Latest & greatest articles for knee replacement

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Top results for knee replacement

121. Rivaroxaban and dabigatran for thromboprophylaxis in patients undergoing total hip or knee replacement

Rivaroxaban and dabigatran for thromboprophylaxis in patients undergoing total hip or knee replacement Home - Monash Health Find a Location Latest news Victorian Minister for Health Jenny Mikakos MP meets a patient and researcher leading the world-first safety trial examining stem cells as therapy for acute stroke. Your health Heat kills more people than any natural disaster. Be prepared and survive the heat this summer. Our children’s hospital Monash Children’s Hospital is one of Australia’s

2009 Monash Health Evidence Reviews

122. Prostheses for primary total knee replacement in Italy

Prostheses for primary total knee replacement in Italy Prostheses for primary total knee replacement in Italy Prostheses for primary total knee replacement in Italy Cerbo M, Fella D, Jefferson T, Migliore A, Paone S, Perrini MR, Velardi L 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 Cerbo M, Fella D, Jefferson T, Migliore A, Paone S (...) , Perrini MR, Velardi L. Prostheses for primary total knee replacement in Italy. Rome: Agenzia nazionale per i servizi sanitari regionali. 2009 Authors' objectives We aimed to identify the TKR prostheses currently used in Italy, to retrieve evidence of performance for all the models identified from clinical studies and arthroplasty registers, and to construct a cost-effectiveness model to support the choice for healthcare payers. Authors' conclusions Despite the limitations and constraints of our study

2009 Health Technology Assessment (HTA) Database.

123. Apixaban or enoxaparin for thromboprophylaxis after knee replacement. (PubMed)

Apixaban or enoxaparin for thromboprophylaxis after knee replacement. The optimal strategy for thromboprophylaxis after major joint replacement has not been established. Low-molecular-weight heparins such as enoxaparin predominantly target factor Xa but to some extent also inhibit thrombin. Apixaban, a specific factor Xa inhibitor, may provide effective thromboprophylaxis with a low risk of bleeding and improved ease of use.In a double-blind, double-dummy study, we randomly assigned patients (...) undergoing total knee replacement to receive 2.5 mg of apixaban orally twice daily or 30 mg of enoxaparin subcutaneously every 12 hours. Both medications were started 12 to 24 hours after surgery and continued for 10 to 14 days. Bilateral venography was then performed. The primary efficacy outcome was a composite of asymptomatic and symptomatic deep-vein thrombosis, nonfatal pulmonary embolism, and death from any cause during treatment. Patients were followed for 60 days after anticoagulation therapy

2009 NEJM

124. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults

Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults National Institute for Health and Clinical Excellence Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation National Institute for Health and Clinical Excellence. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults. London: National Institute for Health and Clinical Excellence (NICE). Technology Appraisal Guidance 170. 2009 Authors' conclusions Rivaroxaban, within its marketing authorisation, is recommended as an option for the prevention of venous thromboembolism in adults having elective total hip

2009 Health Technology Assessment (HTA) Database.

125. Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis

Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis Survival and clinical function of cemented and uncemented prostheses in total knee replacement: a meta-analysis Gandhi R, Tsvetkov D, Davey JR, Mahomed NN CRD summary This review compared survival and clinical outcomes of cemented and uncemented techniques in primary total (...) knee replacement and concluded that there was improved survival for cemented implants. Given the presence of publication bias, uncertain study quality and conclusions based on pooling of two study types, the authors' conclusions should be interpreted with caution. Authors' objectives To compare survival and clinical outcomes of cemented and uncemented techniques in primary total knee replacement. Searching PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register

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2009 DARE.

126. A cost-effectiveness model comparing rivaroxaban and dabigatran etexilate with enoxaparin sodium as thromboprophylaxis after total hip and total knee replacement in the Irish healthcare setting

A cost-effectiveness model comparing rivaroxaban and dabigatran etexilate with enoxaparin sodium as thromboprophylaxis after total hip and total knee replacement in the Irish healthcare setting A cost-effectiveness model comparing rivaroxaban and dabigatran etexilate with enoxaparin sodium as thromboprophylaxis after total hip and total knee replacement in the Irish healthcare setting A cost-effectiveness model comparing rivaroxaban and dabigatran etexilate with enoxaparin sodium (...) as thromboprophylaxis after total hip and total knee replacement in the Irish healthcare setting McCullagh L, Tilson L, Walsh C, Barry M 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 examined the cost-effectiveness of rivaroxaban

2009 NHS Economic Evaluation Database.

127. Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism after total knee and hip replacement surgery

Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism after total knee and hip replacement surgery Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism after total knee and hip replacement surgery Economic evaluation of dabigatran etexilate for the prevention of venous thromboembolism after total knee and hip replacement surgery Wolowacz S E, Roskell N S, Maciver F, Beard S M, Robinson P A, Plumb J M, Dolan G, Brenkel I J (...) 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 examined the cost-effectiveness of oral dabigatran etexilate (DE) versus subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement

2009 NHS Economic Evaluation Database.

128. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults (TA170)

Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults (TA170) Overview | Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults | Guidance | NICE Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults Technology appraisal guidance [TA170] Published date: 22 April 2009 Share Guidance on rivaroxaban (Xarelto) for preventing venous (...) thromboembolism after total hip or total knee replacement in adults. Guidance development process Is this guidance up to date? . We found nothing new that affects the recommendations in this guidance. Next review: This guidance will be reviewed if there is new evidence that is likely to change the recommendations. Your responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health

2009 National Institute for Health and Clinical Excellence - Technology Appraisals

129. After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial (PubMed)

After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient (...) -reported kneeling ability following partial knee replacement (PKR).Sixty adults with medial compartment osteoarthritis, suitable for a PKR, participated.This was a single-blind, prospective randomized controlled trial. Six weeks after PKR, participants randomly received either kneeling advice and education or routine care where no specific kneeling advice was given. Reassessment was at 1 year postoperatively. The primary outcome measure was patient-reported kneeling ability, as assessed by question 7

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2008 EvidenceUpdates

130. Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement (PubMed)

Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: a multi-centre randomised controlled trial using the Kinemax total knee replacement We compared patient-reported outcomes of the Kinemax fixed- and mobile-bearing total knee replacement in a multi-centre randomised controlled trial. Patients were randomised to the fixed- or the mobile-bearing prosthesis via a sealed envelope method after the bone cuts had been made in the operating theatre. Randomisation (...) was stratified by centre and diagnosis. Patients were assessed pre-operatively and at eight to 12 weeks, one year and two years post-operatively. Validated questionnaires were used which included the Western Ontario MacMasters University, Short-Form 12, Mental Health Index-5, Knee Injury and Osteoarthritis Outcome Score for Knee-Related Quality of Life and Function in Sport and Recreation scales and a validated scale of satisfaction post-operatively. In total, 242 patients (250 knees) with a mean age of 68

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2008 EvidenceUpdates

131. Pre-operative injections of epoetin-{alpha} versus post-operative retransfusion of autologous shed blood in total hip and knee replacement (PubMed)

Pre-operative injections of epoetin-{alpha} versus post-operative retransfusion of autologous shed blood in total hip and knee replacement This prospective randomised clinical trial evaluated the effect of alternatives for allogeneic blood transfusions after total hip replacement and total knee replacement in patients with pre-operative haemoglobin levels between 10.0 g/dl and 13.0 g/dl. A total of 100 patients were randomly allocated to the Eprex (pre-operative injections of epoetin (...) ) and 30% (nine of 30 patients) (p = 0.047) respectively, whereas in total knee replacement, the percentages were 0% (0 of 20 patients) and 25% (five of 20 patients) respectively (p = 0.042). Pre-operative epoetin injections are more effective but more costly in reducing the need for allogeneic blood transfusions in mildly anaemic patients than post-operative retransfusion of autologous blood.

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2008 EvidenceUpdates

132. Computer-assisted and conventional total knee replacement (PubMed)

Computer-assisted and conventional total knee replacement After obtaining informed consent, 80 patients were randomised to undergo a navigated or conventional total knee replacement. All received a cemented, unconstrained, cruciate-retaining implant with a rotating platform. Full-length standing and lateral radiographs and CT scans of the hip, knee and ankle joint were carried out five to seven days after operation. No notable differences were found between computer-assisted navigation

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2008 EvidenceUpdates

133. Inpatient compared with home-based rehabilitation following primary unilateral total hip or knee replacement: a randomized controlled trial (PubMed)

Inpatient compared with home-based rehabilitation following primary unilateral total hip or knee replacement: a randomized controlled trial Home-based rehabilitation is increasingly utilized to reduce health-care costs; however, with a shorter hospital stay, the possibility arises for an increase in adverse clinical outcomes. We evaluated the effectiveness and cost of care of home-based compared with inpatient rehabilitation following primary total hip or knee joint replacement.We randomized (...) elective primary total hip or knee replacement as it is the more cost-effective strategy.

2008 EvidenceUpdates

134. Total knee replacement performed with either a mini-midvastus or a standard approach (PubMed)

Total knee replacement performed with either a mini-midvastus or a standard approach We report the clinical and radiological results of a two- to three-year prospective randomised study which was designed to compare a minimally-invasive technique with a standard technique in total knee replacement and was undertaken between January 2004 and May 2007. The mini-midvastus approach was used on 50 patients (group A) and a standard approach on 50 patients (group B). The mean follow-up in both groups (...) difference in the mean maximum flexion between the groups (p = 0.08). Technical errors were identified in six patients from group A (12%) on radiological evaluation. Based on these results, the authors currently use minimally-invasive techniques in total knee replacement in selected cases only.

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2008 EvidenceUpdates

135. Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up (PubMed)

Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up Approximately 12,000 hip and knee replacements were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, but there is conflicting evidence regarding the effect. We therefore performed an efficacy study of an accelerated perioperative care and rehabilitation intervention (...) in patients receiving primary total hip replacement, and both total and unicompartmental knee replacement.A randomized clinical trial was undertaken in which 87 patients were randomized to either a control group receiving the current perioperative procedure, or an intervention group receiving a new accelerated perioperative care and rehabilitation procedure. Outcome measures were length of stay (LOS) in hospital, and gain in quality of life (QOL) using EQ-5D from baseline to 3-month follow-up.Mean LOS

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2008 EvidenceUpdates

136. Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. (PubMed)

Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. Joint replacements are common procedures and treatment of choice for those with intractable joint pain and disability arising from arthropathy of the hip or knee. Multidisciplinary rehabilitation is considered integral to the outcome of joint replacement.To assess the evidence for effectiveness of multidisciplinary rehabilitation on activity and participation in adults following (...) hip or knee joint replacement for chronic arthropathy.We searched the Cochrane Musculoskeletal Group Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and CINAHL up to September 2006.Randomised controlled trials (RCTs) that compared organised multidisciplinary rehabilitation with routine services following hip or knee replacement, and included outcome measures of activity and participation in accordance with the International Classification of Functioning, Health

2008 Cochrane

137. Total knee replacement with and without patellar resurfacing: A Prospective, randomised trial using the profix total knee system (PubMed)

Total knee replacement with and without patellar resurfacing: A Prospective, randomised trial using the profix total knee system We have examined the differences in clinical outcome of total knee replacement (TKR) with and without patellar resurfacing in a prospective, randomised study of 181 osteoarthritic knees in 142 patients using the Profix total knee system which has a femoral component with features considered to be anatomical and a domed patellar implant. The procedures were carried out (...) between February 1998 and November 2002. A total of 159 TKRs in 142 patients were available for review at a mean of four years (3 to 7). The patients and the clinical evaluator were blinded in this prospective study. Evaluation was undertaken annually by an independent observer using the knee pain scale and the Knee Society clinical rating system. Specific evaluation of anterior knee pain, stair-climbing and rising from a seated to a standing position was also undertaken. No benefit was shown of TKR

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2008 EvidenceUpdates

138. A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components (PubMed)

A prospective randomised double-blind study of functional outcome and range of flexion following total knee replacement with the NexGen standard and high flexion components Modifications in the design of knee replacements have been proposed in order to maximise flexion. We performed a prospective double-blind randomised controlled trial to compare the functional outcome, including maximum knee flexion, in patients receiving either a standard or a high flexion version of the NexGen legacy (...) posterior stabilised total knee replacement. A total of 56 patients, half of whom received each design, were assessed pre-operatively and at one year after operation using knee scores and analysis of range of movement using electrogoniometry. For both implant designs there was a significant improvement in the function component of the knee scores (p < 0.001) and the maximum range of flexion when walking on the level, ascending and descending a slope or stairs (all p < 0.001), squatting (p = 0.020

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2008 EvidenceUpdates

139. Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis

Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis Costs and outcomes of total hip and knee joint replacement for rheumatoid arthritis March L M, Barcenilla A L, Cross M J, Lapsley H M, Parker D, Brooks P M 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 examined the clinical and economic impact of primary unilateral total knee replacement (TKR) and total hip replacement (THR) in patients with rheumatoid arthritis. The authors concluded that surgery reduced the post-operative costs from the perspective of the patient and the health care system, and improved the health outcomes for both THR and TKR

2008 NHS Economic Evaluation Database.

140. A prospective randomised controlled trial of autologous retransfusion in total knee replacement (PubMed)

A prospective randomised controlled trial of autologous retransfusion in total knee replacement We undertook a prospective randomised controlled trial to investigate the efficacy of autologous retransfusion drains in reducing the need for allogenic blood requirement after unilateral total knee replacement. We also monitored the incidence of post-operative complications. There were 86 patients in the control group, receiving standard care with a vacuum drain, and 92 who received an autologous (...) on this study, the cost-effectiveness and continued use of autologous drains in total knee replacement should be questioned.

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2008 EvidenceUpdates