Bankstown Hospital - Grand Rounds - Further Reading

Welcome to the Grand Rounds Further Reading List.

This library guide is to help support you in your professional development.

If you have any questions, please contact the Clinical Library on 9722 8250 or email SWSLHD-BankstownLibrary@health.nsw.gov.

Total Hip Replacement

Balck, F., et al. (2022). "The impact of illness perception on functionality, pain, stiffness, and activity of daily living after total hip replacement surgery." Journal of Psychosomatic Research 155: 110749 https://www.sciencedirect.com/science/article/pii/S0022399922000344 ARTICLE REQUEST FORM

Objective According to the Common Sense Model (CSM), cognitive and emotional representations influence recovery. We used groups of individuals grouping multiple cognitive representations (schemas) to predict the recovery process after total hip arthroplasty (THR). Methods The aim of this prospective cohort study with three collection time points was to examine the significance of these schemas for functionality three and six months after THR. We assessed illness perception with the Illness Perception Questionnaire-Revised and the functionality with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were collected four weeks before (n = 317), three (n = 268), and six months after (n = 292) primary THR. Groups of individuals with the same schemas were identified using a two-step cluster analysis across cognitive representations. Controlling for WOMAC variables (functionality, stiffness, pain, and activities of daily living) before THR, we calculated the regression of schemas and emotional representations before THR on WOMAC variables after THR. Results Before THR, two cognitive schemes were found: Schema One: medium identity, long duration, many consequences, low personal and treatment control, and low coherence; Schema Two: low identity, short timeline, low consequences, and high personal and treatment control. Patients with Schema Two had better functionality and lower pain and stiffness three months after surgery compared to those with Schema One. After three months, the influence of cognitive schemas was stronger on functionality than that of emotional representation (f2: 0.04 /0.02). Conclusion Further study is needed to determine whether a psychological intervention can change Schema One.

Bistolfi, A., et al. (2021). "Ultra-high molecular weight polyethylene (UHMWPE) for hip and knee arthroplasty: The present and the future." Journal of Orthopaedics 25: 98-106 https://www.sciencedirect.com/science/article/pii/S0972978X21001057 ARTICLE REQUEST FORM

Purpose to review advances and clinical performance of polyethylene in total joint arthroplasty, summing up historical problems and focusing on the latest innovations. Methods search for medical grade Ultra-High-Molecular-Weight-Polyethylene (UHMWPE); Data Sources: PubMed, Scopus, Cochrane Library. Results the increasing number of joint arthroplasties and high-activity patients led to progressive developments of bearing surfaces to improve performance and durability. Different strategies such as crosslinking UHMWPE (HXLPE) and the addition of vitamin-E (HXLPE) have been tested to improve wear and oxidation resistance. Conclusion Recent innovations about UHMWPE showed improvements either for hip and knee, with the potential of long-term survivorship.

Blakeney, W. G. and M. Kuster (2023). "Advances in Hip Replacement Surgery." Journal of Clinical Medicine 12(10): 3439 https://www.mdpi.com/2077-0383/12/10/3439  PDF @ Link

Purpose: to review advances and clinical performance of polyethylene in total joint arthroplasty, summing up historical problems and focusing on the latest innovations.

Methods: search for medical grade Ultra-High-Molecular-Weight-Polyethylene (UHMWPE); Data Sources: PubMed, Scopus, Cochrane Library.

Results: the increasing number of joint arthroplasties and high-activity patients led to progressive developments of bearing surfaces to improve performance and durability. Different strategies such as crosslinking UHMWPE (HXLPE) and the addition of vitamin-E (HXLPE) have been tested to improve wear and oxidation resistance.

Conclusion: Recent innovations about UHMWPE showed improvements either for hip and knee, with the potential of long-term survivorship.

Cetinkaya Eren, O., et al. (2022). "The effect of video-assisted discharge education after total hip replacement surgery: a randomized controlled study." Scientific Reports 12(1): 3067 https://doi.org/10.1038/s41598-022-07146-y  PDF @ Link

This study aimed to investigate the effect of a video-assisted discharge education program on activities of daily living, functionality, and patient satisfaction following total hip replacement (THR) surgery. This study included 31 patients who were randomly divided into the physiotherapy group (n = 18), and the video-assisted discharge education (VADE) group (n = 13). Both groups received a physiotherapy program. The VADE group was also received the VADE program. Face-to-face instruction was used in all of the educational programs. There was a significant difference in favor of the VADE group in Harris Hip Score, Nottingham Extended Activities of Daily Living Scale’s movement score, Tampa Scale of Kinesiophobia, Patient Satisfaction Questionnaire (p < 0.05). There was a significant difference between groups on resting pain levels in the first week and on resting and activity pain levels in the third month in favor of the VADE group (p < 0.05). The results of this study demonstrated that VADE can be effective in improving patient satisfaction and functionality, reducing pain and kinesiophobia following THR.

Günther, K. P., et al. (2021). "Total Hip Replacement for Osteoarthritis-Evidence-Based and Patient-Oriented Indications." Dtsch Arztebl Int 118(43): 730-736 https://pmc.ncbi.nlm.nih.gov/articles/PMC8820083/  PDF @ Link

BACKGROUND: Total Hip Replacement (THR) belongs to the most common inpatient operations in Germany, with over 240 000 procedures performed per year. 90% of the artificial joints are still functional at 15 years, and up to 60% at 20 years after surgery. It is essential that the indications for such procedures should be uniform, appropriate, and patient-oriented. METHODS: This review is based on publications retrieved by a systematic literature search for national and international guidelines and systematic reviews on the topic of hip osteoarthritis and THR. RESULTS: THR should be performed solely with radiologically demonstrated advanced osteoarthritis of the hip (Kellgren and Lawrence grade 3 or 4), after at least three months of conservative treatment, and in the presence of high subjective distress due to symptoms arising from the affected hip joint. Contraindications include refractory infection, acute or chronic accompanying illnesses, and BMI ≥= 40 kg/m2. Patients should stop smoking at least one month before surgery. In patients with diabetes mellitus, preoperative glycemic control to an HbA1c value below 8% is advisable. It is recommended that patients should lower their weight below a BMI of 30 kg/m2. CONCLUSION: The decision to perform THR should be taken together by both the physician and the patient when the expected treatment benefit outweighs the risks. Evidence suggests that a worse preoperative condition is associated with a poorer surgical outcome.

Morrell, A. T., et al. (2021). "Enhanced Recovery After Primary Total Hip and Knee Arthroplasty: A Systematic Review." JBJS 103(20): 1938-1947 https://journals.lww.com/jbjsjournal/fulltext/2021/10200/enhanced_recovery_after_primary_total_hip_and_knee.9.aspx ARTICLE REQUEST FORM

Background: Enhanced Recovery After Surgery (ERAS) has become increasingly implemented to reduce costs, to increase efficiency, and to optimize patient outcomes after a surgical procedure. This study aimed to systematically review the effect of ERAS after primary elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) on hospital length of stay, total procedure-related morbidity, and readmission. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and with guidance from the Cochrane Handbook for Systematic Reviews of Interventions. MEDLINE, Embase, and Cochrane databases were searched from inception (1946 for MEDLINE and 1974 for Embase; Cochrane is a composite of multiple databases and thus does not report a standard inception date) until January 15, 2020. Prospective nonrandomized cohort studies and randomized controlled trials comparing adult patients undergoing elective primary THA or TKA with ERAS or traditional protocols were included. Articles examining outpatient, nonelective, or revision surgical procedures were excluded. Two reviewers independently assessed the risk of bias and extracted data. The primary outcome was length of stay. The secondary outcomes included total procedure-related morbidity and readmission. Results: Of the 1,018 references identified (1,017 identified through an electronic search and 1 identified through a manual search), 9 individual studies met inclusion criteria. Data were reported from 7,789 participants, with 2,428 receiving ERAS and 5,361 receiving traditional care. Narrative synthesis was performed instead of meta-analysis, given the presence of moderate to high risk of bias, wide variation of ERAS interventions, and inconsistent methods for assessing and reporting outcomes among included studies. Adherence to ERAS protocols consistently reduced hospital length of stay. Few studies demonstrated reduced total procedure-related morbidity, and there was no significant effect on readmission rates. Conclusions: ERAS likely reduced the length of stay after primary elective THA and TKA, with a more pronounced effect in selected healthier patient populations. We found minimal to no impact on perioperative morbidity or readmission. The quality of existing evidence was limited because of study heterogeneity and a significant risk of bias. Further high-quality research is needed to definitively assess the impact of ERAS on total joint arthroplasty. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Ursavaş, F. E. and Y. U. Yaradılmış (2021). "Relationship Between Pain Beliefs and Postoperative Pain Outcomes After Total Knee and Hip Replacement Surgery." Journal of PeriAnesthesia Nursing 36(2): 187-193 https://www.sciencedirect.com/science/article/pii/S1089947220303117 ARTICLE REQUEST FORM

Purpose The aim of this study was to investigate the relationship between pain beliefs and postoperative pain outcomes in patients who underwent total knee replacement or total hip replacement. Design This was a descriptive, prospective, and cross-sectional study. Methods The study population included all patients who met the sampling criteria and agreed to participate in the study between April 2019 and January 2020 (N = 91). Data were collected using a sociodemographic and clinical characteristics form, the Pain Beliefs Questionnaire (PBQ), and the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR). Sociodemographic and clinical data and PBQ scores were obtained preoperatively, and the APS-POQ-R-TR was applied 24 hours after surgery. Findings In the first 24 hours, the mean lowest pain level was 2.96 ± 2.29; mean highest pain level was 8.05 ± 2.66. In the evaluation of the relationships between patients' sociodemographic characteristics and mean PBQ organic and psychological beliefs scores, statistically significant differences were observed according to income and education level. Mean PBQ organic and psychological beliefs scores were not significantly associated with APS-POQ-R-TR total scores or subscale scores for pain severity, activity interference, sleep interference, and perception of care; affective effect of pain; or adverse effects of pain treatment. Conclusions The results of our study indicate that education level and socioeconomic status were associated with patients' pain beliefs, but we observed no relationship between pain beliefs and perceived pain outcomes.

Wixted, C. M., et al. (2021). "Three-dimensional Printing in Orthopaedic Surgery: Current Applications and Future Developments." JAAOS Global Research & Reviews 5(4): e20.00230-00211 https://journals.lww.com/jaaosglobal/fulltext/2021/04000/three_dimensional_printing_in_orthopaedic_surgery_.8.aspx  PDF @ Link

Three-dimensional (3D) printing is an exciting form of manufacturing technology that has transformed the way we can treat various medical pathologies. Also known as additive manufacturing, 3D printing fuses materials together in a layer-by-layer fashion to construct a final 3D product. This technology allows flexibility in the design process and enables efficient production of both off-the-shelf and personalized medical products that accommodate patient needs better than traditional manufacturing processes. In the field of orthopaedic surgery, 3D printing implants and instrumentation can be used to address a variety of pathologies that would otherwise be challenging to manage with products made from traditional subtractive manufacturing. Furthermore, 3D bioprinting has significantly impacted bone and cartilage restoration procedures and has the potential to completely transform how we treat patients with debilitating musculoskeletal injuries. Although costs can be high, as technology advances, the economics of 3D printing will improve, especially as the benefits of this technology have clearly been demonstrated in both orthopaedic surgery and medicine as a whole. This review outlines the basics of 3D printing technology and its current applications in orthopaedic surgery and ends with a brief summary of 3D bioprinting and its potential future impact.