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Table of Contents
doi : 10.1016/S0883-5403(22)01068-3
Volume 38, Issue 2, February 2023, Pages A7-A9
Hospital Revenue, Cost, and Contribution Margin in Inpatient Versus Outpatient Primary Total Joint Arthroplasty
Thomas H. Christensen, BS, Thomas Bieganowski, BS, Alex W. Malarchuk, MS, Roy I. Davidovitch, MD, Joseph A. Bosco III, MD, Ran Schwarzkopf, MD, MSc, William B. Macaulay, MD, James D. Slover, MD, Claudette M. Lajam, MD
doi : 10.1016/j.arth.2022.08.019
Volume 38, Issue 2, February 2023, Pages 203-208
Removal of primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA) from the inpatient-only list has financial implications for both patients and institutions.
The Impact of Epilepsy on Complication Rates After Total Joint Arthroplasty: A Propensity Score–Matched Cohort Study
Matthew W. Cole, MD a , Timothy L. Waters, BS a , Bailey J. Ross, MD b , Lacee K. Collins, BS a , Garrett H. Williams, MD a , William F. Sherman, MD, MBA a, *
doi : 10.1016/j.arth.2022.08.022
Volume 38, Issue 2, February 2023, Pages 209-214.e1
It is unclear how epilepsy may affect total joint arthroplasty outcomes. The purpose of this study is to analyze the impact of epilepsy on prosthesis-related complications following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Tranexamic Acid and Prothrombotic Complications Following Total Hip and Total Knee Arthroplasty: A Population-Wide Safety Analysis Accounting for Surgeon Selection Bias
Nathanael D. Heckmann, MD *, Taseen F. Haque, Amit S. Piple, MD, Cory K. Mayfield, MD, Gabriel J. Bouz, MD, Lucas W. Mayer, MD, Daniel A. Oakes, MD, Jay R. Lieberman, MD, Alexander B. Christ, MD
doi : 10.1016/j.arth.2022.08.026
Volume 38, Issue 2, February 2023, Pages 215-223
Tranexamic acid (TXA) utilization during total joint arthroplasty (TJA) has become ubiquitous. However, concerns remain regarding the risk of thrombotic complications.
Is Intraoperative Dexamethasone Utilization Associated With Increased Rates of Periprosthetic Joint Infection Following Total Joint Arthroplasty?
Nathanael D. Heckmann, MD *, Jennifer C. Wang, Amit S. Piple, MD, Glenda A. Marshall, Emily S. Mills, MD, Kevin C. Liu, Jay R. Lieberman, MD, Alexander B. Christ, MD
doi : 10.1016/j.arth.2022.08.028
Volume 38, Issue 2, February 2023, Pages 224-231.e1
Intraoperative dexamethasone can reduce postoperative pain and nausea following total knee (TKA) and total hip arthroplasty (THA). To the best of our knowledge, no study to date has been adequately powered to detect the risk of periprosthetic joint infection (PJI) from early dexamethasone exposure.
A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty
Joseph J. Hejkal, MD a, *, Taylor M. Ditoro, MD a, b , Rachel E. Thompson, MD, MPH c, d , Robin R. High, MBA, MA e , Kristy J. Carlson, PhD c, f , Jason F. Shiffermiller, MD, MPH c
doi : 10.1016/j.arth.2022.08.027
Volume 38, Issue 2, February 2023, Pages 232-238
Postoperative urinary retention (POUR) is a common surgical complication of major joint arthroplasty and is associated with increased lengths of stay and urinary tract infections.
Tapered Dose Postoperative Opioid Prescriptions Following Inpatient Total Hip and Knee Arthroplasty: Quality Improvement Study and Retrospective Review
Vasil V. Kukushliev a, b, *, Katherine A. Sherman a , Christopher M. Kurylo a, b , Stephen D. Ortmann a, b , Robert A. Scheidt c , Karl B. Scheidt a, b
doi : 10.1016/j.arth.2022.08.043
Volume 38, Issue 2, February 2023, Pages 239-244
Overprescription of pain medications directly fuels the opioid epidemic. Veterans are profoundly impacted. Tapered dose protocols may reduce excessive prescribing.
The Influence of Surgeon Caseload and Usage on the Long-Term Outcomes of Mobile-Bearing Unicompartmental Knee Arthroplasty: An Analysis of Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man
Hasan R. Mohammad, MRCS (Eng), MRes (Dist), DPhil (Oxon) a, b, c, *, Andrew Judge, BSc, MSc, PhD a, b , David W. Murray, MD, FRCS a
doi : 10.1016/j.arth.2022.08.011
Volume 38, Issue 2, February 2023, Pages 245-251
Unicompartmental knee arthroplasty (UKA) revision rates are variable and known to be influenced by a surgeon’s caseload (number of UKAs performed annually) and usage (UKA as a proportion of overall knee arthroplasty practice).
Obese Patients Achieve Good Improvements in Patient-Reported Outcome Measures After Medial Unicompartmental Knee Arthroplasty Despite a Lower Preoperative Score
Anders Bagge, BMSc *, Christian B. Jensen, MD, Mette Mikkelsen, MD, PhD, Kirill Gromov, MD, PhD, Christian S. Nielsen, MD, PhD, Anders Troelsen, MD, PhD, DMSc
doi : 10.1016/j.arth.2022.09.002
Volume 38, Issue 2, February 2023, Pages 252-258.e2
In this study, we examined the association between obesity and patient-reported outcome measures after medial unicompartmental knee arthroplasty (MUKA), assessed through score changes, Patient Acceptable Symptom State (PASS), and minimal important change (MIC).
Does Metabolic Syndrome Impact the Risk of Reoperation, Revision, or Complication After Primary Total Knee Arthroplasty?
Cameron K. Ledford, MD a , Arun R. Kumar, MD a , Christian G. Guier, BS a , Kristin M. Fruth, BS b , Mark W. Pagnano, MD c , Daniel J. Berry, MD c , Matthew P. Abdel, MD c, *
doi : 10.1016/j.arth.2022.08.040
Volume 38, Issue 2, February 2023, Pages 259-265
Metabolic syndrome (MetS) is an increasingly frequent condition characterized by insulin resistance, abdominal obesity, hypertension, and dyslipidemia. This study evaluated implant survivorship, complications, and clinical outcomes of primary TKAs performed in patients who have MetS.
Increased Risk of Hospital Readmissions and Implant-Related Complications in Patients Who Had a Recent History of Fragility Fracture: A Matched Cohort Analysis
J. Alex Albright, BS a, *, Edward J. Testa, MD b , Ozair Meghani, BA b , Kenny Chang, BS a , Alan H. Daniels, MD b , Thomas J. Barrett, MD b
doi : 10.1016/j.arth.2022.08.036
Volume 38, Issue 2, February 2023, Pages 266-273
With the increasing utilization of total knee arthroplasty (TKA) in a continually aging US population, the number of patients who have low bone mineral density who undergo TKA may concomitantly increase.
The Impact of Frailty Is Age Dependent in Patients Undergoing Primary Total Knee Arthroplasty: The Age-Adjusted Modified Frailty Index
Ryan S. Zamanzadeh, BS a , Jesse Seilern und Aspang, MD a , Andrew M. Schwartz, MD b , J. Ryan Martin, MD c , Adam R. Boissonneault, MD a , Jacob M. Wilson, MD c, *
doi : 10.1016/j.arth.2022.08.038
Volume 38, Issue 2, February 2023, Pages 274-280
Frailty is a well-established risk factor in patients undergoing total knee arthroplasty (TKA). How age modifies the impact of frailty on outcomes in these patients, however, remains unknown.
Anterior Knee Pain Following Primary Unilateral Total Knee Arthroplasty With Posterior-Stabilized Prosthesis and Patellar Resurfacing: Prevalence and Clinical Implications
Danilo De Oliveira Silva, PhD a, *, Kate E. Webster, PhD b , Julian A. Feller, PhD b, c , Jodie A. McClelland, PhD
doi : 10.1016/j.arth.2022.08.042
Volume 38, Issue 2, February 2023, Pages 281-285
Anterior knee pain following total knee arthroplasty (TKA) is associated with patient dissatisfaction. Factors related to postoperative anterior knee pain and its impact on patient outcomes are poorly understood.
Is Highly Cross-Linked Polyethylene Safe for Use in High-Flexion Posterior Stabilized Total Knee Arthroplasty?
Young-Hoo Kim, MD a, *, Jang-Won Park, MD b , Young-Soo Jang, MD a , Eun-Jung Kim, MD
doi : 10.1016/j.arth.2022.08.025
Volume 38, Issue 2, February 2023, Pages 286-292
Application of highly cross-linked polyethylene (HXLPE) to a posterior cruciate-substituting total knee arthroplasty (TKA) might add the risk of fracture and failure of the tibial polyethylene insert.
Should We Aim to Help Patients “Feel Better� or “Feel Good� After Total Hip Arthroplasty? Determining Factors Affecting the Achievement of the Minimal Clinically Important Difference and Patient Acceptable Symptom State
Graham S. Goh, MD *, Saad Tarabichi, MD, Colin M. Baker, BS, Qudratullah S. Qadiri, BS, Matthew S. Austin, MD
doi : 10.1016/j.arth.2022.08.014
Volume 38, Issue 2, February 2023, Pages 293-299
Recent attempts have been made to use preoperative patient-reported outcome measure (PROM) thresholds as prior authorization criteria based on the assumption that patients who have higher baseline scores are less likely to achieve the minimal clinically important difference (MCID).
Antiviral Therapy for Chronic Hepatitis B Infection Improves Outcomes After Total Hip Arthroplasty: A Multicenter Retrospective Study
Tao Cheng, MD, PhD a, *, Guoyong Li, MD, PhD b, c , Huiming Ning, MD d , Liang Hao, MD, PhD c
doi : 10.1016/j.arth.2022.08.005
Volume 38, Issue 2, February 2023, Pages 300-306
Previous studies have shown that chronic hepatitis B virus (HBV) infection may place patients at increased risk of postoperative adverse events. However, there is limited information on the effects of antiviral treatment (AVT) on postoperative outcomes following total hip arthroplasties (THAs).
Total Hip Arthroplasty in Patients Who Have Respiratory Disease Who use Supplemental Home Oxygen
John F. Burke, MD, Nicole D. Quinlan, MD, MS, Brian C. Werner, MD, James A. Browne, MD
doi : 10.1016/j.arth.2022.08.012
Volume 38, Issue 2, February 2023, Pages 307-313.e2
The purpose of this study is to investigate the association between supplemental home oxygen prior to surgery and both medical and surgical complications after primary elective total hip arthroplasty (THA) in patients who have respiratory disease (RD).
The Safety and Efficacy of the Anterior Approach Total Hip Arthroplasty as per Body Mass Index
Jeroen C.F. Verhaegen, MD a, b, c , Roger Wei, BSc a , Paul Kim, MD, FRCSC a , Paul E. Beaule, MD, FRCSC a , Kristoff Corten, MD, PhD b, d , George Grammatopoulos, MBBS, DPhil Oxon, MRCS, FRCS a,
doi : 10.1016/j.arth.2022.08.021
Volume 38, Issue 2, February 2023, Pages 314-322.e1
Obesity is associated with component malpositioning and increased revision risk after total hip arthroplasty (THA). With anterior approaches (AAs) becoming increasingly popular, the goal of this study was to assess whether clinical outcome post-AA-THA is affected by body mass index (BMI).
Objective Activity Levels and Patient-Reported Outcomes After Total Hip Arthroplasty and Periacetabular Osteotomy: Retrospective Matched Cohort Study at Mean 12-Year Follow-Up
Kyohei Shiomoto, MD, PhD a , Satoshi Hamai, MD, PhD a, b, *, Daisuke Hara, MD, PhD a , Satoru Harada, MD, PhD a , Goro Motomura, MD, PhD a , Yasuharu Nakashima, MD, PhD
doi : 10.1016/j.arth.2022.08.034
Volume 38, Issue 2, February 2023, Pages 323-328
There is increasing interest in improving activity after total hip arthroplasty (THA) and periacetabular osteotomy (PAO). The present study evaluated whether there were differences in the subjective and objective activity levels of THA and PAO patients at mean 12-year follow-up (range 4-20) and what factors influence the objective activity levels.
Reduction in Offset Is Associated With Worse Functional Outcomes Following Total Hip Arthroplasty
Michael E. Bullen, FRACS, FAOrthA a, *, Sina Babazadeh, PhD, FRACS, FAOrthA a , Dirk van Bavel, FRACS, FAOrthA a , Dean P. McKenzie, PhD b , Michelle M. Dowsey, PhD a, c , Peter F. Choong, MD, FRACS, FAOrthA
doi : 10.1016/j.arth.2022.09.001
Volume 38, Issue 2, February 2023, Pages 329-334
Conflicting reports exist about the effect of offset variation on functional outcomes following total hip arthroplasty. Reproducing native hip offset is thought to optimize function by restoring biomechanics and appropriately tensioning the hip abductor muscles. The aim of this study is to assess the effect of failing to restore global hip offset in comparison to the native contralateral hip.
Isolated Versus Full Component Revision in Total Knee Arthroplasty for Aseptic Loosening
Rit Apinyankul, MD a, *, Katherine Hwang, MS b , Nicole Alexandriadria Segovia, MPH b , Derek F. Amanatullah, MD, PhD b , James I. Huddleston, MD b , William J. Maloney, MD b , Stuart B. Goodman, MD, PhD
doi : 10.1016/j.arth.2022.09.006
Volume 38, Issue 2, February 2023, Pages 335-340
Revision of both femoral and tibial components of a total knee arthroplasty (TKA) for aseptic loosening has favorable outcomes. Revision of only one loose component with retention of others has shorter operative time and lower cost; however, implant survivorship and clinical outcomes of these different operations are unclear.
Risk Factors Associated With Femorotomy or Fracture During Cementless Stem Removal and Generation of an Individual Predictive Risk Score
Thomas Aubert, MD *, Guillaume Auberger, MD, Philippe Gerard, MD, Luc Lhotellier, MD, Simon Marmor, MD, Wilfrid Graff, MD
doi : 10.1016/j.arth.2022.09.012
Volume 38, Issue 2, February 2023, Pages 341-346.e2
Femorotomy is a commonly used technique during cementless stem removal but should be preferred in selective revision cases to prevent intraoperative femoral fracture associated with deteriorated clinical outcome. Our aim was to assess the risk factors for fracture or femorotomy and develop a predictive risk stratification score.
Is 2-Stage Septic Revision Worth the Money? A Cost-Utility Analysis of a 1-Stage Versus 2-Stage Septic Revision of Total Knee Arthroplasty
Charles E. Okafor, MPharm a, b, *, Son Nghiem, PhD c , Joshua Byrnes, PhD a, b
doi : 10.1016/j.arth.2022.09.003
Volume 38, Issue 2, February 2023, Pages 347-354
Two-stage exchange arthroplasty remains the gold standard for the management of prosthetic joint infection (PJI) of the knee, but several studies have demonstrated that 1-stage exchange is as effective as 2-stage exchange.
Risk Factors for Treatment Failure in Patients Who Have Knee Periprosthetic Joint Infection Treated With Two-Stage Exchange Arthroplasty as Well as Their Fate
Yi-Chen Chen, MD a, b , Yu-Chih Lin, MD a, c, d , Chih-Hsiang Chang, MD a, c, d , Sheng-Hsun Lee, MD a, c, d , Yuhan Chang, MD, PhD
doi : 10.1016/j.arth.2022.08.033
Volume 38, Issue 2, February 2023, Pages 355-360
Two-stage exchange arthroplasty is considered the gold standard treatment for chronic periprosthetic joint infection (PJI). However, there is a scarcity of research investigating the major risk factors for infection recurrence and the prognosis after infection recurrence.
Dislocation After Debridement, Antibiotics, and Implant Retention for Periprosthetic Joint Infections of the Hip
Tyler J. Humphrey, BA a, b , Mehdi S. Salimy, BS a , Christopher M. Melnic, MD a, b , Hany S. Bedair, MD
doi : 10.1016/j.arth.2022.08.029
Volume 38, Issue 2, February 2023, Pages 361-366
Debridement, antibiotics, and implant retention (DAIR) is a common treatment option for hip periprosthetic joint infection (PJI). However, noninfectious outcomes of DAIR such as instability are not well reported. The purpose of this study was to evaluate risk factors for hip dislocation post-DAIR for PJI of both primary and revision total hip arthroplasty (THA).
The Impact of Exchanging Cerclage Fixation after Extended Trochanteric Osteotomy in Revision Total Hip Arthroplasty for Periprosthetic Joint Infection
Mathew J. Whittaker, MD, Prerna Arora, MTech, James I. Huddleston III, MD, Stuart B. Goodman, MD, PhD, William J. Maloney, MD, Derek F. Amanatullah, MD, PhD
doi : 10.1016/j.arth.2022.08.041
Volume 38, Issue 2, February 2023, Pages 367-371
An extended trochanteric osteotomy (ETO) is a powerful tool for femoral component revision. There is limited evidence that directly supports its use in the setting of a periprosthetic joint infection (PJI). Cerclage fixation raises the theoretical concern for persistent infection.
Manipulation Under Anesthesia is Safe After Cementless Total Knee Arthroplasty: A Multicenter Study
Trevor R. Grace, MD a, *, Graham S. Goh, MD b , R. Scott Runyon, MD c , Ilan Small, MD d , Joseph T. Gibian, MD e , Ryan M. Nunley, MD f , Jess H. Lonner, MD
doi : 10.1016/j.arth.2022.08.035
Volume 38, Issue 2, February 2023, Pages 372-375
Cementless total knee arthroplasty (TKA) is thought to facilitate durable, biological fixation between the bone and implant. However, the 4-12 weeks required for osseointegration coincides with the optimal timeframe to perform a manipulation under anesthesia (MUA) if a patient develops postoperative stiffness.
What Patient and Implant Factors Affect Trunnionosis Severity? An Implant Retrieval Analysis of 664 Femoral Stems
Anastasia M. Codirenzi, MESc a , Brent A. Lanting, MD, MSc, FRCSC b , Matthew G. Teeter, PhD
doi : 10.1016/j.arth.2022.08.023
Volume 38, Issue 2, February 2023, Pages 376-382
Corrosion at the modular head-neck taper interface of total and hemiarthroplasty hip implants (trunnionosis) is a cause of implant failure and thus a clinical concern. Patient and device factors contributing to the occurrence of trunnionosis have been investigated in prior implant retrieval studies but generally with limited sample sizes and a narrow range of models.
Metrics of Clinically Important Changes in Total Hip Arthroplasty: A Systematic Review
Kira K. Tanghe a , Zodina A. Beiene, MD b , Alexander S. McLawhorn, MD, MBA c , Catherine H. MacLean, MD, PhD d, e , Elizabeth B. Gausden, MD, MPH
doi : 10.1016/j.arth.2022.09.007
Volume 38, Issue 2, February 2023, Pages 383-388
Although patient-reported outcome measures (PROMs) have become a regularly used metric, there is little consensus on the methodology used to determine clinically relevant postoperative outcomes.
Metal Augments Used in Revision Hip Arthroplasty: A Systematic Review and Single-Arm Meta-Analysis
Chenao Xiong, MD, Dexuan Meng, MD, Renhua Ni, MD, Hong Cai, MD
doi : 10.1016/j.arth.2022.08.010
Volume 38, Issue 2, February 2023, Pages 389-396.e1
Porous metal augments are used in complex hip arthroplasty; however, few studies have assessed their efficacy and safety. This systematic review analyzed the use of augments in revision hip arthroplasty and summarized the clinical research findings.
Ceramic Femoral Heads Exhibit Lower Wear Rates Compared to Cobalt Chrome: A Meta-Analysis
Kevin C. Mertz a , JaeWon Yang, MD b , Brian C. Chung, MD a , Xiao Chen, MD c , Cory K. Mayfield, MD a , Nathanael D. Heckmann, MD
doi : 10.1016/j.arth.2022.09.008
Volume 38, Issue 2, February 2023, Pages 397-405
Wear between the femoral head and acetabular liners continues to limit the longevity of total hip arthroplasty implants despite advances in implant materials. The purpose of this meta-analysis was to compare linear wear rates of cobalt-chromium (CoCr) and fourth-generation ceramic femoral heads on highly cross-linked polyethylene (XLPE) liners.
Letter to the Editor on “Who is Still Receiving Blood Transfusions After Primary and Revision Total Joint Arthroplasty?�
Jorge H. Nunez, PhDArtro-EsportDavid Mateu Vicent, MDFrancesc Angles, MD
doi : 10.1016/j.arth.2022.10.005
Volume 38, Issue 2, February 2023, Page e1
Response to Letter to the Editor From Nunez et al
David E. DeMik, MD, PharmDChristopher N. Carender, MDNicholas A. Bedard, MDNatalie A. Glass, PhDTimothy S. Brown, MD
doi : 10.1016/j.arth.2022.10.006
Volume 38, Issue 2, February 2023, Page e2
Structural Barriers and Racial Disparities in Orthopaedic Surgical Procedures
Rasheed Hosein-Woodley, BARahim Hirani, MSAsma Hirani, MBBS
doi : 10.1016/j.arth.2022.08.009
Volume 38, Issue 2, February 2023, Page e3
Reply to Letter to the Editor: Structural Barriers and Racial Disparities in Orthopaedic Surgical Procedures
Troy B. Amen, MD, MBA
doi : 10.1016/j.arth.2022.08.008
Volume 38, Issue 2, February 2023, Page e4
Conflict of Interest Statement
doi : 10.1016/S0883-5403(22)01069-5
Volume 38, Issue 2, February 2023, Page 406
Table of Contents
doi : 10.1016/S0883-5403(22)01068-3
Volume 38, Issue 2, February 2023, Pages A7-A9
Hospital Revenue, Cost, and Contribution Margin in Inpatient Versus Outpatient Primary Total Joint Arthroplasty
Thomas H. Christensen, BS, Thomas Bieganowski, BS, Alex W. Malarchuk, MS, Roy I. Davidovitch, MD, Joseph A. Bosco III, MD, Ran Schwarzkopf, MD, MSc, William B. Macaulay, MD, James D. Slover, MD, Claudette M. Lajam, MD
doi : 10.1016/j.arth.2022.08.019
Volume 38, Issue 2, February 2023, Pages 203-208
Removal of primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA) from the inpatient-only list has financial implications for both patients and institutions.
The Impact of Epilepsy on Complication Rates After Total Joint Arthroplasty: A Propensity Score–Matched Cohort Study
Matthew W. Cole, MD a , Timothy L. Waters, BS a , Bailey J. Ross, MD b , Lacee K. Collins, BS a , Garrett H. Williams, MD a , William F. Sherman, MD, MBA a, *
doi : 10.1016/j.arth.2022.08.022
Volume 38, Issue 2, February 2023, Pages 209-214.e1
It is unclear how epilepsy may affect total joint arthroplasty outcomes. The purpose of this study is to analyze the impact of epilepsy on prosthesis-related complications following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Tranexamic Acid and Prothrombotic Complications Following Total Hip and Total Knee Arthroplasty: A Population-Wide Safety Analysis Accounting for Surgeon Selection Bias
Nathanael D. Heckmann, MD *, Taseen F. Haque, Amit S. Piple, MD, Cory K. Mayfield, MD, Gabriel J. Bouz, MD, Lucas W. Mayer, MD, Daniel A. Oakes, MD, Jay R. Lieberman, MD, Alexander B. Christ, MD
doi : 10.1016/j.arth.2022.08.026
Volume 38, Issue 2, February 2023, Pages 215-223
Tranexamic acid (TXA) utilization during total joint arthroplasty (TJA) has become ubiquitous. However, concerns remain regarding the risk of thrombotic complications.
Is Intraoperative Dexamethasone Utilization Associated With Increased Rates of Periprosthetic Joint Infection Following Total Joint Arthroplasty?
Nathanael D. Heckmann, MD *, Jennifer C. Wang, Amit S. Piple, MD, Glenda A. Marshall, Emily S. Mills, MD, Kevin C. Liu, Jay R. Lieberman, MD, Alexander B. Christ, MD
doi : 10.1016/j.arth.2022.08.028
Volume 38, Issue 2, February 2023, Pages 224-231.e1
Intraoperative dexamethasone can reduce postoperative pain and nausea following total knee (TKA) and total hip arthroplasty (THA). To the best of our knowledge, no study to date has been adequately powered to detect the risk of periprosthetic joint infection (PJI) from early dexamethasone exposure.
A Retrospective Study of Anticholinergic Use and Later Mobilization as Risk Factors for Urinary Retention After Major Lower Extremity Joint Arthroplasty
Joseph J. Hejkal, MD a, *, Taylor M. Ditoro, MD a, b , Rachel E. Thompson, MD, MPH c, d , Robin R. High, MBA, MA e , Kristy J. Carlson, PhD c, f , Jason F. Shiffermiller, MD, MPH c
doi : 10.1016/j.arth.2022.08.027
Volume 38, Issue 2, February 2023, Pages 232-238
Postoperative urinary retention (POUR) is a common surgical complication of major joint arthroplasty and is associated with increased lengths of stay and urinary tract infections.
Tapered Dose Postoperative Opioid Prescriptions Following Inpatient Total Hip and Knee Arthroplasty: Quality Improvement Study and Retrospective Review
Vasil V. Kukushliev a, b, *, Katherine A. Sherman a , Christopher M. Kurylo a, b , Stephen D. Ortmann a, b , Robert A. Scheidt c , Karl B. Scheidt a, b
doi : 10.1016/j.arth.2022.08.043
Volume 38, Issue 2, February 2023, Pages 239-244
Overprescription of pain medications directly fuels the opioid epidemic. Veterans are profoundly impacted. Tapered dose protocols may reduce excessive prescribing.
The Influence of Surgeon Caseload and Usage on the Long-Term Outcomes of Mobile-Bearing Unicompartmental Knee Arthroplasty: An Analysis of Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man
Hasan R. Mohammad, MRCS (Eng), MRes (Dist), DPhil (Oxon) a, b, c, *, Andrew Judge, BSc, MSc, PhD a, b , David W. Murray, MD, FRCS a
doi : 10.1016/j.arth.2022.08.011
Volume 38, Issue 2, February 2023, Pages 245-251
Unicompartmental knee arthroplasty (UKA) revision rates are variable and known to be influenced by a surgeon’s caseload (number of UKAs performed annually) and usage (UKA as a proportion of overall knee arthroplasty practice).
Obese Patients Achieve Good Improvements in Patient-Reported Outcome Measures After Medial Unicompartmental Knee Arthroplasty Despite a Lower Preoperative Score
Anders Bagge, BMSc *, Christian B. Jensen, MD, Mette Mikkelsen, MD, PhD, Kirill Gromov, MD, PhD, Christian S. Nielsen, MD, PhD, Anders Troelsen, MD, PhD, DMSc
doi : 10.1016/j.arth.2022.09.002
Volume 38, Issue 2, February 2023, Pages 252-258.e2
In this study, we examined the association between obesity and patient-reported outcome measures after medial unicompartmental knee arthroplasty (MUKA), assessed through score changes, Patient Acceptable Symptom State (PASS), and minimal important change (MIC).
Does Metabolic Syndrome Impact the Risk of Reoperation, Revision, or Complication After Primary Total Knee Arthroplasty?
Cameron K. Ledford, MD a , Arun R. Kumar, MD a , Christian G. Guier, BS a , Kristin M. Fruth, BS b , Mark W. Pagnano, MD c , Daniel J. Berry, MD c , Matthew P. Abdel, MD c, *
doi : 10.1016/j.arth.2022.08.040
Volume 38, Issue 2, February 2023, Pages 259-265
Metabolic syndrome (MetS) is an increasingly frequent condition characterized by insulin resistance, abdominal obesity, hypertension, and dyslipidemia. This study evaluated implant survivorship, complications, and clinical outcomes of primary TKAs performed in patients who have MetS.
Increased Risk of Hospital Readmissions and Implant-Related Complications in Patients Who Had a Recent History of Fragility Fracture: A Matched Cohort Analysis
J. Alex Albright, BS a, *, Edward J. Testa, MD b , Ozair Meghani, BA b , Kenny Chang, BS a , Alan H. Daniels, MD b , Thomas J. Barrett, MD b
doi : 10.1016/j.arth.2022.08.036
Volume 38, Issue 2, February 2023, Pages 266-273
With the increasing utilization of total knee arthroplasty (TKA) in a continually aging US population, the number of patients who have low bone mineral density who undergo TKA may concomitantly increase.
The Impact of Frailty Is Age Dependent in Patients Undergoing Primary Total Knee Arthroplasty: The Age-Adjusted Modified Frailty Index
Ryan S. Zamanzadeh, BS a , Jesse Seilern und Aspang, MD a , Andrew M. Schwartz, MD b , J. Ryan Martin, MD c , Adam R. Boissonneault, MD a , Jacob M. Wilson, MD c, *
doi : 10.1016/j.arth.2022.08.038
Volume 38, Issue 2, February 2023, Pages 274-280
Frailty is a well-established risk factor in patients undergoing total knee arthroplasty (TKA). How age modifies the impact of frailty on outcomes in these patients, however, remains unknown.
Anterior Knee Pain Following Primary Unilateral Total Knee Arthroplasty With Posterior-Stabilized Prosthesis and Patellar Resurfacing: Prevalence and Clinical Implications
Danilo De Oliveira Silva, PhD a, *, Kate E. Webster, PhD b , Julian A. Feller, PhD b, c , Jodie A. McClelland, PhD
doi : 10.1016/j.arth.2022.08.042
Volume 38, Issue 2, February 2023, Pages 281-285
Anterior knee pain following total knee arthroplasty (TKA) is associated with patient dissatisfaction. Factors related to postoperative anterior knee pain and its impact on patient outcomes are poorly understood.
Is Highly Cross-Linked Polyethylene Safe for Use in High-Flexion Posterior Stabilized Total Knee Arthroplasty?
Young-Hoo Kim, MD a, *, Jang-Won Park, MD b , Young-Soo Jang, MD a , Eun-Jung Kim, MD
doi : 10.1016/j.arth.2022.08.025
Volume 38, Issue 2, February 2023, Pages 286-292
Application of highly cross-linked polyethylene (HXLPE) to a posterior cruciate-substituting total knee arthroplasty (TKA) might add the risk of fracture and failure of the tibial polyethylene insert.
Should We Aim to Help Patients “Feel Better� or “Feel Good� After Total Hip Arthroplasty? Determining Factors Affecting the Achievement of the Minimal Clinically Important Difference and Patient Acceptable Symptom State
Graham S. Goh, MD *, Saad Tarabichi, MD, Colin M. Baker, BS, Qudratullah S. Qadiri, BS, Matthew S. Austin, MD
doi : 10.1016/j.arth.2022.08.014
Volume 38, Issue 2, February 2023, Pages 293-299
Recent attempts have been made to use preoperative patient-reported outcome measure (PROM) thresholds as prior authorization criteria based on the assumption that patients who have higher baseline scores are less likely to achieve the minimal clinically important difference (MCID).
Antiviral Therapy for Chronic Hepatitis B Infection Improves Outcomes After Total Hip Arthroplasty: A Multicenter Retrospective Study
Tao Cheng, MD, PhD a, *, Guoyong Li, MD, PhD b, c , Huiming Ning, MD d , Liang Hao, MD, PhD c
doi : 10.1016/j.arth.2022.08.005
Volume 38, Issue 2, February 2023, Pages 300-306
Previous studies have shown that chronic hepatitis B virus (HBV) infection may place patients at increased risk of postoperative adverse events. However, there is limited information on the effects of antiviral treatment (AVT) on postoperative outcomes following total hip arthroplasties (THAs).
Total Hip Arthroplasty in Patients Who Have Respiratory Disease Who use Supplemental Home Oxygen
John F. Burke, MD, Nicole D. Quinlan, MD, MS, Brian C. Werner, MD, James A. Browne, MD
doi : 10.1016/j.arth.2022.08.012
Volume 38, Issue 2, February 2023, Pages 307-313.e2
The purpose of this study is to investigate the association between supplemental home oxygen prior to surgery and both medical and surgical complications after primary elective total hip arthroplasty (THA) in patients who have respiratory disease (RD).
The Safety and Efficacy of the Anterior Approach Total Hip Arthroplasty as per Body Mass Index
Jeroen C.F. Verhaegen, MD a, b, c , Roger Wei, BSc a , Paul Kim, MD, FRCSC a , Paul E. Beaule, MD, FRCSC a , Kristoff Corten, MD, PhD b, d , George Grammatopoulos, MBBS, DPhil Oxon, MRCS, FRCS a,
doi : 10.1016/j.arth.2022.08.021
Volume 38, Issue 2, February 2023, Pages 314-322.e1
Obesity is associated with component malpositioning and increased revision risk after total hip arthroplasty (THA). With anterior approaches (AAs) becoming increasingly popular, the goal of this study was to assess whether clinical outcome post-AA-THA is affected by body mass index (BMI).
Objective Activity Levels and Patient-Reported Outcomes After Total Hip Arthroplasty and Periacetabular Osteotomy: Retrospective Matched Cohort Study at Mean 12-Year Follow-Up
Kyohei Shiomoto, MD, PhD a , Satoshi Hamai, MD, PhD a, b, *, Daisuke Hara, MD, PhD a , Satoru Harada, MD, PhD a , Goro Motomura, MD, PhD a , Yasuharu Nakashima, MD, PhD
doi : 10.1016/j.arth.2022.08.034
Volume 38, Issue 2, February 2023, Pages 323-328
There is increasing interest in improving activity after total hip arthroplasty (THA) and periacetabular osteotomy (PAO). The present study evaluated whether there were differences in the subjective and objective activity levels of THA and PAO patients at mean 12-year follow-up (range 4-20) and what factors influence the objective activity levels.
Reduction in Offset Is Associated With Worse Functional Outcomes Following Total Hip Arthroplasty
Michael E. Bullen, FRACS, FAOrthA a, *, Sina Babazadeh, PhD, FRACS, FAOrthA a , Dirk van Bavel, FRACS, FAOrthA a , Dean P. McKenzie, PhD b , Michelle M. Dowsey, PhD a, c , Peter F. Choong, MD, FRACS, FAOrthA
doi : 10.1016/j.arth.2022.09.001
Volume 38, Issue 2, February 2023, Pages 329-334
Conflicting reports exist about the effect of offset variation on functional outcomes following total hip arthroplasty. Reproducing native hip offset is thought to optimize function by restoring biomechanics and appropriately tensioning the hip abductor muscles. The aim of this study is to assess the effect of failing to restore global hip offset in comparison to the native contralateral hip.
Isolated Versus Full Component Revision in Total Knee Arthroplasty for Aseptic Loosening
Rit Apinyankul, MD a, *, Katherine Hwang, MS b , Nicole Alexandriadria Segovia, MPH b , Derek F. Amanatullah, MD, PhD b , James I. Huddleston, MD b , William J. Maloney, MD b , Stuart B. Goodman, MD, PhD
doi : 10.1016/j.arth.2022.09.006
Volume 38, Issue 2, February 2023, Pages 335-340
Revision of both femoral and tibial components of a total knee arthroplasty (TKA) for aseptic loosening has favorable outcomes. Revision of only one loose component with retention of others has shorter operative time and lower cost; however, implant survivorship and clinical outcomes of these different operations are unclear.
Risk Factors Associated With Femorotomy or Fracture During Cementless Stem Removal and Generation of an Individual Predictive Risk Score
Thomas Aubert, MD *, Guillaume Auberger, MD, Philippe Gerard, MD, Luc Lhotellier, MD, Simon Marmor, MD, Wilfrid Graff, MD
doi : 10.1016/j.arth.2022.09.012
Volume 38, Issue 2, February 2023, Pages 341-346.e2
Femorotomy is a commonly used technique during cementless stem removal but should be preferred in selective revision cases to prevent intraoperative femoral fracture associated with deteriorated clinical outcome. Our aim was to assess the risk factors for fracture or femorotomy and develop a predictive risk stratification score.
Is 2-Stage Septic Revision Worth the Money? A Cost-Utility Analysis of a 1-Stage Versus 2-Stage Septic Revision of Total Knee Arthroplasty
Charles E. Okafor, MPharm a, b, *, Son Nghiem, PhD c , Joshua Byrnes, PhD a, b
doi : 10.1016/j.arth.2022.09.003
Volume 38, Issue 2, February 2023, Pages 347-354
Two-stage exchange arthroplasty remains the gold standard for the management of prosthetic joint infection (PJI) of the knee, but several studies have demonstrated that 1-stage exchange is as effective as 2-stage exchange.
Risk Factors for Treatment Failure in Patients Who Have Knee Periprosthetic Joint Infection Treated With Two-Stage Exchange Arthroplasty as Well as Their Fate
Yi-Chen Chen, MD a, b , Yu-Chih Lin, MD a, c, d , Chih-Hsiang Chang, MD a, c, d , Sheng-Hsun Lee, MD a, c, d , Yuhan Chang, MD, PhD
doi : 10.1016/j.arth.2022.08.033
Volume 38, Issue 2, February 2023, Pages 355-360
Two-stage exchange arthroplasty is considered the gold standard treatment for chronic periprosthetic joint infection (PJI). However, there is a scarcity of research investigating the major risk factors for infection recurrence and the prognosis after infection recurrence.
Dislocation After Debridement, Antibiotics, and Implant Retention for Periprosthetic Joint Infections of the Hip
Tyler J. Humphrey, BA a, b , Mehdi S. Salimy, BS a , Christopher M. Melnic, MD a, b , Hany S. Bedair, MD
doi : 10.1016/j.arth.2022.08.029
Volume 38, Issue 2, February 2023, Pages 361-366
Debridement, antibiotics, and implant retention (DAIR) is a common treatment option for hip periprosthetic joint infection (PJI). However, noninfectious outcomes of DAIR such as instability are not well reported. The purpose of this study was to evaluate risk factors for hip dislocation post-DAIR for PJI of both primary and revision total hip arthroplasty (THA).
The Impact of Exchanging Cerclage Fixation after Extended Trochanteric Osteotomy in Revision Total Hip Arthroplasty for Periprosthetic Joint Infection
Mathew J. Whittaker, MD, Prerna Arora, MTech, James I. Huddleston III, MD, Stuart B. Goodman, MD, PhD, William J. Maloney, MD, Derek F. Amanatullah, MD, PhD
doi : 10.1016/j.arth.2022.08.041
Volume 38, Issue 2, February 2023, Pages 367-371
An extended trochanteric osteotomy (ETO) is a powerful tool for femoral component revision. There is limited evidence that directly supports its use in the setting of a periprosthetic joint infection (PJI). Cerclage fixation raises the theoretical concern for persistent infection.
Manipulation Under Anesthesia is Safe After Cementless Total Knee Arthroplasty: A Multicenter Study
Trevor R. Grace, MD a, *, Graham S. Goh, MD b , R. Scott Runyon, MD c , Ilan Small, MD d , Joseph T. Gibian, MD e , Ryan M. Nunley, MD f , Jess H. Lonner, MD
doi : 10.1016/j.arth.2022.08.035
Volume 38, Issue 2, February 2023, Pages 372-375
Cementless total knee arthroplasty (TKA) is thought to facilitate durable, biological fixation between the bone and implant. However, the 4-12 weeks required for osseointegration coincides with the optimal timeframe to perform a manipulation under anesthesia (MUA) if a patient develops postoperative stiffness.
What Patient and Implant Factors Affect Trunnionosis Severity? An Implant Retrieval Analysis of 664 Femoral Stems
Anastasia M. Codirenzi, MESc a , Brent A. Lanting, MD, MSc, FRCSC b , Matthew G. Teeter, PhD
doi : 10.1016/j.arth.2022.08.023
Volume 38, Issue 2, February 2023, Pages 376-382
Corrosion at the modular head-neck taper interface of total and hemiarthroplasty hip implants (trunnionosis) is a cause of implant failure and thus a clinical concern. Patient and device factors contributing to the occurrence of trunnionosis have been investigated in prior implant retrieval studies but generally with limited sample sizes and a narrow range of models.
Metrics of Clinically Important Changes in Total Hip Arthroplasty: A Systematic Review
Kira K. Tanghe a , Zodina A. Beiene, MD b , Alexander S. McLawhorn, MD, MBA c , Catherine H. MacLean, MD, PhD d, e , Elizabeth B. Gausden, MD, MPH
doi : 10.1016/j.arth.2022.09.007
Volume 38, Issue 2, February 2023, Pages 383-388
Although patient-reported outcome measures (PROMs) have become a regularly used metric, there is little consensus on the methodology used to determine clinically relevant postoperative outcomes.
Metal Augments Used in Revision Hip Arthroplasty: A Systematic Review and Single-Arm Meta-Analysis
Chenao Xiong, MD, Dexuan Meng, MD, Renhua Ni, MD, Hong Cai, MD
doi : 10.1016/j.arth.2022.08.010
Volume 38, Issue 2, February 2023, Pages 389-396.e1
Porous metal augments are used in complex hip arthroplasty; however, few studies have assessed their efficacy and safety. This systematic review analyzed the use of augments in revision hip arthroplasty and summarized the clinical research findings.
Ceramic Femoral Heads Exhibit Lower Wear Rates Compared to Cobalt Chrome: A Meta-Analysis
Kevin C. Mertz a , JaeWon Yang, MD b , Brian C. Chung, MD a , Xiao Chen, MD c , Cory K. Mayfield, MD a , Nathanael D. Heckmann, MD
doi : 10.1016/j.arth.2022.09.008
Volume 38, Issue 2, February 2023, Pages 397-405
Wear between the femoral head and acetabular liners continues to limit the longevity of total hip arthroplasty implants despite advances in implant materials. The purpose of this meta-analysis was to compare linear wear rates of cobalt-chromium (CoCr) and fourth-generation ceramic femoral heads on highly cross-linked polyethylene (XLPE) liners.
Letter to the Editor on “Who is Still Receiving Blood Transfusions After Primary and Revision Total Joint Arthroplasty?�
Jorge H. Nunez, PhDArtro-EsportDavid Mateu Vicent, MDFrancesc Angles, MD
doi : 10.1016/j.arth.2022.10.005
Volume 38, Issue 2, February 2023, Page e1
Response to Letter to the Editor From Nunez et al
David E. DeMik, MD, PharmDChristopher N. Carender, MDNicholas A. Bedard, MDNatalie A. Glass, PhDTimothy S. Brown, MD
doi : 10.1016/j.arth.2022.10.006
Volume 38, Issue 2, February 2023, Page e2
Structural Barriers and Racial Disparities in Orthopaedic Surgical Procedures
Rasheed Hosein-Woodley, BARahim Hirani, MSAsma Hirani, MBBS
doi : 10.1016/j.arth.2022.08.009
Volume 38, Issue 2, February 2023, Page e3
Reply to Letter to the Editor: Structural Barriers and Racial Disparities in Orthopaedic Surgical Procedures
Troy B. Amen, MD, MBA
doi : 10.1016/j.arth.2022.08.008
Volume 38, Issue 2, February 2023, Page e4
Conflict of Interest Statement
doi : 10.1016/S0883-5403(22)01069-5
Volume 38, Issue 2, February 2023, Page 406
