The Experts below are selected from a list of 8595 Experts worldwide ranked by ideXlab platform

G.f. Milligan - One of the best experts on this subject based on the ideXlab platform.

M. Needoff - One of the best experts on this subject based on the ideXlab platform.

Ashley W Blom - One of the best experts on this subject based on the ideXlab platform.

  • pain and function recovery trajectories following revision Hip Arthroplasty short term changes and comparison with Primary Hip Arthroplasty in the adapt cohort study
    Journal of Bone and Joint Surgery-british Volume, 2017
    Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W Blom
    Abstract:

    Patients report similar or better pain and function before revision Hip Arthroplasty than before Primary Arthroplasty but poorer outcomes after revision surgery. The trajectory of post-operative recovery during the first 12 months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after revision Hip Arthroplasty to 12-months post-operatively and compared them with those observed after Primary Hip Arthroplasty. We conducted a single-centre UK cohort study of patients undergoing Primary (n = 80) or revision (n = 43) Hip Arthroplasty. WOMAC pain and function scores and 20-metres walking time were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of post-operative change (0–3 months and 3–12 months) between the types of surgery. Patients undergoing Primary Arthroplasty had a total Hip replacement (n=74) or Hip resurfacing (n=6). Osteoarthritis was the indication for surgery in 92% of Primary cases. Patients undergoing revision Arthroplasty had revision of a total Hip Arthroplasty (n=37), hemiArthroplasty (n=2) or Hip resurfacing (n=4). The most common indication for revision Arthroplasty was aseptic loosening (n=29); the remaining indications were pain (n=4), aseptic lymphocyte-dominated vasculitis-associated lesion (n=4) or other reasons (n=6). Primary (87%) and revision arthroplasties (98%) were mostly commonly performed via a posterior surgical approach. The improvements in pain and function following revision Arthroplasty occurred within the first 3-months following operation (WOMAC-pain, p 0.05) While the pattern of recovery after revision Arthroplasty was similar to that observed after Primary Arthroplasty, improvements in the first 3-months were smaller after revision compared to Primary Arthroplasty (p Patients undergoing revision Hip Arthroplasty should be informed that the majority of their improvement will occur in the first 3-months following surgery and that the expected improvement will be less marked than that experienced following Primary surgery. More research is now required to 1.) identify whether specific in-patient and post-discharge rehabilitation tailored towards patients undergoing revision Arthroplasty would improve or achieve equivalent outcomes to Primary surgery and 2.) whether patients who are achieving limited improvements at 3-months post-operative would benefit from more intensive rehabilitation. This will become all the more important with the increasing volume of revision surgery and the high expectations of patients who aspire to a disease-free and active life.

  • pain and function recovery trajectories following revision Hip Arthroplasty short term changes and comparison with Primary Hip Arthroplasty in the adapt cohort study
    PLOS ONE, 2016
    Co-Authors: Erik Lenguerrand, Michael R Whitehouse, Vikki Wylde, Rachael Goobermanhill, Ashley W Blom
    Abstract:

    Background and Purpose Patients report similar or better pain and function before revision Hip Arthroplasty than before Primary Arthroplasty but worse results are reported after revision surgery than after Primary surgery. The trajectory of post-operative recovery during the first months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after revision Hip Arthroplasty to 12-months post-operatively and compare them with those observed after Primary Hip Arthroplasty. Methods This study is a prospective cohort study of patients undergoing Primary (n = 80 with 92% for an indication of osteoarthritis) and revision (n = 43) Hip arthroplasties. WOMAC pain and function scores and walking speed were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of change (0–3 months and 3–12 months) between types of surgery. Results The improvements in pain and function following revision Arthroplasty occurred within the first 3-months with no evidence of further change beyond this initial period. While the pattern of recovery was similar to the one observed after Primary Arthroplasty, improvements in the first 3-months were smaller after revision compared to Primary Arthroplasty. Patients listed for revision surgery reported lower pre-operative pain levels but similar post-operative levels compared to those undergoing Primary surgery. At 12-months post-operation patients who underwent a revision Arthroplasty had not reached the same level of function achieved by those who underwent Primary Arthroplasty. Conclusion The post-operative improvements in pain and function are larger following Primary Hip Arthroplasty than following revision Hip Arthroplasty. Irrespectively of surgery type, most of the improvements occur in the first three post-operative months. More research is required to identify whether the recovery following revision surgery could be improved with specific post-operative interventions.

V. Raut - One of the best experts on this subject based on the ideXlab platform.

  • INFECTION IN Primary Hip Arthroplasty AFTER PRIOR STEROID INFILTRATION
    2008
    Co-Authors: R Sreekumar, R Venkiteswaran, V. Raut
    Abstract:

    Introduction: Steroid Infiltration into arthritic joints are a common means of treating pain. They are also sometimes done to differentiate pain in the Hip from the low back or knee. There are recent reports which suggest that the rate of infection in Hip Arthroplasty after injection is higher than in previously uninjected joints. Methods: We performed a retrospective review of the notes of all patients who underwent Hip replacements in Wrightington Hospital under the care of the senior author from 1997 to 2004. We identified all patients who had at least one year follow up after the procedure. The infection rates in the patients who had an injection of steroid into the joint prior to Hip replacement were compared to those who had no such intervention. Results: There were 589 patients who had a Hip replacement in this period. Of these, 72 had a prior injection of steroid into the joint. In the injected group, there was no incidence of infection during the period of follow up. There was one case of infection in a patient who did not have an injection prior to the Arthroplasty. Discussion: Steroid injections are a valuable adjunct in the management of patients with arthritic joints. This review clearly identifies no increased risk of infection in patients who had the injection prior to the operation.

  • Infection in Primary Hip Arthroplasty after previous steroid infiltration.
    International orthopaedics, 2006
    Co-Authors: R Sreekumar, R Venkiteswaran, V. Raut
    Abstract:

    Steroid Infiltration into arthritic joints is a common means of treating pain. It is also sometimes done to differentiate pain in the Hip from that in the low back or knee. We performed a retrospective review of the notes of all patients who had undergone Hip replacements in Wrightington Hospital under the care of the senior author (V.R.) from 1997 to 2004. We identified all patients who had at least 1 year follow up after the procedure. The infection rates in the patients who had received an injection of steroid into the joint prior to Hip replacement and in a matched cohort who had received no such intervention were compared. In the injected group there was no incidence of infection during the period of follow up. There was one case of infection in a patient who had not had an injection prior to the Arthroplasty. There was also a case of superficial infection in a patient who had no steroid infiltration prior to surgery, which responded to antibiotics. Steroid injections are a valuable adjunct in the management of patients with arthritic joints. This review clearly identifies no increased risk of infection in patients who had received the injection prior to the operation.

K. Elsharkawy - One of the best experts on this subject based on the ideXlab platform.

  • EFFECT OF SURGICAL TECHNIQUE ON REDUCING TOTAL COST IN Primary Hip Arthroplasty
    2018
    Co-Authors: Stephen B. Murphy, William Murphy, K. Elsharkawy
    Abstract:

    IntroductionWhile total Hip Arthroplasty is considered to be one of the most cost-effective medical interventions, the total cost of care for a population patients treated by THR can present a significant burden on the payer, whether it be an employer, private insurer or government. Data on the true cost of care has rarely been made available to the treating physician. Such lack of information makes comprehensive management difficult. Bundled payment models of care require knowledge of all costs associated with the care of our patients and opens new opportunity for analysis to improve management and outcomes. The current study assess the influence of surgical technique on total cost of care for total Hip Arthroplasty.MethodsPayment data for 341 patients who underwent total Hip Arthroplasty at a single institution from June 1st, 2011 to October 31st, 2014 were analyzed. Each procedure was performed using either the superior, anterior, or posterior exposure. The superior exposure was performed with femoral ...

  • EFFECT OF SURGICAL TECHNIQUE ON REDUCING TOTAL COST IN Primary Hip Arthroplasty
    Journal of Bone and Joint Surgery-british Volume, 2017
    Co-Authors: Stephen B. Murphy, William Murphy, K. Elsharkawy
    Abstract:

    Introduction While total Hip Arthroplasty is considered to be one of the most cost-effective medical interventions, the total cost of care for a population patients treated by THR can present a significant burden on the payer, whether it be an employer, private insurer or government. Data on the true cost of care has rarely been made available to the treating physician. Such lack of information makes comprehensive management difficult. Bundled payment models of care require knowledge of all costs associated with the care of our patients and opens new opportunity for analysis to improve management and outcomes. The current study assess the influence of surgical technique on total cost of care for total Hip Arthroplasty. Methods Payment data for 341 patients who underwent total Hip Arthroplasty at a single institution from June 1st, 2011 to October 31st, 2014 were analyzed. Each procedure was performed using either the superior, anterior, or posterior exposure. The superior exposure was performed with femoral head excision and without dislocation of the Hip. The data were analyzed for total cost, inpatient cost, inpatient physician cost, readmission cost, skilled nursing facility cost, and home healthcare agency cost among the different approaches. Results The superior Hip approach for total Hip Arthroplasty results in a significant total cost savings over a 90-day episode of care when compared to both the anterior and posterior exposure techniques. It reduced overall costs by approximately $2,000 and $7,000 per case versus the other groups respectively. The superior approach also demonstrated savings in inpatient and skilled nursing facility cost when compared to the other groups. Conclusions Surgical technique can have a profound influence on the total cost of care for Hip Arthroplasty patients. The current study demonstrates that the posterior exposure resulted in the largest consumption of resources post-operatively as measured by total cost of care and that the superior exposure resulted in the least consumption of resources among the three surgical exposures assessed. The study suggests that while we focus on many aspects of improvement in the overall episode of care for our patients, that focus on surgical technique may be worthwhile.