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The Evolving Influence of Spino-Pelvic Biomechanics and Research on Hip Arthroplasty
Viktor E. Krebs, MDDaniel Hameed, MDMichael A. Mont, MD
doi : 10.1016/j.arth.2023.02.049
Volume 38, Issue 4, April 2023, Pages 611-613
FOCAL Committee Activity Update
Cara A. Cipriano, MD, MSc Vivek M. Shah, MD Eric M. Cohen, MD Nicholas B. Frisch, MD Michael D. Hellman, MD Luke J. Garbarino, MD Michael A. Mont, MD Thomas G. Myers, MDAmy BolivarWilliam G. Hamilton, MD
doi : 10.1016/j.arth.2023.02.050
Volume 38, Issue 4, April 2023, Pages 614-615
Nuts and Bolts of Patient-Reported Outcomes in Orthopaedics
Minji K. Lee, PhD a , Isabella Zaniletti, PhD b , Dirk R. Larson, MS a , David G. Lewallen, MD c , Daniel J. Berry, MD c , Hilal Maradit Kremers, MD, MSc
doi : 10.1016/j.arth.2022.11.011
Volume 38, Issue 4, April 2023, Pages 616-621
Patient-reported outcomes (PROs) are commonly used in orthopaedic clinical practice, comparative effectiveness research (CER), and label claims. In this paper, we provide an overview of PROs, their development, validation, and use in orthopaedic research with examples and conclude with practical guidelines for researchers and reviewers.
Propensity Scores: Confounder Adjustment When Comparing Nonrandomized Groups in Orthopaedic Surgery
Dirk R. Larson, MS a , Isabella Zaniletti, PhD b , David G. Lewallen, MD c , Daniel J. Berry, MD c , Hilal Maradit Kremers, MD, MSc
doi : 10.1016/j.arth.2022.08.030
Volume 38, Issue 4, April 2023, Pages 622-626
Many studies in arthroplasty research are based on nonrandomized, retrospective, registry-based cohorts. In these types of studies, patients belonging to different treatment or exposure groups often differ with respect to patient characteristics, medical histories, surgical indications, or other factors.
How to Develop and Validate Prediction Models for Orthopedic Outcomes1
Isabella Zaniletti, PhD a , Dirk R. Larson, MS b , David G. Lewallen, MD c , Daniel J. Berry, MD c , Hilal Maradit Kremers, MD, MSc
doi : 10.1016/j.arth.2022.12.032
Volume 38, Issue 4, April 2023, Pages 627-633
Prediction models are common in medicine for predicting outcomes such as mortality, complications, or response to treatment.
How to Distinguish Correlation From Causation in Orthopaedic Research
Isabella Zaniletti, PhD a , Dirk R. Larson, MS b , David G. Lewallen, MD c , Daniel J. Berry, MD c , Hilal Maradit Kremers, MD, MSc b, c
doi : 10.1016/j.arth.2022.11.019
Volume 38, Issue 4, April 2023, Pages 634-637
Correlations in observational studies are commonly misinterpreted as causation. Although correlation is necessary to establish a causal relationship between two variables, correlations may also arise due to chance, reverse causality, or confounding. There are several methods available to orthopaedic researchers to determine whether the observed correlations are causal.
The Cost of Stiffness After Total Knee Arthroplasty
Aaron A. Olsen, DO a , Darren Z. Nin, PhD b , Ya-Wen Chen, MD, MPH b , Ruijia Niu, MPH a , David C. Chang, PhD, MPH, MBA b , Eric L. Smith, MD a , Carl T. Talmo, MD
doi : 10.1016/j.arth.2022.10.040
Volume 38, Issue 4, April 2023, Pages 638-643
Stiffness after primary total knee arthroplasty (TKA) is debilitating and poorly understood. A heterogenous approach to the treatment is often utilized, including both nonoperative and operative treatment modalities.
Licensed and Liable. Insurance, Road Regulations, and Driving After Hip and Knee Arthroplasty Surgery
Catherine S. Hibberd, MBBS, MS *, James M. Broderick, MBBS, MCh, Michael Nieboer, MD, MSc, Amir Khoshbin, MD, MSc, Amit Atrey, MD, MSc, MRCS
doi : 10.1016/j.arth.2022.10.024
Volume 38, Issue 4, April 2023, Pages 644-648
There is a reliance on surgeons to provide advice to patients regarding safe return to driving following hip or knee arthroplasty. Concerns arise that misinformation may place the surgeon in a position of potential legal implication.
Patients With Previous COVID-19 Infection Can Safely Undergo Primary Total Joint Arthroplasty
Samuel Rosas, MD, PhD, MBA a, *, David C. Pollock, MD a , Martin W. Roche, MD b , Farideh Najafi, MD c , Neusha Hollingsworth, BS c , Leonard T. Buller, MD d , Chad A. Krueger, MD
doi : 10.1016/j.arth.2022.10.041
Volume 38, Issue 4, April 2023, Pages 649-654
The COVID-19 virus is believed to increase the risk of diffusing intravascular coagulation. Total joint arthroplasty (TJA) is one of the most common elective surgeries and is also associated with a temporarily increased risk of venous thromboembolism (VTE).
Relationships Between Preoperative Mental Health and Improvements in Patient-Reported Outcomes After Total Hip and Knee Arthroplasty
Renee Ren, BA a, *, Tiffany Y. Lim, MD a , Brocha Z. Stern, PhD, MOT a, b , Hsin-Hui Huang, MD, PhD a, b , Jashvant Poeran, MD, PhD a, b , Brett L. Hayden, MD a , Darwin D. Chen, MD a , Calin S. Moucha, MD
doi : 10.1016/j.arth.2022.10.043
Volume 38, Issue 4, April 2023, Pages 655-661.e3
Poor preoperative mental health has been associated with worse outcomes after total hip (THA) and total knee arthroplasty (TKA). To fully understand these relationships, we assessed post-THA and post-TKA improvements in patient-reported mental and joint health by preoperative mental health groups.
Does Generalized Joint Laxity Affect Postoperative Alignment and Clinical Outcomes Following Medial Opening-Wedge High Tibial Osteotomy?
Man Soo Kim, MD, PhD, Jae Jung Kim, MD, Ki Ho Kang, MD, Kyung Jun Sin, MD, Yong In, MD, PhD
doi : 10.1016/j.arth.2022.10.033
Volume 38, Issue 4, April 2023, Pages 662-667
The purpose of this study was to investigate whether generalized joint laxity affects the postoperative alignment and clinical outcomes of medial opening-wedge high tibial osteotomy (MOWHTO).
Reasons and Risk Factors for Failed Same-Day Discharge After Primary Total Knee Arthroplasty
Tony S. Shen, MD a, *, Samuel Rodriguez, MD a , Drake G. LeBrun, MD a , Jonathan S. Yu, BS b , Alejandro Gonzalez Della Valle, MD a , Michael P. Ast, MD a , Jose A. Rodriguez, MD
doi : 10.1016/j.arth.2022.10.044
Volume 38, Issue 4, April 2023, Pages 668-672
As ambulatory total knee arthroplasty (TKA) becomes increasingly common, unplanned admission after surgery presents a challenge for the health care system. Studies evaluating the reasons and risk factors for this occurrence are limited. We sought to evaluate the reasons for unplanned admission after surgery and identify risk factors associated with this occurrence.
Spinal Versus General Anesthesia in Total Knee Arthroplasty: Are There Differences in Complication and Readmission Rates?
Nathanael D. Heckmann, MD a , Ayushmita De, PhD b , Kimberly R. Porter, MPH, PhD b , Jeffrey B. Stambough, MD
doi : 10.1016/j.arth.2022.10.036
Volume 38, Issue 4, April 2023, Pages 673-679.e1
Spinal anesthesia (SP) utilization continues to expand in total knee arthroplasty (TKA). However, little is known regarding differences in complication rates between spinal and general anesthesia used for primary TKA.
Concurrent Hardware Removal is Associated With Increased Odds of Infection Following Conversion Total Knee Arthroplasty
Hayden P. Baker, MD a, *, Henry Seidel, MD a , Lohith Vatti, MD a , Douglas Weaver, MD a , Sara S. Wallace, MD a , Bryan L. Scott, MD
doi : 10.1016/j.arth.2022.10.029
Volume 38, Issue 4, April 2023, Pages 680-684.e1
The optimal timing of removal of periarticular implants prior to conversion total knee arthroplasty (TKA) remains to be determined. The purpose of this study was to compare infection rates in conversion TKA when hardware removal was performed in either a staged or concurrent manner.
Optimized Tourniquet Use in Primary Total Knee Arthroplasty: AÂ Comparative, Prospective, and Randomized Study
Douglas M. Pav~ao, MD, MSc, PhD a, b, *, Rodrigo S. Pires eAlbuquerque, MD, PhD a , Jose Leonardo R. de Faria, MD, MSc a, b , Yuri D. Sampaio, MD a , Eduardo B. de Sousa, MD, PhD a , Fabricio Fogagnolo, MD, PhD
doi : 10.1016/j.arth.2022.10.026
Volume 38, Issue 4, April 2023, Pages 685-690
The results of recent studies investigating tourniquet (TNQ) use for knee arthroplasty are controversial. Therefore, this study aimed to compare patients undergoing total knee arthroplasty who did not have a TNQ to those in whom an optimized TNQ protocol was applied.
Is Cementless Total Knee Arthroplasty Safe in Women Over 75 Y of Age?
John P. Gibbons, MSc a, *, Roslyn S. Cassidy, MMedSci, PhD a , Leeann Bryce a , Richard J. Napier, MScEd a , Benjamin V. Bloch b , David E. Beverland, MD
doi : 10.1016/j.arth.2022.10.021
Volume 38, Issue 4, April 2023, Pages 691-699
Cementless total knee arthroplasty (TKA) is the subject of renewed interest. Previous concerns about survivorship have been addressed and there is an appeal in terms of biological fixation and surgical efficiency.
Risk of Dislocation and Revision Following Primary Total Hip Arthroplasty in Patients With Prior Lumbar Fusion With Spinopelvic Fixation
Daniel S. Yang, BS, Christopher L. McDonald, MD, Kevin J. DiSilvestro, MD, Shyam A. Patel, MD, Neill Y. Li, MD, Eric M. Cohen, MD, Alan H. Daniels, MD *
doi : 10.1016/j.arth.2022.03.061
Volume 38, Issue 4, April 2023, Pages 700-705.e1
The effect of spinopelvic fixation in addition to lumbar spinal fusion (LSF) on dislocation/instability and revision in patients undergoing primary total hip arthroplasty (THA) has not been reported previously.
High Prevalence of Spinopelvic Risk Factors in Patients With Post-Operative Hip Dislocations
Jonathan M. Vigdorchik, MD a, *, Chameka S. Madurawe b , Douglas A. Dennis, MD c , Jim W. Pierrepont, PhD b , Tristan Jones b , James I. Huddleston 3rd, MD
doi : 10.1016/j.arth.2022.05.016
Volume 38, Issue 4, April 2023, Pages 706-712
Excessive standing posterior pelvic tilt (PT), lumbar spine stiffness, low pelvic incidence (PI), and severe sagittal spinal deformity (SSD) have been linked to increased dislocation rates.
Sacral Slope Change From Standing to Relaxed-Seated Grossly Overpredicts the Presence of a Stiff Spine
Abhinav K. Sharma, MD a , George Grammatopoulos, MBBS, BSc, DPhil b , Jim W. Pierrepont, PhD c , Chameka S. Madurawe, BEng c , Moritz M. Innmann, MD b, d , Jonathan M. Vigdorchik, MD e, *, Andrew J. Shimmin, MBBS
doi : 10.1016/j.arth.2022.05.020
Volume 38, Issue 4, April 2023, Pages 713-718.e1
Several authors propose that a change in sacral slope of ≤10° between the standing and relaxed-seated positions (�SSstanding→relaxed-seated) identifies a patient with a stiff lumbar spine and has suggested the use of dual-mobility bearings for such patients undergoing a total hip arthroplasty (THA).
The Influence of Dorr Type and Femoral Fixation on Outcomes Following Total Hip Arthroplasty for Acute Femoral Neck Fractures: A Multicenter Study
Michael M. Kheir, MD a, *, Julian E. Dilley, MD b , Jacob Speybroeck, MD c , Emile-Victor Kuyl, BS d , George Ochenjele, MD c , Alexander S. McLawhorn, MD d , R. Michael Meneghini, MD
doi : 10.1016/j.arth.2022.10.028
Volume 38, Issue 4, April 2023, Pages 719-725
The American Academy of Orthopaedic Surgeons guidelines report moderate evidence for cementing femoral stems for hip fractures, mainly derived from hemiarthroplasty literature.
The Association of Postoperative Osteoporosis Therapy With Periprosthetic Fracture Risk in Patients Undergoing Arthroplasty for Femoral Neck Fractures
Jordan S. Cohen, MD a, *, Amil R. Agarwal b , Matthew J. Kinnard, MD c , Savyasachi C. Thakkar, MD d , Gregory J. Golladay, MD
doi : 10.1016/j.arth.2022.10.042
Volume 38, Issue 4, April 2023, Pages 726-731
Displaced femoral neck fractures in older adults are generally treated with hip arthroplasty. One concern following hip arthroplasty is the risk for periprosthetic fractures (PPFs).
Comparison of Dislocation and Outcome Between Piriformis-Sparing and Conventional Posterior Approach After Bipolar Hemiarthroplasty for Femoral Neck Fracture in Patients Over 60 Years
Rit Apinyankul, MD a , Yodhathai Satravaha, DDS, PhD b , Krissada Mokmongkolkul, MD c , Ong-art Phruetthiphat, MD
doi : 10.1016/j.arth.2022.10.025
Volume 38, Issue 4, April 2023, Pages 732-736
Hemiarthroplasty is a treatment option for femoral neck fractures in patients aged more than 60 years and postoperative dislocation after a posterior approach is not uncommon.
Postoperative Delirium in Patients Receiving Hip Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures: The Risk Factors and Further Clinical Outcomes
Deng Horng Lee, MD a , Chih-Hsun Chang, MD b , Chih-Wei Chang, MD, PhD a , Yi-Chen Chen, MSN, RN c , Ta-Wei Tai, MD, PhD
doi : 10.1016/j.arth.2022.10.022
Volume 38, Issue 4, April 2023, Pages 737-742
Postoperative delirium in patients who have hip fractures may lead to poor outcomes. This study aimed to determine perioperative risk factors and clinical outcomes of postoperative delirium in patients undergoing hip bipolar hemiarthroplasty for displaced femoral neck fractures.
Long-Term Results (Minimum of 20 Years) of a Pure Proximal-Loading Metaphyseal-Fitting Anatomic Cementless Stem Without Distal Stem Fixation in Hip 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.2022.10.034
Volume 38, Issue 4, April 2023, Pages 743-750
There are no reported results for more than 20 years of a pure proximal-loading anatomic cementless femoral stem without diaphyseal stem fixation. The purpose of this study was to evaluate the long-term (minimum 20 years) clinical results, bone remodeling, revision rate, and survivorship of these implants in patients aged less than 60 years.
Periprosthetic Femoral Fractures in Cementless Short Versus Straight Stem Total Hip Arthroplasty: A Propensity Score Matched Analysis
Matthias Luger, MD a, b, *, Sandra Feldler, BSc a, b , Lorenz Pisecky, MD a, b , Antonio Klasan, MD, PhD b, c , Tobias Gotterbarm, MD a, b , Clemens Schopper, MD
doi : 10.1016/j.arth.2022.10.027
Volume 38, Issue 4, April 2023, Pages 751-756
Recent studies indicate a decreased risk of periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA) for short compared to straight stems. However, the results are still inconclusive. Therefore, we retrospectively investigated the rate of PFFs within the first year between cementless short and straight stem THA.
Undersizing the Tibial Baseplate in Cementless Total Knee Arthroplasty has Only a Small Impact on Bone-Implant Interaction: A Finite Element Biomechanical Study
Fernando J. Quevedo Gonzalez, PhD a, *, Peter K. Sculco, MD b , Cynthia A. Kahlenberg, MD b , David J. Mayman, MD b , Joseph D. Lipman, MS a , Timothy M. Wright, PhD a , Jonathan M. Vigdorchik, MD
doi : 10.1016/j.arth.2022.10.032
Volume 38, Issue 4, April 2023, Pages 757-762
The tibial component in total knee arthroplasty (TKA) is often chosen to maximize coverage of the tibial cut, which can result in excessive internal rotation of the component.
A Systematic Review of the Efficacy and Safety of Ketamine in Total Joint Arthroplasty
Charles P. Hannon, MD, MBA a, *, Yale A. Fillingham, MD b , Jeremy M. Gililland, MD c , Scott M. Sporer, MD d , Francisco D. Casambre, MPH e , Tyler J. Verity, BA e , Anne Woznica, MLIS e , Nicole Nelson, MPH e , William G. Hamilton, MD f , Craig J. Della Valle, MD
doi : 10.1016/j.arth.2022.10.037
Volume 38, Issue 4, April 2023, Pages 763-768.e2
Ketamine is administered intraoperatively to treat pain associated with primary total hip (THA) and knee arthroplasty (TKA). The purpose of this study was to evaluate the efficacy and safety of ketamine in primary THA and TKA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons (AAHKS), American Academy of Orthopaedic Surgeons (AAOS), Hip Society, Knee Society, and the American Society of Regional Anesthesia and Pain Management (ASRA).
Intraosseous Regional Administration of Antibiotic Prophylaxis for Total Knee Arthroplasty: A Systematic Review
Benjamin Miltenberg, MD a , Leanne Ludwick, BS a , Raisa Masood, MS b , Mariano E. Menendez, MD c , Michael A. Moverman, MD b , Nicholas R. Pagani, MD b , Richard N. Puzzitiello, MD b , Eric L. Smith, MD
doi : 10.1016/j.arth.2022.10.023
Volume 38, Issue 4, April 2023, Pages 769-774
Intraosseous regional administration (IORA) of antibiotics after tourniquet inflation has recently been introduced as a technique to deliver antibiotics directly to the surgical site among patients undergoing total knee arthroplasty (TKA).
Corrigendum to: ‘Tranexamic Acid Administration Is Associated With a Decreased Odds of Prosthetic Joint Infection Following Primary Total Hip and Primary Total Knee Arthroplasty: A National Database Analysis’ [The Journal of Arthroplasty Volume 36, Issue 3, March 2021, Pages 1109-1113]
Genewoo J. Hong, MD, JD a, b, *, Lauren A. Wilson, MPH a , Jiabin Liu, MD, PhD a, b , Stavros G. Memtsoudis, MD, PhD, MBA
doi : 10.1016/j.arth.2023.01.009
Volume 38, Issue 4, April 2023, Page 775
Low Molecular Weight Heparin is Superior to Aspirin in the Prevention of Thromboembolic Disease, or is it? Response to an Editorial
Ian A. Harris, PhD
doi : 10.1016/j.arth.2023.01.002
Volume 38, Issue 4, April 2023, Pages e7-e8
Commentary on “Low Molecular Weight Heparin is Superior to Aspirin in the Prevention of Thromboembolic Disease, or is It? Response to an Editorial�
Javad Parvizi, MDMichael J. Dunbar, MD, FRCSC, PhDMichael A. Mont, MDPaul A. Lachiewicz, MD
doi : 10.1016/j.arth.2023.01.001
Volume 38, Issue 4, April 2023, Page e9
Conflict of Interest Statement
doi : 10.1016/S0883-5403(23)00165-1
Volume 38, Issue 4, April 2023, Page A9
