Cognition Following Computer-Assisted Total Knee Arthroplasty

Haytmanek, C. Thomas; Pour, Aidin Eslam; Restrepo, Camilo; Nikhil, Jagana; Parvızı, Javad; Hozack, William J.

doi:10.2106/jbjs.h.00497

Cited by 11 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in a polytraumatized patient or a patient with pulmonary or cerebral injury from a trauma in addition to a long-bone fracture, decreasing emboli could be potentially life-saving. In addition, with the recent focus on changes in mini-mental status scores and cognitive impairment in patients after intramedullary canal manipulation, perhaps these clinical findings have always been evident and are only now being recognized [13][14][15][16][17][18][19] .…”

Section: Discussionmentioning

confidence: 99%

“…More recently, studies have examined cognitive deficits after orthopaedic procedures, mostly focusing on total joint arthroplasty and hip fracture surgery, with the rate of cognitive impairment noted to be as high as 73% [13][14][15][16][17] . Although many etiologies for these cognitive deficits have been discussed, to our knowledge, no one has yet directly demonstrated whether embolic events may be at least partially responsible.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Use of the Reamer/Irrigator/Aspirator Decreases Carotid and Cranial Embolic Events in a Canine Model

Miller

Deal

Green³

et al. 2016

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Use of the Reamer/Irrigator/Aspirator Decreases Carotid and Cranial Embolic Events in a Canine Model

Miller

Deal

Green³

et al. 2016

The Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

show abstract

“…Cohorts in all these studies were, however, very small and offer low levels of evidence, and contradictory evidence does exist showing no difference in blood loss [25,33] and thromboembolic phenomena [13] between the two groups. More recently, in a prospective study examining cognitive change following TKA, Haytmanek et al [34] found no difference in postoperative cognitive function between navigated and conventional TKA cohorts. In a commentary on this methodologically well-designed study, Masri recommended that ''a larger sample size may be required to definitively prove that there is no such difference'' [35] (Haytmanek et al having only reviewed 61 patients in total).…”

Section: Mortality and Morbiditymentioning

confidence: 99%

Computer navigated total knee arthroplasty: Aspects of a single unit's experience of 777 cases

Harvie

Sloan

Beaver

2011

Computer Aided Surgery

View full text Add to dashboard Cite

The use of computer navigation and conventional techniques in total knee arthroplasty remains controversial. Advocates of computer navigated techniques cite better alignment of components and reduced morbidity associated with avoidance of intramedullary instrumentation as a rationale for their use. In contrast, proponents of conventional techniques argue that better alignment does not correlate with a better functional outcome and that the conventional approach avoids the perceived risk of fracture associated with bicortical insertion of navigation tracker pins.All total knee arthoplasties performed at our institution are prospectively monitored for life in a dedicated Joint Replacement Assessment Clinic (JRAC). Patients are reviewed by physiotherapists, independent of the surgeons who performed surgery, both preoperatively and at six weeks, three and six months, and one, two and five years postoperatively (and every five years thereafter). Patients are assessed using validated outcome measures (Knee Society Score, Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, Short Form SF-36 Health Survey (version 2) and a patient satisfaction score). In addition, at 6 months post surgery, a CT scan of each implanted prosthesis is performed using the Perth CT knee protocol.The findings of a single unit's experience of 777 navigated primary total knee replacements are discussed and critically compared to the body of literature that currently relates to this controversial topic.

show abstract

“…However, a comparison study failed to show a decrease in postoperative confusion or respiratory thromboembolic events in patients undergoing navigated TKA vs conventional TKA. 29,30 Similarly, many studies reveal no difference in hemoglobin drop, blood loss, or transfusion requirements. 30 Although a reduction in outliers of mechanical axis may be achieved with the technique, other proposed outcomes have not been borne out in the research to date.…”

Section: Computer Navigationmentioning

confidence: 99%

Protocol-Based Arthroplasty: Less Is More

Gutowski¹,

Parvızı²,

Purtill³

2015

Orthopedics

Self Cite

View full text Add to dashboard Cite

As a result of reading this article, physicians should be able to: 1. State an argument for, and background information on, patient-centered arthroplasty protocols. 2. Describe specific recommendations for designing a simplified arthroplasty care pathway that is reproducible in other institutions. 3. Discuss cost-effectiveness research on the latest value-delivering protocols. 4. Recognize areas of continued research and opportunities for future improvement in protocol development. Total joint arthroplasty is a successful orthopedic procedure that is performed in high volume in the United States and internationally. As economic pressures continue to mount in the US health care system, it will become increasingly important to minimize cost and improve quality and value. At the authors' institution, a protocol-based arthroplasty model is used, in many ways based on simplification of the patient care pathway. The largely evidence-based protocol has its foundation in eliminating unnecessary dogmatic practices, enhancing the patient experience, and achieving cost-effectiveness. The authors believe that a model like this can be applied to joint arthroplasty practices across the country in the future to maximize the value delivered to patients.

show abstract

Cognition Following Computer-Assisted Total Knee Arthroplasty

Abstract: Further research is needed to determine if fat and bone-marrow-debris embolization is truly decreased by the use of computer-assisted total knee arthroplasty and if such a reduction has any clinical relevance.

Cited by 11 publications

References 8 publications

Use of the Reamer/Irrigator/Aspirator Decreases Carotid and Cranial Embolic Events in a Canine Model

Use of the Reamer/Irrigator/Aspirator Decreases Carotid and Cranial Embolic Events in a Canine Model

Computer navigated total knee arthroplasty: Aspects of a single unit's experience of 777 cases

Protocol-Based Arthroplasty: Less Is More

Contact Info

Product

Resources

About