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Table of Contents
doi : 10.1016/S0883-5403(21)00683-5
Volume 36, Issue 10, October 2021, Pages A5, A6, A8, A10
A Statistics Review for the Arthroplasty Community
Chad A.KruegerMDMichael A.MontMDHilal MaraditKremersMDDaniel J.BerryMDDavid G.LewallenMDJohn J.CallaghanMD
doi : 10.1016/j.arth.2021.08.026
Volume 36, Issue 10, October 2021, Pages 3353-3354
Remembering Lawrence D. Dorr, MD: Founding Member of the American Association of Hip and Knee Surgeons, Founder of Operation Walk
John J.CallaghanMD
doi : 10.1016/j.arth.2021.08.019
Volume 36, Issue 10, October 2021, Pages 3355-3357
Living With Survival Analysis in Orthopedics1
Cynthia S.CrowsonPhDacDirk R.LarsonMSaKatrina L.DevickPhDbElizabeth J.AtkinsonMSaCarly S.LundgreenBSaDavid G.LewallenMDdDaniel J.BerryMDcHilalMaradit KremersMD, MScad
doi : 10.1016/j.arth.2021.04.014
Volume 36, Issue 10, October 2021, Pages 3358-3361
Time to event data occur commonly in orthopedics research and require special methods that are often called “survival analysis.” These data are complex because both a follow-up time and an event indicator are needed to correctly describe the occurrence of the outcome of interest. Common pitfalls in analyzing time to event data include using methods designed for binary outcomes, failing to check proportional hazards, ignoring competing risks, and introducing immortal time bias by using future information. This article describes the concepts involved in time to event analyses as well as how to avoid common statistical pitfalls. Please visit the following https://youtu.be/QNETrx8B6IU and https://youtu.be/8SBoTr9Jy1Q for videos that explain the highlights of the paper in practical terms.
Competing Risk Analysis: What Does It Mean and When Do We Need It in Orthopedics Research?1
HilalMaradit KremersMD, MScacKatrina L.DevickPhDbDirk R.LarsonMSaDavid G.LewallenMDcDaniel J.BerryMDcCynthia S.CrowsonPhDad
doi : 10.1016/j.arth.2021.04.015
Volume 36, Issue 10, October 2021, Pages 3362-3366
Most orthopedic studies involve survival analysis examining the time to an event of interest, such as a specific complication or revision surgery. Competing risks commonly arise in such studies when patients are at risk of more than one mutually exclusive event, such as death, or when the rate of an event depends on the rates of other competing events. In this article, we briefly describe the survival analysis censoring methodology, common fatal and nonfatal competing events, and define circumstances where standard survival analysis can fail in the setting of competing risks with real-world examples from orthopedics. Please visit the following https://youtu.be/ifj_Mm3eGu8 for a video that explains the highlights of the paper in practical terms.
Adjusted Survival Curves Improve Understanding of Multivariable Cox Model Results1
Carly S.LundgreenBSaDirk R.LarsonMSaElizabeth J.AtkinsonMSaKatrina L.DevickPhDbDavid G.LewallenMDcDaniel J.BerryMDcHilalMaradit KremersMD, MScacCynthia S.CrowsonPhDad
doi : 10.1016/j.arth.2021.06.002
Volume 36, Issue 10, October 2021, Pages 3367-3371
Kaplan-Meier survival curves are the most common methods for unadjusted group comparison of outcomes in orthopedic research. However, they may be misleading due to an imbalance of confounders between patient groups. The Cox model is frequently used to adjust for confounders, but graphical display of adjusted survival curves is not commonly utilized. We describe the circumstances when adjusted survival curves are useful in orthopedic research, describe and use 2 different methods to obtain adjusted curves, and illustrate how they can improve understanding of the multivariable Cox model results. We further provide practical strategies for identifying the need for and performing adjusted survival curves. Please visit the following https://youtu.be/ys0hy2CiMCA for a video that explains the highlights of the paper in practical terms.
Immortal Time Bias in the Analysis of Time-to-Event Data in Orthopedics1
Dirk R.LarsonMSaCynthia S.CrowsonPhDabKatrina L.DevickPhDcDavid G.LewallenMDdDaniel J.BerryMDdHilalMaradit KremersMD, MScad
doi : 10.1016/j.arth.2021.06.012
Volume 36, Issue 10, October 2021, Pages 3372-3377
Many outcomes in arthroplasty research are analyzed as time-to-event outcomes using survival analysis methods. When comparison groups are defined after a time-delayed exposure or intervention, a period of immortal time arises and can lead to biased results. In orthopedics research, immortal time bias often arises when a minimum amount of follow-up is required for study inclusion or when comparing outcomes in staged bilateral vs unilateral arthroplasty patients. We present an explanation of immortal time and the associated bias, describe how to correctly account for it using proper data preparation and statistical techniques, and provide an illustrative example using real-world arthroplasty data. We offer practical guidelines for identifying and properly handling immortal time to avoid bias. Please visit the following https://youtu.be/58p8w5o-ci4 for a video that explains the highlights of the paper in practical terms.
The Near-Term Ramifications of Long-Term Trends in Orthopedic Surgical Reimbursement
Louis F.McIntyreMDaWilliam S.BeachMDbEricStiefelMDcSara E.PearsonPhDb
doi : 10.1016/j.arth.2021.05.016
Volume 36, Issue 10, October 2021, Pages 3378-3380
There has been 25-year trend of decreasing value for orthopedic surgical work based on the Resource-Based Relative Value Scale (RBRVS) for Medicare reimbursement. This study was undertaken to estimate the time that Medicare payment rates for time spent in the office doing cognitive work will equal time dedicated in the operating room to performing procedural work based on long-term negative payment trends.
The 2021 Centers for Medicare and Medicaid Services Fee Schedule’s Impact on Adult Reconstruction Surgeon Productivity and Reimbursement
Christopher D.SkeehanMDDionisioOrtizIIIMDChelsea SueSicatMSRichardIorioMDJamesSloverMDJoseph A.BoscoIIIMD
doi : 10.1016/j.arth.2021.06.004
Volume 36, Issue 10, October 2021, Pages 3381-3387
On December 20, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized its proposed rule: CMS-1734-P. This 2021 Final Rule significantly changed Medicare total joint arthroplasty (TJA) reimbursement. The precise impact on surgeon productivity and reimbursement is unknown. In the present study, we sought to model the potential impact of these changes for multiple unique practice configurations.
Age at the Time of Surgery Is Not Predictive of Early Patient-Reported Outcomes After Periacetabular Osteotomy
Brian T.MufflyMDaAnthony J.ZachariasMDaKate N.JochimsenPhDbStephen T.DuncanMDaCale A.JacobsPhDaANCHOR Study GroupJohn C.ClohisyMDc
doi : 10.1016/j.arth.2021.05.029
Volume 36, Issue 10, October 2021, Pages 3388-3391
The clinical success of periacetabular osteotomy (PAO) for the treatment of symptomatic acetabular dysplasia is well-documented. Conflicting evidence exists regarding the correlation of age with clinical outcomes. Hip disability and Osteoarthritis Outcome Score - global (HOOSglobal) is a recently validated patient-reported outcome measure following PAO. The purpose of this study is to asses HOOSglobal and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at early follow-up based on age at the time of PAO.
Factors Associated With Early Return to Driving Following Total Joint Arthroplasty
Evan M.DugdaleMDMatthew P.SiljanderMDRobert T.TrousdaleMD
doi : 10.1016/j.arth.2021.05.028
Volume 36, Issue 10, October 2021, Pages 3392-3400
Patients often ask when they can safely return to driving a car following total joint arthroplasty (TJA). Most prior research has relied on driving simulators. Our study sought to learn more about real-world patient experiences in returning to driving after total knee arthroplasty (TKA) or total hip arthroplasty (THA).
Perioperative Statin Use May Reduce Postoperative Arrhythmia Rates After Total Joint Arthroplasty
John C.BonanoMDAshley K.ArataniMDTanmaya D.SambareBAStuart B.GoodmanMD, PhDJames I.HuddlestonIIIMDWilliam J.MaloneyMDDavid R.BurkMDAlistair J.AaronsonMDAndrea K.FinlayPhDDerek F.AmanatullahMD, PhD
doi : 10.1016/j.arth.2021.05.022
Volume 36, Issue 10, October 2021, Pages 3401-3405
Postoperative arrhythmias are associated with increased morbidity and mortality in total joint arthroplasty (TJA) patients. HMG-CoA (3-hydroxy-3-methyl-glutaryl-CoA) reductase inhibitors (statins) decrease atrial fibrillation rates after cardiac surgery, but it is unknown if this cardioprotective effect is maintained after joint reconstruction surgery. We aim to determine if perioperative statin use decreases the incidence of 90-day postoperative arrhythmias in patients undergoing primary TJA.
Preoperative Flexion Contracture Does Not Compromise the Outcomes and Survivorship of Medial Fixed Bearing Unicompartmental Knee Arthroplasty
Graham S.GohMBBS, MRCSGerald J.ZengMBBS, MRCSJerry Y.ChenMBBS, FRCSNgai-NungLoMBBS, FRCSSeng-JinYeoMBBS, FRCSMing Han LincolnLiowMBBS, FRCS
doi : 10.1016/j.arth.2021.05.019
Volume 36, Issue 10, October 2021, Pages 3406-3412
Despite the expanding indications for unicompartmental knee arthroplasty (UKA), the classic indication that limits flexion contracture to <5° in fixed bearing UKA excludes most patients with arthritic knees and has not been challenged in modern literature. This study compared the clinical outcomes between patients with severe flexion contracture and controls undergoing UKA.
Early Recovery Following Total and Unicompartmental Knee Arthroplasty Assessed Using Novel Patient-Reported Measures
Louise H.StricklandDPhil(Oxon), MSc, RN, CNOR, RNFAaAzmiRahmanBSc (Med Sci with Bioeng)aCrispinJenkinsonBA, MA, MSc, DPhil (Oxon)bHemant G.PanditMBBS, MS (Orth), DNB (Orth), FRCS (Orth)acDavid W.MurrayMA, MD, FRCS (Orth)a
doi : 10.1016/j.arth.2021.05.025
Volume 36, Issue 10, October 2021, Pages 3413-3420
The early postoperative recovery period following unicompartmental (UKA) and total knee arthroplasty (TKA) is an important area for research with increasingly sensitive metrics and new technologies. This study uses 2 recently developed patient-reported scores to compare the recovery following UKA and TKA.
Efficacy of Two Unique Combinations of Nerve Blocks on Postoperative Pain and Functional Outcome After Total Knee Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Study
QiuruWangMDaJianHuMMbYanZengMMbDonghaiLiMD, PhDaJingYangMD, PhDbPengdeKangMD, PhDa
doi : 10.1016/j.arth.2021.05.014
Volume 36, Issue 10, October 2021, Pages 3421-3431
This study aimed to explore the efficacy of two unique combinations of nerve blocks on postoperative pain and functional outcome after total knee arthroplasty (TKA).
Increased Revisions in Conversion Total Knee Arthroplasty After Periarticular Open Reduction Internal Fixation Compared With Primary Total Knee Arthroplasty: A Matched Cohort Analysis
Seth N.StakeMDaAlexGuMDaSafa C.FassihiMDaPradipRamamurtiMDaPatawutBovonratwetMDbSavyasachi C.ThakkarMDcGregory J.GolladayMDd
doi : 10.1016/j.arth.2021.05.021
Volume 36, Issue 10, October 2021, Pages 3432-3436.e1
Prior studies on conversion total knee arthroplasty (cTKA) have reported increased technical challenges and risk of complications compared with primary knee arthroplasty. The purpose of this study was to compare two-year postoperative complication/revision rates between patients undergoing cTKA after prior periarticular open reduction and internal fixation (ORIF) and those undergoing primary TKA.
Comparison of Surgical Site Complications With Negative Pressure Wound Therapy vs Silver Impregnated Dressing in High-Risk Total Knee Arthroplasty Patients: A Matched Cohort Study
David M.DomanMDaAllison M.YoungBSbLeonard T.BullerMDcEvan R.DeckardBSEcR. MichaelMeneghiniMDc
doi : 10.1016/j.arth.2021.05.030
Volume 36, Issue 10, October 2021, Pages 3437-3442
Closed incision negative pressure wound therapy (ciNPWT) may reduce surgical site complications following total joint arthroplasty. Although unlikely necessary for all patients, the criteria for utilizing ciNPWT in primary total knee arthroplasty (TKA) remain poorly defined. This study’s purpose was to compare the incidence of incisional wound complications, non-incisional complications (ie, dressing reactions), reoperations, and periprosthetic joint infections (PJIs) among a group of high-risk primary TKA patients treated with ciNPWT vs an occlusive silver impregnated dressing.
Onlay Patellar Resurfacing in a Posterior-Stabilized Total Knee Arthroplasty Increases Patellar Crepitus Complication: A Randomized, Controlled Trial
SatitThiengwittayapornMDNattapolSumranwanichMDNatthapongHongkuMDPichaiSansawatMD
doi : 10.1016/j.arth.2021.05.031
Volume 36, Issue 10, October 2021, Pages 3443-3450
Patellar crepitus (PC) is a potentially problematic complication after total knee arthroplasty (TKA) more commonly occurring with a posterior-stabilized (PS) prosthesis. Patellar resurfacing has been reported to reduce PC complications; however, no study has compared the PC complication rates between 2 different resurfacing techniques, namely inlay and onlay.
Electromagnetic Navigated Versus Conventional Total Knee Arthroplasty—A Five-Year Follow-Up of a Single-Blind Randomized Control Trial
Andrew N.ClarkMDaAdamHounatMDaSineadO’DonnellBScaPaulineMayaJamesDoonanPhDaPhilipRowePhDbBryn G.JonesMDaMark J.G.BlythMDa
doi : 10.1016/j.arth.2021.06.007
Volume 36, Issue 10, October 2021, Pages 3451-3455
The objective of this study is to provide the 5-year follow-up results of a randomized study comparing conventional versus electromagnetic computer navigated total knee arthroplasty.
Contemporary Mortality Rate and Outcomes in Nonagenarians After Primary Total Knee Arthroplasty
LouisDagneauxMDaAdam W.AmundsonMDbDirk R.LarsonMScMark W.PagnanoMDaDaniel J.BerryMDaMatthew P.AbdelMDa
doi : 10.1016/j.arth.2021.05.015
Volume 36, Issue 10, October 2021, Pages 3456-3462
Nonagenarians (90-99 years) have experienced the fastest percent growth in primary total knee arthroplasty (TKA) utilization recently. However, there are limited data on the results of the procedure in this population. The goals of this study are to determine the mortality rate, implant survivorship, clinical outcomes, and complications of primary TKAs in nonagenarians.
Bikini Incision Increases the Incidence of Lateral Femoral Cutaneous Nerve Injury in Direct Anterior Approach Hip Arthroplasty: A Prospective Ultrasonic, Electrophysiological, and Clinical Study
WeilinSangPhDaSongXueMDaYimingXuMDaYuLiuPhDbLiboZhuMDaJinzhongMaPhDa
doi : 10.1016/j.arth.2021.05.012
Volume 36, Issue 10, October 2021, Pages 3463-3470
Lateral femoral cutaneous nerve (LFCN) injury has been widely reported as one of the most common complications of direct anterior approach (DAA) hip arthroplasty. Bikini incision is considered to increase the incidence of this complication.
Heterotopic Ossification Following Direct Anterior Total Hip Arthroplasty With and Without Postoperative Analgesic Nonsteroidal Anti-inflammatories
Brandon H.NaylorDOaCesar R.IturriagaDObcYash B.BisenBAdMatthew J.CaidDOaKeith R.ReinhardtMDe
doi : 10.1016/j.arth.2021.05.017
Volume 36, Issue 10, October 2021, Pages 3471-3477
Heterotopic ossification (HO) can result in poorer clinical outcomes following total hip arthroplasty (THA). Multiple modes of intervention have been evaluated for HO prevention, including the use of nonsteroidal anti-inflammatories. Additionally, multimodal pain management strategies including celecoxib have become more prominent. Therefore, this study aims to evaluate the influence of celecoxib as part of postoperative analgesia on the risk of developing HO following the direct anterior approach (DA) for THA.
Does the Patient-Reported Outcomes Measurement Information System Correlate to Legacy Scores in Measuring Physical Health in Young Total Hip Arthroplasty Patients?
WahidAbu-AmerMDCharles M.LawrieMDSusanThapaMPH, PhDJeffrey J.NeppleMDJohn C.ClohisyMD
doi : 10.1016/j.arth.2021.06.003
Volume 36, Issue 10, October 2021, Pages 3478-3484
The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed by the National Institutes of Health to collect outcome data in rapid dynamic fashion on electronic platforms. The potential role of PROMIS in monitoring pain and function in young total hip arthroplasty (THA) patients has been under-investigated. The purpose of this study is to investigate correlation between PROMIS Physical Function (PF) and PROMIS Pain Interference (PI) and legacy scores with similar considerations.
High Satisfaction and Activity Levels After Total Hip Arthroplasty in Patients Under Age 21
Cynthia A.KahlenbergMD, MPHMatthew D.GarveyBAJason L.BlevinsMDThomas P.SculcoMDPeter K.SculcoMDMark P.FiggieMD
doi : 10.1016/j.arth.2021.05.020
Volume 36, Issue 10, October 2021, Pages 3485-3489
With improved materials and bearing surfaces, the use of total hip arthroplasty (THA) in young patients is increasing. Functional outcomes and activity level are particularly relevant in this higher-demand patient population. There is a paucity of data on patient-reported outcomes and activity levels after THA in extremely young (<21 years old) patients.
Cobalt Levels and Pseudotumor Characteristics Vary due to Metal Ion Source: Modular Femoral Neck vs Metal-on-Metal Articulations
Zachary A.McConnellBSJeffrey B.StamboughMDC. LowryBarnesMDBecky L.WilsonBSSimon C.MearsMD, PhD
doi : 10.1016/j.arth.2021.05.018
Volume 36, Issue 10, October 2021, Pages 3490-3497
This study examines cobalt levels and pseudotumor characteristics in a non-recalled modular femoral prosthesis. We sought to determine relationships between serum cobalt levels and pseudotumors following modular and metal-on-metal (MoM) total hip arthroplasty (THA), the location and size of pseudotumors, and changes to pseudotumor grade over time.
Ceramic Bearings Are Associated With a Significantly Reduced Revision Rate in Primary Hip Arthroplasty: An Analysis From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man
Richard J.HolleymanMBBS, MSc, MRCSaRebecca J.CritchleyMBBS, FRCS (Tr&Ortho)bJames M.MasonDphil, MSccSimon S.JamesonMBBS, FRCS (Tr&Ortho), PhDdMike R.ReedMBBS, MD, FRCS (Tr&Ortho)bAjayMalviyaMBBS, FRCS (Tr&Ortho), PhDbe
doi : 10.1016/j.arth.2021.05.027
Volume 36, Issue 10, October 2021, Pages 3498-3506
Prosthetic joint infection (PJI) is a devastating complication. Studies have suggested reduction in PJI with the use of ceramic bearings.
Survivorship of Ceramic-on-Ceramic Total Hip Arthroplasty With Metal-Backed Acetabular Liners at 10 Years
MoritzWagnerMDaHannesSchönthaleraFranzEndstrasserMDaSabrinaNeururer(PhD)bHermannLeitnerbAlexanderBrunnerMDa
doi : 10.1016/j.arth.2021.05.038
Volume 36, Issue 10, October 2021, Pages 3507-3512
Ceramic-on-ceramic bearings are becoming increasingly popular in primary total hip arthroplasty (THA). To enhance ceramic-on-ceramic liner exchange in case of revision surgery, metal-backed liner systems have been proposed. Little is known about the clinical performance of these implants. The purpose of this study is to evaluate a metal-backed liner implant system for primary THA.
What Is the 30-Day Mortality Burden After Elective Total Hip Arthroplasty? An Analysis of 194,062 Patients
Kara M.McConaghyBSaMelissa N.OrrBSbDanielGritsBSbAhmed K.EmaraMDbRobert M.MolloyMDbNicolas S.PiuzziMDb
doi : 10.1016/j.arth.2021.05.026
Volume 36, Issue 10, October 2021, Pages 3513-3518.e2
This study aims to answer the following questions regarding elective total hip arthroplasty (THA): What is (1) the overall 30-day mortality rate; (2) the mortality rate when stratified by age, comorbidities, and preoperative diagnosis; and (3) the distribution of patient demographics, comorbidities, and preoperative diagnoses between the mortality and mortality-free cohorts?
Minimum 10-Year Results of Cementless Ceramic-On-Ceramic Total Hip Arthroplasty Performed With Transverse Subtrochanteric Osteotomy in Crowe Type IV Hips
RemziCaylakMDaCagriOrsMDbEmreTogrulMDa
doi : 10.1016/j.arth.2021.05.035
Volume 36, Issue 10, October 2021, Pages 3519-3526
Total hip arthroplasty (THA) performed for developmental dysplasia of the hip is a technically difficult procedure with a high complication rate, especially in the presence of completely dislocated hips. This study aimed to evaluate at least 10 years of follow-up results of cementless, ceramic-on-ceramic (CoC) THA performed with transverse subtrochanteric osteotomy in Crowe type IV hips.
Evaluating Alternate Registration Planes for Imageless, Computer-Assisted Navigation During Total Hip Arthroplasty
Jonathan M.VigdorchikMDaPeter K.SculcoMDaAllan E.InglisMDaRanSchwarzkopfMD, MSbJeffrey M.MuirMSc, DC, MSc (Clin Epi)c
doi : 10.1016/j.arth.2021.05.037
Volume 36, Issue 10, October 2021, Pages 3527-3533
Imageless computer navigation improves component placement accuracy in total hip arthroplasty (THA), but variations in the registration process are known to impact final accuracy measurements. We sought to evaluate the registration accuracy of an imageless navigation device during THA performed in the lateral decubitus position.
Total Hip Arthroplasty in Patients With Cerebral Palsy: A Matched Comparison of 90-Day Adverse Events and 5-Year Implant Survival
Harold G.MooreBSaMursalGardeziBSbPatrick J.BurroughsBSbLee E.RubinMDcDavid B.FrumbergMDcJonathan N.GrauerMDc
doi : 10.1016/j.arth.2021.05.039
Volume 36, Issue 10, October 2021, Pages 3534-3537
People with cerebral palsy (CP) may be considered for total hip arthroplasty (THA). However, short- and long-term outcomes after THA in this population remain poorly characterized.
Migration Patterns for Revision Total Knee Arthroplasty in the United States as Reported in the American Joint Replacement Registry
Kevin A.LawsonMDaAntonia F.ChenMD, MBAbBryan D.SpringerMDcRichard L.IllgenMDdDavid G.LewallenMDeJames I.HuddlestonIIIMDaDerek F.AmanatullahMD, PhDa
doi : 10.1016/j.arth.2021.06.005
Volume 36, Issue 10, October 2021, Pages 3538-3542
Revision total knee arthroplasty (TKA) is associated with a higher complication rate and a greater cost when compared to primary TKA. Based on patient choice, referral, or patient transfers, revision TKAs are often performed in different institutions by different surgeons than the primary TKA. The aim of this study is to evaluate the effect of hospital size, teaching status, and revision indication on the migration patterns of failed primary TKA in patients 65 years of age and older.
High Survivorship of Short-Cemented Femoral Stems in Condylar Revision Total Knee Arthroplasty Without Significant Metaphyseal Bone Loss: Minimum 5-Year Follow-Up
Hosam E.MatarMSc (Res), FRCS (Tr&Orth)Benjamin V.BlochMBBS, FRCS (Tr&Orth)Peter J.JamesDipBiomech, FRCS, FRCS (Tr&Orth)
doi : 10.1016/j.arth.2021.05.036
Volume 36, Issue 10, October 2021, Pages 3543-3550
We aimed to evaluate the outcomes of hybrid fixation technique in condylar revision total knee arthroplasty (rTKA) using cementless metaphyseal tibial sleeves and short-cemented femoral stems with a rotating platform articulation.
Early, Mid-Term, and Late-Term Aseptic Femoral Revisions After THA: Comparing Causes, Complications, and Resource Utilization
Julia S.SchwarzMDKatherine A.LygrisseMDMackenzie A.RoofMD, MBAWilliam J.LongMDRan M.SchwarzkopfMD, MScMatthew S.HepinstallMD
doi : 10.1016/j.arth.2021.05.041
Volume 36, Issue 10, October 2021, Pages 3551-3555
Registry data suggest increasing rates of early revisions after total hip arthroplasty (THA). We sought to analyze modes of failure over time after index THA to identify risk factors for early revision.
Synchronous Periprosthetic Joint Infections: High Mortality, Reinfection, and Reoperation
Elizabeth B.GausdenMD, MPHaMark W.PagnanoMDaKevin I.PerryMDaGina A.SuhMDbDaniel J.BerryMDaMatthew P.AbdelMDa
doi : 10.1016/j.arth.2021.05.010
Volume 36, Issue 10, October 2021, Pages 3556-3561
Synchronous periprosthetic joint infections (PJIs) are a catastrophic complication with potentially high mortality. We aimed to report mortality, risk of reinfection, revision, reoperation, and implant survivorship after synchronous PJIs.
Debridement, Antibiotics, and Implant Retention in Periprosthetic Joint Infection: What Predicts Success or Failure?
Rui XiangTohMBBS (S’pore), MRCSEdaZhen NingYeoMedical StudentbMing Han LincolnLiowMBBS, MRCSEd, MMed (Ortho), FRCSEd (Orth)aSeng-JinYeoMBBS, FRCSEd, FAMSaNgai-NungLoMBBS, FRCSEd, FAMSaJerry YongqiangChenMBBS, MRCSEd, MMed (Ortho), FRCSEd (Orth)a
doi : 10.1016/j.arth.2021.05.023
Volume 36, Issue 10, October 2021, Pages 3562-3569
Debridement, antibiotics and implant retention (DAIR) is the treatment of choice for acute postoperative and acute hematogenous periprosthetic joint infection (PJI). There is limited literature on predictive prognostic factors for DAIR. We aim to report the outcomes of DAIR and investigate the predictive prognostic factors.
What Is the Optimal Irrigation Solution in the Management of Periprosthetic Hip and Knee Joint Infections?
AhmedSiddiqiDO, MBAabcZuhdi E.AbdoMDdStephen R.RossmanDObMichael A.KellyMDbNicolas S.PiuzziMDeCarlos A.HigueraMDfRanSchwarzkopfMDgBryan D.SpringerMDhAntonia F.ChenMDiJavadParviziMDj
doi : 10.1016/j.arth.2021.05.032
Volume 36, Issue 10, October 2021, Pages 3570-3583
Thorough irrigation and debridement using an irrigation solution is a well-established treatment for both acute and chronic periprosthetic joint infections (PJIs). In the absence of concrete data, identifying the optimal irrigation agent and protocol remains challenging.
Statin Exposure and Risk of Prosthetic Joint Infection After Total Knee or Hip Arthroplasty Among U.S. Veterans
S. ScottSuttonPharmDabJoseph C.MagagnoliMSabTammy H.CummingsPhDabJames W.HardinPhDac
doi : 10.1016/j.arth.2021.06.006
Volume 36, Issue 10, October 2021, Pages 3584-3588.e1
Statins have a variety of pleiotropic effects that could be beneficial for patients undertaking total knee or hip arthroplasty. In vitro and in vivo models suggest the beneficial effects of statins through bone formation and modulating proinflammatory cytokines triggered by implant debris. However, statins also exhibit antimicrobial action and may reduce the risk of revision surgery via reducing the risk of infection. We sought to explore the relationship between statin use and prosthetic joint infection (PJI) after total knee or hip arthroplasty.
No Increased Risk of Venous Thromboembolism in High-Risk Patients Continuing Their Dose of 75 mg Aspirin Compared to Healthier Patients Given Low-Molecular-Weight Heparin
OysteinHovikMDEinar J.AmlieMDKjersti KaulJenssenMD, PhD
doi : 10.1016/j.arth.2021.06.001
Volume 36, Issue 10, October 2021, Pages 3589-3592
Optimum venous thromboembolism (VTE) prophylaxis for patients undergoing total hip or knee arthroplasty remains undefined. The purpose of this study is to compare complication rates among total joint arthroplasty patients using either low-dose aspirin (75 mg once daily) or low-molecular-weight heparin (LMWH; Fragmin/dalteparin 5000 U) for VTE prophylaxis.
Limb Length Discrepancy in Total Hip Arthroplasty: Is the Lesser Trochanter a Reliable Measure of Leg Length?
Matthew C.GalloBAaBrian C.ChungBSaDouglass W.TuckerMDaAmit S.PipleMDbAlexander B.ChristMDaJay R.LiebermanMDaNathanael D.HeckmannMDa
doi : 10.1016/j.arth.2021.06.009
Volume 36, Issue 10, October 2021, Pages 3593-3600
Limb length discrepancy (LLD) after total hip arthroplasty may affect clinical outcomes and patient satisfaction. Preoperative LLD estimates on anteroposterior pelvic radiographs fail to account for anatomical limb variation distal to the femoral reference points. The objective of this study is to determine how variations in lower limb skeletal lengths contribute to true LLD.
Outcomes of Vancouver C Periprosthetic Femur Fractures
Elizabeth B.GausdenMD, MPHMeagan E.TibboMDKevin I.PerryMDDaniel J.BerryMDBrandon J.YuanMDMatthew P.AbdelMD
doi : 10.1016/j.arth.2021.05.033
Volume 36, Issue 10, October 2021, Pages 3601-3607
Periprosthetic femur fractures (PFFs) that occur distal to a total hip arthroplasty, Vancouver C fractures, are challenging to treat. We aimed to report patient mortality, reoperations, and complications following Vancouver C PFFs in a contemporary cohort all treated with a laterally based locking plate.
Clinical and Administrative Databases Used in Lower Extremity Arthroplasty Research
Mitchell K.NgMDaRushabh M.VakhariaMDaKevin J.BozicMD, MBAbJohn J.CallaghanMDcMichael A.MontMDd
doi : 10.1016/j.arth.2021.05.034
Volume 36, Issue 10, October 2021, Pages 3608-3615
The use of national databases in lower extremity arthroplasty research has grown rapidly in recent years. We aimed to better characterize available databases by: (1) quantifying the number of these studies in the highest impact arthroplasty journals; (2) comparing respective sample sizes; and (3) contrasting their measured variables/outcomes.
Google Trends Analysis Shows Increasing Public Interest in Platelet-Rich Plasma Injections for Hip and Knee Osteoarthritis
Samuel A.CohenBSThompsonZhuangBAMichelleXiaoBSJohn B.MichaudBSDerek F.AmanatullahMDRobin N.KamalMD, MBA
doi : 10.1016/j.arth.2021.05.040
Volume 36, Issue 10, October 2021, Pages 3616-3622
Osteoarthritis is a chronic musculoskeletal condition that frequently affects the hip and knee joints. Given the burden associated with surgical intervention for hip and knee osteoarthritis, patients continue to search for potential nonoperative treatments. One biologic therapy with mixed clinical and basic science evidence for treating osteoarthritis is platelet-rich plasma injections into the affected joint. We used the Google Trends tool to provide a quantitative analysis of national interest in platelet-rich plasma injections for hip and knee osteoarthritis.
A Complication Profile of Total Hip and Knee Arthroplasty in Liver Transplantation Patients: A Meta-Analysis
George J.HanBAaMatthew E.DerenMDb
doi : 10.1016/j.arth.2021.05.024
Volume 36, Issue 10, October 2021, Pages 3623-3630
There is an increasing demand for total joint arthroplasty in liver transplantation patients. However, significant heterogeneity in existing studies creates difficulty to draw conclusions on the risk profile of arthroplasty in this population.
Corrigendum to ‘Tibial Component Migration After Total Knee Arthroplasty With High-Viscosity Bone Cement [The Journal of Arthroplasty 36 (2021) 2000-2005]’
Elise K.LaendePhDabC. GlenRichardsonMD, FRCSC, MScaAlexander R.MeldrumMD, FRCSCaMichael J.DunbarMD, FRCSC, PhDab
doi : 10.1016/j.arth.2021.06.013
Volume 36, Issue 10, October 2021, Page 3631
Erratum to ‘Effect of Different Tourniquet Pressure on Postoperative Pain and Complications After Total Knee Arthroplasty: A Prospective, Randomized Controlled Trial [The Journal of Arthroplasty 36 (2021) 1638-1644]’
PiyaPinsornsakMDaPunnawitPinitchanonMDaKritBoontanapibulMDb
doi : 10.1016/j.arth.2021.07.016
Volume 36, Issue 10, October 2021, Pages 3632-3633
Corrigendum to ‘Effect of Antibiotic-Impregnated Bone Cement in Primary Total Knee Arthroplasty [The Journal of Arthroplasty 34 (2019) 2091-2095]
Hiba K.AnisMDaNipunSodhiMDaMhamadFaourMDbAlison K.KlikaMSaMichael A.MontMDaWael K.BarsoumMDbCarlos A.HigueraMDbRobert M.MolloyMDa
doi : 10.1016/j.arth.2021.07.017
Volume 36, Issue 10, October 2021, Page e1
Erratum to ‘Real Time Conversations: Changes to the Letters to the Editor [The Journal of Arthroplasty 36 (2021) 2249]’
C.A.KruegerD.J.BacksteinJ.A.BrowneV.E.KrebsJ.B.MasonM.A.MontM.J.TauntonJ.J.Callaghan
doi : 10.1016/j.arth.2021.07.009
Volume 36, Issue 10, October 2021, Page e2
Conflict of Interest Statement
doi : 10.1016/S0883-5403(21)00684-7
Volume 36, Issue 10, October 2021, Page 3634
