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  • Bentham Science Publishers Ltd.  (3)
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  • Bentham Science Publishers Ltd.  (3)
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  • 1
    Online Resource
    Online Resource
    Bentham Science Publishers Ltd. ; 2020
    In:  The Open Orthopaedics Journal Vol. 14, No. 1 ( 2020-04-21), p. 26-32
    In: The Open Orthopaedics Journal, Bentham Science Publishers Ltd., Vol. 14, No. 1 ( 2020-04-21), p. 26-32
    Abstract: Acute postoperative pain control after Total Knee Arthroplasty (TKA) is important given that poorly controlled, persistent pain can delay rehabilitation. The purpose of this study was to compare pain intensity during the early postoperative period (following the first and second surgeries) in patients who underwent bilateral, scheduled, staged TKAs. Materials and Methods: We enrolled 32 patients (64 knees) in this study and evaluated the number of requests for analgesic agents during the first 3 days after TKA, time to walking, and the Wong–Baker FACES pain assessment score (WBS). Results: Comparing the postoperative period following the first and second TKA, there were no significant differences in WBS 24, 48, and 72 h postoperatively. The frequency of requests, and the total number of requests for analgesics did not differ when comparing the first and second TKA, at any time point. The total number of analgesic requests exhibited a moderately strong, positive correlation between the first and second TKA (p 〈 0.001, r = 0.623). Patients’ WBS scores and requests for analgesics showed a moderately strong, positive correlation, but only at 24 h following the second TKA (p = 0.002, r = 0.567). After both TKAs, patients required a median of 1 day to resume walking. Conclusion: Patients undergoing staged bilateral TKA experienced equivalent early postoperative pain when comparing their experience following their first and second TKAs. Therefore, regarding pain control following the second TKA, we recommend considering the analgesic administration schedule and requirements of the first TKA.
    Type of Medium: Online Resource
    ISSN: 1874-3250
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2020
    detail.hit.zdb_id: 2395994-0
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  • 2
    Online Resource
    Online Resource
    Bentham Science Publishers Ltd. ; 2016
    In:  The Open Orthopaedics Journal Vol. 10, No. 1 ( 2016-08-19), p. 396-403
    In: The Open Orthopaedics Journal, Bentham Science Publishers Ltd., Vol. 10, No. 1 ( 2016-08-19), p. 396-403
    Abstract: Preoperative periarticular bone quality is affected by joint loading. The purpose of this study was to determine the periarticular bone mineral density of the knee joint of patients undergoing total knee arthroplasty, and whether the location of the load-bearing axis correlates with the measured bone mineral density. Materials and Methods: The bone mineral densities of the medial and lateral femoral condyles and the medial and lateral tibial condyles were analyzed in consecutive 116 osteoarthritic patients (130 knees) by dual energy x-ray absorptiometry. Results: The median bone mineral density values in the condyles were 1.138 in femoral medial, 0.767 in femoral lateral, 1.056 in tibial medial, and 0.714 in tibial lateral. The medial condyles showed significantly higher bone mineral densities than the lateral condyles in both the femur and tibia. In addition, the femoral medial showed significantly higher bone mineral density levels than the tibial medial, and the femoral lateral condyle had higher bone mineral density levels than the tibial lateral. The bone mineral density Medial/Lateral ratio was significantly negatively correlated with the location (tibial medial edge 0%, lateral edge 100%) of the load-bearing axis in the femur and tibia. Conclusion: Preoperative bone mineral density values may provide against the changes in bone mineral density after total knee arthroplasty by reflecting the correlation with joint loading axis. These results help explain why total knee arthroplasty has such good long-term clinical outcomes with a low frequency of component loosening and periarticular fractures despite a high degree of postoperative bone loss.
    Type of Medium: Online Resource
    ISSN: 1874-3250
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2016
    detail.hit.zdb_id: 2395994-0
    Location Call Number Limitation Availability
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  • 3
    Online Resource
    Online Resource
    Bentham Science Publishers Ltd. ; 2016
    In:  The Open Orthopaedics Journal Vol. 10, No. 1 ( 2016-08-05), p. 382-388
    In: The Open Orthopaedics Journal, Bentham Science Publishers Ltd., Vol. 10, No. 1 ( 2016-08-05), p. 382-388
    Abstract: The preoperative prevalence of osteoporosis and/or osteopenia and overall bone quality in prospective total knee arthroplasty (TKA) patients may affect the postoperative outcome after prosthetic insertion into the bone. The purpose of this study is to determine the baseline bone mineral density (BMD) and bone turnover in preoperative, female, primary TKA patients. Methods: We prospectively measured the lumbar spine and hip BMDs using dual-energy X-ray absorptiometry (DEXA) scans in a cohort of 119 knees (107 patients) one day before surgery. We also assessed bone turnover using urinary levels of N-telopeptide (NTX), a type I collagen crosslinker, normalized to creatinine. Results: The prevalence of osteoporosis by DEXA scan (T-score ≤ −2.5) among the TKAs was 12% in the spine and 10% in the hip. Eighty-three knees (70%) had osteopenia or osteoporosis of either the spine or hip. The mean T-score of the spine was −0.7 (SD 1.6), which is within normal limits, and of the hip was −1.2 (SD 1.0), which is defined as osteopenia. The mean Z-scores of 0.9 (SD 1.4) in the spine and 0.6 (SD 0.9) in the hip were positive. The median urinary NTX/creatinine ratio was elevated at 58.1 (interquartile range: 13.7 to 188.4). Conclusion: Based on Z-scores, the TKA patients had higher spine and hip BMDs than the age-matched general population. Elevated NTX levels may suggest a systemic or local abnormal bone turnover. Further study is needed to determine whether such turnover, as a type of patient-related medical systemic disorder, affects postoperative clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 1874-3250
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2016
    detail.hit.zdb_id: 2395994-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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