Tag Archive | Knee

Adductor Canal Block Compared with Periarticular Bupivacaine Injection for Total Knee Arthroplasty

In the last decade, the widespread use of regional anesthesia in total knee arthroplasty has led to improvements in pain control, more rapid functional recovery, and reductions in the length of the hospital stay. #JBJS #JBJSInfoGraphics #visualabsrtact

Full article: https://bit.ly/2zrZvJW

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Intravenous Versus Topical Tranexamic Acid in Total Knee Arthroplasty

Tranexamic acid (TXA) reduces bleeding and the need for transfusion after total knee arthroplasty. Most literature has focused on intravenous (IV) administration of TXA, with less data available on the efficacy of topically administered TXA. https://bit.ly/2tysir0JBJS.IG.17.00908.ig

Progression of Cervical Spine Degeneration Over 20 Years

Few studies have addressed in detail long-term degenerative changes in the cervical spine. https://jbjs.org/reader.php?source=The_Journal_of_Bone_and_Joint_Surgery/100/10/843/fulltext&id=30295&rsuite_id=1666209#info #JBJSInfographics #VisualAbstract

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Concomitant Ankle Osteoarthritis Is Related to Increased Ankle Pain and a Worse Clinical Outcome Following Total Knee Arthroplasty

Occasionally, patients experience new or increased ankle pain following total knee arthroplasty (TKA). https://bit.ly/2IkLoGD #JBJS  #JBJSVideoSummaries

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Risk Reduction Compared with Access to Care: The Trade-Off of Enforcing a BMI Eligibility Criterion for Joint Replacement

Morbidly obese patients with severe osteoarthritis benefit from successful total joint arthroplasty. However, morbid obesity increases the risk of complications. https://bit.ly/2qpfj8w #JBJS

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Effect of Postoperative Mechanical Axis Alignment on Survival and Functional Outcomes of Modern Total Knee Arthroplasties with Cement

Abdel et al. report on the 20-year survivorship of total knee arthroplasty implants that were mechanically aligned (0° ± 3° relative to the mechanical axis) compared with those that were outside that range and considered outliers. https://bit.ly/2uqY77S #JBJS

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Webinar on Dec. 13—Patient Satisfaction After ACL Surgery

webinar speakersAn estimated 300,000 ACL surgeries are performed in the US annually, at an estimated cost of up to $1 billion, but we still have many unanswered questions about patient satisfaction after these procedures. Among them:

  • Does the cost of postoperative physical therapy affect patient satisfaction?
  • What are the rates and predictors of return to play after ACL reconstruction? Does graft choice play a role?
  • What is the relationship between return to play and patient satisfaction?

On Wednesday, December 13, 2017 at 8:00 PM EST, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) and The Journal of Bone & Joint Surgery (JBJS) will host a complimentary* LIVE webinar that addresses these and other important questions.

JOSPT co-author Caitlin J. Miller, PT, DPT and JBJS co-author Benedict U. Nwachukwu, MDMBA, will discuss findings from their respective studies, and the webinar will include additional insights from Mark V. Paterno, PT, PhD, MBA, SCS, ATC, and Elizabeth Matzkin, MD. Moderated by Tara Jo ManalPT, DPT, OCS, SCS, FAPTA, the webinar will conclude with a live Q&A session between the audience and panelists.

Seats are limited so REGISTER NOW.

*All registrants will have free access to the webinar for 24 hours following the live broadcast.

Patient Satisfaction After ACL Reconstruction—Dec. 13 Webinar

webinar speakersWe still have many unanswered questions about patient satisfaction after anterior cruciate ligament (ACL) reconstruction.

  • Do specific patient populations benefit from more or fewer physical therapy (PT) visits?
  • Does the cost of PT affect patient satisfaction?
  • Should patients be classified by factors beyond their medical diagnoses to achieve the best outcomes while minimizing costs?
  • What are the rates and predictors of return to play after ACL reconstruction? Does graft choice play a role?
  • What is the relationship between return to play and patient satisfaction?

On Wednesday, December 13, 2017 at 8:00 PM EST, the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) and The Journal of Bone & Joint Surgery (JBJS) will host a complimentary* LIVE webinar that addresses these important and clinically applicable questions.

JOSPT co-author Caitlin J. Miller, PT, DPT, will share the results of a retrospective cohort study examining the relationship between patient demographics, number of physical therapy visits, and the cost of postoperative interventions with revision rates and patient-reported outcomes following primary ACL reconstruction.

JBJS co-author Benedict U. Nawachukwu, MD, MBA, will discuss findings from a study  of return to play and patient satisfaction among athletes following ACL reconstruction. This study also explores the efficacy of patellar tendon autografts and the preinjury impact of certain sports.

Moderated by Tara Jo Manal, PT, DPT, OCS, SCS, FAPTA, a leading authority on the spine and the knee, the webinar will include additional insights from expert commentators Mark V. Paterno, PT, PhD, MBA, SCS, ATC, and Elizabeth Matzkin, MD. The last 15 minutes will be devoted to a live Q&A session between the audience and panelists.

Seats are limited so REGISTER NOW.

*All registrants will have free access to the webinar for 24 hours following the live broadcast.

With OCA, Don’t Fret About Condyle Matching

OCA for OBuzz

Osteochondral allograft transplantations (OCAs) are becoming a mainstay of treatment for knee-cartilage injuries. To help ensure that the allograft plug is transplanted with <1 mm of step-off from the surrounding recipient cartilage, many surgeons restrict themselves to orthotopic OCAs—matching the graft-recipient condyles in a lateral-to-lateral or medial-to-medial fashion.

However, in the October 4, 2017 issue of The Journal of Bone & Joint Surgery, Wang et al. demonstrated that both orthotopic and non-orthotopic (e.g., lateral condyle-to-medial condyle) OCA resulted in significantly improved outcomes in 77 cases followed for a mean of 4.3 years. The authors found that reoperation rates and pre- and postoperative scores in physical functioning and pain did not differ significantly between the orthotopic (n=50) and non-orthotopic (n=27) groups. These results suggest that condyle-specific matching may not be necessary.

One problem with orthotopic OCA is that 75% of the available allograft is supplied in the form of lateral condyles, while most full-thickness cartilage lesions presenting for treatment occur in the medial condyle. Consequently, surgeon preferences for orthotopic OCA limit the number of available matches and lead to an estimated 13% of available grafts being discarded.

Noting that many factors contribute to successful resurfacing of cartilage defects in the knee, the authors say that “it may be overly simplistic to assume that a conventionally matched orthotopic allograft will ensure a smooth surface contour at the recipient site.” They go on to conclude that “if surgeons forewent condyle-specific matching, more allografts would be readily available, which would shorten wait times, provide fresher grafts with increased chondrocyte viability, and lower procedure costs.”

June 2017 Article Exchange with JOSPT

JOSPT_Article_Exchange_LogoIn 2015, JBJS launched an “article exchange” collaboration with the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) to support multidisciplinary integration, continuity of care, and excellent patient outcomes in orthopaedics and sports medicine.

During the month of June 2017, JBJS and OrthoBuzz readers will have open access to the JOSPT article titled “The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis.”

Based on 17 studies included in the meta-analysis, the authors found that recreational runners had a lower occurrence of osteoarthritis compared with competitive runners and sedentary controls.