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Scanning 2022In order to solve the problems of large trauma, many postoperative complications, and complex operation of artificial hip arthroplasty, a method to analyze the... (Randomized Controlled Trial)
Randomized Controlled Trial
In order to solve the problems of large trauma, many postoperative complications, and complex operation of artificial hip arthroplasty, a method to analyze the application effect of operating room nursing intervention in artificial hip arthroplasty was proposed. Firstly, 120 patients who underwent hip arthroplasty in our hospital from January to December 2017 were selected; Secondly, they were randomly divided into routine group (60 cases) and intervention group (60 cases); finally, on this basis, the intervention group strengthened the nursing in the operating room and used nanoceramic prosthesis. The Harris score of hip joint, the incidence of postoperative complications, and the satisfaction with nursing services were compared between the two groups. The results showed that the Harris score of hip joint and the satisfaction score of nursing service in the intervention group were significantly higher than those in the routine group ( < 0.05); the incidence of postoperative complications in the intervention group was significantly lower than that in the routine group ( < 0.05). It is proved that actively carrying out nursing intervention in the operating room and using nanoceramic prosthesis can not only improve the clinical efficacy and nursing service satisfaction of patients undergoing total hip arthroplasty but also reduce the incidence of complications.
Topics: Arthroplasty, Replacement, Hip; Ceramics; Hip Joint; Hip Prosthesis; Humans; Postoperative Complications; Treatment Outcome
PubMed: 35832302
DOI: 10.1155/2022/2421723 -
Medicine Oct 2020To investigate the efficacy and complications that might be associated with pyrocarbon compared with silicone in patients undergoing joint replacement surgery. (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
To investigate the efficacy and complications that might be associated with pyrocarbon compared with silicone in patients undergoing joint replacement surgery.
METHODS
The full-text papers about the clinical efficacy of pyrocarbon and silicone were retrieved from multiple databases. Review Manager version 5.0 was adopted for meta-analysis and analyses of sensitivity and bias.
RESULTS
Ultimately, we studied 232 patients across eight studies that met the eligibility criteria. The meta-analysis suggested a significant difference between the pyrocarbon and silicone groups in terms of the Disabilities of the Arm, Shoulder, and Hand (DASH) score (standard mean difference (SMD) = 1.48; 95% CI [0.97, 1.99]; P = .009; P for Heterogeneity <0.00001; I = 63%); Visual Analogue Score (VAS) (SMD = 1.68; 95% CI [1.36, 1.99]; P < .00001; P for heterogeneity = 0.01; I = 61%), and the abnormal radiolucent line (RR = 6.66; 95% CI [3.19, 13.89]; P < .00001; P for heterogeneity = 0.87, I = 0%); and ossification development (RR = 0.90; 95% CI [0.56, 1.44], P = .66; P for heterogeneity = 0.94, I = 0%).
CONCLUSION
This study showed that pyrocarbon might be an efficient material compared with silicone for joint replacement surgery, but resulted in poorer functional and pain outcomes compared with silicone.
Topics: Arthroplasty, Replacement; Biocompatible Materials; Carbon; Disability Evaluation; Humans; Joint Prosthesis; Pain Measurement; Prosthesis Design; Silicones
PubMed: 33031299
DOI: 10.1097/MD.0000000000022548 -
Clinical Orthopaedics and Related... Aug 2011Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis... (Review)
Review
BACKGROUND
Highly crosslinked polyethylene (HXLPE) was introduced to reduce wear and osteolysis in total joint arthroplasty. While many studies report wear and osteolysis associated with HXLPE, analytical techniques, clinical study design and followup, HXLPE formulation and implant design characteristics, and patient populations differ substantially among investigations, complicating a unified perspective.
QUESTIONS/PURPOSES
Literature on first-generation HXLPE was summarized. We systematically reviewed the radiographic wear data and incidence of osteolysis for HXLPE in hip and knee arthroplasty.
METHODS
PubMed identified 391 studies; 28 met inclusion criteria for a weighted-averages analysis of two-dimensional femoral head penetration rates. To determine the incidence of osteolysis, we estimated a pooled odds ratio using a random-effects model.
RESULTS
Weighted-averages analyses of femoral head penetration rates in HXLPE liners and conventional UHMWPE liners resulted, respectively, in a mean two-dimensional linear penetration rate of 0.042 mm/year based on 28 studies (n=1503 hips) and 0.137 mm/year based on 18 studies (n=695 hips). The pooled odds ratio for the risk of osteolysis in HXLPE versus conventional liners was 0.13 (95% confidence interval, 0.06-0.27) among studies with minimum 5-year followup. We identified two clinical studies of HXLPE in TKA, preventing systematic analysis of outcomes.
CONCLUSIONS
HXLPE liner studies consistently report lower femoral head penetration and an 87% lower risk of osteolysis. Reduction in femoral head penetration or osteolysis risk is not established for large-diameter (>32 mm) metallic femoral heads or ceramic femoral heads of any size. Few studies document the clinical performance of HXLPE in knees.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Cross-Linking Reagents; Femur Head; Hip Prosthesis; Humans; Knee Prosthesis; Materials Testing; Osteolysis; Polyethylenes; Prosthesis Design; Prosthesis Failure
PubMed: 21431461
DOI: 10.1007/s11999-011-1872-4 -
The Journal of Bone and Joint Surgery.... Nov 2012Periprosthetic joint infection (PJI) is a devastating complication which can follow a total joint arthroplasty (TJA). Although rare, this ongoing threat undermines the... (Review)
Review
Periprosthetic joint infection (PJI) is a devastating complication which can follow a total joint arthroplasty (TJA). Although rare, this ongoing threat undermines the success of TJA, a historically reputable procedure. It has haunted the orthopedic community for decades and several ongoing studies have provided insights and new approaches to effectively battle this multilayered problem.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Hip Prosthesis; Humans; Knee Prosthesis; Perioperative Care; Prosthesis-Related Infections; Risk Assessment; Risk Factors
PubMed: 23118379
DOI: 10.1302/0301-620X.94B11.30833 -
Acta Ortopedica Mexicana 2014The wear products and adverse reactions that occur on bearing surfaces represent one of the greatest challenges in prosthetic replacements, as the latter experience... (Review)
Review
The wear products and adverse reactions that occur on bearing surfaces represent one of the greatest challenges in prosthetic replacements, as the latter experience increasing demands due to the large number of young and older adult patients that have a long life expectancy and remarkable activity. The purpose of this review is to analyze the pros and cons of the new advances in the bearing components of the articular surfaces of current total hip arthroplasties. We also discuss the strategies used historically, their problems, results and the surgeon's role in prescribing the tribologic couple that best fits each patient's needs. We conclude with practical recommendations for the prescription and management of the latest articular couples for total hip arthroplasty.
Topics: Arthroplasty, Replacement, Hip; Ceramics; Hip Prosthesis; Humans; Metal-on-Metal Joint Prostheses; Polyethylenes; Prosthesis Design; Sterilization
PubMed: 26021098
DOI: No ID Found -
Arthroplasty implant registries over the past five decades: Development, current, and future impact.Journal of Orthopaedic Research :... Sep 2018Local, regional, and national registries have played an important role in the development of hip and knee arthroplasty and the treatment of patients with various... (Review)
Review
Local, regional, and national registries have played an important role in the development of hip and knee arthroplasty and the treatment of patients with various maladies of these joints. Four arthroplasty registries stand out as leading forces behind the drive to popularize the use of registries and pursue the concept of evidence based medicine. The Mayo registry, started by Mark Coventry, is recognized as the oldest continuing registry for arthroplasty. The Harris Registry at Massachusetts General Hospital, along with the Mayo Registry, has greatly contributed to the advancement of arthroplasty surgery and have served an important role of identifying poorly performing implants and techniques in the United States. The Swedish Knee Arthroplasty Registry is the oldest national registry dedicated to joint arthroplasty and along with the Swedish Hip Arthroplasty Registry have established the infrastructure, analysis and reporting mechanisms, and leadership that has enabled other countries to subsequently develop national registries around the world. As more countries have adopted the concept of national registries, a new area of research is possible by pooling the resources of large registries as is now occurring with the Nordic countries. Several international organizations have been formed to promote future collaboration and develop international standards. The process of globalization of registries is a result of continued efforts over the past 50 years in improving and disseminating the knowledge gained from the early registries. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2319-2330, 2018.
Topics: Arthroplasty, Replacement, Elbow; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Arthroplasty, Replacement, Shoulder; Data Collection; Elbow Prosthesis; Evidence-Based Medicine; Hip Prosthesis; Humans; International Cooperation; Knee Prosthesis; Orthopedics; Prosthesis Design; Prosthesis Failure; Registries; Shoulder Prosthesis; Societies, Medical; Sweden; United States
PubMed: 29663575
DOI: 10.1002/jor.24014 -
Clinical Orthopaedics and Related... Apr 2011
Topics: Arthroplasty, Replacement; Humans; Infection Control; Joint Prosthesis; Prosthesis-Related Infections; Risk Factors
PubMed: 21128032
DOI: 10.1007/s11999-010-1714-9 -
Medicina (Kaunas, Lithuania) Mar 2024Periprosthetic joint infection is a feared complication after the megaprosthetic reconstruction of oncologic and non-oncologic bone defects of including the knee or hip... (Review)
Review
Periprosthetic joint infection is a feared complication after the megaprosthetic reconstruction of oncologic and non-oncologic bone defects of including the knee or hip joint. Due to the relative rarity of these procedures, however, optimal management is debatable. Considering the expanding use of megaprostheses in revision arthroplasty and the high revision burden in orthopedic oncology, the risk of PJI is likely to increase over the coming years. In this non-systematic review article, we present and discuss current management options and the associated results focusing on studies from the last 15 years and studies from dedicated centers or study groups. The indication, surgical details and results in controlling infection are presented for debridement, antibiotics, irrigation and retention (DAIR) procedure with an exchange of the modular components, single-stage implant exchange, two-stage exchanges and ablative procedures.
Topics: Humans; Prosthesis-Related Infections; Debridement; Arthroplasty, Replacement, Hip; Anti-Bacterial Agents; Reoperation; Arthroplasty, Replacement, Knee; Knee Prosthesis; Hip Prosthesis; Therapeutic Irrigation
PubMed: 38674229
DOI: 10.3390/medicina60040583 -
The Journal of Bone and Joint Surgery.... Nov 2012
Review
Topics: Arthroplasty, Replacement, Knee; Humans; Knee Joint; Knee Prosthesis; Surgery, Computer-Assisted
PubMed: 23118405
DOI: 10.1302/0301-620X.94B11.30831 -
Clinical Orthopaedics and Related... Nov 2015Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the risk of revision in the presence of competing risks (such as death). Because the magnitude of overestimation is not well documented, the potential associated impact on clinical and policy decision-making remains unknown.
QUESTIONS/PURPOSES
We performed a meta-analysis to answer the following questions: (1) To what extent does the Kaplan-Meier method overestimate the cumulative incidence of revision after joint replacement compared with alternative competing-risks methods? (2) Is the extent of overestimation influenced by followup time or rate of competing risks?
METHODS
We searched Ovid MEDLINE, EMBASE, BIOSIS Previews, and Web of Science (1946, 1980, 1980, and 1899, respectively, to October 26, 2013) and included article bibliographies for studies comparing estimated cumulative incidence of revision after hip or knee arthroplasty obtained using both Kaplan-Meier and competing-risks methods. We excluded conference abstracts, unpublished studies, or studies using simulated data sets. Two reviewers independently extracted data and evaluated the quality of reporting of the included studies. Among 1160 abstracts identified, six studies were included in our meta-analysis. The principal reason for the steep attrition (1160 to six) was that the initial search was for studies in any clinical area that compared the cumulative incidence estimated using the Kaplan-Meier versus competing-risks methods for any event (not just the cumulative incidence of hip or knee revision); we did this to minimize the likelihood of missing any relevant studies. We calculated risk ratios (RRs) comparing the cumulative incidence estimated using the Kaplan-Meier method with the competing-risks method for each study and used DerSimonian and Laird random effects models to pool these RRs. Heterogeneity was explored using stratified meta-analyses and metaregression.
RESULTS
The pooled cumulative incidence of revision after hip or knee arthroplasty obtained using the Kaplan-Meier method was 1.55 times higher (95% confidence interval, 1.43-1.68; p < 0.001) than that obtained using the competing-risks method. Longer followup times and higher proportions of competing risks were not associated with increases in the amount of overestimation of revision risk by the Kaplan-Meier method (all p > 0.10). This may be due to the small number of studies that met the inclusion criteria and conservative variance approximation.
CONCLUSIONS
The Kaplan-Meier method overestimates risk of revision after hip or knee arthroplasty in populations where competing risks (such as death) might preclude the occurrence of the event of interest (revision). Competing-risks methods should be used to more accurately estimate the cumulative incidence of revision when the goal is to plan healthcare services and resource allocation for revisions.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Hip Prosthesis; Humans; Incidence; Kaplan-Meier Estimate; Knee Prosthesis; Postoperative Complications; Prosthesis Failure; Reoperation; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
PubMed: 25804881
DOI: 10.1007/s11999-015-4235-8