, compared with the conventional total knee replacement which requires an incision 20 to 30 cm long. The same prostheses are inserted using specially designed instruments. W40

2010 National Institute for Health and Clinical Excellence - Interventional Procedures

114. Clinical and radiological outcomes of fixed- versus mobile-bearing total knee replacement: a meta-analysis

Clinical and radiological outcomes of fixed- versus mobile-bearing total knee replacement: a 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.

2010 DARE.

115. Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis (PubMed)

Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis Using meta-analysis we compared the survival and clinical outcomes of cemented and uncemented techniques in primary total knee replacement. We reviewed randomised controlled trials and observational studies comparing cemented and uncemented fixation. Our primary outcome was survival of the implant free of aseptic loosening. Our secondary outcome was joint function as measured (...) by the Knee Society score. We identified 15 studies that met our final eligibility criteria. The combined odds ratio for failure of the implant due to aseptic loosening for the uncemented group was 4.2 (95% confidence interval (CI) 2.7 to 6.5) (p < 0.0001). Subgroup analysis of data only from randomised controlled trials showed no differences between the groups for odds of aseptic loosening (odds ratio 1.9, 95% CI 0.55 to 6.40, p = 0.314). The weighted mean difference for the Knee Society score was 0.005

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2009 EvidenceUpdates

116. A comparison of regional and general anaesthesia for total replacement of the hip or knee: a meta-analysis (PubMed)

A comparison of regional and general anaesthesia for total replacement of the hip or knee: a meta-analysis We performed a meta-analysis to evaluate the relative efficacy of regional and general anaesthesia in patients undergoing total hip or knee replacement. A comprehensive search for relevant studies was performed in PubMed (1966 to April 2008), EMBASE (1969 to April 2008) and the Cochrane Library. Only randomised studies comparing regional and general anaesthesia for total hip or knee (...) ). Regional anaesthesia therefore seems to improve the outcome of patients undergoing total hip or knee replacement.

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2009 EvidenceUpdates

117. Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam (PubMed)

Postoperative analgesia and early rehabilitation after total knee replacement: a comparison of continuous low-dose intravenous ketamine versus nefopam The effects of nefopam and ketamine on pain control and rehabilitation after total knee replacement were compared in a prospective, double blinded study. Seventy-five patients were randomly assigned to receive a 0.2mg kg(-1) bolus of nefopam or ketamine, followed by a 120microg kg(-1) h(-1) continuous infusion until the end of surgery (...) , respectively, p=0.01). Ketamine produces opioid-sparing, decreases pain intensity, and improves mobilization after total knee replacement. Nefopam achieves less significant results in that circumstances.

2009 EvidenceUpdates

118. Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement (PubMed)

Oral rivaroxaban for the prevention of symptomatic venous thromboembolism after elective hip and knee replacement A once-daily dose of rivaroxaban 10 mg, an oral, direct Factor Xa inhibitor, was compared with enoxaparin 40 mg subcutaneously once daily for prevention of venous thromboembolism in three studies of patients undergoing elective hip and knee replacement (RECORD programme). A pooled analysis of data from these studies (n = 9581) showed that rivaroxaban was more effective than

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2009 EvidenceUpdates

119. A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: a randomized controlled trial (PubMed)

A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: a randomized controlled trial To evaluate the effect of inpatient aquatic physiotherapy in addition to usual ward physiotherapy on the recovery of strength, function, and gait speed after total hip or knee replacement surgery.Pragmatic randomized controlled trial with blinded 6-month follow-up.Acute-care private hospital.People (n=65) undergoing primary hip or knee arthroplasty (...) at any time point in the trial, but relative differences favored the aquatic physiotherapy intervention at day 14. No adverse events occurred with early aquatic intervention.A specific inpatient aquatic physiotherapy program has a positive effect on early recovery of hip strength after joint replacement surgery. Further studies are required to confirm these findings. Our research indicates that aquatic physiotherapy can be safely considered in this early postoperative phase.

2009 EvidenceUpdates

120. Land-based versus water-based rehabilitation following total knee replacement: A randomized, single-blind trial (PubMed)

Land-based versus water-based rehabilitation following total knee replacement: A randomized, single-blind trial To compare outcomes between land-based and water-based exercise programs delivered in the early subacute phase up to 6 months after total knee replacement (TKR).Two weeks after surgery (baseline), 102 patients were randomized to participate in either land-based (n = 49) or water-based (n = 53) exercise classes. Treatment parameters were guided by current clinical practice protocols (...) . Therefore, each study arm involved 1-hour sessions twice a week for 6 weeks, with patient-determined exercise intensity. Session attendance was recorded. Outcomes were measured at baseline and at 8 and 26 weeks postsurgery. Outcomes included distance on the 6-Minute Walk test, stair climbing power (SCP), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (n = 85 English-proficient patients), visual analog scale for joint pain, passive knee range of motion, and knee edema

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2009 EvidenceUpdates