Cognitive Dysfunction After Total Knee Arthroplasty

Rodriguez, R; Tellier, Andrée; Grabowski, Jenny; Fazekas, A; Turek, Michelle; Miller, Donald R.; Wherrett, Christopher; Villeneuve, Paul J.; Giachino, A. Alan

doi:10.1016/j.arth.2005.05.004

Cited by 54 publications

(7 citation statements)

References 27 publications

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“…A total of 21 studies assessed depression or anxiety after TJR using a single-sample (TJR) repeated-measures design (pre-and post-surgery assessments; Attal et al, 2014;Badura-Brzoza et al, 2008;Cremeans-Smith et al, 2009;Dahlen, Zimmerman, & Barron, 2006;Davis et al, 2011;Duivenvoorden et al, 2013;Faller, Kirschner, & K€ onig, 2003;Hartley, Vance, Elliott, Cuckler, & Berry, 2008;Lopez-Olivio et al, 2011;McHugh, Campbell, & Luker, 2013;Montin et al, 2007;Papakostidou et al, 2012;Patel, Stygall, Harrington, Newman, & Haddad, 2010;Perez-Prieto et al, 2014;Pinto, McIntyre, Ferrero, Almeida, & Ara ujo-Soares, 2013;Rodriguez et al, 2005;Smith & Zautra, 2004;Stecz & Kocur, 2014b;Swinkels et al, 2009;Utrillas-Compaired, De la Torre-Escuredo, Tebar-Martinez, & Asunsolo-Del Barco, 2014). An additional four studies involved clinical trials where patients were randomly allocated into 'treatment' (experimental) and 'standard care' groups that were assessed pre-and post-surgery (Buker et al, 2014;Lin, 2011;Pellino et al, 2005).…”

Section: Research Designs and Data Preparationmentioning

confidence: 99%

Depression and anxiety after total joint replacement among older adults: a meta-analysis

Scott

Mathias

Kneebone

2015

Aging & Mental Health

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TJR patients appear to have higher rates of clinically significant symptoms of depression before and after surgery, compared to the general population, however more research with adequate control groups is needed to confirm this. Only a modest improvement in the severity of depression and anxiety symptoms was noted post-surgery. However, existing research is limited; preventing definite conclusions regarding the impact of TJR on mood.

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Section: Research Designs and Data Preparationmentioning

confidence: 99%

Depression and anxiety after total joint replacement among older adults: a meta-analysis

Scott

Mathias

Kneebone

2015

Aging & Mental Health

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“…55 Some of these neurological outcomes can be explained by the presence of an intracardiac shunt such as a patent foramen ovale (PFO), which allows for large diameter emboli to bypass the 8–10 mm diameter sieve created by the pulmonary capillaries and enter into the systemic circulation. However, there are a surprisingly large percentage of individuals without a PFO who suffer neurological insults.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary pathways and mechanisms regulating transpulmonary shunting into the general circulation: An update

Lovering

Elliott

Beasley

et al. 2010

Injury

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Embolic insults account for a significant number of neurologic sequelae following many routine surgical procedures. Clearly, these post-intervention embolic events are a serious public health issue as they are potentially life altering. However, the pathway these emboli utilize to bypass the pulmonary microcirculatory sieve in patients without an intracardiac shunt such as an atrial septal defect or patent foramen ovale, remains unclear. In the absence of intracardiac routes and large diameter pulmonary arteriovenous malformations, inducible large diameter intrapulmonary arteriovenous anastomoses in otherwise healthy adult humans may prove to be the best explanation. Our group and others have demonstrated that inducible large diameter intrapulmonary arteriovenous anastomoses are closed at rest but can open during hyperdynamic conditions such as exercise in more than 90% of healthy humans. Furthermore, the patency of these intrapulmonary anastomoses can be modulated through the fraction of inspired oxygen and by body positioning. Of particular clinical interest, there appears to be a strong association between arterial hypoxemia and neurologic insults, suggesting a breach in the filtering ability of the pulmonary microvasculature under these conditions. In this review, we present evidence demonstrating the existence of inducible intrapulmonary arteriovenous anastomoses in healthy humans that are modulated by exercise, oxygen tension and body positioning. Additionally, we identify several clinical conditions associated with both arterial hypoxemia and an increased risk for embolic insults. Finally, we suggest some precautionary measures that should be taken during interventions to keep intrapulmonary arteriovenous anastomoses closed in order to prevent or reduce the incidence of paradoxical embolism.

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“…Symptoms may persist for months 1,2 . Orthopedic and trauma surgery are the noncardiac settings that place patients at the greatest risk 3–5 . The causes of POCD remain unclear and only age seems to be an independent risk factor 3 months after surgery 3,5–9 .…”

mentioning

confidence: 99%

Intraoperative warming and post-operative cognitive dysfunction after total knee replacement

Salazar

Doñate

Boget

et al. 2011

Acta Anaesthesiologica Scandinavica

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Cognitive Dysfunction After Total Knee Arthroplasty

Cited by 54 publications

References 27 publications

Depression and anxiety after total joint replacement among older adults: a meta-analysis

Depression and anxiety after total joint replacement among older adults: a meta-analysis

Pulmonary pathways and mechanisms regulating transpulmonary shunting into the general circulation: An update

Intraoperative warming and post-operative cognitive dysfunction after total knee replacement

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