393 results match your criteria Arthroplasty today[Journal]


Revision of a Tronzo Total Hip Arthroplasty.

Arthroplast Today 2020 Jun 12;6(2):186-189. Epub 2020 May 12.

Michigan Orthopedic Center, Lansing, MI, USA.

Revision total hip arthroplasty presents many challenges in regards to reconstructing or managing large amounts of bone loss and soft-tissue damage. Modern revision components, as well as techniques, have helped to address these challenges; however, the goal of any surgery is to provide the least amount of surgery with the most successful outcome. This case highlights a 74-year-old man with a Tronzo total hip arthroplasty placed over 50 years prior. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225601PMC

Increased Intercondylar Femoral Box Cut-to-Femur Size Ratio During Posterior-Stabilized Total Knee Arthroplasty Increases Risk for Intraoperative Fracture.

Arthroplast Today 2020 Jun 11;6(2):180-185. Epub 2020 May 11.

Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

Background: Iatrogenic intraoperative fractures are preventable complications in total knee arthroplasty. As press-fit fixation becomes more popular, further investigation into risk factors is needed. Some authors have suggested that smaller femurs may be at higher risk in posterior-stabilized constructs owing to industry designs trending toward larger, constant box sizes that increase the amount of bone resection relative to bone stock. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218157PMC

Fracture of the Neck of a Modern Cementless, Titanium Femoral Stem.

Arthroplast Today 2020 Jun 11;6(2):176-179. Epub 2020 May 11.

Division of Adult Reconstruction, Department of Orthopedics and Rehabilitation, University of Florida College of Medicine, University of Florida, Gainesville, FL, USA.

Intraprosthetic fracture of a femoral component is a rare but devastating complication after total hip arthroplasty (THA). We present the case of a 68-year-old man who presented with acute hip pain approximately 8 years after a left THA with a modern cementless, titanium femoral component. Radiographs revealed a fracture of the midportion of the neck of the stem, below the level of the trunnion. Read More

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http://dx.doi.org/10.1016/j.artd.2020.04.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218161PMC

Revision Total Knee Arthroplasty Is Associated With Significantly Higher Opioid Consumption as Compared With Primary Total Knee Arthroplasty in the Acute Postoperative Period.

Arthroplast Today 2020 Jun 11;6(2):172-175. Epub 2020 May 11.

NYU Langone, Department of Orthopedics - Division of Adult Joint Reconstruction, New York, NY, USA.

Background: There is a scarcity of studies investigating narcotic use after revision total knee arthroplasty (TKA). We compared immediate postsurgical narcotic consumption after revision TKA and primary TKA.

Methods: A single-institution database was used to identify patients who underwent revision TKA or primary TKA between 2016 and 2019. Read More

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http://dx.doi.org/10.1016/j.artd.2020.04.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218159PMC

A Novel Method of Determining Acetabular Component Size to Guide Explant in Revision Hip Arthroplasty.

Arthroplast Today 2020 Jun 24;6(2):169-171. Epub 2020 Apr 24.

National Trauma Research Institute, Melbourne, Victoria, Australia.

Revision hip arthroplasty is a frequently performed procedure and is projected to increase annually. Removal of a well-fixed acetabular component can involve loss of much needed bone stock. Contemporary instruments allow acetabular removal with minimal morbidity; however, their use requires accurate knowledge of the component size. Read More

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http://dx.doi.org/10.1016/j.artd.2020.02.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184100PMC

Total Hip and Knee Arthroplasy Prosthetic Joint Infections.

Arthroplast Today 2020 Jun 23;6(2):163-168. Epub 2020 Apr 23.

Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.

Prosthetic joint infections (PJIs) are typically caused by and coagulase-negative species. species are microorganisms of the human skin and mucous membranes that are often considered contaminants when grown in culture. In the past, species were often classified as diphtheroids based on growing as gram-positive rods in aerobic environments, but with advances in technology, the identification of species has improved. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184103PMC

Polyester mesh dressings reduce delayed wound healing rates after total hip arthroplasty compared with silver-impregnated occlusive dressings.

Arthroplast Today 2020 Jun 23;6(2):158-162. Epub 2020 Apr 23.

Center for Hip and Knee Replacement, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Background: New dressings purport to reduce surgical wound complications after total hip arthroplasty (THA). This study compared delayed wound healing rates and reoperations between 2 increasingly popular dressings: a silver-impregnated occlusive (standard) dressing and a 2-octyl cyanoacrylate adhesive with polyester mesh.

Methods: This retrospective cohort study reviewed 431 consecutive THAs performed by 2 surgeons between January 2017 and May 2019. Read More

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http://dx.doi.org/10.1016/j.artd.2020.01.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184099PMC

Nonsurgical Management of Distal Femur Stem Cortical Perforation.

Arthroplast Today 2020 Jun 23;6(2):153-157. Epub 2020 Apr 23.

Department of Joint Surgery, Chinese PLA General Hospital, Haidian, Beijing, China.

Distal femur stem cortical perforation is a rare but potentially catastrophic complication during total hip arthroplasty. If unrecognized, it can lead to transverse fracture of the femur while the patient is ambulating. If an uncemented femur stem was used, previous literature unanimously agrees that revision surgery should be performed. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184104PMC

N-Acetyl-Cysteine Reduces Blood Chromium and Cobalt Levels in Metal-on-Metal Hip Arthroplasty.

Arthroplast Today 2020 Jun 23;6(2):149-152. Epub 2020 Apr 23.

IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.

The most common reasons for revision of metal-on-metal hip arthroplasty are aseptic loosening and metal reaction. Failure of a metal-on-metal implant due to the aggressive destruction of periprosthetic tissues may require extensive reconstruction procedures. The aim of this case report is to describe the treatment in an asymptomatic patient with high levels of chromium and cobalt, using chelation therapy. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183002PMC

Total Knee Arthroplasty in Ambulatory Surgery Centers: The New Reality!

Arthroplast Today 2020 Jun 23;6(2):146-148. Epub 2020 Apr 23.

Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA.

By streamlining surgical care and eliminating postoperative hospitalization, the transition to ambulatory total knee arthroplasty (TKA) has the potential to improve efficiency and minimize the costs of care. However, practical, legal, and financial implications remain to be addressed. The Centers for Medicare and Medicaid Services has also yet to address concerns generated by the removal of TKA from the Inpatient-Only List and provide guidance on patient selection. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183008PMC

Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure.

Arthroplast Today 2020 Jun 23;6(2):141-145. Epub 2020 Apr 23.

Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA, USA.

We present a case report of a 51-year-old Ghanaian immigrant who underwent total hip arthroplasty in the setting of spontaneous ankylosis of unknown etiology. The increase in offset of the patient's limb through reconstruction, in combination with severe soft-tissue atrophy of the lower extremity, resulted in a soft-tissue defect that could not be closed primarily. This ultimately required a rectus femoris rotational flap and skin grafting for coverage. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183003PMC

Drug-Induced Thrombocytopenia Secondary to Commonly Used Antibiotics in Total Joint Arthroplasty.

Arthroplast Today 2020 Jun 22;6(2):137-140. Epub 2020 Apr 22.

Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

Drug-induced thrombocytopenia secondary to antibiotic exposure is a rare complication more commonly associated with other medications. In this review, we present a case of antibiotic-induced thrombocytopenia and discuss the clinical picture and approach to identifying the complication. With increasing use of antibiotics that may be associated with drug-induced thrombocytopenia in perioperative prophylaxis protocols, surgeons need to be cognizant of this cause of thrombocytopenia in the postoperative patient. Read More

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http://dx.doi.org/10.1016/j.artd.2020.03.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183004PMC

Establishing Telemedicine in an Academic Total Joint Arthroplasty Practice: Needs and Opportunities Highlighted by the COVID-19 Pandemic.

Arthroplast Today 2020 Apr 23. Epub 2020 Apr 23.

The Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.

The COVID-19 pandemic has prompted rapid restructuring of the healthcare system in an effort to stop the spread of the virus and to treat patients who are acutely ill with COVID-19, while continuing to provide outpatient care for the remainder of patients. To help control spread of this pandemic, many centers have boosted telemedicine capability to care for patients who would typically be seen in person in outpatient settings, including total joint arthroplasty clinics. We review key components relevant to the establishment and effective use of telemedicine, focused on patient education, practice logistics, technological considerations, and sensitive patient health information-associated compliance factors, which are necessary to provide care remotely for total joint arthroplasty patients. Read More

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http://dx.doi.org/10.1016/j.artd.2020.04.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177124PMC

Response to letter to the editor on "Asymptomatic intraprosthetic dual mobility cup dislocation with increased metal ion levels".

Arthroplast Today 2020 Mar 16;6(1):134-135. Epub 2020 Feb 16.

Department of Orthopedics, Erasmus Medical Center, Rotterdam, the Netherlands.

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http://dx.doi.org/10.1016/j.artd.2020.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083732PMC

Response to letter to the editor on "Titanium neck-titanium stem taper corrosion in a modular neck stem".

Arthroplast Today 2020 Mar 3;6(1):130-131. Epub 2020 Mar 3.

Department of Orthopaedic Surgery, New England Baptist Hospital, Boston, MA, USA.

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http://dx.doi.org/10.1016/j.artd.2020.01.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083733PMC

Letter to the editor on "Titanium neck-titanium stem corrosion in a modular neck stem".

Authors:
Kazuo Hirakawa

Arthroplast Today 2020 Mar 29;6(1):129. Epub 2020 Feb 29.

Director, Adult Reconstruction Hip and Knee Service, Shonan Kamakura Joint Reconstruction Center, Kamakura, Japan.

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http://dx.doi.org/10.1016/j.artd.2020.01.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083723PMC

Successful reimplantation surgery after extraction of well-fixed cementless stems by femoral longitudinal split procedure.

Arthroplast Today 2020 Mar 3;6(1):123-128. Epub 2020 Mar 3.

Department of Orthopedic Surgery, Sapporo Medical University, Sapporo, Hokkaido, Japan.

Background: Well-fixed cementless stems sometimes need to be extracted in patients with complications including periprosthetic infection, stem-neck breakage, or trunnionosis. The purpose of this study was to report the clinical outcome in patients undergoing reimplantation surgery after removal of a well-fixed porous-coated cementless stem by the femoral longitudinal split (FLS) procedure.

Methods: We conducted a retrospective study and radiographic review of 16 patients who had undergone reimplantation following the FLS procedure to remove a well-fixed stem due to periprosthetic infection, stem-neck breakage, or trunnionosis. Read More

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http://dx.doi.org/10.1016/j.artd.2020.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083742PMC

Portable compression devices in total joint arthroplasty: poor outpatient compliance.

Arthroplast Today 2020 Mar 6;6(1):118-122. Epub 2020 Mar 6.

Department of Orthopaedics, West Virginia University, Morgantown, WV, USA.

Background: Aspirin and mechanical compression devices are approved means of venous thromboembolism (VTE) prophylaxis after total joint arthroplasty. Prior studies of mechanical compression pumps after joint arthroplasty have been limited to the inpatient setting. The purpose of this study was to evaluate outpatient compliance and utilization factors in a rural population after elective hip or knee arthroplasty. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083727PMC

Trends and patient factors associated with technology-assisted total hip arthroplasty in the United States from 2005 to 2014.

Arthroplast Today 2020 Mar 9;6(1):112-117.e1. Epub 2020 Mar 9.

Department of Orthopaedic Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.

Background: Technology-assisted total hip arthroplasty (TA-THA) using either computer-assisted navigation or robotic assistance has become increasingly more popular. The purpose of this study was to examine the trends and patient factors associated with TA-THA.

Methods: This is a retrospective review utilizing the National Inpatient Sample, a large national database incorporating inpatient hospitalization information. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083725PMC

How do cemented short Exeter stems perform compared with standard-length Exeter stems? The experience of the New Zealand National Joint Registry.

Arthroplast Today 2020 Mar 3;6(1):104-111. Epub 2020 Mar 3.

Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, New Zealand.

Background: The standard Exeter (Stryker) cemented stem is 150 mm long with standard offsets ranging from 37.5 mm to 56 mm. Exeter short stems of 125 mm are also available in the offsets of 37. Read More

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http://dx.doi.org/10.1016/j.artd.2020.01.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083739PMC

Observed effect of femoral component undersizing and a collarless design in the development of radiolucent lines in cementless total hip arthroplasty.

Arthroplast Today 2020 Mar 6;6(1):99-103. Epub 2020 Jan 6.

Musgrave Park Hospital, Belfast, Northern Ireland.

Background: The objective of this study was to determine the prevalence of radiolucent lines (RLLs) around the femoral component in a cohort of patients who underwent well-functioning cementless total hip arthroplasty (THA).

Methods: A cohort of unrevised Corail (DePuy Synthes, Raynham, MA) femoral components (n = 636) were analyzed at a median follow-up of 6.0 years (interquartile range: 5. Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083744PMC

Does the use of intraoperative fluoroscopy improve postoperative radiographic component positioning and implant size in total hip arthroplasty utilizing a direct anterior approach?

Arthroplast Today 2020 Mar 28;6(1):94-98. Epub 2019 Dec 28.

Colorado Joint Replacement, Porter Adventist Hospital, Denver, CO, USA.

Background: The direct anterior approach (DAA) for total hip arthroplasty (THA) has gained recent popularity, with 1 purported benefit being access to intraoperative fluoroscopy. However, there are limited data demonstrating improved component position with the use of intraoperative fluoroscopy. The aim of this study is to compare radiographic implant positioning on 2 consecutive cohorts of patients undergoing DAA THA performed by 1 surgeon either utilizing intraoperative fluoroscopy or not. Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083709PMC

Maryland's Global Budget Revenue model associated with lower inpatient costs and 30-day readmissions in patients undergoing total hip arthroplasty.

Arthroplast Today 2020 Mar 9;6(1):88-93. Epub 2020 Jan 9.

Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, USA.

Background: Maryland implemented the Global Budget Revenue (GBR) to reduce hospital costs, improve quality, and decrease readmissions. Studies assessing its impact on inpatient total hip arthroplasty (THA) procedures are lacking. This study compared before and after GBR changes in 1) patient characteristics; 2) discharge dispositions and lengths of stay (LOS); 3) costs and charges of inpatient stays; and 4) 30-day readmission rates (RR) for THA recipients. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083717PMC

Disparity of health services in patients with knee osteoarthritis before total knee arthroplasty.

Arthroplast Today 2020 Mar 8;6(1):81-87. Epub 2020 Jan 8.

Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.

Background: Recent evidence describes which interventions are driving insurance payments in the management of osteoarthritis (OA) before total knee arthroplasty (TKA); however, relatively little is known about how these costs are distributed among patients.

Methods: We reviewed the Humana claims database for patients who underwent primary TKA from 2009 to 2016. Insurance payments for treatment, imaging, and evaluation and management were calculated from OA diagnosis to TKA, the distribution of payments was determined, and a high-payment group was identified by determining the point at which patients began to account for a disproportionate percentage of payments. Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083741PMC

Diagnosis of depression and other patient factors impacts length of stay after total knee arthroplasty.

Arthroplast Today 2020 Mar 8;6(1):77-80. Epub 2020 Jan 8.

Departments of Orthopaedic Surgery and Population Health, NYU School of Medicine, New York, NY, USA.

Background: The length of in-hospital stay (LOS) is an important measure of efficiency in the use of hospital resources and care quality outcomes after orthopaedic surgery. This study investigated the influence of patients' characteristics including demographic factors and the presence of comorbid preoperative depression on LOS after primary total knee arthroplasty (TKA).

Methods: Data were extracted from the California Healthcare Cost and Utilization Project database for hospital discharges after primary TKA for adults aged 50 years and older from 2007 to 2010 (n = 133,603). Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083721PMC

Presurgical optimization and opioid-minimizing enhanced recovery pathway for ambulatory knee and hip arthroplasty: postsurgical opioid use and clinical outcomes.

Arthroplast Today 2020 Mar 30;6(1):71-76. Epub 2019 Sep 30.

Paragon Orthopedic Center, Grants Pass, OR, USA.

Background: Enhanced recovery after surgery (ERAS) pathways offer approaches to achieve successful ambulatory primary total knee and total hip arthroplasty (TKA/THA) while meeting the "Triple Aim" of healthcare: patient satisfaction, population health, and value. We evaluated outcomes from an ERAS pathway designed to maximize patients' eligibility for ambulatory TKA/THA while reducing costs, complications, and postsurgical opioid use.

Methods: This retrospective study included 220 consecutive unique commercially insured patients who underwent TKA (n = 113) or THA (n = 138) in an ambulatory surgery center between June 1, 2015 and November 16, 2017. Read More

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http://dx.doi.org/10.1016/j.artd.2019.08.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083728PMC

Wearable activity sensors and early pain after total joint arthroplasty.

Arthroplast Today 2020 Mar 6;6(1):68-70. Epub 2020 Mar 6.

University of California San Francisco, San Francisco, CA, USA.

A prospective observational cohort of 20 primary total hip arthroplasty (n = 12) and total knee arthroplasty (n = 8) patients (mean age: 63 ± 6 years) was passively monitored with a consumer-level wearable activity sensor before and 6 weeks after surgery. Patients were clustered by minimal change or decreased activity using sensor data. Decreased postoperative activity was associated with greater pain reduction (-5. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083735PMC

Patient-reported outcome measures in total joint arthroplasty: defining the optimal collection window.

Arthroplast Today 2020 Mar 25;6(1):62-67. Epub 2019 Nov 25.

Department of Orthopaedic Surgery, University Connecticut Health Center, Farmington, CT, USA.

Background: The purpose of this study was to determine the optimal window for collection of patient-reported outcome measures (PROMs) after total joint arthroplasty (TJA).

Methods: Our prospectively collected institutional joint registry was queried for patients who underwent primary, unilateral TJAs. The primary outcomes were the net changes in WOMAC, SF-12 MCS, SF-12 PCS, OHS, KSCRS, and UCLA activity rating system at 6, 12, and 24 months postoperatively. Read More

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http://dx.doi.org/10.1016/j.artd.2019.10.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083724PMC

Elephant's ear sign: a new radiographic finding indicative of acetabular retroversion.

Arthroplast Today 2020 Mar 11;6(1):59-61. Epub 2020 Jan 11.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

Acetabular retroversion is a relatively common condition affecting the hip that can result in symptoms in some patients. Diagnosis of acetabular retroversion relies on obtaining a proper anteroposterior radiograph of the pelvis. Cross-over, posterior wall, and ischial spine signs are usually present in patients on the radiographs of patients with acetabular retroversion. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083708PMC

Total knee arthroplasty in hemophilia A.

Arthroplast Today 2020 Mar 6;6(1):52-58.e1. Epub 2020 Mar 6.

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA.

Hemophilia A is a rare genetic disorder involving a deficiency of clotting factor VIII. Coagulation factor replacement therapy has prolonged the life expectancy of patients with hemophilia, but recurrent hemarthrosis of major joints is often a common occurrence. Therefore, orthopaedic adult reconstructive surgeons increasingly encounter hemophilic arthropathy in young adults and consider treating with total joint arthroplasty. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083729PMC

Unicondylar knee arthroplasty following a patellectomy.

Arthroplast Today 2020 Mar 30;6(1):48-51. Epub 2019 Nov 30.

Orthopaedic Department, Sint-Dimpna Hospital, Geel, Belgium.

We present a case of a 59-year-old woman with a history of a right-sided patellectomy. She presented with right-sided anteromedial osteoarthritis. A unicondylar knee arthroplasty was performed. Read More

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http://dx.doi.org/10.1016/j.artd.2019.10.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083750PMC

Total hip arthroplasty in an adult patient with pelvic dysmorphism, unilateral sacroiliac joint autofusion, and developmental hip dysplasia.

Arthroplast Today 2020 Mar 30;6(1):41-47. Epub 2019 Nov 30.

Department of Orthopaedic Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

This case describes the challenges associated with total hip arthroplasty in a patient with unique anatomy, including developmental dysplasia of the hip, pelvic dysmorphism, and unilateral sacroiliac joint autofusion. A 30-year-old female, with a history of developmental dysplasia of the hip treated with presumed pelvic osteotomy complicated by postoperative infection, presented with hip pain refractory to conservative management. Radiographic studies demonstrated a 10-cm leg length discrepancy, 20° of acetabular retroversion, severe hemipelvic dysmorphism, ipsilateral sacroiliac joint autofusion, and significant femoral head dysplasia. Read More

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http://dx.doi.org/10.1016/j.artd.2019.10.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083716PMC

Failure at the femoral stem extension-condylar interface in a rotating hinge knee without radiographic evidence of loosening.

Arthroplast Today 2020 Mar 12;6(1):36-40. Epub 2019 Dec 12.

Department of Orthopedic Surgery, Adventist Health, Aspire Orthopedic Institute, Portland, OR, USA.

Modular stem extensions have become ubiquitous in revision total knee arthroplasty systems. Although stem extensions are valuable in addressing bone deficiencies and improving implant fixation, the stem extension-condylar interface may be a point of implant failure. We report a case of failure at the femoral stem extension-condylar interface in a Zimmer NexGen Rotating Hinge Knee (Zimmer, Warsaw, IN). Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083710PMC

Proximal tibial replacement in revision knee arthroplasty for non-oncologic indications.

Arthroplast Today 2020 Mar 28;6(1):23-35. Epub 2020 Jan 28.

Rothman Institute, Philadelphia, PA, USA.

Proximal tibial metaphyseal bone loss compromises the alignment and fixation of components during revision total knee arthroplasty. In massive, segmental defects with loss of collateral ligamentous support and lack of bone to support the use of prosthetic augments or metaphyseal cones or sleeves, a hinged proximal tibial replacement or a so-called "megaprosthesis" should be available. While proximal tibial replacement is the reconstructive method of choice in the setting of bone tumor resection, applications in non-oncologic joint arthroplasty are rare and may offer an opportunity for limb salvage in dire clinical scenarios with massive proximal tibial bone loss. Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083738PMC

Early failure of sequentially annealed polyethylene in total knee arthroplasty.

Arthroplast Today 2020 Mar 9;6(1):18-22. Epub 2020 Jan 9.

Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.

Improvements in the processing of polyethylene have led to a dramatic reduction in wear rates in total hip arthroplasty. This led to the adoption of modern highly cross-linked polyethylene in total knee arthroplasty (TKA). However, the differences in modes of wear and failure between total hip arthroplasty and TKA have tempered expectations regarding similar decreases in polyethylene-related complications in TKA. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083714PMC

Invagination of elevated lip liner preventing reduction of dislocated total hip.

Arthroplast Today 2020 Mar 7;6(1):14-17. Epub 2020 Jan 7.

Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.

Instability is the most common indication for revision total hip arthroplasty in the United States. Elevated-rim acetabular liners were introduced to minimize the risk of posterior instability. We describe a patient with multiple total hip arthroplasty dislocations secondary to component subsidence leading to instability. Read More

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http://dx.doi.org/10.1016/j.artd.2019.11.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083719PMC

Prosthetic femoral head erosion through an acetabular component treated with revision and implant preservation.

Arthroplast Today 2020 Mar 14;6(1):9-13. Epub 2020 Jan 14.

Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.

We present a case report of the rare complication of a femoral head prosthesis eroding through the acetabular liner and shell resulting in a clinical presentation of pseudo-dislocation. The patient presented with a 1-month history of progressive anterior and peritrochanteric hip pain without antecedent trauma. Radiographs demonstrated presumed hip dislocation with superior-posterior superimposition of the femoral head over the acetabular component. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083747PMC

Polyethylene liner dissociation with the Pinnacle acetabular component: should we be concerned?

Arthroplast Today 2020 Mar 9;6(1):5-8. Epub 2020 Jan 9.

Department of Trauma and Orthopaedics, Dunedin Hospital Dunedin, Dunedin, New Zealand.

Between 2007 and 2018, 535 total hip arthroplasties using the uncemented Pinnacle acetabular component (DePuy Synthes, Warsaw, IN) and polyethylene liner were implanted in our unit. Of these, 6 patients presented acutely with liner polyethylene dissociation, giving a rate of liner dissociation of 1.11%. Read More

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http://dx.doi.org/10.1016/j.artd.2019.12.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083726PMC

A tribute to Brian J. McGrory, MD.

Arthroplast Today 2020 Mar 27;6(1):3-4. Epub 2020 Feb 27.

Department of Orthopaedic Surgery, VCU Health, Richmond, VA, USA.

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http://dx.doi.org/10.1016/j.artd.2020.02.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083740PMC

Gratitude and vision.

Arthroplast Today 2020 Mar 3;6(1):1-2. Epub 2020 Mar 3.

Department of Orthopaedic Surgery, VCU Health, Richmond, VA, USA.

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http://dx.doi.org/10.1016/j.artd.2020.02.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083720PMC

Surgical selection criteria compliance is associated with a lower risk of periprosthetic joint infection in total hip arthroplasty.

Arthroplast Today 2019 Dec 30;5(4):521-524. Epub 2019 Nov 30.

Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA, USA.

Background: Periprosthetic joint infection (PJI) is a devastating complication of total hip arthroplasty (THA). Patient optimization represents an important target for PJI prevention. Unfortunately, best practice screening guidelines are not consistently followed by all surgeons. Read More

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http://dx.doi.org/10.1016/j.artd.2019.10.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921180PMC
December 2019

Efficacy of manipulation under anesthesia beyond three months following total knee arthroplasty.

Arthroplast Today 2019 Dec 10;5(4):515-520. Epub 2019 Oct 10.

Department of Orthopedic Surgery, New England Baptist Hospital, Boston, MA, USA.

Background: Stiffness after total knee arthroplasty (TKA) is often treated with manipulation under anesthesia (MUA) to improve range of motion (ROM). However, many authors recommend against MUA beyond 3 months after TKA. This study investigates the timing of MUA for stiffness after TKA, focusing on MUA performed at >12 weeks. Read More

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http://dx.doi.org/10.1016/j.artd.2019.08.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920722PMC
December 2019

Anatomic dual mobility compared to modular dual mobility in primary total hip arthroplasty: a matched cohort study.

Arthroplast Today 2019 Dec 6;5(4):509-514. Epub 2019 Dec 6.

Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA.

Background: Dual mobility (DM) has been used in primary total hip arthroplasty recently for their low dislocation rates, low revision rates, and improved patient functional outcomes. We compared 2 DM systems, anatomic dual mobility (ADM; Stryker, Mahwah, NJ) and modular dual mobility (MDM; Stryker, Mahwah, NJ), to determine differences in dislocation rates, revision rates, and patient outcome scores.

Methods: The study was a single-center matched retrospective review of prospectively collected data of patients who underwent primary total hip arthroplasty surgery with an ADM or MDM system by a single surgeon from 2012 to 2017. Read More

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http://dx.doi.org/10.1016/j.artd.2019.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920720PMC
December 2019

Total hip arthroplasty utilizing an uncemented, flat, tapered stem with a reduced distal profile.

Arthroplast Today 2019 Dec 19;5(4):503-508. Epub 2019 Sep 19.

Adult Reconstruction & Joint Replacement Division, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Background: The aim of this study was to report the midterm results of an uncemented, flat, and tapered femoral stem with a reduced distal profile.

Methods: 219 total hip arthroplasties were performed using this stem between March 2007 and October 2012. Survival, radiographs, and modified Harris Hip Scores were analyzed. Read More

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http://dx.doi.org/10.1016/j.artd.2019.08.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920712PMC
December 2019

Patient-optimizing enhanced recovery pathways for total knee and hip arthroplasty in Medicare patients: implication for transition to ambulatory surgery centers.

Arthroplast Today 2019 Dec 25;5(4):497-502. Epub 2019 Sep 25.

Paragon Orthopedic Center, Grants Pass, OR, USA.

Background: Medicare-insured patients may be candidates for outpatient total knee and hip arthroplasty (TKA/THA) because postsurgical complications are often age unrelated. We evaluated an opioid-minimizing enhanced recovery after surgery (ERAS) pathway in an inpatient setting designed to presurgically optimize and prepare patients to reduce risk of avoidable postsurgical complications and maximize feasibility of same-day discharge.

Methods: This single-center retrospective chart review included 601 unique consecutive Medicare-insured patients who underwent TKA (n = 337) or THA (n = 308) between June 1, 2015 and November 16, 2017. Read More

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http://dx.doi.org/10.1016/j.artd.2019.08.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920716PMC
December 2019

Effect of morbid obesity on patient-reported outcomes in total joint arthroplasty: a minimum of 1-year follow-up.

Arthroplast Today 2019 Dec 28;5(4):493-496. Epub 2019 Sep 28.

Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT, USA.

The objective of this study is to explore the effect of morbid obesity on patient-reported outcomes in primary total joint arthroplasty. We retrospectively reviewed 755 primary total joint arthroplasty cases with a minimum of 1-year follow-up. Two groups were compared: (1) patients with BMI < 40 and (2) those with BMI ≥ 40. Read More

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http://dx.doi.org/10.1016/j.artd.2019.08.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920710PMC
December 2019

Medicare coverage is an independent predictor of prolonged hospitalization after primary total joint arthroplasty.

Arthroplast Today 2019 Dec 18;5(4):489-492. Epub 2019 Oct 18.

Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT, USA.

The purpose of this study was to investigate the association between insurance type and length of stay (LOS) in primary total joint arthroplasty. A retrospective review of 848 patients was performed. Patients were divided into 3 groups based on their insurance type: Medicare, Medicaid, or commercial coverage. Read More

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http://dx.doi.org/10.1016/j.artd.2019.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920717PMC
December 2019

The prevalence of elevated-rim polyethylene liner use in primary total hip arthroplasty in the New York State metropolitan area.

Arthroplast Today 2019 Dec 20;5(4):486-488. Epub 2019 Nov 20.

Division of Adult Reconstruction, Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.

In existing radiographic studies on primary total hip arthroplasty (THA) examining the spino-pelvic effect on THA instability, there is no control of the type of polyethylene liner used, which may be a significant confounder of the results. We sought to determine the prevalence of the use of elevated liners in primary THA using regional implant company sales data. A total of 12,528 liners were analyzed, demonstrating that the overall regional percentage use of lipped liner use is high and varies inversely with larger head sizes. Read More

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http://dx.doi.org/10.1016/j.artd.2019.10.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921167PMC
December 2019

Creating a dual articulating antibiotic spacer for management of an infected total femur prosthesis hemiarthroplasty.

Arthroplast Today 2019 Dec 13;5(4):482-485. Epub 2019 Aug 13.

Department of Orthopaedic Surgery and Rehabilitation, University of Oklahoma, Oklahoma City, OK, USA.

The gold standard for management of chronic periprosthetic joint infections is a 2-stage revision arthroplasty with the first stage being explantation, debridement, and placement of a spacer. While there are implants designed to manage periprosthetic infections in hip and knee arthroplasty, there are not any commercially available implants designed to specifically manage an infected total femur megaprosthesis. This creates a unique surgical challenge and requires custom construction of a spacer to be performed by the surgeon intraoperatively. Read More

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http://dx.doi.org/10.1016/j.artd.2019.07.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920719PMC
December 2019