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Academic literature on the topic 'Knee Surgery Risk factors'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Knee Surgery Risk factors"

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Chaiyakit, Pruk, Weeranate Umpanpong, and Tawipat Watcharotayangkoon. "Risk factors of blood transfusion in knee arthroplasty." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (May 1, 2020): 2325967120S0001. http://dx.doi.org/10.1177/2325967120s00018.

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Objectives: The amount of blood transfusion after knee arthroplasty seem to vary in different reported study. We carried out a retrospective study to analysis pre-operative risk factors for blood transfusion in patient whom underwent knee arthroplasty in our institution. Methods: A retrospective study of 190 patients treated with 194 procedure (186 unilateral knee arthroplasty, 4 bilateral knee arthroplasty) from November 2014 to October 2015 was analyzed. A univariate analysis was performed to establish the relationship between all variables and the need for postoperative transfusion. Variables that were determined to have significant relationship were include in a multivariable analysis.. Results: The univariate analysis revealed a significant relationship between need for postoperative blood transfusion and preoperative hemoglobin levels, surgical technique, arthrotomy approach, DVT prophylaxis, operative blood loss, surgical technique and surgeon experience. The multivariate analysis identified a significant relationship between need for transfusion and preoperative hemoglobin level, surgical technique and operative blood loss. Patients with a preoperative hemoglobin less than 12 g/dL had a 5.1 times greater risk of having a transfusion than those with a hemoglobin level ≥ 12 g/dL. The surgical technique with computer assisted surgery had a 0.15 times lesser risk of having a transfusion than those with the conventional technique. Conclusion: The preoperative hemoglobin level < 12 g/dL was shown to increase risk of the need for blood transfusion after knee arthroplasty, while computer assist surgery total knee arthroplasty was shown to decrease risk of blood transfusion. We suggest that patients with preoperative hemoglobin < 12 g/dL need to be crossmatching PRC in pre-operative steps.
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Parikh, Shital, and Neil Rajdev. "ARE THERE SIDE-TO-SIDE DIFFERENCES IN KNEE MORPHOLOGY IN PATIENTS WITH BILATERAL PATELLAR INSTABILITY." Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (March 1, 2019): 2325967119S0011. http://dx.doi.org/10.1177/2325967119s00117.

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Introduction It is not known if there are side-to-side differences in knee morphology in patients with bilateral patellar instability (BPI). Such knowledge would help to answer the question whether similar treatment and prognosis could be expected for both knees in patients with BPI. The purpose of our study was to evaluate and compare anatomic / morphologic risk factors between knees in patients with BPI. Materials and Methods Of 294 patients who underwent surgical stabilization for patellar instability (2008-2017), 32 patients were identified who underwent staged or simultaneous bilateral surgery. This formed the study cohort. Demographic data, mechanism of initial injury and first knee side to be symptomatic were recorded. Radiographs and MRI of these 64 knees were evaluated for trochlear dysplasia (trochlear depth), patellar height (Caton-Deschamps index, Insall-Salvati ratio), patellar tilt, TT-TG distance, sulcus angle (cartilaginous and bony) and trochlear bump (cartilaginous and bony). The number and percentage of knees with pathologic values for measured risk factors were analyzed. For each risk factor, 15% side-to-side differences were considered significant. Statistical correlation was calculated between the time of presentation (first symptomatic knee) and magnitude of risk factors. All measurements were repeated after a 3-week interval and ICC was calculated to determine intraobserver reliability. Results The mean age of 32 patients was 14.6 years. 17/32 patients were females. 29 patients had staged surgery with mean interval of 21 months between surgeries; 3 patients had simultaneous surgery on each knee. Patients with BPI had multiple risk factors. 22/32 patients (69%) had the same Dejour type of trochlear dysplasia. For each measured risk factor, the number and percentage of patients with 15% or more side-to-side differences is shown (Table 1). There were significant side-to-side differences in patellar height ratios, TT-TG distance, and trochlear bump. The timing of presentation did not correlate with increased risk factors, i.e, the knee that presented earlier did not have increased risk factors compared to contralateral knee. ICC showed excellent intraobserver reliability. Conclusion There were significant side-to-side differences between knees in patients with BPI. Treatment and prognosis should be based on anatomic risk factors for each knee in patients with BPI. [Table: see text]
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Davis, Brent R., Jason Chen, Maria C. S. Inacio, Rebecca Love, Heather A. Prentice, and Gregory B. Maletis. "The Incidence of Subsequent Meniscal Surgery Is Higher in the Anterior Cruciate Ligament–Reconstructed Knee Than in the Contralateral Knee." American Journal of Sports Medicine 45, no. 14 (August 28, 2017): 3216–22. http://dx.doi.org/10.1177/0363546517721685.

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Background: A goal of anterior cruciate ligament (ACL) reconstruction is to provide a meniscal protective effect for the knee. Purpose: (1) To evaluate whether there was a different likelihood of subsequent meniscal surgery in the ACL-reconstructed knee or in the normal contralateral knee and (2) to compare the risk factors associated with subsequent meniscal surgery in the ACL-reconstructed knee and contralateral knee. Study Design: Cohort study; Level of evidence, 3. Methods: Using an integrated health care system’s ACL reconstruction registry, patients undergoing primary ACL reconstruction, with no meniscal injury at the time of index surgery and a normal contralateral knee, were evaluated. Subsequent meniscal tears associated with ACL graft revision were excluded. Subsequent meniscal surgery in either knee was the outcome of interest. Sex, age, and graft type were assessed as potential risk factors. Survival analysis was used to compare meniscal surgery–free survival rates and to assess risk factors of subsequent meniscal surgery. Results: Of 4087 patients, there were 32 (0.78%) patients who underwent subsequent meniscal surgery in the index knee and 9 (0.22%) in the contralateral knee. The meniscal surgery–free survival rate at 4 years was 99.08% (95% CI, 98.64%-99.37%) in the index knee and 99.65% (95% CI, 99.31%-99.82%) in the contralateral knee. There was a 3.73 (95% CI, 1.73-8.04; P < .001) higher risk of subsequent meniscal surgery in the index knee compared with the contralateral knee, or a 0.57% absolute risk difference. After adjustments, allografts (hazard ratio [HR], 5.06; 95% CI, 1.80-14.23; P = .002) and hamstring autografts (HR, 3.11; 95% CI, 1.06-9.10; P = .038) were risk factors for subsequent meniscal surgery in the index knee compared with bone–patellar tendon–bone (BPTB) autografts. Conclusion: After ACL reconstruction, the overall risk of subsequent meniscal surgery was low. However, the relative risk of subsequent meniscal surgery in the ACL-reconstructed knee was higher compared with the contralateral knee. Only graft type was found to be a risk factor for subsequent meniscal surgery in the ACL-reconstructed knee, with a higher risk for allografts and hamstring autografts compared with BPTB autografts.
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van Eck, Carola Francisca, Drew Burleson, and Daniel Fariborz Kharrazi. "Worker compensation status increases the risk for presence of pain in the contralateral knee at final follow-up after arthroscopic knee surgery." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 4, no. 2 (March 2019): 82–85. http://dx.doi.org/10.1136/jisakos-2019-000281.

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ObjectivesIn patients undergoing arthroscopic knee surgery, it is not uncommon to complain of pain in both the ipsilateral and the contralateral knee. The primary aim of the present study was to evaluate the prevalence of contralateral knee pain in patients undergoing arthroscopic knee surgery. The secondary aim was to identify risk factors for contralateral knee pain in this population.MethodsAll patient who underwent arthroscopic knee surgery between 2015 and 2017 were included. The prevalence of pain in the contralateral knee prior to and at the final follow-up after ipsilateral knee surgery was assessed. The following potential risk factors for contralateral knee pain were evaluated: age, gender, worker comp status, duration of symptoms, pre-operative diagnosis, activity level, history of a fall, use of a walking aid and findings during surgery.ResultsA total of 142 patients met the inclusion criteria. The average age was 45±11 years, 104 patients (73%) were men. Prior to the surgery on the ipsilateral knee, only 1 patient (<1%) reported pain in the contralateral knee, which increased to 113 patients (80%) at final follow-up surgery. Of the assessed risk factors, only worker compensation status was significant for the development of contralateral knee pain (OR 2.93 95% CI 1.08 to 7.95, p=0.040).ConclusionPain in the contralateral knee is uncommon prior to arthroscopic knee surgery, but common after. The risk for the development of contralateral knee pain is increased if the index injury was workers compensation related.Level of evidenceLevel IV case series.
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Flynn, Megan, Anthony Egger, Yuxuan Jin, Elizabeth Sosic, Greg Strnad, Kurt Spindler, and Paul Saluan. "What are the Risk Factors for Worse Outcomes of Meniscus Surgery in 23-39-Year-Old Patients Ligamentously Stable Knees?" Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (July 1, 2020): 2325967120S0046. http://dx.doi.org/10.1177/2325967120s00468.

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Objectives: Meniscus tears are a common and significant source of knee dysfunction in active young adult patients, and no high-quality prospective cohort or RCTs studies exist evaluating patient-reported outcomes in patients in this age group with ligamentously stable knees. Our objective was to identify patient-reported outcomes and patient-specific risk factors from a prospective cohort with a minimum of one-year follow-up following meniscal repair or excision in patients with ligamentously stable knees. We hypothesized that both groups would have significant improvement in outcomes; patients undergoing meniscal repair would have a higher reoperation rate; and articular cartilage injuries, subsequent knee surgery, and certain demographic characteristics would be significant risk factors to inferior outcomes at one year. Methods: Between February 2015 and December 2017, ligamentously stable meniscal procedures were enrolled and prospectively followed using the outcomes management evaluation system (OME) at Cleveland Clinic. Patients aged 23-39 preoperatively completed a series of validated outcome measurements including the Knee Injury and Osteoarthritis Outcome Score for both Pain (KOOS Pain) and Quality of Life (KOOS QoL). At the time of surgery, physicians documented all intra-articular findings, treatment, and surgical techniques utilized. Patients were followed at minimum of 1-year postoperatively through the OME platform and asked to complete the same outcome instruments done at baseline as well as a question designed to evaluate the Patient Acceptable Symptom State (PASS). The incidence and details of any subsequent knee surgeries were also obtained. Multivariable regression analysis was used to identify significant predictors of outcomes. Results: A total of 371 patients aged 23-39 underwent meniscus excision or repair during the study period. One hundred ninety-four met inclusion criteria, and one-year follow-up was obtained on 72% (n = 139) of the cohort (67% male; median age 32). Both KOOS Pain and KOOS QoL improved significantly at one-year for the entire cohort. Fourteen percent of the cohort (9% on the ipsilateral knee, 5% on the contralateral knee) underwent subsequent surgery at a minimum of one-year postoperatively. The patient-specific risk factors for worse one-year outcomes included preoperative baseline mental capacity score (VR-12 MCS), lower baseline KOOS QoL score, and the intraoperative finding of any grade 3 or 4 chondral changes. Conclusion: Young adult patients with ligamentously stable knees undergoing meniscal surgery have significantly improved patient-reported outcomes regardless of excision or repair; however, 14% of patients underwent additional knee surgery at a minimum of one-year postoperatively. The risk factors for worse outcomes include lower baseline mental health score, lower baseline KOOS QoL score, and any grade 3 or 4 chondromalacia scene.
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Jämsen, Esa, Heini Huhtala, Timo Puolakka, and Teemu Moilanen. "Risk Factors for Infection After Knee Arthroplasty." Journal of Bone and Joint Surgery-American Volume 91, no. 1 (January 2009): 38–47. http://dx.doi.org/10.2106/jbjs.g.01686.

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Fournier, Gaspard, Romain Gaillard, John Swan, Cécile Batailler, Sébastien Lustig, and Elvire Servien. "Stiffness after unicompartmental knee arthroplasty: Risk factors and arthroscopic treatment." SICOT-J 7 (2021): 35. http://dx.doi.org/10.1051/sicotj/2021034.

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Introduction: One of the principal complications after total knee arthroplasty (TKA) is stiffness. There are no publications concerning stiffness after unicompartmental knee arthroplasty (UKA). Study objectives were to describe the incidence of stiffness after UKA, to look for risk factors, and to describe safe and effective arthroscopic treatment. Methods: There were 240 UKA performed between March 2016 and January 2019 included. Robotic-assisted surgery was performed in 164 patients and mechanical instrumentation in 76 patients. Stiffness was defined as flexion < 90° or a flexion contracture > 10° during the first 45 post-operative days. Patients with stiffness were treated with arthroscopic arthrolysis. Several factors were studied to look for risk factors of stiffness: body mass index, gender, age, mechanical or robotic instrumentation, preoperative flexion, previous meniscectomy, and anticoagulant treatment. Arthrolysis effectiveness was evaluated by flexion improvement and UKA revision rate. Results: 22 patients (9%) developed stiffness. Mechanical instrumentation significantly increased the risk of stiffness with OR = 0.26 and p = 0.005. Robotic-assisted surgery decreased the risk of stiffness by five-fold. Before arthrolysis, mean knee flexion was 79°, versus 121° (53% improvement) after arthroscopic arthrolysis. Only 2 patients (9%) underwent UKA revision after arthrolysis. Discussion: Stiffness after UKA is an important complication with an incidence of 9% in this study. Arthroscopic arthrolysis is a safe and effective treatment with a range of motion improvement of > 50%. Robotic-assisted surgery significantly decreases the risk of postoperative stiffness. Level of evidence: Level III, therapeutic study, retrospective cohort study
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Ristic, Vladimir, Sinisa Ristic, Mirsad Maljanovic, Vladimir Djan, Vukadin Milankov, and Vladimir Harhaji. "Risk factors for bilateral anterior cruciate ligament injuries." Medical review 68, no. 5-6 (2015): 192–97. http://dx.doi.org/10.2298/mpns1506192r.

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Introduction. The aim of this study has been to identify which risk factors can influence bilateral anterior cruciate ligament injury. Material and Methods. Thirty-two operated patients took part in this survey during the period of ten years. There were 5 women and 27 men, with average age of 30.46 years (19-55). The respondents filled in the questionnaire by answering the questions regarding the time when getting injured and operated, mechanism of injuries, genetic and anthropometric data, characteristics of sports and every day activities. Results. The incidence of reconstructed bilateral injuries in relation to unilateral ones was 2.3% (50/2168). The age of respondents and side of the injured knee did not correlate significantly with the achieved subjective physical activity level after the second knee surgery. The average time from the first injury to operation was 10 months and 4.3 years since that moment up to the injury of the other knee. It took more than 9 months on average until the reconstruction of contralateral anterior cruciate ligament. The most of athletes were injured in football matches. Three-quarters of athletes returned to competition activities after the first operation, which caused the same injury of the contralateral knee. Discussion and Conclusion. Anterior cruciate ligament rupture of the contralateral knee most often occurs in young active athletes within the first four years after the initial reconstruction. Its frequency is not affected by sex, side of extremity, genetic predisposition, type of sport, concomitant injuries and the choice of graft. Returning to the same or higher level of sports activities after the first reconstruction is one of the preconditions for injuring the other knee in the same way.
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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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Jid, Lee Qunn, Mak Wai Ping, Wong Yiu Chung, and Wai Yuk Leung. "Visible glove perforation in total knee arthroplasty." Journal of Orthopaedic Surgery 25, no. 1 (January 1, 2017): 230949901769561. http://dx.doi.org/10.1177/2309499017695610.

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Purpose: The risk of superficial surgical site infection (SSI) and periprosthetic joint infection (PJI) after glove perforation is not evident. This study was to identify risk factors for glove perforation in primary TKR (total knee replacement) and the risk of subsequent superficial SSI and PJI. Methods and materials: Results of visible glove perforation of both inner and outer gloves during TKR were reviewed. A case–control analysis was performed on the preoperative and operative variables to identify predictive risk factors for glove perforation. Rate of SSI and PJI was compared between perforation and non-perforation groups, including 1226 series and 183 case–control subset. Results: One thousand two hundred twenty-six primary TKR from 2011 to 2014 was reviewed. Fifty-five knees had visible glove perforations. The operation perforation rate was 4.5%. Risk factors identified were body mass index (BMI) > 30, bilateral surgery, operation time >120 min and non-trainee surgeons. Superficial SSI was significantly higher in glove perforation group (9.15 vs. 0.51% and 0.55%). PJI was not significantly different (1.82% vs. 0.60% and 1.1%). The adjusted odds ratio for superficial SSI after perforation was 15.2, independent of BMI and operation time. Conclusion: Visible glove perforation in TKR is associated with several risk factors. The risk of superficial SSI is higher after perforation.
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Dissertations / Theses on the topic "Knee Surgery Risk factors"

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Bottomley, Nicholas J. "Anteromedial osteoarthritis : a surgical perspective of incidence, progression and risk factors." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:34c87265-bbae-4018-b120-ef1d6bed73aa.

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Anteromedial osteoarthritis of the knee (AMOA) has been defined anatomically, histologically and radiologically and yet little is known about the epidemiology of the disease or the risk factors involved in the development of the disease. The broad aim of this thesis was to combine clinical insight with the utilisation of modern, large epidemiological datasets to provide information to inform better the clinical management of patients with AMOA. Specifically, the prevalence and incidence of AMOA, the time taken to progress from early disease to severe disease that may require surgical intervention, the radiological characterisation of disease and the assessment of mechanical risk factors implicit in the development of this pattern of disease are investigated. A cross-sectional study of the radiological prevalence of AMOA in a symptomatic cohort in a specialist secondary care knee clinic showed that AMOA was the commonest pattern of knee OA, present in more than 60% of symptomatic subjects. Less than 25% of subjects with AMOA presented with advanced or 'bone-on-bone' disease, emphasising the clinical importance of understanding the progression from earlier stages of disease to this advanced stage. A 20-year longitudinal radiographic study was performed on 1000 women to describe the prevalence, incidence and progression of AMOA. The prevalence of AMOA was 43% and the incidence over 20-years was 0.4. Life table analysis showed that the risk of developing advanced AMOA in a previously normal knee was 2.6%. Of those subjects with early radiological AMOA, 11% progressed to advanced 'bone-on-bone' disease within 10 years and 37% within 20 years. The role of mechanical risk factors in the development of AMOA showed that both anatomical limb and proximal tibial alignment were significantly more varus aligned in those that developed AMOA at 20-years. Assessment of the shape of the medial tibial plateau in a longitudinal MRI study showed that the angle of the upslope at the anterior aspect of the plateau was significantly increased in the group that subsequently developed AMOA. To enable AMOA to be studies in future MRI studies, the MRI description of the disease was defined. In summary, AMOA was shown to be the most common pattern of knee OA both in symptomatic surgical cohorts and in the community. The progression of the disease from an early stage to an advanced stage, which may require surgical intervention, was described for the first time. To enable better the recognition of AMOA in modern epidemiological studies, the MRI description of AMOA was defined and the clinical relevance of modern MRI was discussed. The anatomical alignment of the limb, the alignment of the proximal tibia and the morphology of the tibial plateau were all shown to have a role in the development of AMOA. Addressing these mechanical factors may provide a therapeutic surgical target for the management of patients with AMOA.
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White, Derek A. "Factors affecting changes in joint alignment following knee osteotomy surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ63389.pdf.

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Groll, Dianne L. "Factors influencing patient perceived health status following total knee replacement surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq22316.pdf.

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Ingham, Sarah Louise. "Knee pain in the community : risk factors, incidence, and outcome." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/11134/.

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Background: Knee pain affects 1 in 4 people over 55 years, and is a leading cause of disability in the elderly (Peat et al, 2001). Whilst the prevalence of knee pain has been examined, the natural history of knee pain and associated risk factors remain unknown (O’Reilly, 1996). Objectives: to determine in a community sample over a 10 year period: [1] the incidence of knee pain; [2] the outcome of knee pain; and [3] risk factors for both incidence and outcome of knee pain. Materials and method: This was a retrospective cohort study. Baseline data were collected between 1996-1999, and the cohort was reviewed during 2007-2008. Knee pain was defined as pain around the knee for most days of at least a month. Participants without knee pain at baseline who developed knee pain during the subsequent 10 years were defined as incident cases. Participants with knee pain at baseline who reported worsening of symptoms, improvement of symptoms, no change in symptoms, or who underwent TKR during the past 10 years were defined as outcome cases. Other measures included: age of onset and time from baseline to the first episode of knee pain. Putative risk factors measured at baseline included age, gender and body mass index (BMI); risk factors assessed at follow-up included knee malalignment and foot angulation. Relative risk (RR) was estimated using odds ratio (OR) or hazard ratio (HR) depending on outcomes. Confounding factors were adjusted using logistic regression or COX regression. Results: 9,429 participants were questioned at baseline (2,868 knee pain positive/6,397 knee pain negative). After 10 years, 5,479 were eligible for follow-up. Of them 3,109 responded and 424 underwent x-rays at both baseline and follow-up. The baseline age of this cohort ranged between 40-83 years, with a mean age of 57 years old; 1,725 (55.5%) were women. The incident rate for knee pain cases during the 10 year follow-up period was 742/2,156 (34.4%); this was similar in men (32%) and women (35%). During the 10 year period 250 (27.4%) of the 914 people with pain at baseline experienced worsening of their symptoms, with 81 (8.9%) requiring total knee joint replacements (TKR). A number of risk factors were explored. Obesity (OR 2.19; 95%CI 1.49, 3.22) and varus malalignment (OR 2.82; 95%CI 1.57, 5.06) significantly associated with incident knee pain, whereas back pain (aOR 1.47; 95%CI 1.02, 2.10) and physical work (aOR 1.88; 95%CI 1.02, 3.50) were related to poor outcome. Conclusions: For people over the age of 40 years old, 1 in 3 will develop significant knee pain in the next 10 years. Of people with knee pain, 1 in 4 will worsen over a 10 year period and 1 in 11 will require surgery. A number of risk factors were identified including both systemic/constitutional and more local biomechanical factors. This could have practical implications for primary and secondary prevention particularly in relation to modifiable risk factors, such as reduction in BMI, occupational protection of the knees and possible adjustment of knee malalignment.
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Wills, Andrew K. "Gait kinematics and risk factors for overuse anterior knee pain." Thesis, University of Surrey, 2006. http://epubs.surrey.ac.uk/844510/.

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Overuse anterior knee pain (AKP) is precipitated by activity and affects up to 30% of young and active populations. There is little empirical evidence for the multitude of cited risk factors for the condition and a lack of prospective studies. The main aim of this PhD was to examine the role of gait kinematics as a risk factor for AKP. The first study examined variables other than gait that may need to be controlled or statistically adjusted for in future studies to avoid masking true risk factors or effects. A prospective study of military recruits was undertaken into the effect of prior activity levels, aerobic fitness and social and medical history on the development of AKP. The incidence of AKP was high (8.6%; 95% CI: 6.8-10.4) despite the short 12-week exposure to training. Heavy smokers (odds ratio (OR): 6.37) and individuals with a previous ankle injury (OR; 2.48) had an increased risk of AKP that was independent of lifestyle factors. The association between 3D gait kinematics and patellofemoral pain syndrome (PFPS) was then explored prospectively. Principle components analysis was applied to reduce the gait data into its main factors and multivariate logistic regression was used to explore the association between these factors and PFPS. Three factors from treadmill running explained 47% of the variance between individuals who developed PFPS and those that remained injury-free. These factors contained increased hip and tibial internal rotation, increased hip adduction and decreased knee internal rotation during stance. These results contradicted findings from case-control studies. The association between variability in gait movement patterns and PFPS was assessed using the continuous relative phase method. The main risk factor was reduced inter-stride variability in the joint coordination relationships that contained tibial rotation. The main limitation of the gait study was the small sample size of the PFPS group (n=7). A study was thus undertaken to cross-validate the findings in a new sample with PFPS. This new sample was captured using a 3-year follow up study of the original gait cohort. The results were not replicated in the new PFPS group, and there were no other gait characteristics correlated with PFPS. The lack of validation was attributed to differences in the symptom-complex between the case groups of the two studies. To date, all published evidence for an association between gait and AKP originates from case-control studies. The key issue with this design is inferring the correct temporal sequence of a finding. Thus, to assess the effect of PFPS on gait and inform the interpretation of these studies, a repeated measures study of 6 subjects before and after the onset of PFPS was undertaken. Despite the mild symptoms of the group and the absence of pain during testing, the subjects showed some subtle gait inhibition post onset of PFPS. This questions the use of the case-control study to validly quantify risk factors in gait. Future research should cross-validate the significant risk factors found' in these studies, explore other potentially salient variables such as patellofemoral alignment and examine the causes of these risk factors. It is hoped that such work will benefit the prevention and treatment of AKP.
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Jaf, Andersson Victor. "Seroma formation following breast surgery - incidence and risk factors." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-52541.

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Alolayan, Albraa Badr A. "Risk factors of neurosensory disturbance following bimaxillary orthognathic surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hub.hku.hk/bib/B50639511.

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Objectives: To report the incidence of objective and subjective neurosensory disturbance (NSD) after orthognathic surgery in a major orthognathic centre in Hong Kong, and to investigate the risk factors that contributed to the incidence of NSD after orthognathic surgery. Materials and Methods: A retrospective cross-sectional study on NSD after orthognathic surgery in a local major orthognathic centre. Patients who had bimaxillary orthognathic surgery reviewed at post-operative 6 months, 12 months or 24 months were recruited to undergo a neurosensory test with subjective and 3 objective assessments. Possible risk factors of NSD including subjects’ age and gender, surgical procedures and surgeons’ experience were analyzed. Results: 238 patients with 476 sides each of maxillary and mandibular procedures were recruited. The incidences of subjective NSD after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively. Objective neurosensory tests showed general reduced sensitivity in subjects with subjective NSD. Increased age was found to be a significant risk factor of NSD after orthognathic surgery at short term (at 6 months and 12 months) but not at 24 months. SSO has a significantly higher risk of NSD when compared to VSSO. SSO in combination with anterior mandibular surgery has a higher risk of NSD when compared to VSSO in combination with anterior mandibular surgery or anterior mandibular surgery alone. Gender of patients a nd surgeons’ experience were not found to be risk factors of NSD after orthognathic surgery. Conclusion: The incidence of NSD after maxillary and mandibular orthognathic procedures at post-operative 6 months, 12 months and 24 months was reported. Increased age was identified as a risk factor of short term post-operative NSD but not in long term (24 months or more). Specific mandibular procedures were related to higher incidence of NSD after orthognathic surgery.
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Boling, Michelle Clara Padua Darin A. "A prospective investigation of biomechanical risk factors for anterior knee pain." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2008. http://dc.lib.unc.edu/u?/etd,1740.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.
Title from electronic title page (viewed Sep. 16, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Interdisciplinary Human Movement Science School of Medicine." Discipline: Human Movement Science; Department/School: Medicine.
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Barlow, Timothy. "Factors affecting patients' decision-making and the development of a prognostic model in total knee replacement surgery." Thesis, University of Warwick, 2016. http://wrap.warwick.ac.uk/86003/.

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Osteoarthritis of the knee is a common condition, affecting more than 10% of the population aged over 55 years. It can lead to pain, functional loss, and a reduction in the quality of life. Total knee replacement is a common procedure for those with severe osteoarthritis with over 90,000 procedures performed each year in the UK; however, around 20% of patients are dissatisfied with the outcome. How to identify these patients pre-operatively is a research priority, as set out by the British Orthopaedic Association, Arthritis Research U.K., and the National Institute for Health and Care Excellence. The effect such an advance would have on patients’ decision-making is not known. Therefore, in this thesis I set out to understand the factors important to patients when contemplating a knee replacement, how an outcome prediction tool could affect that process, and then go on to develop an prognostic model for use in patients considering a total knee replacement. I first performed a systematic review of factors that influence patient’s decision-making; I then describe two qualitative projects, the first developed a model of decision-making, the second investigated how providing predictions of outcome could affect expectations and decision-making. This information, combined with a systematic review of the factors that affect outcome in knee replacements, allowed me to develop a multicentre cohort study designed to generate a prognostic model. This study recruited 600 patients, and the linear regression model accounts for 36% of the variability in outcome – more than any previous study. This thesis provides a better understanding of patients’ decision-making, which should facilitate doctor-patient communication. I describe a model that can predict more variability in outcome than any previous models. The usefulness of the model in individual prediction and potential future areas of study include how more variability could be incorporated, how to develop such a model into a prediction tool, and other approaches to addressing poor outcomes after total knee replacement.
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Hedberg, Magnus. "Stroke during cardiac surgery : risk factors, mechanisms and survival effects." Doctoral thesis, Umeå universitet, Kirurgi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-38079.

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Introduction: Neurological complications and stroke in association with cardiac surgery is a serious problem. The stroke event can occur during surgery (early stroke) or in the postoperative period with a symptom free interval (delayed stroke). Particle embolization due to aortic manipulation during surgery has been suspected as a mechanism for early stroke. The present thesis address mechanisms and survival effects of stroke both clinically (I-III) and experimentally (IV-V). Methods: Study I) Within a cohort of 2641 consecutive cases, a group of cardiac surgery patients with stroke and evaluated by computed tomography (CT) were studied (n=77). CT-findings were analyzed in relation to stroke symptoms. Study II) Data from 9122 patients undergoing coronary surgery were analyzed. Records of patients with any signs of neurological complications were reviewed to extract 149 subjects with stroke at extubation (early, 1.6%) versus 99 patients having a free interval (delayed, 1.1%). Early and delayed stroke were evaluated separately. Independent risk factors for stroke were analyzed by logistic regression and survival by Cox regression (9.3 years median follow-up). Study III) Patients with early (n=223) and delayed stroke (n=116) were identified among 10809 patients undergoing cardiac and aortic surgery, both groups exposed to cardiopulmonary bypass. Stroke patients were subdivided by the hemispheric location of lesions. Subgroups were compared and their associated pre- and peroperative variables and survival were analyzed. Study IV) Aortic cross-clamp manipulation was studied in a human cadaveric perfusion model. The pressurized aorta was repeatedly cross-clamped and washout samples were collected before and after clamp maneuvers. Particles in the washout samples were evaluated by microscopy and by digital image analysis. Study V) Pig aortas were pressurized and cannulated. Washout samples were collected before and after cannulation (n = 40). Particles were deposited onto a 10-μm filter to be evaluated by microscopy and digital image analysis. Results: Study I) In the group of patients exposed to routine cardiac surgery (i.e., clamping and cannulation) and with early stroke, right-hemispheric lesions were more frequent than of the contra-lateral side (P=0.005). Patients with aortic dissections had a strong dominance of bilateral findings, which was different from the unilateral pattern in the routine-surgery group (P<0.001). Study II) Early and delayed stroke did not share any risk factors. Both early and delayed stroke explained mortality in the early postoperative period (P<0.001, P<0.001 respectively) but also at long term follow-up (P=0.008, P<0.001 respectively). For patients surviving their first postoperative year, delayed but not early stroke influenced long-term mortality (P=0.001 and P=0.695, respectively). Study III) Stroke lesions in association to cardiac surgery were near exclusively ischemic. Early stroke had a preponderance for right-hemispheric lesions (P=0.009). In contrast, patients with early stroke that had undergone surgery of the aorta with circulatory arrest showed a pattern with more bilateral lesions compared to ‘cardiac-type’ operations (P<0.001). Patients with bilateral lesions had a dramatically impaired survival compared to those with unilateral lesions (P<0.001). Study IV) In the cadaveric perfusion model, cross-clamping produced a significant output of particles, which was seen for size intervals of 1 mm and smaller (P=0.002 to P=0.022). In all size intervals the particle output correlated with the degree of overall aortic calcification (P =0.002 to P=0.025). Study V) At cannulation of the pig aorta, more particles were noted after cannulation compared to before the maneuver (P<0.001). This increase included small (<0.1 mm, P<0.001) and intermediate-size particles (0.1-0.5 mm, P< 0.001). Particles above 0.5 mm were few and were not associated with cannulation. Conclusions: The influence of stroke on mortality was devastating, for both early and delayed stroke. These two stroke groups had obvious differences in both their risk factors and their hemispheric distribution. It is here emphasized that early and delayed stroke should be considered as two separate entities with suggested mechanistic differences. Ischemic lesions accounted for near all stroke events seen in association to cardiac surgery. For early stroke, these were mostly located within the right hemisphere. Results from the experimental studies underscore microembolic risks associated with aortic manipulation.
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Books on the topic "Knee Surgery Risk factors"

1

Andris, Kazmers, ed. Cardiac risk assessment before vascular surgery. Armonk, NY: Futura Pub. Co., 1994.

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Jungblut, Hans-Dieter. Erfassung und Bewertung des Krebsrisikos beim Menschen. Mainz: Akademie der Wissenschaften und der Literatur, 1989.

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Satō, Atsuko. Coronary artery disease, cardiac arrest, and bypass surgery: Risk factors, health effects, and outcomes. Hauppauge, N.Y: Nova Science Publishers, 2011.

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E, Moreyra Abel, and Kostis John B, eds. Manual of surgical clearance. St. Louis, Mo: Ishiyaku EuroAmerica, 1988.

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Saving the whole woman: Natural alternatives to surgery for pelvic organ prolapse and urinary incontinence. Albuquerque, NM: Bridgeworks, 2003.

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Saving the whole woman: Natural alternatives to surgery for pelvic organ prolapse and urinary incontinence. 2nd ed. Albuquerque, NM: Bridgeworks, 2006.

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A, Silverstein Barbara, and Washington (State). Safety and Health Assessment and Research for Prevention., eds. Musculoskeletal disorders, risk factors and prevention steps: A survey of employers in Washington State. Olympia, Wash: Safety & Health Assessment & Research for Prevention, 1999.

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From the feet up. 2nd ed. North Sydney, N.S.W: Harlequin Mira, 2014.

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AIDS--what the government isn't telling you. Palm Desert, Calif: Rockford Press, 1991.

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T, Evans Stephen R., and Chahine A. Alfred, eds. Surgical pitfalls: An evidence-based approach to prevention and management. Philadelphia, PA: Saunders/Elsevier, 2009.

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Book chapters on the topic "Knee Surgery Risk factors"

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Canata, Gian Luigi, Valentina Casale, and Antonio Pastrone. "Assessment of Risk Factors for Failure of ACLR: When to Address Concomitant Pathology." In Advances in Knee Ligament and Knee Preservation Surgery, 21–34. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-84748-7_3.

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Yamazaki, Junya, and Lars Engebretsen. "Anterior Cruciate Ligament Surgery: Risk Factors for Development of Osteoarthritis: What Can We Do to Prevent It?" In The ACL-Deficient Knee, 41–48. London: Springer London, 2012. http://dx.doi.org/10.1007/978-1-4471-4270-6_4.

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Heetun, Adam, Ellen Copson, and Ramsey Cutress. "Modifiable Risk Factors." In Oncoplastic Breast Surgery, 274–80. Boca Raton: CRC Press, 2022. http://dx.doi.org/10.1201/9781315115146-60.

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Kim, Ok-Gul, and Seung-Suk Seo. "Etiology and Risk Factors." In A Strategic Approach to Knee Arthritis Treatment, 55–62. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-4217-3_3.

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Weber, Alexander E., Bernard R. Bach, and Asheesh Bedi. "How Do We Eliminate Risk Factors for ACL Injury?" In Rotatory Knee Instability, 465–72. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-32070-0_39.

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Wladis, Edward J., and Michael I. Rothschild. "Systemic Risk Factors." In Avoiding and Managing Complications in Cosmetic Oculofacial Surgery, 7–11. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-51152-4_2.

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Araf, Davi, and Jaqueline Silva de Rezende. "Periocular Risk Factors." In Avoiding and Managing Complications in Cosmetic Oculofacial Surgery, 13–23. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-51152-4_3.

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Dowlatshahi, Shadi, Wei-I. Vickie Wu, and Michael Donald Wang. "Patient’s Own Risk Factors." In Complications in Robotic Urologic Surgery, 3–15. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-62277-4_1.

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Thomas, Matthew, Ian C. Phillips, and Brendon J. Coventry. "Risk Management and Human Factors." In General Surgery Risk Reduction, 273–87. London: Springer London, 2013. http://dx.doi.org/10.1007/978-1-4471-5391-7_9.

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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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Conference papers on the topic "Knee Surgery Risk factors"

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Jamison, Steve T., Xueliang Pan, and Ajit M. W. Chaudhari. "Dynamic Trunk Control Influence on Run-to-Cut Maneuver: A Risk Factor for ACL Rupture." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53697.

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Anterior Cruciate Ligament (ACL) rupture is one of the most common serious knee injuries in field and court sports, with an estimated 70% of these injuries being non-contact in nature, often from sudden changes in direction or pivoting [3]. ACL injury results in both short- and long-term consequences for the athlete, which may include surgery, decreased activity levels, elevated pain levels during activities and increased risk of osteoarthritis. Previous studies have shown that knee abduction and tibial internal rotation moments independently strain the ACL, and that these moments have an interaction effect at physiologic load levels, creating strains approaching the reported range of ACL rupture [2, 6–8].
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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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Safaei, Mohsen, and Steven R. Anton. "Sensing and Energy Harvesting Performance, and Fatigue Life of Embedded Piezoelectric Transducer in Total Knee Arthroplasty." In ASME 2016 Conference on Smart Materials, Adaptive Structures and Intelligent Systems. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/smasis2016-9216.

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Growing demands for Total Knee Arthroplasty (TKA) and also total knee revision surgery combined with the cost, risk, and complication of the surgery have led to numerus attempts to improve surgical techniques, implant design, and postoperative orthopedic therapies. Although abundant information about knee function and reaction forces and moments have been provided by researchers through biomechanical models, cadaver testing, in-vitro testing, and limited in-vivo measurements, rigorous real-time in-vivo data from knee implants is still required to improve the performance of TKAs. Instrumented knee implants using piezoelectric (PZT) transducers have promising potential to satisfy clinical needs in terms of continuous in-vivo data acquisition, self-powered operation, and retention of prevalent implant design, which can ultimately lead to improved patient satisfaction. In this study, a simplified Ultra High Molecular Weight (UHMW) Polyethylene TKA bearing geometry with an embedded PZT on the bottom surface is proposed and investigated to analyze sensing and power harvesting, and longevity of the conceptual design. As a result, this work is separated into two distinct sections. The first part provides an evaluation study on the performance of the design in terms of output voltage and power using both simulations and experimental tests. Finite element analysis (FEA) is employed to model the stress-strain behavior of the system and to develop effective force reaction on the PZT transducer. An analytical model is used to describe the electromechanical behavior of the PZT transducer under the effective force predicted by FEA, and the output voltage and power of the system are simulated. Furthermore, results obtained from modeling are validated through experimental compression testing using simulated gait conditions. Embedding a PZT element in the knee bearing may cause changes in stress distribution in UHMW and as a result the variation in the fatigue life of the bearings with encapsulated PZTs is considered as a remarkable factor to investigate. Therefore, in the second part of the work, a parametric study on the effect of dimensional parameters on the longevity and electromechanical performance of the design is performed. High cycle stress life of the polyethylene component with embedded PZT transducer as well as transferred force to the PZT and generated voltage under periodic knee load are studied. . The diameter and depth of the pocket machined in the UHMW bearing, the thickness ratio of the PZT element to the UHMW component, and modification of the contact edges inside the PZT pocket and PZT are considered as effective geometrical parameters on the fatigue life of the UHMW bearing and are studied individually. Two designs are investigated; the initial design with sharp corners and a revised design with filleted corners. The results show a significant fatigue life improvement by adding a fillet radius modification on the sharp corners of the UHMW and PZT components accompanied by a slight reduction in output voltage. The effect of pocket diameter is dependent on the geometry and for the initial design the fatigue life and output voltage increase when diameter increases. For the revised design, fatigue life decreases for large fillet radii and increases for small fillet radii and converge as diameter is increased, whereas the output voltage slightly increases with large pocket diameters. Pocket depth has a significant reverse effect on fatigue life and output voltage of the PZT, such that a 0.05 mm deeper pocket results in no force transfer and no voltage but improved fatigue life.
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Chaari, Zied, Abderrahmen Ammar, Walid Abid, Abdessalem Hentati, and Imed Frikha. "Bronchiectasis surgery: indications and risk factors?" In ERS International Congress 2021 abstracts. European Respiratory Society, 2021. http://dx.doi.org/10.1183/13993003.congress-2021.pa2071.

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Melikoglu, M. Alkan, and A. Kul. "AB0809 Fall risk and related factors in knee osteoarthritis." In Annual European Congress of Rheumatology, 14–17 June, 2017. BMJ Publishing Group Ltd and European League Against Rheumatism, 2017. http://dx.doi.org/10.1136/annrheumdis-2017-eular.3072.

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Alekseeva, L., S. Anikin, N. Kashevarova, E. Sharapova, E. Taskina, T. Korotkova, T. Raskina, et al. "FRI0545 Risk factors predicting radiological progression of knee osteoarthritis." In Annual European Congress of Rheumatology, EULAR 2018, Amsterdam, 13–16 June 2018. BMJ Publishing Group Ltd and European League Against Rheumatism, 2018. http://dx.doi.org/10.1136/annrheumdis-2018-eular.2089.

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Froemke, Cecily, and Martin Zwick. "Predicting risk of adverse outcomes in knee replacement surgery with reconstructability analysis." In 2017 IEEE Symposium Series on Computational Intelligence (SSCI). IEEE, 2017. http://dx.doi.org/10.1109/ssci.2017.8280870.

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Novacek, G., W. Reinisch, S. Reinisch, C. Primas, W. Eigner, H. Vogelsang, C. Dejaco, et al. "Risk factors for first intestinal surgery in Crohn's disease." In 52. Jahrestagung & 30. Fortbildungskurs der Österreichischen Gesellschaft für Gastroenterologie & Hepatologie (ÖGGH). Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1691864.

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Demal, T. J., F. Sitzmann, L. Bax, J. Konertz, D. Gaekel, J. Brickwedel, H. Reichenspurner, and C. Detter. "Risk Factors for Acute Kidney Injury in Aortic Surgery." In 50th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery (DGTHG). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1725638.

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Reports on the topic "Knee Surgery Risk factors"

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Stein, Daniel, and Richard Santucci. Incidence, risk factors and tips for the prevention of urologic injuries in pelvic surgery. BJUI Knowledge, July 2020. http://dx.doi.org/10.18591/bjuik.0081.v2.

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Wang, Lei, Yi Dong, Xiaochai Lv, Jianzhi Du, Yongqiang Qiu, Xiaofu Dai, and Liangwan Chen. Risk factors for acute kidney injury after surgery of type A acute aortic dissection: a meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, June 2020. http://dx.doi.org/10.37766/inplasy2020.6.0100.

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He, Miao, Zhaoqiong Zhu, Min Jiang, Xingxing Liu, Rui Wu, and Junjie Zhou. Risk factors for postanesthetic emergence delirium in adults: A systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, January 2022. http://dx.doi.org/10.37766/inplasy2022.1.0021.

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Review question / Objective: Patientor population: patients with emergence delirium; Exposure: anaesthesia and surgery; Control: patients with no emergence delirium; Outcome: risk factors; Study design: meta-analysis. Eligibility criteria: To ensure the quality of this meta-analysis, inclusion criteria was decided before we carried out the search. These criteria were: (a) Original researches that carried out in observational studies. (b)Adult patients who were extubated and recovered at PACU, operation room, or intensive care unit (ICU) after surgeries and anesthesia (including general and neuraxial anesthesia, peripheral nerve blocks and sedation). (c) Risk factors for delirium must be assessed with odds ratio (OR) with 95% confidence interval (CI). Researches must present the results of multivariate regression to be considered eligible for inclusion, since multivariate analysis results shall be used to identify variables eligible for meta-analysis. (d) Full-text available literatures.
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Huang, XiMeng, ZeXi Yang, and Ying Huang. Lateral Wedge Insoles for Reducing Biomechanical Risk Factors for Medial Knee Osteoarthritis after a period of time: a meta-analysis of controlled randomized trials. INPLASY - International Platform of Registered Systematic Review Protocols, March 2020. http://dx.doi.org/10.37766/inplasy2020.3.0015.

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Abedinov, Filip, Violeta Groudeva, Iliyan Petrov, Hristo Angelov, Georgy Tsaryanski, and Plamen Krastev. Analysis of Functional Capacity and Risk Factors in Patients with Prolonged Treatment in Intensive Care Unit after Cardiac Surgery - Long-term Results. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, January 2021. http://dx.doi.org/10.7546/crabs.2021.01.16.

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Huang, Xi-Meng, Ze-Xi Yang, and Ying Huang. Physical Therapy and Orthopedic Equipment-induced Reduction in the Biomechanical Risk Factors Related to Knee Osteoarthritis: a Bayesian network meta-analysis of randomized controlled trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, September 2020. http://dx.doi.org/10.37766/inplasy2020.9.0054.

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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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Harris, Gregory, Brooke Hatchell, Davelin Woodard, and Dwayne Accardo. Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0010.

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Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.
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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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Tourniquets increase the risk of serious complications in knee replacement surgery. National Institute for Health Research, August 2021. http://dx.doi.org/10.3310/alert_47393.

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