Skip header and navigation

Refine By

58 records – page 1 of 6.

[Accelerated recovery program after hip fracture surgery]

https://arctichealth.org/en/permalink/ahliterature61643
Source
Ugeskr Laeger. 2002 Dec 30;165(1):29-33
Publication Type
Article
Date
Dec-30-2002
Author
Sten Rasmussen
Billy B Kristensen
Susanne Foldager
Lis Myhrmann
Henrik Kehlet
Author Affiliation
Ortopaedkirurgisk afdeling, Vejle Sygehus, DK-7300 Vejle. sten.rasmussen@dadlnet.dk
Source
Ugeskr Laeger. 2002 Dec 30;165(1):29-33
Date
Dec-30-2002
Language
Danish
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - methods - rehabilitation
Comparative Study
Denmark
Early Ambulation - methods
English Abstract
Female
Hip Fractures - rehabilitation - surgery
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Postoperative Care - methods
Preoperative Care - methods
Prospective Studies
Recovery of Function
Research Support, Non-U.S. Gov't
Retrospective Studies
Abstract
INTRODUCTION: A multimodal approach to minimise the effect of the surgical stress response can reduce complications and hospital stay after abdominal surgery and hip arthroplasty. The aim of the study was to assess the results of a well-defined rehabilitation programme after hip fracture. MATERIAL AND METHODS: In an open intervention study, we entered 200 consecutive patients with hip fracture allowing full weight-bearing after operative treatment. The effect of a revised, optimised perioperative care programme with continuous epidural analgesia, early oral nutrition, oxygen supplementation, restricted volume and transfusion therapy, and intensive physiotherapy and mobilisation was assessed (n = 100) and compared with the conventional perioperative treatment programme before the intervention (n = 100). The median age was 82 (56-96) years in the control group and 82 (63-101) years in the accelerated multimodal perioperative treatment group. RESULTS: The median hospital stay was reduced from 21 (range 1-162, mean 32) to 11 (range 1-100, mean 17) days. The total use of days in hospital was reduced from 3211 to 1667. There were fewer complications, whereas the need for home care after discharge was unchanged. CONCLUSION: An accelerated clinical pathway with focus on pain relief, oral nutrition, and rehabilitation may reduce hospital stay and improve recovery after hip fracture.
PubMed ID
12529945 View in PubMed
Less detail

Aprotinin decreases exposure to allogeneic blood during primary unilateral total hip replacement.

https://arctichealth.org/en/permalink/ahliterature198533
Source
J Bone Joint Surg Am. 2000 May;82(5):675-84
Publication Type
Article
Date
May-2000
Author
J M Murkin
G M Haig
K J Beer
N. Cicutti
J. McCutchen
M E Comunale
R. Hall
B B Ruzicka
Author Affiliation
Department of Anaesthesia, London Health Sciences Center-UC, University of Western Ontario, Canada.
Source
J Bone Joint Surg Am. 2000 May;82(5):675-84
Date
May-2000
Language
English
Publication Type
Article
Keywords
Aprotinin - therapeutic use
Arthroplasty, Replacement, Hip - methods
Blood Loss, Surgical - prevention & control
Blood Transfusion
Canada - epidemiology
Double-Blind Method
Female
Hemostatics - therapeutic use
Humans
Infusions, Intravenous
Male
Middle Aged
Postoperative Complications - epidemiology - prevention & control
United States - epidemiology
Venous Thrombosis - epidemiology - prevention & control
Abstract
Aprotinin, a hemostatic agent, regulates fibrinolysis, modulates the intrinsic coagulation pathway, stabilizes platelet function, and exhibits anti-inflammatory properties through inhibition of serine proteases, such as trypsin, plasmin, and kallikrein. Aprotinin has been used successfully for many years in cardiac operations, and there have been preliminary investigations of its use in hip replacement operations. The objectives of this multicenter, randomized, placebo-controlled, double-blind trial were to evaluate the efficacy and safety of aprotinin as a blood-sparing agent in patients undergoing an elective primary unilateral total hip replacement and to examine its effect on the prevalence of deep-vein thrombosis in this population.
Seventy-three patients received a placebo; seventy-six patients, a low dose of aprotinin (a load of 500,000 kallikrein inhibitor units [KIU]); seventy-five, a medium dose of aprotinin (a load of 1,000,000 KIU, with infusion of 250,000 KIU per hour); and seventy-seven patients, a high dose of aprotinin (a load of 2,000,000 KIU, with infusion of 500,000 KIU per hour). The end points for the determination of efficacy were transfusion requirements and blood loss. Patients received standard prophylaxis against deep-vein thrombosis and underwent compression ultrasonography with color Doppler imaging of the proximal and distal venous systems of both legs to evaluate for the presence of deep-vein thrombosis.
Aprotinin reduced the percentages of patients who required any form of blood transfusion (47 percent of the patients managed with a placebo needed a transfusion compared with 28 percent of those managed with low-dose aprotinin [p = 0.02],27 percent of those managed with high-dose aprotinin [p = 0.008], and 40 percent of those managed with medium-dose aprotinin [p = 0.5]). Only 6 percent (twelve) of the 212 patients treated with aprotinin required allogeneic blood compared with 15 percent (ten) of the sixty-eight patients treated with the placebo (p = 0.03). Aprotinin decreased the estimated intraoperative blood loss (p = 0.02 for the low-dose group, p = 0.04 for the medium-dose group, and p = 0.1 for the high-dose group), the measured postoperative drainage volume (p = 0.4 for the low-dose group, p = 0.006 for the medium-dose group, and p = 0.000 for the high-dose group), and the mean reduction in the hemoglobin level on the second postoperative day (thirty-four grams per liter for the placebo group, twenty-eight grams per liter for the low-dose group [p = 0.000], twenty-six grams per liter for the medium-dose group [p = 0.000], and twenty-three grams per liter for the high-dose group [p = 0.0001). The rate of deep-vein thrombosis was similar for all groups.
We concluded that aprotinin is safe and effective for use as a hemostatic agent in primary unilateral total hip replacements. In patients who are at high risk of receiving allogeneic blood, use of aprotinin may be of particular clinical and economic benefit.
PubMed ID
10819278 View in PubMed
Less detail

Arthroplasty implant registries over the past five decades: Development, current, and future impact.

https://arctichealth.org/en/permalink/ahliterature300373
Source
J Orthop Res. 2018 09; 36(9):2319-2330
Publication Type
Journal Article
Review
Date
09-2018
Author
Henrik Malchau
Göran Garellick
Daniel Berry
William H Harris
Otto Robertson
Johan Kärrlholm
David Lewallen
Charles R Bragdon
Lars Lidgren
Peter Herberts
Author Affiliation
Sahlgrenska University Hospital, Molndal, Sweden.
Source
J Orthop Res. 2018 09; 36(9):2319-2330
Date
09-2018
Language
English
Publication Type
Journal Article
Review
Keywords
Arthroplasty, Replacement, Elbow - methods - statistics & numerical data
Arthroplasty, Replacement, Hip - methods - statistics & numerical data
Arthroplasty, Replacement, Knee - methods - statistics & numerical data
Arthroplasty, Replacement, Shoulder - methods - statistics & numerical data
Data Collection
Elbow Prosthesis
Evidence-Based Medicine
Hip Prosthesis
Humans
International Cooperation
Knee Prosthesis
Orthopedics
Prosthesis Design
Prosthesis Failure
Registries
Shoulder Prosthesis
Societies, Medical
Sweden
United States
Abstract
Local, regional, and national registries have played an important role in the development of hip and knee arthroplasty and the treatment of patients with various maladies of these joints. Four arthroplasty registries stand out as leading forces behind the drive to popularize the use of registries and pursue the concept of evidence based medicine. The Mayo registry, started by Mark Coventry, is recognized as the oldest continuing registry for arthroplasty. The Harris Registry at Massachusetts General Hospital, along with the Mayo Registry, has greatly contributed to the advancement of arthroplasty surgery and have served an important role of identifying poorly performing implants and techniques in the United States. The Swedish Knee Arthroplasty Registry is the oldest national registry dedicated to joint arthroplasty and along with the Swedish Hip Arthroplasty Registry have established the infrastructure, analysis and reporting mechanisms, and leadership that has enabled other countries to subsequently develop national registries around the world. As more countries have adopted the concept of national registries, a new area of research is possible by pooling the resources of large registries as is now occurring with the Nordic countries. Several international organizations have been formed to promote future collaboration and develop international standards. The process of globalization of registries is a result of continued efforts over the past 50 years in improving and disseminating the knowledge gained from the early registries. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2319-2330, 2018.
PubMed ID
29663575 View in PubMed
Less detail

[A small number of patient characteristics influence the length of hospital stay after total hip and knee arthroplasty].

https://arctichealth.org/en/permalink/ahliterature178275
Source
Ugeskr Laeger. 2004 Sep 6;166(37):3197-201
Publication Type
Article
Date
Sep-6-2004

Assessment of the Swedish EQ-5D experience-based value sets in a total hip replacement population.

https://arctichealth.org/en/permalink/ahliterature273735
Source
Qual Life Res. 2015 Dec;24(12):2963-70
Publication Type
Article
Date
Dec-2015
Author
Szilárd Nemes
Kristina Burström
Niklas Zethraeus
Ted Eneqvist
Göran Garellick
Ola Rolfson
Source
Qual Life Res. 2015 Dec;24(12):2963-70
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - methods - psychology
Female
Humans
Male
Middle Aged
Postoperative Period
Quality of Life - psychology
Sickness Impact Profile
Surveys and Questionnaires
Sweden
Young Adult
Abstract
All patients undergoing elective total hip replacement (THR) in Sweden are asked to complete a survey, including the EQ-5D. Thus far, EQ-5D values have been presented using the UK TTO value set based on hypothetical values. Shift to the use of the recently introduced Swedish experience-based value set, derived from a representative Swedish population, is an appealing alternative.
To investigate how accurate the Swedish experience-based VAS value set predicts observed EQ VAS values and to compare correlations between Swedish and UK value sets including two provisional value sets derived from the THR population.
Pre- and one-year postoperative data from 56,062 THR patients from the Swedish Hip Arthroplasty Register were used. Agreement between the observed and the predicted EQ VAS values was assessed with correlation. Based on pre- and postoperative data, we constructed two provisional VAS value sets.
Correlations between observed and calculated values using the Swedish VAS value set were moderate (r = 0.46) in preoperative data and high (r = 0.72) in postoperative data. Correlations between UK and register-based value sets were constantly lower compared to Swedish value sets. Register-based values and Swedish values were highly correlated.
The Swedish value sets are more accurate in terms of representation of the Swedish THR patients than the currently used UK TTO value set. We find it feasible to use the experience-based Swedish value sets for further presentation of EQ-5D values in the Swedish THR population.
PubMed ID
26038221 View in PubMed
Less detail

British and Danish surgeons advise against using dangerous hips.

https://arctichealth.org/en/permalink/ahliterature126289
Source
BMJ. 2012;344:e1725
Publication Type
Article
Date
2012

Care principles at four fast-track arthroplasty departments in Denmark.

https://arctichealth.org/en/permalink/ahliterature142504
Source
Dan Med Bull. 2010 Jul;57(7):A4166
Publication Type
Article
Date
Jul-2010
Author
Henrik Husted
Søren Solgaard
Torben B Hansen
Kjeld Søballe
Henrik Kehlet
Author Affiliation
Alloplastiksektionen, Ortopaedkirurgisk Afdeling, Hvidovre Hospital, 2650 Hvidovre, Denmark. henrikhusted@dadlnet.dk
Source
Dan Med Bull. 2010 Jul;57(7):A4166
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Analgesia - methods - standards
Arthroplasty, Replacement, Hip - methods - standards - statistics & numerical data
Arthroplasty, Replacement, Knee - methods - standards - statistics & numerical data
Denmark
Humans
Length of Stay - statistics & numerical data
Patient Care - standards
Perioperative Care
Venous Thrombosis - prevention & control
Abstract
The goal of this study was to describe the logistic and clinical set-up at four Danish arthroplasty departments offering fast-track surgery.
Based on the National Patient Registry's information on patients who have undergone total hip and knee arthroplasty, four departments were chosen for evaluation in accordance with the following inclusion criteria: documented fast-track surgery with written care plans, a surgical volume of > 450 arthroplasties and short length of stay (LOS) (
PubMed ID
20591341 View in PubMed
Less detail

[Cases of complex endoprosthetic surgery of the hip joint].

https://arctichealth.org/en/permalink/ahliterature183238
Source
Voen Med Zh. 2003 Aug;324(8):16-22, 96
Publication Type
Article
Date
Aug-2003
Author
V K Nikolenko
B P Buriachenko
Iu V Aksenov
Source
Voen Med Zh. 2003 Aug;324(8):16-22, 96
Date
Aug-2003
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Arthroplasty, Replacement, Hip - methods
Femoral Neck Fractures - radiography - surgery
Follow-Up Studies
Hip Prosthesis - statistics & numerical data
Hospitals, Military - statistics & numerical data
Humans
Male
Middle Aged
Military Medicine - methods
Postoperative Care
Russia
Abstract
140 complex endoprosthetics of the hip joint were performed in 124 patients treated in the traumatology and arthrology Center of the Buyrdenko Main Military Clinical Hospital during the period from 1988 to 2001. It constituted 14.3% of all patients with diseases and trauma sequelae of such localization treated in the Hospital. There were 6 main patient groups in whom the pathological changes were considerably expressed and required the special approaches to the operation, i.e. the primary simultaneous bilateral hip joint endoprosthetics. The patients' age was 17-65 (the mean age 48.7), while during the conventional primary endoprosthetics the mean age was 68. We have developed the method of hip joint endoprosthetics performed in two stages. (Patent No 2173108 RF). This method was applied in 16 patients (group 1-11 and group 2-5 patients). The post-operative follow-up period lasted 1-6 years. Excellent and good results were obtained in 14 (87.5%) patients that were evaluated according to Harris's method. We think that it is reasonable to consider the primary complex endoprosthetics as the independent type of surgical intervention as it requires the special approaches to planning and performance of the operation, high skill and special up-to-date equipment.
PubMed ID
14564953 View in PubMed
Less detail

Cemented total hip replacement for primary osteoarthritis in patients aged 55 years or older: results of the 12 most common cemented implants followed for 25 years in the Finnish Arthroplasty Register.

https://arctichealth.org/en/permalink/ahliterature153964
Source
J Bone Joint Surg Br. 2008 Dec;90(12):1562-9
Publication Type
Article
Date
Dec-2008
Author
K. Mäkelä
A. Eskelinen
P. Pulkkinen
P. Paavolainen
V. Remes
Author Affiliation
Department of Orthopaedics and Traumatology, Turku University Central Hospital, Rauhankatu 24 D 32, 20100 Turku, Finland. keijo.makela@tyks.fi
Source
J Bone Joint Surg Br. 2008 Dec;90(12):1562-9
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - methods - statistics & numerical data
Bone Cements - therapeutic use
Equipment Failure Analysis - statistics & numerical data
Female
Finland
Follow-Up Studies
Hip Prosthesis - standards - statistics & numerical data
Humans
Male
Middle Aged
Osteoarthritis, Hip - surgery
Prosthesis Design
Prosthesis Failure
Reoperation - statistics & numerical data
Time Factors
Treatment Outcome
Abstract
We have analysed from the Finnish Arthroplasty Register the long-term survivorship of the 12 most commonly-used cemented implants between 1980 and 2005 in patients aged 55 years or older with osteoarthritis. Only two designs of femoral component, the Exeter Universal and the Müller Straight femoral component had a survivorship of over 95% at ten years with revision for aseptic loosening as the endpoint. At 15 years of the femoral and acetabular component combinations, only the Exeter Universal/Exeter All-poly implant had a survival rate of over 90% with revision for aseptic loosening as the endpoint. In the subgroup of patients aged between 55 and 64 years, survivorship overall was less than 90% at ten years. The variation in the long-term rates of survival of different cemented hip implants was considerable in patients aged 55 years or older. In those aged between 55 and 64 years, none of the cemented prostheses studied yielded excellent long-term survival rates (> or = 90% at 15 years).
PubMed ID
19043125 View in PubMed
Less detail

Cemented versus cementless total hip replacements in patients fifty-five years of age or older with rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature137782
Source
J Bone Joint Surg Am. 2011 Jan 19;93(2):178-86
Publication Type
Article
Date
Jan-19-2011
Author
Keijo T Mäkelä
Antti Eskelinen
Pekka Pulkkinen
Petri Virolainen
Pekka Paavolainen
Ville Remes
Author Affiliation
Department of Orthopaedics and Traumatology, Turku University Central Hospital, Luolavuorentie 2, PL 28, 20701 Turku, Finland. keijo.makela@tyks.fi
Source
J Bone Joint Surg Am. 2011 Jan 19;93(2):178-86
Date
Jan-19-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Arthritis, Rheumatoid - diagnosis - surgery
Arthroplasty, Replacement, Hip - methods
Bone Cements - pharmacology
Female
Finland
Follow-Up Studies
Hip Joint - physiopathology - surgery
Hip Prosthesis
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Postoperative Complications - physiopathology
Proportional Hazards Models
Prosthesis Design
Prosthesis Failure
Registries
Retrospective Studies
Risk assessment
Sex Factors
Time Factors
Treatment Outcome
Abstract
results obtained from single-center studies indicate that a cemented total hip replacement is the treatment of choice for the management of patients over fifty-five years of age with rheumatoid arthritis. The aim of this study was to analyze population-based survival rates for cemented and cementless total hip replacements in patients aged fifty-five years or over with rheumatoid arthritis in Finland.
between 1980 and 2006, a total of 6000 primary total hip replacements performed for the management of rheumatoid arthritis in patients who were fifty-five years of age or older were entered in the Finnish Arthroplasty Registry. 4019 of them fulfilled our inclusion criteria and were subjected to analysis. The implants were classified into one of three possible groups: (1) a cementless group (a noncemented proximally porous-coated stem and a noncemented porous-coated press-fit cup), (2) a cemented group 1 (a cemented, loaded-taper stem combined with a cemented, all-polyethylene cup), or (3) a cemented group 2 (a cemented, composite-beam stem with a cemented, all-polyethylene cup).
cementless stems and cups, analyzed separately, had a significantly lower risk of revision for aseptic loosening than cemented implants in patients who were fifty-five years of age or older with rheumatoid arthritis. The fifteen-year survival rate of cementless total hip replacements (80%) was comparable with the rates of the cemented groups (86% in cemented group 1 and 79% in cemented group 2) when revisions for any reason were used as the end point.
cementless and cemented total hip replacements produced comparable long-term results in patients who were fifty-five years of age or older with rheumatoid arthritis.
therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
PubMed ID
21248215 View in PubMed
Less detail

58 records – page 1 of 6.