8,806 results match your criteria Journal of Arthroplasty[Journal]


Changes in Discharge to Rehabilitation: Potential Unintended Consequences of Medicare Total Hip Arthroplasty/Total Knee Arthroplasty Bundled Payments Should They Be Implemented on a Nationwide Scale.

J Arthroplasty 2019 Feb 18. Epub 2019 Feb 18.

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

Background: As a part of the 2010 Affordable Care Act, Medicare was committed to changing 50% of its reimbursement to alternative payment models by 2018. One strategy included introduction of "bundled payments" or a fixed price for an episode of care. Early studies of the first operative bundles for elective total hip and knee arthroplasty (THA/TKA) suggest changes in discharge to rehabilitation. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.068DOI Listing
February 2019

Donning Gloves Before Surgical Gown Eliminates Sleeve Contamination.

J Arthroplasty 2019 Jan 16. Epub 2019 Jan 16.

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

Background: There are numerous studies in the literature that have recognized the importance of the glove-gown interface as a potential source of intraoperative bacterial contamination. It has been demonstrated that the methods with which one dons their surgical gown and gloves can alter the level of gown contamination. We hypothesize that donning undergloves before the surgical gown will decrease if not eliminate sleeve contamination. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.015DOI Listing
January 2019

Efficacy of Intraoperative Antiseptic Techniques in the Prevention of Periprosthetic Joint Infection: Superiority of Betadine.

J Arthroplasty 2019 Feb 11. Epub 2019 Feb 11.

Department of Orthopaedic Surgery, University of Alabama at Birmingham Hospital, Birmingham, AL.

Background: Povidone-iodine (PI), chlorhexidine gluconate (CHG), and vancomycin (VANC) powder are common intrawound prophylactic agents to prevent periprosthetic joint infection during primary total joint arthroplasty. The aims of this study are (1) to determine the minimal inhibitory concentration (MIC) and time to death for PI, CHG, and VANC against multiple bacteria and (2) to determine time to death against bacteria dried on titanium discs.

Methods: A standard quantitative suspension assay was performed to determine the MIC for PI, CHG, and VANC against methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Haemophilus influenzae, Pseudomonas aeruginosa, Burkholderia cepacia, and Escherichia coli. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.002DOI Listing
February 2019

Two-Stage Debridement With Prosthesis Retention for Acute Periprosthetic Joint Infections.

J Arthroplasty 2019 Feb 16. Epub 2019 Feb 16.

Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, AZ.

Background: Historically, infection control rates with debridement and component retention have been poor in the management of acute prosthetic joint infections. We previously described a 2-stage debridement with prosthesis retention protocol for acute periprosthetic joint infection and reported a 90% success rate in a sample of 20 patients.

Methods: A retrospective review of 83 patients who underwent a 2-stage debridement with implant retention with a minimum 1-year follow-up was performed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193015
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http://dx.doi.org/10.1016/j.arth.2019.02.013DOI Listing
February 2019
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Sonication of Extracted Implants Improves Microbial Detection in Patients With Orthopedic Implant-Associated Infections.

J Arthroplasty 2019 Feb 20. Epub 2019 Feb 20.

Department of Orthopedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.

Background: We assessed whether combining the conventional culture and implant sonicate fluid culture (SFC) methods increased the diagnostic accuracy of orthopedic implant-associated infection (OIAI).

Methods: Consecutive patients (n = 66) undergoing implant removal (OIAI, 17; non-OIAI, 49) were evaluated prospectively. We analyzed 493 samples (39 preoperative joint aspirates, 243 peri-implant tissue specimens, 124 implant sonication, 67 controls, and 20 water bath samples). Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.020DOI Listing
February 2019

Corrigendum to 'Patient Perceptions of the Safety of Outpatient Total Knee Arthroplasty' [The Journal of Arthroplasty 34 (2019) 462-464].

J Arthroplasty 2019 Mar 11. Epub 2019 Mar 11.

Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO.

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http://dx.doi.org/10.1016/j.arth.2019.02.028DOI Listing

Ten-Year Results Following One-Stage Septic Hip Exchange in the Management of Periprosthetic Joint Infection.

J Arthroplasty 2019 Feb 20. Epub 2019 Feb 20.

Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany.

Background: Although 2-stage revision is still considered the gold standard for surgical management of periprosthetic joint infection (PJI), 1-stage revision has been reported to be as effective. Long-term reports for 1-stage revision in hip PJIs are lacking.

Methods: We reviewed our 10-11 years of results of 85 patients who underwent 1-stage exchange of the hip with an antibiotic-loaded bone cemented prosthesis due to PJI to determine the following: (1) What is the infection-free survival? (2) What is the overall survival? and (3) What are the long-term clinical outcomes? All 1-stage revision total hip arthroplasties (THAs) for infection between January 2006 and December 2007, with a minimum 10-year follow-up (range 10-11), were included in this retrospective cohort. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.021DOI Listing
February 2019
3 Reads

To Cement or Not? Five-Year Results of a Prospective, Randomized Study Comparing Cemented vs Cementless Total Knee Arthroplasty.

J Arthroplasty 2019 Feb 21. Epub 2019 Feb 21.

Anderson Orthopaedic Research Institute, Inova Center for Joint Replacement at Inova Mount Vernon Hospital, Alexandria, VA.

Background: The optimal mode of fixation in total knee arthroplasty is a continuing subject of debate.

Methods: Previously, we reported 2-year results for this prospective, randomized trial. Knee Society Scores, Oxford scores, and pain visual analog scales were collected pre-operatively and post-operatively. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.024DOI Listing
February 2019

High Hip Center Reduces the Dynamic Hip Range of Motion and Increases the Hip Load: A Gait Analysis Study in Hip Arthroplasty Patients With Unilateral Developmental Dysplasia.

J Arthroplasty 2019 Feb 18. Epub 2019 Feb 18.

Cerrahpasa Medical Faculty, Orthopaedics and Traumatology Department, Istanbul University - Cerrahpasa, Istanbul, Turkey.

Background: Long-term favorable clinical outcomes of anatomical or high hip center techniques in total hip arthroplasty (THA) are reported in patients with developmental dysplasia of the hip (DDH). However, there is little information about the effect of the hip center location on gait characteristics. The purpose of this study was to compare these surgical techniques with gait analysis, analyze the effect of the hip rotation center location on gait parameters, and discuss the possible problems that may arise. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.017DOI Listing
February 2019

Cross-Cultural Adaptation, Reliability, and Validity of the Chinese Version of the Tampa Scale for Kinesiophobia-11 Among Patients Who Have Undergone Total Knee Arthroplasty.

J Arthroplasty 2019 Feb 6. Epub 2019 Feb 6.

Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Background: The shortened version of the Tampa Scale for Kinesiophobia (TSK-11) has been well characterized in the literature. However, to the best of our knowledge, no previous studies have evaluated the reliability and validity of the TSK-11 for Chinese-speaking patients who have undergone total knee arthroplasty (TKA). Thus, the objectives of this study were to translate and adapt the TSK-11 cross-culturally into Chinese and to evaluate its reliability and validity in a sample of Chinese TKA patients. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.076DOI Listing
February 2019

Letter to the Editor on "Choices, Compromises, and Controversies in Total Knee and Total Hip Arthroplasty Modifiable Risk Factors: What You Need to Know".

J Arthroplasty 2019 Feb 18. Epub 2019 Feb 18.

Department of Endocrinology, Metabolism, and Clinical Nutrition, Medical College of Wisconsin, Milwaukee, WI.

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193015
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http://dx.doi.org/10.1016/j.arth.2019.02.014DOI Listing
February 2019
2 Reads

Improved Range of Motion and Patient-Reported Outcome Scores With Fixed-Bearing Revision Total Knee Arthroplasty for Suboptimal Axial Implant Rotation.

J Arthroplasty 2019 Feb 14. Epub 2019 Feb 14.

Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA.

Background: Suboptimal implant rotation has consequences with respect to knee kinematics and clinical outcomes. We evaluated the functional outcomes of revision total knee arthroplasty (TKA) for poor axial implant rotation.

Methods: We retrospectively reviewed 42 TKAs undergoing aseptic revision for poor axial implant rotation. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.007DOI Listing
February 2019
2 Reads
2.666 Impact Factor

Fretting and Corrosion Damage of Retrieved Dual-Mobility Total Hip Arthroplasty Systems.

J Arthroplasty 2019 Feb 14. Epub 2019 Feb 14.

Department of Orthopaedic Research, Beaumont Health, Royal Oak, MI; Department of Orthopaedic Surgery, Oakland University-William Beaumont School of Medicine, Rochester, MI.

Background: Dual-mobility (DM) total hip arthroplasty (THA) systems are designed to increase stability while potentially avoiding problems associated with large femoral heads. Complications of these systems are not yet fully understood. This study aims at characterizing in vivo performance of DM hip systems and assessing modes of clinical failure. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193014
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http://dx.doi.org/10.1016/j.arth.2019.02.008DOI Listing
February 2019
3 Reads

Choices, Compromises, and Controversies in Total Knee and Total Hip Arthroplasty Modifiable Risk Factors: What You Need to Know.

J Arthroplasty 2019 Feb 18. Epub 2019 Feb 18.

Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193015
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http://dx.doi.org/10.1016/j.arth.2019.02.015DOI Listing
February 2019
1 Read
2.666 Impact Factor

Inflammatory Arthritis Is a Risk Factor for Multiple Complications After Total Hip Arthroplasty: A Population-Based Comparative Study of 68,348 Patients.

J Arthroplasty 2019 Feb 18. Epub 2019 Feb 18.

Hospital for Special Surgery, New York, NY.

Background: Patients with inflammatory arthritis (IA) are likely at higher risk of postoperative complications following total hip arthroplasty (THA), from the underlying disease, the degree of articular deformity, and immunosuppressive medications. The purpose of this study was to perform a comparative study of the risk of complications after THA between IA and osteoarthritis.

Methods: A national private insurance database was used to select patients undergoing unilateral primary THA. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.018DOI Listing
February 2019
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Current Practice Trends in Primary Hip and Knee Arthroplasties Among Members of the American Association of Hip and Knee Surgeons: A Long-Term Update.

J Arthroplasty 2019 Feb 12. Epub 2019 Feb 12.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

At the 2018 Annual Meeting of the American Association of Hip and Knee Surgeons, an audience response poll was conducted to determine current practice patterns among its members. The poll pertained to primary total hip arthroplasties and primary total knee arthroplasties, and results were compared to the findings from similar polls completed at previous annual meetings of the American Association of Hip and Knee Surgeons. This article summarizes the current findings and compares trends over time from the previous polls. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.006DOI Listing
February 2019

Perioperative Periprosthetic Femur Fractures are Strongly Correlated With Fixation Method: an Analysis From the American Joint Replacement Registry.

J Arthroplasty 2019 Feb 10. Epub 2019 Feb 10.

Dell Medical School, University of Texas at Austin, Austin, TX.

Background: Perioperative periprosthetic femur fractures (PPFx) after total hip arthroplasty (THA) remain a leading cause of early stem failure and revision and are associated with high rates of morbidity and mortality. American Joint Replacement Registry (AJRR) data have been analyzed to determine the relationship of femoral stem fixation to PPFx revision.

Methods: All early (≤3 months from index arthroplasty) linked primary and revision hip arthroplasties reported to the AJRR between 2012 and 2017 were analyzed. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.004DOI Listing
February 2019
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Prognostic Role of Serum Albumin, Total Lymphocyte Count, and Mini Nutritional Assessment on Outcomes After Geriatric Hip Fracture Surgery: A Meta-Analysis and Systematic Review.

J Arthroplasty 2019 Feb 11. Epub 2019 Feb 11.

Department of Orthopedics, The Seventh Medical Center of PLA General Hospital, Beijing, China.

Background: Hip fracture is a significant health risk for older adults and malnutrition indicates hip fracture risk.

Methods: We evaluated whether nutrition status could predict clinical outcomes and mortality after hip fracture surgery in older adults. MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched for studies published until July 1, 2018, in patients with serum albumin or total lymphocyte count (TLC) at admission, nutritional status by Mini Nutritional Assessment (MNA), and in-hospital follow-up. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.003DOI Listing
February 2019
1 Read

Smoking Cessation Before and After Total Joint Arthroplasty-An Uphill Battle.

J Arthroplasty 2019 Feb 5. Epub 2019 Feb 5.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Background: Patients actively smoking at the time of primary total joint arthroplasty (TJA) are at increased risk of perioperative complications. Employing strategies for smoking cessation has therefore become routine. A potential benefit of cessation in anticipation of TJA may be long-term cessation. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.073DOI Listing
February 2019

The Effect of Body Mass Index on 30-day Complications After Revision Total Hip and Knee Arthroplasty.

J Arthroplasty 2019 Feb 13. Epub 2019 Feb 13.

Department of Orthopaedic Surgery, Cleveland Clinic, Weston, FL.

Background: We aimed to explore the effect of body mass index (BMI) on 30-day complications after aseptic revision total knee arthroplasty (rTKA) and aseptic revision total hip arthroplasty (rTHA), considering BMI as both a categorical and continuous variable.

Methods: A total of 18,866 patients (9093 rTHA and 9773 rTKA) patients were included for analysis using the American College of Surgeons National Surgical Quality Improvement Project database. Thirty-day rates of readmissions, reoperations, and major and minor complications were compared between different weight categories (overweight: BMI >25 and ≤30 kg/m; obese: BMI >30 and ≤40 kg/m; morbidly obese: BMI >40 kg/m) and the normal weight category (BMI >18. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.005DOI Listing
February 2019

Diagnosing Prosthetic Joint Infections in Patients With Inflammatory Arthritis: A Systematic Literature Review.

J Arthroplasty 2019 Jan 31. Epub 2019 Jan 31.

Department of Medicine, Hospital for Special Surgery, New York, NY.

Background: Patients with inflammatory arthritis (IA) are at increased risk of prosthetic joint infections (PJI), yet differentiating between septic and aseptic failure is a challenge. The aim of our systematic review is to evaluate synovial biomarkers and their efficacy at diagnosing PJI in patients with IA.

Methods: A comprehensive literature search was performed in the following databases from inception to January 2018: Ovid MEDLINE, Ovid EMBASE, and the Cochrane Library. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.051DOI Listing
January 2019
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Synovial Fluid Viscosity Test is Promising for the Diagnosis of Periprosthetic Joint Infection.

J Arthroplasty 2019 Feb 13. Epub 2019 Feb 13.

Department of Orthopaedics, Chinese People's Liberation Army General Hospital (301 Hospital), Beijing, PR China.

Background: So far there is no "gold standard" test for the diagnosis of periprosthetic joint infection (PJI), compelling clinicians to rely on several serological and synovial fluid tests with no 100% accuracy. Synovial fluid viscosity is one of the parameters defining the rheology properties of synovial fluid. We hypothesized that patients with PJI may have a different level of synovial fluid viscosity and aimed to investigate the sensitivity and specificity of synovial fluid viscosity in detecting PJI. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.009DOI Listing
February 2019

Design, Material, and Seating Load Effects on In Vitro Fretting Corrosion Performance of Modular Head-Neck Tapers.

J Arthroplasty 2019 Jan 24. Epub 2019 Jan 24.

Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY; Syracuse Biomaterial Institute, Syracuse, NY; Department of Bioengineering, Clemson University, Clemson, SC; Clemson - Medical University of South Carolina Combined Program in Bioengineering, Charleston, SC.

Background: The short-term corrosion and micromechanical behavior of 32 unique head-neck taper design/material/assembly conditions was tested using an incremental cyclic fretting corrosion (ICFC) test method previously developed.

Methods: Seven materials, design, and simulated surgical parameters were evaluated, each being assigned 2 conditions for testing, using a 2 (7 factor, quarter factorial) design of experiments test matrix. The factors explored were (1) seating load, (2) head-neck offset, (3) material combination, (4) taper diameter, (5) taper roughness, (6) angular mismatch/engagement, and (7) taper length. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.043DOI Listing
January 2019

Physical Therapy on Postoperative Day Zero Following Total Knee Arthroplasty: A Randomized, Controlled Trial of 394 Patients.

J Arthroplasty 2019 Feb 13. Epub 2019 Feb 13.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Background: Surgeons have increasingly emphasized early mobilization as a way to facilitate discharge following total knee arthroplasty (TKA). The purpose of this study was to determine whether starting formal physical therapy (PT) the afternoon of postoperative day (POD) 0, instead of starting PT the morning of POD 1, could shorten hospital length of stay (LOS).

Methods: Patients undergoing elective TKA with a planned minimum 1-night hospital stay were randomized to start formal PT the afternoon following surgery or the morning of POD 1. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.010DOI Listing
February 2019

Failed Debridement and Implant Retention Does Not Compromise the Success of Subsequent Staged Revision in Infected Total Knee Arthroplasty.

J Arthroplasty 2019 Feb 2. Epub 2019 Feb 2.

Department of Orthopaedics, North Shore Hospital, Auckland, New Zealand.

Background: Periprosthetic joint infection (PJI) is the leading cause of early revisions after total knee arthroplasty. Debridement, antibiotics, and implant retention (DAIR) procedures are often the initial treatment for PJI. However, there is concern that failed DAIR undermines the future success of revision procedures. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.066DOI Listing
February 2019
2.666 Impact Factor

Contemporary Revision Total Knee Arthroplasty in Patients Younger Than 50 Years: 1 in 3 Risk of Re-Revision by 10 Years.

J Arthroplasty 2019 Feb 11. Epub 2019 Feb 11.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Background: There is a paucity of literature on contemporary aseptic revision total knee arthroplasty in patients ≤50 years. We sought to determine risk factors for failure in this population, with specific emphasis on survivorship free of (1) all-cause re-revision and (2) re-revision for instability.

Methods: We retrospectively reviewed 135 nononcologic revision total knee arthroplasties (TKAs) performed from 2000 to 2012 in patients ≤50 years. Read More

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http://dx.doi.org/10.1016/j.arth.2019.02.001DOI Listing
February 2019

Conversion Total Knee Arthroplasty: A Distinct Surgical Procedure With Increased Resource Utilization.

J Arthroplasty 2019 Feb 4. Epub 2019 Feb 4.

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

Background: Current Procedural Terminology coding currently makes no distinction between primary total knee arthroplasty (TKA) and conversion TKA, in which periarticular hardware components must be removed prior to or during TKA. We hypothesize that conversion TKA will carry increased operative time, blood loss, postoperative complications, and 90-day emergency department/readmission rate compared to primary TKA.

Methods: Patients undergoing conversion TKA from 2005 to 2017 were identified from an institutional database and matched to primary TKA patients by age, gender, American Society of Anesthesiologists score, body mass index, and procedure date (±1 year). Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.070DOI Listing
February 2019

Greater Rates of Acute Kidney Injury in African American Total Knee Arthroplasty Patients.

J Arthroplasty 2019 Jan 31. Epub 2019 Jan 31.

Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY.

Background: This retrospective study compared the change in serum creatinine between African American and Caucasian total knee arthroplasty (TKA) patients. The authors hypothesized that African Americans would demonstrate significantly greater change, and that a significantly greater proportion would demonstrate creatinine changes consistent with acute kidney injury (AKI).

Methods: Primary TKAs performed at a single institution between July 2011 and June 2016 were identified: 1035 primary TKAs met inclusion and exclusion criteria (110 African American, 925 Caucasian, excluding Hispanic and Asian patients). Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.058DOI Listing
January 2019

Can Prophylactic Cables Stop Crack Propagation in Revision Arthroplasty: A Biomechanical Study.

J Arthroplasty 2019 Jan 7. Epub 2019 Jan 7.

Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; Department of Orthopaedic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia; Research Foundation, Perth Orthopaedic and Sport Medicine Centre, West Perth, Western Australia, Australia.

Background: Intraoperative femur fractures are a common complication of revision hip arthroplasty. This study examined the use of a prophylactic cable in stopping a crack from propagating beyond the cable.

Methods: Seventy sheep femora were prepared. Read More

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http://dx.doi.org/10.1016/j.arth.2018.12.039DOI Listing
January 2019
2 Reads

Rotating-Hinge Revision Total Knee Arthroplasty for Treatment of Severe Arthrofibrosis.

J Arthroplasty 2019 Feb 5. Epub 2019 Feb 5.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Background: Revision total knee arthroplasty (TKA) for arthrofibrosis is fraught with challenges. Because rotating-hinge (RH) prostheses do not rely on ligaments for stability, a more aggressive soft-tissue release is possible. The goal of this study was to report arc of motion, Knee Society scores, and implant survivorship in patients with arthrofibrosis revised with an RH. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.072DOI Listing
February 2019

Preoperative Patient-Reported Outcomes and Clinical Characteristics as Predictors of 90-Day Cost/Utilization and Complications.

J Arthroplasty 2019 Jan 31. Epub 2019 Jan 31.

Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, NY.

Background: With the advent of mandatory bundle payments for total joint arthroplasty (TJA), assessing patients' risk for increased 90-day complications and resource utilization is crucial. This study assesses the degree to which preoperative patient-reported outcomes predict 90-day complications, episode costs, and utilization in TJA patients.

Methods: All TJA cases in 2017 at 2 high-volume hospitals were queried. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.059DOI Listing
January 2019
1 Read

Sleep Apnea Increases Ninety-Day Complications and Cost Following Primary Total Joint Arthroplasty.

J Arthroplasty 2018 Dec 30. Epub 2018 Dec 30.

Holy Cross Hospital, Orthopedic Research Institute, Fort Lauderdale, FL.

Background: Sleep apnea (SA) negatively affects bone mineralization, cognition, and immunity. There is paucity in the literature regarding the impact of SA on total joint arthroplasty (TJA). The purpose of this study is to compare complications in patients with and without SA undergoing either total knee (TKA) or total hip arthroplasty (THA). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403183121
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http://dx.doi.org/10.1016/j.arth.2018.12.018DOI Listing
December 2018
2 Reads

Fifteen-Year Results of Total Hip Arthroplasty With Cobalt-Chromium Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50 Years and Less.

J Arthroplasty 2019 Feb 5. Epub 2019 Feb 5.

Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

Background: Highly cross-linked polyethylene (HXLPE) is the most commonly used bearing surface in total hip arthroplasty (THA) because of its superior wear properties, but long-term results in young patients are limited. Mid-term survivorship has been promising; however, polyethylene wear rates and need for revision surgeries remain a concern in this population. The purpose of our study is to investigate polyethylene wear rates, implant survivorship, wear-related revisions, and patient-reported outcomes in a young patient cohort at 15-year follow-up. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193011
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http://dx.doi.org/10.1016/j.arth.2019.01.071DOI Listing
February 2019
3 Reads
2.666 Impact Factor

Age and Frailty Influence Hip and Knee Arthroplasty Reimbursement in a Bundled Payment Care Improvement Initiative.

J Arthroplasty 2019 Jan 30. Epub 2019 Jan 30.

Langone Orthopedic Hospital, Department of Orthopaedic Surgery, New York University, New York, NY; Insall Scott Kelly Institute, New York, NY.

Background: The Bundled Payment Care Improvement (BPCI) initiative aims to improve quality of patient care while mitigating cost. How patient age and frailty affect reimbursement after hip and knee total joint arthroplasty (TJA) is not known. This study evaluates if patient age and frailty affect cost of care. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.050DOI Listing
January 2019
1 Read

Creation and Validation of Linkage Between Orthopedic Registry and Administrative Data Using Indirect Identifiers.

J Arthroplasty 2019 Feb 2. Epub 2019 Feb 2.

Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY.

Background: Registries and administrative databases have unique and complementary strengths in device epidemiologic studies. We sought to develop, validate, and assess a sequential algorithm using indirect identifiers to link registry and administrative data.

Methods: Hip and knee arthroplasty procedures performed at 6 New York State hospitals enrolled in American Joint Replacement Registry in 2014 were included. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.063DOI Listing
February 2019
2 Reads

Patient Dissatisfaction After Primary Total Joint Arthroplasty: The Patient Perspective.

J Arthroplasty 2019 Feb 5. Epub 2019 Feb 5.

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

Background: Despite improvements in surgical technique and implant longevity, some patients continue to report dissatisfaction after total joint arthroplasty (TJA). As patient satisfaction is increasingly used as a quality metric, the objective of this study was to gain better understanding of satisfaction with total joint arthroplasty from the patient perspective.

Methods: Five hundred fifty-one primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) with a minimum of 1-year follow-up and were responsive to a satisfaction survey were analyzed. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.075DOI Listing
February 2019
1 Read

Local Infiltration Analgesia With Liposomal Bupivacaine Improves Early Outcomes After Total Knee Arthroplasty: 24-Hour Data From the PILLAR Study.

J Arthroplasty 2018 Dec 25. Epub 2018 Dec 25.

Department of Orthopaedic Surgery, Lenox Hill Hospital of Northwell Health, New York, NY.

Background: Enhanced postoperative care pathways have shifted total knee arthroplasty (TKA) to outpatient and short-stay settings, placing greater emphasis on predischarge outcomes. In this study, we report prespecified secondary and tertiary end points of the PILLAR study within 24 hours after TKA in patients receiving local infiltration analgesia (LIA) with or without liposomal bupivacaine (LB).

Methods: Patients with knee osteoarthritis were randomized 1:1 to receive LIA with LB 266 mg/20 mL admixed with bupivacaine HCl 0. Read More

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http://dx.doi.org/10.1016/j.arth.2018.12.026DOI Listing
December 2018
1 Read

Are Ceramic Bearings Becoming Cost-Effective for All Patients Within a 90-Day Bundled Payment Period?

J Arthroplasty 2019 Feb 5. Epub 2019 Feb 5.

OrthoCarolina, Hip and Knee Center, Charlotte, NC.

Background: We analyzed whether the total hospital cost in a 90-day bundled payment period for ceramic-on-polyethylene (C-PE) and ceramic-on-ceramic (COC) total hip arthroplasty (THA) bearings was changing over time, and whether the cost differential between ceramic bearings and metal-on-polyethylene (M-PE) bearings was approaching the previously published tipping point for cost-effectiveness of US$325.

Methods: A total of 245,077 elderly Medicare patients (65+) who underwent primary THA between 2010 and 2015 were identified from the United States Medicare 100% national administrative hospital claims database. The total inpatient cost, calculated up to 90 days after index discharge, was computed using cost-to-charge ratios, and hospital payment was analyzed. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.074DOI Listing
February 2019

Corrigendum to "The Efficacy of Combined Use of Intraarticular and Intravenous Tranexamic Acid on Reducing Blood Loss and Transfusion Rate in Total Knee Arthroplasty" [Journal of Arthroplasty (2015) 776-780].

J Arthroplasty 2019 Feb 21. Epub 2019 Feb 21.

Department of Orthopaedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Orthopaedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

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http://dx.doi.org/10.1016/j.arth.2019.01.056DOI Listing
February 2019

Large Opioid Prescriptions Are Unnecessary After Total Joint Arthroplasty: A Randomized Controlled Trial.

J Arthroplasty 2019 Feb 4. Epub 2019 Feb 4.

Adult Reconstruction Division, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.

Background: The purpose of this randomized controlled trial is to determine whether the quantity of opioid pills prescribed at discharge is associated with the number of opioid pills consumed or unused by patients after primary hip and knee arthroplasty within 30 days after discharge.

Methods: A total of 304 opioid-naïve patients were randomized to receive either 30 or 90 5-mg oxycodone immediate-release (OxyIR) pills at discharge. Daily opioid consumption, number of unused pills, and pain scores were calculated for 30 days with a patient-completed medication diary. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.065DOI Listing
February 2019
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Arthroplasty in the Face of Morbid Obesity, Time for a Paradigm Shift.

Authors:
Mark I Froimson

J Arthroplasty 2019 Feb 6. Epub 2019 Feb 6.

Riverside Health Advisors, Hunting Valley, OH.

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http://dx.doi.org/10.1016/j.arth.2019.01.067DOI Listing
February 2019

Perioperative Dietary Restriction of Carbohydrates in the Management of Blood Glucose Levels in Patients Undergoing Total Knee Replacement.

J Arthroplasty 2019 Jan 29. Epub 2019 Jan 29.

Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA.

Background: Approximately 75% of the US population over 65 years has prediabetes or diabetes. Despite current evidence for the efficacy of carbohydrate restriction in managing blood glucose, this practice has not been implemented as part of routine perioperative blood sugar management. We hypothesize that a carbohydrate reduced hospital diet (CRD) of 135 g/d may improve blood sugar levels following total knee arthroplasty (TKA) compared to a non-carbohydrate reduced hospital diet (NCRD). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08835403193009
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http://dx.doi.org/10.1016/j.arth.2019.01.049DOI Listing
January 2019
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The Effect of Payer Type on Patient-Reported Outcomes in Total Joint Arthroplasty Is Modulated by Baseline Patient Characteristics.

J Arthroplasty 2019 Feb 2. Epub 2019 Feb 2.

Department of Orthopaedic Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA.

Background: Patient-reported outcomes (PROs) are gaining an important role in the assessment of quality of care. There are currently limited data on the effect of payer type on PROs in total joint arthroplasty (TJA). This study compared both disease-specific and general health PROs among patients stratified according to their payer type. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.069DOI Listing
February 2019

Richard H. Rothman, MD, PhD (1936-2018).

J Arthroplasty 2019 Feb 10;34(2):193. Epub 2019 Jan 10.

Rothman Orthopaedic Institute, Orthopedic Surgery, Philadelphia, PA.

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http://dx.doi.org/10.1016/j.arth.2018.12.007DOI Listing
February 2019

Modifying Patient Expectations Can Enhance Total Hip Arthroplasty Postoperative Satisfaction.

J Arthroplasty 2019 Jan 6. Epub 2019 Jan 6.

Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY.

Background: A better understanding of patient expectations within the perioperative setting will enable clinicians to better tailor care to the needs of the total hip arthroplasty (THA) recipient. Such an approach will promote patient-centered decision-making and optimize recovery times while enhancing mandated hospital quality metrics. In the present study, we preoperatively and postoperatively surveyed THA candidates to elucidate the relationship between patient expectations and length of stay (LOS). Read More

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http://dx.doi.org/10.1016/j.arth.2018.12.038DOI Listing
January 2019

Uncemented Total Hip Arthroplasty Through the Direct Anterior Approach: Analysis of a Consecutive Series of 275 Hips With a Minimum Follow-Up of 10 Years.

J Arthroplasty 2019 Jan 31. Epub 2019 Jan 31.

Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Background: The purpose of this study was to document complications, outcomes, and 10-year survivorship of primary total hip arthroplasty (THA) using a direct anterior approach with an uncemented, straight, hydroxyapatite-coated stem and an uncemented cup.

Methods: A retrospective, consecutive series of 275 primary THAs through a direct anterior approach with traction table using Medacta Versafit cup and Quadra-H stem with a minimum of 10-year follow-up was identified. The cumulative 10-year survival of the implants was estimated using Kaplan-Meier estimator. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.062DOI Listing
January 2019

Neither Anterior nor Posterior Referencing Consistently Balances the Flexion Gap in Measured Resection Total Knee Arthroplasty: A Computational Analysis.

J Arthroplasty 2019 Jan 30. Epub 2019 Jan 30.

Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medicine of Cornell University, New York, NY.

Background: Whether anterior referencing (AR) or posterior referencing (PR) produces a more balanced flexion gap in total knee arthroplasty (TKA) using measured resection remains controversial. Our goal was to compare AR and PR in terms of (1) medial and lateral gaps at full extension and 90° of flexion, and (2) maximum medial and lateral collateral ligament (MCL and LCL) forces in flexion.

Methods: Computational models of 6 knees implanted with posterior-stabilized TKA were virtually positioned with both AR and PR techniques. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.052DOI Listing
January 2019

Predicting Inpatient Dissatisfaction Following Total Joint Arthroplasty: An Analysis of 3,593 Hospital Consumer Assessment of Healthcare Providers and Systems Survey Responses.

J Arthroplasty 2019 Jan 11. Epub 2019 Jan 11.

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

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, created by the Centers for Medicare and Medicaid, is directly tied to hospital reimbursement. The purpose of this study is to identify factors that are predictive HCAHPS survey responses following primary hip and knee arthroplasty.

Methods: Prospectively collected HCAHPS responses from patients undergoing elective hip and knee arthroplasty between January 2013 and October 2017 at our institution were analyzed. Read More

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http://dx.doi.org/10.1016/j.arth.2019.01.008DOI Listing
January 2019
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