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The Young Arthroplasty Group “YAG�
Nicholas B. Frisch, MD, MBABrian M. Culp, MDJoshua M. Kerr, MAJeffrey K. Lange, MDAnna R. Cohen-Rosenblum, MDBradford S. Waddell, MD
doi : 10.1016/j.arth.2023.01.016
Volume 38, Issue 6, June 2023, Pages 981-983
Is Industry- Versus Government-Sponsored Research a Zero-Sum Game?
Zeev N. Kain, MD, MBAChild Study CenterMitchel Tsai, MD, MMMJames Browne, MD
doi : 10.1016/j.arth.2023.02.017
Volume 38, Issue 6, June 2023, Pages 984-985
Pro-Con Debate: Interdisciplinary Perspectives on Industry-Sponsored Research
Daniel I. Sessler, MD a, *, Benjamin A. Alman, MD b , Miriam M. Treggiari, MD, PhD, MPH c , Michael A. Mont, MD
doi : 10.1016/j.arth.2023.02.018
Volume 38, Issue 6, June 2023, Pages 986-991
Over Half of All Medicare Total Knee Arthroplasty Patients Are Now Classified as an Outpatient–Three-Year Impact of the Removal From the Inpatient-Only List
Robert A. Burnett, MD a , Toby N. Barrack, MD a , E. Bailey Terhune, MD a , Craig J. Della Valle, MD a , Roshan P. Shah, MD b , P. Maxwell Courtney, MD
doi : 10.1016/j.arth.2022.12.029
Volume 38, Issue 6, June 2023, Pages 992-997
In 2018, Centers for Medicare & Medicaid Services removed total knee arthroplasty (TKA) from its inpatient-only list, triggering many unintended consequences. The purpose of this study was to determine how the impact of TKA removal affected the number of outpatient TKA patients, which patients were being labeled outpatient, and how outpatient classification affected discharge location and readmission rates.
Conversion Total Hip Arthroplasty in the Era of Bundled Care Payments: Impacts on Costs of Care
Michael D. Hunter, MD, Jason D. Desmarais, MD, Edward J. Quilligan, BS, Travis S. Scudday, MD, Jay J. Patel, MD, Steven L. Barnett, MD, Robert S. Gorab, MD, Nader A. Nassif, MD *
doi : 10.1016/j.arth.2022.12.028
Volume 38, Issue 6, June 2023, Pages 998-1003
Conversion hip arthroplasty is defined as a patient who has had prior open or arthroscopic hip surgery with or without retained hardware that is removed and replaced with arthroplasty components. Currently, it is classified under the same diagnosis-related group as primary total hip arthroplasty (THA); however, it frequently requires a higher cost of care.
Chronic Opioid Use Independently Increases Complications and Resource Utilization After Primary Total Joint Arthroplasty
Dianne N. Pagan, BS, Victor H. Hernandez, MD, Gireesh B. Reddy, MD, Michele R. D’Apuzzo, MD
doi : 10.1016/j.arth.2022.12.021
Volume 38, Issue 6, June 2023, Pages 1004-1009
Current literature suggests a link between the chronic use of opioids and musculoskeletal surgical complications. Given the current opioid epidemic, the need to elucidate the effects of chronic opioid use (OD) on patient outcomes and cost has become important. The purpose of this study was to determine if OD is an independent risk factor for inpatient postoperative complications and resource utilization after primary total joint arthroplasty.
Identifying Risk Factors for Complication and Readmission with Same-Day Discharge Arthroplasty
Maveric K.I. L. Abella a, b , Chukwunweike N. Ezeanyika, MS a, c , Andrea K. Finlay, PhD a , Derek F. Amanatullah, MD, PhD
doi : 10.1016/j.arth.2022.12.036
Volume 38, Issue 6, June 2023, Pages 1010-1015.e2
Positive Preoperative Colonization With Methicillin Resistant Staphylococcus Aureus Is Associated With Inferior Postoperative Outcomes in Patients Undergoing Total Joint Arthroplasty
Itay Ashkenazi, MD a, b, *, Jeremiah Thomas a , Kyle W. Lawrence a , Joshua C. Rozell, MD a , Claudette M. Lajam, MD a , Ran Schwarzkopf, MD, MSc
doi : 10.1016/j.arth.2023.02.065
Volume 38, Issue 6, June 2023, Pages 1016-1023
The impact of preoperative nasal colonization with methicillin resistant staphylococcus aureus (MRSA) on total joint arthroplasty (TJA) outcomes is not well understood. This study aimed to evaluate complications following TJA based on patients’ preoperative staphylococcal colonization status.
Does Prednisone Dose Affect Rates of Periprosthetic Joint Infection Following Primary Total Hip and Total Knee Arthroplasty?
Amit S. Piple, MD, Jennifer C. Wang, Kareem J. Kebaish, MD, Emily S. Mills, MD, Daniel A. Oakes, MD, Jay R. Lieberman, MD, Alexander B. Christ, MD, Nathanael D. Heckmann, MD
doi : 10.1016/j.arth.2022.12.033
Volume 38, Issue 6, June 2023, Pages 1024-1031
Prednisone use is associated with higher rates of periprosthetic joint infection (PJI) following total joint arthroplasty (TJA). However, the relationship between prednisone dosage and infection risk is ill-defined. Therefore, this study aimed to assess the relationship between prednisone dosage and rates of PJI following TJA.
A Novel Method for Stratification of 30-Day Major Complication Risk Using Body Mass Index Thresholds for Patients Undergoing Total Knee Arthroplasty: A National Cohort of 443,157 Patients
Amil R. Agarwal a, *, Andrew B. Harris, MD a , Zachary C. Pearson a , Savyasachi C. Thakkar, MD a , Gregory J. Golladay, MD
doi : 10.1016/j.arth.2023.02.051
Volume 38, Issue 6, June 2023, Pages 1032-1036
The Association of Metabolic Syndrome on Complications and Implant Survivorship in Primary Total Knee Arthroplasty in Morbidly Obese Patients
Ittai Shichman, MD a, b , Christian T. Oakley, BS a , Jaclyn A. Konopka, MD a , Itay Ashkenazi, MD a, b , Joshua Rozell, MD a , Ran Schwarzkopf, MD, MSc
doi : 10.1016/j.arth.2022.12.039
Volume 38, Issue 6, June 2023, Pages 1037-1044
Metabolic syndrome (MetS) includes interrelated conditions such as insulin resistance, abdominal obesity, hypertension, and dyslipidemia. This study sought to determine the association of MetS in morbidly obese patients (body mass index >40) on complications and clinical outcomes after primary total knee arthroplasty (TKA).
Conversion Total Knee Arthroplasty After Failed Osteochondral Allograft Reconstruction: Similar Functional Performance With Lower Patient Satisfaction
Lasun O. Oladeji, MD, MS, Brenton G. Albracht, MD, James A. Keeney, MD
doi : 10.1016/j.arth.2023.02.084
Volume 38, Issue 6, June 2023, Pages 1045-1051
This study presents surgical techniques used in conversion total knee arthroplasty (cTKA) following early failure of large osteochondral allograft joint replacement and compares postoperative patient reported outcomes measures (PROMs) and satisfaction scores with a contemporary primary total knee arthroplasty (pTKA) cohort.
Are There More Radiolucent Lines in Patients Who Underwent Total Knee Arthroplasty With or Without a Tourniquet During Cementation at 5 to 8 Years After Surgery?
Haijun Xu, MD a , Antonia F. Chen, MD, MBA b , Monica M. Shoji, MD b , Wolfgang Fitz, MD b , Jeffrey K. Lange, MD
doi : 10.1016/j.arth.2023.02.057
Volume 38, Issue 6, June 2023, Pages 1052-1056
This study investigated the presence and progression of radiolucent lines (RLLs) after cemented total knee arthroplasty (TKA) with or without tourniquet use.
Patella Denervation With Circumferential Electrocautery in Primary Knee Arthroplasty: A Randomized Controlled Trial
Simon J. Spencer, MBChB, FRCSGlasg(Tr&Orth) a , Bilal Jamal, MBChB, FRCS(Tr&Orth) a , Simon G.F. Abram, BMBCh, FRCS(Tr&Orth), DPhil a, b, *, Nicholas Kane, BSc Business, Post Grad IT a , Aslam Mohammed, MBChB, FRCS(Eng, Glasg), MD, FRCS(Tr&Orth)
doi : 10.1016/j.arth.2023.02.062
Volume 38, Issue 6, June 2023, Pages 1057-1062
The aim of this study was to investigate the clinical effectiveness of patella rim electrocautery “denervation� versus no denervation in patients undergoing total knee arthroplasty (TKA).
Interval Time of at Least 6 Weeks Between Bilateral Total Knee Arthroplasties is Associated With Decreased Postoperative Complications
Amil R. Agarwal a, b, *, Alex Gu, MD a , Kevin Y. Wang, MD b , Andrew B. Harris, MD b , Joshua C. Campbell, MD a , Savyasachi C. Thakkar, MD b , Gregory J. Golladay, MD
doi : 10.1016/j.arth.2022.12.037
Volume 38, Issue 6, June 2023, Pages 1063-1069
The Utility of Routine Postoperative Radiographs in the Asymptomatic Total Hip Arthroplasty Patient
Nathanael D. Heckmann, MD *, Brian C. Chung, MD, Julian Wier, BS, Kevin C. Liu, BS, Cory K. Mayfield, MD, Jay R. Lieberman, MD
doi : 10.1016/j.arth.2022.12.030
Volume 38, Issue 6, June 2023, Pages 1070-1074
Total hip arthroplasty (THA) patients often receive routine radiographs in the year following their index surgery. This study sought to investigate the clinical and economic value of obtaining routine postoperative hip radiographs for asymptomatic patients following primary elective THA.
The Current Proposed Total Hip Arthroplasty Surgical Planning Guidelines Based on Classification of Spine Stiffness May be Flawed Due to Incorrect Assumptions
Aidin E. Pour, MD, MS a, *, Jordan H. Green, MD b , Thomas H. Christensen c , Nishanth Muthusamy c , Ran Schwarzkopf, MD, MSc
doi : 10.1016/j.arth.2023.02.063
Volume 38, Issue 6, June 2023, Pages 1075-1081
The available classifications and preoperative planning tools for total hip arthroplasty assume that: 1) there is no variation in the sagittal pelvic tilt (SPT) if the radiographs are repeated, and 2)Â there is no significant change in the postoperative SPT postoperatively. We hypothesized that there would be significant differences in postoperative SPT tilt as measured by the sacral slope, thus rendering the current classifications and tools flawed.
Assessment of the Damage to Hip Abductor Muscles in Primary Total Hip Arthroplasty With a Minimally Invasive Anterolateral Approach With or Without Trochanteric Flip Osteotomy
Yusuke Takaoka, MD *, Koji Goto, MD, PhD, Yutaka Kuroda, MD, PhD, Toshiyuki Kawai, MD, PhD, Yaichiro Okuzu, MD, PhD, Shuichi Matsuda, MD, PhD
doi : 10.1016/j.arth.2023.02.075
Volume 38, Issue 6, June 2023, Pages 1082-1088
Although introduction of minimally invasive techniques via anterolateral approaches considerably decreased prolonged limp after total hip arthroplasty (THA), potential damage to the abductor muscles is still a concern. This study aimed to evaluate the residual damage after primary THA with two types of anterolateral approach by assessing fatty infiltration and atrophy of the gluteus medius (GMed) and gluteus minimus (GMin) muscles.
No Difference in the Rate of Periprosthetic Joint Infection in Patients Undergoing the Posterolateral Compared to the Direct Anterior Approach
Brian P. Chalmers, MD a, *, Simarjeet Puri a , Adam Watkins b , Agnes D. Cororaton, MS c , Andy O. Miller, MD d , Alberto V. Carli, MD a , Michael M. Alexiades, MD
doi : 10.1016/j.arth.2023.03.003
Volume 38, Issue 6, June 2023, Pages 1089-1095
There remains inconsistent data about the association of surgical approach and periprosthetic joint infection (PJI). We sought to evaluate the risk of reoperation for superficial infection and PJI after primary total hip arthroplasty (THA) in a multivariate model.
Efficacy of Ultrasound-Guided Pericapsular Nerve Group (PENG) Block Combined With Local Infiltration Analgesia on Postoperative Pain After Total Hip Arthroplasty: A Prospective, Double-Blind, Randomized Controlled Trial
Jian Hu, MM a , Qiuru Wang, MD b , Jie Hu, MM a , Pengde Kang, MD, PhD b, **, Jing Yang, MD, PhD
doi : 10.1016/j.arth.2022.12.023
Volume 38, Issue 6, June 2023, Pages 1096-1103
This study examined whether pericapsular nerve group (PENG) block combined with local infiltration analgesia (LIA) could improve pain management and functional recovery after total hip arthroplasty.
Is a Total Hip Arthroplasty Stem in Varus a Risk Factor of Long-Term Mechanical Complication?
Baptiste Montbarbon, MD a , Hoel Letissier, MD, MSc b, c, d, *, Remi Di Francia, MD b , Eric Stindel, MD, PhD b, c, d , Frederic Dubrana, MD, PhD b, d , Thomas Williams, MD
doi : 10.1016/j.arth.2022.12.025
Volume 38, Issue 6, June 2023, Pages 1104-1109
The impact of implanting cementless femoral stems in varus alignment on long-term mechanical complications remains poorly defined in the literature. The aim of our study was to compare survivorship and functional and radiographic outcomes of stems in varus alignment to those in neutral alignment with and average follow-up of 10 years.
Effects of Depression, Anxiety, and Pain Catastrophizing on Total Hip Arthroplasty Patient Activity Level
Seth Reine a , Yin Xi, PhD b , Holden Archer a , Avnessh Chhabra, MD b , Michael Huo, MD a , Joel Wells, MD, MPH
doi : 10.1016/j.arth.2022.12.026
Volume 38, Issue 6, June 2023, Pages 1110-1114
Improvements in psychological factors are strongly associated with increased physical activity in the general population. The effects of depression, anxiety, and pain catastrophizing on activity level have not been thoroughly explored in patients undergoing total hip arthroplasty (THA).
Primary and Revision Total Hip Arthroplasty in Patients With Pulmonary Hypertension: High Perioperative Mortality and Medical Complications
Courtney E. Baker, MD a , Brian P. Chalmers, MD a , Michael J. Taunton, MD a , Adam W. Amundson, MD b , Daniel J. Berry, MD a , Matthew P. Abdel, MD
doi : 10.1016/j.arth.2022.12.027
Volume 38, Issue 6, June 2023, Pages 1115-1119
Perioperative medical management during total hip arthroplasty (THA) is continuously improving, allowing an increasing number of medically complex patients to undergo total joint arthroplasty. This study examined mortalities, medical complications, implant survivorships, and clinical outcomes of THA in patients who have pulmonary hypertension (HTN).
Direct Cementation of Dual Mobility Cups Into the Bony Acetabulum in Primary Total Hip Arthroplasty: Clinical and Radiographic Outcomes at a Minimum 5-Year Follow-Up
Alexander Antoniadis, MD, Julien Wegrzyn, MD, PhD
doi : 10.1016/j.arth.2022.12.031
Volume 38, Issue 6, June 2023, Pages 1120-1125
Cemented dual mobility cups (DMCs) are commonly used in combination with acetabular reinforcement devices. Indeed, according to literature, direct cementation of metal-backed acetabular components into the bony acetabulum remains controversial as this technique is potentially associated with increased rates of aseptic loosening. Therefore, this study aimed to evaluate the clinical and radiographic outcomes of DMC cemented into the bony acetabulum in primary total hip arthroplasty (THA).
Surgeons Experience More Physiologic Stress and Strain During Revision Than Primary Total Joint Arthroplasty
Irfan A. Khan, ATC, Colin M. Baker, MBA, Justin A. Magnuson, MD, P. Maxwell Courtney, MD, Chad A. Krueger, MD, Jess H. Lonner, MD
doi : 10.1016/j.arth.2022.12.022
Volume 38, Issue 6, June 2023, Pages 1126-1130
Revision total knee arthroplasty (rTKA) and total hip arthroplasty (rTHA) procedures are more complex than primary TKA and THA, but their physiologic burden to the surgeon has not been quantified.
Prevention Techniques Have Had Minimal Impact on the Population Rate of Prosthetic Joint Infection for Primary Total Hip and Knee Arthroplasty: A National Database Study
Michael P. Murphy, MD *, Ashley E. MacConnell, MD, Cameron J. Killen, MD, Daniel R. Schmitt, MD, Karen Wu, MD, William J. Hopkinson, MD, Nicholas M. Brown, MD
doi : 10.1016/j.arth.2023.02.059
Volume 38, Issue 6, June 2023, Pages 1131-1140
Several studies over the years have offered modalities that may greatly decrease the rate of periprosthetic joint infection when implemented. As a result, one would expect a drastic decrease in infection rate among the implementing population with its widespread use. The purpose of this study was to assess whether there exists a decrease in infection rate over time, after accounting for available confounding variables, within a large national database.
Unexpected Positive Cultures in Patients Who Have a History of Septic Revision in the Same Joint
Ana Ribau, MD a, b, *, Seper Ekhtiari, MD a , Maximilian Budin a , Luigi Zanna, MD a , Mustafa Fatih Dasci, MD a , Thorsten Gehrke, MD a , Mustafa Citak, MD, MBA
doi : 10.1016/j.arth.2023.02.078
Volume 38, Issue 6, June 2023, Pages 1141-1144
The prevalence of unexpected positive cultures (UPC) in an aseptic revision surgery of the joint with a prior septic revision in the same joint remains unknown. The purpose of this study was to determine the prevalence of UPC in that specific group. As secondary outcomes, we explored risk factors for UPC.
Articulating Knee Spacers in the Treatment of Periprosthetic Joint Infection: All Polyethylene Tibia or Tibial Insert?
Kathleen D. Kinder a , Andrew E. Apple, MD b , C. Lowry Barnes, MD a , Benjamin M. Stronach, MD a , Simon C. Mears, MD, PhD a , Jeffrey B. Stambough, MD
doi : 10.1016/j.arth.2023.02.079
Volume 38, Issue 6, June 2023, Pages 1145-1150
The best antibiotic spacer for periprosthetic knee joint infection treatment is unknown. Using a metal-on-polyethylene (MoP) component provides a functional knee and may avoid a second surgery.
Trends in Revision Hip Arthroplasty for Prosthetic Joint Infection: AÂ Single-Center Study of 423 Hips at a High-Volume Center Between 2008 and 2021
Rasmus J. Liukkonen, BM a, *, Meeri Honkanen, MD, PhD b , Aleksi P. Reito, MD, PhD a , Eerik T. Skytt€a, MD, PhD a , Matti Karppelin, MD, PhD b , Antti P. Eskelinen, MD, PhD
doi : 10.1016/j.arth.2023.02.061
Volume 38, Issue 6, June 2023, Pages 1151-1159
Prosthetic joint infection (PJI) is one of the most devastating complications after total hip arthroplasty (THA), and comorbidities increase the risk. We examined whether there was a temporal change in the demographics, especially regarding comorbidities, of patients who have PJIs and were treated over a 13-year study period at a high-volume academic joint arthroplasty center. In addition, the surgical methods used and the microbiology of the PJIs were assessed.
Wound Complications Are Affected by Different Skin Closure Methods in Primary Hip and Knee Arthroplasty
Ajay Premkumar, MD, MPH *, Jacqueline Grubel, Nathaniel T. Ondeck, MD, Alex Koo, Yu-Fen Chiu, MPH, Jason L. Blevins, MD, Peter K. Sculco, MD, David S. Mayman, MD, Alejandro Gonzalez Della Valle, MD
doi : 10.1016/j.arth.2023.02.074
Volume 38, Issue 6, June 2023, Pages 1160-1165
Axial and Sagittal Rotation of Cementless Tibial Baseplates Occurs in Bone Under Joint Loading
Matthew G. Teeter, PhD a, b, c, *, Jordan S. Broberg a, c , James L. Howard, MD, MSc b , Brent A. Lanting, MD, MSc
doi : 10.1016/j.arth.2023.03.002
Volume 38, Issue 6, June 2023, Pages 1166-1171
There has been a recent increase in the use of cementless fixation for primary total knee arthroplasty. While the early results of contemporary cementless implants are promising, understanding the behavior of cementless tibial baseplates under loading remains an ongoing interest. The objective of this study was to identify the pattern of displacement that occurred under loading for a single cementless tibial baseplate design at one year post operation for stable and continuously migrating implants.
Polyethylene Dual Mobility Liners Show Minimal Polyethylene Changes in Early Retrievals
Dual mobility (DM) liners were introduced to reduce instability in total hip arthroplasty. They were found to allow for motion predominantly at the femoral head and the inner bearing of the acetabular liner; however, little is known if this motion is sufficient to alter polyethylene material characteristics.
doi : 10.1016/j.arth.2023.02.068
Volume 38, Issue 6, June 2023, Pages 1172-1176
The Fragility of Tourniquet Use in Total Knee Arthroplasty: AÂ Systematic Review of Randomized Controlled Trials
John K. Cordero, MD a , Kyle W. Lawrence b, *, Ashley N. Brown a , Xinning Li, MD b , Brett L. Hayden, MD a , Robert L. Parisien, MD
doi : 10.1016/j.arth.2022.12.035
Volume 38, Issue 6, June 2023, Pages 1177-1183
Infection Risk Increases After Total Hip Arthroplasty Within 3Â Months Following Intra-Articular Corticosteroid Injection. AÂ Meta-Analysis on Knee and Hip Arthroplasty
Jacopo Albanese a, *, Pietro Feltri a , Angelo Boffa b , Brian C. Werner c , Francesco Traina d , Giuseppe Filardo
doi : 10.1016/j.arth.2022.12.038
Volume 38, Issue 6, June 2023, Pages 1184-1193.e2
Conflict of Interest Statement
doi : 10.1016/S0883-5403(23)00412-6
Volume 38, Issue 6, June 2023, Page 1194
