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Table of Contents
doi : 10.1016/S0883-5403(22)00944-5
Volume 37, Issue 12, December 2022, Pages A5, A6, A8
Self-Reported Health of Severely Obese US Adults With Osteoarthritis
David C. Landy, MD, PhD a, *, Jonathan D. Grabau, MD a, K. Keely Boyle, MD b,Michael P. Ast, MD c , James A. Browne, MD d , Cale A. Jacobs, PhD a,Stephen T. Duncan, MD a, Eric M. Hecht, MD PhD
doi : 10.1016/j.arth.2022.06.018
Volume 37, Issue 12, December 2022, Pages 2317-2322
Severe obesity is associated with complications following arthroplasty, leading surgeons to increasingly counsel patients regarding weight loss. For patients seeking arthroplasty, learning that severe obesity may be a relative contraindication to surgery can create a challenging clinical interaction. We sought to describe the self-reported health of United States (US) adults who had severe obesity and osteoarthritis (OA) to better understand patient perspectives.
Online Crowdsourcing Survey of United States Population Preferences and Perceptions Regarding Outpatient Hip and Knee Arthroplasty
Nicholas R. Pagani, MD a, *, Richard N. Puzzitiello, MD a, Jeffrey B. Stambough, MD b,Arjun Saxena, MD, MBA
doi : 10.1016/j.arth.2022.06.011
Volume 37, Issue 12, December 2022, Pages 2323-2332
Outpatient total joint arthroplasty (TJA) has been shown to be both safe and cost-effective in appropriately selected patients and continues to expand substantially across the United States. Using online crowdsourcing, we aimed to assess population perceptions regarding outpatient TJA and to determine factors associated with preference for outpatient versus inpatient arthroplasty.
Impact of Indication for Revision THA on Resource Utilization
Ittai Shichman, MD, Mark Kurapatti, Mackenzie Roof, MD, MBA,Thomas H. Christensen, Joshua C. Rozell, MD, Ran Schwarzkopf, MD, MS
doi : 10.1016/j.arth.2022.06.007
Volume 37, Issue 12, December 2022, Pages 2333-2339
Demographic variables play an important role in outcomes following revision total hip arthroplasty (rTHA). Surgical and in-patient variables as well as outcomes vary between indications for rTHA. The purpose of this study was to investigate the impact of the indication for the rTHA on costs and postoperative outcomes.
Changes in Patient Reported Outcome Measure Scores From Initial Presentation to Day-of-Surgery in Patients Undergoing Hip and Knee Arthroplasty
Jonathan H. Shaw, MD, Alexander Swantek, MD, Kevin Lindsay-Rivera, MD,Tahsin M. Rahman, MD, Jason J. Davis, MD, Eric C. Makhni, MD, MBA
doi : 10.1016/j.arth.2022.05.046
Volume 37, Issue 12, December 2022, Pages 2340-2346
It is not well understood how patient reported outcome measures (PROMs) change from initial presentation to day-of-surgery (DOS). This study sought to quantify preoperative PROM changes for hip and knee arthroplasty patients.
What are the Outcomes After Primary Total Hip and Knee Arthroplasty in Patients With Prior Cerebrovascular Accidents?
Cameron K. Ledford, MD, Michael R. Wolverton, MD,Luke S. Spencer-Gardner, MD, Mark W. Pagnano, MD, Daniel J. Berry, MD,Matthew P. Abdel, MD
doi : 10.1016/j.arth.2022.06.026
Volume 37, Issue 12, December 2022, Pages 2347-2352
For patients who have a history of cerebrovascular accident (CVA) with neurological sequelae undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA), we sought to determine mortality rate, implant survivorship, complications, and clinical outcomes.
Optimizing Spinal Anesthesia in Same-Day Discharge Knee Arthroplasty Patients: Mepivacaine Versus Ropivacaine
David C. Evans, MD, Raylin F. Xu, BA, Nathan H. Varady, MD, MBA,David A. Shaff, MD, Wolfgang Fitz, MD, Vivek M. Shah, MD,Antonia F. Chen, MD, MBA
doi : 10.1016/j.arth.2022.07.001
Volume 37, Issue 12, December 2022, Pages 2353-2357
Short-acting spinal anesthetics are playing an increasing role in same-day discharge total joint arthroplasty though their direct comparison remains to be studied. Therefore, this study aims to compare two formulations of spinal anesthesia regarding time to discharge following knee arthroplasty surgery.
Computer-Navigated and Robotic-Assisted Total Knee Arthroplasty: Increasing in Popularity Without Increasing Complications
Jennifer C. Wang, BS, Amit S. Piple, MD, William J. Hill, MD,Matthew S. Chen, BA, Brandon S. Gettleman, BS, Mary Richardson, BS,Nathanael D. Heckmann, MD, Alexander B. Christ, MD
doi : 10.1016/j.arth.2022.06.014
Volume 37, Issue 12, December 2022, Pages 2358-2364
Data on the clinical impact of computer navigation (CN) and robotic assistance (RA) in total knee arthroplasty (TKA) are mixed. This study aims to describe modern utilization trends in CN-TKA, RA-TKA, and traditionally-instrumented (TD) TKA and to assess for differences in postoperative complications and opioid consumption by procedure type.
An Analysis of a National Administrative Dataset Demonstrating No Evidence of Increase in Elective Primary Total Hip Arthroplasty Dislocation Rates When Postoperative Hip Precautions are Not Used
John T. Machin, MA(Oxf), MBBS, FRCS(Tr&Orth) a, *, William K. Gray, PhD b,Ally Roberts, MCSP c , Louise Kenworthy, MCSP c ,Andrew R.J. Manktelow, FRCS(Tr&Orth) d , Timothy W.R. Briggs, CBE, MD(Res), FRCS
doi : 10.1016/j.arth.2022.05.040
Volume 37, Issue 12, December 2022, Pages 2365-2373
The purpose of this study is to determine whether there is a higher dislocation rate when postoperative hip precautions are not used for primary total hip arthroplasty (THA).
Total Hip Arthroplasties for Hartofilakidis Type C1 and C2 High Hip Dislocations Demonstrate Similar Survivorship and Clinical Function at Minimum 10-year Follow-up With Cementless Implants
Yong Huang, MD a, Yixin Zhou, MD, PhD a, *, Hongyi Shao, MD a, Yaming Chu, MD a,Jianming Gu, MD a, Hua Li, MD
doi : 10.1016/j.arth.2022.06.005
Volume 37, Issue 12, December 2022, Pages 2374-2380
This study aimed to determine the differences in survivorship, clinical function, and complications among patients who have Hartofilakidis Type C1 or C2 developmental dysplasia of the hips and underwent total hip arthroplasty (THA) with cementless implants.
Fracture Risk Assessment Tool Scores and Radiographical Bone Measurements in Total Hip Arthroplasty Patients
Zhaorui Wang, BS a, *, Teerapat Tutaworn, MD b, Mark D. Wishman, BS a,Justin E. Levin, BA b, Isabelle G. Hentschel, BA b, Joseph M. Lane, MD
doi : 10.1016/j.arth.2022.06.015
Volume 37, Issue 12, December 2022, Pages 2381-2386
Osteoporosis is a major risk factor for periprosthetic fractures (PPFx) in total hip arthroplasty (THA) patients but is not routinely screened for in this population. Given the availability of hip x-rays and preoperative screenings, Fracture Risk Assessment Tool (FRAX) scores and radiographic bone measurements are potentially promising, novel risk stratification tools. This study aims to characterize FRAX scores and radiographic bone measurements in THA and PPFx patients.
Procedure Duration, Time Under Anesthesia, and Readmissions in Direct Anterior and Posterior Approach Total Hip Arthroplasty
Kent R. Kraus, MD a, Julian E. Dilley, MD a, Mary Ziemba-Davis, BA b,R. Michael Meneghini, MD
doi : 10.1016/j.arth.2022.06.022
Volume 37, Issue 12, December 2022, Pages 2387-2393
Operative time is related to complications in primary total hip arthroplasty (THA). This study compared operative time in direct anterior (DA) and posterior approach THA and whether differences were related to increased hospital readmissions within 90 days of discharge.
Modular Augmentation in Varus-Valgus–Constrained Knee Arthroplasty—Do We Need Sleeves to Avoid Femoral Loosening After Excessive Distal Augmentation?
Igor Lazic, MD a, *, Florian Pohlig, PhD a, Alexander T. Haug, MD a,Christian Suren, PhD a, Severin Langer, MD a, Peter M. Prodinger, PhD
doi : 10.1016/j.arth.2022.07.004
Volume 37, Issue 12, December 2022, Pages 2394-2398
In revision total knee arthroplasty, zonal fixation methods with a combination of augments, press-fit stems, and sleeves are popular. We hypothesized that high distal femoral augmentation with diaphyseal press-fit stems leads to an increased rate of early aseptic loosening and that femoral metaphyseal sleeves improve implant survival. Therefore, we retrospectively investigated implant survival in relation to augment heights and sleeves.
Revision Total Hip Arthroplasty for Aseptically Failed Metal-On-Metal Hip Resurfacing Arthroplasty
Harold I. Salmons, MD, Kristin M. Fruth, BS, David G. Lewallen, MD,Robert T. Trousdale, MD, Daniel J. Berry, MD, Matthew P. Abdel, MD
doi : 10.1016/j.arth.2022.06.013
Volume 37, Issue 12, December 2022, Pages 2399-2405
While common, studies assessing outcomes of failed metal-on-metal (MoM) resurfacings converted to total hip arthroplasties (THAs) are limited. We determined the outcomes following revision THA of aseptic MoM hip resurfacings.
Risk Stratification and Pain Outcomes Following Revision Total Hip Arthroplasty for Adverse Local Tissue Reactions
Akshay V. Daji, MD a, Kalain K. Workman, DO b, Charlie J. Yoo, DO b ,Clair N. Smith, MS c , Deepak Kumar, MD d , Margaret A. Weber, MD e ,Matthew J. Snyder, MD f , Kenneth L. Urish, MD, PhD
doi : 10.1016/j.arth.2022.06.012
Volume 37, Issue 12, December 2022, Pages 2406-2411
Revision total hip arthroplasty (THA) for adverse local tissue reactions (ALTRs) secondary to head-neck taper corrosion is associated with a high complication rate. Diagnosis of ALTR is based on risk stratification using the patient’s history and examination, implant risk, serum metal ion levels, and imaging. The purpose of this study was to determine if stratification using similar risk factors is predictive of outcomes following revision THA for metal-on-polyethylene (MoP) ALTR.
Prior Instability is Strongly Associated With Dislocation After Isolated Head and Liner Exchange
Elyse J. Berlinberg, BS, Mackenzie A. Roof, MD, MBA, Ittai Shichman, MD,Morteza Meftah, MD, Ran Schwarzkopf, MD, MSc
doi : 10.1016/j.arth.2022.06.019
Volume 37, Issue 12, December 2022, Pages 2412-2419
Isolated head and liner exchange is an appealing alternative to a more extensive revision total hip arthroplasty in patients who have well-fixed components. Despite efforts to increase femoral offset and restore soft tissue tensioning, limited component revision may be associated with higher rates of postoperative instability.
Long-Term Outcomes of Revision Total Hip Arthroplasty Using a Tapered and Fluted Modular Stem: A Mean Follow-Up of 16 Years
Chan-Woo Park, MD a, Jong-Hyun Lee, MD a, Sang Soo Shin, MD a,Young-Wan Moon, MD a, Seung-Jae Lim, MD a, **, Youn-Soo Park, MD
doi : 10.1016/j.arth.2022.06.017
Volume 37, Issue 12, December 2022, Pages 2420-2426
Tapered modular stems are increasingly used in revision total hip arthroplasty (THA) with deficient femoral bone stock. This study aimed to report the long-term outcomes of revision THA using a tapered and fluted modular stem.
Many Common Pathogens are Present in the Operative Room Air During Surgery
Emanuele Chisari, MD a, Garrett Largoza, BA a, Samuel Clarkson, MD a,Chad A. Krueger, MD a, David Kirschman, MD b, Javad Parvizi, MD
doi : 10.1016/j.arth.2022.07.007
Volume 37, Issue 12, December 2022, Pages 2427-2430
The main objective of this study was to assess the sanitary measures of operating theaters using next-generation sequencing.
Alpha-Defensin Offers Limited Utility in Work-Up Prior to Reimplantation in Chronic Periprosthetic Joint Infection in Total Joint Arthroplasty Patients
Jessell M. Owens, MD, Douglas A. Dennis, MD, Paula M. AbilaRoseann M. Johnson, Jason M. Jennings, MD, DPT
doi : 10.1016/j.arth.2022.06.024
Volume 37, Issue 12, December 2022, Pages 2431-2436
Alpha-defensin (AD) is a synovial biomarker included in the 2018 consensus criteria for diagnosing periprosthetic joint infection (PJI). Its value in assessing eradication of infection prior to second stage reimplantation is unclear. The purpose of this study was to evaluate the impact of AD on eligibility for reimplantation following resection for chronic PJI.
Synovial C-Reactive Protein is a Useful Adjunct for Diagnosis of Periprosthetic Joint Infection
Colin M. Baker, BS, Graham S. Goh, MD, Saad Tarabichi, MD, Noam Shohat, MD,Javad Parvizi, MD, FRCS
doi : 10.1016/j.arth.2022.06.016
Volume 37, Issue 12, December 2022, Pages 2437-2443.e1
The diagnostic utility of synovial C-reactive protein (CRP) has been debated for a while. Existing studies are limited by small sample sizes and using outdated criteria for periprosthetic joint infection (PJI). Furthermore, the relationship between synovial and serum CRP has rarely been investigated in the setting of PJI. This study aimed to evaluate the diagnostic utility of synovial CRP and to assess its relationship with serum CRP and other common biomarkers.
Low-Dose Aspirin for Venous Thromboembolism Prophylaxis is Associated With Lower Rates of Periprosthetic Joint Infection After Total Joint Arthroplasty
Farideh Najafi, MD, Joseph K. Kendal, MD, Nicholas V. Peterson, MD,Kerri-Anne Ciesielka, MPH, Camilo Restrepo, MD, Javad Parvizi, MD, FRCS,Nicholas M. Bernthal, MD
doi : 10.1016/j.arth.2022.07.006
Volume 37, Issue 12, December 2022, Pages 2444-2448.e1
Aspirin as a venous thromboembolism (VTE) prophylactic agent has been shown to have antistaphylococcal and antibiofilm roles. Optimal acetylsalicylic acid (ASA) dosage would facilitate antimicrobial effects while avoiding over-aggressive inhibition of platelet antimicrobial function. Our purpose was to determine the periprosthetic joint infection (PJI) rate after total joint arthroplasty in patients receiving low-dose ASA (81 mg twice a day), in comparison to high-dose ASA (325 mg twice a day).
The Performance of Diagnostic Tests for Identifying Periprosthetic Joint Infection After Failed Partial Knee Arthroplasty
Wayne B. Cohen-Levy, MD, MSc a, b, *, Mehdi S. Salimy, BS c , Jonathan Lans, MD, PhD c ,Alejandro E. Canas, BS c , Christopher M. Melnic, MD d, Hany S. Bedair, MD
doi : 10.1016/j.arth.2022.06.021
Volume 37, Issue 12, December 2022, Pages 2449-2454
Cell-free Deoxyribonucleic Acid: A Potential Biomarker of Chronic Periprosthetic Knee Joint Infection
Hugo A. de A.B. Cobra, PhD a, *, Alan P. Mozella, MSc a, Idemar M. da Palma, MSc b, c ,Rodrigo Salim, PhD d, Ana C. Leal, PhD
doi : 10.1016/j.arth.2022.07.002
Volume 37, Issue 12, December 2022, Pages 2455-2459
The correct diagnosis of a chronic periprosthetic joint infection (PJI) is a major challenge in clinical practice, with the “gold standard� for diagnosis yet to be established. Synovial fluid analysis has been proven to be a useful tool for that purpose. Cell-free DNA (cf-DNA) levels have been shown to be increased in several conditions such as cancer, trauma, and sepsis. Therefore, this study was designed to evaluate the potential of synovial fluid cf-DNA quantification for the diagnosis of chronic periprosthetic infections following total knee arthroplasty.
Extended Oral Antibiotic Prophylaxis After Aseptic Revision Total Hip Arthroplasty: Does It Decrease Infection Risk?
Brandon R. Bukowski, MD a, Aaron R. Owen, MD a, Travis W. Turner, BS a,Kristin M. Fruth, BS b, Douglas R. Osmon, MD c , Mark W. Pagnano, MD a,Daniel J. Berry, MD a, Matthew P. Abdel, MD
doi : 10.1016/j.arth.2022.06.023
Volume 37, Issue 12, December 2022, Pages 2460-2465
Extended oral antibiotic prophylaxis (EOA) has been shown to reduce infection after high-risk primary total hip arthroplasties (THAs) and reimplantations. However, data are limited regarding EOA after aseptic revision THAs. This study evaluated the impact of EOA on infection-related outcomes after aseptic revision THAs.
Inadequate Reporting of Complications in Randomized Controlled Trials Cited as Supporting Evidence Underpinning AAOS CPG Recommendations for Hip and Knee Osteoarthritis: Application of the CONSORT Harms Checklist
J. Michael Anderson, DO a, *, Conner Howard b, Jordan Staggs b , Robert Steele, DO c ,Thomas Strasser c , Travis Small, DO a, Matt Vassar, PhD b, Jake X. Checketts, DO
doi : 10.1016/j.arth.2022.06.004
Volume 37, Issue 12, December 2022, Pages 2466-2472.e2
Randomized controlled trials (RCTs) have been shown to influence clinical decision-making and health policy. Therefore, it is essential that trial outcomes—including harms—are completely reported.
Characterization and Potential Relevance of Randomized Controlled Trial Patient Populations in Total Joint Arthroplasty in the United States: A Systematic Review
Jonathan S. Yu a, *, Leonardo Sanchez a, Jacob Zeitlin a, Branden Sosa a ,Peter Sculco, MD a, b, Ajay Premkumar, MD, MPH
doi : 10.1016/j.arth.2022.06.010
Volume 37, Issue 12, December 2022, Pages 2473-2479.e1
A substantial number of randomized controlled trial (RCT) studies in total joint arthroplasty (TJA) are published each year in the United States (US). However, it is unknown how closely the demographic and clinical characteristics of these cohorts resemble that of the US patient population undergoing TJA. Thus, the purpose of this systematic review was to evaluate the patient characteristics of published RCTs in TJA in the US and to compare these characteristics against patient cohorts from national patient databases.
Biologic Therapies for the Treatment of Knee Osteoarthritis: An Updated Systematic Review
Ronald E. Delanois, MD *, Oliver C. Sax, DO MS, Zhongming Chen, MD,Jacob M. Cohen, Daniel M. Callahan, BS, Michael A. Mont, MD
doi : 10.1016/j.arth.2022.05.031
Volume 37, Issue 12, December 2022, Pages 2480-2506
Use of “orthobiologics� continues to expand for patients who have knee osteoarthritis (OA). We sought to perform a systemic review of biologic therapies relative to comparative groups, including the following: (1) platelet-rich plasma (PRP); (2) bone marrow–derived mesenchymal stem cells (BMSCs); (3) adipose-derived mesenchymal stem cells (ADSCs); and (4) amniotic-derived mesenchymal stem cells (AMSCs). We assessed the following: (1) study methodologies; (2) cell preparations and formulations; (3) patient-reported outcome scores (PROMs); and (4) structural changes.
Measurement Techniques for Leg Length Discrepancy in Total Hip Arthroplasty: A Systematic Review of Reliability and Validity
Matthew H. Pettit, BA (Cantab) a, Sathisvaran Kanavathy b,Nicholas McArthur, FRCS (Tr & Orth) c , Ori Weiss, MD c ,Vikas Khanduja, MA (Cantab), MSc, FRCS (Tr & Orth), PhD
doi : 10.1016/j.arth.2022.05.029
Volume 37, Issue 12, December 2022, Pages 2507-2516.e11
Total hip arthroplasty (THA) carries a substantial litigative burden. THA may introduce leg length discrepancy (LLD), necessitating a valid and reliable technique for LLD measurement. This study investigates the reliability and validity of techniques quantitively measuring LLD in both pre- and post-THA.
Conflict of Interest Statement
doi : 10.1016/S0883-5403(22)00945-7
Volume 37, Issue 12, December 2022, Page A13
