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Table of Contents
doi : 10.1016/S0883-5403(21)00720-8
Volume 36, Issue 11, November 2021, Pages A5, A6, A8
Can Prior Episode-of-Care Costs Predict the Future? Identifying High-Cost Outliers for Subsequent Total Hip and Knee Arthroplasty
Paul L.SousaMD, MBATrevor R.GraceMDMichaelYayacMDChrisVannelloBSP. MaxwellCourtneyMDChad A.KruegerMD
doi : 10.1016/j.arth.2021.06.027
Volume 36, Issue 11, November 2021, Pages 3635-3640
It remains unknown if a patient’s prior episode-of-care (EOC) costs for total hip (THA) or knee (TKA) arthroplasty procedure can be used to predict subsequent costs for future procedures. The purpose of this study is to evaluate whether there is a correlation between the EOC costs for a patient’s index and subsequent THA or TKA.
The Frequency, Reasoning, and Impact of Repeated Radiographs at the Initial Orthopedic Arthroplasty Visit
MichaelYayacMDGregory R.TociBSEric B.SmithMDAndrew M.StarMDJavadParviziMD, FRCSArjunSaxenaMD, MBA
doi : 10.1016/j.arth.2021.07.007
Volume 36, Issue 11, November 2021, Pages 3641-3645
Patients presenting to an orthopedic clinic with joint pain often seek prior care and imaging before consultation. It is unknown how often orthopedic surgeons must repeat imaging and whether repeat imaging has an impact on diagnosis or management. The purpose of this study was to determine the frequency, reason, and impact of repeating radiographs in outpatient orthopedic clinics.
Red Cell Distribution Width: Commonly Performed Test Predicts Mortality in Primary Total Joint Arthroplasty
ArashAali-RezaieMDaFeng-ChihKuoMDabElieKozailyMDaHamedVahediMDacJavadParviziMD, FRCSaPeter F.SharkeyMDa
doi : 10.1016/j.arth.2021.07.002
Volume 36, Issue 11, November 2021, Pages 3646-3649
Mortality after total joint arthroplasty (TJA) has been thoroughly explored. Short and long-term mortality appear to be correlated with patient comorbidities. Red Cell Distribution Width (RDW) is a commonly performed test that reflects the variation in red blood cell size. This study investigated the utility of RDW, when combined with comorbidity indices, in predicting mortality after TJA.
Preoperative Osteoarthritic Grade Affects Forgotten Joint Status and Patient Acceptable Symptom State After Robotic Arm-Assisted Unicompartmental Knee Arthroplasty
FrancescoZambianchiMDaValerioDaffaraMDaAlbertoNegriMDaGiorgioFranceschiMDbGuglielmoSchiavonMDcFabioCataniMDa
doi : 10.1016/j.arth.2021.06.028
Volume 36, Issue 11, November 2021, Pages 3650-3655
This retrospective observational study was designed to investigate the association between radiographic Ahlbäck osteoarthritis (OA) grade and postoperative joint perception in a cohort of patients undergoing medial robotic arm-assisted unicompartmental knee arthroplasty (RA-UKA), using the Forgotten Joint Status and Patient Acceptable Symptom State (PASS) as outcomes.
Octogenarians Undergoing Medial Unicompartmental Knee Arthroplasty Have Similar Patient-Reported Outcomes as Their Younger Counterparts
Graham S.GohMDJohn J.CorviBSTrevor R.GraceMDIpekEralpMSIlanSmallBSJess H.LonnerMD
doi : 10.1016/j.arth.2021.06.014
Volume 36, Issue 11, November 2021, Pages 3656-3661
As a procedure with lower surgical morbidity, unicompartmental knee arthroplasty (UKA) may present a practical solution for elderly patients with unicompartmental arthritis. However, few studies have analyzed the results of UKA in the extreme elderly. This study compared the functional and perioperative outcomes between octogenarians and age-appropriate controls undergoing UKA.
No Difference Between Hemiarthroplasty and Total Hip Arthroplasty in the Treatment of Pathologic Femoral Neck Fractures
Brett L.HaydenMDabNathan H.VaradyMDaeAyeshaAbdeenMDdSantiago A.Lozano-CalderonMDcAntonia F.ChenMD, MBAaJohn E.ReadyMDa
doi : 10.1016/j.arth.2021.06.015
Volume 36, Issue 11, November 2021, Pages 3662-3666
Hemiarthroplasty (HA) and total hip arthroplasty (THA) have been widely discussed as treatment options for displaced osteoporotic femoral neck fractures. Pathologic femoral neck fractures from primary or metastatic tumors are comparatively rare and poorly investigated. The purpose of this study was to compare outcomes, complications, and perioperative survival for HA and THA in the treatment of pathologic femoral neck fractures of neoplastic etiology.
Cemented Vs Cementless Femoral Fixation for Total Hip Arthroplasty After Displaced Femoral Neck Fracture: A Nationwide Analysis of Short-Term Complications and Readmission Rates
Nathanael D.HeckmannMDaXiao T.ChenMDbAlexander M.BallatoriBAaAndyTonBSaShaneShahrestaniMSaBrian C.ChungBSaAlexander B.ChristMDa
doi : 10.1016/j.arth.2021.06.029
Volume 36, Issue 11, November 2021, Pages 3667-3675.e4
Active patients with displaced femoral neck fractures are often treated with total hip arthroplasty (THA). However, optimal femoral fixation in these patients is controversial. The purpose of this study was to compare early complication and readmission rates in patients with hip fracture treated with THA receiving cemented vs cementless femoral fixation.
Mepivacaine vs Bupivacaine Spinal Anesthesia in Total Hip Arthroplasty at an Ambulatory Surgery Center
Tyler E.CalkinsMDSamuel G.McClatchyMDCarson M.RiderMDPatrick C.ToyMD
doi : 10.1016/j.arth.2021.07.014
Volume 36, Issue 11, November 2021, Pages 3676-3680
Mepivacaine spinal anesthetic may facilitate more rapid postoperative recovery in joint arthroplasty than bupivacaine. This study compared recovery, pain, and complications between the 2 anesthetics in anterior-approach total hip arthroplasty (THA) at a free-standing ambulatory surgery center (ASC).
Risk Factors for Prolonged Time to Discharge in Total Hip Patients Performed in an Ambulatory Surgery Center due to Complaints of the Inability to Void
MattMathewMDTyler D.RagsdaleMDZachary K.PharrMDCarson M.RiderMDWilliam M.MihalkoMD, PhDPatrick C.ToyMD
doi : 10.1016/j.arth.2021.06.010
Volume 36, Issue 11, November 2021, Pages 3681-3685
Postoperative urinary retention (POUR) is among the reasons for delay in discharge after outpatient total hip arthroplasty (THA), occurring in 2%-46% of patients. We hypothesized that the frequency of POUR following outpatient THA in the ambulatory surgery center (ASC) is low compared to previously reported rates and that management can be effective in the perioperative period when it is encountered.
Effect of Mobilization on the Day of Surgery After Total Hip Arthroplasty in Elderly, Obese, and Severely Diseased Patients
JanOberfeldaSebastian P.von Hertzberg-BoelchMDaManuelWeissenbergerMDaBoris M.HolzapfelMD, PhDbMaximilianRudertMDaAxelJakuscheitMDa
doi : 10.1016/j.arth.2021.06.024
Volume 36, Issue 11, November 2021, Pages 3686-3691
Mobilization on the day of surgery after total hip arthroplasty (THA) is widely used. However, elderly, obese and severely diseased patients are often excluded from early mobilization. Therefore, it was our aim to investigate the effect of mobilization on the day of surgery with focus on these patients.
Is Dislocation Risk due to Posterior Pelvic Tilt Reduced With Direct Anterior Approach Total Hip Arthroplasty?
Justin K.FritzMDaBradford S.WaddellMDbcKurt J.KitzigerMDbcPaul C.PetersJr.MDbcBrian P.GladnickMDbc
doi : 10.1016/j.arth.2021.07.003
Volume 36, Issue 11, November 2021, Pages 3692-3696
Pelvic tilt affects acetabular anteversion, and thus total hip arthroplasty (THA) dislocation risk. The pubic symphysis-sacrococcygeal distance (PSCD) is an indicator of pelvic tilt, and a PSCD < 0 mm (ie, excessive posterior pelvic tilt) is associated with a 3.7-fold increase in postoperative dislocation rate. However, it is not known if the direct anterior (DA) approach might reduce this dislocation rate, specifically in high-risk populations such as negative PSCD.
Long-Term Outcomes of a Titanium-Encased Ceramic Liner Total Hip Arthroplasty (15 to 21Year Results)
RicardoFernández-FernándezMD, PhDFernandoOñorbe-San FranciscoMDEnriqueGil-GarayMD, PhD
doi : 10.1016/j.arth.2021.06.016
Volume 36, Issue 11, November 2021, Pages 3697-3702
Historically, aseptic loosening and osteolysis were responsible for most of the revisions among young and more active patients. Ceramic-on-ceramic bearings reduced wear but presented mechanical issues such ceramic fracture or liner chipping during insertion. To prevent this from happening a titanium-encased alumina liner was developed. The aim of this study is to address long-term results of this specific ceramic design.
Periprosthetic Femoral Fracture Is a Leading Cause of Early Revision With Taper-Slip Stems in Primary Total Hip Arthroplasty: An Analysis of 2765 Total Hip Arthroplasties From a High-Volume Hospital
Oskari A.PakarinenBMabPerttu S.NeuvonenMD, PhDaOlli S.LainialaMD, PhDacAleksi R.P.ReitoMD, PhDadAntti P.EskelinenMD, PhDa
doi : 10.1016/j.arth.2021.06.022
Volume 36, Issue 11, November 2021, Pages 3703-3708.e2
In 2016, the CPT stem replaced the Exeter stem as the main cemented stem at our institution. We assessed the prevalence of revision for periprosthetic femoral fracture (PFF) in patients operated on with either CPT or Exeter stem and compared the risk for revision between these stems.
Risk Factors for Significant Radiolucent Line Development in a Fully Coated Hydroxyapatite Stem
Paul N.KarayiannisMRCSEd, MScaRoslyn S.CassidyMMedSci, PhDaGrahamIsaacPhDbIoanHughesMedical StudentcJanet C.HillPhD, MEng, MScdAlainMachenaudMDeDavid E.BeverlandMD, FRCSd
doi : 10.1016/j.arth.2021.07.001
Volume 36, Issue 11, November 2021, Pages 3709-3715
The risk factors for and clinical impact of radiolucent lines (RLLs) in cementless total hip arthroplasty remain contentious. The aim of this work was to describe a method of classification that has clinical significance and to identify risk factors.
No Difference in Dislocation Rates Comparing Large Diameter Jumbo Femoral Heads and Dual-Mobility Bearings in Revision Total Hip Arthroplasty
Kevin A.SonnMDabEvan R.DeckardBSEaR. MichaelMeneghiniMDab
doi : 10.1016/j.arth.2021.07.008
Volume 36, Issue 11, November 2021, Pages 3716-3721
Dual-mobility (DM) bearings reduce instability in revision total hip arthroplasty (THA); however, DM bearings are costly and reports of corrosion have recently emerged. Furthermore, no study has compared DM to standard bearings with large diameter femoral heads ?40-mm. This study’s purpose was to compare postoperative dislocation rates of standard and DM bearings with large femoral heads after revision THA.
Combined Strut Onlay Allografting, Reduction Osteotomy, and Extensively Porous-Coated Stem for Reconstruction of Severe Femoral Defects During Revision Hip Arthroplasty
Young-HooKimMDaYoung-SooJangMDaJang-WonParkMDbEun-JungKimMDa
doi : 10.1016/j.arth.2021.07.011
Volume 36, Issue 11, November 2021, Pages 3722-3727
The purpose of this study is to determine the long-term (up to 27 years) results of a modified technique applying strut allografts combined with a reduction osteotomy over an extensively porous-coated stem.
Which International Consensus Meeting Preoperative Minor Criteria is the Most Accurate Marker for the Diagnosis of Periprosthetic Joint Infection in Hip and Knee Arthroplasty?
AliLeventMDabMichael E.NeufeldMD, MScaPongsiriPiakongMDacChristianLausmannMDaThorstenGehrkeMDaMustafaCitakMD, PhDa
doi : 10.1016/j.arth.2021.06.030
Volume 36, Issue 11, November 2021, Pages 3728-3733
The accurate preoperative diagnosis of periprosthetic joint infection (PJI) is critical. The aim of this study was to evaluate the diagnostic accuracy and performance of the 2018 International Consensus Meeting (ICM) preoperative minor criteria for the diagnosis of chronic PJI in total hip and knee arthroplasty.
The Risk Factor and Outcome of Metachronous Periprosthetic Joint Infections: A Retrospective Analysis With a Minimum Ten-Year Follow-Up
Sheng-HsunLeeMDabcChih-HsiangChangMDabcChih-ChienHuMDabcYuhanChangPhDabcPang-HsinHsiehMDabcYu-ChihLinMDabc
doi : 10.1016/j.arth.2021.07.019
Volume 36, Issue 11, November 2021, Pages 3734-3740
Patients with multiple prosthetic joints are at risk of developing periprosthetic joint infections (PJIs). We aimed to determine whether PJI development at one site may lead to infection at another prosthetic joint site and assess the risk factors leading to this subsequent infection.
Irrigation and Debridement With Implant Retention: Does Chronicity of Symptoms Matter?
T. DavidTarityMDIoannisGkiatasMD, PhDAllina A.NoconPhDChristopher W.JonesMDAlberto V.CarliMDPeter K.SculcoMD
doi : 10.1016/j.arth.2021.07.018
Volume 36, Issue 11, November 2021, Pages 3741-3749
Periprosthetic joint infection (PJI) remains a rare, yet devastating complication of total joint arthroplasty (TJA). Chronic infection is generally considered a contraindication to debridement, antibiotics, and implant retention (DAIR); however, outcomes stratified by chronicity have not been well documented.
Cruciate-Retaining vs Posterior-Stabilized Antibiotic Cement Articulating Spacers for Two-Stage Revision of Prosthetic Knee Infection: A Retrospective Cohort Study
Tsung-LiLinMDabcChun-HaoTsaiMD, PhDabYi-ChinFongMD, PhDabdMing-YouShiePhDefgHui-YiChenMDhYi-WenChenPhDceg
doi : 10.1016/j.arth.2021.06.023
Volume 36, Issue 11, November 2021, Pages 3750-3759.e2
Antibiotic cement articulating spacers are recommended during 2-stage revision for prosthetic knee infection because of increased range of motion (ROM) and improved function; however, spacer mechanical complications have been reported. We aimed to determine the association between different constraints of articulating spacers and the rate of complications and infection eradication, functional outcomes, and ROM.
Primary and Revision Total Knee Arthroplasty in Patients With Pulmonary Hypertension: High Perioperative Mortality and Complications
Courtney E.BakerMDBrian P.ChalmersMDMichael J.TauntonMDHilalMaradit KremersMDAdam W.AmundsonMDDaniel J.BerryMDMatthew P.AbdelMD
doi : 10.1016/j.arth.2021.07.005
Volume 36, Issue 11, November 2021, Pages 3760-3764
Although perioperative medical management during total knee arthroplasty (TKA) has improved, there is limited literature characterizing outcomes of patients with pulmonary hypertension (HTN). This study examined mortality, medical complications, implant survivorship, and clinical outcomes in this medically complex cohort.
Partial and Combined Partial Knee Arthroplasty: Greater Anterior-Posterior Stability Than Posterior Cruciate–Retaining Total Knee Arthroplasty
Amy J.GarnerBMBCh (Oxon), MRCS, MA (Oxon), PGDipLATHE (Dist. Oxon)abcdOliver W.DandridgeMEngbAndrew A.AmisFREng, DSc(Eng), PhD, FIMechE, CEngbJustin P.CobbMCh (Oxon), FRCSaRichard J.van ArkelPhDb
doi : 10.1016/j.arth.2021.06.025
Volume 36, Issue 11, November 2021, Pages 3765-3772.e4
Little is known regarding anterior-posterior stability after anterior cruciate ligament–preserving partial (PKA) and combined partial knee arthroplasty (CPKA) compared to standard posterior cruciate–retaining total knee arthroplasty (TKA).
Anatomic vs Dome Patella: Is There a Difference Between Fixed- vs Mobile-Bearing Posterior-Stabilized Total Knee Arthroplasties?
Lauren A.SmithMSaMichael T.LaCourPhDaDouglas A.DennisMDbRichard D.KomistekPhDa
doi : 10.1016/j.arth.2021.07.006
Volume 36, Issue 11, November 2021, Pages 3773-3780
It has been hypothesized that the patella, working in conjunction with both medial and lateral femoral condyles, can influence kinematic parameters such as posterior femoral rollback and axial rotation. The objective of this study is to determine the in vivo kinematics of subjects implanted with a fixed-bearing (FB) or mobile-bearing (MB) posterior-stabilized (PS) total knee arthroplasty (TKA), with a specific focus on evaluating the impact that Anatomic and Medialized Dome patellar components have on tibiofemoral kinematic patterns.
Surgical Ergonomics and Musculoskeletal Pain in Arthroplasty Surgeons
Kade S.McQuiveyMDaZachary K.ChristopherMDaDavid G.DeckeyMDaLanyuMiMSbJoshua S.BinghamMDaMark J.SpangehlMDa
doi : 10.1016/j.arth.2021.06.026
Volume 36, Issue 11, November 2021, Pages 3781-3787.e7
One occupational hazard inherent to total joint replacement surgeons is procedural-related musculoskeletal pain (MSP). The purpose of this study is to identify the prevalence of work-related MSP among arthroplasty surgeons and analyze associated behaviors, attitudes, and beliefs toward surgical ergonomics.
Industry Payments to Adult Reconstruction-Trained Orthopedic Surgeons: An Analysis of the Open Payments Database From 2014 to 2019
Peter B.WhiteDO, MSaCesarIturriagaDOabNicholasFraneDOaMatthew J.PartanDOaUcheOnonujuMDcMichael A.MontMDdAdamBittermanDOe
doi : 10.1016/j.arth.2021.07.004
Volume 36, Issue 11, November 2021, Pages 3788-3795
In recent time, there has been an increased push toward transparency in industry funding toward physicians. The Physician Payments Sunshine Act called for the creation of the Open Payments Database managed by the Centers for Medicare & Medicaid Services. To our knowledge, there have been no studies evaluating the trends in payments among adult reconstruction fellowship-trained orthopedic surgeons. The purpose of this study is to investigate trends in all payments to adult reconstruction-trained orthopedic surgeons from 2014 to 2019. Secondary outcomes included evaluating trends in yearly subpayment categories, regional variations, as well as characterizing the top 5 industry companies.
Preoperative Nonsurgical Weight Loss Interventions Before Total Hip and Knee Arthroplasty: A Systematic Review
Michael W.SewardMDabLogan G.BriggscPaul A.BainPhD, MLISdAntonia F.ChenMD, MBAa
doi : 10.1016/j.arth.2021.06.021
Volume 36, Issue 11, November 2021, Pages 3796-3806.e8
An upcoming total joint arthroplasty (TJA) may motivate patients with severe obesity (body mass index [BMI] > 40 kg/m2) to lose weight. Weight loss can optimize outcomes following TJA, and many surgeons use a 40 kg/m2 cut-off for undergoing TJA to reduce the risk of complications. However, few patients who are denied TJA for severe obesity successfully lose weight. This is the first systematic review of nonsurgical weight loss interventions before TJA.
Association Between Preoperative Depression and Readmission Rate Following Primary Total Joint Arthroplasty: A Systematic Review and Meta-Analysis
HarinKimMDaChul-HoKimMD, PhDb
doi : 10.1016/j.arth.2021.06.020
Volume 36, Issue 11, November 2021, Pages 3807-3813
To date, no meta-analysis of the relationship between hospital readmission after total joint arthroplasty (TJA) and preoperative depression has been conducted. Hence, this systematic review and meta-analysis aimed to evaluate the association of preoperative depression with the readmission rate following TJA.
Preoperative Opioid Use Is Associated With Higher Revision Rates in Total Joint Arthroplasty: A Systematic Review
Michael-AlexanderMalahiasMD, PhDabRafaelLoucasMDcMariosLoucasMDcMatteoDentiMDbdPeter K.SculcoMDaAlexanderGreenbergMDae
doi : 10.1016/j.arth.2021.06.017
Volume 36, Issue 11, November 2021, Pages 3814-3821
Although preoperative opioid use has been associated with poor postoperative patient-reported outcome measures and delayed return to work in patients undergoing total joint arthroplasty, direct surgery-related complications in patients on chronic opioids are still not clear. Thus, we sought to perform a systematic review of the literature to evaluate the influence of preoperative opioid use on postoperative complications and revision following primary total joint arthroplasty.
Conflict of Interest Statement
doi : 10.1016/S0883-5403(21)00721-X
Volume 36, Issue 11, November 2021, Page A19
