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Risk Factors for Increased Hospital Cost for Primary Total Hip Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-03-14 Hemant P. Reddy MD, Michael Biskup BS, Jonathan Rubin BS, Yungtai Lo Phd, Zeynep Seref-Ferlengez PhD, Eli Kamara MD
Patient medical complexity increases the cost of primary total hip arthroplasty (THA). The goal of this study was to quantify the impact of specific medical comorbidities on the real hospital cost of primary THA. This study consisted of a retrospective analysis of 1,222 patient encounters for Current Procedural Terminology (CPT) code 27130 (primary THA) between January 2017 and March 2020 at a high-volume
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Social Determinants of Health in Total Joint Arthroplasty: Education J. Arthroplasty (IF 3.5) Pub Date : 2024-03-13 Jeremy Dubin BA, Sandeep Bains MD MBA DC, Ugonna N. Ihekweazu MD, Michael Mont MD, Ronald Delanois MD
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Use and Application of Large Language Models for Patient Questions following Total Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-03-13 Sandeep S. Bains MD DC MBA, Jeremy A. Dubin BA, Daniel Hameed MD, Oliver C. Sax DO, Scott Douglas MD, Michael Mont MD, James Nace DO MPT, Ronald E. Delanois MD
A consumer-focused health care model not only allows unprecedented access to information, but equally warrants consideration of the appropriateness of providing accurate patient health information. Nurses play a large role in influencing patient satisfaction following total knee arthroplasty (TKA), but they come at a cost. A specific natural language artificial intelligence (AI) model, ChatGPT (Generative
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Differences in Diagnostic Sensitivity of Cultures Between Sample Types in Periprosthetic Joint Infections: A Systematic Review and Meta-Analysis J. Arthroplasty (IF 3.5) Pub Date : 2024-03-13 Shintaro Watanabe MD PhD, Emi Kamono, Hyonmin Choe MD PhD, Hiroyuki Ike MD PhD, Yutaka Inaba MD PhD, Naomi Kobayashi MD PhD
Differences between the bacterial culture results of the preoperative fluid, intraoperative tissue, and sonication fluid of implants in the diagnosis of periprosthetic joint infection (PJI) are important issues in clinical practice. This study aimed to identify the differences in pooled diagnostic accuracy between culture sample types for diagnosing PJI by performing a systematic review and meta-analysis
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The Orthopaedic Device Infection Network (ODIN): Building an Evidence Base for the Treatment of Periprosthetic Joint Infection through International Collaboration J. Arthroplasty (IF 3.5) Pub Date : 2024-03-13 Elise R. Naufal BA(Hons), Marjan Wouthuyzen-Bakker MD PhD, Alex Soriano MD, Simon W. Young MBChB PhD FRACS, Carlos A. Higuera-Rueda MD, Jesse E. Otero MD PhD, Yale A. Fillingham MD, Thomas K. Fehring MD, Bryan D. Springer MD, Cade Shadbolt MA, Mei Lin Tay PhD, Craig Aboltins DMedSc FRACP, Jarrad Stevens MBBS ChM, Jonathan Darby MBBS, Yves S. Poy Lorenzo Bpharm Mbiostat, Peter F.M. Choong MBBS MD, Michelle
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The Frank Stinchfield Award: Assembly and Dissociation Forces Differ Between Commonly Used Dual Mobility Implants: A Biomechanical Study J. Arthroplasty (IF 3.5) Pub Date : 2024-03-12 Katherine E. Mallett M.D, Sergio F. Guarin-Perez M.D, Alexander W. Hooke M.S, Allison Tanner B.S, Joshua Bland M.S, James S. Fitzsimmons M.S, Michael J. Taunton M.D, Rafael J. Sierra M.D
Intra-prosthetic dissociation (IPD) is a complication unique to dual mobility (DM) implants where the outer polyethylene head dissociates from the inner femoral head. Increasing reports of IPD at the time of closed reduction of large head DM dislocations prompted this biomechanical study evaluating the assembly and dissociation forces of DM heads. We tested 17 polyethylene DM heads from five vendors
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The American Association of Hip and Knee Surgeons Adult Reconstruction Fellowship Recognition Initiative: It’s About Time J. Arthroplasty (IF 3.5) Pub Date : 2024-03-11 William G. Hamilton MD, Michael A. Mont MD, Giles R. Scuderi MD
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Reply to Letter to the Editor on “Efficacy of Anterior Quadratus Lumborum Block and Pain After Total Hip Arthroplasty: A Randomized Controlled Trial” J. Arthroplasty (IF 3.5) Pub Date : 2024-03-11 Yu Takeda MD, Kazuyuki Tsujimoto MD, Teru Okamoto MD, Takuya Nakai MD, Shigeo Fukunishi MD, Toshiya Tachibana MD PhD
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Comparing Analgesic Efficacy of Different Regional Blocks After Total Hip Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-03-11 Nong He MD, Fu S. Xue MD, Cheng W. Li MD
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Response to Letter to the Editor J. Arthroplasty (IF 3.5) Pub Date : 2024-03-11 Michael J. DeFrance DO, Giles R. Scuderi MD
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Letter to the Editor in Response to “Are 20% of Patients Actually Dissatisfied Following Total Knee Arthroplasty? A Systematic Review of the Literature” J. Arthroplasty (IF 3.5) Pub Date : 2024-03-11 Abdul K. Zalikha MD
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The Association Between Oral Bone Mineral Density-Reducing Medications and the Risk of 2-Year Implant-Related Complications Following Total Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-03-10 Emile-Victor Kuyl BS, Philip M. Parel BS, Amil R. Agarwal BA, Alex Gu MD, Andrew B. Harris MD, Sandesh Rao MD, Gregory J. Golladay MD, Savyasachi C. Thakkar MD
Certain medications interfere with the bone remodeling process and may potentially increase the risk of complications after total knee arthroplasty (TKA). As patients undergoing TKA may be taking these bone mineral density (BMD)-reducing medications, it is unclear as to whether and which medications impact TKA outcomes. Therefore, the purpose of this study was to observe the impact of various BMD-reducing
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The Evolution of Revision Hip Arthroplasty and Impact on the Trainee’s Experience J. Arthroplasty (IF 3.5) Pub Date : 2024-03-10 Stefano Muscatelli MD, Alexander V. Strait, Henry Ho MS, John R. Dunn, Robert H. Hopper Jr. PhD, Kevin B. Fricka MD, William G. Hamilton MD
Advances in total hip arthroplasty (THA) have resulted in evolving revision indications and intraoperative techniques, which can influence the exposure of trainees to complex cases. We report three decades of revision experience from a tertiary referral center that trains fellows, comparing the reasons for revision and the complexity of revisions over time. We retrospectively reviewed all revision
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Outcomes Following Total Hip Arthroplasty in Patients Who Have Von Willebrand Disease Depend on Postoperative Anticoagulation J. Arthroplasty (IF 3.5) Pub Date : 2024-03-08 Will Jiang BS, Joshua Sanchez BA, Meera M. Dhodapkar BA, Zachary J. Radford MD, Lee E. Rubin MD, Jonathan N. Grauer MD
Von Willebrand disease (VWD) is the most common congenital bleeding disorder. This autosomal dominant condition arises from quantitative or qualitative defects of Von Willebrand factor. To our knowledge, this study leveraged a national database to characterize the largest VWD cohort of total hip arthroplasty (THA) patients to date, assessing 90-day postoperative adverse events and 5-year revision-free
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Goals of Care Discussions in Orthopaedic Surgery: Geriatric Hip Fractures J. Arthroplasty (IF 3.5) Pub Date : 2024-03-08 Brienne Paradis B.S., Brandon Klein D.O. M.B.A., Lucas E. Bartlett D.O., Randy M. Cohn M.D., Adam D. Bitterman D.O.
Due to the severity of hip fracture complications in the geriatric population, including major morbidity and mortality, it is crucial to establish treatment goals and manage expectations as a patient-centered multidisciplinary team. Goals of care (GOC) are personalized treatment programs designed to align with the individual patient’s values and preferences. There is a paucity of literature on the
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Intraosseous Versus Intravenous Vancomycin in Tourniquetless Primary Total Knee Arthroplasty: A Randomized Trial J. Arthroplasty (IF 3.5) Pub Date : 2024-03-08 Austin E. Wininger MD, Pradyumna Gurusamy MD, Thomas C. Sullivan, Stefano Serpelloni PhD, Francesca Taraballi PhD, Kwan J. Park MD, Timothy S. Brown MD
Intraosseous (IO) administration of vancomycin at the time of total knee arthroplasty (TKA) has been shown to be safer and more effective than intravenous (IV) administration at preventing early periprosthetic joint infection. Previous studies have relied on tourniquet inflation to enhance local tissue concentrations and mitigate systemic release. A single-blinded, randomized clinical trial was performed
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Total Hip Arthroplasty in Human Immunodeficiency Virus Positive Patients: A Systematic Review of Outcomes J. Arthroplasty (IF 3.5) Pub Date : 2024-03-06 Alexandra Baker Lutz, Deepak V. Patel, Christopher Bibbo, Ian S. Hong, Daniel Hameed, Jeremy Dubin, Michael A. Mont
Total hip arthroplasty (THA) has become a common intervention for Human Immunodeficiency Virus (HIV)-positive patients who have osteonecrosis of the femoral head. This paper provides a systematic review to assess survivorships, patient-reported outcomes (PROMs), infection rates, other complications, and immune competence for patients who had THAs who did and did not have HIV. A comprehensive and systematic
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Finding the Optimal Screening Test for Periprosthetic Joint Infection: A Prospective Study J. Arthroplasty (IF 3.5) Pub Date : 2024-03-06 Saad Tarabichi MD, Juan D. Lizcano MD, Elizabeth A. Abe BS, Graham S. Goh MD, Colin M. Baker DO MBA, Javad Parvizi MD
No single test has demonstrated absolute accuracy in the diagnosis of periprosthetic joint infection (PJI). Serological markers are often used as screening tools to avoid unnecessary joint aspiration in cases with a low probability of infection. This study aimed to determine the utility of standard-of-care serological tests as a screening tool for PJI in patients undergoing revision arthroplasty. This
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Surgery Within 24 Hours Reduces Mortality and General Complication Rates in Patients Who Have Periprosthetic Femoral Fractures at the Hip J. Arthroplasty (IF 3.5) Pub Date : 2024-03-02 Christian Wulbrand, Bernd Füchtmeier, Markus Weber, Christoph Eckstein, Alexander Hanke, Franz Müller
In patients who have hip fractures, treatment within 24 hours reduces mortality and complication rates. A similar relationship can be assumed for patients who have hip periprosthetic fractures (PPF) owing to the similar baseline characteristics of the patient populations. This monocentric retrospective study aimed to compare the complication and mortality rates in patients who had hip PPF treated within
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Decreased Patellar Fractures and Subluxation with Patellar Component Replacement at Stage-One Spacer J. Arthroplasty (IF 3.5) Pub Date : 2024-03-01 Joshua P. Rainey MD, Brenna E. Blackburn PhD, Zachary Moore, Michael J. Archibeck MD, Christopher E. Pelt MD, Lucas A. Anderson MD, Jeremy M. Gililland MD
Periprosthetic joint infection (PJI) is a devastating complication of total knee arthroplasty (TKA) and is often treated with two-stage revision. We retrospectively assessed whether replacing the patellar component with articulating stage-one spacers was associated with improved outcomes compared to spacers without patellar component replacement. A total of 139 patients from a single academic institution
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AAHKS Clinical Research Award: Extended Postoperative Oral Tranexamic Acid in Total Knee Arthroplasty: A Randomized Controlled Pilot Study J. Arthroplasty (IF 3.5) Pub Date : 2024-02-29 Mateo J. Kirwan, Zachary R. Diltz, Derek T. Dixon, Carlos A. Rivera-Peraza, Christal J. Gammage, Willliam M. Mihalko, James W. Harkess, James L. Guyton, John R. Crockarell, Marcus C. Ford
Perioperative tranexamic acid (TXA) use with total knee arthroplasty (TKA) is widely accepted today. Recently, a few international groups have published on the safety and outcomes of extending TXA use in the postoperative period. Through a double-blinded, randomized control trial, we aimed to investigate the safety and clinical efficacy of extended postoperative oral TXA use in TKA performed in an
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Synovial Calprotectin is Superior to Synovial Leukocyte Count in Excluding Chronic Periprosthetic Joint Infections, a Retrospective Cohort Study. J. Arthroplasty (IF 3.5) Pub Date : 2024-02-29 Mohammed F. Alkadhem, Harmen Ettema, Lucie M.F. Wagenmakers-Huizenga, Joris J.W. Ploegmakers, Anneke C. Muller Kobold, Marjan Wouthuyzen-Bakker, Pieter B.A.A. van Driel
Synovial calprotectin is a promising biomarker for diagnosing chronic periprosthetic joint infections (PJI), but its diagnostic value has not been directly compared to synovial leukocyte count and polymorphonuclear neutrophils (PMNs). This study aimed to: 1) evaluate and compare the diagnostic accuracy between these markers in patients undergoing revision arthroplasty for chronic PJI or aseptic reasons;
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Continuation of Oral Anti-Diabetic Medications Was Associated With Better Early Post-Operative Blood Glucose Control Compared to Sliding Scale Insulin After Total Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Justin Leal, Samuel S. Wellman, William A. Jiranek, Thorsten M. Seyler, Michael P. Bolognesi, Sean P. Ryan
This study evaluated blood glucose (BG), creatinine levels, metabolic issues, length of stay (LOS), and early post-operative complications in diabetic primary total knee arthroplasty (TKA) patients. It examined those who continued home oral anti-diabetic medications and those who switched to insulin post-operatively. The hypothesis was that continuing home medications would lead to lower BG levels
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Obesity Severity Does Not Associate with Rate, Timing, or Invasiveness of Early Reinterventions After Total Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Daniel A. Driscoll, Jacqueline Grubel, Justin Ong, Yu-Fen Chiu, Lisa A. Mandl, Fred Cushner, Michael L. Parks, Alejandro Gonzalez Della Valle
The use of body mass index (BMI) cut-off values has been suggested for proceeding with total knee arthroplasty (TKA) in obese patients. However, the relationship between obesity severity and early reoperations after TKA is poorly defined. This study evaluated whether increased World Health Organization (WHO) Obesity Class was associated with risk, severity, and timing of reintervention within one year
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Mode of fixation and Survivorship in Primary Total Knee Arthroplasty in the American Joint Replacement Registry J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 David P. Martin, David Rossi, Brett R. Bukowski, Olivia Sterling, Kyle Mullen, David Hennessy, Brian Nickel, Richard Illgen
A recent rapid increase in cementless total knee arthroplasty (TKA) has been noted in the American Joint Replacement Registry (AJRR). The purpose of our study is to compare TKA survivorship based on the mode of fixation reported to the AJRR in the Medicare population. Primary TKAs from Medicare patients submitted to AJRR from 2012 to 2022 were analyzed. The Medicare and AJRR databases were merged.
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The Impact of Obesity on Total Hip Arthroplasty Outcomes when Performed by High Volume Surgeons – A Propensity Matched Analysis from a High-Volume Urban Center J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Itay Ashkenazi, Jeremiah Thomas, Kyle W. Lawrence, Morteza Meftah, Joshua C. Rozell, Ran Schwarzkopf
Previous data suggest that obesity does not impact surgical outcomes following total knee arthroplasty performed by high-volume (HV) surgeons. However, this effect has yet to be studied in total hip arthroplasty (THA) patients. This study aimed to evaluate the impact of patient obesity on THA outcomes when surgery is performed by HV surgeons. A retrospective analysis of patients who underwent primary
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The Financial Burden of Patient Comorbidities on Total Hip Arthroplasties – A Matched Cohort Analysis of High Comorbidity Burden and Non-High Comorbidity Burden Patients J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Itay Ashkenazi, Jeremiah Thomas, Jonathan Katzman, Morteza Meftah, Roy Davidovitch, Ran Schwarzkopf
The impact of increased patient comorbidities on the cost-effectiveness of total hip arthroplasty (THAs) is lacking. This study aimed to compare revenue, costs, and short-term (90 days) surgical outcomes between patients who have and do not have a high comorbidity burden (HCB). We retrospectively reviewed 14,949 patients who underwent an elective, unilateral THA between 2012 and 2021. Patients were
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Association of Total Hip Arthroplasty Flexural Rigidity with Magnetic Resonance Imaging and Histological Findings J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Sara E. Sacher, Elexis C. Baral, Timothy Wright, Thomas W. Bauer, Qian Li, Douglas Padgett, Hollis G. Potter, Matthew F. Koff
Modular connections in total hip arthroplasty (THA) offer surgical advantages, but can contribute to implant fretting and corrosion due to micromotion at the head-stem interface. Previous studies implicated lower flexural rigidity as a key contributing factor to THA corrosion and fretting, but none associated flexural rigidity with direct histological evaluation or magnetic resonance imaging (MRI)
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How Active Are Our Patients in the First 6 Weeks Following Total Knee Arthroplasty? J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Fred D. Cushner, Olivia F. Hunter, David Lee
Patient activity after total knee arthroplasty (TKA) surgery has been estimated through patient- reported outcome measures. The use of data from an implanted sensor that transmits daily gait activity provides a more objective, complete recovery trajectory. In this retrospective analysis of 794 patients who received a TKA with sensors in the tibial extension between October 4, 2021, and January 13,
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Improved Clinical Outcomes with Dynamic, Force-Controlled, Gap-Balancing in Posterior-Stabilized Total Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 Rosa S. Valtanen, Marshall Seligson, Heather G. Huddleston, Laurent Angibaud, James I. Huddleston
Optimal soft-tissue management in total knee arthroplasty (TKA) may reduce symptomatic instability. We hypothesized that TKA outcomes using a computer-assisted dynamic ligament balancer that acquires medial and lateral gap sizes throughout the motion arc would show improved Knee Society Scores (KSS) compared to TKAs done with a traditional tensioner at 0 and 90. We also sought to quantify the degree
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Rheumatoid Arthritis is Not a Contraindication to Unicompartmental Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-28 David G. Deckey, Sayi P. Boddu, Zachary K. Christopher, Mark J. Spangehl, Henry D. Clarke, Jeremy M. Gililland, Joshua S. Bingham
Rheumatoid arthritis (RA) has historically been considered a contraindication for unicompartmental knee arthroplasty (UKA). However, the widespread use of disease-modifying anti-rheumatic drugs (DMARDs) has substantially improved the management of RA and prevented disease progression. The objective of this study was to ascertain whether RA impacts UKA revision-free survivorship. Patients undergoing
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Role of Preoperative Intra-Articular Corticosteroid Injections on Periprosthetic Joint Infection in Total Hip Arthroplasty and Its Association with Preoperative Timing: A Single-Center Series of 5,909 Hips J. Arthroplasty (IF 3.5) Pub Date : 2024-02-27 Ante Prkić, Marijn Peet, Joyce L. Benner, Karin Slot, Jelle P. van der List, Olivier P.P. Temmerman, Stan J. Vos
Preoperative intra-articular corticosteroid injections to the hip joint increase the risk of periprosthetic joint infection (PJI) during primary total hip arthroplasty (THA). This study aimed to determine the relationship between preoperative timing of intra-articular corticosteroid injections and PJI risk following THA using data from a single-center hospital. This single-center, retrospective cohort
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No Difference in Revision Rates up to 10 years Following Total Hip Arthroplasty in Patients Who Had Prior Bariatric Surgery When Compared to Patients Who Had Class III Obesity: A Propensity Matched Analysis J. Arthroplasty (IF 3.5) Pub Date : 2024-02-27 Sanjay Kubsad, Daniel A. Raftis, Amil R. Agarwal, Majd Marrache, Jordan S. Cohen, Savyasachi C. Thakkar, Gregory J. Golladay
There is no clear research showcasing bariatric surgery’s impact on long-term surgical complications following total hip arthroplasty (THA). Therefore, this study compared the 10-year cumulative incidence and risk of revision following THA in patients who underwent bariatric surgery when compared to the general population and class III obesity patients who did not undergo bariatric surgery. Patients
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The Chitranjan S. Ranawat Award: Manipulation Under Anesthesia (MUA) to Treat Postoperative Stiffness after Total Knee Arthroplasty: A Multicenter Randomized Clinical Trial J. Arthroplasty (IF 3.5) Pub Date : 2024-02-27 Matthew P. Abdel, Harold I. Salmons, Dirk R. Larson, Matthew S. Austin, C. Lowry Barnes, Michael P. Bolognesi, Craig J. Della Valle, Douglas A. Dennis, Kevin L. Garvin, Jeffrey A. Geller, Stephen J. Incavo, Adolph V. Lombardi, Christopher L. Peters, Ran Schwarzkopf, Peter K. Sculco, Bryan D. Springer, Mark W. Pagnano, Daniel J. Berry
Manipulation under anesthesia (MUA) occurs in 4% of patients after total knee arthroplasty (TKA). Anti-inflammatory medications may target arthrofibrosis pathogenesis, but the data are limited. This multicenter randomized clinical trial (RCT) investigated the effect of adjuvant anti-inflammatory medications with MUA and physical therapy (PT) on range of motion (ROM) and outcomes. There were 124 patients
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Is American Joint Replacement Registry Data Consistent with International Survivorship in Hip and Knee Arthroplasty? A Comparative Analysis J. Arthroplasty (IF 3.5) Pub Date : 2024-02-27 Bryan D. Springer, Kyle Mullen, Patrick Donnelly, Keith Tucker, Edward Caton, James Huddleston
In collaboration with the Orthopedic Data Evaluation Panel (ODEP), the American Joint Replacement Registry (AJRR) investigated the consistency of hip and knee arthroplasty survivorship results compared to the UK National Joint Registry (NJR). A total of three primary knee devices and three primary hip devices were selected by AJRR and ODEP with known variation in performance. Implant manufacturers
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Predictive Factors of Pain and Functional Outcome 5-year Following Total Hip Arthroplasty: A Prospective FORCE-TJR Cohort Study J. Arthroplasty (IF 3.5) Pub Date : 2024-02-25 Mohamed Yousef, Hua Zheng, Wenyun Yang, David C. Ayers
Previous reports have identified a number of potential predictors of pain and function after total hip arthroplasty (THA). However, the results of these studies were conflicting, and most had a short follow-up after THA. The purpose of this study is to identify factors predictive of pain and function five years after THA. A multi-center cohort of 7,934 primary unilateral THA patients was prospectively
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Durability of Primary Total Hip Arthroplasty with Cementless Stems without a Collar in Elderly Patients Age 75 Years and Over J. Arthroplasty (IF 3.5) Pub Date : 2024-02-24 Robert Saldivar, Leonard T. Buller, Evan R. Deckard, Kevin A. Sonn, R. Michael Meneghini
Cementless femoral fixation in total hip arthroplasty (THA) has increased in prevalence worldwide. However, cementless fixation in elderly patients is controversial due to the risk of periprosthetic fracture and aseptic loosening. This study evaluated outcomes in patients undergoing primary THA utilizing a cementless stem without a collar, comparing those less than 75 years to those older than 75 years
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The Efficacy of Preoperative Video-Based Opioid Counseling on Postoperative Opioid Consumption after Total Knee Arthroplasty: A Prospective Randomized Controlled Trial J. Arthroplasty (IF 3.5) Pub Date : 2024-02-24 Arlene R. Maheu, Alexandra L. Hohmann, Nicholas F. Cozzarelli, Irfan A. Khan, William J. Hozack, Asif M. Ilyas, Jess H. Lonner
There are myriad strategies to reduce opioid consumption after total knee arthroplasty (TKA). Recent studies have suggested that preoperative counseling may reduce opioid use after a variety of orthopaedic procedures. The purpose of this study was to investigate whether preoperative video-based patient education regarding opioid use and abuse reduces opioid consumption after TKA. In this prospective
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Knee Arthroscopy Following Total Knee Arthroplasty is not Associated with an Elevated Risk of Infection J. Arthroplasty (IF 3.5) Pub Date : 2024-02-24 Brian D. Wahlig, Matthew B. Shirley, Matthew L. Hadley, Prabin Thapa, Aaron J. Krych, Michael J. Stuart, Robert T. Trousdale
Recent literature has suggested that knee arthroscopy (KA) following ipsilateral primary total knee arthroplasty (TKA) may be associated with an increased risk of periprosthetic joint infection (PJI). However, prior studies on this subject have relied on insurance databases or have lacked control groups for comparison. This study aimed to evaluate the risk of PJI in patients undergoing ipsilateral
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Financial Conflicts of Interest and Industry Funding are Associated with Conclusions Favorable to New Technologies: A Review of Published Economic Analyses in Hip and Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-24 Nadim Barakat, Pradip Ramamurti, Ian M. Duensing, James A. Browne
New technologies in hip and knee arthroplasty are commonly evaluated using cost-effectiveness analyses (CEAs) and similar economic assessments. There is wide variation in the methodology of these studies, introducing the potential for bias. The purpose of this study was to evaluate associations between potential financial conflicts of interest (COI) and the outcomes of economic analyses. We hypothesized
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Integrating Smartphone Applications and Wearable Devices for Post-Operative Rehabilitation in Total Knee Arthroplasty: A Critical Review J. Arthroplasty (IF 3.5) Pub Date : 2024-02-24 Daniel Hameed, Nipun Sodhi, Jeremy Dubin, Andrew Schneider, Robert L. Barrack, Michael A. Mont
Smartphone and wearable technologies offer innovative methods for monitoring postoperative recovery in total knee arthroplasty (TKA) patients. This review assessed the benefits of these technologies in postoperative care, focusing on: 1) smartphone applications; 2) wearable devices; and 3) their combination. A systematic search identified studies on smartphone apps and wearables for post-TKA monitoring
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Efficacy of Oral Nefopam on Multimodal Analgesia in Total Knee Arthroplasty: A Prospective, Double-Blind, Placebo-Controlled, Randomized Trial J. Arthroplasty (IF 3.5) Pub Date : 2024-02-23 Qiuru Wang MD, Jian Hu MD, Shuwei Ye MM, Jing Yang MD PHD, Pengde Kang MD PHD
Multimodal analgesia is central to pain management after total knee arthroplasty (TKA). This study aimed to evaluate the efficacy of adding oral nefopam to multimodal analgesia for post-TKA pain management. In this prospective, double-blind, placebo-controlled, randomized trial, 100 patients who underwent TKA at our hospital were randomized to either the nefopam or the control group. After surgery
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Intramedullary Positive Tissue Culture Increases the Risk of Reinfection Following One-Stage Septic Revision Total Knee Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-23 Luigi Zanna MD, Minjae Lee MD, Taner Karlidag MD, T. David Luo MD PhD, Thorsten Gehrke MD, Mustafa Citak MD MBA
Intraoperative acquisition of representative tissue samples is essential during revision arthroplasty of the infected total knee arthroplasty (TKA). While the number of intraoperative tissue samples needed to identify the organism is well described in the literature, there is still a paucity of evidence regarding the location of positive intraoperative samples and their correlation to postoperative
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Results of Primary Total Knee Arthroplasty in Patients on Chronic Psychotropic Medications J. Arthroplasty (IF 3.5) Pub Date : 2024-02-23 Nolan S. Smith MD, Sarag Abhari MD, Langan S. Smith BS, Kyle M. Altman MD, Madhusudhan R. Yakkanti MD, Arthur L. Malkani MD
Psychotropic medications are commonly used to treat several mental health conditions. The aim of this study was to determine the impact of psychotropic medications in patients undergoing primary total knee arthroplasty (TKA) with respect to postoperative opioid use, complications, patient-reported outcome measures, and satisfaction. This is a retrospective cohort study of 514 consecutive patients undergoing
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Acetabular Distraction Technique: A Multicenter Study With a Minimum 2-Year Radiographic Follow-Up J. Arthroplasty (IF 3.5) Pub Date : 2024-02-23 Christopher M. Melnic MD, Mehdi S. Salimy BS, Gregory T. Minutillo MD MPH, Acetabular Distraction Revision Arthroplasty Consortium, Sabrina F. Schundler BS, Robert A. Burnett 3rd MD, Colin M. Baker DO MBA, P. Maxwell Courtney MD, Hany S. Bedair MD, Scott M. Sporer MD, Wayne G. Paprosky MD, Neil P. Sheth MD
Chronic pelvic discontinuity is a challenge during revision total hip arthroplasty due to the loss of structural continuity of the superior and inferior aspects of the acetabulum from severe acetabular bone loss. Acetabular distraction provides an alternative surgical treatment by stabilizing the acetabular component through elastic recoil of the pelvis, which may be supplemented with modular porous
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Addition of Surgeon-Administered Adductor Canal Infiltration to the Periarticular Infiltration in Total Knee Arthroplasty: Effect on Pain and Early Outcomes J. Arthroplasty (IF 3.5) Pub Date : 2024-02-23 Adit R. Maniar MBBS MS (Orth) DNB (Orth), Ashwini Khokhar MBBS MS (Orth), Akshay Nayak MBBS MS (Orth) DNB (Orth), Dinesh Kumar MBBS MS (Orth), Ishan Khanna MBBS MS (Orth), Rajesh N. Maniar MS (Orth) MCh Orth
Our aim was to study the additive effect of surgeon-administered adductor canal infiltration (SACI) over routine periarticular infiltration (PAI) on pain control [morphine consumption and pain score by the visual analog scale (VAS)] and early function [flexion and Timed Up and Go (TUG) test] post–total knee arthroplasty (TKA). We prospectively randomized 60 patients into 2 groups. Group I patients
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Outpatient Total Hip Arthroplasty Volume up Nearly 8-Fold After Regulatory Changes With Expanding Demographics and Unchanging Outcomes: A 10-Year Analysis J. Arthroplasty (IF 3.5) Pub Date : 2024-02-22 Ignacio Pasqualini MD, Oguz Turan MS, Ahmed K. Emara MD, Alvaro Ibaseta MD MS, James Xu MD, Austin Chiu MD, Nicolas S. Piuzzi MD
With the removal of total hip arthroplasty (THA) from the inpatient-only (IPO) lists, the orthopedic landscape across the United States has changed rapidly. Thus, this study aimed to: 1) characterize the change in THA volume for outpatient and inpatient surgeries; 2) elucidate demographical differences before and after removal from the IPO list; and 3) analyze 30-day complications, readmissions, and
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Reconstruction of Chronic Quadriceps Tendon Rupture: The Quadriceps Advancement and Imbrication Technique J. Arthroplasty (IF 3.5) Pub Date : 2024-02-22 Sebastian Braun MD PhD, Dimitrios A. Flevas MD PhD, Carolena Rojas Marcos MPH, Friedrich Boettner MD, Peter K. Sculco MD, Thomas P. Sculco MD
Chronic extensor mechanism disruption after total knee arthroplasty (TKA) is a rare but challenging condition. There are several surgical approaches for quadriceps tendon repairs. In this report, we present a modified surgical technique for quadriceps tendon repair in chronic extensor mechanism disruption without the use of allografts or mesh augmentation. We retrospectively reviewed 12 consecutive
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Outcomes Following Intraoperative Calcar Fractures During Cementless Total Hip Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-22 Eric J. Wilson MD, Alexander V. Strait MS, Kevin B. Fricka MD, William G. Hamilton MD, Robert A. Sershon MD
Intraoperative calcar fractures (IOCFs) are an established complication of cementless total hip arthroplasty (THA). Prompt recognition and management may prevent subsequent postoperative complications. This study aimed to evaluate the outcomes and revision rates of THAs with IOCFs identified and managed intraoperatively. There were 11,438 primary cementless THAs performed at a single institution from
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Does Melatonin Improve Sleep Following Primary Total Knee Arthroplasty? A Randomized, Double-Blind, Placebo-Controlled Trial J. Arthroplasty (IF 3.5) Pub Date : 2024-02-22 Muhammad A. Haider, Kyle W. Lawrence, Thomas Christensen MD, Ran Schwarzkopf MD MSc, William Macaulay MD, Joshua C. Rozell MD
Sleep impairment following total knee arthroplasty (TKA) is common and may decrease patient satisfaction and recovery. Standardized postoperative recommendations for sleep disturbances have not been established. We aimed to assess whether melatonin use could promote healthy sleep and reduce sleep disturbance in the acute period following TKA. Patients undergoing primary, elective TKA between July 19
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A “Dry Tap” in Prosthetic Joint Infection Workup of Total Hip Arthroplasty Is Not Reassuring J. Arthroplasty (IF 3.5) Pub Date : 2024-02-22 Emily A. Treu MD, Nathan F. Behrens, Brenna E. Blackburn PhD, Daniel M. Cushman MD, Michael J. Archibeck MD
Synovial fluid analysis is important in diagnosing prosthetic joint infection (PJI). The rate of culture-positive PJI in patients who have a dry tap of a total hip arthroplasty (THA) is not well described. We reviewed all image-guided THA aspirations, performed from 2014 to 2021 at a single academic institution. Aspirations were categorized as successful (≥ 0.5 mL) or unsuccessful (< 0.5 mL, “dry tap”)
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Short-Term (6 Months or Less) Pain in Cemented Versus Cementless Total Knee Arthroplasty: A Systematic Review and Meta-Analysis J. Arthroplasty (IF 3.5) Pub Date : 2024-02-21 Nikhil Ailaney, Matthew Barra, Derek Schloemann, Caroline P. Thirukumaran, Nathan B. Kaplan
Cementless total knee arthroplasty (TKA) has increased in popularity to potentially improve survivorship. Radiostereometric studies demonstrate increased component migration during the first 3 to 6 months in cementless constructs, generating concern for increased post-operative pain during early osseointegration. The purpose of this study was to evaluate short-term (≤ 6 months) pain and function in
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Preoperative Depression Screening for Primary Total Knee Arthroplasty: An Evaluation of Its Modifiability on Outcomes in Patients Who Have Depression J. Arthroplasty (IF 3.5) Pub Date : 2024-02-19 Adam M. Gordon, Matthew L. Magruder, Jake Schwartz, Mitchell K. Ng, Orry Erez, Michael A. Mont
Few studies have evaluated preoperative depression screenings in patients who have depression. We studied whether depression screenings before total knee arthroplasty (TKA) were associated with lower: 1) medical complications; 2) emergency department (ED) utilizations and readmissions; 3) implant complications; and 4) costs. A nationwide sample from January 1, 2010 to April 30, 2021 was collected using
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Can Patients Who Have Low-Grade Hip Osteoarthritis Expect the Same Outcome After Total Hip Arthroplasty Compared to Those Who Have End-Stage Osteoarthritis? – A Matched Case-Control Study J. Arthroplasty (IF 3.5) Pub Date : 2024-02-17 Wouter Peeters MD, Frans-Jozef Vandeputte MD, Annick Timmermans PhD, Stijn Roose, Jeroen C.F. Verhaegen MD, Kristoff Corten MD PhD
Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis (OA). In addition, when hip preservation surgery is no longer indicated due to the presence of early or mild arthritic changes, THA can also be considered. Whether these patients can expect the same outcome after THA as patients who have end-stage OA remains unclear. The goal of this study was to compare
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Return to Sport after Unicompartmental Knee Arthroplasty and Patello-femoral Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-16 Nicholas F. Cozzarelli, Irfan A. Khan, Armin Arshi, Matthew B. Sherman, Jess H. Lonner, Yale A. Fillingham
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Advanced Concepts in Outpatient Joint Arthroplasty J. Arthroplasty (IF 3.5) Pub Date : 2024-02-15 Robert A. Sershon MD, Michael P. Ast MD, Charles A. DeCook MD, Craig J. Della Valle MD, William G. Hamilton MD
As the adoption and utilization of outpatient total joint arthroplasty continues to grow, key developments have enabled surgeons to safely and effectively perform these surgeries while increasing patient satisfaction and operating room efficiency. Here, the authors will discuss the evidence-based principles that have guided this paradigm shift in joint arthroplasty surgery, as well as practical methods
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Development of a Machine-Learning Model for Anterior Knee Pain After Total Knee Arthroplasty With Patellar Preservation Using Radiological Variables J. Arthroplasty (IF 3.5) Pub Date : 2024-02-15 Maximiliano Barahona MSc MD, Mauricio A. Guzmán MD, Sebastian Cartes Eng, Andrés E. Arancibia Eng, Javier E. Mora MD, Macarena A. Barahona PT, Daniel Palma MD, Jaime R. Hinzpeter MD, Carlos A. Infante MD, Cristian N. Barrientos MD
Anterior knee pain (AKP) following total knee arthroplasty (TKA) with patellar preservation is a common complication that significantly affects patients’ quality of life. This study aimed to develop a machine-learning model to predict the likelihood of developing AKP after TKA using radiological variables. A cohort of 131 anterior stabilized TKA cases (105 patients) without patellar resurfacing was
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Assessing Ability for ChatGPT to Answer Total Knee Arthroplasty-Related Questions J. Arthroplasty (IF 3.5) Pub Date : 2024-02-14 Matthew L. Magruder, Ariel Rodriguez, Che Hang Jason Wong, Orry Erez, Nicolas S. Piuzzi, Gil R. Scuderi, James Slover, Jason H. Oh, Ran Schwarzkopf, Antonia F. Chen, Richard Iorio, Stuart B. Goodman, Michael A. Mont
Artificial intelligence (AI) in the field of orthopaedics has been a topic of increasing interest and opportunity in recent years. Its applications are widespread both for physicians and patients, including use in clinical decision-making, in the operating room, and in research. In this study, we aimed to assess the quality of ChatGPT answers when asked questions related to total knee arthroplasty
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No Impact of Contact Between The Medial Collar of a Hydroxyapatite-Coated Triple-Tapered Stem and The Femoral Neck on Periprosthetic Bone Mineral Density J. Arthroplasty (IF 3.5) Pub Date : 2024-02-14 Kentaro Iwakiri, Yoichi Ohta, Yukihide Minoda, Shuhei Ueno, Akio Kobayashi, Hiroaki Nakamura
Hydroxyapatite-coated, triple-tapered, shorter-length stems with a medial collar have been reported with good results for a few years. We investigated whether contact between the medial collar and femoral neck affects clinical outcomes and changes in bone mineral density in patients who have this type of stem in their total hip arthroplasty (THA) construct. This was a retrospective, single-center study
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Social Determinants of Health in Total Joint Arthroplasty: Insurance J. Arthroplasty (IF 3.5) Pub Date : 2024-02-13 Jeremy Dubin BA, Sandeep Bains MD MBA DC, Ugonna N. Ihekweazu MD, Michael A. Mont MD, Ronald Delanois MD