Soft Tissue Coverage of Complex Periprosthetic Defects in Patients With Total Knee Arthroplasty: Analysis of Factors That Influence Reconstructive and Functional Outcomes. (Record no. 3726)

MARC details
000 -LEADER
fixed length control field 03749nam a22003977a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 180928s20182018 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1044-7946
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code WNDS20180730-1 [pii]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 30212373
245 ## - TITLE STATEMENT
Title Soft Tissue Coverage of Complex Periprosthetic Defects in Patients With Total Knee Arthroplasty: Analysis of Factors That Influence Reconstructive and Functional Outcomes.
251 ## - Source
Source Wounds-A Compendium of Clinical Research & Practice. 2018 Jul 30
252 ## - Abbreviated Source
Abbreviated source WOUNDS. 2018 Jul 30
253 ## - Journal Name
Journal name Wounds : a compendium of clinical research and practice
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2018
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2019
265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE]
Publication status aheadofprint
266 ## - Date added to catalog
Date added to catalog 2018-09-28
520 ## - SUMMARY, ETC.
Abstract CONCLUSIONS: Early intervention with limited-frequency, and thorough debridement and prompt soft tissue coverage optimizes the chances of functional limb salvage in patients with complex periprosthetic TKA wounds. These findings may inform practice patterns and surgical treatment of patients presenting with compromised TKA and suggest that early involvement by reconstructive surgeons should be advocated to optimize reconstructive and functional outcomes in this difficult patient population.
520 ## - SUMMARY, ETC.
Abstract INTRODUCTION: Wound breakdown following total knee arthroplasty (TKA) increases the risk of device exposure, infection, and major amputation. Although a variety of options to facilitate coverage of compromised knee joint prostheses exist, the relative safety, efficacy, and functional impact of each has not been determined.
520 ## - SUMMARY, ETC.
Abstract MATERIALS AND METHODS: A 5-year retrospective review of outcomes following surgical management of TKA wounds was undertaken. Data pertaining to the timing of presentation, type and frequency of operative interventions, rates of implant/limb salvage, ambulatory status, visual analogue scores (VAS) for pain, and complications were collected.
520 ## - SUMMARY, ETC.
Abstract OBJECTIVE: This study aims to identify those perioperative factors that influence reconstructive and functional outcomes in patients with periprosthetic TKA defects.
520 ## - SUMMARY, ETC.
Abstract RESULTS: Thirty patients were identified during the study period with a mean follow-up of 20 months. Rates of limb salvage (66.7% vs. 91.7% vs. 75% vs. 0%, P < .001) and postoperative ambulation (100% vs. 83.3% vs. 75% vs. 54.5%, P = .036) were significantly different between patients who underwent primary closure, local muscle flap coverage, free tissue transfer coverage, and above-the-knee amputation, respectively. The number of debridements prior to definitive closure did not significantly influence rates of limb salvage (P = .21). Active tobacco use (odds ratio [OR], 4; 95% confidence interval [CI], 1.13-14.2; P = .03) and time to initial presentation from the index joint replacement (OR, 0.99; 95% CI, 0.9-1.0; P = .04) adversely impacted device salvage. Both of these factors similarly influenced the overall likelihood of limb salvage (OR, 6.5; 95% CI, 1.5-28.8; P = .01; OR, 0.99; 95% CI, 0.99-1.0; P = .04). The VAS scores were not significantly different between index closure types (P = .77) but were significantly lower for patients who required < 10 debridements prior to definitive closure (P = .02).
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element IN PROCESS -- NOT YET INDEXED
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Washington Hospital Center
656 ## - INDEX TERM--OCCUPATION
Department Surgery/Plastic Surgery
657 ## - INDEX TERM--FUNCTION
Medline publication type Journal Article
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Anghel, Ersilia
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Local Authors DeFazio, Michael V
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Local Authors Economides, James M
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Hung, Rex
700 ## - ADDED ENTRY--PERSONAL NAME
Local Authors Lakhiani, Chrisovalantis
790 ## - Authors
All authors Anghel EL, Attinger CE, Cinque M, DeFazio MV, Economides JM, Evans KK, Golshani K, Hung R, Lakhiani C
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 09/28/2018   30212373 30212373 09/28/2018 09/28/2018 Journal Article

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