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Table of Contents
doi : 10.1016/S0883-5403(21)00610-0
Volume 36, Issue 9, September 2021, Pages A5, A6, A8, A10
Improving Arthroplasty Efficiency and Quality Through Concentrating Service Volume by Complexity: Surviving the Medicare Policy Changes
RichardIorioMDPatrick R.PeavyMDDavid W.KeyesMSSusan M.DempseyMBADavid O.McCreadyMBA, MHAJames D.KangMD
doi : 10.1016/j.arth.2021.04.005
Volume 36, Issue 9, September 2021, Pages 3055-3059
We have an academic medical center (AMC), an associated community-based hospital (CBH) and several ambulatory care centers which are being prepared to provide same day discharge (SDD) total joint arthroplasty (TJA) and unicompartmental knee arthroplasty (UKA). The near-capacity AMC cared for medically and technically complicated TJA patients. The CBH wanted to increase volume, improve margins, and become a center of excellence with an efficient hospital outpatient department and SDD TJA experience.
Intersectionality of Net Worth and Race Relative to Utilization of Total Hip and Knee Arthroplasty
Chloe C.DlottBSaXunPeiMSbJennifer L.IttnerMAbSteven L.LefarBAbMary I.O’ConnorMDc
doi : 10.1016/j.arth.2021.04.037
Volume 36, Issue 9, September 2021, Pages 3060-3066.e1
Although the number of total hip arthroplasty and total knee arthroplasty (THA and TKA) increases, individuals of color continue to be less likely to undergo these procedures. Socioeconomic status may be a key influencer of THA and TKA utilization and outcomes. We explore the influence of net worth and race on THA and TKA utilization and outcomes of length of stay and readmissions using a large patient database.
Economic Burden of Patient-Reported Penicillin Allergy on Total Hip and Total Knee Arthroplasty
Olivia C.LeeMDabDarren C.ChengMS, BSMbJonathan L.PaulBSbBailey J.RossBAbBarrett J.HawkinsMDbWilliam F.ShermanMD, MBAb
doi : 10.1016/j.arth.2021.04.032
Volume 36, Issue 9, September 2021, Pages 3067-3072
Self-reported penicillin allergies in patients undergoing total joint arthroplasty often results in the use of second-line prophylactic antibiotics. A higher risk of prosthetic joint infection (PJI) is associated with suboptimal antibiotics vs first generation cephalosporins, which have historically been grouped with other beta-lactam antibiotics such as penicillin for potential allergic reactions. This study evaluates the economic burden of self-reported penicillin allergies in total joint arthroplasty (TJA).
Length of Stay After Joint Arthroplasty is Less Than Predicted Using Two Risk Calculators
Colin J.CarrBASimon C.MearsMD, PhDC. LowryBarnesMDJeffrey B.StamboughMD
doi : 10.1016/j.arth.2021.04.010
Volume 36, Issue 9, September 2021, Pages 3073-3077
Predicting the length of stay (LOS) after total joint arthroplasty (TJA) has become more important with their recent removal from inpatient-only designation. The American College of Surgeons (ACS) National Surgical Quality Improvement Program surgical risk calculator and the CMS’ diagnosis-related group (DRG) calculator are two common LOS predictors. The aim of our study was to determine how our actual LOS compared with those predicted by both the ACS and DRG.
A Randomized Trial Investigating the Cost-Utility of Patient-Specific Instrumentation in Total Knee Arthroplasty in an Obese Population
Bryn O.ZomarPhDabEdward M.VasarhelyiMD, MSc, FRCSCbcdLyndsay E.SomervillePhDacBrent A.LantingMD, MSc, FRCSCbcdJames L.HowardMD, MSc, FRCSCbcdJacquelyn D.MarshPhDab
doi : 10.1016/j.arth.2021.04.029
Volume 36, Issue 9, September 2021, Pages 3078-3088
Patient-specific instrumentation (PSI) has been introduced in total knee arthroplasty (TKA) with the goal of increased accuracy of component positioning by custom fitting cutting guides to the patient’s bony anatomy. A criticism of this technology is the associated cost. The purpose of this randomized controlled trial was to determine the cost-utility of PSI compared with standard of care (SOC) instrumentation for TKA in an obese population.
Leg Length Change After Curved Periacetabular Osteotomy and Its Impact on the Clinical Outcomes
MasahiroSuzukiMDKoichiKinoshitaMD, PhDTetsuyaSakamotoMD, PhDHajimeSeoMD, PhDSakaeKinoshitaMDTakuakiYamamotoMD, PhD
doi : 10.1016/j.arth.2021.04.019
Volume 36, Issue 9, September 2021, Pages 3089-3096
Curved periacetabular osteotomy (CPO) is one of the periacetabular osteotomies for the treatment of acetabular dysplasia. Several complications have been described after CPO, however, there have been no reports on the leg length change (LLC). This study aimed to investigate the LLC after CPO and its impact on the clinical outcomes.
Effects of the Obesity Epidemic on Total Hip and Knee Arthroplasty Demographics
Charles A.JohnsonMDaCharles C.WhiteMDbBryce F.KunkleBSaJosef K.EichingerMDaRichard J.FriedmanMD, FRCSCa
doi : 10.1016/j.arth.2021.04.017
Volume 36, Issue 9, September 2021, Pages 3097-3100
Higher body mass index (BMI) is a well-known risk factor for the development of hip and knee osteoarthritis and predicts total hip arthroplasty (THA) and total knee arthroplasty (TKA) at an earlier age. The purpose of this study is to document the nationwide trends in age and obesity in primary THA and TKA throughout the obesity epidemic.
The Fate of Morbidly Obese Patients With Joint Pain: A Retrospective Study of Patient Outcomes
Russell A.ReevesMD, MSaGlenn D.HefterMSbVincent D.PellegriniJr.MDcJacob M.DrewMDdWilliam R.BarfieldPhDeHarry A.DemosMDe
doi : 10.1016/j.arth.2021.02.069
Volume 36, Issue 9, September 2021, Pages 3101-3107.e1
The number of obese patients seeking a total joint arthroplasty (TJA) continues to increase. Weight loss is often recommended to treat joint pain and reduce risks associated with TJA. We sought to determine the effectiveness of an orthopedic surgeon’s recommendation to lose weight.
Quantifying Patient Engagement in Total Joint Arthroplasty Using Digital Application-Based Technology
Paul W.KnappDOaRobert A.KellerMDbKathryn A.MabeeBSbRajiPillaiPhDcNicholas B.FrischMD, MBAb
doi : 10.1016/j.arth.2021.04.022
Volume 36, Issue 9, September 2021, Pages 3108-3117
Digital patient engagement has been suggested as a mean to increase patient activation and patient satisfaction after total joint arthroplasty. The purpose of this study was to assess patient engagement with application-based educational tools and to explore what content was most useful to patients in the perioperative period surrounding total hip arthroplasty (THA) and total knee arthroplasty (TKA), respectively.
The Natural Course of Serum D-Dimer, C-Reactive Protein, and Erythrocyte Sedimentation Rate Levels After Uneventful Primary Total Joint Arthroplasty
IbrahimAzboyMDaBilgehanÇatalMDaKeremBa?ar?rMDbMürenMutluMDcÖmer F.BilgenMDcJavadParviziMD, FRCSd
doi : 10.1016/j.arth.2021.04.031
Volume 36, Issue 9, September 2021, Pages 3118-3122
This study aimed to assess the baseline levels of D-dimer, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) and monitor the natural course of these serum markers after uneventful primary total joint arthroplasty.
Relevance of the Tibial Slope on Functional Outcomes in ACL-Deficient and ACL Intact Fixed-Bearing Medial Unicompartmental Knee Arthroplasty
Kevin D.PlancherMD, MPHabcdJaya PrasadShanmugamMDcdJasmine E.BriteBScKaren K.BriggsMPHdStephanie C.PettersonMPT, PhDd
doi : 10.1016/j.arth.2021.04.041
Volume 36, Issue 9, September 2021, Pages 3123-3130
Excessive posterior tibial slope in medial unicompartmental knee arthroplasty (UKA) has been implicated in early failure. The purpose of this study was to evaluate the relationship between preoperative posterior tibial slope and postoperative slope of the implant (PSI) on outcomes in patients with anterior cruciate ligament (ACL) intact and ACL-deficient knees after fixed-bearing medial UKA.
New-Onset Depression After Total Knee Arthroplasty: Consideration of the At-Risk Patient
Andrew M.SchwartzMDJacob M.WilsonMDKevin X.FarleyMSThomas L.BradburyJr.MDGeorge N.GuildIIIMD
doi : 10.1016/j.arth.2021.04.008
Volume 36, Issue 9, September 2021, Pages 3131-3136
Postoperative new-onset depression (NOD) has gained recent attention as a previously unrecognized complication which may put patients at risk for poor outcomes after elective total hip arthroplasty. We aimed to investigate risk factors for the development of NOD after total knee arthroplasty (TKA) and assess its association with postoperative complications.
Good Postoperative Flexion Angle Improves Knee Function and Improvement of Flexion Angle Increases Patient Satisfaction After Total Knee Arthroplasty
MitsuhikoKuboMD, PhDTsutomuMaedaMD, PhDKosukeKumagaiMD, PhDYasutakaAmanoMDTakuKawasakiMD, PhDShinjiImaiMD, PhD
doi : 10.1016/j.arth.2021.04.040
Volume 36, Issue 9, September 2021, Pages 3137-3140
Total knee arthroplasty (TKA) is a well-established procedure for treating knee joint diseases. However, the postoperative range of motion (ROM) varies and is an important indicator of TKA success. Recently, patient-reported outcome measures (PROMs) and patient satisfaction have drawn attention. However, the relationship between ROM and knee function obtained by PROM and satisfaction is not well understood.
2-Octyl Cyanoacrylate Topical Adhesive as an Alternative to Subcuticular Suture for Skin Closure After Total Knee Arthroplasty: A Randomized Controlled Trial in the Same Patient
Keun YoungChoiMDaIn JunKohMD, PhDbMan SooKimMD, PhDaDong ChulParkMDaYong GyuSungMDaYongInMD, PhDa
doi : 10.1016/j.arth.2021.04.033
Volume 36, Issue 9, September 2021, Pages 3141-3147
The 2-octyl cyanoacrylate topical adhesive with flexible self-adhesive polyester mesh (Dermabond Prineo) is becoming widely used in many surgical fields. However, no prior studies have tested the efficacy and safety of this topical adhesive compared with subcuticular suture in the same patient. The purpose of this study was to compare the efficacy and safety between Dermabond Prineo and subcuticular suture for skin closure in patients undergoing same-day bilateral total knee arthroplasties (TKAs).
Influence of Patellar Morphology Classified by Wiberg Classification on Knee Joint Function and Patellofemoral Tracking After Total Knee Arthroplasty Without Patellar Resurfacing
LeCaoMDaKaiSunMDa1HaitaoYangMDaHanbangWangMDaRanZengMDbHaitaoFanMDa
doi : 10.1016/j.arth.2021.04.009
Volume 36, Issue 9, September 2021, Pages 3148-3153
To evaluate the influence of patellar morphology on knee joint function and patellofemoral tracking in patients with primary osteoarthritis after total knee arthroplasty (TKA) without patellar resurfacing.
Posterior-Stabilized TKA in Patients With Severe Genu Recurvatum Achieves Good Clinical and Radiological Results at 5-year Minimum Follow-Up: A Case-Controlled Study
GuillaumeMesnardMDaCécileBataillerMDabCamdonFaryFRACScdAxelSchmidtMDaElvireServienMD, PhDaeSébastienLustigMD, PhDab
doi : 10.1016/j.arth.2021.04.020
Volume 36, Issue 9, September 2021, Pages 3154-3160
Genu recurvatum is a rare knee deformity. Total knee arthroplasty (TKA) in severe preoperative recurvatum requires surgical adjustments. Few studies have assessed the clinical and radiological results of TKA in recurvatum. The aim was to compare the clinical and radiological outcomes, complications, and revision rates after posterior-stabilized TKA in severe recurvatum with those without recurvatum.
Prospective Mid-Term Results of a Completely Metal-Free Ceramic Total Knee Endoprosthesis: A Concise Follow-Up of a Previous Report
RobertBreuerMDaRainerFialaMDbKlemensTriebMDcdBjoernRathMDa
doi : 10.1016/j.arth.2021.05.007
Volume 36, Issue 9, September 2021, Pages 3161-3167
Hypersensitivity reactions are suspected to cause premature aseptic loosening in susceptible patients after total knee arthroplasty. In response, metal-free implants have been developed. The aim of this prospective, observational midterm study was the assessment of a completely metal-free ceramic knee replacement system as a concise follow-up of a previous report.
The Impact of the Largest National Joint Registry on Current Knee Replacement Longevity Estimates: An Analysis and Review of Knee Prosthesis Brand and Fixation Technique
SamiRashedBSc, MBBSaSaadLakhaniMBChB, MScbAdamManncLawrence M.J.BestBSc, MBBS, PhDdSarahShehzadBSc, MBBSdMuhammad ZahidSaeedMBBS, FRCS (Tr & Orth), FEBOT (Tr & Ortho)e
doi : 10.1016/j.arth.2021.05.001
Volume 36, Issue 9, September 2021, Pages 3168-3173.e1
The UK National Joint Registry is the single largest joint registry in the world enrolling 1.3 million patients and recently reaching 17 years of follow-up data. Current knee prosthesis longevity estimates are based off smaller sized international registries and the impact of fixation type on prosthesis survival remains unclear.
Metaphyseal Stem Tip Location is a Risk Factor for Aseptic Loosening of Cemented Distal Femoral Replacements
DanielleGreigMDRishiTrikhaMDErik J.GeigerMDTroySekimuraBSJeffrey J.EckardtMDNicholas M.BernthalMD
doi : 10.1016/j.arth.2021.04.035
Volume 36, Issue 9, September 2021, Pages 3174-3180
The objective of this study was to describe the incidence of aseptic loosening (AL) of cemented stem distal femoral replacements (DFR) and to identify modifiable risk factors for its development.
Effect of Dementia on Outcomes After Surgically Treated Hip Fracture in Older Adults
Robert N.JorissenMBiostat, PhDaMaria C.InacioMS, PhDacMonicaCationsPhDabCatherineLangBSc(Hons)aGillian E.CaugheyBSc(Hons), PhDacMariaCrottyMPH, PhD, FAFRM (RACP), FRACGP, FAFPHMb
doi : 10.1016/j.arth.2021.04.030
Volume 36, Issue 9, September 2021, Pages 3181-3186.e4
Hip fractures are associated with increased mortality and functional limitations. However, the effect that dementia has on these outcomes in individuals in aged care settings after fracture is not well established. This study examined the association of dementia with post-hip fracture mortality, permanent residential aged care entry, transition care use, and change in activities of daily living (ADL) needs.
Preoperative Posterior Tilt Increases the Risk of Later Conversion to Arthroplasty After Osteosynthesis for Femoral Neck Fracture
Jukka S.HonkanenMDaElina M.EkmanMD, PhDbVille K.HuovinenMDcKeijo T.MäkeläMD, PhDbMariKoivistoMScdMikko P.KarvonenMDbInariLaaksonenMD, PhDab
doi : 10.1016/j.arth.2021.04.039
Volume 36, Issue 9, September 2021, Pages 3187-3193
Femoral neck fractures (FNFs) are one of the most common injuries in the elderly. Treatment is either internal fixation or primary arthroplasty. The main aim of this study is to assess the risk factors associated with fixation failure leading to further arthroplasty in FNFs treated with cannulated screws.
Risk of Total Hip Arthroplasty After Acetabular Fracture Fixation: The Importance of Age
AmirKhoshbinMD, MSc, FRCS(C)abGraemeHoitMDbcPatrick D.G.HenryMD, FRCS(C)bdJ. MichaelPatersonMScceAnjieHuangMSceAmitAtreyMD, MSc, FRCSCabHans J.KrederMD, MPH, FRCS(C)bcdRichardJenkinsonMD, MSc, FRCS(C)bdDavidWassersteinMD, MSc, FRCS(C)bd
doi : 10.1016/j.arth.2021.04.025
Volume 36, Issue 9, September 2021, Pages 3194-3199.e1
Geriatric patients are the most rapidly growing cohort of patients sustaining acetabular fractures (AFs). The purpose of this study was to examine the risk of a secondary total hip arthroplasty (THA) in older patients (>60 year old) with a prior AF open reduction internal fixation (ORIF) compared with younger patients (<60 year old) with an AF ORIF on a large population level.
Hueter Anterior Approach for Metal-on-Metal Hip Resurfacing Arthroplasty: 555 Cases at a Minimum Five-Year Follow-Up
Alison B.SuraciMD, MScaRamandeep S.BhullarMBBSaJohanna S.DobranskyMHKaPaul E.BeauléMD, FRSCSab
doi : 10.1016/j.arth.2021.04.023
Volume 36, Issue 9, September 2021, Pages 3200-3208
Purpose of this study was to determine implant survivorship and resultant outcomes, including modes of failure, for metal-on-metal hip resurfacing through the Hueter anterior approach (HAA).
Assessment of Early Biological Fixation of Cementless Tapered-Wedge Stems Using Digital Tomosynthesis
KazukiOishiMD, PhDRyoInoueMD, PhDYujiYamamotoMD, PhDYoshifumiHaradaMD, PhDEijiSasakiMD, PhDYasuyukiIshibashiMD, PhD
doi : 10.1016/j.arth.2021.04.021
Volume 36, Issue 9, September 2021, Pages 3209-3213
We aimed to compare radiographic and digital tomosynthesis assessments of early biological fixation of a cementless stem in primary total hip arthroplasty and to investigate the factors associated with early biological fixation.
Long-Term Outcome of Small Head Metal-On-Metal Total Hip Arthroplasty: A 15-to-22 Year Follow-Up
AntonMaliarovMD, FRCSCOlga L.HukMD, MSc, FRCSCLaura M.EpureEng. MScStephane G.BergeronMD, MPH, FRCSCJohnAntoniouMD, PhD, FRCSCDavid J.ZukorMD, FRCSC
doi : 10.1016/j.arth.2021.04.011
Volume 36, Issue 9, September 2021, Pages 3214-3220
The Metasul articular interface was a second-generation metal-on-metal (MoM) total hip arthroplasty (THA) that was introduced as a promising interface with improved manufacturing technology, better clearances, and enhanced metal hardness. In December 2001, the manufacturer recalled these implants due to the failure of cup osseointegration.
Long-Term Survivorship of Modular Cementless Femoral Stem in Complex Primary Total Hip Arthroplasty: A Concise Minimum 15-Year Follow-Up Report
RajeshBawaleMRCSEd, SICOT Dip Orth, FEBOT(T&O), FRCS(T&O)aHosam E.MatarMSc(Res), FRCS(Tr&Orth)aFelipe LópezIllanesMDaHugh U.CameronMD, FRCSCb
doi : 10.1016/j.arth.2021.05.004
Volume 36, Issue 9, September 2021, Pages 3221-3225
S-ROM hip is a well-established and versatile prosthesis that offers extensive metaphyseal and diaphyseal geometries providing solutions for a variety of surgical scenarios. The aim of this study is to report on long-term survivorship and radiographic outcomes of complex primary total hip arthroplasty (THA) using a modular cementless stem (S-ROM).
Highly Crosslinked Polyethylene Can Reduce Wear Rate in THA for High-Demand Patients: A Matched-Paired Controlled Study
SylvainGuyMDaXavierFlecherMD, PhDaAkashSharmaMBBS, FRCSbJean-NoëlArgensonMD, PhDaMatthieuOllivierMD, PhDa
doi : 10.1016/j.arth.2021.04.036
Volume 36, Issue 9, September 2021, Pages 3226-3232
The average age of patients benefiting from total hip arthroplasty (THA) has been declining. In addition to pain relief, patients seek to return to physical activity. However, the latter may increase polyethylene wear and therefore the potential risk of early aseptic loosening. The introduction of highly crosslinked polyethylene (HXLPE) has reduced wear rates in the general patient population. The objective of this study was to evaluate the influence of impact sports in patients operated with THA using ceramic-on-conventional polyethylene (cPE) versus ceramic-on-HXLPE, in terms of wear and function, with a minimum of five year follow-up.
A Comparison of Revision Rates for Dislocation and Aseptic Causes Between Dual Mobility and Large Femoral Head Bearings in Primary Total Hip Arthroplasty With Subanalysis by Acetabular Component Size: An Analysis of 106,163 Primary Total Hip Arthroplasties
WayneHoskinsMBBS (Hons), PhDabRogerBinghamMBBS, FRACSbcChelseaDyerBScdSophiaRainbirdPhDeStephen E.GravesMBBS, DPhil(Oxon), FRACS(Orth), FAOrthAef
doi : 10.1016/j.arth.2021.05.008
Volume 36, Issue 9, September 2021, Pages 3233-3240
Dual mobility (DM) and large femoral head bearings (?36 mm) both decrease the risk of dislocation in total hip arthroplasty (THA). There is limited comparable data in primary THA. This study compared the revision rates for dislocation and aseptic causes between DM and large femoral heads and subanalyzed by acetabular component size.
Lumbar Spine Fusion and Symptoms of Leg Length Discrepancy After Hip Arthroplasty
Michael S.PheasantMSaJohn L.CoulterMSaCalumWallaceMSaAmalie K.Kropp LopezMSaEdward M.DelSoleMDabJohn J.MercuriMDab
doi : 10.1016/j.arth.2021.05.006
Volume 36, Issue 9, September 2021, Pages 3241-3247.e1
Hip length discrepancy (HLD) is common after total hip arthroplasty (THA); however, the effect of spinal fusion on perceived leg length discrepancy (LLD) symptoms after THA has not been examined. This study tested the hypothesis that LLD symptoms are increased in patients who underwent lumbar spinal fusion and THA, compared with patients with THA only.
MRI Assessment of Muscle Damage After the Posterolateral Versus Direct Anterior Approach for THA (Polada Trial). A Randomized Controlled Trial
KyrillRykovMDaTim W.G.M.MeysMDbBas A.S.KnobbenMD, PhDaMaurits S.SietsmaMDaInge H.F.ReiningaPhDcBas L.E.F.ten HaveMDa
doi : 10.1016/j.arth.2021.05.009
Volume 36, Issue 9, September 2021, Pages 3248-3258.e1
There is controversy in literature whether the direct anterior approach (DAA) results in less muscle damage compared with the posterolateral approach (PLA) for total hip arthroplasty. The aim of this randomized controlled trial was to assess muscle damage between these two approaches.
Factors Affecting Range of Motion After Revision Total Knee Arthroplasty
Katherine A.LygrisseMDMackenzie A.RoofBSMohamadSharanMDGregTeoMDWilliam J.LongMD, FRCSCRanSchwarzkopfMD, MSc
doi : 10.1016/j.arth.2021.04.016
Volume 36, Issue 9, September 2021, Pages 3259-3263
Range of motion (ROM) after revision total knee arthroplasty (RTKA) is an important clinical outcome, as decreased ROM can lead to patient dissatisfaction and diminished mobility. This study sought to determine the effect of type of revision, implant constraint level, and reason for revision has on RTKA ROM.
Custom Triflange Cups: 20-Year Experience
Robert A.SershonMDabJames F.McDonaldIIIBSbSairaNagdabWilliam G.HamiltonMDabC. AndersonEnghJr.MDab
doi : 10.1016/j.arth.2021.05.005
Volume 36, Issue 9, September 2021, Pages 3264-3268
The custom triflange acetabular component is used during revision THA to address severe acetabular bone loss. Midterm results are promising, with low rates of loosening and triflange revision reported. However, reoperation and overall complication rates remain high. We aim to investigate our institution’s custom triflange experience over 20 years by evaluating implant survivorship, reoperations, complications, and clinical outcomes.
A Role for Modern Primary Cementless Femoral Stems in Revision Hip Arthroplasty
Hope E.SkibickiDOaZachary D.PostMDbAndrew B.KayMDbMiranda M.CzymekBSbAlvin C.OngMDbFabio R.OrozcoMDcDanielle Y.PonzioMDb
doi : 10.1016/j.arth.2021.04.042
Volume 36, Issue 9, September 2021, Pages 3269-3274
In revision total hip arthroplasty (THA) cases with preserved femoral metaphyseal bone, tapered proximally porous-coated “primary” femoral stems may be an option. The objective of this study was to compare outcomes of patients with Paprosky I or II femoral bone loss undergoing revision THA with either a primary metaphyseal-engaging cementless stem or a revision diaphyseal-engaging stem.
Accuracy and Cost-Effectivenss of a Novel Method for Alpha Defensins Measurement in the Diagnosis of Periprosthetic Joint Infections
RaffaeleIorioPhDabEdoardoVigliettaMDabDanieleMazzaMDbAndreaPetruccaPhDdMarinaBorroPhDacSantinoIolandaPhDadMaurizioSimmacoPhDacdAndreaFerrettiPhDab
doi : 10.1016/j.arth.2021.05.013
Volume 36, Issue 9, September 2021, Pages 3275-3281
Two methods for detecting synovial fluids alpha defensins are available: the enzyme-linked immunosorbent assay and the lateral flow test. For both, the proper role and accuracy remain uncertain. The purpose of this study was to assess the accuracy of the matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) for alpha defensin detection in synovial fluids of patients with total knee arthroplasty/total hip arthroplasty failures. The hypothesis was that the alpha defensin measurement through MALDI-TOF MS assay could be a high sensitive and specific test for periprosthetic joint infections (PJI) diagnosis as compared with Musculoskeletal Infection Society (MSIS) criteria.
A Novel Biomarker to Screen for Malnutrition: Albumin/Fibrinogen Ratio Predicts Septic Failure and Acute Infection in Patients Who Underwent Revision Total Joint Arthroplasty
ZulipikaerMaimaitiMD, PhDabChiXuMDbJunFuMDbWilliamTianyu LiMDcWeiChaiMDbYonggangZhouMDbJiyingChenMDb
doi : 10.1016/j.arth.2021.04.027
Volume 36, Issue 9, September 2021, Pages 3282-3288
This study aimed to investigate the efficacy of the albumin/fibrinogen ratio (AFR) in the assessment of malnutrition and to compare its ability to predict early postoperative periprosthetic joint infection (PJI) in patients with aseptic revisions.
Renal Toxicity Associated With Resection and Spacer Insertion for Chronic Hip PJI
LouisDagneauxMDaAfton K.LimbergBSaDouglas R.OsmonMDbNelsonLeungMDcDaniel J.BerryMDaMatthew P.AbdelMDa
doi : 10.1016/j.arth.2021.04.012
Volume 36, Issue 9, September 2021, Pages 3289-3293
Two-stage exchange arthroplasty with high-dose antibiotic-loaded bone cement spacer and intravenous (IV) antibiotics is the most common method of managing infected total hip arthroplasties. However, the contemporary incidence, risk factors, and outcomes of acute kidney injuries (AKIs) in this cohort are unknown.
Abnormal Coagulation as a Risk Factor for Postoperative Complications After Primary and Revision Total Hip and Total Knee Arthroplasty
Joyce J.ChungBAaMartine T.DolanBSaMichael J.PatettaMDbJustin T.DesLaurierBSbNickolasBorodaMDbMark H.GonzalezMD, PhDb
doi : 10.1016/j.arth.2021.04.024
Volume 36, Issue 9, September 2021, Pages 3294-3299
Patients undergoing total joint arthroplasty (TJA) have an increased likelihood of having an abnormal coagulation profile compared with the general population. Coagulation abnormalities are often screened for before surgery and considered during perioperative planning. This study assesses a preoperative abnormal coagulation profile as a risk factor for postoperative complications after total hip arthroplasty (THA), revision THA (rTHA), total knee arthroplasty (TKA), and revision TKA (rTKA) and then examines specific coagulopathies to determine their influence on complication rates.
Thirty Days of Aspirin for Venous Thromboembolism Prophylaxis Is Adequate Following Total Knee Arthroplasty, Regardless of the Dose Used
NoamShohatMDabLeanneLudwickaRahulGoelMDaJonathanLedesmaaSydneyStreicheraJavadParviziMD, FRCSa
doi : 10.1016/j.arth.2021.05.002
Volume 36, Issue 9, September 2021, Pages 3300-3304
The optimal length of aspirin prophylaxis to minimize venous thromboembolism (VTE) following total knee arthroplasty (TKA) remains unknown. This study aimed to determine the timing of VTE after TKA in patients who received low and high dose aspirin, and determine if 30 days of prophylaxis remains adequate.
Is Surgical Approach for Primary Total Hip Arthroplasty Associated With Timing, Incidence, and Characteristics of Periprosthetic Femur Fractures?
Katherine A.LygrisseMDGaukhman D.GaukhmanMD, MSGregTeoMDRanSchwarzkopfMD, MScWilliam J.LongMD, FRCSCVinay K.AggarwalMD
doi : 10.1016/j.arth.2021.04.026
Volume 36, Issue 9, September 2021, Pages 3305-3311
Periprosthetic femur fractures (PFF) involving primary total hip arthroplasty (THA) remain a significant concern. The purpose of this study was to evaluate the effect of surgical approach during primary THA on early PFF with respect to fracture timing, incidence, radiographic parameters, and surgery-related factors.
Synovial Fluid Metal Ion Levels are Superior to Blood Metal Ion Levels in Predicting an Adverse Local Tissue Reaction in Failed Total Hip Arthroplasty
Matthew T.HoudekMDaMichael J.TauntonMDaCody C.WylesMDaPaul J.JannettoPhDbDavid G.LewallenMDaDaniel J.BerryMDa
doi : 10.1016/j.arth.2021.04.034
Volume 36, Issue 9, September 2021, Pages 3312-3317.e1
Adverse local tissue reactions (ALTR) are associated with total hip arthroplasty (THA) failure in patients with metal-on-metal bearings and/or taper corrosion, which can also occur in metal-on-polyethylene articulations. Patients are monitored with blood cobalt (Co) and chromium (Cr) concentrations which do not always correlate with the degree of soft tissue reaction at revision THA. The purpose of this study was to determine how the blood and prosthetic hip synovial fluid levels of Co and Cr correlate with one another, and determine which concentration is more predictive of ALTR.
Periprosthetic Hip Fractures With a Loose Stem: Open Reduction and Internal Fixation Versus Stem Revision
DavidGonzález-MartínMDabJosé LuisPais-BritoPhDabSergioGonzález-CasamayorMDaAyronGuerra-FerrazMDaPabloMartín-VélezMDaMarioHerrera-PérezPhDab
doi : 10.1016/j.arth.2021.05.003
Volume 36, Issue 9, September 2021, Pages 3318-3325
It is recommended revision for periprosthetic hip fractures (PPHF) with a loose stem. However, several authors have argued that under certain conditions, this fracture could be treated using osteosynthesis. The aim is to compare stem revision versus internal fixation in the treatment of PPHF with a loose stem.
Changes in Mediolateral Postural Control Mechanisms During Gait After Total Knee Arthroplasty
JunsigWangPhDaAnna C.SeverinPhDabSimon C.MearsMD, PhDaJeffrey B.StamboughMDaC. LowryBarnesMDaErin M.MannenPhDac
doi : 10.1016/j.arth.2021.04.038
Volume 36, Issue 9, September 2021, Pages 3326-3332
Patients who have total knee arthroplasty (TKA) likely suffer from decreased postural stability because of postoperative changes in musculoskeletal structure and loss of proprioception. The purpose of this experimental biomechanical study was to determine if patients who have TKA improve their dynamic postural control during walking after TKA as compared with before TKA. The secondary purpose was to assess changes in postural control between post-TKA patients and healthy controls.
How Does Contact Length Impact Titanium Tapered Splined Stem Stability: A Biomechanical Matched Pair Cadaveric Study
IoannisGkiatasMD PhDaMichael-AlexanderMalahiasMD PhDaWilliamXiangBSaKathleen N.MeyersMSbLisa A.TorresMSbT. DavidTarityMDaJose A.RodriguezMDaMathias P.BostromMDaTimothy M.WrightPhDbPeter K.SculcoMDa
doi : 10.1016/j.arth.2021.04.013
Volume 36, Issue 9, September 2021, Pages 3333-3339
Titanium tapered stems (TTS) achieve fixation in the femoral diaphysis and are commonly used in revision total hip arthroplasty. The initial stability of a TTS is critical, but the minimum contact length needed and impact of implant-specific taper angles on axial stability are unknown. This biomechanical study was performed to better guide operative decision-making by addressing these clinical questions.
The Efficacy and Safety of Glucocorticoid on Periarticular Infiltration Analgesia in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
ZiquanLiMDabZengLiMDcKaiyuanChengMDabXishengWengMDab
doi : 10.1016/j.arth.2021.03.056
Volume 36, Issue 9, September 2021, Pages 3340-3350
The objective of this systematic review and meta-analysis was to examine the effect and safety of multimodal cocktail protocols implemented with or without glucocorticoids on periarticular infiltration analgesia (PIA) in patients undergoing total knee arthroplasty (TKA).
Corrigendum to ‘Outpatient Hip Safety in an Ambulatory Surgery Center Is Independent of Approach [The Journal of Arthroplasty 36 (2021) 231-235]’
Zachary K.PharrMDaCarson M.RiderMDaJack W.BellBSbJames H.WilderBSbTimothy J.WestbrooksBSbPatrick C.ToyMDa
doi : 10.1016/j.arth.2021.06.011
Volume 36, Issue 9, September 2021, Page 3351
Conflict of Interest Statement
doi : 10.1016/S0883-5403(21)00611-2
Volume 36, Issue 9, September 2021, Page 3352
