Search

Objective: This study aims to investigate the effect of video-assisted patient education (VPE) on knee functions, quality of life (QoL) and decrease complications in total knee replacement (TKR) patients.Methods: This study is designed as a prospective, parallel, two-arm, randomized clinical trial. It included 44 patients who underwent elective TKR at an orthopedics and traumatology clinic. The VPE group received VPE including early postoperative care for TKR, activities of daily living, and gradual exercise program in addition to the existing routine care at the clinic. The control group received only routine care. The results were collected with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-36 (SF-36) scores measured at baseline, 1st and 3rd months after TKR. Results: The mean scores of the VPE group on the pain, stiffness, and physical function of the WOMAC were significantly lower in 3rd month after TKR than the control group. The VPE group had significantly higher scores than the control group on SF-36 of all subcategories except pain, emotional role, and mental health in 3rd month after TKR.Conclusion: The VPE can improve knee function and QoL in TKR patients. Nurses can use the VPE method in patients to improve knee functions and QoL after TKR.

Copyright of Journal of Nursology is the property of Ataturk University Coordinatorship of Scientific Journals 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.)

Amputees face several gait deficits due to their mechanically passive prostheses' lack of control and power. Of crucial importance among these deficits are those related to balance, as falls and a fear of falling can cause an avoidance of activity that leads to further debilitation. A transfemoral an artificial limb replaces a missing leg above the knee. A transfemoral prosthesis consists of a socket, knee, shank, foot, and mechanism for the suspension. The current 3D neuromuscular model of a healthy person in this study is adjusted to depict a transfemoral amputee with a 3R60. The model is simulated by Matlab 2019b Simulink program with a walking speed of 0.9 m/s and 1.2 m/s. The model's performance is assessed by comparing the distinctions between the healthy model and the amputee to the literature results. The amputee gait simulated is in keeping with the literature, particularly at speeds of 1.2 m/s. The oscillations of the model in the coronal plane are 0.9 m/s, indicating that balance is difficult to maintain. A case study was also conducted with a gyroscope control moment in the prosthetic shank on fall prevention. The gyroscope control moment enhances flexing the knee and extending it to prevent a drop. The step was more balanced with the extra control time whirligig at 1.2 m/s. [ABSTRACT FROM AUTHOR]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY 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.)

Amaç: Total diz artroplastisi(TDA) sonrası kan kaybını, hemoglobin düşüklüğünü, kan transfüzyon ihtiyacını ve hastanede kalış süresini azaltmak için traneksamik asit (TXA)’ in topikal uygulamasındaki etkinliğini değerlendirmektir.Yöntem: Total diz artroplastisi yapılan 40 hasta, 59-83 yaşları arasından seçilmiştir. VAS 7’ nin üzerinde, Ahlback evre 4-5 ve ASA 1. ve 2. grup olan hastalar çalışmaya dahil edilmiştir. Ameliyatlar aynı cerrah ve standart medial parapatellar artrotomi ile aynı marka implantlar kullanılarak yapılmıştır. Ameliyat boyunca turnike sadece sementleme aşamasında kullanılmıştır. Koagülopati, pulmoner emboli, akut myokard enferktüsü, beyin felci, kronik arter hastalığı hikayesi olanlar ve hemoglobin seviyesi 10 g/dl nin altında olan hastalar çalışmaya alınmamıştır. Hastalar 2 gruba ayrıldı. Grup A’ daki hastalara artrotomi kapatıldıktan sonra 4 ampül 250 mg %10 TXA salin ile seyreltilerek diz eklemine enjekte edildi. 2 saat boyunca dren kapalı tutuldu. Grup B’ deki hastalarda TXA kullanılmadı. Drenler 48. Saat sonunda çekildi. Kan hemoglobin değerleri 8 g/dl’ nin altına düşmedikçe kan transfüzyonu yapılmadı. Hastalar ko-morbiditeleri açısından da değerlendirmeye alındı.Bulgular: 40 hastanın 8 (%20)’ ine kan transfüzyonu yapıldı. Bunların 6 (%75)’ sı TXA kullanılmayan Grup B’ deki hastalar idi. Grup A’ da sadece hastaların 2 (%10)’ sine kan trasfüzyonu yapıldı. Grup B’ deki kan trasfüzyonu yapılan hastaların 1 tanesine 2 ünite kan replase edilmiştir. Ameliyat sonrası ilk 24 saatteki kan drenaj miktarlarına bakıldığında Grup A’ da 232,5 cc, Grup B’ de 407,75 cc idi. 48. saat sonundaki toplam drenaj miktarına bakıldığında Grup A’ da 370,5 cc, Grup B’ de 552,2 cc olarak görüldü. Ameliyat sırasında ortalama kanama miktarı Grup A’ da 247,5 cc, Grup B’ de 235 cc idi. Ameliyat öncesi ortalama hemoglobin değeri Grup A’ da 13 g/dl iken Grup B’ de 12,75 g/dl idi. Ameliyattan sonraki 6. Saatte alınan hemoglobin değeri Grup A’ da 11,7, Grup B’ de 11 g/dl olarak gözlendi. Ameliyat sonrası ilk 24. saatteki hemoglobin değerleri Grup A’ da 11,07 iken Grup B’ de 10,6 idi. 48. saatteki hemoglobin değerleri Grup A’ da 10,3 iken Grup B’ de 9,5 olarak gözlendi. Postop dönemdeki hemoglobin değişim seviyelerine ve drenaj miktarlarına bakıldığında TXA kullanılan grupta özellikle ilk 24. saatteki drenaj miktarında diğer gruba oranla önemli bir azalma olduğu gözlemlenmiştir.Çıkarımlar: Total diz artroplastisinde traneksamik asit kullanımı postoperatif kanama miktarını anlamlı şekilde azaltır. TXA' nın intravenöz yerine eklem içi olarak uygulanmasıyla sistemik absorpsiyon azaltılabilir ve istenmeyen yan etkiler hafifletilebilir. Bu çalışmanın bulguları toplam kan kaybında ve hemoglobin seviyelerindeki azalmada bir düşüş olduğunu ve dolayısıyla kan transfüzyonu ihtiyacını azalttığını göstermiştir.

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri 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.)

Objective: The objective of this study was to assess the frequency and the risk factors of the knee and hip prosthesis and to evaluate treatment responses in rheumatoid arthritis (RA) patients receiving biologic therapy. Methods: A total of 998 RA patients who received biology therapy and were registered in the Hacettepe University Biologic Registry were enrolled in the study. Demographic and clinical features of the patients, comorbidities, and the history of knee and/or hip prosthesis surgery and also total swollen-tender joint counts, erythrocyte sedimentation rate (ESR) levels, C-reactive protein levels, disease activity (DAS28-ESR), functional status (HAQ-DI) and patient visual analog scale (VAS) scores for pain, fatigue and global at the last examination were recorded from the files. Results: Of the RA patients receiving biological therapy, 93 (9%) had knee and/or hip prosthesis. In multivariate analysis, the duration of RA >15 years [odds ratio (OR) 3.73] and the count of comorbidities (OR 1.189) were associated with knee/hip prosthesis. The RA patients with prosthesis had a higher patient global-VAS, patient pain-VAS, DAS28-ESH, HAQ-DI scores, a higher ESH levels, a higher HAQ-DI >1 rates and had a lower DAS28-ESH remission rates in comparison to RA patients without prosthesis. The female gender and obesity ratio were higher in knee prosthesis patients than hip prosthesis patients, but disease activity and functional status evaluations were similar. Conclusion: RA patients with knee and hip prosthesis have different clinical and demographic features. Disease duration and comorbidities may be risk factors for prosthetic surgery. Due to the fact that RA patients with prosthesis were older and had more comorbidities, treatment goals may not have been achieved. [ABSTRACT FROM AUTHOR]

Total Knee Arthroplasty (TKA) treatment has been widely used for knee joint, having the most complex motion sequences and shape of the body, in case of loss of motion ability such as gonarthrosis. Lots of failures such as loosening, wear and instability have occurred as a result of increasing usage period. Instability is the most commonly seen failure associated with fixation. Especially loosening of tibial component is more common than that of femoral component. Evaluation of bone in terms of shape related with patient's weight, height and gender is required to increase the success of TKAs comprising traditional tibial components. Most of the current commercially available knee prostheses are designed based on the anthropometric data of Caucasian knees. This means an accordance problem for the people in different regions having different joint size. In this study, a patient specific tibial component has been designed according to cutting surface of tibial bone obtained from the patient's computed tomography images. This proposed design has been comparatively investigated with the traditional cemented tibial component by using the finite element analysis. In conclusion, more uniform stress distribution on the tibial trabecular bone related with stress shielding due to long term use was obtained in the patient specific prosthesis. The results have shown that the compatibility between the tibial bone and its component is better than the traditional model and possibility of loosening failure in the patient specific model is lower. [ABSTRACT FROM AUTHOR]

Objective: Effect of the tibial posterior slope on knee scores and knee range of motion in knees that were performed PCL retaining total knee arthroplasty with fixed bearing. Material and methods: 41 gonarthrosis diagnosed knee have been performed PCL retaining total knee arthroplasty with fixed bearing. Knee scoring was performed and range of motion was measured before surgery. Patients were re-evaluated with knee scores and knee range of motion. Patients divided into two groups. First group is 18 patients with posterior tibial slope 50 and greater than 50, second group is 23 patients with posterior tibial slope less than50. Both groups were evaluated statistically. Results: In the group with posterior tibial slope less than 50 mean preoperative flexion was measured 100.30+10.59, in the group with posterior tibial slope 50 and greater mean preoperative flexion was measured 98.50±7.31. At the last postoperative control in the group with posterior tibial slope less than 50 the mean flexion was measured 111.80±12.23. In the group with posterior tibial slope 50 and greater the mean flexion was measured 1090 ±11.48 at the last postoperative control. Preoperativly in the group with posterior tibial slope less than 50 the mean knee score was 35.9+6.63, the mean functional knee score was 23.7+16.18. In the postoperative last control the mean knee score was 83.9+8.16, mean functional knee score was 82.4+12.51. In the group with posterior tibial slope 50 and greater the mean knee score was 42.2+12.73, the mean functional knee score was 23.6+17.97 preoperatively. In the postoperative last control the mean knee score was 83+9.08, the mean knee functional score was 84.1+16.29 for group with posterior tibial slope 50 and greater Conclusion: The pre operative and post operative knee scores in both groups were found to be statisticaly significantly different. In terms of knee motion there was no statistically significant difference between the groups. Statistically significant relationship was not found between range of motion of the knee with the tibial slope. Knee scores had a significant increase after surgery, but it was determined independently from tibial slope. [ABSTRACT FROM AUTHOR]

Total knee arthroplasty is ene of the most effective surgical treatment modalities among orthopedic procedures. Several complications including infection, periprostatic fracture, knee dislocation, patellar tendon ruptures, neurovascular injuries may happen after surgery. In our case, bilateral knee arthroplasty had been performed during the same session in another center Open reduction and internal fixation had been performed due to a supracondylar femur fracture in the right knee occurred in the early post-Operative period. After a period, a fracture in the right knee and knee dislocation in the left knee had occurred. We performed an open reduction internal fixation for the right knee and knee arthroplasty revision for left knee. In this case report, our aim was to inform and discuss the treatment options for the complications that may occur as a result of knee replacement surgery. [ABSTRACT FROM AUTHOR]