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Comparative study of innovative postoperative wound dressings after total knee arthroplasty / Andreas DOBBELAERE in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)
[article]
Titre : Comparative study of innovative postoperative wound dressings after total knee arthroplasty Type de document : texte imprimé Auteurs : Andreas DOBBELAERE, Auteur ; Nika SCHUERMANS, Auteur ; Steven SMET, Auteur Année de publication : 2015 Article en page(s) : p.454-461 Langues : Anglais (eng) Mots-clés : knee arthroplasty Résumé : Purpose: Postoperative wound complications, especially surgical site infections, influence the outcome after total knee arthroplasty. The purpose of our study was to compare four different wound dressings.
Following research questions were asked: (1) Which dressing is associated with least wound complications? (2) Which dressing application is the cheapest? (3) Which dressing is most comfortable for the patient?
Methods: 111 patients undergoing a total knee arthroplasty were randomized in 4 groups. Each group received a different dressing with its specific wound management protocol: (1) Zetuvit® with Cosmopor E®, (2) Zetuvit® with Opsite Post-Op Visible®, (3) Aquacel Surgical® and (4) Mepilex Border®. Followup evaluations were performed on the fifth postoperative day and included assessment of the wound, status of the wound dressing and the patient’s own judgment. Cumulative costs were calculated.
Results: Clinically Mepilex Border®, a silicone dressing, scored the best. No wound complications were seen in this group. The mean number of dressing renewals was 1.9 for the standard dressing which was significantly higher (p <.0001) compared to the other dressings. Opsite Post-op Visible® was the cheapest dressing. Mepilex Border® had the best scores for pain, freedom of movement and general comfort.
Conclusions: Mepilex Border® is the most skinfriendly dressing. The number of dressing renewals is a defining factor to calculate the costs. Mepilex Border® appeared to be the best dressing to use after a total knee arthroplasty.Permalink : ./index.php?lvl=notice_display&id=40921
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.454-461[article] Comparative study of innovative postoperative wound dressings after total knee arthroplasty [texte imprimé] / Andreas DOBBELAERE, Auteur ; Nika SCHUERMANS, Auteur ; Steven SMET, Auteur . - 2015 . - p.454-461.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.454-461
Mots-clés : knee arthroplasty Résumé : Purpose: Postoperative wound complications, especially surgical site infections, influence the outcome after total knee arthroplasty. The purpose of our study was to compare four different wound dressings.
Following research questions were asked: (1) Which dressing is associated with least wound complications? (2) Which dressing application is the cheapest? (3) Which dressing is most comfortable for the patient?
Methods: 111 patients undergoing a total knee arthroplasty were randomized in 4 groups. Each group received a different dressing with its specific wound management protocol: (1) Zetuvit® with Cosmopor E®, (2) Zetuvit® with Opsite Post-Op Visible®, (3) Aquacel Surgical® and (4) Mepilex Border®. Followup evaluations were performed on the fifth postoperative day and included assessment of the wound, status of the wound dressing and the patient’s own judgment. Cumulative costs were calculated.
Results: Clinically Mepilex Border®, a silicone dressing, scored the best. No wound complications were seen in this group. The mean number of dressing renewals was 1.9 for the standard dressing which was significantly higher (p <.0001) compared to the other dressings. Opsite Post-op Visible® was the cheapest dressing. Mepilex Border® had the best scores for pain, freedom of movement and general comfort.
Conclusions: Mepilex Border® is the most skinfriendly dressing. The number of dressing renewals is a defining factor to calculate the costs. Mepilex Border® appeared to be the best dressing to use after a total knee arthroplasty.Permalink : ./index.php?lvl=notice_display&id=40921 Exemplaires (1)
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Exclu du prêtCurrent opinions about coronal plane alignment in total knee arthroplasty?: A survey article / Emmanuel Thienpont in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)
[article]
Titre : Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article Type de document : texte imprimé Auteurs : Emmanuel Thienpont, Auteur ; O. CORNU, Auteur ; Johan Bellemans, Auteur Année de publication : 2015 Article en page(s) : p.471-477 Langues : Anglais (eng) Mots-clés : Knee arthroplasty alignment varus survey Résumé : Purpose: To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty.
Methods: Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention.
Results: Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however varus alignment is acceptable in constitutional varus patients. This residual varus should be obtained through a femoral varus cut rather than a tibial varus cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central loadbearing axis through the middle of the arthroplasty.
Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis.
Conclusions: Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual varus it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction.Permalink : ./index.php?lvl=notice_display&id=40923
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.471-477[article] Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article [texte imprimé] / Emmanuel Thienpont, Auteur ; O. CORNU, Auteur ; Johan Bellemans, Auteur . - 2015 . - p.471-477.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.471-477
Mots-clés : Knee arthroplasty alignment varus survey Résumé : Purpose: To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty.
Methods: Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention.
Results: Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however varus alignment is acceptable in constitutional varus patients. This residual varus should be obtained through a femoral varus cut rather than a tibial varus cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central loadbearing axis through the middle of the arthroplasty.
Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis.
Conclusions: Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual varus it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction.Permalink : ./index.php?lvl=notice_display&id=40923 Exemplaires (1)
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Exclu du prêtLow blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients / Yoeri Bemelmans in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)
[article]
Titre : Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients Type de document : texte imprimé Auteurs : Yoeri Bemelmans ; Emil Van Haaren ; Bert Boonen ; Roel Hendrickx ; Martijn Schotanus Année de publication : 2021 Article en page(s) : p. 9-16 Note générale : https://doi.org/10.52628/87.1.02 Langues : Anglais (eng) Mots-clés : Tranexamic acid fast-track surgery knee arthroplasty hip arthroplasty unicompartmental knee arthroplasty Résumé : The purpose of this study was to retrospectively evaluate the efficacy of a tranexamic acid (TXA) perioperative protocol for primary hip- and knee arthroplasty, in terms of allogenic blood transfusion rates. A retrospective cohort study was conducted and included all primary hip and knee arthroplasty procedures in the period of 2014-2019. Patients who underwent surgery due to trauma or revision were excluded. A total amount of 5205 patients were eligible for inclusion. Two equal and weight depending doses of TXA were given, preoperative as an oral dose and intravenously at wound closure. The primary outcome was blood transfusion rate. Further analysis on patient characteristics (e.g. age, gender), blood loss, perioperative haemoglobin (Hb) levels and complication/readmission rate was performed.
A total of 49 (0.9%) patients received perioperative allogenic blood transfusions. Mean age, distribution of gender, body-mass index, American Society of Anaesthesiologists score, duration of surgery, type of arthroplasty, estimated blood loss, perioperative Hb levels and length of stay were statistically significant different between transfused and not-transfused patients. The incidence of thromboembolic adverse events (e.g. deep vein thrombosis/lung embolism) was 0.5%. Low blood transfusion rate was found after implementation of a standardized perioperative TXA protocol for primary hip and knee arthroplasty.Permalink : ./index.php?lvl=notice_display&id=96571
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 9-16[article] Low blood transfusion rate after implementation of tranexamic acid for fast- track hip- and knee arthroplasty. An observational study of 5205 patients [texte imprimé] / Yoeri Bemelmans ; Emil Van Haaren ; Bert Boonen ; Roel Hendrickx ; Martijn Schotanus . - 2021 . - p. 9-16.
https://doi.org/10.52628/87.1.02
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 9-16
Mots-clés : Tranexamic acid fast-track surgery knee arthroplasty hip arthroplasty unicompartmental knee arthroplasty Résumé : The purpose of this study was to retrospectively evaluate the efficacy of a tranexamic acid (TXA) perioperative protocol for primary hip- and knee arthroplasty, in terms of allogenic blood transfusion rates. A retrospective cohort study was conducted and included all primary hip and knee arthroplasty procedures in the period of 2014-2019. Patients who underwent surgery due to trauma or revision were excluded. A total amount of 5205 patients were eligible for inclusion. Two equal and weight depending doses of TXA were given, preoperative as an oral dose and intravenously at wound closure. The primary outcome was blood transfusion rate. Further analysis on patient characteristics (e.g. age, gender), blood loss, perioperative haemoglobin (Hb) levels and complication/readmission rate was performed.
A total of 49 (0.9%) patients received perioperative allogenic blood transfusions. Mean age, distribution of gender, body-mass index, American Society of Anaesthesiologists score, duration of surgery, type of arthroplasty, estimated blood loss, perioperative Hb levels and length of stay were statistically significant different between transfused and not-transfused patients. The incidence of thromboembolic adverse events (e.g. deep vein thrombosis/lung embolism) was 0.5%. Low blood transfusion rate was found after implementation of a standardized perioperative TXA protocol for primary hip and knee arthroplasty.Permalink : ./index.php?lvl=notice_display&id=96571 Exemplaires (1)
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Exclu du prêtThe effects of preoperative neuromuscular electrical stimulation on the postoperative quadriceps muscle strength and functional status in patients with fast-track total knee arthroplasty / Raziya Savkin in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : The effects of preoperative neuromuscular electrical stimulation on the postoperative quadriceps muscle strength and functional status in patients with fast-track total knee arthroplasty Type de document : texte imprimé Auteurs : Raziya Savkin ; Nihal Buker ; Harun R. Güngör Année de publication : 2021 Article en page(s) : p. 735-744 Note générale : https://doi.org/10.52628/87.4.19 Langues : Anglais (eng) Mots-clés : knee arthroplasty neuromuscular electrical stimulation fast-track physiotherapy patient-reported outcomes quadriceps muscle strength Résumé : This study aimed to investigate the effect of pre- operative neuromuscular electrical stimulation (NMES) on postoperative quadriceps muscle strength, functional status, and quality of life in patients with fast-track total knee arthroplasty (TKA).
This prospective study was carried out at Orthopedics department from September 2017 to October 2018. A total of 40 patients were randomly divided into NMES (n=20) and control group (n=20). Patients in NMES group were asked to use home NMES device daily for 20 minutes, 5 times a day, for 6 weeks before surgery. The control group was placed on the 6-week waiting list for surgery without any preoperative intervention. Standard home exercise program was applied to both groups after discharge. The patients were evaluated baseline, preoperatively (6-weeks after baseline) and at the 4th and 12th weeks after surgery. Knee range of motion, quadriceps muscle strength, patient-reported (WOMAC and KOOS) and performance-based activity limitation (30-second chair-stand test, 40-meter fast-paced walk test, and stair-climb test) were evaluated at each visit.
Preoperative NMES resulted in significant improve- ment in KOOS-function in daily living and WOMAC total score (p≤0.05) but had a non-significant trend toward to improve quadriceps muscle strength, KOOS-pain and -other symptoms, performance- based activity limitation, and quality of life scores (p>0.05). However, there was no significant difference between groups in the postoperative period (p>0.05).
NMES has beneficial effects in terms of patient- reported and performance-based physical functions and quality of life in preoperative period ; however, it does not provide any additional benefit for post- operative outcomes in patients with fast-track TKA.Permalink : ./index.php?lvl=notice_display&id=102054
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 735-744[article] The effects of preoperative neuromuscular electrical stimulation on the postoperative quadriceps muscle strength and functional status in patients with fast-track total knee arthroplasty [texte imprimé] / Raziya Savkin ; Nihal Buker ; Harun R. Güngör . - 2021 . - p. 735-744.
https://doi.org/10.52628/87.4.19
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 735-744
Mots-clés : knee arthroplasty neuromuscular electrical stimulation fast-track physiotherapy patient-reported outcomes quadriceps muscle strength Résumé : This study aimed to investigate the effect of pre- operative neuromuscular electrical stimulation (NMES) on postoperative quadriceps muscle strength, functional status, and quality of life in patients with fast-track total knee arthroplasty (TKA).
This prospective study was carried out at Orthopedics department from September 2017 to October 2018. A total of 40 patients were randomly divided into NMES (n=20) and control group (n=20). Patients in NMES group were asked to use home NMES device daily for 20 minutes, 5 times a day, for 6 weeks before surgery. The control group was placed on the 6-week waiting list for surgery without any preoperative intervention. Standard home exercise program was applied to both groups after discharge. The patients were evaluated baseline, preoperatively (6-weeks after baseline) and at the 4th and 12th weeks after surgery. Knee range of motion, quadriceps muscle strength, patient-reported (WOMAC and KOOS) and performance-based activity limitation (30-second chair-stand test, 40-meter fast-paced walk test, and stair-climb test) were evaluated at each visit.
Preoperative NMES resulted in significant improve- ment in KOOS-function in daily living and WOMAC total score (p≤0.05) but had a non-significant trend toward to improve quadriceps muscle strength, KOOS-pain and -other symptoms, performance- based activity limitation, and quality of life scores (p>0.05). However, there was no significant difference between groups in the postoperative period (p>0.05).
NMES has beneficial effects in terms of patient- reported and performance-based physical functions and quality of life in preoperative period ; however, it does not provide any additional benefit for post- operative outcomes in patients with fast-track TKA.Permalink : ./index.php?lvl=notice_display&id=102054 Réservation
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DisponibleExtra-articular tibial deformity management in total knee replacement / Sanjeev Agarwal in Acta Orthopaedica Belgica, Vol. 87/4 (Décembre 2021)
[article]
Titre : Extra-articular tibial deformity management in total knee replacement Type de document : texte imprimé Auteurs : Sanjeev Agarwal ; Sarah Choi ; Rakesh Kumar Année de publication : 2021 Article en page(s) : p. 659-664 Note générale : https://doi.org/10.52628/87.4.11 Langues : Anglais (eng) Mots-clés : Knee replacement knee arthroplasty tibia malunion tibia deformity Résumé : Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant.
Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance.
The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction.
Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6.
Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction.
Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm.Permalink : ./index.php?lvl=notice_display&id=102016
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 659-664[article] Extra-articular tibial deformity management in total knee replacement [texte imprimé] / Sanjeev Agarwal ; Sarah Choi ; Rakesh Kumar . - 2021 . - p. 659-664.
https://doi.org/10.52628/87.4.11
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol. 87/4 (Décembre 2021) . - p. 659-664
Mots-clés : Knee replacement knee arthroplasty tibia malunion tibia deformity Résumé : Background : Presence of an extra-articular deformity in the femur or tibia poses a challenge to the surgeon undertaking knee replacement procedure. The conundrum is whether to correct the deformity beforehand, or accept the deformity and compensate for this through placement of the implant.
Material and Methods : This is a retro-spective study comprising six patients who had a knee replacement in the presence of an extra-articular deformity of the tibia treated at our centre. All six had the knee replacement without correction of deformity. The data evaluated included clinical outcome, mechanical axis correction, type of implant, and the use of any software / computer guidance.
The deformity was managed through planning of tibial resection without the need for pre-operative deformity correction.
Results : Mean age was 66.5 years. Mean coronal plane deformity in the tibia was 8.6 degrees. The hip- knee-ankle improved from a mean 12.6 degrees to 4 degrees. Mean Oxford knee score improved from a mean of 19 to 33.6.
Conclusion : Planning the tibial resection on the basis of mechanical axis of tibia allows correction of alignment without the need for preoperative correction.
Correction of the deformity may not be needed if the maximum tibial resection is less than 15 mm.Permalink : ./index.php?lvl=notice_display&id=102016 Réservation
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DisponibleThe use of adaptive equipment following total knee replacement / Jamie McNaught in The British Journal of Occupational Therapy, Volume 78 numéro 3 (Mars 2015)
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