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[PMID]:29254318
[Au] Autor:Vicenti G; Pesce V; Bizzoca D; Nappi V; Palmiotto F; Carrozzo M; Moretti B
[Ad] Endereço:School of Medicine, University of Bari Aldo Moro, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, Bari, Italy.
[Ti] Título:Perioperative plasmatic presepsin levels in patients undergoing total hip or knee replacement: a preliminary study.
[So] Source:J Biol Regul Homeost Agents;31(4):1081-1086, 2017 Oct-Dec.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Presepsin (sCD14-ST) is an emerging biomarker in the diagnosis of sepsis. In the field of orthopaedics, it could be useful in the diagnosis and management of periprosthetic joint infections (PJI). The aim of this study is to define the normal perioperative plasmatic levels of presepsin in patients undergoing primary cementless total hip replacement (THR) or primary cemented total knee replacement (TKR). For this purpose, 50 patients (19 male, 31 female, mean age= 64.04±8.88) were recruited. The patients were divided into two groups: Group A patients underwent cementless THR, whereas Group B patients underwent cemented TKR. On recruitment, anthropometric data, smocking status, osteoarthritis stage according to Kellgren and Lawrence, Harris Hip Score (HHS) for Group A patients and Knee Society Score (KSS) for Group B patients, drugs assumption and comorbidities were recorded. All the patients underwent serial blood tests, including complete blood count, presepsin (PS), C-reactive protein (CRP) and procalcitonin (PCT) 24 hours before arthroplasty (T0) and at 24 (T1), 48 (T2), 72 (T3) and 96 (T4) hours postoperatively. Body temperature (θ) was recorded every six hours in the time lapse T0-T4. Presepsin plasmatic concentration was comparable at baseline in both groups. After surgery, however, a significant increase of presepsin was observed in Group A, whereas in Group B no significant changes of presepsin were recorded. A comparable trend of this biomarker was found in the two groups, i.e. presepsin increased from T0 to T3, when it reached its maximum value, and its decrease started at T4. Finally, presepsin resulted more accurate than CRP in the evaluation of perioperative inflammatory response in patients undergoing THR or TKR. These data will be helpful in defining a reference interval for presepsin in patients with prosthetic joint implants, and a cut-off of this biomarker for the diagnosis of PJI.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Receptores de Lipopolissacarídeos/sangue
Osteoartrite do Quadril/sangue
Osteoartrite do Joelho/sangue
Fragmentos de Peptídeos/sangue
Sepse/sangue
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/sangue
Proteína C-Reativa/metabolismo
Calcitonina/sangue
Feminino
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/complicações
Osteoartrite do Quadril/diagnóstico
Osteoartrite do Quadril/cirurgia
Osteoartrite do Joelho/complicações
Osteoartrite do Joelho/diagnóstico
Osteoartrite do Joelho/cirurgia
Período Perioperatório
Dados Preliminares
Sepse/complicações
Sepse/diagnóstico
Sepse/cirurgia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Lipopolysaccharide Receptors); 0 (Peptide Fragments); 0 (presepsin protein, human); 9007-12-9 (Calcitonin); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE


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[PMID]:29384974
[Au] Autor:Zhu J; Zhu Y; Lei P; Zeng M; Su W; Hu Y
[Ad] Endereço:Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, China.
[Ti] Título:Efficacy and safety of tranexamic acid in total hip replacement: A PRISMA-compliant meta-analysis of 25 randomized controlled trials.
[So] Source:Medicine (Baltimore);96(52):e9552, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hip osteoarthritis is one of the most prevalent musculoskeletal degenerative diseases in elderly. Total hip arthroplasty (THA) is the most effective surgical treatment for end stage hip osteoarthritis. Tranexamic acid (TA) is a potent drug to reduce surgical blood loss in surgery, therefore, as a potential drug for application in THA. OBJECTIVES: To identify the combined efficacy of TA administration in THA. A meta-analysis including 25 randomized controlled trials was conducted for generating synthesized effects. METHODS: This meta-analysis followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines for reporting systematic reviews and meta-analysis. A total of 25 Randomized controlled trials (RCTs) were included for meta-analysis. RESULTS: The pooled results illustrated that total blood loss, intraoperative blood loss, postoperative blood loss, hemoglobin drop, transfusion rate, and average hospital stay were significantly lower than controls (standardized mean difference or odds ratio (OR) (95%CI): -0.87, (-1.13,-0.61), -0.68, (-0.96,-0.39), -1.41, (-2.24,-0.59), -1.11, (-1.63,-0.58), 0.28, (0.20,-0.38), -0.17, (-0.49,0.14), P < .05, respectively). Moreover, TA acts efficiently without increasing risk of thromboembolic events with OR = 1.14, 95%CI = 0.50-2.62, P = .75. Subgroup analysis indicated no statistically significant differences between a higher dose of topical TA (≥2 g or 15 mg/kg) or a lower dose (<2 g or 15 mg/kg). CONCLUSION: The findings indicated that TA is clinically effective and safe in patients receiving total hip arthroplasty.
[Mh] Termos MeSH primário: Antifibrinolíticos/administração & dosagem
Artroplastia de Quadril/métodos
Perda Sanguínea Cirúrgica/prevenção & controle
Osteoartrite do Quadril/cirurgia
Ácido Tranexâmico/administração & dosagem
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Tópica
Transfusão de Sangue
Hemoglobinas
Seres Humanos
Tempo de Internação
Ensaios Clínicos Controlados Aleatórios como Assunto
Trombose Venosa/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Hemoglobins); 6T84R30KC1 (Tranexamic Acid)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009552


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[PMID]:29284048
[Au] Autor:Johnsen MB; Hellevik AI; Småstuen MC; Langhammer A; Furnes O; Flugsrud GB; Nordsletten L; Zwart JA; Storheim K
[Ad] Endereço:Research and Communication Unit for Musculoskeletal Health, Oslo University Hospital, Oslo, Norway.
[Ti] Título:The mediating effect of body mass index on the relationship between smoking and hip or knee replacement due to primary osteoarthritis. A population-based cohort study (the HUNT Study).
[So] Source:PLoS One;12(12):e0190288, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To investigate the total effect of smoking on total hip or knee replacement (THR/TKR) due to primary osteoarthritis (OA) and to quantify the indirect effect of smoking through body mass index (BMI). Participants from the Nord-Trøndelag Health Study (the HUNT Study) were linked to the Norwegian Arthroplasty Register to detect the first THR or TKR due to primary OA. A mediation analysis was used to decompose the total effect of smoking into a direct and indirect effect. BMI was considered a mediator in the analysis. All effects were estimated as hazard ratios (HRs) with 95% confidence intervals (CIs). The indirect effect of smoking mediated through BMI was expressed as a percentage (proportion*100). In total 55 188 participants were followed up during 17.2 years (median). We identified 1322 THRs and 754 TKRs. For men, the total effect of current vs. never smoking revealed a decreased risk of THR (HR 0.59, 95% CI 0.46-0.76) and TKR (HR 0.47, 95% CI 0.32-0.66). For women, current smoking increased the risk of THR (HR 1.34, 95% CI 1.11-1.60). For men, 6% and 7% of the risk reduction for THR and TKR, respectively, was mediated by BMI. We found a negative association between smoking and THR or TKR for men. On the contrary, smoking was associated with increased risk of THR for women. Most of the effect of smoking on joint replacement risk remained unexplained by BMI.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Índice de Massa Corporal
Osteoartrite do Quadril/cirurgia
Osteoartrite do Joelho/cirurgia
Fumar
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171229
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190288


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[PMID]:29341571
[Au] Autor:Vukomanovic A; Durovic A; Brdareski Z
[Ti] Título:Diagnostic accuracy of the A-test and cutoff points for assessing outcomes and planning acute and post-acute rehabilitation of patients surgically treated for hip fractures and osteoarthritis.
[So] Source:Vojnosanit Pregl;73(12):1139-48, 2016 Dec.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: The A-test is used in daily clinical practice for monitoring functional recovery of orthopedic patients during early rehabilitation. The aim of this study was to determine the accuracy of A-test and cutoff point at which the test can separate patients with and without functional disability at the end of early rehabilitation. Also, it was important to determine whether A-test has that discriminative ability (and at which cutoff points) in the first days of early rehabilitation in order to have time to plan post acute rehabilitation. Methods: This measurement-focused study was conducted in the Orthopedic Ward during early inpatient rehabilitation (1st−5th day after the operation) of 60 patients with hip osteoarthritis (HO) that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF). For measurements we used the A-test and the University of Iowa Level of Assistance Scale (ILAS) as the gold standard. For statistical analysis we used the receiver operating characteristic (ROC) curve and the area under the curve (AUC) with 95% confidence interval for the results of A-test from the first to the fifth day of rehabilitation, sensitivity, specificity, the rate of false positive and false negative errors, positive and negative predictive value, ratio of positive and negative likelihood ratio, accuracy, point to the ROC curve closest to 0.1 and Youden index for all the cutoff points. Results: The AUC was 0.825 (0.744−0.905) for the first day of rehabilitation, 0.922 (0.872−0.972) for the second day of rehabilitation, 0.980 (0.959−1.000) for the third day of rehabilitation, 0.989 (0.973−1.004) for the fourth day, and 0.999 (0.996−1.001) for the fifth day of rehabilitation. The optimal cutoff for the results of A-test was: 7/8 for the first day, 29/30 for the fourth day, and 34/35 for the fifth day of rehabilitation. On the second and the third day A-test had two cutoff points, the lower point safely separated the patients with functional disability, while the upper point ruled out functional disability. On the 2nd rehabilitation day the cutoff points were 12/13 and 17/18, on the 3rd rehabilitation day cutoff points were 13/14 and 18/19. Conclusion: The A-test has all characteristics of an accurate tool which can be used for separating patients with and without functional disability at all stages of early rehabilitation after surgically treated hip disease or fracture. Based on the results of A-test within the first days of early rehabilitation, it is possible to make a plan for postacute rehabilitation.
[Mh] Termos MeSH primário: Artroplastia de Quadril/reabilitação
Técnicas de Apoio para a Decisão
Fixação de Fratura/reabilitação
Fraturas do Quadril/reabilitação
Fraturas do Quadril/cirurgia
Osteoartrite do Quadril/reabilitação
Osteoartrite do Quadril/cirurgia
Planejamento de Assistência ao Paciente
Cuidados Pós-Operatórios/métodos
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Idoso
Idoso de 80 Anos ou mais
Área Sob a Curva
Artroplastia de Quadril/efeitos adversos
Tomada de Decisão Clínica
Avaliação da Deficiência
Feminino
Fixação de Fratura/efeitos adversos
Fraturas do Quadril/diagnóstico
Fraturas do Quadril/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/diagnóstico
Osteoartrite do Quadril/fisiopatologia
Valor Preditivo dos Testes
Estudos Prospectivos
Curva ROC
Recuperação de Função Fisiológica
Reprodutibilidade dos Testes
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150819056V


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[PMID]:29201297
[Au] Autor:Lee M; Yoo J; Kim JG; Kyung HS; Bin SI; Kang SB; Choi CH; Moon YW; Kim YM; Han SB; In Y; Choi CH; Kim J; Lee BK; Cho S
[Ad] Endereço:Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
[Ti] Título:A Randomized, Multicenter, Phase III Trial to Evaluate the Efficacy and Safety of Polmacoxib Compared with Celecoxib and Placebo for Patients with Osteoarthritis.
[So] Source:Clin Orthop Surg;9(4):439-457, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: The aim of this study was to evaluate the safety and analgesic efficacy of polmacoxib 2 mg versus placebo in a superiority comparison or versus celecoxib 200 mg in a noninferiority comparison in patients with osteoarthritis (OA). Methods: This study was a 6-week, phase III, randomized, double-blind, and parallel-group trial followed by an 18-week, single arm, open-label extension. Of the 441 patients with knee or hip OA screened, 362 were randomized; 324 completed 6 weeks of treatment and 220 completed the extension. Patients were randomized to receive oral polmacoxib 2 mg (n = 146), celecoxib 200 mg (n = 145), or placebo (n = 71) once daily for 6 weeks. During the extension, all participants received open-label polmacoxib 2 mg. The primary endpoint was the change in Western Ontario and McMaster Universities (WOMAC)-pain subscale score from baseline to week 6. Secondary endpoints included WOMAC-OA Index, OA subscales (pain, stiffness, and physical function) and Physician's and Subject's Global Assessments at weeks 3 and 6. Other outcome measures included adverse events (AEs), laboratory tests, vital signs, electrocardiograms, and physical examinations. Results: After 6 weeks, the polmacoxib-placebo treatment difference was -2.5 (95% confidence interval [CI], -4.4 to -0.6; = 0.011) and the polmacoxib-celecoxib treatment difference was 0.6 (CI, -0.9 to 2.2; = 0.425). According to Physician's Global Assessments, more subjects were "much improved" at week 3 with polmacoxib than with celecoxib or placebo. Gastrointestinal and general disorder AEs occurred with a greater frequency with polmacoxib or celecoxib than with placebo. Conclusions: Polmacoxib 2 mg was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with OA. The results obtained during the 18-week trial extension with polmacoxib 2 mg were consistent with those observed during the 6-week treatment period, indicating that polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. More importantly, the results of this study showed that polmacoxib has the potential to be used as a pain relief drug with reduced gastrointestinal side effects compared to traditional nonsteroidal anti-inflammatory drugs for OA.
[Mh] Termos MeSH primário: Celecoxib/uso terapêutico
Inibidores de Ciclo-Oxigenase 2/uso terapêutico
Furanos/uso terapêutico
Dor Musculoesquelética/tratamento farmacológico
Osteoartrite do Quadril/tratamento farmacológico
Osteoartrite do Joelho/tratamento farmacológico
Sulfonamidas/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Celecoxib/efeitos adversos
Inibidores de Ciclo-Oxigenase 2/efeitos adversos
Método Duplo-Cego
Feminino
Furanos/efeitos adversos
Gastroenteropatias/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Dor Musculoesquelética/etiologia
Osteoartrite do Quadril/complicações
Osteoartrite do Quadril/fisiopatologia
Osteoartrite do Joelho/complicações
Osteoartrite do Joelho/fisiopatologia
Amplitude de Movimento Articular
Sulfonamidas/efeitos adversos
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE III; COMPARATIVE STUDY; EQUIVALENCE TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (CG100649); 0 (Cyclooxygenase 2 Inhibitors); 0 (Furans); 0 (Sulfonamides); JCX84Q7J1L (Celecoxib)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.439


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[PMID]:29201293
[Au] Autor:Tetsunaga T; Fujiwara K; Endo H; Tetsunaga T; Shiota N; Sato T; Ozaki T
[Ad] Endereço:Department of Orthopaedic Surgery, Okayama University, Okayama, Japan.
[Ti] Título:Calcar Femorale in Patients with Osteoarthritis of the Hip Secondary to Developmental Dysplasia.
[So] Source:Clin Orthop Surg;9(4):413-419, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: We investigated whether the calcar femorale, a cortical septum in the region of the lesser trochanter of the femur, correlates with results of femoral stem implantation in patients with osteoarthritis of the hip secondary to developmental dysplasia using computed tomography. Methods: This retrospective study included 277 hips (41 males and 236 females; age, 37 to 92 years) of patients who had presented to Okayama Medical Center with hip pain. Of these, a total of 219 hips (31 males and 188 females) had previously undergone total hip arthroplasty. According to the Crowe classification, 147 hips were classified as Crowe grade I, 72 hips as Crowe grade II-IV, and 58 hips as normal. Results: The calcar femorale was identified in 267 hips (96.4%). The calcar femorale was significantly shorter and more anteverted in Crowe grade II-IV hips than in Crowe grade I or normal hips. Significant differences in the shape of the calcar femorale were found according to the severity of hip deformity. Three stem designs were analyzed: single-wedge (59 hips), double-wedge metaphyseal filling (147 hips), and modular (13 hips). Single-wedge stems were inserted more parallel to the calcar femorale rather than femoral neck anteversion, while other types of stems scraped the calcar femorale. Conclusions: The angle of the calcar femorale differs according to the severity of hip deformity, and the calcar femorale might thus serve as a more useful reference for stem insertion than femoral neck anteversion in total hip arthroplasty using a single-wedge stem.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Fêmur/anatomia & histologia
Luxação Congênita de Quadril/complicações
Osteoartrite do Quadril/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/instrumentação
Feminino
Fêmur/diagnóstico por imagem
Prótese de Quadril
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/cirurgia
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.413


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[PMID]:29201291
[Au] Autor:Park KS; Cho KJ; Yang HY; Eshnazarov KE; Yoon TR
[Ad] Endereço:Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea.
[Ti] Título:Long-term Results of Modified Salter Innominate Osteotomy for Legg-Calvé-Perthes Disease.
[So] Source:Clin Orthop Surg;9(4):397-404, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: In a previous study, we reported clinical and radiographic results of our modified Salter innominate osteotomy technique in 16 hips affected by Legg-Calvé-Perthes disease (LCPD) with an average follow-up of 31.8 months. In this study, we present the long-term results of the osteotomy in LCPD patients followed until physeal closure. Methods: Thirty hips of 29 patients were followed until skeletal maturation after modified Salter innominate osteotomy. The mean follow-up duration was 12.9 years (range, 9.1 to 16.0 years). Eleven hips (36.7%) were classified as Catterall group III and 19 (63.3%) as Catterall group VI. Stable interposition of a bone block was achieved using one biodegradable screw in nine hips and without any fixation device in 21 hips by simply changing the direction of osteotomy. The Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and hip function were evaluated at the last follow-up. Radiological outcomes were evaluated using Wiberg's center-edge angle, the Mose method, and Stulberg classification, and osteoarthritic changes were evaluated using the Tonnis classification. Results: Mean HHS and WOMAC score were 80.2 points and 54 points, respectively, preoperatively and these were improved to 96.2 points and 28 points, respectively, at the last follow-up. Clinical results, according to Robinson's criteria, were good in 18, fair in seven, and poor in five hips. Radiological results assessed using the Mose method were good in 18, fair in six, and poor in six hips, and according to the Stulberg classification, nine hips were class I, nine were class II, eight were class III, and four were class IV. The mean center-edge angle improved from 19.7° preoperatively to 29.6° at the final follow-up. According the Tonnis classification, three hips were grade 2, five were grade 1, and 22 were grade 0. Of the three grade 2 hips, two underwent Chiari osteotomy 12.1 and 8.8 years postoperatively, and the other underwent total hip arthroplasty 12.9 years postoperatively. Conclusions: The modified Salter innominate osteotomy produced relatively satisfactory long-term clinical and radiological results.
[Mh] Termos MeSH primário: Articulação do Quadril/fisiopatologia
Doença de Legg-Calve-Perthes/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Desenvolvimento Ósseo
Criança
Pré-Escolar
Feminino
Seguimentos
Articulação do Quadril/diagnóstico por imagem
Seres Humanos
Doença de Legg-Calve-Perthes/complicações
Doença de Legg-Calve-Perthes/fisiopatologia
Masculino
Osteoartrite do Quadril/diagnóstico por imagem
Osteoartrite do Quadril/etiologia
Radiografia
Amplitude de Movimento Articular
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.397


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[PMID]:29292335
[Au] Autor:Konan S; Duncan CP
[Ad] Endereço:University College London Hospitals NHS Trust, 250 Euston Road, London NW1 2BU, UK.
[Ti] Título:Total hip arthroplasty in patients with neuromuscular imbalance.
[So] Source:Bone Joint J;100-B(1 Supple A):17-21, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Patients with neuromuscular imbalance who require total hip arthroplasty (THA) present particular technical problems due to altered anatomy, abnormal bone stock, muscular imbalance and problems of rehabilitation. In this systematic review, we studied articles dealing with THA in patients with neuromuscular imbalance, published before April 2017. We recorded the demographics of the patients and the type of neuromuscular pathology, the indication for surgery, surgical approach, concomitant soft-tissue releases, the type of implant and bearing, pain and functional outcome as well as complications and survival. Recent advances in THA technology allow for successful outcomes in these patients. Our review suggests excellent benefits for pain relief and good functional outcome might be expected with a modest risk of complication. Cite this article: 2018;100-B(1 Supple A):17-21.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Doenças Neuromusculares/complicações
Osteoartrite do Quadril/cirurgia
Equilíbrio Postural
[Mh] Termos MeSH secundário: Artroplastia de Quadril/instrumentação
Artroplastia de Quadril/métodos
Seres Humanos
Doenças Neuromusculares/fisiopatologia
Osteoartrite do Quadril/complicações
Complicações Pós-Operatórias/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0571.R1


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[PMID]:29212685
[Au] Autor:Hunt LP; Blom A; Wilkinson JM
[Ad] Endereço:University of Bristol, Level 1, Learning and Research Building, Southmead Hospital, Bristol, BS10 5NB, UK.
[Ti] Título:An analysis of 30-day mortality after weekend weekday elective joint arthroplasty in England and Wales: a cohort study using the National Joint Registry Dataset.
[So] Source:Bone Joint J;99-B(12):1618-1628, 2017 Dec.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To investigate whether elective joint arthroplasty performed at the weekend is associated with a different 30-day mortality that performed between Monday and Friday. PATIENTS AND METHODS: We examined the 30-day cumulative mortality rate (Kaplan-Meier) for all elective hip and knee arthroplasties performed in England and Wales between 1st April 2003 and 31st December 2014, comprising 118 096 episodes undertaken at the weekend and 1 233 882 episodes performed on a weekday. We used Cox proportional-hazards regression models to assess for time-dependent variation and adjusted for identified risk factors for mortality. RESULTS: The cumulative 30-day mortality for hip arthroplasty was 0.15% (95% confidence interval (CI) 0.12 to 0.19) for patients operated on at the weekend versus 0.20% (95% CI 0.19 to 0.21) for patients undergoing surgery during the normal working week. For knee arthroplasty, the cumulative 30-day mortality was 0.14% (95% CI 0.11 to 0.17) for weekend-operated patients versus 0.18% (95% CI 0.17 to 0.19) for weekday-operated patients. These differences were independent of any differences in patient age, gender, American Society of Anaesthesiologists grade, surgeon seniority, surgical and anaesthetic practices, and thromboprophylaxis choice in weekend weekday-operated patients. CONCLUSION: The 30-day mortality rate after elective joint arthroplasty is low. Surgery performed at the weekend is associated with lower post-operative mortality operations performed on a weekday. Cite this article: 2017;99-B:1618-28.
[Mh] Termos MeSH primário: Artroplastia de Quadril/mortalidade
Artroplastia do Joelho/mortalidade
Osteoartrite do Quadril/cirurgia
Osteoartrite do Joelho/cirurgia
[Mh] Termos MeSH secundário: Estudos de Coortes
Procedimentos Cirúrgicos Eletivos/mortalidade
Inglaterra/epidemiologia
Seres Humanos
Osteoartrite do Quadril/mortalidade
Osteoartrite do Joelho/mortalidade
Sistema de Registros
Fatores de Tempo
País de Gales/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B12.BJJ-2017-0347.R1


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[PMID]:29040125
[Au] Autor:Stevenson C; Ogonda L; Blaney J; Dennison J; O'Brien S; Beverland D
[Ad] Endereço:1Musgrave Park Hospital, Belfast, Northern Ireland, United Kingdom.
[Ti] Título:Minimal Incision Total Hip Arthroplasty: A Concise Follow-up Report on Functional and Radiographic Outcomes at 10 Years.
[So] Source:J Bone Joint Surg Am;99(20):1715-1720, 2017 Oct 18.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In 2005, we conducted a prospective randomized controlled trial that demonstrated that, compared with a standard incision, a minimal incision technique did not improve early outcomes of total hip arthroplasty (THA). There was concern that reduced exposure could compromise long-term outcome. For the current study, all surviving participants were invited to return for 10-year radiographic and clinical evaluation. Outcome scores were available for 152 patients (69.4%) from the original cohort, and radiographs were available for 126 (57.5%). The median duration of follow-up was 124 months. We did not find significant differences in functional status or radiographic outcome between the minimal and standard incision groups at 10 years. The 10-year implant survival rate was 99.1% (95% confidence interval [CI] = 97.3% to 100%) in the standard incision group and 97.9% (95% CI = 95.1% to 100%) in the minimal incision group (p = 0.57). We concluded that minimal incision THA performed by a high-volume surgeon does not compromise long-term results but offers no benefit over a standard incision. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Osteoartrite do Quadril/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/diagnóstico por imagem
Estudos Prospectivos
Radiografia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00950



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