Challenges to Implementing Total Joint Replacement Programs in Developing Countries

In this review article, the authors present the many challenges that orthopedic surgeons in developing countries face when implementing arthroplasty programs. The issues of cost, sterility, and patient demographics are specifically addressed. Despite the many challenges, developing countries are beginning to offer hip and knee reconstructive surgery to respond to the increasing demand for such elective operations as the prevalence of osteoarthritis continues to increase. The authors shed light on these nascent arthroplasty programs.
Source: Orthopedic Clinics of North America - Category: Orthopaedics Authors: Source Type: research

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ConclusionWhile these practices were implemented because of sound biologic plausibility or encouraging observational data, well-done RCTs have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high quality evidence demonstrating efficacy.
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research
This study evaluated self-reported knee pain (KP) and its effect on physical performance during military service in the Estonian Defense Forces. MATERIAL AND METHODS: Ninety-five male conscripts aged 19-25 years were divided into two study groups based on the occurrence of KP or not. Self-reported KP and function according to the Knee Injury and Osteoarthritis Outcome Score (KOOS) were measured. Physical fitness level was scored using the Army Physical Fitness Test (APFT). KOOS and APFT were measured in the beginning and at the end of the 6-month period of military service. RESULTS: Significant differences in ...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Test your medicine knowledge with the  MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman undergoes perioperative evaluation. She has osteoarthritis of the right hip since sustaining injuries in a motor vehicle accident 15 years ago and is scheduled for elective hip arthroplasty in the next fe w months. Medical history is otherwise notable […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Oncology/Hematology Orthopedics Source Type: blogs
We report a novel technique of modified dorsal intercarpal ligament (DICL) capsulodesis for the treatment of SL dissociation. The surgical indication for this procedure is complete SL ligament tear with a reducible carpal malalignment and no secondary osteoarthritis. This procedure is indicated when the remnant of torn ligament in the dorsal SL interosseous space is available for repair. First, carpal malalignment is corrected and the scaphoid and the lunate are temporarily fixed with a transosseous screw or Kirschner wires. Using a dorsal approach, the DICL is then exposed, which originates from the triquetrum and attache...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Technique Source Type: research
Introduction: Both overweight and obesity are major risk factors of development and progression of hip and knee osteoarthritis (OA) and increased risk of mobility limitation after total hip replacement (THR) and total knee replacement (TKR).
Source: Nutrition, Metabolism, and Cardiovascular Diseases : NMCD - Category: Nutrition Authors: Source Type: research
This study aimed to identify clinical phenotypes based on clinical prognostic factors in patients with secondary hip OA using data from prospective cohort studies and to define the clinical features of each phenotype.MethodsFifty patients participated. Two-step cluster analysis was performed to identify the phenotypes using the following potential prognostic factors for hip OA progression: spinal inclination in standing, thoracolumbar spine mobility, daily cumulative hip moment, and minimum joint space width (JSW) at baseline. Comprehensive basic and clinical features (age, body mass index, hip pain, Harris hip score, JSW,...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
AbstractObjectiveThe study was aimed to compare the impact of thumb base osteoarthritis (TBOA) on pain, function, and quality of life in patients with erosive or non-erosive hand osteoarthritis (HOA).MethodsThis observational retrospective study included 232 patients: 64 with erosive HOA (EHOA) and concomitant TBOA, 36 with isolated EHOA, 97 with non-erosive HOA (non-EHOA) and TBOA, and 35 with isolated non-EHOA. Hand pain by a visual analogue scale (VAS), Functional Index for Hand Osteoarthritis (FIHOA) score, Health Assessment Questionnaire (HAQ), the Medical Outcomes Study 36-Item Short Form (SF-36), and the possible co...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Ankylosing spondylitis (AS) is a seronegative inflammatory disease that progressively affects the spine and sacroiliac joints and is more common in men with the B 27 human leucocyte antigen. This leads to inflammation, synovitis and, eventually, secondary arthritis in the hips of those affected. Hips of those affected are often completely ankylosed at time of presentation to the orthopedic surgeon. Total hip arthroplasty offers a stable mobile hip for patients who are functionally disabled due to their debilitating disease. As disease progresses, the native hip anatomy, which is familiar to orthopedic surgeon in routine to...
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Publication date: April 2020Source: Journal of Functional Foods, Volume 67Author(s): Nurhan UnusanAbstractGrape seeds are rich sources of proanthocyanidins, which comprise polyhydroxyflavan oligomers or polymers. The beneficial health properties of grape seed proanthocyanidins are attributed to their conjugated and colonic metabolites. There is potential for a two-way relationship between the gut microbiota and grape seed proanthocyanidin. In particular, numerous in vitro and in vivo studies have demonstrated that grape seed proanthocyanidins appear to exert pharmacological effects. These include anti-oxidant, anti-microbi...
Source: Journal of Functional Foods - Category: Nutrition Source Type: research
ENGLEWOOD, Colo., Feb. 21, 2020 -- (Healthcare Sales &Marketing Network) -- Ampio Pharmaceuticals, Inc. (NYSE American: AMPE) a development stage biopharmaceutical company, executing a Special Protocol Assessment ("SPA") Phase III clinical tria... Biopharmaceuticals, Orthopaedic Ampio Pharmaceuticals, Ampion, osteoarthritis
Source: HSMN NewsFeed - Category: Pharmaceuticals Source Type: news
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