Academic literature on the topic 'Hip joint Surgery Risk factors'
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Journal articles on the topic "Hip joint Surgery Risk factors"
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Slobodskoy, A. B., E. Yu Osintsev, A. G. Lezhnev, I. V. Voronin, I. S. Badak, and A. G. Dunaev. "Risk Factors for Periprosthetic Infection after Large Joint Arthroplasty." Vestnik travmatologii i ortopedii imeni N.N. Priorova, no. 2 (June 30, 2015): 13–18. http://dx.doi.org/10.32414/0869-8678-2015-2-13-18.
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Risk factors for the development of purulent complications after large joints arthroplasty were studied by the results of 3641 operations (3210 patients). Hip, knee, shoulder and elbow arthroplasty was performed in 2523, 881, 105 and 132 patients, respectively. Hip and knee revision replacements were performed in 221 cases and in 492 cases surgical interventions were performed for dysplastic coxarthrosis, congenital and acquired deformities, under conditions of bone tissue deficit and other complicated cases. Three hundred fifty one patients were operated on due to acute injury. Periprosthetic infection was diagnosed in 58 cases (1.59%). It was stated that risk factors for periprosthetic infection development included severe concomitant pathology (diabetes mellitus,operations somatic diseases, degree of their severity and duration, HIV infection and other conditions), surgical interventions for dysplastic coxarthrosis and complex total hip replacement. In those cases the risk of complications increased by 1.5-3.5 times. Pyo-inflammatory process in the area of hip joint in history as well as every repeated surgery on the hip increased therisk of postoperative complications significantly. No differences in complication rate depending on the type of fixation and implant manufacturers were noted.
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Slobodskoy, A. B., E. Yu Osintsev, A. G. Lezhnev, I. V. Voronin, I. S. Badak, and A. G. Dunaev. "Risk Factors for Periprosthetic Infection after Large Joint Arthroplasty." N.N. Priorov Journal of Traumatology and Orthopedics 22, no. 2 (June 15, 2015): 13–18. http://dx.doi.org/10.17816/vto201522213-18.
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Risk factors for the development of purulent complications after large joints arthroplasty were studied by the results of 3641 operations (3210 patients). Hip, knee, shoulder and elbow arthroplasty was performed in 2523, 881, 105 and 132 patients, respectively. Hip and knee revision replacements were performed in 221 cases and in 492 cases surgical interventions were performed for dysplastic coxarthrosis, congenital and acquired deformities, under conditions of bone tissue deficit and other complicated cases. Three hundred fifty one patients were operated on due to acute injury. Periprosthetic infection was diagnosed in 58 cases (1.59%). It was stated that risk factors for periprosthetic infection development included severe concomitant pathology (diabetes mellitus,operations somatic diseases, degree of their severity and duration, HIV infection and other conditions), surgical interventions for dysplastic coxarthrosis and complex total hip replacement. In those cases the risk of complications increased by 1.5-3.5 times. Pyo-inflammatory process in the area of hip joint in history as well as every repeated surgery on the hip increased therisk of postoperative complications significantly. No differences in complication rate depending on the type of fixation and implant manufacturers were noted.
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Guo, Heng, Chi Xu, and Jiying Chen. "Risk factors for periprosthetic joint infection after primary artificial hip and knee joint replacements." Journal of Infection in Developing Countries 14, no. 06 (June 30, 2020): 565–71. http://dx.doi.org/10.3855/jidc.11013.
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Introduction: We aimed to explore the risk factors for periprosthetic joint infection (PJI) after primary artificial hip and knee joint replacements by performing a case-control study.
Methodology: The clinical data of patients receiving primary hip and knee joint replacements were retrospectively analyzed. The case group included 96 patients who suffered from PJI, comprising 42 cases of hip joint replacement and 54 cases of knee joint replacement. Another 192 patients who received joint replacement at the ratio of 1:2 in the same period and did not suffer from PJI were selected as the control group. Differences between the two groups were compared in regard to etiology, pathogen, blood type, urine culture, body mass index (BMI), surgical time, intraoperative blood loss, postoperative 1st day and total drainage volumes, length of hospitalization stay, and history of surgery at the affected sites.
Results: Gram-positive bacteria were the main pathogens for PJI. The most common infection after hip joint replacement was caused by Staphylococcus epidermidis, which accounted for 38.10%, while Staphylococcus aureus was mainly responsible for the infection of knee joint (40.74%). High BMI, long surgical time, large postoperative drainage volume, long hospitalization stay, history of surgery at incisions, previous use of immunosuppressants, preoperative hypoproteinemia and superficial infection were independent risk factors (p < 0.05).
Conclusions: PJI after primary replacement was mainly caused by gram-positive bacteria, and patients with high BMI, long surgical time, large postoperative drainage volume, long hospitalization stay, history of surgery at incisions, previous use of immunosuppressants, preoperative hypoproteinemia and superficial infection were more vulnerable.
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Braginа, S. V., V. P. Moskalev, A. L. Petrushin, and P. A. Berezin. "Perioperative prognosis of infectious complications after total hip and knee arthroplasties. Part II (literature review)." Genij Ortopedii 28, no. 4 (August 2022): 608–18. http://dx.doi.org/10.18019/1028-4427-2022-28-4-608-618.
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Introduction Risk factors in the perioperative period are important for reduction of the infection rate following total hip and knee arthroplasty. The objective of the review was to systematize information on potentially modifiable risk factors for infectious complications following total hip and knee arthroplasty and the possibilities to control them. Material and methods For a comprehensive search, PubMed, eLIBRARY, Scopus, Dimensions were used. The search depth was 30 years. Results The review reports potentially modifiable risk factors and the possibility to control them in the perioperative period. Patients undergoing total joint replacements often suffer comorbid conditions that must be addressed preoperatively and postoperatively. Comorbidities can be associated with such joint pathologies as oligo-, polyosteoarthrosis, arthroplasty of other joints, septic arthritis or with a history of periprosthetic joint infection. Somatic disorders can be associated with abnormal laboratory findings. All these risk factors cannot be eliminated completely and are detrimental for hip and knee arthroplasty. Discussion The current level of information on the risks of infectious complications following total hip and knee arthroplasty may be insufficient to reduce the spread of an infectious agent. There is controversy regarding some predictors of surgical site infection and periprosthetic joint infection. There may be equivocal cause-effect relationships between the patient's potentially unfavorable features and the adverse outcome, which requires further in-depth study of this problem.
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Stołtny, Tomasz, Jarosław Pasek, Dominika Rokicka, Marta Wróbel, Michał Dobrakowski, Paweł Kamiński, Rafał Domagalski, Szymon Czech, Krzysztof Strojek, and Bogdan Koczy. "Are there really specific risk factors for heterotopic ossifications? A case report of ‘non-risk factor’ after total hip replacement." Journal of International Medical Research 50, no. 6 (June 2022): 030006052210952. http://dx.doi.org/10.1177/03000605221095225.
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Femoral neck fractures are one of the most common fractures in the elderly population. Due to frequent complications of the fixation of these fractures, patients are more and more often eligible for hip replacement surgery. One of the most frequently mentioned postoperative complication is the formation of heterotopic ossification. This case report describes as a 70-year-old male patient that presented with an old hip fracture accompanied by a mild craniocerebral trauma. The patient underwent total cementless hip arthroplasty followed by rehabilitation. At 8 months after surgery, the patient was diagnosed with Brooker IV° heterotopic ossification in the area of the operated hip joint. Due to the persistent pain and complete loss of mobility in the operated joint, computed tomography imaging was performed and the patient was recommended for a revision surgery. The procedure was performed 14 months after the original surgical treatment, resulting in a significant improvement in the range of motion and reduction of pain.
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Venher, Ihor, Sviatoslav Kostiv, and Dymytrii Khvalyboha. "Risk factors for venous thrombosis in patients with endoprosthetics of hip joints." Journal of Education, Health and Sport 11, no. 9 (September 30, 2021): 875–85. http://dx.doi.org/10.12775/jehs.2021.11.09.102.
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Background. Important part of orthopaedic surgery is endoprosthetics of hip joints, which eliminates pain syndrome, restores the amplitude of movements and the support ability of the lower limb. But there is a number of complications; venous thromboembolism among them occupies a leading place.
Material and methods. 219 patients with a mean age of 64.7 ± 3.8 years were operated. In 137 (62.1%) observations, total cement hip replacement was performed for osteoarthritis. 82 (37.4%) patients received total and unipolar cement hip replacement for cervical femoral neck fractures.
Results. Clinical manifestations of non-specific connective tissue dysplasia were detected in 83 (37.9%) patients, which were confirmed by the laboratory determination of the level of general, bound and free oxyproline. In the postoperative period, the thrombotic process in the venous system of the inferior vena cava was diagnosed in 23 (10.5%) observations. Operative intervention on the hip joint in patients with nonspecific dysplasia of connective tissue in 11 (13.3%) cases was complicated by the development of venous thrombosis. In patients without non-specific connective tissue dysplasia, postoperative thrombosis in the system of the inferior vena cava was diagnosed in 12 (8.8%) observations.
Conclusions. Patients with osteoarthrosis of the hip joint and the femoral neck fracture accompanied by the non-specific dysplasia of the connective tissue are characterized by expressed levels of endothelial dysfunction and increased activity of the blood-coagulation system.
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GANDHI, RAJIV, FAHAD RAZAK, J. RODERICK DAVEY, and NIZAR N. MAHOMED. "Metabolic Syndrome and the Functional Outcomes of Hip and Knee Arthroplasty." Journal of Rheumatology 37, no. 9 (July 15, 2010): 1917–22. http://dx.doi.org/10.3899/jrheum.091242.
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Objective.Patients with an elevated systemic inflammatory state are known to report greater pain with knee osteoarthritis (OA). We investigated the influence of risk factors of metabolic syndrome (MetS) on patient function before and after hip and knee replacement surgery.Methods.A total of 677 consecutive patients with primary knee replacement and 547 consecutive patients with primary hip replacement with at least one MetS risk factor were reviewed from our joint registry. Demographic variables of age, sex, and comorbidity were retrieved. MetS risk factors were defined as body mass index (BMI) > 30 kg/m2, diabetes, hypertension, and hypercholesterolemia. Baseline and 1-year Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores were compared across patients by number of MetS risk factors, ranging from 1 to 4. Linear regression modeling was used to evaluate the effects of the MetS risk groups and the individual metabolic abnormalities on predicting baseline and 1-year WOMAC scores. Knee and hip patients were reviewed separately.Results.The knee and hip patients showed a significant difference in sex distribution, BMI, and mean comorbidity across risk groups (p < 0.05). Unadjusted analysis showed that baseline and 1-year WOMAC scores, for both knee and hip patients, increased significantly with increasing number of MetS risk factors (p < 0.05). The linear regression model with the individual metabolic abnormalities was found to be more predictive of outcome than one with the number of MetS risk factors. Hypertension and obesity were the metabolic factors most predictive of a poorer outcome following hip surgery as compared to just obesity for knee patients.Conclusion.Patient function following joint replacement surgery, particularly hip surgery, is negatively affected by metabolic abnormalities perhaps secondary to the systemic proinflammatory state. This knowledge should be used when counseling patients prior to surgery.
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Bourget-Murray, Jonathan, Isabel Horton, Jared Morris, Antoine Bureau, Simon Garceau, Hesham Abdelbary, and George Grammatopoulos. "Periprosthetic joint infection following hip hemiarthroplasty." Bone & Joint Open 3, no. 12 (December 1, 2022): 924–32. http://dx.doi.org/10.1302/2633-1462.312.bjo-2022-0138.r1.
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Aims The aims of this study were to determine the incidence and factors for developing periprosthetic joint infection (PJI) following hemiarthroplasty (HA) for hip fracture, and to evaluate treatment outcome and identify factors associated with treatment outcome. Methods A retrospective review was performed of consecutive patients treated for HA PJI at a tertiary referral centre with a mean 4.5 years’ follow-up (1.6 weeks to 12.9 years). Surgeries performed included debridement, antibiotics, and implant retention (DAIR) and single-stage revision. The effect of different factors on developing infection and treatment outcome was determined. Results A total of 1,984 HAs were performed during the study period, and 44 sustained a PJI (2.2%). Multiple logistic regression analysis revealed that a higher CCI score (odds ratio (OR) 1.56 (95% confidence interval (CI) 1.117 to 2.187); p = 0.003), peripheral vascular disease (OR 11.34 (95% CI 1.897 to 67.810); p = 0.008), cerebrovascular disease (OR 65.32 (95% CI 22.783 to 187.278); p < 0.001), diabetes (OR 4.82 (95% CI 1.903 to 12.218); p < 0.001), moderate-to-severe renal disease (OR 5.84 (95% CI 1.116 to 30.589); p = 0.037), cancer without metastasis (OR 6.42 (95% CI 1.643 to 25.006); p = 0.007), and metastatic solid tumour (OR 15.64 (95% CI 1.499 to 163.087); p = 0.022) were associated with increasing PJI risk. Upon final follow-up, 17 patients (38.6%) failed initial treatment and required further surgery for HA PJI. One-year mortality was 22.7%. Factors associated with treatment outcome included lower preoperative Hgb level (97.9 g/l (SD 11.4) vs 107.0 g/l (SD 16.1); p = 0.009), elevated CRP level (99.1 mg/l (SD 63.4) vs 56.6 mg/l (SD 47.1); p = 0.030), and type of surgery. There was lower chance of success with DAIR (42.3%) compared to revision HA (66.7%) or revision with conversion to total hip arthroplasty (100%). Early-onset PJI (≤ six weeks) was associated with a higher likelihood of treatment failure (OR 3.5 (95% CI 1.2 to 10.6); p = 0.007) along with patients treated by a non-arthroplasty surgeon (OR 2.5 (95% CI 1.2 to 5.3); p = 0.014). Conclusion HA PJI initially treated with DAIR is associated with poor chances of success and its value is limited. We strongly recommend consideration of a single-stage revision arthroplasty with cemented components. Cite this article: Bone Jt Open 2022;3(12):924–932.
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Wu, Meng-Huang, Christopher Wu, Jiann-Her Lin, Li-Ying Chen, Ching-Yu Lee, Tsung-Jen Huang, Yi-Chen Hsieh, and Li-Nien Chien. "Risk Factors for Spine Reoperation and Joint Replacement Surgeries after Short-Segment Lumbar Spinal Surgeries for Lumbar Degenerative Disc Disease: A Population-Based Cohort Study." Journal of Clinical Medicine 10, no. 21 (October 31, 2021): 5138. http://dx.doi.org/10.3390/jcm10215138.
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Background: Short-segment lumbar spinal surgery is the most performed procedure for treatment of degenerative disc disease. However, population-based data regarding reoperation and joint replacement surgeries after short-segment lumbar spinal surgery is limited. Methods: The study was a retrospective cohort design using the Taiwan National Health Insurance Research Database for data collection. Patients selected were diagnosed with lumbar degenerative disc disease and undergone lumbar discectomy surgery between 2002 and 2013. The Kaplan–Meier method was used to estimate the incidence of 1-year spine reoperation and joint replacement surgeries, and the Cox proportional hazard regression was used to examine risk factors associated with the outcomes of interest. Results: A total of 90,105 patients were included. Incidences of 1-year spine reoperation and joint replacement surgeries for the hip and knee were 0.27, 0.04, and 0.04 per 100 people/month. Compared to fusion with the fixation group, fusion without fixation and the non-fusion group had higher risks of spine reoperation. Risk factors associated with spine reoperation included fusion without fixation, non-fusion surgery, age ≥ 45 years old, male gender, diabetes, a Charlson Comorbidity Index = 0, lowest social economic status, and steroid use history. Spine surgeries were not risk factors for joint replacement surgeries. Conclusions: Non-fusion surgery and spinal fusion without fixation had higher risks for spine reoperation. Spine surgeries did not increase the risk for joint replacement surgeries.
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Naal, Florian D., Aileen Müller, Viju D. Varghese, Vanessa Wellauer, Franco M. Impellizzeri, and Michael Leunig. "Outcome of Hip Impingement Surgery: Does Generalized Joint Hypermobility Matter?" American Journal of Sports Medicine 45, no. 6 (January 31, 2017): 1309–14. http://dx.doi.org/10.1177/0363546516688636.
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Background: Generalized joint hypermobility (JH) might negatively influence the results of surgical femoroacetabular impingement (FAI) treatment, as JH has been linked to musculoskeletal pain and injury incidence in athletes. JH may also be associated with worse outcomes of FAI surgery in thin females. Purpose: To (1) determine the results of FAI surgery at a minimum 2-year follow-up by means of patient-reported outcome measures (PROMs) and failure rates, (2) assess the prevalence of JH in FAI patients and its effect on outcomes, and (3) identify other risk factors associated with treatment failure. Study Design: Cohort study; Level of evidence, 3. Methods: We included 232 consecutive patients (118 females; mean age, 36 years) with 244 hips surgically treated for symptomatic FAI between 2010 and 2012. All patients completed different PROMs preoperatively and at a mean follow-up of 3.7 years. Satisfaction questions were used to define subjective failure (answering any of the 2 subjective questions with dissatisfied/ very dissatisfied and/or didn’t help/ made things worse). Conversion to total hip replacement (THR) was defined as objective failure. JH was assessed using the Beighton score. Results: All PROM values significantly ( P < .001) improved from preoperative measurement to follow-up (Oxford Hip Score: 33.8 to 42.4; University of California at Los Angeles Activity Scale: 6.3 to 7.3; EuroQol−5 Dimension Index: 0.58 to 0.80). Overall, 34% of patients scored ≥4 on the Beighton score, and 18% scored ≥6, indicating generalized JH. Eleven hips (4.7%) objectively failed and were converted to THR. Twenty-four patients (10.3%) were considered as subjective failures. No predictive risk factors were identified for subjective failure. Tönnis grade significantly ( P < .001) predicted objective failure (odds ratio, 13; 95% CI, 4-45). There was a weak inverse association ( r = −0.16 to −0.30) between Beighton scores and preoperative PROM values. There were no significant associations between Beighton scores and postoperative PROM values or subjective failure rates, but patients who objectively failed had lower Beighton scores than did nonfailures (1.6 vs 2.6; P = .049). Conclusion: FAI surgery yielded favorable outcomes at short- to midterm follow-up. JH as assessed by the Beighton score was not consistently associated with subjective and objective results. Joint degeneration was the most important risk factor for conversion to THR. Although statistical significance was not reached, female patients with no joint degeneration, only mild FAI deformity, and higher Oxford scores at the time of surgery seemed to be at increased risk for subjective dissatisfaction.
Dissertations / Theses on the topic "Hip joint Surgery Risk factors"
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Sörensen, Duppils Gill. "Delirium during Hospitalisation : Incidence, Risk Factors, Early Signs and Patients' Experiences of Being Delirious." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3814.
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Delirium is common among old patients admitted to hospital, but is often a neglected problem in patient care. The principal aim of this thesis was to evaluate aspects of delirium in relation to incidence, risk factors, behavioural changes, cognitive function and health-related quality of life (HRQOL). A further aim was to describe patients’ experiences of being delirious. The study was prospective, descriptive and comparative, with repeated measures (six-month follow up). The sample consisted of 225 consecutive patients, aged 65 years or older, who were to be operated on due to hip fracture or hip replacement. Exclusion criteria were serious cognitive disorder or delirium on admission. Data were collected via frequent daily observations, cognitive functioning tests (MMSE), HRQOL questionnaires (SF-36) and interviews. Delirium was assessed according to the DSM-IV criteria. A total of 45/225 became delirious, with an incidence of 24.3% among patients undergoing hip fracture surgery and 11.7% among those with hip replacement surgery. A predictive model for delirium included four factors: impaired hearing, passivity, low cognitive functioning, and waiting more than 18h for hip fracture surgery. Disorientation and urgent calls for attention were the most frequent behavioural changes in the prodromal phase prior to delirium. Delirium in connection with hip fracture revealed deteriorated HRQOL and cognitive functioning when measured at a six-month follow-up. The experience of being delirious was described by the patients as a sudden change of reality. Such an experience gave rise to strong emotional feelings, as did recovery from delirium. Nurses’ observations of behavioural changes in old patients with impaired cognitive function may be the first step in managing and reducing delirium. The predictive model of delirium ought to be tested further before use in clinical practice.
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Puhto, A. P. (Ari-Pekka). "Prosthetic joint infections of the hip and knee:treatment and predictors of treatment outcomes." Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526209456.
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Abstract Prosthetic joint infection (PJI) is one of the most devastating complications of hip or knee arthroplasty. Treatment options for PJI include prosthesis retention, prosthesis exchange and salvage procedures (e.g., arthrodesis or amputation). The purpose of this retrospective study is to assess the impact of shortening antibiotic treatment durations in PJIs treated with debridement, antibiotics and implant retention (DAIR) and to evaluate the predictors of DAIR treatment failure for PJIs. A second aim is to evaluate the outcomes and reimplantation microbiologies of PJIs treated with two-stage revision. The main data consist of 197 patients with PJI treated in Oulu University Hospital, Finland, between February 2001 and August 2009. Patients were identified retrospectively using the hospital’s patient databases. The study shows that, if antibiotic treatments for PJI are completed as planned, then DAIR treatment success rates (88%) are excellent. Prolonging antibiotic treatment over three months in total knee arthroplasty PJIs or over two months in total hip arthroplasty PJIs does not seem to offer any additional benefits. The failure of DAIR in the treatment of PJI is independently associated with high leucocyte counts at admission and with ineffective empirical antibiotics. Rifampin combination therapy, especially the combination of rifampin and ciprofloxacin, is significantly associated with successful DAIR treatments of staphylococcal PJIs. Our study also shows that a six-week course of antibiotics between stages is sufficient for treating PJIs with two-stage revision. Positive reimplantation cultures do not seem to be associated with significantly worse outcomesTiivistelmä Tekonivelinfektio on yksi vakavimmista lonkan ja polven tekonivelleikkauksen komplikaatioista. Tekonivelinfektion hoitovaihtoehtoja ovat tekonivelen säästävä hoito, tekonivelen vaihto ja ns. salvage-toimenpiteet (esimerkiksi jäykistys tai amputaatio). Tämän retrospektiivisen tutkimuksen tavoitteena oli selvittää lyhennetyn mikrobilääkehoidon toimivuutta tekonivelinfektion säästävässä hoidossa. Lisäksi pyrittiin löytämään tekonivelinfektion hoidon epäonnistumiselle altistavia tekijöitä. Tavoitteena oli myös selvittää hoidon tuloksia silloin, kun hoidetaan tekonivelinfektiota kaksivaiheisella revisiolla, sekä tutkia revision toisessa vaiheessa otettavien mikrobinäytteiden merkitystä hoidon onnistumiselle. Tutkimusaineisto koostui 197 potilaasta, joilta hoidettiin tekonivelinfektiota Oulun yliopistollisessa sairaalassa helmikuun 2001 ja huhtikuun 2009 välisenä aikana. Potilastiedot saatiin sairaalan hoitotietojärjestelmästä. Tutkimuksessa todettiin, että lyhyemmällä hoitoajalla voidaan saavuttaa erinomaiset hoitotulokset (88 %) tekonivelinfektion säästävässä hoidossa, jos suunniteltu antibioottihoitoaika voidaan toteuttaa. Yli kahden kuukauden (lonkan tekonivelinfektio) ja kolmen kuukauden (polven tekonivelinfektio) hoitoajasta ei näytä olevan hyötyä säästävässä hoidossa. Lisäksi todettiin, että sairaalaantulovaiheessa mitattu veren leukosyyttiarvo > 10×109/l ja tehoton empiirinen antibiootti ovat itsenäisesti hoidon epäonnistumiselle altistavia tekijöitä. Rifampisiini-yhdistelmähoidon, erityisesti rifampisiini yhdistettynä siprofloksasiiniin, todettiin olevan merkittävästi yhteydessä hoidon onnistumiseen silloin, kun hoidetaan stafylokokki-infektiota tekonivelen säästävällä hoidolla. Tutkimuksemme osoitti myös, että kuuden viikon antibioottihoito on riittävä hoidettaessa tekonivelinfektiota kaksivaiheisella revisiolla. Positiivinen mikrobiviljelynäyte toisen vaiheen leikkauksessa ei näytä olevan yhteydessä huonompaan hoitotulokseen
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Shituleni, Sibasthiaan Gometomab. "Displaced intracapsular neck of femur fractures: dislocation rate after total hip arthroplasty." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16788.
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Includes bibliographical referencesBackground: Dislocation is one of the most common orthopaedic complications after primary total hip arthroplasty (THA). The reported dislocation rate in elective THR is 5 - 8%. This number increases up to 22% for THA done for neck of femur fractures. Larger femoral head sizes increase the head-neck ratio and range of motion before impingement, therefore reducing the dislocation rate. Due to the reported increase in dislocation for trauma, some surgeons prefer to do a hemi-arthroplasty or open reduction and internal fixation (ORIF). Methods: A retrospective review of all THA done for neck of femur fractures during 2006 - 2012 was undertaken at a large referral hospital. Records were reviewed for patient related and surgical risk factors. We excluded all pathological fractures, extra-capsular fractures and failed ORIF. Results: A total of 96 cases were identified as suitable for analysis. Average age at surgery was 73.2 years (range 30 - 81). Delay to surgery was 5.3 days (range 1 - 63). Average follow up period was 18.3 months (range 3 months - 4.3years). Four patients (4.3%) had a confirmed dislocation. The four patients who had confirmed dislocation had the following characteristics, 28 mm femoral head size, age over 60 years, 2 posterior approaches and 3 females, although not statistically significant. Conclusion: The outcomes of THR in patients with neck of femur fractures can be favourable and provide good long-term prosthesis survival. We report on low dislocation rate post total hip replacement for intra-capsular neck of femur fractures.
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Persson, Per-Erik. "Heterotopic Ossification : Clinical and Experimental Studies on Risk Factors, Etiology and Inhibition by Non-steroidal Anti-inflammatory Drugs." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3908.
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Buckley, John G., Gurvinder K. Panesar, Michael J. MacLellan, Ian E. Pacey, and Brendan T. Barrett. "Changes to Control of Adaptive Gait in Individuals with Long-standing Reduced Stereoacuity." Association for Research in Vision and Ophthalmology, 2010. http://hdl.handle.net/10454/4728.
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PURPOSE. Gait during obstacle negotiation is adapted in visually normal subjects whose vision is temporarily and unilaterally blurred or occluded. This study was conducted to examine whether gait parameters in individuals with long-standing deficient stereopsis are similarly adapted.
METHODS. Twelve visually normal subjects and 16 individuals with deficient stereopsis due to amblyopia and/or its associated conditions negotiated floor-based obstacles of different heights (7-22 cm). Trials were conducted during binocular viewing and monocular occlusion. Analyses focused on foot placement before the obstacle and toe clearance over it.
RESULTS. Across all viewing conditions, there were significant group-by-obstacle height interactions for toe clearance (P < 0.001), walking velocity (P = 0.003), and penultimate step length (P = 0.022). Toe clearance decreased (similar to 0.7 cm) with increasing obstacle height in visually normal subjects, but it increased (similar to 1.5 cm) with increasing obstacle height in the stereo-deficient group. Walking velocity and penultimate step length decreased with increasing obstacle height in both groups, but the reduction was more pronounced in stereo-deficient individuals. Post hoc analyses indicated group differences in toe clearance and penultimate step length when negotiating the highest obstacle (P < 0.05).
CONCLUSIONS. Occlusion of either eye caused significant and similar gait changes in both groups, suggesting that in stereo-deficient individuals, as in visually normal subjects, both eyes contribute usefully to the execution of adaptive gait. Under monocular and binocular viewing, obstacle-crossing performance in stereo-deficient individuals was more cautious when compared with that of visually normal subjects, but this difference became evident only when the subjects were negotiating higher obstacles; suggesting that such individuals may be at greater risk of tripping or falling during everyday locomotion.RCUK (Research Councils, UK)
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Lopes, Junior Osmar Valadão. "Avaliação da articulação coxofemoral ipsilateral em indivíduos do sexo masculino com ruptura do ligamento cruzado anterior com e sem contato físico." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/88429.
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Objetivo: Avaliar a amplitude de movimento (ADM) do quadril em pacientes que sofreram lesão do ligamento cruzado anterior (LCA), por traumatismo direto, e compará-la a de pacientes com a lesão por entorse sem contato físico sobre o joelho. Fazer uma análise radiográfica do quadril dos indivíduos avaliados. Método: A ADM do quadril foi avaliada em 35 pacientes com lesão do LCA ocorrida por traumatismo direto (grupo com contato) e comparada a de 45 pacientes que sofreram a lesão por entorse do joelho sem contato físico (grupo sem contato). A amplitude rotacional do quadril também foi avaliada segundo os pontos de corte de 70° e 80°. Exames radiográficos do quadril foram realizados para avaliar a presença de deformidade tipo cam e tipo pincer. Resultados: A ADM do quadril foi estatisticamente superior nos pacientes do grupo com contato. Os pacientes do grupo sem contato tiveram uma amplitude rotacional do quadril de 66,1° ± 8,4° comparada a 79,4° ± 10,6° do grupo com contato (p<0,001). Dos pacientes do grupo sem contato, 77,8% e 93,3% tiveram uma amplitude de rotação do quadril menor do que 70° e 80°, respectivamente, comparada a 17,1% e 42,9% do grupo com contato (p<0,001). Não houve diferença na prevalência de deformidade tipo cam ou pincer entre os grupos. A prevalência de cam e pincer não foi maior nos pacientes com limitação da amplitude de movimento. Conclusão: Na amostra avaliada, os pacientes com lesão do LCA ocorrida por entorse do joelho sem contato físico tiveram menor amplitude de movimento do quadril do que pacientes vítimas da lesão do LCA por traumatismo direto. A presença de deformidade tipo cam ou pincer foi semelhente em ambos os grupos e não esteve relacionada a uma diminuição da amplitude de movimento do quadril.Objective: To evaluate the range of motion (ROM) of the hip in patients who suffered contact anterior cruciate ligament (ACL) injury and compare it to patients with non-contact ACL injury. To performe a hip radiographic analysis of all subjects included. Method: ROM of the hip was evaluated in 35 patients with contact ACL injury (contact group) and compared to that of 45 patients who suffered a non-contact ACL injury (non-contact group). The sum of hip rotation (IR+ER) was also assessed according to the cutoff points of 70° and 80°. Radiographic hip were performed to assess the presence of deformity cam and pincer type. Results: ROM of the hip was statistically higher in the patients with contact ACL injury. The average sum of hip rotation was 66.1° ± 8.4° in non-contact group compared to 79.4° ± 10.6° in contact group (p<0.001). Seventy-seven percent of patients in non-contact group had a sum of hip rotation less than 70° and 93% had less than 80°, repectivally, compared to 17.1% and 42.9% in the contact group (p<0.001). The prevalence of cam or pincer deformity was similar between groups. Cam or pincer deformity was not more frequent in patients with limited range of motion of the hip. Conclusion: In our study, patients with contact ACL injury had greater range of motion of the hip than patients that suffered non-contact ACL injury. The presence of deformity cam or pincer was similar in both groups and was not related to a decreased range of motion of the hip.
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LIU, HSIN-PEI, and 劉欣蓓. "Explore the risk factors of hip revision surgery." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/fqm8u6.
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碩士國立臺北護理健康大學
護理研究所
107
Due to population aging, the size of the population covered by Taiwan’s National Health Insurance has increased alongside the total number of indications for surgery. The number of patients that underwent hip replacement surgery in the past 10 years has substantially increased. According to statistics from Taiwan’s Ministry of Health and Welfare, the number of patients that undergo hip replacements in Taiwan each year ranges between 6000 and 8000. Active lifestyles among younger patients increase wear and risk loosening implant devices. For pain relief, patients may have to undergo multiple joint revision surgeries. Not only does the task of recovering from surgery cause burden and pain to patients but it also increases burden on medical resources, personnel, and equipment of government agencies. Therefore, it is vital to understand the factors affecting joint revision surgery. Therefore, this study examined factors related to revision hip arthroplasty (RHA) among patients who have undergone total hip arthroplasty. This study adopted a retrospective research design and collected data from a regional teaching hospital in northern Taiwan. The medical records of 140 patients that underwent hip replacement surgery from 2010 to 2014 were obtained. First, a medical record review was conducted using a customized data collection form. SPSS Version 20.0 was used to process and analyze the collected data; specifically, multiple regression analysis was performed to determine the risk factors influencing the numbers of RHA, which may serve as relevant predictors. Results show that the numbers of RHA of case patients who consented to undergoing total or partial hip arthroplasty were significantly lower than that of patients who consented to only undergoing RHA (β = −.49, p < .001). The numbers of RTHA of patients with fractures were significantly lower than that of patients with other principal diagnoses (β = −.30, p < .05). The present correlation analysis results show that although patient demographics (e.g., weight and physical mobility), hospitalization data (e.g., hospitalization duration, surgery duration, and surgery complications), and disease characteristics (e.g., hypertension, hepatobiliary disease, digestive disease, malignant tumors, and albumin levels) were correlated with RHA, the results were nonsignificant. Nonetheless, the influence of these factors cannot be overlooked and should be included in surgical assessments. Most case patients in this study had RHA for traumatic conditions, and had favorable familial support. This study recommends Taiwan to establish an arthroplasty registry as other Western countries have and integrate basic science research with clinical evidence.After undergoing hip replacement, patients can utilize postacute care (PAC) in accordance with the policies of the Ministry of Health and Welfare. Patient and family involvement should be encouraged to significantly lower familial and health care burden.
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Wu, Chia-Yen, and 吳佳燕. "Risk factors of survival after surgery in elderly patients with hip fracture." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/33866824019632915139.
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碩士國立臺灣大學
護理學研究所
100
Hip fracture is one of major factor leading to morbidity and mortality in the elders. It causes negative impacts on older people’s lives and also costs enormous medical expenses. Previous studies has shown that older adults with hip fracture have a relatively higher risk of death. Currently, surgery is the primary treatment for hip fracture but there are several factors to influence post-surgery survival rate. In this study, we aim to explore some risk factors which could be used to predict the survival outcome in patients with hip fractures after surgery treatment. This study used secondary analysis, the original data was collected from Apil 2004 to January 2006. The inclusion criteria were noninstitutionalized patients with age ≧ 60 years old and who had first low-trauma hip fractures treated by surgery in Taipei’s medical center was eligible. In this study, 217 patients were recuited and data analysis was combined with death of statistical data from Bureau of health promotion, department of health in Taiwan. Survival rate of post-surgery was analyzed by using Kaplan- Meier method. To analyize the influence factors of survival rate, Log-Rank test was performed for each variable. Cox proportional hazard models were used to calculate the hazard ratios (HRs) of the factors with regard to mortality. Our data showed that hip fracture more commonly occurs in elder women with age over 80 years old. One-year survival rate of post-surgery was 87.6% in all subjects. For gender comparison, one-year and 4.8-year survival rate of post- surgery were all significant lower in men than those in women. From multivariate Cox regression analysis, we found that predictors for one-year survival rate of post-surgery were male, illiterate and body mass index (BMI) less than 20. For 4.8-year survival rate of post- surgery, there was five predictors which included male, illiterate, BMI≦20, T score of bone density≦-2.16 and ADLs difficult. In addition, we also noted that education and MMSE both reveal significant associations with one-year and 4.8-year survival rate, but no significant association with death-risk post-surgery.
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Lungu, Eugen. "Identification of patients at risk of poor outcomes following hip or knee arthroplasty." Thèse, 2015. http://hdl.handle.net/1866/16264.
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Les arthroplasties totales de la hanche (ATH) et du genou (ATG) sont souvent offertes aux patients atteints de dégénérescence articulaire sévère. Bien qu’efficace chez la majorité des patients, ces interventions mènent à des résultats sous-optimaux dans de nombreux cas. Il demeure difficile d’identifier les patients à risque de résultats sous-optimaux à l’heure actuelle. L’identification de ces patients avant la chirurgie pourrait permettre d’optimiser la gamme de soins et de services offerts et de possiblement améliorer les résultats de leur chirurgie. Ce mémoire a comme objectifs : 1) de réaliser une revue systématique des déterminants associés à la douleur et aux incapacités fonctionnelles rapportées par les patients à moyen-terme suivant ces deux types d’arthroplastie et 2) de développer des modèles de prédiction clinique permettant l’identification des patients à risque de mauvais résultats en terme de douleur et d’incapacités fonctionnelles suivant l’ATH et l’ATG.
Une revue systématique de la littérature identifiant les déterminants de la douleur et de la fonction suivant l’ATH et l’ATG a été réalisée dans quatre bases de données jusqu’en avril 2015 et octobre 2014, respectivement. Afin de développer un algorithme de prédiction pouvant identifier les patients à risque de résultats sous-optimaux, nous avons aussi utilisé des données rétrospectives provenant de 265 patients ayant subi une ATH à l’Hôpital Maisonneuve-Rosemont (HMR) de 2004 à 2010. Finalement, des données prospectives sur 141 patients recrutés au moment de leur inclusion sur une liste d’attente pour une ATG dans trois hôpitaux universitaires à Québec, Canada et suivis jusqu’à six mois après la chirurgie ont permis l’élaboration d’une règle de prédiction clinique permettant l’identification des patients à risque de mauvais résultats en terme de douleur et d’incapacités fonctionnelles.
Vingt-deux (22) études d’une qualité méthodologique moyenne à excellente ont été incluses dans la revue. Les principaux déterminants de douleur et d’incapacités fonctionnelles après l’ATH incluaient: le niveau préopératoire de douleur et de fonction, un indice de la masse corporelle plus élevé, des comorbidités médicales plus importantes, un état de santé générale diminué, une scolarité plus faible, une arthrose radiographique moins sévère et la présence d’arthrose à la hanche controlatérale. Trente-quatre (34) études évaluant les déterminants de douleur et d’incapacités fonctionnelles après l’ATG avec une qualité méthodologique moyenne à excellente ont été évaluées et les déterminants suivant ont été identifiés: le niveau préopératoire de douleur et de fonction, des comorbidités médicales plus importantes, un état de santé générale diminué, un plus grands niveau d’anxiété et/ou de symptômes dépressifs, la présence de douleur au dos, plus de pensées catastrophiques ou un faible niveau socioéconomique.
Pour la création d’une règle de prédiction clinique, un algorithme préliminaire composé de l’âge, du sexe, de l’indice de masse corporelle ainsi que de trois questions du WOMAC préopératoire a permis l’identification des patients à risque de résultats chirurgicaux sous-optimaux (pire quartile du WOMAC postopératoire et percevant leur hanche opérée comme artificielle avec des limitations fonctionnelles mineures ou majeures) à une durée moyenne ±écart type de 446±171 jours après une ATH avec une sensibilité de 75.0% (95% IC: 59.8 – 85.8), une spécificité de 77.8% (95% IC: 71.9 – 82.7) et un rapport de vraisemblance positif de 3.38 (98% IC: 2.49 – 4.57).
Une règle de prédiction clinique formée de cinq items du questionnaire WOMAC préopratoire a permis l’identification des patients en attente d’une ATG à risque de mauvais résultats (pire quintile du WOMAC postopératoire) six mois après l’ATG avec une sensibilité de 82.1 % (95% IC: 66.7 – 95.8), une spécificité de 71.7% (95% IC: 62.8 – 79.8) et un rapport de vraisemblance positif de 2.9 (95% IC: 1.8 – 4.7).
Les résultats de ce mémoire ont permis d’identifier, à partir de la littérature, une liste de déterminants de douleur et d’incapacités fonctionnelles après l’ATH et l’ATG avec le plus haut niveau d’évidence à ce jour. De plus, deux modèles de prédiction avec de très bonnes capacités prédictives ont été développés afin d’identifier les patients à risque de mauvais résultats chirurgicaux après l’ATH et l’ATG. L’identification de ces patients avant la chirurgie pourrait permettre d’optimiser leur prise en charge et de possiblement améliorer les résultats de leur chirurgie.Total joint arthroplasties (TJA) are commonly performed procedures for patients afflicted with hip and knee osteoarthritis (OA), and although successful, these surgeries can yield suboptimal results in a non-negligible proportion of patients. In order to improve surgical outcomes, patients at risk of poor results could be targeted with focused interventions. However, the evidence regarding the ability to identify which patients are at risk of poor outcomes is scarce. The objectives of this memoir were 1) to systematically review the literature of preoperative determinants of medium-term patient-reported pain and physical function after total hip arthroplasty (THA) and total knee arthroplasty (TKA) and 2) to develop clinical prediction models allowing the individual identification of patients at risk of poor outcomes following THA and TKA. Systematic literature searches targeting studies evaluating all studied determinants of pain and function following THA and TKA were performed in four important databases until April 2015 and October 2014 respectively. Moreover, retrospective data from 265 patients having undergone THA at the Hôpital Maisonneuve-Rosemont from 2004 to 2010 was used to develop a preliminary prediction algorithm (PA) to identify patients at risk of poor surgical results. Finally, prospective data from 141 patients recruited at their inclusion on a preoperative waitlist for TKA in three hospitals in Québec City, Canada and followed 6 months postoperatively was used to develop a clinical prediction rule (CPR) to identify patients at risk of poor outcomes Twenty-two (22) studies evaluating determinants of poor pain and function after THA with moderate-to-excellent methodological quality found that preoperative levels of pain and function, higher body mass index (BMI), greater medical comorbidities, worse general health, lower education level, lower OA radiographic severity and contralateral hip OA were consistently associated with poor THA outcomes. Thirty-four (34) studies evaluating determinants of poor pain and function after TKA with moderate-to-excellent methodological quality identified preoperative levels of pain and function, greater medical comorbidity, lower general health, greater levels of depression and/or anxiety, presence of back pain, greater pain catastrophizing and greater socioeconomic deprivation as consistently associated with worse outcomes. A preliminary PA consisting of age, gender, BMI and three items of the preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was able to identify patients at risk of suboptimal outcomes (worst quartile of the postoperative WOMAC score and perceiving their operated hip as artificial with minor or major limitations) on an average±standard deviation (SD) of 446±171 days after THA with a sensitivity of 75.0% (95% CI: 59.8 – 85.8), a specificity of 77.8% (95% CI: 71.9 – 82.7) and a positive likelihood ratio of 3.38 (98% CI: 2.49 – 4.57). A CPR consisting of five items of the preoperative WOMAC was able to predict the identity of patients awaiting TKA at the highest risk of poor outcomes (worst quintile of the postoperative WOMAC score) six months postoperatively with a sensitivity of 82.1 % (95% CI: 66.7 – 95.8), a specificity of 71.7% (95% CI: 62.8 – 79.8) and a positive likelihood ratio of 2.9 (95% CI: 1.8 – 4.7). This memoir led to the identification of a list of determinants of pain and disability following TKA and THA with the highest level of evidence to date. Moreover, two clinical prediction models with good predictive capabilities were developed in order to allow the identification of patients at risk of poor outcomes following TKA and THA. These findings could help target the patients most likely to benefit from interventions aimed at diminishing their risk profile and improving surgical outcomes of hip or knee arthroplasties. External validation of these rules is warranted before clinical implementation.
Books on the topic "Hip joint Surgery Risk factors"
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Pollock, Rob. Total hip replacement: modes of failure. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.007010.
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♦ Total hip replacements (THRs) may fail in various ways. They may become infected, they may be subject to aseptic loosening, they may dislocate, or a periprosthetic fracture may occur. The patient with a failed THR must be thoroughly assessed before treatment is contemplated♦ Infection may be acute or chronic. Assessment involves clinical assessment, plain radiographs, blood tests (C-reactive protein and erythrocyte sedimentation rate), hip aspiration, and, sometimes, nuclear medicine. The acutely infected hip may be treated with one-stage revision. This involves thorough lavage, debridement, and exchange of all modular components as well as long-term antibiotic therapy. The gold standard of treatment for a chronically infected THR is a two-stage revision. Success rates of 80–90% can be expected♦ Aseptic loosening typically occurs at the cement bone interface in hips where a metal-on-polyethylene bearing couple has been used. Bone resorption takes place as a result of an inflammatory response to small wear particles. After infection has been excluded the treatment of choice is a single-stage revision♦ Dislocation may be the result of patient factors, implant factors, or poor surgical technique. It is imperative for the clinician to minimize the risk by selecting patients carefully, using the correct combination of implants and performing surgery accurately♦ The management of periprosthetic fractures depends on how well the implants are fixed and quality of bone stock. Treatment ranges from simple fixation of the fracture through to revision augmented with strut allograft.
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Doherty, Michael. Osteoarthritis. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0266.
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Osteoarthritis (OA) is a disorder of synovial joints and is characterized by the combination of focal hyaline cartilage loss and accompanying subchondral bone remodelling and marginal new bone formation (osteophyte). It has genetic, constitutional, and environmental risk factors and presents a spectrum of clinical phenotypes and outcomes. OA commonly affects just one region (e.g. knee OA, hip OA). However, multiple hand interphalangeal joint OA, usually accompanied by posterolateral firm swellings (nodes), is a marker for a tendency towards polyarticular ‘generalized nodal OA’.
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Aspden, Richard, and Jenny Gregory. Morphology. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0011.
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The study of joint morphology can help us to understand the risk factors for osteoarthritis (OA), how it progresses, and aids in developing imaging biomarkers for study of the disease. OA results in gross structural changes in affected joints. Growth of osteophytes, deformation of joint components, and loss of joint space where cartilage has broken down are all characteristics of the disorder. Certain bone shapes as well as malalignment predispose people to future OA, or may be a marker for early OA. Geometrical measures, such as the alpha angle or Wiberg’s CE angle, used to be the primary tool for investigating morphology. In recent years, however, statistical shape modelling (SSM) has become increasingly popular. SSM can be used with any imaging modality and has been successfully applied to a number of musculoskeletal conditions. It uses sets of landmark points denoting the anatomy of one or more bones to generate new variables (modes) that describe and quantify the shape variation in a set of images via principal components analysis. With the aid of automated search algorithms for point placement, the use of SSMs is expanding and provides a valuable and versatile tool for exploration of bone and joint morphometry. Whilst the majority of research has focused on hip and knee OA, this chapter provides an overview of joint morphology through the whole skeleton and how it has helped our ability to understand and quantify the risk and progression of osteoarthritis.
Book chapters on the topic "Hip joint Surgery Risk factors"
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Zmistowski, Benjamin, and Pouya Alijanipour. "Risk Factors for Periprosthetic Joint Infection." In Periprosthetic Joint Infection of the Hip and Knee, 15–40. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7928-4_2.
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Berry, D. J. "Risk Factors for Dislocation after Total Hip Arthroplasty: Results of a Long Term Analysis." In Bioceramics in Joint Arthroplasty, 137–38. Heidelberg: Steinkopff, 2004. http://dx.doi.org/10.1007/978-3-7985-1968-8_24.
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Sigward, Susan M., and Christine D. Pollard. "Proximal Risk Factors for ACL Injury: Role of the Hip Joint and Musculature." In ACL Injuries in the Female Athlete, 207–23. Berlin, Heidelberg: Springer Berlin Heidelberg, 2018. http://dx.doi.org/10.1007/978-3-662-56558-2_11.
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Farne, Hugo, Edward Norris-Cervetto, and James Warbrick-Smith. "Acute joint pain." In Oxford Cases in Medicine and Surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/oso/9780198716228.003.0033.
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The ‘must exclude’ diagnosis is septic arthritis. Not only can it destroy articular cartilage within days if not treated (hence permanently reducing joint function), but it is also associated with a mortality of about 10% due to underlying bacteraemia. Remember that pain may be referred from elsewhere. For example, hip pathology may present as knee pain, and lumbar spine pathology may present as hip pain. The causes of a single, acutely painful joint include those shown in Figure 27.1, with larger font size highlighting those that are more common. • Pain. You should characterize the pain as for any other pain along the lines of SOCRATES (see Chapter 1). Pain that worsens with movement and improves with rest is likely to be non-inflammatory. An acute onset (hours) is consistent with septic arthritis, gout/pseudogout, and trauma. A more insidious onset is more common in conditions like bursitis and tendonitis, where the relevant anatomical structure becomes inflamed with overuse. Chronic onset suggests osteoarthritis (note that some rheumatologists prefer the term osteoarthrosis to reflect the fact that the inflammation is not the primary pathology). The severity of pain can usefully be assessed by asking about joint function—for example, can the patient weight bear? • Trauma. Mr Sullivan has already said he does not remember there being any trauma, but you must always ask and make sure. Even the slightest of knocks can cause significant pain. However, this does not exclude other diagnoses—trauma can precipitate infection or gout, for example. • Common risk factors for gout. There are many potential causes of gout, but the more common ones that you should ask about include use of thiazide diuretics, recent heavy alcohol intake, chronic renal failure, and chemotherapy (high cell apoptosis, leading to degradation of DNA and excess urate). A history of renal stones or previous episodes of gout also makes gout more likely. • Common risk factors for septic arthritis. Again there are many possible risk factors, but the key ones are immunosuppression (e.g. diabetes, HIV, steroid use) and any prosthetic joints. • Risk factors for haemarthrosis. Typically due to a coagulopathy (e.g. classically haemophilia), anticoagulant use (typically warfarin) or trauma (e.g. a ruptured anterior cruciate ligament in the knee).
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"Risk Factors." In Septic Bone and Joint Surgery, edited by Reinhard Schnettler and Hans-Ulrich Steinau. Stuttgart: Georg Thieme Verlag, 2010. http://dx.doi.org/10.1055/b-0034-88092.
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Gilbertson-Dahdal, Dorothy L. "Developmental Hip Dysplasia." In Musculoskeletal Imaging Volume 2, edited by Mihra S. Taljanovic and Tyson S. Chadaz, 297–300. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190938178.003.0113.
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Chapter 112 focuses on developmental dysplasia of the hip, which includes a spectrum of abnormalities ranging from a stable hip with a mildly dysplastic acetabulum to complete hip dislocation. Pathophysiology, clinical findings, and screening studies are explored. The pathophysiology is multifactorial including mechanical, genetic and hormonal factors. Imaging strategies, findings, and treatment options are also discussed. Screening US, which is the imaging modality of choice, is performed on infants with predisposing risk factors. Outcome is quite variable with many cases resolving spontaneously without treatment whereas others stabilize with acetabular dysplasia. Treatment options include immobilization and surgery. MRI is used for problem solving in postoperative patients.
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Khan, Umraz, Graeme Perks, Rhidian Morgan-Jones, Peter James, Colin Esler, Vince Smyth, and Vanya Gant. "Thromboprophylaxis and haematomas." In Pathways in Prosthetic Joint Infection, 23–26. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198791881.003.0004.
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This chapter discusses thromboprophylaxis and haematomas within periprosthetic joint infection. The issue of venous thromboembolism is important for all surgical patients and, as such, those undergoing arthroplasty must undergo a careful and accurate risk assessment. Prolonged surgery and delayed postoperative mobilization are risk factors and are common to most major joint arthroplasty. Use of prophylactic agents to prevent thrombosis must be balanced with the avoidance of haematoma formation as the latter contributes to a risk of prosthetic joint infection. Should deep vein thrombosis occur then swift methods of diagnosis and treatment must be in place.
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Wall, Peter, Matthew Wyse, and Damian Griffin. "Principles of lower limb surgery." In Oxford Textbook of Rheumatology, 698–704. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0091.
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Lower limb surgery can be broadly grouped into five categories: injections, joint-preserving procedures, soft tissue procedures, arthrodesis, and arthroplasty. Lower limb surgery should be expedited at a time that will offer the optimal outcome and minimal risk. Decisions on diagnosis, surgical timing, and fitness for surgery should be made by a multidisciplinary team which may include both rheumatologists and anaesthetists. A thorough preoperative assessment and adequate preoperative imaging will allow surgery to proceed safely and without undue delay. Measures to reduce the main risks of surgery including infection and venous thromboembolism should be undertaken. The effects on both patients and healthcare resources of surgical site infection are immense. Surgery should take place in modern ultraclean theatres where possible. Controlling and managing surgical blood loss will allow patients to rehabilitate more rapidly; this can be achieved with careful monitoring of blood losses, antifibrinolytics and blood transfusions where necessary. Diagnostic injections should be used to help determine the likely success of surgery in patients with complex symptoms. Therapeutic arthroscopy now offers a real alternative to open surgery for many conditions, and joint-preserving surgery represents a key area where more research is needed in order to help manage rheumatological disease in the future. Ankle arthroplasty continues to improve but early failure is still a concern. Total hip and knee arthroplasty are both highly effective operations in the treatment of arthritis and should not be delayed in patients in whom medical management is failing.
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Dave, Jayshree, and Rohma Ghani. "Bone and Joint Infections." In Tutorial Topics in Infection for the Combined Infection Training Programme. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198801740.003.0039.
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Patients with bone and joint infections can present with native joint septic arthritis, osteomyelitis, or implant-associated bone and joint infections. Patients often present with an acute onset of hot, swollen, painful joint with restricted function in one or more joints over a couple of weeks. On examination the affected joint is painful with a limited range of movement, and fever is present. Risk factors for septic arthritis include an abnormal joint architecture due to pre-existing joint disease, e.g. patients with rheumatoid arthritis, or patients on haemodialysis, with diabetes mellitus, or older than 80 years of age. The differential diagnosis includes reactive arthritis, pre-patellar bursitis, gout, Lyme disease, brucellosis, and Whipples disease. Staphylococcus aureus is the most common cause of septic arthritis, followed by Group A streptococcus and other haemolytic streptococci including B, C and G. Gram-negative rods such as Escherichia coli are implicated in the elderly, immunosuppressed, or patients with comorbidities. Pseudomonas aeruginosa is implicated in intravenous (IV) drug users and patients post-surgery or intra-articular injections. Kingella kingae causes septic arthritis in children younger than four years of age. Neisseria gonorrhoeae, Neisseria meningitidis, and Salmonella species can also cause septic arthritis as part of a disseminated infection. Septic monoarthritis commonly occurs in patients with disseminated gonococcal infection. Blood cultures, white blood cell count, C reactive protein (CRP), electrolytes, and liver function tests are indicated. Serial CRP is useful in monitoring response to treatment. If there is a history of unprotected sexual intercourse, gonococcal testing is recommended. Brucella serology and Tropheryma whippei serology may be considered based on the clinical history. Joint fluid aspiration should be performed by a specialist within the hospital. Joint fluid aspirate is processed in the laboratory for microscopy, culture, and sensitivity. Gram stain can show an increase in neutrophils and presence of bacteria. The guidelines provided by the British Society for Rheumatology on the management of hot swollen joints in adults has provided advice for empirical treatment for suspected septic arthritis, but the local antibiotic policy should also be considered. Initial treatment is with intravenous flucloxacillin 2g four times daily, or 450– 600mg four times daily of intravenous clindamycin to cover S. aureus.
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Gueldner, Sarah H., Guruprasad Madhavan, Eric D. Newman, and Carolyn S. Pierce. "Diagnostics, Therapeutics, and Health Informatics in Osteoporosis." In Encyclopedia of Healthcare Information Systems, 446–51. IGI Global, 2008. http://dx.doi.org/10.4018/978-1-59904-889-5.ch057.
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Osteoporosis, usually silent until a fracture occurs, is among the most common health problems facing elders worldwide. By definition, osteoporosis is a “systemic” skeletal disease characterized by a low bone mass and a micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture (“The Burden of Musculoskeletal Conditions,” 2003). The incidence of osteoporotic hip fracture increases exponentially with age, and the increase in older persons globally could dramatically increase the number of hip fractures, posing a devastating increase in disability and cost for elders worldwide. Therefore, it is imperative that diagnostic and treatment measures be developed and instituted worldwide to support preventative measures for osteoporosis and consequential fractures. Toward that purpose, the World Health Organization (WHO) has declared 2002–2011as the Decade of the Bone and Joint, uniting nations throughout the world in the commitment of energy and resources to accelerate progress in bone health and prevention of fractures. Keeping in mind this global context, this discussion includes information about the prevalence and impact of osteoporosis, its signature pathology (including bone remodeling), factors which place individuals at risk for developing osteoporosis, and the role of diagnostics, therapeutics, and informatics in the realm of osteoporosis. Encouraging information is also provided about recent innovative technological developments that may enhance our ability to detect and treat osteoporosis earlier, in time to reduce and better manage its unwelcome sequelae.
Conference papers on the topic "Hip joint Surgery Risk factors"
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Khosroshahi, Maryam, Fred Barez, Amer El-Hage, and James Kao. "Dependence of Elastic Properties of Human Femoral Cortical Bone on Porosity." In ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-52318.
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Hip fracture is one of the most serious and common health problems among elderly which may lead to permanent disability or death. Hip fracture commonly occurs in the femoral bone, the major bone in the hip joint. Microscopic age-related changes in the structure of cortical bone is one of the factors that is considered to be partially responsible for the increase of fracture risk in elderly. It is of great interest to develop a predictable model of such fractures for the aging population in preparation of a suitable therapy. These micro structural changes influence mechanical properties and, therefore, behavior of bone and are critical to understand risk and mechanics of fracture of bone. Correlation between cortical bone strength and porosity, as a microscopic structural factor, has been examined frequently as a function of age and/or porosity. These studies have investigated the effect of porosity experimentally and have not studied the effect of porosity independently from other structural factors such as bone mineral density. In this study effect of porosity on elastic properties of human femoral cortical bone was studied independently using finite element analysis assuming transversely isotropic behavior in terms of elastic properties with the axis of elastic properties along the longitudinal axis of femur shaft. In this study, published standard mechanical tests for transversely isotropic materials were simulated using finite element computer simulation on models with different porosities. The developed finite element model utilized material properties based on the best fit regression in previously published articles. Pores’ size, shape and distribution were also modeled based on previous experimental studies. The finite element model, in general, predicted behavior of five independent elastic mechanical properties, namely, longitudinal Young’s modulus, transverse poisson’s ratio, transverse shear modulus, transverse Young’s modulus and longitudinal poisson’s ratio, as a function of porosity. Furthermore, effect of porosity on the elastic properties across various age groups was investigated using published data on age-related changes in bone porosity. Mathematical models based on Finite Element Analysis results have been developed using linear least square regression. These models show negative linear relationship between studied elastic properties of human femoral cortical bone and porosity. The Finite Element Analysis results compared well with the previously published experimental data. Furthermore, the results obtained show the elastic properties as functions of age for females and males. The predicted values for elastic properties are lower for men compared to women of age 20 to 40 years old. However, after the age of 44, elastic properties of femoral cortical bone for men are higher than women. The Finite Element Model developed in this study will help to create a clinical bone model for the prediction of fracture risk or the selection of suitable therapy in orthopedic surgery.
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Saidane, Olfa, Leila Gafsi, Rim Barhoumi, Aicha Ben Tekaya, Rawdha Tekaya, Ines Mahmoud, and Leila Abdelmoula. "AB0444 RISK FACTORS OF JOINT SURGERY IN RHEUMATOID ARTHRITIS TUNISIAN PATIENTS." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.7756.
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Li, M., C. Ren, L. Sun, T. Ma, Q. Wang, Z. Li, and K. Zhang. "The analysis of perioperative risk factors on postoperative complications and death after hip fracture surgery in senile patients." In Deutscher Kongress für Orthopädie und Unfallchirurgie. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1717274.
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Foucher, Kharma C., Debra E. Hurwitz, Thomas P. Andriacchi, Aaron G. Rosenberg, and Dale R. Sumner. "An Evaluation of Muscle Force Predictions at the Hip Joint." In ASME 1998 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1998. http://dx.doi.org/10.1115/imece1998-0159.
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Abstract Understanding the loading of the hip joint and femur is a critical factor in understanding the progression of osteoarthritis (OA) and the mechanical factors influencing the outcome of total hip replacement surgery (THR). While in vivo transducers provide unique and valuable information about hip joint loading, they are limited to evaluating small numbers of postoperative THR patients. Musculoskeletal models, however, easily provide estimates of the hipjoint loads in larger patient populations with a variety of orthopedic conditions. Comparing the predicted forces with in vivo data is one approach to evaluating the results of such a model. The physiological phenomenon that bone changes in response to its loading environment presents an alternate method for evaluating modeled muscle forces. Validation of musculoskeletal models can be obtained by comparing femoral bone mineral density (BMD) patterns to the predicted forces. To evaluate muscle force predictions of a parametric three dimensional musculoskeletal model of the hip joint and femur, this study tested the hypothesis that the predicted abductor muscle force and greater trochanter BMD were significantly correlated and that the predicted contact force and proximal femur BMD were significantly correlated.
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Lowe, G. D. O. "EPIDEMIOLOGY AND RISK PREDICTION OF VENOUS THROMBOEMBOLISM." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642965.
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Uses of epidemiology. Venous thromboembolism continues to be an important cause of death and disability in Western Countries. Its epidemiology may provide clues to etiology, e.g. the increased incidence in oral contraceptive users, and the low prevalence at autopsy in Central Africa or Japan compared to the U.S.A. A second use is the monitoring of time-trends: the diagnosis of pulmonary embolism increased during the 1970s, although the case fatality decreased. A third use is the identification and quantification of risk factors: these could be modified in the hope of prevention, or else used to select high risk groups for selective prophylaxis, e.g. during acute illness. Prevention is the only feasible approach to reducing the burden of venous thromboembolism, since most cases are not diagnosed, and since the value of current treatment is debatable.Case definition. Presents problems: clinical diagnosis is unreliable, and should if possible be supported by objective methods. Autopsy studies are performed on selected populations, at a decreasing rate; the frequency of thromboembolism depends on technique; and pathologists cannot be blinded and are open to bias. It can also be difficult to judge whether a patient dying with pulmonary embolism died from pulmonary embolism. 125I-fibrinogen scans indicate minimal disease, and now present ethical problems in screening due to risks of viral transmission. Venography is invasive and is not readily repeatable, which limits its use as a screening method. Plethysmography merits wider evaluation, since it is non-invasive, and sensitive to major thrombosis.Community epidemiology. Data on the community epidemiology are limited. The risk increases with age. When age is taken into account, there is little sex difference. Overweight in women, use of oral contraceptives and blood group A increase the risk: smoking, varicose veins, blood pressure, cholesterol and glucose do not, on current evidence. Long-term follow-up of patients with proven thromboembolism shows an increased risk of malignancy, hence occult cancer may also be a risk factor. Polycythaemia and certain congenital deficiencies (e.g. antithrombin III) are also well-recognised risk factors, although uncommon.Hospital epidemiology. Data on hospital epidemiology are derived largely from autopsy prevalence, and from short-term incidence of minimal thrombosis detected by 125I—fibrinogen scanning. Old, immobile and traumatised patients are most at risk. Previous thromboembolism, polycythaemia, antithrombin III deficiency, hip and leg fractures, elective hip and leg surgery, hemiplegia, paraplegia, and heart failure carry high risks, and merit consideration for routine prophylaxis. The risk in elective surgery precedes the operation, and increases with age, overweight, malignancy, varicose veins, non-smoking, and operative factors (duration, approach, general anaesthesia, intravenous fluids). Diabetics appear to have no extra risk. Combinations of clinical variables can be used to predict high risk groups for selective prophylaxis, but combination indices require further study. Laboratory variables may increase the predictability of deep vein thrombosis, but the results of published studies are conflicting, and the cost-effectiveness of laboratory prediction should be evaluated.
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Zheng, Nigel, Hongsheng Wang, and Koco Eaton. "Ulnar Collateral Ligament and Elbow Joint Loading During Throwing." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80699.
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Ulnar collateral ligament (UCL) rupture is one of the most common throwing arm injuries for throwing athletes. Reconstructive surgery known as Tommy John surgery is often performed to restore joint stability [1]. According to the 2002 Major League Baseball Disability Analysis, almost 70% of players on the disabled list are pitchers and throwing arm related injuries account for 53% of all disabled list placements. To reach a high ball speed, pitchers cock, or excessively externally rotate their pitching arm to or near an extreme ROM of 180° [2]. The shoulder is then immediately internally rotated at over 7000°/s after the leading foot contact. The excessive external rotation ROM and astonishing internal rotation velocity are thought to contribute to throwing arm injury [3]. Repeated exposure to the large valgus torque may cause excessive laxity and catastrophic rupture of UCL [2]. A recent study showed that uninjured pitchers with higher elbow valgus torque exhibited UCL thickening whereas uninjured pitchers with lower elbow valgus torque did not have such adaptation in UCL appearance [4]. It is believed that microtear and catastrophic rupture of UCL are related to higher elbow valgus torque [2]. However, it is not clear how the conditions of the UCL are related to the elbow valgus torque during throwing. Therefore, it is our interest to investigate risk factors to throwing arm injuries. In this study, we investigated the elbow joint loading during throwing among subjects without UCL injury at the time of testing and after testing, with UCL reconstruction (UCL-R) at the time of testing, and UCL reconstruction after testing (PUCL-R). It was hypothesized that there was no significant differences in elbow joint loading between subjects with UCL-R, PUCL-R and uninjured groups. Findings from this may improve our understanding of UCL injury and assist us to identify risk factors for UCL injury.
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Schooley, Ben, Akanksha Singh, Sarah Floyd, Stephan Pill, and John Brooks. "Direct Weighting Interactive Design of Patient Preferences for Shared Decision Making in Orthopaedic Practice." In 13th International Conference on Applied Human Factors and Ergonomics (AHFE 2022). AHFE International, 2022. http://dx.doi.org/10.54941/ahfe1002105.
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Patients need the ability to accurately and efficiently communicate their preferences across outcome domains to their healthcare providers.1-7 No existing system provides an efficient and timely approach to collect and communicate patient preferences across outcome domains to support shared decision making (SDM) in orthopaedic practice.2-4,8-19 The overarching goal of this research is to design, build, and test an app that collects baseline patient preferences and health status across orthopaedic outcomes and reports this information to the provider for use in patient care. A core component of the app is a Direct-Weighting (DW) preference assessment approach, originated from our prior research, and applied in a touchscreen based interactive design. It is envisioned that patients will use the app after scheduling a first visit to a surgeon for a new orthopaedic condition. Direct weighting (DW) approaches calculate patient-specific preference weights across outcomes by asking patients to disperse portions of a hypothetical “whole” across outcomes in a manner that reflects a patient’s preferences.20 DW has low respondent burden but it requires respondents to make “implicit” comparisons which may be difficult to conceptualize.20 However, the DW approach has become generally accepted in the quality-of-life literature and it has been shown that patients dividing up pieces of a “pie” across quality-of-life domains yields valid representations of patient preferences across the domains.20-22 However, the DW approach has not been validated with specific clinical scenarios using a clinically focused set of outcomes or by using a mobile software app. Drawing on prior research, we iteratively design and develop the app with input from prior DW research, informaticians, and clinicians. We use a qualitative approach to pilot test the app with 20 first-time visit patients presenting with joint pain and/or function deficiency. Participants were interviewed about their outcome preferences for care, used the app to prioritize outcome preferences, answered interview questions about their experience using the app, and completed a mHealth App Usability Questionnaire (MAUQ). Interview questions focused on the utility and usability of the mobile app for communicating with their provider, and capability of the app to capture their outcome preferences. Results validated five core preference domains, with most users dividing their 100-point allocation across 1-3 domains. The tool received moderate to high usability scores. Patients with older age and lower literacy found the DW approach more difficult in terms of allocating 100 points across 5 domains. Suggestions for DW interface interaction improvement included instantiation of a token/points oriented DW preference scoring methodology rather than a 1-10 sliding scale approach for improved preference weighting cognition and SDM with a provider. As more patient reported outcome (PRO) apps hit the marketplace across a broad spectrum of health conditions, these results provide evidence for a DW approach and interactive design for patients to communicate their treatment preferences to their providers.References:1.Baumhauer JF, Bozic KJ. Value-based Healthcare: Patient-reported Outcomes in Clinical Decision Making. Clin Orthop Relat Res. 2016;474(6):1375-1378.2. Slim K, Bazin JE. From informed consent to shared decision-making in surgery. J Visc Surg. 2019;156(3):181-184.3. Damman OC, Jani A, de Jong BA, et al. The use of PROMs and shared decision-making in medical encounters with patients: An opportunity to deliver value-based health care to patients. J Eval Clin Pract. 2020;26(2):524-540.4. Sorensen NL, Hammeken LH, Thomsen JL, Ehlers LH. Implementing patient-reported outcomes in clinical decision-making within knee and hip osteoarthritis: an explorative review. BMC Musculoskelet Disord. 2019;20(1):230.5. Kamal RN, Lindsay SE, Eppler SL. Patients Should Define Value in Health Care: A Conceptual Framework. J Hand Surg Am. 2018;43(11):1030-1034.6. Charles C, Gafni A, Whelan T. Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model. Social Science & Medicine. 1999;49(5):651-661.7. Niburski K, Guadagno E, Mohtashami S, Poenaru D. Shared decision making in surgery: A scoping review of the literature. Health Expect. 2020.8. Selten EM, Geenen R, van der Laan WH, et al. Hierarchical structure and importance of patients' reasons for treatment choices in knee and hip osteoarthritis: a concept mapping study. Rheumatology (Oxford). 2017;56(2):271-278.9. Kannan S, Seo J, Riggs KR, Geller G, Boss EF, Berger ZD. Surgeons' Views on Shared Decision-Making. J Patient Cent Res Rev. 2020;7(1):8-18.10. Briffa N. The employment of Patient-Reported Outcome Measures to communicate the likely benefits of surgery. Patient Relat Outcome Meas. 2018;9:263-266.
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Fisher, Matthew B., Ho-Joong Jung, Rui Liang, Kwang Kim, Patrick J. McMahon, and Savio L. Y. Woo. "Use of Extracellular Matrix Bioscaffolds to Enhance ACL Healing: A Multidisciplinary Approach in a Goat Model." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19559.
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Due to the poor healing potential of the anterior cruciate ligament (ACL) of the knee, surgical reconstruction using soft tissue replacement grafts is performed to restore knee stability and function. However, the surgery has serious complications including a high incidence of donor site morbidity and the development of osteoarthritis in the long-term. Recently, functional tissue engineering approaches to heal an injured ACL using biological stimulation via growth factors and bioscaffolds have yielded some positive clinical and laboratory results. As the healing process for the ACL is slow, additional suture repair of the ACL has been needed to provide initial joint stability and to reduce the risk of injury to neighboring tissues.
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Choi, Kwang Won, Farid Amirouche, Mark H. Gonzalez, and Wayne Goldstein. "Optimal Position for the Artifical Patella During Resurfacing to Decrease Stress and Avoid Pre-Prosthetic Patellar Fracture." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19419.
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Total knee arthroplasty (TKA) is known to be an excellent solution to patients experiencing considerable pain at the joint and difficulty flexing and extending their knee. Unfortunately, after surgery, cases of peri-prosthetic patellar fracture are possible. The prevalence of this fracture ranges from 0.11% to 21.4% for the over 400,000 TKAs that are conducted in the United States every year and therefore, patellar fracture can become a serious concern. The factors that lead to this are several and many researchers are still investigating this problem. This research shows that the position of the surgically inserted artificial patella, also referred to as the patellar button, influences occurrence of patellar fractures and attempts to derive the ideal position for the button to reduce the risk of patellar fracture.
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Lowe, O. DG. "RHEOLOGY AND VENOUS THROMBOEMBOLISM." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643990.
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Changes in the composition of the blood, venous stasis, and interaction of the blood with the vessel wall (Virchow's triad) all have rheological aspects which may promote venous thrombogenesis.Blood composition and rheology. Increasing levels of venous haematocrit and fibrinogen increase bulk blood viscosity, especially at low shear rates such as are encountered in veins, when red cell aggregation occurs. Static blood requires a minimum shear stress for flow (yield stress), which is also strongly dependent on haematocrit and fibrinogen levels. Increases in haematocrit and fibrinogen also promote platelet adhesion and aggregation. Polycythaemia carries an increased risk of venous thromboembolism, which can be reduced by lowering the haematocrit; conversely, anaemic patients (renal failure, pernicious anaemia) have a subnormal prevalence of pulmonary embolism at autopsy. Increased preoperative levels of haematocrit, fibrinogen and blood viscosity predicted postoperative deep vein thrombosis in some studies, but not in others: they have complex relationships to other risk factors and illnesses. Postoperative changes in haematocrit, fibrinogen and blood viscosity may also be relevant to thrombogenesis, as may haemoconcentration in leg veins.Venous flow disturbance and rheology. The flow behaviour of particles and cells in venous valve pockets has been studied by Karino: particles and cells were observed to leave mainstream flow and circulate in paired vortices in low-shear areas within the valve pockets. A cell-poor hypoxic area at the apex of the valve pocket may favour thrombogenesis. Valve pockets might therefore act as in vivo aggregometers, with optimal conditions for activated cells or coagulation products to promote platelet and red cell aggregation, which might be facilitated by increases in haematocrit or fibrinogen. Sevitt has observed cellular aggregates in valve pockets at autopsy, which might act as a nidus for thrombus initiation. Successive layers of thrombus will disturb flow steamlines, as well as generating procoagulant activity: hence a series of "aggregometers" might result in successive bursts of thrombosis and the layered structure of venous thrombi observed by Sevitt. Variations in haematocrit, fibrinogen and red cell aggregation may influence stasis of blood following venous occlusion by thrombus, and hence affect thrombotic extension; they may also influence residual lung perfusion following pulmonary embolism.Therapeutic aspects of rheology. Leg stockings and other physical methods of preventing deep vein thrombosis may improve flow disturbance in valve pockets, as well as in axial veins. The efficacy of perioperative dextran in prevention of venous thromboembolism may partly reflect haemodilution and its rheological consequences. Likewise, postoperative defibrination with ancrod reduced the incidence and extent of deep vein thrombosis after hip surgery, which may partly reflect reductions in plasma viscosity and red cell aggregation. Defibrination with ancrod reduced the haemodynamic disturbance, and the mortality, of experimental pulmonary embolism in dogs, possibly by increasing residual perfusion.. Similarly, improved perfusion after thrombolytic therapy of pulmonary embolism in man may reflect the rheological consequences of fibrinogen depletion, as well as thrombolysis.
Reports on the topic "Hip joint Surgery Risk factors"
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Zhou, Yujun, Qing Wang, Lin Lv, Hongyan Zhang, Dongli She, Long Ge, and Lin Han. Predictors of pressure injury in patients with hip fracture: a meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2022. http://dx.doi.org/10.37766/inplasy2022.5.0028.
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Review question / Objective: The purpose of this study was to investigate the predictors of pressure injury in patients with hip fracture in order to provide a reference for clinical practice. Condition being studied: Hip fracture has become a major public health issue of common concern in both developed and developing countries. and its incidence is estimated to rise to 6.26 million by 2050. Hip fracture patients are prone to various complications during treatment and rehabilitation, and pressure injury (PI) is one of the common complications of hip fracture. Studies have reported that the incidence of pressure injury in patients with hip fracture is 3.4%-59.8%. In addition, pressure injury may occur at any time when patients with hip fracture are hospitalized, which not only greatly aggregates the pain of patients, but also increases the difficulty of treatment and nursing, and seriously threatens the safety of patients. Clarifying the influencing factors of pressure injury after hip fracture will help medical staff quickly identify high-risk patients and strengthen preventive measures. However, previous studies have only discussed the influence of individual factors on the occurrence of pressure injury in patients with hip fracture from the perspectives of diabetes and early surgery, and there is still a lack of systematic analysis on the influencing factors of pressure injury in patients with hip fracture.
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Konnyu, Kristin J., Louise M. Thoma, Monika Reddy Bhuma, Wagnan Cao, Gaelen P. Adam, Shivani Mehta, Roy K. Aaron, et al. Prehabilitation and Rehabilitation for Major Joint Replacement. Agency for Healthcare Research and Quality (AHRQ), November 2021. http://dx.doi.org/10.23970/ahrqepccer248.
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Objectives. This systematic review evaluates the rehabilitation interventions for patients who have undergone (or will undergo) total knee arthroplasty (TKA) or total hip arthroplasty (THA) for the treatment of osteoarthritis. We addressed four Key Questions (KQs): comparisons of (1) rehabilitation prior (“prehabilitation”) to TKA versus no prehabilitation, (2) comparative effectiveness of different rehabilitation programs after TKA, (3) prehabilitation prior to THA versus no prehabilitation, (4) comparative effectiveness of different rehabilitation programs after THA. Data sources and review methods. We searched Medline®, PsycINFO®, Embase®, the Cochrane Register of Clinical Trials, CINAHL®, Scopus®, and ClinicalTrials.gov from Jan 1, 2005, to May 3, 2021, to identify randomized controlled trials (RCTs) and adequately adjusted nonrandomized comparative studies (NRCSs). We evaluated clinical outcomes selected with input from a range of stakeholders. We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. Meta-analysis was not feasible, and evidence was synthesized and reported descriptively. The PROSPERO protocol registration number is CRD42020199102. Results. We found 78 RCTs and 5 adjusted NRCSs. Risk of bias was moderate to high for most studies. • KQ 1: Compared with no prehabilitation, prehabilitation prior to TKA may increase strength and reduce length of hospital stay (low SoE) but may lead to comparable results in pain, range of motion (ROM), and activities of daily living (ADL) (low SoE). There was no evidence of an increased risk of harms due to prehabilitation (low SoE). • KQ 2: Various rehabilitation interventions after TKA may lead to comparable improvements in pain, ROM, and ADL (low SoE). Rehabilitation in the acute phase (initiated within 2 weeks of surgery) may lead to increased strength (low SoE) but result in similar strength when delivered in the post-acute phase (low SoE). No studies reported evidence of risk of harms due to rehabilitation delivered in the acute period following TKA. Compared with various controls, post-acute rehabilitation may not increase the risk of harms (low SoE). • KQ 3: For all assessed outcomes, there is insufficient (or no) evidence addressing the comparison between prehabilitation and no prehabilitation prior to THA. • KQ 4: Various rehabilitation interventions after THA may lead to comparable improvements in pain, strength, ADL, and quality of life. There is some evidence of no increased risk of harms due to the intervention (low SoE). • There is insufficient evidence regarding which patients may benefit from (p)rehabilitation for all KQs and insufficient evidence regarding comparisons of different providers and different settings of (p)rehabilitation for all KQs. There is insufficient evidence on costs of (p)rehabilitation and no evidence on cost effectiveness for all KQs. Conclusion. Despite the large number of studies found, the evidence regarding various prehabilitation programs and comparisons of rehabilitation programs for TKA and THA is ultimately sparse. This is a result of the diversity of interventions studied and outcomes reported across studies. As a result, the evidence is largely insufficient or of low SoE. New high-quality research is needed, using standardized intervention terminology and core outcome sets, especially to allow network meta-analyses to explore the impact of intervention attributes on patient-reported, performance-based, and healthcare-utilization outcomes.
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Joint infection after hip replacement is linked to some risk factors that could be modified. National Institute for Health Research, November 2018. http://dx.doi.org/10.3310/signal-000679.
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