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  1. Article ; Online: Results of Primary Total Knee Arthroplasty in Patients on Chronic Psychotropic Medications.

    Smith, Nolan S / Abhari, Sarag / Smith, Langan S / Altman, Kyle M / Yakkanti, Madhusudhan R / Malkani, Arthur L

    The Journal of arthroplasty

    2024  

    Abstract: Background: Psychotropic medications are commonly used to treat several mental health conditions. The aim of this study was to determine the impact of psychotropic medications in patients undergoing primary total knee arthroplasty (TKA) with respect to ... ...

    Abstract Background: Psychotropic medications are commonly used to treat several mental health conditions. The aim of this study was to determine the impact of psychotropic medications in patients undergoing primary total knee arthroplasty (TKA) with respect to postoperative opioid use, complications, patient-reported outcome measures, and satisfaction.
    Methods: This is a retrospective cohort study of 514 consecutive patients undergoing primary TKA. There were 120 patients (23.3%) who were excluded due to preoperative opioid usage. The remaining 394 patients had a minimum 1-year follow-up. Of those, 133 (34%) were on psychotropic medications preoperatively and were compared to the remaining 261 (66%) patients who were not on psychotropics. Clinical data, satisfaction, Knee Society (KS) scores, Western Ontario McMaster Universities Arthritis Index, Patient-Reported Outcomes Measurement Index Score, Forgotten Joint Scores, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, postoperative opioid medication usage, and complications were compared.
    Results: The study cohort (psychotropic medications) had significantly lower postoperative KS Function, KS Knee, Forgotten Joint Scores, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, Western Ontario McMaster Universities Arthritis Index, and Patient-Reported Outcomes Measurement Index Score compared to the control group. The study group had a lower overall satisfaction score (Likert scale 1 to 5) and a lower percentage of patients either satisfied or very satisfied (4.55 versus 4.79, P < .001; 92.0 versus 97.24%, P = .03, respectively). Postoperative opioid usage was significantly greater in the study group at both 6.4 weeks (range, 4 to 8) and 12-month follow-up (52.76 versus 13.33%, P < .001; 5.51 versus 0.39%, P = .002, respectively). There were no differences in complications and revisions between the groups.
    Conclusions: Patients on psychotropic medications should be educated on the risk of increased opioid consumption, diminished satisfaction, and patient-reported outcome measures following primary TKA. Given the large number of patients on psychotropic medications undergoing TKA, additional studies are needed to further improve clinical outcomes in this group.
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2024.02.037
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2134: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Does Preoperative Opioid Consumption Influence Patient Satisfaction following Total Knee Arthroplasty?

    Smith, Austin F / Smith, Nolan S / Smith, Langan S / Yakkanti, Madhusudhan R / Malkani, Arthur L

    The journal of knee surgery

    2022  Volume 36, Issue 13, Page(s) 1374–1379

    Abstract: Chronic opioid use prior to total knee arthroplasty (TKA) has been implicated in adverse outcomes. The purpose of this study was to evaluate clinical outcome measures and patient satisfaction in patients with a history of preoperative chronic opioid use ... ...

    Abstract Chronic opioid use prior to total knee arthroplasty (TKA) has been implicated in adverse outcomes. The purpose of this study was to evaluate clinical outcome measures and patient satisfaction in patients with a history of preoperative chronic opioid use undergoing primary TKA. A retrospective cohort study was performed on 296 consecutive patients undergoing primary TKA. Seventy-four (25%) patients were identified with chronic preoperative opioid use (study group; 22 males, 52 females). A 3:1 matched cohort ratio of control versus study group was utilized resulting in a control group consisting of 222 patients (97 males, 125 females) without chronic opioid use prior to surgery. There was no statistically significant difference in age, BMI, or follow-up. Average follow-up was 23.4 months in the control group and 23.6 months in the study group (
    MeSH term(s) Male ; Female ; Humans ; Arthroplasty, Replacement, Knee/adverse effects ; Patient Satisfaction ; Analgesics, Opioid/therapeutic use ; Retrospective Studies ; Opioid-Related Disorders ; Knee Joint/surgery ; Osteoarthritis, Knee/surgery ; Treatment Outcome
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2022-09-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2075354-8
    ISSN 1938-2480 ; 1538-8506 ; 0899-7403
    ISSN (online) 1938-2480
    ISSN 1538-8506 ; 0899-7403
    DOI 10.1055/a-1946-6217
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3867: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Results of a Highly Porous Metal-Backed Cementless Patella Implant: A Minimum 5-Year Follow-Up.

    Baker, James F / Smith, Nolan S / Likine, Elive F / Smith, Langan S / Yakkanti, Madhusudhan R / Malkani, Arthur L

    The journal of knee surgery

    2023  Volume 37, Issue 4, Page(s) 267–274

    Abstract: Initial design cementless metal-backed patellar implants failed due to multiple reasons including implant design, use of first-generation polyethylene, and surgical technique. This study evaluates clinical outcomes and survivorship of total knee ... ...

    Abstract Initial design cementless metal-backed patellar implants failed due to multiple reasons including implant design, use of first-generation polyethylene, and surgical technique. This study evaluates clinical outcomes and survivorship of total knee arthroplasty (TKA) using a current generation highly porous metal-backed patellar component. One-hundred twenty-five consecutive primary cementless TKAs with a compression molded highly porous metal-backed patella were reviewed. One-hundred three TKAs (82.4%) with 5-year clinical and radiographic follow-up were available for review. These were matched with 103 consecutive TKAs using a cemented patella of the same implant design. The cementless cohort had a mean age of 65.5 years, body mass index (BMI) of 33.0, and follow-up of 64.4 months. Indications for cementless TKA were based on multiple factors including age, BMI, and bone quality. There were no revisions for loosening or mechanical failure of the cementless patella compared with two cemented patellae revised for aseptic loosening. Eight patients required revisions in the cementless cohort: three for prosthetic joint infection (PJI), two for instability, one periprosthetic femur fracture, one for patella instability, and one for extensor mechanism rupture. Five patients required revisions in the cemented cohort: two for aseptic patellar loosening, one for aseptic femoral loosening, one for PJI, and one for instability. All-cause survivorship at 5 years was 92.2 and 95.1% for the cementless metal-backed implant and cemented implant cohorts, respectively. Use of a compression molded highly porous metal-backed patella component demonstrated excellent clinical and radiographic results at 5-year follow-up. Longer follow-up is required to evaluate the ability of highly porous cementless patella implants to provide durable long-term fixation.
    MeSH term(s) Humans ; Aged ; Patella/diagnostic imaging ; Patella/surgery ; Knee Prosthesis ; Follow-Up Studies ; Porosity ; Arthroplasty, Replacement, Knee/methods ; Metals ; Reoperation ; Prosthesis Design ; Treatment Outcome ; Prosthesis Failure
    Chemical Substances Metals
    Language English
    Publishing date 2023-04-11
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2075354-8
    ISSN 1938-2480 ; 1538-8506 ; 0899-7403
    ISSN (online) 1938-2480
    ISSN 1538-8506 ; 0899-7403
    DOI 10.1055/s-0043-56997
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3867: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Revision Reverse Total Shoulder Arthroplasty for Failed Anatomic Total Shoulder Arthroplasty With Massive Irreparable Rotator Cuff Tear.

    Ganokroj, Phob / Preuss, Fletcher R / Peebles, Annalise M / Smith, Nolan S / Donovan, Madeline / Whalen, Ryan J / Provencher, Matthew T

    Arthroscopy techniques

    2022  Volume 12, Issue 1, Page(s) e25–e31

    Abstract: Anatomic total shoulder arthroplasty (TSA) has become more common as surgical indications have expanded. However, the burden of revision shoulder arthroplasty has inevitably increased as well. Multiple studies have examined the use of reverse total ... ...

    Abstract Anatomic total shoulder arthroplasty (TSA) has become more common as surgical indications have expanded. However, the burden of revision shoulder arthroplasty has inevitably increased as well. Multiple studies have examined the use of reverse total shoulder arthroplasty (rTSA) as a revision option for failed anatomic TSA with a massive irreparable rotator cuff tear. Successful reconstruction of failed TSA with rTSA requires sufficient glenoid bone to place the glenoid segment, enough proximal humeral bone to allow for implantation of the humeral component, and sufficient tension in the soft-tissue envelope to ensure implant stability. In this article, we describe our preferred rTSA revision technique for the treatment of a failed TSA.
    Language English
    Publishing date 2022-12-21
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2022.08.053
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article: Does Preoperative Opioid Consumption Influence Patient Satisfaction following Total Knee Arthroplasty?

    Smith, Austin F. / Smith, Nolan S. / Smith, Langan S. / Yakkanti, Madhusudhan R. / Malkani, Arthur L.

    The Journal of Knee Surgery

    2022  Volume 36, Issue 13, Page(s) 1374–1379

    Abstract: Chronic opioid use prior to total knee arthroplasty (TKA) has been implicated in adverse outcomes. The purpose of this study was to evaluate clinical outcome measures and patient satisfaction in patients with a history of preoperative chronic opioid use ... ...

    Abstract Chronic opioid use prior to total knee arthroplasty (TKA) has been implicated in adverse outcomes. The purpose of this study was to evaluate clinical outcome measures and patient satisfaction in patients with a history of preoperative chronic opioid use undergoing primary TKA. A retrospective cohort study was performed on 296 consecutive patients undergoing primary TKA. Seventy-four (25%) patients were identified with chronic preoperative opioid use (study group; 22 males, 52 females). A 3:1 matched cohort ratio of control versus study group was utilized resulting in a control group consisting of 222 patients (97 males, 125 females) without chronic opioid use prior to surgery. There was no statistically significant difference in age, BMI, or follow-up. Average follow-up was 23.4 months in the control group and 23.6 months in the study group ( p  = 0.87). Clinical data including patient satisfaction (Likert score), Knee Society (KS) Knee scores, KS Function scores, Forgotten Joint Score (FJS), length of stay (LOS), and complications were evaluated. Patient satisfaction at the most recent visit was 92.8% in the control group versus 83.8% in the chronic opioid group ( p  = 0.0016). Differences in patient-reported outcomes measures comparing the control and study cohorts included KS Function Score of 83.23 versus 75.31 ( p  = 0.0034). The FJS of 63.7 versus 58 ( p  = 0.1883) and the KS Knee Score of 89.5 versus 88.1 ( p  = 0.4075) were not significant. Postoperative opioid usage for the control versus the study group was 62/222 (27.9%) versus 56/74 (75.7%) at 4 to 8 weeks ( p <0.0001), and 4/222 (1.80%) versus 27/74 (36.5%) at 12 months ( p <0.0001). Overall complication occurrence was 18.9% in the study group versus 11.3% in the control group ( p  = 0.11). Patients with history of chronic preoperative opioid use had significantly lower patient satisfaction and KS Function scores and increased postoperative opioid usage at 12 months compared with patients without a history of opioid use prior to TKA.
    Keywords primary TKA ; opioid use ; TKA ; patient satisfaction
    Language English
    Publishing date 2022-09-18
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2075354-8
    ISSN 1938-2480 ; 1538-8506 ; 0899-7403
    ISSN (online) 1938-2480
    ISSN 1538-8506 ; 0899-7403
    DOI 10.1055/a-1946-6217
    Database Thieme publisher's database

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    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3867: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article: Results of a Highly Porous Metal-Backed Cementless Patella Implant: A Minimum 5-Year Follow-Up

    Baker, James F. / Smith, Nolan S. / Likine, Elive F. / Smith, Langan S. / Yakkanti, Madhusudhan R. / Malkani, Arthur L.

    The Journal of Knee Surgery

    2023  Volume 37, Issue 04, Page(s) 267–274

    Abstract: Initial design cementless metal-backed patellar implants failed due to multiple reasons including implant design, use of first-generation polyethylene, and surgical technique. This study evaluates clinical outcomes and survivorship of total knee ... ...

    Abstract Initial design cementless metal-backed patellar implants failed due to multiple reasons including implant design, use of first-generation polyethylene, and surgical technique. This study evaluates clinical outcomes and survivorship of total knee arthroplasty (TKA) using a current generation highly porous metal-backed patellar component. One-hundred twenty-five consecutive primary cementless TKAs with a compression molded highly porous metal-backed patella were reviewed. One-hundred three TKAs (82.4%) with 5-year clinical and radiographic follow-up were available for review. These were matched with 103 consecutive TKAs using a cemented patella of the same implant design. The cementless cohort had a mean age of 65.5 years, body mass index (BMI) of 33.0, and follow-up of 64.4 months. Indications for cementless TKA were based on multiple factors including age, BMI, and bone quality. There were no revisions for loosening or mechanical failure of the cementless patella compared with two cemented patellae revised for aseptic loosening. Eight patients required revisions in the cementless cohort: three for prosthetic joint infection (PJI), two for instability, one periprosthetic femur fracture, one for patella instability, and one for extensor mechanism rupture. Five patients required revisions in the cemented cohort: two for aseptic patellar loosening, one for aseptic femoral loosening, one for PJI, and one for instability. All-cause survivorship at 5 years was 92.2 and 95.1% for the cementless metal-backed implant and cemented implant cohorts, respectively. Use of a compression molded highly porous metal-backed patella component demonstrated excellent clinical and radiographic results at 5-year follow-up. Longer follow-up is required to evaluate the ability of highly porous cementless patella implants to provide durable long-term fixation.
    Keywords cementless TKA ; cementless patella ; outcomes ; complications ; survivorship
    Language English
    Publishing date 2023-04-11
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2075354-8
    ISSN 1938-2480 ; 1538-8506 ; 0899-7403
    ISSN (online) 1938-2480
    ISSN 1538-8506 ; 0899-7403
    DOI 10.1055/s-0043-56997
    Database Thieme publisher's database

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3867: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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