Total Knee Arthroplasty in Hemophilic Arthropathy

Norian, J.M.; Ries, Michael D.; Karp, S.; Hambleton, Julie

doi:10.2106/00004623-200207000-00007

Cited by 90 publications

(108 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings corroborate a recent Mayo Clinic study that found obesity (and every five-unit BMI increase over 30 kg/m 2 ) increased hospital costs USD 500 and 90-day costs by USD 900 after THA [23]. Furthermore, the most costly comorbidities have been previously implicated as independent risk factors for complication after arthroplasty [3,16,22,26]. The cause of higher costs in these multiply comorbid patients is likely multifactorial.…”

Section: Discussionsupporting

confidence: 86%

Comorbidities in Patients Undergoing Total Knee Arthroplasty: Do They Influence Hospital Costs and Length of Stay?

Pugely

Martin

Gao

et al. 2014

Clin Orthop Relat Res

109

View full text Add to dashboard Cite

Background Increasing national expenditures and use associated with TKA have resulted in pressure to reduce costs through various reimbursement cuts. However, within the arthroplasty literature, few studies have examined the association of medical comorbidities on resource use and length of stay after joint arthroplasty. Questions/purposes The purpose of this study was to examine the association between individual patient characteristics (including demographic factors and medical comorbidities) on resource allocation and length of stay (LOS) after TKA. Methods We queried the 2009 Nationwide Inpatient Sample dataset for International Classification of Diseases, 9 th Revision code, 81.54, for TKAs. An initial 621,029-patient cohort was narrowed to 516,745 after inclusion of elective TKAs on patients aged between 40 and 95 years. Using generalized linear models, we estimated the effect of comorbidities on resource use (using cost-to-charge conversions to estimate hospital costs) and the LOS controlling for patient and hospital characteristics. Across the 2009 national cohort with TKAs, 12.7% had no comorbidities, whereas 32.6% had three or more. The most common conditions included hypertension (67.8%), diabetes (20.0%), and obesity (19.8%). Mean hospital costs were USD 14,491 (95% confidence interval [CI],14,525) and mean hospital LOS was 3.3 days (95% CI,

show abstract

Section: Discussionsupporting

confidence: 86%

Comorbidities in Patients Undergoing Total Knee Arthroplasty: Do They Influence Hospital Costs and Length of Stay?

Pugely

Martin

Gao

et al. 2014

Clin Orthop Relat Res

109

View full text Add to dashboard Cite

show abstract

“…The infection rate in patients with haemophilia and HIV was reported to be as high as 18-26%, and seemed to be influenced by the CD4 count (Ragni et al, 1995;Hicks et al, 2001). Others have not observed a higher rate of infection in HIV positive patients compared with HIV negative patients (Norian et al, 2002;Powell et al, 2005).…”

Section: Joint Arthroplastymentioning

confidence: 90%

Modern management of haemophilic arthropathy

2007

View full text Add to dashboard Cite

SummaryCurrently available factor concentrates for treatment of patients with haemophilia are virally inactivated or are made by recombinant technology and their broad use in developed nations has resulted in the dramatic elimination of the treatment‐related viral illnesses that decimated the haemophilia community in the late 20th century. The major morbidity experienced by patients with haemophilia today is joint disease, a result of repeated bleeding episodes into joint spaces. Although administration of factor concentrates to prevent bleeding has been demonstrated to prevent haemophilic joint disease when applied assiduously, repeated bleeding episodes induce synovitis that is irreversible and may progress despite subsequent prophylaxis. Surgical and nuclear medicine interventions are available to reduce the pain of haemophilic arthropathy and to reduce further bleeding episodes. Patients with high titre inhibitors are at great risk for the development of joint disease and present the greatest therapeutic challenges when joint surgery is needed.

show abstract

“…A flexion contracture of less than 30°can usually be corrected during surgery and one would normally be expected to achieve full extension of the joint. More significant contractures, however, demand a more rigorous and systematic approach [15][16][17]. The mainstay of treatment essentially lies in the prevention of flexion contractures if at all possible.…”

Section: Total Knee Replacementmentioning

confidence: 99%

“…Haemophilic patients with inhibitors or infected by the human immunodeficiency virus (HIV) have a higher risk of failure as a result of infection. Most infections are related to Staphylococcus epidermidis, because of haematogenous spread during administration of coagulation factor [15][16][17]. This complication could be reduced through proper skyn hygiene with meticulous antisepsis with sef-infusion, regular medical check-ups, prophylactic antibiotics prior to dental work and any other procedures with a potential for contamination.…”

Section: Total Knee Replacementmentioning

confidence: 99%

Management of arthrofibrosis in haemophilic arthropathy

et al. 2010

View full text Add to dashboard Cite

Summary. Hemophilic arthropathy is one of the conditions most associated with arthrofibrosis and loss of range of motion. Progressive fibrosis of synovium leads to pain, spasm, and shortening of muscles, resulting in joint contractures and restriction of joint motion. It is common to see even young children with severe loss of motion of elbows, knees and ankles. Treatment should be primarily by physiotherapy, splintage, and corrective devices. The late or severe cases may require surgical correction in the form of soft‐tissue procedures, osteotomy and especially joint replacement

show abstract

Total Knee Arthroplasty in Hemophilic Arthropathy

Cited by 90 publications

References 19 publications

Comorbidities in Patients Undergoing Total Knee Arthroplasty: Do They Influence Hospital Costs and Length of Stay?

Comorbidities in Patients Undergoing Total Knee Arthroplasty: Do They Influence Hospital Costs and Length of Stay?

Modern management of haemophilic arthropathy

Management of arthrofibrosis in haemophilic arthropathy

Contact Info

Product

Resources

About