31 results on '"Revision rates"'
Search Results
2. A comparison of revision rates for stemmed and stemless primary anatomic shoulder arthroplasty with all-polyethylene glenoid components: analysis from the Australian Orthopaedic Association National Joint Replacement Registry.
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Gill, David R.J., Corfield, Sophia, Harries, Dylan, and Page, Richard S.
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We compared the rate of all-cause revision of 2 classes of primary anatomic shoulder arthroplasty, stemmed (stTSA) and stemless (slTSA), undertaken with cemented all-polyethylene glenoid components. A large national arthroplasty registry identified 2 cohort groups for comparison, stTSA and l undertaken for all diagnoses between January 1, 2011, and December 31, 2021. A subanalysis from January 1, 2017, allowed capturing of additional patient demographics including American Society of Anesthesiologists score, body mass index, and glenoid morphology. The cumulative percent revision (CPR) was determined using Kaplan-Meier estimates of survivorship and hazard ratios (HR) from Cox proportional hazard models adjusted for age and gender. Of the 7995 stTSA procedures, the CPR at 9 years was 5.6% (95% confidence interval [CI]: 5.0, 6.4), and for 3156 slTSA procedures, the CPR was 4.4% (95% CI: 3.6, 5.5). There was no significant difference in the rate of revision between the study groups (HR = 0.76 [95% CI: 0.51, 1.14], P =.189, adjusted for age, gender, humeral head size, humeral fixation, bearing surface, glenoid design, and mean surgeon volume [MSV]). There was an increased rate of revision for stTSA and slTSA undertaken with humeral head sizes <44 mm (stTSA <44 mm vs. 44-50 mm, HR = 1.56 [CI: 1.18, 2.08], P =.001; slTSA <44 mm vs. 44-50 mm, HR = 2.08 [CI: 1.32, 3.33], P =.001). MSV as a continuous predictor was not a revision risk to stTSA vs. slTSA, but categorically, a low MSV (<10 stTSA + slTSA cases per annum) was associated with a higher revision rate for stTSA (10-20 cases/yr vs. <10 cases/yr, HR = 0.72 [CI: 0.55, 0.95], P =.019) but was not in slTSA. Revision rates were increased for stTSA with non–crosslinked polyethylene (XLPE) glenoids vs. XPLE after 2 years (HR = 2.20 [CI: 1.57, 3.08], P <.001) but did not significantly differ for slTSA. Metal/XPLE (humeral/glenoid) bearing surface of stTSA rate of revision was not different from each combination of slTSA bearing surface. Instability/dislocation was a revision risk for slTSA vs. stTSA (HR = 1.93 [CI: 1.28, 2.91], P =.001), but from 2017, neither of American Society of Anesthesiologists score, body mass index, and glenoid morphology changed the rate of revision. Revision rates of stTSA and slTSA did not significantly differ and were associated with humeral head size but not patient characteristics. Surgeon inexperience of anatomic shoulder arthroplasty and non-XLPE glenoids were risk factors for stTSA revision but not slTSA. The metal/XLPE stTSA rate of revision was not found to differ significantly from slTSA regardless of polyethylene or humeral head bearing type. Revision for instability/dislocation was more common for slTSA. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Single center evaluation of outcomes of modular dual mobility liners during revision total hip arthroplasty: A five-year follow-up.
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Dubin, Jeremy A., Bains, Sandeep S., Chen, Zhongming, Hameed, Daniel, Moore, Mallory C., Mont, Michael A., Nace, James, and Delanois, Ronald E.
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TOTAL hip replacement ,JOINT instability ,SURGICAL complications ,RETROSPECTIVE studies ,ACQUISITION of data ,ARTIFICIAL joints ,TREATMENT effectiveness ,HIP joint dislocation ,REOPERATION ,MEDICAL records ,DESCRIPTIVE statistics ,PROSTHESIS design & construction ,LONGITUDINAL method ,COMPLICATIONS of prosthesis ,DISEASE risk factors - Abstract
Revision total hip arthroplasty (rTHA) is at increased risk for postoperative instability when compared to primary cases, which has been mitigated to some extent with the introduction of dual mobility (DM) reconstructions. These constructs were designed to lower dislocation rates and to improve impingement-free range of motion. As a follow-up to our prior institutional study, we expanded on a cohort of DM reconstructions compared to non-DM constructs. We examined a modular dual mobility system in rTHA to measure loosening of the acetabular component, as well as revision and dislocation rates in comparison to an historical cohort of single articulation prostheses. Materials/Methods: This retrospective cohort study from a single center included 254 patients who underwent rTHA with a dual mobility liner by three fellowship-trained surgeons between January 1, 2014 and December 1, 2019. This was a follow-up to an historical cohort of revisions performed with a single articulation prosthesis (n = 120) from the same surgeons performed between January 1, 2011 and December 23, 2013. The inclusion criteria included consecutively performed rTHAs that had a minimum follow-up of 2 years. We excluded patients who had femoral revisions and head/liner revisions only. The average follow-up in the dual mobility cohort and the single articulation cohort was 5 years (range, 2–10 years) and 2.5 years (range, 1.5–4.3 years), respectively. The primary outcomes were dislocation, aseptic loosening, and re-revision rates. Secondary outcomes were radiographic analyses of cup migration and osteolysis. There were 4 out of 256 (1.6%) dislocations from the dual mobility cohort compared to 7 out of 120 (5.8%), P < 0.001 from the single articulation cohort. The rates of aseptic loosening were 3.2% (8 out of 254) and 4.2% (5 out of 120), P = 0.124, respectively, between the cohorts. The re-revision rate was 5.9% for the DM liners and 8.3% in the control cohort, P = 0.38. Radiographic analyses revealed no cup migration and osteolysis in any of the patients that had no dislocations. The dual mobility articulations in rTHA demonstrated improved results in terms of lower dislocations rates when compared to a single articulation prostheses. Our center uses these articulations for revisions and surgeons should consider the use of these bearings when performing rTHA. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Postoperative outcomes of total elbow replacement in haemophilic elbow arthropathy: A systematic review.
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Anazor, Fitzgerald Chukwuemeka, Uthraraj, Nachappa, and Relwani, Jaikumar
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ELBOW , *TREATMENT effectiveness , *JOINT diseases , *TOTAL ankle replacement , *LENGTH of stay in hospitals , *VISUAL analog scale - Abstract
Introduction: Total elbow replacement (TER) is a surgical treatment option for haemophilic elbow arthropathy. Aim: To review the outcomes of TER in haemophilic elbow arthropathy. The primary outcome measures were perioperative blood loss, postoperative complications, revision rates and length of hospital stay (LOS). Secondary outcomes were elbow range of motion (ROM), functional outcome scores and the visual analogue pain scale (VAS). Materials and methods: PubMed, Medline, Embase and the Cochrane register were searched conforming to the PRISMA guidelines. Only studies with a minimum postoperative follow‐up of 1 year were included. Quality appraisal was performed utilizing the MINORS criteria. Results: One hundred and thirty‐eight articles were identified. Following article screening, only seven studies met the inclusion criteria. A total of 51 TERs in 38 patients were performed, with the Coonrad–Morrey prosthesis utilized in 51% of cases. The pooled postoperative complication and revision rates were 49% and 29%, respectively. Surgery‐related postoperative mortality was 3.9%. The mean preoperative Mayo elbow performance score (MEPS) was 43 ± 20 whereas the mean postoperative MEPS was 89 ± 6. Mean preoperative VAS was 7.2 ± 1.9 while the mean postoperative VAS was 2.0 ± 1.4. Mean preoperative and postoperative elbow flexion arcs were 54 ± 15 and 91 ± 10 degrees, respectively. Mean preoperative and postoperative forearm rotation arcs were 86 ± 40 and 135 ± 19 degrees, respectively. Conclusion: TER for haemophilic elbow arthropathy provides good to excellent improvements in pain and elbow ROM postoperatively. However, the overall complication and revision rates are relatively high, when compared to TER performed for other indications. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Cementless Compared to Cemented Total Knee Arthroplasty is Associated With More Revisions Within 1 Year of Index Surgery
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Daniel Chiou, MD, Alan K. Li, BS, Alexander Upfill-Brown, MD, Armin Arshi, MD, Peter Hsiue, MD, Kevin Chen, BA, Alexandra Stavrakis, MD, and Christos Demetris Photopoulos, MD
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Total knee arthroplasty ,Cementless ,Cemented ,Revision rates ,Orthopedic surgery ,RD701-811 - Abstract
Background: Cementless total knee arthroplasties (TKAs) have gained renewed interest due to improved implant designs and lower rates of revision than its cemented counterparts. The purpose of this study was to compare revision rates between cemented vs cementless TKAs within 1 year of primary arthroplasty. Methods: This was a retrospective review from the PearlDiver Patient Record Database. International Classification of Diseases and Current Procedural Terminology codes were used to identify patients who had undergone cemented and cementless TKAs and subsequent surgical revisions. An unadjusted univariate analysis of patient demographics, Charlson Comorbidity Index score, and surgical revisions at 90 days and 1 year after TKA was performed using chi-squared testing. Multivariate logistic regression analyses were subsequently performed for 1-year surgical complications requiring revision. Results: Of 324,508 patients, 312,988 (96.45%) underwent cemented TKAs, and 11,520 (3.55%) underwent cementless TKAs. Patients undergoing cementless TKA tended to be younger than patients undergoing cemented TKA (63.67 ± 9.15 cementless vs 66.22 ± 8.85 cemented, P < .001). Univariate chi-squared testing showed that cementless patients were more likely to require 1-component femoral or tibial revision at 90 days and 1 year, irrigation and debridement at 90 days and 1 year, and arthroscopy with lysis of adhesions at 1 year only. Similar findings were observed for these 3 revision procedures at 1 year after correcting for age, gender, and Charlson Comorbidity Index score using multivariate logistic regression analysis as cementless TKA patients had higher odds ratios for each of the revisions. Conclusions: Small but significant differences were found in surgical revisions among cementless TKAs when compared to cemented TKAs within 1 year of the index procedure.
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- 2023
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6. No Difference in Revision Rates up to 10 years Following Total Hip Arthroplasty in Patients Who Had Prior Bariatric Surgery When Compared to Patients Who Had Class III Obesity: A Propensity Matched Analysis.
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Kubsad, Sanjay, Raftis, Daniel A., Agarwal, Amil R., Marrache, Majd, Cohen, Jordan S., Thakkar, Savyasachi C., and Golladay, Gregory J.
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There is no clear research showcasing bariatric surgery's (BS's) impact on long-term surgical complications following total hip arthroplasty (THA). Therefore, this study compared the 10-year cumulative incidence and risk of revision following THA in patients who underwent BS when compared to the general population and class III obesity patients who did not undergo BS. Patients who underwent elective THA from 2010 to 2021 were identified using an all-payer claims database. Patients who underwent BS prior to THA were separately matched to a control of the general population and those who had class III obesity (body mass index ≥40) by age, sex, Charlson Comorbidity Index, and diabetes using a 1:4 ratio. Kaplan-Meier analyses generated 10-year cumulative incidence rates, and a Cox proportional hazard ratio (HR) model generated HRs and 95% confidence intervals (CIs). When compared to the general control, patients who have a history of BS had an elevated 10-year risk of all-cause revision (HR 1.31, 95% CI: 1.16 to 1.47, P <.001), prosthetic joint infection (HR: 1.62, CI: 1.30 to 2.04; P <.001), mechanical loosening (HR: 1.20, CI: 1.01 to 1.44; P =.040), and dislocation/instability (HR: 1.35, CI: 1.09 to 1.68; P =.007). There was no difference in the 10-year risk of all-cause revision or other indications for revision in the BS cohort compared to the matched class III obesity cohort (P =.142). Those who underwent BS before THA had comparable 10-year revision rates when compared to those who had class III obesity and higher rates compared to the general population. This suggests BS may not reduce the 10-year surgical risks associated with obesity when compared to a class III obese surgical population. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee chondroplasty
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Ayoade Adeyemi, Leo Nherera, Paul Trueman, and Anil Ranawat
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Coblation ,Chondroplasty ,Mechanical shaver debridement ,Cost-effectiveness ,Revision rates ,Cartilage lesions ,Medicine (General) ,R5-920 - Abstract
Abstract Background To compare costs and outcomes following knee chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. Methods A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. Results The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14–66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Conclusion Coblation chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee.
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- 2020
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8. Cervical spine degenerative disease is an independent risk factor for increased revision rate following total knee arthroplasty.
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Malahias, Michael-Alexander, Jang, Seong J., Gu, Alex, Richardson, Shawn S., Chen, Aaron Z., Rao, Raj D., and Sculco, Peter K.
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STATISTICS , *TOTAL knee replacement , *ACQUISITION of data methodology , *CONFIDENCE intervals , *CERVICAL cord , *MULTIVARIATE analysis , *RISK assessment , *REOPERATION , *MEDICAL records , *KAPLAN-Meier estimator , *DESCRIPTIVE statistics , *ODDS ratio , *NEURODEGENERATION , *MEDICAL coding , *COMORBIDITY , *DISEASE complications ,SURGICAL complication risk factors - Abstract
Introduction: The relationship between cervical degenerative pathology and total knee arthroplasty (TKA) revision rates is not well understood. The aim of the study was to determine whether cervical spine degenerative diseases have a role in complications following TKA within 2 years. Methods: Data were collected from the Humana insurance database using the PearlDiver Patient Records Database from 2007–2017. Patients who had a primary TKA were identified using Current Procedural Terminology (CPT) code 27,447, and patients with degenerative cervical disease were identified using CPT and International Classification of Diseases (ICD) codes. Data on patients' demographics, comorbidities and postoperative complications were recorded and analyzed with univariate and multivariate analysis with significance set at p < 0.05. A Kaplan–Meier analysis was conducted to estimate the 1- and 2-year rates of survival free from revision. Results: A total of 81,873 patients were included in this study. Following multivariate analysis, cervical spine degenerative disease patients were at increased risk of all-cause revision surgery following 1 year (OR: 1.342 95% CI: 1.149–1.569; p < 0.001) and 2 year (OR: 1.338; 95% CI: 1.184–1.512; p < 0.001). At 2 years, patients with cervical spine degenerative disease had a survival rate of 97.7%, while the survival rate was 99.2% among the non-cervical degenerative cohort. Conclusions: Based on these results, patients with cervical spine degenerative pathology should be counseled that their spinal pathology may impair outcomes following TKA. [ABSTRACT FROM AUTHOR]
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- 2021
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9. The effect of implant size difference on patient outcomes and failure after bilateral simultaneous total knee arthroplasty.
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Tang, Alex, Yeroushalmi, David, Zak, Stephen, Lygrisse, Katherine, Schwarzkopf, Ran, and Meftah, Morteza
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ARTHROSCOPY ,FEMUR ,RANGE of motion of joints ,EVALUATION of medical care ,PROSTHETICS ,COMPLICATIONS of prosthesis ,REOPERATION ,TIBIA ,TOTAL knee replacement ,RETROSPECTIVE studies - Abstract
Proper sizing of femoral and tibial components has been associated with long-term outcomes and survivorship in simultaneous bilateral total knee arthroplasty (SBTKA) and may be a reason for differences in outcomes between knees. The aim of this study compares post-operative outcomes and revision rates in patients undergoing SBTKA with different component sizes. A retrospective review was conducted at a single academic institution identifying patients who underwent SBTKA from 2011 to 2019. Inclusion criteria included: primary osteoarthritis, similar pre-operative deformity, and same implant manufacturer. The primary outcome compares pre- and post-op (delta, Δ) Knee Society Score-Knee Score (KSS-KS) and range of motion (ROM) between knees. Secondary outcome measures were all-cause revisions rates, including manipulations under anesthesia and arthroscopy with or without lysis of adhesions. 149 patients were identified who met the inclusion criteria: 128 patients had femoral size difference (FSD) of 0, 138 patients had tibial size difference (TSD) of 0, 21 patients with FSD of 1, and 11 patients with TSD of 1. There was no difference in ΔKSS-KS or ΔROM in patients for any FSD or TSD. Revisions for aseptic loosening were greater for TSD 1 compared to TSD 0 (p < 0.001). No other differences in cause of revision were identified. A TSD of 1 may be associated with increased revision rates for aseptic loosening in both smaller and larger sized implants. Surgeons may achieve optimal patient outcomes in SBTKA with proper sized implants through increased awareness of component asymmetry and repeat intraoperative evaluation when asymmetrical measurements occur. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Revision of unicompartmental knee arthroplasty using the in situ referencing technique.
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Weißenberger, Manuel, Petersen, Nils, Bölch, Sebastian, Rak, Dominik, Arnholdt, Jörg, Rudert, Maximilian, and Holzapfel, Boris Michael
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Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2020
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11. Effect of Functional Endoscopic Sinus Surgery on Outcomes in Chronic Rhinosinusitis.
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Alanin, Mikkel Christian and Hopkins, Claire
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Purpose of Review: Chronic rhinosinusitis (CRS) has a significant negative impact on quality of life (QoL). Surgical treatment of CRS is indicated when medical therapy fails to achieve adequate symptom control. This review summarizes the latest information on the outcomes after endoscopic sinus surgery (ESS) with relation to QoL, revision rates, olfaction, absenteeism, asthma control, use of systemic medications, quality of sleep and complications. We also provide an update regarding the factors that can impact outcomes. Recent Findings: CRS has classically been divided into two phenotypes depending on the presence or absence of nasal polyps. However, this is an oversimplification as many factors impact disease burden and outcome after treatment. It has been demonstrated that in many cases, ESS fails to meet the expectations of the patients. Evidence based patient counselling is key to help surgeons guide their patients in the best possible way to make well-informed decisions. Summary: Repeatedly it has been demonstrated that ESS improves QoL, improves olfaction, leads to better asthma control and less use of systemic antibiotics. However, various patient characteristics including phenotype, disease burden, comorbidities, age, gender and surgical technique can influence the outcome after ESSIt is of paramount importance to include a follow-up period when discussing revision rates. Based on available data, the genuine revision rate is probably 15–20% after five to ten years of follow-up. The revision rate is also affected by various factors and comorbidities. [ABSTRACT FROM AUTHOR]
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- 2020
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12. National Trends in the Surgical Management of Lumbar Spinal Stenosis in Adult Spinal Deformity Patients.
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Al Jammal, Omar M., Delavar, Arash, Maguire, Kathleen R., Hirshman, Brian R., Wali, Arvin R., Kazzaz, Majd, and Pham, Martin H.
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Study Design: This is a retrospective analysis of national administrative hospital data.Objective: This study examines national trends in the surgical management of lumbar spinal stenosis (LSS) in patients with and without coexisting scoliosis between 2010 and 2014. The study also examines revision rates for LSS procedures.Summary Of Background Data: There is wide variability in the surgical management of patients with LSS, with and without coexisting spinal deformity.Methods: Data were obtained from the Healthcare Cost and Utilization Project's National Inpatient Sample Database. International Classification of Diseases 9th revision- Clinical Modification codes were used to identify all patients with a primary diagnosis of lumbar spinal stenosis. These patients were divided into two groups: 1) LSS alone and 2) LSS with coexisting scoliosis. The two groups were examined for one of three surgical outcomes: 1) decompression alone (discectomy, laminectomy), 2) simple fusion, and 3) complex fusion (>three vertebrae or 360° fusion). The groups were then further examined for revision operations. National Inpatient Sample discharge weights were applied where relevant.Results: In 2014 national estimates of discharged patients indicated 76,275 patients with a primary diagnosis of LSS (population rate, 23.9; in the elderly (65+) the age-adjusted population rate was 95.4). Of these patients, 88.5% were managed through primary surgery (34.6% decompression, 47.2% simple fusion, 5.7% complex fusion). Between 2010 and 2014, the percentage of decompression decreased from 47.5% to 34.6%, the percent of simple fusion increased from 35.3% to 47.2%, and the percent of complex fusion increased from 5.7% to 7.1% (P < 0.01). In patients with coexisting scoliosis, lumbar spinal stenosis was predominantly managed by simple fusion and complex fusion (15.5% decompression, 51.9% simple fusion, 27.3% complex fusion, in 2014). Revision rates were highest among patients without scoliosis managed with complex fusion (15.8% in 2014) compared with patients with scoliosis (8.8% in 2014). Patients with scoliosis who underwent decompression only had revision rates of 1.7% and 0.62% in 2010 and 2014, respectively.Conclusion: We observed a leveling-off of the rate of operation for patients with a primary diagnosis of LSS at around 88%. There was an increase in the rate of fusion and a decrease in the rate of decompression across all patient groups. We report no difference in revision rates between patients with and without scoliosis, except in those undergoing a complex fusion.Level Of Evidence: 3. [ABSTRACT FROM AUTHOR]- Published
- 2019
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13. Non-cannulated S2AI screws have higher rates of hardware failure compared to cannulated S2AI screws.
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Lara, Nina, Pu, Alex, Chowdhury, Navid, Bruckner, Jacob J., Ye, Ivan B., Thomson, Alexandra E., Smith, Ryan A., Pease, Tyler J., Oster, Brittany, Miseo, Vincent, Cavanaugh, Daniel L., Koh, Eugene Y., Gelb, Daniel E., and Ludwig, Steven C.
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- 2023
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14. Duokopf- versus Totalendoprothese zur Versorgung von Schenkelhalsfrakturen.
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Hungerer, Sven, Glowalla, Claudio, Berninger, Markus, and Stuby, Fabian
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Hintergrund: In Deutschland ist die Therapie der Wahl der dislozierten medialen Schenkelhalsfraktur des älteren Menschen die endoprothetische Versorgung innerhalb von 24 h. Als operative Optionen stehen sich die Hüfttotalendoprothese (HTEP) und die Hemiendoprothese (HE) gegenüber.Fragestellung: Es wird folgenden Fragen nachgegangen: differenzierte Patientenselektion für HTEP oder HE, „Ist die HE eine halbe Sache?", zementierte oder zementfreie (Schaft‑)Implantation, geänderte Vorgehensweise durch neue, operative Zugänge.Material und Methode: Es erfolgte eine Analyse der nationalen Prothesenregister sowie des Endoprothesenregister Deutschlands (EPRD) mit Darstellung der Versorgungshäufigkeit der medialen Schenkelhalsfraktur mit der endoprothetischen Versorgung durch HE vs. HTEP.Ergebnisse: Die Durchsicht der nationalen Register zeigt eine Favorisierung der zementierten Technik bei älteren Patienten und bestätigt die niedrigeren Luxations- und Revisionsraten für die HE im Vergleich zur HTEP. Aus den Daten des EPRD zeigt sich, dass 2017 insgesamt 9,5 % der hüftendoprothetischen Eingriffe mit HEs durchgeführt wurden. Es ergab sich eine höhere Revisionsrate für nichtelektive HTEPs von 7,0 % im Vergleich zu HEs mit 4,5 %.Schlussfolgerungen: Die Auswahl des Implantats für die endoprothetische Versorgung nach medialer Schenkelhalsfraktur ist abhängig von einer Vielzahl von patienten-, operateur- und implantatspezifischen Faktoren. Die geringeren Revisionsraten der HE widerlegen die Annahme, dass eine HE nur „eine halbe Sache" sei. Anteriore oder anterolaterale Zugänge sind dem posterioren Zugang hinsichtlich Luxationstendenz überlegen. Nationale Unterschiede zeigen sich in Bezug auf die Zementierung der Prothese. [ABSTRACT FROM AUTHOR]
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- 2019
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15. Nachhaltigkeit in der Ohranlegeplastik.
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Siegert, R.
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Copyright of Journal für Ästhetische Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2018
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16. Short-Term Results of Ultra-Short Anatomic vs Ultra-Short Non-Anatomic Proximal Loading Uncemented Femoral Stems.
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Kim, Young-Hoo, Park, Jang-Won, and Kim, Jun-Shik
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Background: Question arises as to whether rigid fixation of ultra-short anatomic or ultra-short non-anatomic proximal loading uncemented femoral stem can be obtained without diaphyseal stem fixation. The purpose of this study is to compare the short-term clinical results, radiographic results, revision and survival rates, and complication rates of ultra-short anatomic versus ultra-short non-anatomic uncemented femoral stems.Methods: This study consisted of 50 patients (56 hips) in the ultra-short anatomic uncemented stem group (mean age 61.4 ± 14.7 years) and 50 patients (56 hips) in the ultra-short non-anatomic uncemented stem group (mean age 59.5 ± 15.2 years). The mean follow-up was 3.4 years (range 3-4) in the ultra-short anatomic stem group and 3.5 years (range 3-4) in the ultra-short non-anatomic stem group.Results: At the final follow-up, the mean Harris hip scores (92 vs 93 points), Western Ontario and McMaster Universities Osteoarthritis scores (16 vs 15 points), University of California at Los Angeles activity scores (6.5 vs 6.8 points), the incidence of thigh pain (0% vs 4%), revision rates (0% vs 4%), aseptic loosening rate (0% vs 2%), and complication rates (2% vs 4%) were not significantly different between 2 groups.Conclusion: Both ultra-short anatomic and ultra-short non-anatomic proximal loading uncemented femoral stems obtained rigid fixation without diaphyseal stem fixation in the short-term follow-up. This finding suggests that an ultra-short anatomic uncemented femoral stem can be replaced with an ultra-short non-anatomic uncemented stem to reduce inventory of the femoral stems, and consequently reduce manufacturing and delivery cost of these femoral stems. [ABSTRACT FROM AUTHOR]- Published
- 2018
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17. Factors affecting upper airway control of NSAID‐exacerbated respiratory disease: A real‐world study of 167 patients
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Johanna Sahlman, Anu Laulajainen-Hongisto, Paula Kauppi, Jyri Myller, Seija Vento, Annina Lyly, Sanna Toppila-Salmi, Jura Numminen, Heikki Turpeinen, Saara Sillanpää, Tampere University, Department of Otology and Oral Diseases, Clinical Medicine, Clinicum, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, University of Helsinki, Helsinki University Hospital Area, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, HYKS erva, Päijät-Häme Welfare Consortium, Department of Pathology, and Medicum
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lcsh:Immunologic diseases. Allergy ,0301 basic medicine ,N-ERD ,disease control ,N‐ERD ,medicine.medical_specialty ,Immunology ,CHRONIC RHINOSINUSITIS ,03 medical and health sciences ,0302 clinical medicine ,CLINICAL CHARACTERISTICS ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Eosinophilia ,Nasal polyps ,Prospective Studies ,3125 Otorhinolaryngology, ophthalmology ,Airway Management ,RECURRENCE ,Prospective cohort study ,Retrospective Studies ,Rhinitis ,Original Research ,Asthma ,nasal polyps ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,Hazard ratio ,Ethmoidectomy ,Odds ratio ,asthma ,medicine.disease ,Confidence interval ,PREVALENCE ,3. Good health ,ASPIRIN ,REVISION RATES ,030104 developmental biology ,3121 General medicine, internal medicine and other clinical medicine ,medicine.symptom ,lcsh:RC581-607 ,business ,ENDOSCOPIC SINUS SURGERY ,eosinophilia ,CRS ,030215 immunology - Abstract
Background Nonsteroidal anti‐inflammatory drug (NSAID) exacerbated respiratory disease (N‐ERD) is a triad with asthma, chronic rhinosinusitis with nasal polyps, and NSAID intolerance. Uncontrolled N‐ERD forms a major public health problem due to frequent and difficult‐to‐treat exacerbations and/or requiring putatively frequent endoscopic sinus surgeries (ESS). Our aim was to study factors affecting control of N‐ERD. Methods Retrospective patient record data (patient characteristics, prior sinus surgeries, follow‐up data in 2020) from 167 N‐ERD patients undergoing consultation at three tertiary hospitals from 2001 to 2017 was used. Outcome measurements reflecting uncontrolled N‐ERD were revision ESS, corticosteroids/biological therapy, and antibiotic courses during 2016–2020. Associations were analyzed by using nonparametric tests, Cox's proportional hazard, and binary logistic regression models. Results Nasal polyp eosinophilia increased the risk of revision surgery during the follow‐up (adjusted hazard ratio [aHR] 3.21, confidence interval 1.23–8.38). Also baseline oral corticosteroids (OCS; HR, 1.73, 1.04–2.89) and baseline surgery without total ethmoidectomy increased the risk of revision ESS (HR, 2.17, 1.07–4.42) in unadjusted models. In addition, both baseline OCS (adjusted odds ratio [aOR] 2.78, 1.23–6.26) and a history of ≥4 previous ESS (aOR, 2.15, 0.98–4.70) were associated with the use of OCS/biological therapy during the follow‐up, but not with high number of antibiotics. Conclusions Nasal polyp eosinophilia, baseline OCS, and a history of recurrent ESS predict uncontrolled N‐ERD. These factors might be clinically useful in risk‐estimation of uncontrolled disease and for organizing follow‐ups. Prospective cohort studies with larger sample size are needed to further study the factors affecting the upper airway control of N‐ERD., The patient record data of 167 patients with NSAID‐exacerbated respiratory disease was analyzed to study factors affecting the disease control. Nasal polyp eosinophilia increased the risk of revision surgery, and baseline oral corticosteroids and a history of four or more endoscopic sinus surgeries were associated with poor disease control during the follow‐up.
- Published
- 2021
18. Is there evidence that the outcomes of primary anatomic and reverse shoulder arthroplasty are getting better?
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Somerson, Jeremy, Neradilek, Moni, Hsu, Jason, Service, Benjamin, Gee, Albert, Matsen, Frederick, Somerson, Jeremy S, Neradilek, Moni B, Hsu, Jason E, Service, Benjamin C, Gee, Albert O, and Matsen, Frederick A 3rd
- Subjects
- *
ARTHROPLASTY , *PATIENTS , *SHOULDER surgery , *SURGERY , *JOINT surgery , *SHOULDER joint surgery , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL cooperation , *META-analysis , *REOPERATION , *RESEARCH , *EVALUATION research , *TREATMENT effectiveness - Abstract
Purpose: Have the results of shoulder arthroplasty got better over the last two decades? To answer this question, we sought published evidence that the patient-reported outcomes and re-operation rates have improved in reports of more recently performed anatomic (TSA) and reverse (RSA) total shoulder arthroplasties.Methods: We analyzed the arthroplasty results among studies published from 1990 to 2015, adjusting for the fact that the different publications presented patient groups with different combinations of diagnoses, used various outcome scales, and had different lengths of follow-up.Results: The adjusted clinical outcomes (p = 0.048), but not the revision rates (p = 0.3), were significantly better for articles reporting more recent TSA procedures. Neither the clinical outcomes (p = 0.9) nor the revision rates (p = 0.4) were significantly better in articles reporting more recent RSA surgeries.Conclusions: Better evidence from reports with greater detail will be necessary to show that patients are realizing progressively better outcomes from shoulder arthroplasty.Level Of Evidence: Level IV. [ABSTRACT FROM AUTHOR]- Published
- 2017
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19. International Rates of Patellar Resurfacing in Primary Total Knee Arthroplasty, 2004-2014.
- Author
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Fraser, James F. and Spangehl, Mark J.
- Abstract
Background: Patella resurfacing is performed in >80% of primary total knee arthroplasties (TKAs) in the United States, yet far fewer patellae are resurfaced internationally. Recent registry data have begun to question the long-held belief that patellar resurfacing yields lower revision rates. Multiple current meta-analyses have not shown a difference in patient satisfaction, anterior knee pain, or knee society scores based on patellar resurfacing.Methods: We sought to determine how the rates of patellar resurfacing have changed over the past 10 years worldwide (2004-2014). Data were abstracted from the annual reports of 7 national joint registries, literature review, or via direct correspondence with registry administrators.Results: Average rates of patellar resurfacing from 2004 to 2014 ranged from 4% (Norway) to 82% (United States). The largest decrease in resurfacing rates was in Sweden (15%-2%), whereas the biggest increase was in Australia (44%-59%). In 2010, only 48,367 of 137,813 (35%) primary TKAs from all registries outside the United States were resurfaced. Meta-analyses have demonstrated no difference in anterior knee pain or satisfaction scores but do consistently report increased revision rates for unresurfaced patellae. Recent Swedish registry data, however, showed a reverse trend toward higher revision rates after resurfacing.Conclusion: Despite recent registry data and meta-analyses demonstrating equivalent outcomes among resurfaced and unresurfaced patellae in primary TKA, worldwide trends in patellar resurfacing have changed little over the past decade. Most countries outside the United States continue to resurface a much smaller proportion of patellae. [ABSTRACT FROM AUTHOR]- Published
- 2017
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20. Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee chondroplasty
- Author
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Anil S. Ranawat, Ayoade Adeyemi, L Nherera, and Paul Trueman
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medicine.medical_specialty ,Mechanical shaver debridement ,Cost effectiveness ,medicine.medical_treatment ,Chondroplasty ,Coblation ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,In patient ,030212 general & internal medicine ,Revision rates ,health care economics and organizations ,Cartilage lesions ,030222 orthopedics ,lcsh:R5-920 ,business.industry ,Medial femoral condyle ,Research ,Health Policy ,Cost-effectiveness analysis ,Surgery ,Additional Surgery ,Debridement (dental) ,Cost-effectiveness ,business ,lcsh:Medicine (General) - Abstract
Background To compare costs and outcomes following knee chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. Methods A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. Results The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14–66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Conclusion Coblation chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee.
- Published
- 2020
21. Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee chondroplasty
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Adeyemi, Ayoade, Nherera, Leo, Trueman, Paul, and Ranawat, Anil
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- 2020
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22. Higher Rate of Revision in PFC Sigma Primary Total Knee Arthroplasty With Mismatch of Femoro-Tibial Component Sizes.
- Author
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Young, Simon W., Clarke, Henry D., Graves, Stephen E., Liu, Yen-Liang, and de Steiger, Richard N.
- Abstract
Total knee arthroplasty (TKA) systems permit a degree of femoro-tibial component size mismatch. The effect of mismatched components on revision rates has not been evaluated in a large study. We reviewed 21,906 fixed-bearing PFC Sigma primary TKAs using the Australian Orthopaedic Association National Joint Replacement Registry, dividing patients into three groups: no femoro-tibial size mismatch, tibial component size > femoral component size, and femoral component > tibial component. Revision rates were higher when the femoral size was greater than the tibia, compared to both equal size (HR = 1.20 (1.00, 1.45), P = 0.047) and to tibial size greater than femoral (HR = 1.60 (1.08, 2.37), P = 0.019). Potential mechanisms to explain these findings include edge loading of polyethylene and increased tibial component stresses. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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23. Comparison between Ventriculoatrial Shunt and Ventriculoperitoneal Shunt: Revision Rate and Complications.
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Korrapakc Wangtanaphat and Porn Narischart
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- *
HYDROCEPHALUS , *SURGICAL anastomosis , *CEREBROSPINAL fluid shunts , *SURGICAL complications , *REOPERATION , *POSTOPERATIVE period , *THERAPEUTICS - Abstract
Background and Objective: Hydrocephalus is a common problem in neurosurgical field. In current clinical practice guidelines, ventriculoatrial shunt and ventriculoperitoneal shunt are recommended treatment options. No previous study reported differences between two procedures in term of complications and revision rates. Methods: Chart review of all patients who underwent ventriculoatrial (VA) or ventriculoperitoneal (VP) shunts at the Prasat Neurological Institute, Bangkok, Thailand during 1 May 2012 and 31 October 2013 was carried out. Patients with previous VA or VP shunt operation were excluded. Complications and revision rate were recorded at the postoperative interval of one week, one month, and three months. Results: Thirty eight patients were divided by surgeon preferences. Twelve underwent VA shunt surgery and 26 underwent VP shunt surgery. The rates of complications were 16.7% and 38.5% in the VA shunt and VP shunt respectively. Only 2 patients (7.7%) from VP shunt group required revision. Conclusion: In this study, no difference in complications and revisions between VA and VP shunts was found. Patients with VP shunt placement were more likely to experience complications and revisions than patients with VA shunt placement. [ABSTRACT FROM AUTHOR]
- Published
- 2014
24. Early Experience With the Vanguard Complete Total Knee System: 2–7Years of Follow-Up and Risk Factors for Revision.
- Author
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Kievit, Arthur J., Schafroth, Matthias U., Blankevoort, Leendert, Sierevelt, Inger N., van Dijk, C. Niek, and van Geenen, Rutger C.I.
- Abstract
Abstract: A cross-sectional study in two hospitals was performed on 807 patients with a primary Vanguard (Biomet) total knee Arthroplasty (TKA). The research questions addressed were (1) what are the two- and six year survival rates of the Vanguard, (2) what are the clinical outcome scores, (3) what are the findings at revision and (4) what are predictors for revision? The mean age at time of surgery was 67.0 (SD 10.0). The mean follow-up was 3.6years (95% CI 3.56–3.73). At two years the survival was 97.2% for all-reasons (767 patients remaining) and 99%, for prosthesis-related-reasons (777 remaining). At six years this was 96.5% (40 remaining) and 98.6% (41 remaining). The mean clinical results (84% response on KOOS, Oxford and NRS) were good. A previous osteotomy was a risk factor for revision (hazard ratio 5.1, P =0.001). This early experience with the Vanguard shows a good survival with no adverse outcomes related to the implant and therefore further use of the implant is justified. [Copyright &y& Elsevier]
- Published
- 2014
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25. Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study
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Sanna Toppila-Salmi, Elina Penttilä, Jyri Myller, Anni Koskinen, Maija Hytönen, Saara Sillanpää, Seija Vento, Sari Hammarén-Malmi, Anu Laulajainen-Hongisto, Johanna Sahlman, Markus Lilja, Jura Numminen, Paula Virkkula, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, University of Helsinki, Helsinki University Hospital Area, Clinicum, HYKS erva, Päijät-Häme Welfare Consortium, HUS Inflammation Center, Department of Pathology, Department of Dermatology, Allergology and Venereology, Medicum, Tampere University, Department of Otology and Oral Diseases, and Clinical Medicine
- Subjects
lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Allergy ,Chronic rhinosinusitis ,sinusitis ,3121 Internal medicine ,03 medical and health sciences ,0302 clinical medicine ,LONG-TERM OUTCOMES ,medicine ,Immunology and Allergy ,Nasal polyps ,3125 Otorhinolaryngology, ophthalmology ,030223 otorhinolaryngology ,Sinusitis ,Surgical treatment ,RECURRENCE ,HYPERSENSITIVITY ,Asthma ,Original Research ,nasal polyp ,Aspirin ,business.industry ,chronic rhinosinusitis ,computed tomography ,medicine.disease ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 ,Surgery ,PREVALENCE ,ASPIRIN ,ALLERGY ,Endoscopic sinus surgery ,REVISION RATES ,030228 respiratory system ,Otorhinolaryngology ,ASTHMA ,business ,lcsh:RC581-607 ,ENDOSCOPIC SINUS SURGERY ,medicine.drug - Abstract
BackgroundDeveloping tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients.MethodsData of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001–19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC).ResultsESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60–0.83), p = 0.001, for LM score 0.59 (0.50–0.67), p = 0.054; for NP score 0.56 (0.48–0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46–0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 109/L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8).ConclusionsPolyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.
- Published
- 2020
26. Patients Receiving a Primary Unicompartmental Knee Replacement Have a Higher Risk of Revision but a Lower Risk of Mortality Than Predicted Had They Received a Total Knee Replacement: Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man
- Author
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Ashley W Blom, Andrew D Beswick, Gulraj S. Matharu, J. Mark Wilkinson, Linda P. Hunt, Setor K Kunutsor, and Michael R Whitehouse
- Subjects
musculoskeletal diseases ,Reoperation ,medicine.medical_specialty ,unicompartmental knee ,Total knee replacement ,Unicompartmental knee replacement ,Northern Ireland ,outcomes ,Lower risk ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Registries ,total knee replacement ,Arthroplasty, Replacement, Knee ,030222 orthopedics ,Wales ,business.industry ,Mortality rate ,mortality ,Confidence interval ,Surgery ,Prosthesis Failure ,revision rates ,surgical procedures, operative ,Quartile ,England ,England wales ,Cohort ,business ,Knee Prosthesis - Abstract
Background To determine unicompartmental (UKR) and total knee replacement (TKR) revision rates, compare UKR revision rates with what they would have been had they received TKR instead, and assess subsequent re-revision and 90-day mortality rates. Methods Using National Joint Registry data, we estimated UKR and TKR revision and mortality rates. Flexible parametric survival modeling (FPM) was used to model failure in TKR and make estimates for UKR. Kaplan-Meier estimates were used to compare cumulative re-revision for revised UKRs and TKRs. Results Ten-year UKR revision rates were 2.5 times higher than expected from TKR, equivalent to 70 excess revisions/1000 cases within 10 years (5861 excess revisions in this cohort). Revision rates were 2.5 times higher for the highest quartile volume UKR surgeons compared to the same quartile for TKR and 3.9 times higher for the lowest quartiles respectively. Re-revision rates of revised TKRs (10 years = 17.5%, 95% confidence interval [CI] 16.4-18.7) were similar to revised UKRs (15.2%, 95% CI 13.4-17.1) and higher than revision rates following primary TKR (3.3%, 95% CI 3.1-3.5). Ninety-day mortality rates were lower after UKR compared with TKR (0.08% vs 0.33%) and lower than predicted had UKR patients received a TKR (0.18%), equivalent to 1 fewer death per 1000 cases. Conclusion UKR revision rates were substantially higher than TKR even when demographics and caseload differences were accounted for; however, fewer deaths occur after UKR. This should be considered when forming treatment guidelines and commissioning services. Re-revision rates were similar between revised UKRs and TKRs, but considerably higher than for primary TKR, therefore UKR cannot be considered an intermediate procedure.
- Published
- 2020
27. Patients Receiving a Primary Unicompartmental Knee Replacement Have a Higher Risk of Revision but a Lower Risk of Mortality Than Predicted Had They Received a Total Knee Replacement: Data From the National Joint Registry for England, Wales, Northern...
- Author
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Hunt, Linda P., Blom, Ashley W., Matharu, Gulraj S., Kunutsor, Setor K., Beswick, Andrew D., Wilkinson, J. Mark, and Whitehouse, Michael R.
- Abstract
Background: To determine unicompartmental (UKR) and total knee replacement (TKR) revision rates, compare UKR revision rates with what they would have been had they received TKR instead, and assess subsequent re-revision and 90-day mortality rates.Methods: Using National Joint Registry data, we estimated UKR and TKR revision and mortality rates. Flexible parametric survival modeling (FPM) was used to model failure in TKR and make estimates for UKR. Kaplan-Meier estimates were used to compare cumulative re-revision for revised UKRs and TKRs.Results: Ten-year UKR revision rates were 2.5 times higher than expected from TKR, equivalent to 70 excess revisions/1000 cases within 10 years (5861 excess revisions in this cohort). Revision rates were 2.5 times higher for the highest quartile volume UKR surgeons compared to the same quartile for TKR and 3.9 times higher for the lowest quartiles respectively. Re-revision rates of revised TKRs (10 years = 17.5%, 95% confidence interval [CI] 16.4-18.7) were similar to revised UKRs (15.2%, 95% CI 13.4-17.1) and higher than revision rates following primary TKR (3.3%, 95% CI 3.1-3.5). Ninety-day mortality rates were lower after UKR compared with TKR (0.08% vs 0.33%) and lower than predicted had UKR patients received a TKR (0.18%), equivalent to 1 fewer death per 1000 cases.Conclusion: UKR revision rates were substantially higher than TKR even when demographics and caseload differences were accounted for; however, fewer deaths occur after UKR. This should be considered when forming treatment guidelines and commissioning services. Re-revision rates were similar between revised UKRs and TKRs, but considerably higher than for primary TKR, therefore UKR cannot be considered an intermediate procedure. [ABSTRACT FROM AUTHOR]- Published
- 2021
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28. Journey II BCS has a lower revision rates than journey I
- Author
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Christen, B and Kopjar, B
- Subjects
ddc: 610 ,Journey II ,reoperation ,comparisons ,Revision rates ,610 Medical sciences ,Medicine ,Journey I - Abstract
Objectives: Aim of this study was to compare early reoperation and revision rate of Journey II bi-cruciate stabilized (BCS) total knee system (TKS) and Journey I BCS TKS. Methods: We conducted a retrospective longitudinal non-concurrent cohort study of 141 Journey II TKAs (average follow-up duration[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017)
- Published
- 2017
- Full Text
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29. Early Experience With the Vanguard Complete Total Knee System: 2–7Years of Follow-Up and Risk Factors for Revision
- Author
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Arthur J. Kievit, C. Niek van Dijk, Rutger C. I. van Geenen, Matthias U. Schafroth, Leendert Blankevoort, Inger N. Sierevelt, Graduate School, Other Research, Orthopedic Surgery and Sports Medicine, Amsterdam Movement Sciences, Biomedical Engineering and Physics, and Other departments
- Subjects
medicine.medical_specialty ,total knee arthroplasty ,Vanguard ,Cross-sectional study ,business.industry ,medicine.medical_treatment ,Hazard ratio ,Retrospective cohort study ,Osteotomy ,Arthroplasty ,Surgery ,revision rates ,medicine ,Kaplan–Meier survival ,risk factors ,Orthopedics and Sports Medicine ,Implant ,Risk factor ,business - Abstract
A cross-sectional study in two hospitals was performed on 807 patients with a primary Vanguard (Biomet) total knee Arthroplasty (TKA). The research questions addressed were (1) what are the two- and six year survival rates of the Vanguard, (2) what are the clinical outcome scores, (3) what are the findings at revision and (4) what are predictors for revision? The mean age at time of surgery was 67.0 (SD 10.0). The mean follow-up was 3.6years (95% CI 3.56–3.73). At two years the survival was 97.2% for all-reasons (767 patients remaining) and 99%, for prosthesis-related-reasons (777 remaining). At six years this was 96.5% (40 remaining) and 98.6% (41 remaining). The mean clinical results (84% response on KOOS, Oxford and NRS) were good. A previous osteotomy was a risk factor for revision (hazard ratio 5.1, P =0.001). This early experience with the Vanguard shows a good survival with no adverse outcomes related to the implant and therefore further use of the implant is justified.
- Published
- 2014
- Full Text
- View/download PDF
30. Outcomes of Total Knee Arthroplasty After Osteochondral Allograft Transplantation
- Author
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William D. Bugbee and Amy K. Steinhoff
- Subjects
musculoskeletal diseases ,Allograft transplantation ,medicine.medical_specialty ,total knee arthroplasty ,business.industry ,Total knee arthroplasty ,osteochondral allograft ,Evidence-based medicine ,musculoskeletal system ,outcomes ,eye diseases ,Surgery ,Transplantation ,Function score ,surgical procedures, operative ,revision rates ,Quality of life ,medicine ,Effective treatment ,Orthopedics and Sports Medicine ,Knee injuries ,business - Abstract
Background:Fresh osteochondral allograft (OCA) transplantation is an effective treatment for osteochondral defects. Some patients require further surgical intervention, such as total knee arthroplasty (TKA). The effects of prior OCA transplantation on TKA outcomes are unknown.Purpose:This study evaluated TKA failure rates after long-term follow-up and identified factors that may have contributed to an inferior outcome. Its aims were to (1) assess if having a prior OCA transplantation would increase the surgical complications of the subsequent TKA, (2) measure the infection and failure rates following TKA, (3) ascertain subjective outcomes scores from patients with intact TKA at latest follow-up, and (4) identify potential factors that contributed to inferior outcomes.Study Design:Case series; Level of evidence, 4.Methods:A total of 35 patients who underwent TKA after OCA were identified. Pain, symptoms, function, and quality of life were evaluated using the Knee Society Function score and Knee injury and Osteoarthritis Outcome Score (KOOS). Associations between outcomes scores versus total number of surgeries before TKA were assessed using Spearman correlation. Patient characteristics (age, sex, total OCA area, presentation of osteoarthritis, and number of surgeries before TKA) were calculated between failures and nonfailures.Results:For patients with TKA surviving at latest follow-up (n = 24), mean follow-up time was 9.2 ± 4.3 years after TKA and 16.1 ± 5.2 years after OCA. While TKA after OCA did not present a technical challenge in the operating room, there was a high failure rate (31.4%). Activities of daily living, as measured on KOOS, were negatively correlated with total number of surgeries before TKA (ρ2= –0.5, P = .041). Patient age and number of surgeries before TKA influenced the failure rate, while sex and OCA area did not appear to be factors associated with inferior outcomes.Conclusion:Patients with multiple knee operations before TKA were more likely to experience functional limitations or TKA failure. The patients who experienced TKA failure were part of a challenging subset of young patients treated with numerous orthopaedic procedures, and while these patients had inferior results with TKA after OCA, the OCA transplantation extended the time before a TKA was required without adding surgical complications.
- Published
- 2015
31. Patient-Reported Outcome Measures of Total Knee Arthroplasties for Post-Traumatic Arthritis versus Osteoarthritis: A Short-Term (5- to 10-year) Retrospective Matched Cohort Study.
- Author
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Khoshbin, Amir, Stavrakis, Alexandra, Sharma, Achal, Woo, Pauline, Atrey, Amit, Lee, Yuo-Yu Lily, Joseph, Amethia, and Padgett, Douglas E.
- Abstract
Background: The objective of the study was to compare the patient-reported outcome measures (PROM) of patients with post-traumatic arthritis (PTA) versus patients with osteoarthritis (OA) undergoing total knee arthroplasty (TKA) and compare the rates of revision among these two groups.Methods: Using a prospectively held institutional registry, we retrospectively reviewed patients ≥60 years of age who underwent unilateral TKA between May 2007 and February 2012. Patients with previous or concomitant diagnosis of inflammatory arthropathy or an initial open fracture were excluded. PTA patients were matched 1:5 with OA patients undergoing TKA. Validated PROMs were recorded at baseline before index TKA and the last follow-up. Reason and time to revision surgery was reported, and survivorship was compared using Kaplan-Meier curves.Results: Seventy-five PTA patients were matched to 375 OA patients. There was no difference between these groups with respect to age (67.7 ± 5.6 vs 67.8 ± 5.5 years; P = .876), body mass index (28.6 ± 5.4 vs 28.7 ± 5.3 kg/m2; P = .948), sex (65.3% vs 65.3% females; P = .999), Charlson Comorbidity Index (21.3% vs 21.3% Index 1-2, P = .999), and time to follow-up (93.0 ± 13.4 vs 88.2 ± 13.7 months; P = .999). No statistically significant difference was found in PROMs at baseline and the last follow-up (P > .05), the rate or time to revision surgery between the two groups (P-value = .635; log-rank test).Conclusion: Unlike previous studies, TKA for PTA does not pose lower PROMs or higher revision rates when compared to TKA for OA. These results could help provide surgeons with a frame of reference in terms of expectations for patients with PTA undergoing TKA. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
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