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Preoperative Education for Total Joint Arthroplasty: Does Reimbursement Reduction Threaten Improved Outcomes?
Grayson C. Kelmer, Justin J. Turcotte, Steffanie S. Dolle, Jeanne D. Angeles, James H. MacDonald, Paul J. King
doi : 10.1016/j.arth.2021.03.016
VOLUME 36, ISSUE 8, P2651-2657, AUGUST 01, 2021
Nurse navigation programs have been previously shown to reduce cost and improve outcomes after total joint arthroplasty (TJA). Medicare has proposed a 13.7% reduction in professional fee reimbursement for TJA procedures that may adversely impact providers’ and health systems’ ability to fund ancillary support resources such as nurse navigators.
The Hospital Frailty Risk Score is Not an Accurate Predictor of Treatment Costs for Total Joint Replacement Patients in a Medicare Bundled Payment Population
Christian B. Ong, Chad A. Krueger, Andrew M. Star
doi : 10.1016/j.arth.2021.03.049
VOLUME 36, ISSUE 8, P2658-2664.E2, AUGUST 01, 2021
Medically complex patients require more resources and experience higher costs within total joint arthroplasty (TJA) bundled payment models. While risk adjustment would be beneficial for such patients, no tool currently exists which can reliably identify these patients preoperatively. The purpose of this study is to determine if the Hospital Frailty Risk Score (HFRS) is a valid predictor of high-TJA treatment costs.
What is the Level of Evidence Substantiating Commercial Payers’ Coverage Policies for Total Joint Arthroplasty?
Matthew S. Austin, Blair S. Ashley, Nicholas A. Bedard, Hari P. Bezwada, Charles P. Hannon, Yale A. Fillingham, Yogesh V. Kolwadkar, Harold W. Rees, Matthew J. Grosso, Erik N. Zeegen
doi : 10.1016/j.arth.2021.03.036
VOLUME 36, ISSUE 8, P2665-2673.E8, AUGUST 01, 2021
The prevalence of total joint arthroplasty (TJA) in the United States has drawn the attention of health care stakeholders. The payers have also used a variety of strategies to regulate the medical necessity of these procedures. The purpose of this study was to examine the level of evidence of the coverage policies being used by commercial payers in the United States.
The Cost of Hip and Knee Revision Arthroplasty by Diagnosis-Related Groups: Comparing Time-Driven Activity-Based Costing and Traditional Accounting
Christopher J. Fang, Jonathan M. Shaker, Jacob M. Drew, Andrew Jawa, David A. Mattingly, Eric L. Smith
doi : 10.1016/j.arth.2021.03.041
VOLUME 36, ISSUE 8, P2674-2679.E3, AUGUST 01, 2021
Traditional hospital cost accounting (TA) has innate disadvantages that limit the ability to meaningfully measure care pathways and quality improvement. Time-driven activity-based costing (TDABC) allows a meticulous account of costs in primary total joint arthroplasty (TJA). However, differences between TA and TDABC have not been examined in revision hip and knee TJA (rTJA). We aimed to compare total costs of rTJA by the diagnosis-related group (DRG), measured by TDABC vs TA.
Financial Burden of Revision Hip and Knee Arthroplasty at an Orthopedic Specialty Hospital: Higher Costs and Unequal Reimbursements
Christopher J. Fang, Jonathan M. Shaker, Daniel M. Ward, Andrew Jawa, David A. Mattingly, Eric L. Smith
doi : 10.1016/j.arth.2021.03.044
VOLUME 36, ISSUE 8, P2680-2684, AUGUST 01, 2021
As demand for primary total joint arthroplasty (TJA) continues to grow, a proportionate increase in revision TJA (rTJA) is expected. It is essential to understand costs and reimbursement of rTJA as our country moves to bundled payment models. We aimed (1) to characterize implant and total hospital costs, (2) assess reimbursement, and (3) determine revenue for rTJA in comparison with primary TJA.
Is Conversion TKA a Primary or Revision? Clinical Course and Complication Risks Approximating Revision TKA Rather Than Primary TKA
Matthew Sloan, Gwo-Chin Lee
doi : 10.1016/j.arth.2021.03.034
VOLUME 36, ISSUE 8, P2685-2690.E1, AUGUST 01, 2021
Conversion total knee arthroplasty (convTKA) is associated with increased resource utilization and costs compared with primary TKA. The purpose of this study is to compare 1) surgical time, 2) hospitalization length (LOS), 3) complications, 4) infection, and 5) readmissions in patients undergoing convTKA to both primary TKA and revision TKA patients.
Good Validity and High Internal Consistency of the Forgotten Joint Score-12 in Patients After Medial Opening Wedge High Tibial Osteotomy
Masafumi Itoh, Junya Itou, Umito Kuwashima, Ken Okazaki
doi : 10.1016/j.arth.2021.03.028
VOLUME 36, ISSUE 8, P2691-2697, AUGUST 01, 2021
The Forgotten Joint Score-12 (FJS-12) was originally developed to assess awareness of an artificial joint. Medial opening wedge high tibial osteotomy (MOWHTO), an alternative surgical method of knee replacement, is a joint-preservation surgery; therefore, joint awareness should be used to evaluate its clinical results. However, FJS-12 has not been validated as a tool to evaluate the postoperative results of MOWHTO. This study aimed to validate FJS-12 in MOWHTO.
Publication Trends and Hot Spots in Femoroacetabular Impingement Research: A 20-Year Bibliometric Analysis
Feng Tang, Wan-Bing Dai, Xian-Long Li, Dilshat Turghun, Hou Huang, Yong-Qian Fan
doi : 10.1016/j.arth.2021.03.019
VOLUME 36, ISSUE 8, P2698-2707, AUGUST 01, 2021
Femoroacetabular impingement (FAI) has attracted increasing attention over the past few decades. We aim to evaluate FAI research and predict research hot spots quantitatively and qualitatively.
Surgeon Decision-Making for Individuals With Obesity When Indicating Total Joint Arthroplasty
William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee
doi : 10.1016/j.arth.2021.02.078
VOLUME 36, ISSUE 8, P2708-2715.E1, AUGUST 01, 2021
Obesity is a risk factor for complications after total joint arthroplasty (TJA). This study analyzed the impact of individual surgeon demographics, financial concerns, and other factors in determining patient candidacy for TJA based on body mass index (BMI).
Do Extended Oral Postoperative Antibiotics Prevent Early Periprosthetic Joint Infection in Morbidly Obese Patients Undergoing Primary Total Joint Arthroplasty?
Christopher N. Carender, David E. DeMik, Natalie A. Glass, Nicolas O. Noiseux, Timothy S. Brown, Nicholas A. Bedard
doi : 10.1016/j.arth.2021.03.018
VOLUME 36, ISSUE 8, P2716-2721, AUGUST 01, 2021
Extended oral antibiotic prophylaxis after primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) in patients with body mass index (BMI) ?40 kg/m2 may reduce the rate of early periprosthetic joint infection (PJI); however, existing data are limited. The purpose of this study was to examine rates of wound complications and PJI in patients with BMI ?40 kg/m2 treated with and without extended oral antibiotic prophylaxis after surgery.
Enhanced Recovery After Surgery Protocols in Lower Extremity Joint Arthroplasty: Using Observational Data to Identify the Optimal Combination of Components
Kevin K. Chen, Jimmy J. Chan, Nicole J. Zubizarreta, Jashvant Poeran, Darwin D. Chen, Calin S. Moucha
doi : 10.1016/j.arth.2021.03.003
VOLUME 36, ISSUE 8, P2722-2728, AUGUST 01, 2021
Enhanced recovery after surgery (ERAS) protocols are increasingly used in orthopedic surgery. Data are lacking on which combinations of ERAS components are (1) the most commonly used and (2) the most effective in terms of outcomes.
The Impact of Race and Socioeconomic Status on Total Joint Arthroplasty Care
Linda I. Suleiman, Gregory C. Manista, Alain E. Sherman, Akash H. Adhia, Vasili Karas, Scott M. Sporer, Brett R. Levine
doi : 10.1016/j.arth.2021.03.002
VOLUME 36, ISSUE 8, P2729-2733, AUGUST 01, 2021
Racial minorities and patients from lower socioeconomic backgrounds are less likely to undergo total joint arthroplasty (TJA) for degenerative joint disease (DJD). However, when these patients do present for care, little is known about the overall severity of DJD and surgical wait times.
The Impact of Mental Illness on Postoperative Adverse Outcomes After Outpatient Joint Surgery
Pramod Kamalapathy, Kristina P. Kurker, Alyssa D. Althoff, James A. Browne, Brian C. Werner
doi : 10.1016/j.arth.2021.04.002
VOLUME 36, ISSUE 8, P2734-2741, AUGUST 01, 2021
The effect of pre-existing mental illness on outpatient surgical outcomes is not well characterized. The objective of this study was to evaluate the association between pre-existing mental illness diagnosis and postoperative complications after outpatient total knee (TKA) and total hip arthroplasty (THA) and 2) compare with inpatient total joint arthroplasty (TJA).
Florida State Opioid Prescription Restriction Law: Impact on Opioid Utilization After Total Joint Arthroplasty
Tejbir S. Pannu, Jesus M. Villa, Jorge Fleites, Preetesh D. Patel, Carlos A. Higuera, Aldo M. Riesgo
doi : 10.1016/j.arth.2021.03.055
VOLUME 36, ISSUE 8, P2742-2745, AUGUST 01, 2021
In response to the opioid epidemic, Florida recently passed the opioid prescription limiting law, effective since July 1st, 2018. However, its impact on opioid prescription after total joint arthroplasty (TJA) has not been elucidated. Thus, our objective was to assess if this new law led to reduced opioid prescription after TJA and to determine its impact on perioperative clinical outcomes.
Medial Unicompartmental Knee Arthroplasty After Failed Open-Wedge High Tibial Osteotomy
Andrea Parente, Claudio Legnani, Marco Bargagliotti, Matteo Marullo, Sergio Romagnoli
doi : 10.1016/j.arth.2021.03.008
VOLUME 36, ISSUE 8, P2746-2751, AUGUST 01, 2021
Controversy exists whether or not a previous high tibial osteotomy (HTO) influences the outcome and survival of a unicompartmental knee arthroplasty (UKA). The aim of this retrospective study was to evaluate clinical, radiological, and functional outcomes of UKA after failed open-wedge HTO compared with UKA with no previous HTO.
Implantation Accuracy of a Lateral Unicompartmental Knee Arthroplasty: A Hoffa´s Fat Pad–Preserving Medial Approach Versus the Transpatellar Lateral Approach
Lena Keppler, Steffen Klingbeil, Fanny Navarre, Björn Michel, Christian Fulghum, Wolfgang Reng
doi : 10.1016/j.arth.2021.03.047
VOLUME 36, ISSUE 8, P2752-2758, AUGUST 01, 2021
A small proportion of patients suffer from isolated lateral osteoarthritis where the sole lateral unicompartmental knee arthroplasty (UKA) is a possible treatment option. There, both a medial and a lateral surgical approach can be considered. This study should answer the question whether the lateral approach is superior to a modified medial approach in terms of implantation accuracy and subjective outcome.
Midterm Results of Medial Unicompartmental Knee Arthroplasty Performed in Patients With Lateral Meniscus Abnormalities on Preoperative MRI Without Symptoms Related to Lateral Meniscus
Sang Jin Park
doi : 10.1016/j.arth.2021.03.054
VOLUME 36, ISSUE 8, P2759-2764, AUGUST 01, 2021
The purpose of the present study was to compare the functional outcomes of medial unicompartmental knee arthroplasty (UKA) between patients with lateral meniscal abnormalities (LM [+] group) on the preoperative magnetic resonance imaging and those without lateral meniscal pathology (LM [–] group) and to evaluate the effect of a lateral meniscus lesion on functional outcomes after minimal 5 year follow-ups of medial UKA.
Lower Extremity Girth Does Not Predict Complications in TKA
Eric S. Secrist, Michael D. Baratz, Jacob M. Drew, Jeffrey M. Goldstein, Jonathon K. Salava, Susan M. Odum, Thomas K. Fehring
doi : 10.1016/j.arth.2021.03.039
VOLUME 36, ISSUE 8, P2765-2770, AUGUST 01, 2021
Obese patients have increased complications after total knee arthroplasty (TKA). A body mass index (BMI) cutoff of 40 is frequently used to determine eligibility for TKA. Patients with a BMI <40 and extremely large legs which may predispose them to complications are approved for surgery because they fall below this cutoff. Alternatively, patients with truncal obesity and a BMI >40 are accepted because they have thin legs. We sought to determine whether BMI or girth should be used to determine eligibility.
Evaluating the “Patella-Friendly” Concept in Total Knee Arthroplasty: A Minimum 15-Year Follow-Up Outcome Study Comparing Constant Radius, Multiradius Cruciate-Retaining, and Nonanatomical Cruciate-Retaining Implants
Theofilos Karachalios, George Komnos, Michael Hantes, Sokratis Varitimidis
doi : 10.1016/j.arth.2021.03.007
VOLUME 36, ISSUE 8, P2771-2778, AUGUST 01, 2021
Patella-friendly femoral components were developed in order to reduce anterior knee pain and patellofemoral complications in total knee arthroplasty (TKA), but their effect on long-term outcome is still unclear.
Comparison of KOOS Scores of Middle-Aged Patients Undergoing Total Knee Arthroplasty to the General Dutch Population Using KOOS Percentile Curves: The LOAS Study
Marieke Loef, Maaike G.J. Gademan, Daisy A.J.M. Latijnhouwers, Herman M. Kroon, Herman H. Kaptijn, Willem J.C.M. Marijnissen, Rob G.H.H. Nelissen, Thea P.M. Vliet Vlieland, Margreet Kloppenburg for the LOAS Study Group
doi : 10.1016/j.arth.2021.03.050
VOLUME 36, ISSUE 8, P2779-2787.E4, AUGUST 01, 2021
We aimed to investigate the application of the Knee Injury and Osteoarthritis Outcome Score (KOOS) percentile curves, using preoperative and postoperative data of patients with knee osteoarthritis undergoing total knee arthroplasty (TKA).
Comparison of Area Deprivation Index, Socioeconomic Parameters, and Preoperative Demographics With Postoperative Emergency Department Visits After Total Knee Arthroplasty
Jonathan H Shaw, Luke D. Wesemann, Ayooluwa S. Ayoola, Clifford M Les, Michael A Charters, W Trevor North
doi : 10.1016/j.arth.2021.03.058
VOLUME 36, ISSUE 8, P2788-2794, AUGUST 01, 2021
This study aims to determine if socioeconomic (SE) parameters, primarily area deprivation index (ADI), relate to postoperative emergency department (ED) visits after total knee arthroplasty (TKA).
Ten-Year Follow-Up of High-Flexion Versus Conventional Total Knee Arthroplasty: A Matched-Control Study
Marc R. Angerame, Catie L. Eschen, Roseann M. Johnson, Jason M. Jennings, Douglas A. Dennis
doi : 10.1016/j.arth.2021.03.017
VOLUME 36, ISSUE 8, P2795-2800, AUGUST 01, 2021
High-flexion total knee arthroplasty (HF-TKA) prostheses were designed with hopes of improving knee function. Studies have suggested increased failure with HF-TKAs. The purpose is to compare clinical results of HF-TKA versus conventional TKA (C-TKA) from the same implant system with long-term follow-up.
Robotics Versus Navigation Versus Conventional Total Hip Arthroplasty: Does the Use of Technology Yield Superior Outcomes?
Vivek Singh, John Realyvasquez, Trevor Simcox, Joshua C. Rozell, Ran Schwarzkopf, Roy I. Davidovitch
doi : 10.1016/j.arth.2021.02.074
VOLUME 36, ISSUE 8, P2801-2807, AUGUST 01, 2021
The use of technology such as navigation and robotic systems may improve the accuracy of component positioning in total hip arthroplasty (THA), but its impact on patient-reported outcome measures (PROMs) remains unclear. This study aims to elucidate the association between the use of intraoperative technology and PROMs in patients who underwent primary THA.
Differences in Spinopelvic Characteristics Between Hip Osteoarthritis Patients and Controls
Moritz M. Innmann, Christian Merle, Philippe Phan, Paul E. Beaulé, George Grammatopoulos
doi : 10.1016/j.arth.2021.03.031
VOLUME 36, ISSUE 8, P2808-2816, AUGUST 01, 2021
This study of patients with hip primary osteoarthritis and a matched, asymptomatic, volunteers (controls) group aimed to determine spinopelvic differences between the two groups and their consequences for total hip arthroplasty.
Early Recovery Outcomes in Patients Undergoing Total Hip Arthroplasty Through a Posterior Approach With Modified Postoperative Precautions
Yannick L. Goeb, Ethan C. Krell, Joseph T. Nguyen, Kaitlin M. Carroll, Seth A. Jerabek, David J. Mayman, Peter K. Sculco, Mark P. Figgie
doi : 10.1016/j.arth.2021.03.038
VOLUME 36, ISSUE 8, P2817-2822, AUGUST 01, 2021
Recent data suggest that a modified, more lenient set of precautions after total hip arthroplasty (THA) performed through the posterolateral approach may safely allow more patient movement and exercise in the immediate postoperative period. We hypothesize that 1) patients undergoing THA given modified precautions will demonstrate a fast-track return to functional activity and 2) wrist-based activity trackers will provide valuable information on postoperative activity levels.
Worse Preoperative Pain and Higher Activity Levels Predict Patient Choice of Formal Physical Therapy After Primary Anterior Total Hip Arthroplasty
Brian M. Rao, Thomas J. Cieslewicz, Kyle R. Sochacki, David A. Kohlrieser, Daniel D. Moylan, Thomas J. Ellis
doi : 10.1016/j.arth.2021.03.027
VOLUME 36, ISSUE 8, P2823-2828.E2, AUGUST 01, 2021
The purpose of this randomized controlled trial is (1) to compare the efficacy of supervised formal physical therapy (PT) and self-directed home exercises and (2) to identify independent predictors of transitioning from self-directed home exercises to supervised formal PT following total hip arthroplasty (THA) via an anterior approach.
Intraoperative Complications and Early Return to the Operating Room in Total Hip Arthroplasty Performed Through the Direct Anterior and Posterior Approaches. An Institutional Experience of Surgeons After Their Learning Curve
Ilya Bendich, David C. Landy, Huong Do, Ethan Krell, Alioune Diane, Friedrich Boettner, Jose Rodriguez, Michael Alexiades, Alejandro Gonzalez Della Valle
doi : 10.1016/j.arth.2021.03.046
VOLUME 36, ISSUE 8, P2829-2835, AUGUST 01, 2021
Proponents of the direct anterior approach (DAA) for total hip arthroplasty (THA) claim a faster recovery, whereas critics claim an increased risk of early femoral complications. This study analyzed intraoperative and postoperative complications requiring reoperation within one year after THA through the DAA and posterior approach (PA).
Capsular Management in Direct Anterior Total Hip Arthroplasty: A Randomized, Single-Blind, Controlled Trial
Andrew M. Schwartz, Rahul K. Goel, Aidan P. Sweeney, Thomas L. Bradbury Jr.
doi : 10.1016/j.arth.2021.03.048
VOLUME 36, ISSUE 8, P2836-2842, AUGUST 01, 2021
The direct anterior approach (DAA) is a popular approach to total hip arthroplasty (THA). Unlike the posterior approach, the importance of anterior capsular management is unknown. This randomized controlled trial compares capsular repair versus capsulectomy.
Femoral Neck Notching in Dual Mobility Implants: Is This a Reason for Concern?
Katherine A. Lygrisse, Chelsea Matzko, Roshan P. Shah, William Macaulay, John H. Cooper, Ran Schwarzkopf, Matthew S. Hepinstall
doi : 10.1016/j.arth.2021.03.043
VOLUME 36, ISSUE 8, P2843-2849, AUGUST 01, 2021
Dual mobility (DM) total hip arthroplasty (THA) implants have been advocated for patients at risk for impingement due to abnormal spinopelvic mobility. Impingement against cobalt-chromium acetabular bearings, however, can result in notching of titanium femoral stems. This study investigated the incidence of femoral stem notching associated with DM implants and sought to identify risk factors.
Does Physical Activity Level Influence Total Hip Arthroplasty Expectations, Satisfaction, and Outcomes?
Danielle Y. Ponzio, Shane D. Rothermel, Yu-Fen Chiu, Alexandra I. Stavrakis, Stephen Lyman, Russell E. Windsor
doi : 10.1016/j.arth.2021.03.052
VOLUME 36, ISSUE 8, P2850-2857, AUGUST 01, 2021
Total hip arthroplasty (THA) patients expect pain relief and functional improvement, including return to physical activity. Our objective was to determine the impact of patients' physical activity level on preoperative expectations and postoperative satisfaction and clinical outcomes in patients undergoing THA.
Return to Competitive Level of Play and Performance in Regular Golfers After Total Hip Arthroplasty: Analysis of 599 Patients at Minimum 2-Year Follow-Up
Charles Pioger, Christophe Jacquet, Jonathan P. Bellity, Jérôme Delambre, Olivier Rouillon, Rémy Nizard, Didier Hannouche
doi : 10.1016/j.arth.2021.04.004
VOLUME 36, ISSUE 8, P2858-2863.E2, AUGUST 01, 2021
Total hip arthroplasty (THA) is performed in an increasingly younger and athletic population. Regular and competitive golfers are concerned with the likelihood of recovering their preoperative level of play. The purpose of this study was to assess the impact of primary THA on golfers’ game, with a minimum follow-up of two years.
Long-Term Outcomes for Cementless Anatomic Femoral Components, Compared by Area of Porous Coating, in Patients Younger Than 50 Years Treated for Hip Dysplasia
Ayumi Kaneuji, Eiji Takahashi, Makoto Fukui, Toru Ichiseki, Kiyokazu Fukui, Norio Kawahara
doi : 10.1016/j.arth.2021.03.024
VOLUME 36, ISSUE 8, P2864-2870, AUGUST 01, 2021
We investigated whether the proximal circumferential porous coating of cementless stems would make implant survival of >20 years possible in young patients.
Pseudotumors in Small-Head Metal-on-Metal Total Hip Arthroplasties at a Minimum Follow-Up of 20 Years
Paul Kolbitsch, Iris-Melanie Noebauer-Huhmann, Alexander Giurea, Bernd Kubista, Reinhard Windhager, Richard Lass
doi : 10.1016/j.arth.2021.03.022
VOLUME 36, ISSUE 8, P2871-2877, AUGUST 01, 2021
Metal-on-metal (MOM) surfaces in total hip arthroplasty (THA) have been used widely. Serum cobalt and chromium levels have been the standard investigation for follow-up examinations, but magnetic resonance imaging (MRI) with metal artifact reducing sequences has shown good results in detecting pseudotumors. The aim of this study is to survey a significant correlation among MRI findings, serum metal levels, and clinical scores in patients with small-head MOM implants and if serum cobalt and chromium levels are sufficient in detecting patients with pseudotumors in the long-term follow-up.
Preoperative Mental Health Influences Patient-Reported Outcome Measures and Satisfaction After Revision Total Knee Arthroplasty
Graham S. Goh, Yong Zhi Khow, Darren K. Tay, Ngai-Nung Lo, Seng-Jin Yeo, Ming Han Lincoln Liow
doi : 10.1016/j.arth.2021.03.026
VOLUME 36, ISSUE 8, P2878-2886, AUGUST 01, 2021
A higher prevalence of mental health conditions has been reported in patients undergoing revision total knee arthroplasty (rTKA). This study investigated the effect of preoperative mental health on patient-reported outcome measures (PROMs) and satisfaction after rTKA.
Patient-Reported Function and Quality of Life After Revision Total Knee Arthroplasty: An Analysis of 10,727 Patients from the NHS PROMs Program
Shiraz A. Sabah, Abtin Alvand, Ruth Knight, David J. Beard, Andrew J. Price
doi : 10.1016/j.arth.2021.03.037
VOLUME 36, ISSUE 8, P2887-2895.E7, AUGUST 01, 2021
The aim of the study was to investigate changes in patient-reported outcome measures (PROMs) after revision total knee arthroplasty (rTKA).
Knee Joint Bone Defects: Reconstruction With Bone Transport and Arthrodesis
Leonid N. Solomin, Elena A. Shchepkina, Konstantin L. Korchagin, Joshua R. Buksbaum, Gerard A. Sheridan, S. Robert Rozbruch
doi : 10.1016/j.arth.2021.03.009
VOLUME 36, ISSUE 8, P2896-2906, AUGUST 01, 2021
The increasing in primary total knee arthroplasty has led to an increase in infectious complications, revision surgery, and bone loss. Knee joint bone defects (KJBD) may be managed using bone transport and arthrodesis with Ilizarov or bone transport over nail (BTON) techniques. The aim of this study is to compare both techniques in the reconstruction of KJBDs.
Heterotopic Ossification Negatively Influences Range of Motion After Revision Total Knee Arthroplasty
Ioannis Gkiatas, William Xiang, Allina A. Nocon, Mark P. Youssef, T. David Tarity, Peter K. Sculco
doi : 10.1016/j.arth.2021.03.023
VOLUME 36, ISSUE 8, P2907-2912, AUGUST 01, 2021
The incidence of heterotopic ossification (HO) after total knee arthroplasty (TKA) varies and is of unclear clinical significance. This study aimed to identify the incidence of HO in patients undergoing revision TKA for either stiffness or aseptic loosening/instability and determine if the presence of HO is associated with inferior absolute range of motion (ROM) and ROM gains.
Outcomes of Cemented Distal Femoral Replacement Using “Line to Line” Technique With All-Polyethylene Tibial Implant for Tumors
Bader Tayara, Anas Nooh, Antoine Chalopin, Krista Goulding, Robert E. Turcotte
doi : 10.1016/j.arth.2021.03.033
VOLUME 36, ISSUE 8, P2913-2920, AUGUST 01, 2021
Both cemented and cementless stemmed endoprosthetic implants have been used to reconstruct large skeletal defects after tumor resection with similar outcomes. In this study, we examined the oncologic, clinical, and functional outcomes in patients undergoing distal femur replacement using the French paradox technique.
Independent Risk Factors for Transfusion in Contemporary Revision Total Hip Arthroplasty
Robert A. Sershon, Yale A. Fillingham, Arthur L. Malkani, Matthew P. Abdel, Ran Schwarzkopf, Douglas E. Padgett, Thomas P. Vail, Craig J. Della Valle, Hip Society Research Group
doi : 10.1016/j.arth.2021.03.032
VOLUME 36, ISSUE 8, P2921-2926, AUGUST 01, 2021
The incidence of transfusion in contemporary revision total hip arthroplasty (THA) remains high despite recent advances in blood management, including the use of tranexamic acid. The purpose of this prospective investigation was to determine independent risk factors for transfusion in revision THA.
Hip Hemiarthroplasty for Fractured Neck of Femur Revised to Total Hip Arthroplasty: Outcomes Are Influenced by Patient Age Not Articulation Options
Wayne Hoskins, Sophia Rainbird, Yi Peng, Stephen E. Graves, Roger Bingham
doi : 10.1016/j.arth.2021.04.001
VOLUME 36, ISSUE 8, P2927-2935, AUGUST 01, 2021
Hip hemiarthroplasty is the most common arthroplasty option for fractured neck of femur (FNOF). Revision to total hip arthroplasty (THA) is occasionally required. This study aimed to assess the outcome of hemiarthroplasty revised to THA and to assess the impact of femoral head size, dual mobility (DM), and constrained liners.
Midterm Outcomes After Reconstruction of Superolateral Acetabular Defects Using Flying Buttress Porous Tantalum Augments During Revision Total Hip Arthroplasty
Adrian J. Cassar-Gheiti, Xin Y. Mei, Edem A. Afenu, Oleg A. Safir, Allan E. Gross, Paul R.T. Kuzyk
doi : 10.1016/j.arth.2021.03.040
VOLUME 36, ISSUE 8, P2936-2941, AUGUST 01, 2021
Porous tantalum augments are versatile tools in reconstructing complex acetabular defects during revision total hip arthroplasty (THA). This study examines the clinical and radiographic outcomes of porous tantalum augments placed in the type I (flying buttress) configuration at two to 17-year follow-up in the largest cohort to-date in the literature.
Leukocyte Esterase Versus ICM 2018 Criteria in the Diagnosis of Periprosthetic Joint Infection
Emanuele Chisari, Steven Yacovelli, Karan Goswami, Noam Shohat, Paul Woloszyn, Javad Parvizi
doi : 10.1016/j.arth.2021.03.006
VOLUME 36, ISSUE 8, P2942-2945.E1, AUGUST 01, 2021
A leukocyte esterase (LE) test is inexpensive and provides real-time information about patients suspected of periprosthetic joint infections (PJIs). The 2018 International Consensus Meeting (ICM) recommends it as a diagnostic tool with a 2+ cutoff. There is still a lack of data revealing LE utility versus the ICM 2018 criteria for PJI.
Emergence of Antibiotic Resistance Across Two-Stage Revision for Periprosthetic Joint Infection
Leanne Ludwick, Emanuele Chisari, Jasmine Wang, Samuel Clarkson, Lacee Collins, Javad Parvizi
doi : 10.1016/j.arth.2021.04.007
VOLUME 36, ISSUE 8, P2946-2950, AUGUST 01, 2021
The current preferred treatment for chronic hip and knee periprosthetic joint infection (PJI) involves both surgical intervention and antibiotic treatment as part of a two-stage revision. The purpose of this study is to determine how often patients who underwent a two-stage revision for chronic PJI developed a subsequent antibiotic-resistant infection.
Incomplete Administration of Intravenous Vancomycin Prophylaxis is Common and Associated With Increased Infectious Complications After Primary Total Hip and Knee Arthroplasty
Oren I. Feder, David Yeroushalmi, Charles C. Lin, Matthew S. Galetta, Moretza Meftah, Claudette M. Lajam, James D. Slover, Ran Schwarzkopf, Joseph A. Bosco III, William B. Macaulay
doi : 10.1016/j.arth.2021.03.035
VOLUME 36, ISSUE 8, P2951-2956, AUGUST 01, 2021
Vancomycin is often used as antimicrobial prophylaxis in patients undergoing total hip or knee arthroplasty. Vancomycin requires longer infusion times to avoid associated side effects. We hypothesized that vancomycin infusion is often started too late and that delayed infusion may predispose patients to increased rates of surgical site infections and prosthetic joint infections.
The Alpha-Defensin Prosthetic Joint Infection Test Has Poor Validity for Native Knee Joint Infection
Kasa B. Cooper, Eric R. Siegel, Jeffrey B. Stambough, David B. Bumpass, Simon C. Mears
doi : 10.1016/j.arth.2021.03.020
VOLUME 36, ISSUE 8, P2957-2961, AUGUST 01, 2021
The alpha-defensin test known as Synovaure has been very effective in diagnosis of prosthetic joint infections (PJIs). Being able to easily and accurately differentiate septic and inflammatory arthropathies in native joints would improve diagnostic workup and management. We tested the ability of an alpha-defensin test to distinguish septic from inflammatory or crystalline arthropathy in the native knee.
Ultrasound-Guided Periprosthetic Biopsy in Failed Total Hip Arthroplasty: A Novel Approach to Test Infection in Patients With Dry Joints
Luca M. Sconfienza, Domenico Albano, Carmelo Messina, Rocco D’Apolito, Elena De Vecchi, Luigi Zagra
doi : 10.1016/j.arth.2021.03.029
VOLUME 36, ISSUE 8, P2962-2967, AUGUST 01, 2021
To diagnose periprosthetic joint infection (PJI) preoperatively, ultrasound-guided joint aspiration (US-JA) may not be performed when effusion is minimal or absent. We aimed to report and investigate the diagnostic performance of ultrasound-guided periprosthetic biopsy (US-PB) of synovial tissue to obtain joint samples in patients without fluid around the implants.
Increasing Reoperations and Failures With Increasing BMI in Patients Undergoing 2-Stage Exchange for Infected Total Hip Arthroplasty
Yehuda E. Kerbel, Gregory J. Kirchner, Ariana T. Meltzer-Bruhn, Nicolas Pascual-Leone, Matthew K. Stein, Gwo-Chin Lee
doi : 10.1016/j.arth.2021.03.045
VOLUME 36, ISSUE 8, P2968-2973, AUGUST 01, 2021
While morbid obesity is associated with increased infection after total hip arthroplasty, little is known on the outcomes after 2-stage reimplantation for prosthetic joint infection (PJI) in this population. The purpose of this study is to evaluate the impact of morbid obesity (body mass index>40 kg/m2) on reinfection, postoperative complications, readmissions, and reoperations.
Gastrointestinal Complications Following Total Joint Arthroplasty Are Rare but Have Severe Consequences
Joseph Massaglia, Michael Yayac, Andrew Star, Gregory Deirmengian, P. Maxwell Courtney, Arjun Saxena
doi : 10.1016/j.arth.2021.03.005
VOLUME 36, ISSUE 8, P2974-2979, AUGUST 01, 2021
Gastrointestinal (GI) complications following total joint arthroplasty (TJA) are rare, but can result in substantial morbidity and mortality, especially when intervention is required. The purpose of this study is to identify modifiable risk factors for the development of GI complications and determine their impact on short-term outcomes following TJA.
Acquired Idiopathic Stiffness After Contemporary Total Knee Arthroplasty: Incidence, Risk Factors, and Results Over 25 Years
Aaron R. Owen, Meagan E. Tibbo, Andre J. van Wijnen, Mark W. Pagnano, Daniel J. Berry, Matthew P. Abdel
doi : 10.1016/j.arth.2021.03.051
VOLUME 36, ISSUE 8, P2980-2985, AUGUST 01, 2021
Acquired idiopathic stiffness (AIS) remains a common failure mode of contemporary total knee arthroplasties (TKAs). The present study investigated the incidence of AIS and manipulation under anesthesia (MUA) at a single institution over time, determined outcomes of MUAs, and identified risk factors associated with AIS and MUA.
Patellar Fracture After Total Knee Arthroplasty With Retention: A Retrospective Analysis of 2954 Consecutive Cases
Jung-Su Choe, Seong-Il Bin, Bum-Sik Lee, Jong-Min Kim, Ju-Ho Song, Hyung-Kwon Cho
doi : 10.1016/j.arth.2021.03.053
VOLUME 36, ISSUE 8, P2986-2991, AUGUST 01, 2021
To the best of our knowledge, there have been no large case studies on patellar fracture after total knee arthroplasty (TKA) with patella retention.
Incidence, Risk Factors, and Outcome of Ceramic-On-Ceramic Bearing Breakage in Total Hip Arthroplasty
Wayne Hoskins, Sophia Rainbird, Yi Peng, Michelle Lorimer, Stephen E. Graves, Roger Bingham
doi : 10.1016/j.arth.2021.03.021
VOLUME 36, ISSUE 8, P2992-2997, AUGUST 01, 2021
Ceramic-on-ceramic bearing breakage is a rare but significant complication of total hip arthroplasty. This study aimed to identify risk factors for breakage and to determine the outcome of different revision options.
Retrieval Analysis of Polyethylene Components in Rotating Hinge Knee Arthroplasty Implants
Cynthia A. Kahlenberg, Elexis C. Baral, Lydia Weitzler Lieberman, Ronald C. Huang, Timothy M. Wright, Douglas E. Padgett
doi : 10.1016/j.arth.2021.04.003
VOLUME 36, ISSUE 8, P2998-3003, AUGUST 01, 2021
This study examined a cohort of retrieved rotating hinge (RH) total knee arthroplasty implants of four different designs with emphasis on the surface damage observed on the polyethylene components. Our purpose was to determine if differences in polyethylene damage existed among the designs, and if those differences could be explained by differences in design characteristics.
Industry Payments and Their Association With Academic Influence in Total Joint Arthroplasty
Aaron Z. Chen, Patawut Bovonratwet, Alexander I. Murphy, Bryan K. Ang, Tony S. Shen, Edwin P. Su
doi : 10.1016/j.arth.2021.03.025
VOLUME 36, ISSUE 8, P3004-3009, AUGUST 01, 2021
The relationship between industry payments and academic influence, as measured by the Hirsch index (h-index) and number of publications, among adult reconstruction surgeons is not well characterized. The aims of the present study are to determine the relationship between an adult reconstruction surgeons’ academic influence and their relevant industry payments and National Institutes of Health (NIH) funding.
A Crossover Randomized Trial of Visual Abstracts Versus Plain-Text Tweets for Disseminating Orthopedics Research
Emanuele Chisari, Zane Gouda, Mohammad Abdelaal, John Shields, Jeffrey B. Stambough, Jaime Bellamy, Chad A. Krueger
doi : 10.1016/j.arth.2021.04.006
VOLUME 36, ISSUE 8, P3010-3014, AUGUST 01, 2021
Scientists, surgeons, and trainees are increasingly taking an active role on Twitter to find, disseminate, and exchange knowledge. The purpose of this study was to determine if peer-reviewed journal articles shared on Twitter using visual abstracts (VAs) improve user engagement compared with plain-text tweets.
Abductor Muscle Strength Deficit in Patients After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis
Petros Ismailidis, Peter Kvarda, Werner Vach, Dieter Cadosch, Christian Appenzeller-Herzog, Annegret Mündermann
doi : 10.1016/j.arth.2021.03.042
VOLUME 36, ISSUE 8, P3015-3027, AUGUST 01, 2021
The aims of this study were to assess and quantify hip abductor muscle strength deficits after total hip arthroplasty (THA) and to determine associations with external factors.
Survivorship and Clinical Outcomes of Constrained Acetabular Liners in Primary and Revision Total Hip Arthroplasty: A Systematic Review
Fabio Mancino, Christopher W. Jones, Thomas P. Sculco, Peter K. Sculco, Giulio Maccauro, Ivan De Martino
doi : 10.1016/j.arth.2021.04.028
VOLUME 36, ISSUE 8, P3028-3041, AUGUST 01, 2021
Several studies have evaluated the survivorship and clinical outcomes of constrained acetabular liners (CALs) in complex primary and revision total hip arthroplasty with hip instability; however, there remains no consensus on the overall performance of this constrained implant. We therefore performed a systematic review of the literature to examine survivorship and complication rate of CAL usage.
Postoperative Infection Risk in Total Joint Arthroplasty After Perioperative IV Corticosteroid Administration: A Systematic Review and Meta-Analysis of Comparative Studies
Aoife A. Feeley, Tara B. Feeley, Iain H. Feeley, Eoin Sheehan
doi : 10.1016/j.arth.2021.03.057
VOLUME 36, ISSUE 8, P3042-3053, AUGUST 01, 2021
Perioperative corticosteroid administration is associated with reduced postoperative nausea, pain, and enhanced recovery after surgery. However, potential complications including wound and periprosthetic joint infections remain a concern for surgeons after total joint arthroplasty (TJA).
