Journal of Arthroplasty




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The Second Surge of COVID-19: Better Prepared and a Brighter Light at the End of the Tunnel

M.A. Mont, D.J. Backstein, J.A. Browne, V.E. Krebs, C.A. Krueger, J.B. Mason, M.J. Taunton, J.J. Callaghan

doi : 10.1016/j.arth.2020.12.020

VOLUME 36, ISSUE 2, P395-396, FEBRUARY 01, 2021

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Public Perceptions of Resuming Elective Surgery During the COVID-19 Pandemic

Michael A. Moverman, Richard N. Puzzitiello, Nicholas R. Pagani, C. Lowry Barnes, Andrew Jawa, Mariano E. Menendez

doi : 10.1016/j.arth.2020.07.037

VOLUME 36, ISSUE 2, P397-402.E2, FEBRUARY 01, 2021

Many U.S. health systems are grappling with how to safely resume elective surgery amid the COVID-19 pandemic. We used online crowdsourcing to explore public perceptions and concerns toward resuming elective surgery during the pandemic, and to determine factors associated with the preferred timing of surgery after health systems reopen.

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Differences in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores for a Single Surgeon Comparing Two Institutions: An Unfair Reimbursement Metric

Siddharth A. Mahure, Greg M. Teo, William J. Long

doi : 10.1016/j.arth.2020.08.062

VOLUME 36, ISSUE 2, P403-411, FEBRUARY 01, 2021

Emphasis on value-based purchasing links physician financial remuneration to patient-derived outcome scores. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys aim to provide a uniform comparison tool. Of the 22 different survey questions, only 3 (13.6%) focus on experience related to doctors. We sought to determine how HCAHPS scores differ for a single surgeon performing more than 500 total joint arthroplasties annually, divided almost equally between two centers.

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Medicare Total Knee Arthroplasty Patients Need Not Stay 2 Midnights for Full Facility Reimbursement

Chad A. Krueger, P. Maxwell Courtney, Matthew S. Austin

doi : 10.1016/j.arth.2020.08.053

VOLUME 36, ISSUE 2, P412-415, FEBRUARY 01, 2021

Health care systems are concerned that facility reimbursements will be reduced based on patient length of stay (LOS) of <2 midnights with the removal of total knee arthroplasty (TKA) from the inpatient-only list. The purpose of this study was to evaluate the effect of LOS and postdischarge disposition on facility reimbursement.

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Intra-articular Injections of the Hip and Knee With Triamcinolone vs Ketorolac: A Randomized Controlled Trial

Kevin Jurgensmeier, Darin Jurgensmeier MD, Derek E. Kunz, Peter G. Fuerst, Lucian C. Warth, Steven B. Daines

doi : 10.1016/j.arth.2020.08.036

VOLUME 36, ISSUE 2, P416-422, FEBRUARY 01, 2021

Clinicians commonly utilize intra-articular injections to treat symptomatic primary arthritis. Steroid injections are common yet have immune-modulating effects and can alter gene expression which may delay definitive arthroplasty and further damage cartilage. Nonsteroidal anti-inflammatory injections may offer a safer profile due to their differing mechanism of action; however, there is a relative dearth of information regarding their efficacy. This noninferiority study compares the effectiveness of triamcinolone vs ketorolac in treating symptoms of moderate to advanced primary osteoarthritis of the hip and knee.

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Medial Meniscus Posterior Root Tear Does Not Affect the Outcome of Medial Open-Wedge High Tibial Osteotomy

Kang-Il Kim, Jung-Kwon Bae, Sang-Woo Jeon, Gi Beom Kim

doi : 10.1016/j.arth.2020.08.067

VOLUME 36, ISSUE 2, P423-428, FEBRUARY 01, 2021

This study aimed to verify whether the presence of medial meniscus posterior root tear (MMPRT) affects the clinical and radiographic outcomes of medial open-wedge high tibial osteotomy (MOWHTO) compared to the patients without MMPRT for over a midterm follow-up.

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Magnetic Resonance Imaging Assessment of Abductor Muscles Shortly After Curved Periacetabular Osteotomy

Taiki Matsunaga, Yuki Kamachi, Koichi Kinoshita, Tetsuya Sakamoto, Takuaki Yamamoto

doi : 10.1016/j.arth.2020.08.041

VOLUME 36, ISSUE 2, P429-433, FEBRUARY 01, 2021

Curved periacetabular osteotomy (CPO) is performed via an anterior approach without detachment of the hip abductor muscles. This study aimed to evaluate the abductor muscle status shortly after CPO on magnetic resonance imaging (MRI).

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Return to Work Following Total Knee and Hip Arthroplasty: The Effect of Patient Intent and Preoperative Work Status

Khalid Al-Hourani, Deborah J. MacDonald, Gareth S. Turnbull, Steffen J. Breusch, Chloe E.H. Scott

doi : 10.1016/j.arth.2020.08.012

VOLUME 36, ISSUE 2, P434-441, FEBRUARY 01, 2021

The ability of total knee and hip arthroplasty (TKA/THA) to facilitate return to work (RTW) when it is the patient’s preoperative intent to do so remains unclear. We aimed at determining whether TKA/THA facilitated RTW in patients of working age who intended to return.

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Improvement in Sleep Patterns After Hip and Knee Arthroplasty: A Prospective Study in 780 Patients

Jan P. Van Meirhaeghe, Lucy J. Salmon, Michael D. O'Sullivan, Benjamin R. Gooden, Matthew C. Lyons, Leo A. Pinczewski, Justin P. Roe

doi : 10.1016/j.arth.2020.08.056

VOLUME 36, ISSUE 2, P442-448, FEBRUARY 01, 2021

Postoperative delirium (POD) and delayed neurocognitive recovery are 2 common subtypes of postoperative neurocognitive disorders that occur after total joint arthroplasty (TJA), associated with inferior surgical outcomes. The modified frailty index (mFI) reflects the status of physiologic decline and predicts adverse outcomes in various surgical patient cohorts. This study aims at examining the discriminatory value of the mFI to predict POD and delayed neurocognitive recovery after TJA.

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Modified Frailty Index Independently Predicts Postoperative Delirium and Delayed Neurocognitive Recovery After Elective Total Joint Arthroplasty

Yun Chen, Jinling Qin

doi : 10.1016/j.arth.2020.07.074

VOLUME 36, ISSUE 2, P449-453, FEBRUARY 01, 2021

Postoperative delirium (POD) and delayed neurocognitive recovery are 2 common subtypes of postoperative neurocognitive disorders that occur after total joint arthroplasty (TJA), associated with inferior surgical outcomes. The modified frailty index (mFI) reflects the status of physiologic decline and predicts adverse outcomes in various surgical patient cohorts. This study aims at examining the discriminatory value of the mFI to predict POD and delayed neurocognitive recovery after TJA.

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Narcotic Refills and Patient Satisfaction With Pain Control After Total Joint Arthroplasty

Jeffrey B. Stambough, Ryan Hui, Eric R. Siegel, Paul K. Edwards, C. Lowry Barnes, Simon C. Mears

doi : 10.1016/j.arth.2020.07.073

VOLUME 36, ISSUE 2, P454-461, FEBRUARY 01, 2021

Patient satisfaction has become an important metric for total joint arthroplasty (TJA) used to reimburse hospitals. Despite ubiquitous narcotic use for post-TJA pain control, there is little understanding regarding patient factors associated with obtaining opioid refills and associations with patient satisfaction.

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Routine Basic Metabolic Panels Are Not Needed in All Patients After Primary Total Joint Arthroplasty: An Opportunity for Cost Reduction

Yash P. Chaudhry, Sandesh S. Rao, Syed A. Hasan, Julius K. Oni, Harpal S. Khanuja, Robert S. Sterling

doi : 10.1016/j.arth.2020.08.020

VOLUME 36, ISSUE 2, P462-466, FEBRUARY 01, 2021

As the incidence of total joint arthroplasty (TJA) increases, identifying methods for cost reduction is essential. Basic metabolic panels (BMPs) are obtained routinely after TJA. We aimed at assessing the prevalence of intervention secondary to abnormal BMPs after primary TJA and at identifying predictors of the need for postoperative BMPs.

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Prevalence of Hepatitis C Virus Infection in the Veteran Population Undergoing Total Joint Arthroplasty: An Update

CDR Bennett H. Shapiro, Ramsey C. Cheung, Nicholas J. Giori

doi : 10.1016/j.arth.2020.08.023

VOLUME 36, ISSUE 2, P467-470, FEBRUARY 01, 2021

In 2012, we reported on the prevalence of hepatitis C virus (HCV) infection in Veterans Affairs (VA) patients undergoing total joint arthroplasty (TJA) at our center. In this patient population, 8.4% were antibody positive and 4.5% were viremic with HCV. In 2014, the first all-oral direct-acting antiviral treatment for hepatitis C became available. The Department of Veterans Affairs then underwent an aggressive program to eradicate hepatitis C from the veteran population. The purpose of this report is to provide updated information on the prevalence of HCV viremia among patients undergoing primary TJA at the same center.

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Patients Receiving a Primary Unicompartmental Knee Replacement Have a Higher Risk of Revision but a Lower Risk of Mortality Than Predicted Had They Received a Total Knee Replacement: Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man

Linda P. Hunt, Ashley W. Blom, Gulraj S. Matharu, Setor K. Kunutsor, Andrew D. Beswick, J. Mark Wilkinson, Michael R. Whitehouse

doi : 10.1016/j.arth.2020.08.063

VOLUME 36, ISSUE 2, P471-477.E6, FEBRUARY 01, 2021

To determine unicompartmental (UKR) and total knee replacement (TKR) revision rates, compare UKR revision rates with what they would have been had they received TKR instead, and assess subsequent re-revision and 90-day mortality rates.

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Coronal Alignment of Fixed-Bearing Unicompartmental Knee Arthroplasty Femoral Component May Affect Long-Term Clinical Outcomes

Yong Zhi Khow, Ming Han Lincoln Liow, Merrill Lee, Jerry Yongqiang Chen, Ngai Nung Lo, Seng Jin Yeo

doi : 10.1016/j.arth.2020.07.070

VOLUME 36, ISSUE 2, P478-487, FEBRUARY 01, 2021

This study aims to investigate the clinical effects of femoral component coronal alignment in a cohort of fixed-bearing unicompartmental knee arthroplasty with clinical and radiological follow-up of 10 years.

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Increased Operative Time Impacts Rates of Short-Term Complications After Unicompartmental Knee Arthroplasty

William M. Cregar, J Brett Goodloe, Yining Lu, Tad L. Gerlinger

doi : 10.1016/j.arth.2020.08.032

VOLUME 36, ISSUE 2, P488-494, FEBRUARY 01, 2021

Previous evidence has demonstrated an exacerbating effect of increased operative time on short-term complications in total joint arthroplasty. While the same relationship may be expected for unicompartmental knee arthroplasty (UKA), supporting evidence remains sparse. The purpose of this study is to determine the impact of operative time on short-term complication rates after UKA and determine a critical threshold in operative times after which complications may increase.

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Anterior Cruciate Ligament Deficiency is Not Always a Contraindication for Medial Unicompartmental Knee Arthroplasty: A Retrospective Study in Nondesigner’s Japanese Hospital

Kenichi Kikuchi, Takafumi Hiranaka, Tomoyuki Kamenaga, Yuichi Hida, Takaaki Fujishiro, Koji Okamoto

doi : 10.1016/j.arth.2020.08.024

VOLUME 36, ISSUE 2, P495-500, FEBRUARY 01, 2021

An intact anterior cruciate ligament (ACL) is thought to be prerequisite for successful unicompartmental knee arthroplasty (UKA), but recent studies reported successful midterm results of UKA in ACL-deficient (ACLD) knees. We hypothesized that ACLD is not always a contraindication for medial UKA when preoperative radiographs showed typical anteromedial knee patterns.

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The Functional Status of the ACL in Varus OA of the Knee: The Association With Varus Deformity and Coronal Tibiofemoral Subluxation

Bernhard Springer, Wenzel Waldstein, Ulrich Bechler, Anna Jungwirth-Weinberger, Reinhard Windhager, Friedrich Boettner

doi : 10.1016/j.arth.2020.08.049

VOLUME 36, ISSUE 2, P501-506, FEBRUARY 01, 2021

The present article analyzes the association of the functional anterior cruciate ligament (ACL) status and the overall varus deformity and coronal tibiofemoral subluxation (CTFS) in varus OA of the knee.

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Do Knee Osteoarthritis Patterns Affect Patient-Reported Outcomes in Total Knee Arthroplasty? Results From an International Multicenter Prospective Study With 3-Year Follow-Up

Veronique Vestergaard, Yhan E. Colon Iban, Andreas Kappel, Christopher M. Melnic, Hany Bedair, James I. Huddleston III, Charles R. Bragdon, Henrik Malchau, Anders Troelsen

doi : 10.1016/j.arth.2020.08.033

VOLUME 36, ISSUE 2, P507-513, FEBRUARY 01, 2021

The aim of this multicenter study is to answer (1) Does patellofemoral osteoarthritis (OA) affect preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) scores in total knee arthroplasty (TKA)? and (2) Do different OA patterns affect preoperative and postoperative KOOS scores in TKA?

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Does the Use of Intraoperative Pressure Sensors for Knee Balancing in Total Knee Arthroplasty Improve Clinical Outcomes? A Comparative Study With a Minimum Two-Year Follow-Up

Samuel J. MacDessi, Daniel A. Cohen, Jil A. Wood, Ashish D. Diwan, Ian A. Harris

doi : 10.1016/j.arth.2020.08.025

VOLUME 36, ISSUE 2, P514-519, FEBRUARY 01, 2021

It is undetermined whether using sensors for knee balancing in total knee arthroplasty (TKA) improves patient outcomes. The purpose of this study was to compare clinical outcomes of sensor balance (SB) with manual balance (MB) TKA with a minimum two-year follow-up.

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Progressive Tibial Bearing Sagittal Plane Conformity in Cruciate-Retaining Total Knee Arthroplasty

John B. Meding, Lindsey K. Meding, R. Michael Meneghini, Robert A. Malinzak

doi : 10.1016/j.arth.2020.08.016

VOLUME 36, ISSUE 2, P520-525, FEBRUARY 01, 2021

We hypothesized that when the posterior cruciate ligament (PCL) is found deficient at total knee arthroplasty (TKA), using an anterior-stabilized (AS) tibial insert would provide similar function and survivorship when compared to using a more traditional cruciate-retaining (CR) bearing when the (PCL) is balanced.

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Short-Term Effects of Early Postoperative Celecoxib Administration for Pain, Sleep Quality, and Range of Motion After Total Knee Arthroplasty: A Randomized Controlled Trial

Takeo Mammoto, Keiko Fujie, Noriko Taguchi, Enbo Ma, Takeru Shimizu, Koichi Hashimoto

doi : 10.1016/j.arth.2020.08.018

VOLUME 36, ISSUE 2, P526-531, FEBRUARY 01, 2021

We hypothesized that early postoperative administration of celecoxib would reduce pain scores and improve sleep quality and active range of motion after total knee arthroplasty (TKA) under general anesthesia.

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Impact of Perioperative Pain Control on Knee Range of Motion and Development of Arthrofibrosis Following Primary Total Knee Arthroplasty

Joshua R. Harmer, Cody C. Wyles, Kristin C. Mara, Nafisseh S. Warner, Robert T. Trousdale

doi : 10.1016/j.arth.2020.08.037

VOLUME 36, ISSUE 2, P532-536, FEBRUARY 01, 2021

Inadequate pain control following total knee arthroplasty (TKA) has been postulated to negatively impact knee range of motion (ROM). We sought to determine the association between perioperative pain levels and knee ROM at 3-month follow-up or need for manipulation under anesthesia (MUA).

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Interval Between Staged Bilateral Total Knee Arthroplasties Does Not Affect Early Medical or Surgical Complications

David A. Crawford, Joanne B. Adams, Jason M. Hurst, Michael J. Morris, Keith R. Berend, Adolph V. Lombardi Jr.

doi : 10.1016/j.arth.2020.07.083

VOLUME 36, ISSUE 2, P537-541, FEBRUARY 01, 2021

The purpose of this study is to evaluate early postoperative surgical and medical complications in patients undergoing staged bilateral total knee arthroplasty (TKA) and determine if the interval to the second stage influences the risk of complications.

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The Association of Calcium and Vitamin D Use With Implant Survival of Total Knee Arthroplasty: A Nationwide Population-Based Cohort Study

Youngho Kong, Minkyung Han, Minyoung Lee, Eun Hwa Kim, Inkyung Jung, Kwan Kyu Park

doi : 10.1016/j.arth.2020.08.003

VOLUME 36, ISSUE 2, P542-549.E3, FEBRUARY 01, 2021

Calcium and vitamin D have been regarded as beneficial nutrients for bone metabolism that may affect survival of arthroplasties. However, the relationship between their use and revision rate of knee arthroplasty has not been evaluated. Thus, we investigated an association between calcium and vitamin D use and the revision rate after primary total knee arthroplasty.

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Outcomes of Cemented Total Knee Arthroplasty for Secondary Osteonecrosis of the Knee

Krit Boontanapibul, Derek F. Amanatullah, James I. Huddleston III, William J. Maloney, Stuart B. Goodman

doi : 10.1016/j.arth.2020.08.061

VOLUME 36, ISSUE 2, P550-559, FEBRUARY 01, 2021

Secondary osteonecrosis of the knee (SOK) generally occurs in relatively young patients; at advanced stages of SOK, the only viable surgical option is total knee arthroplasty (TKA). We conducted a retrospective study to investigate implant survivorship, clinical and radiographic outcomes, and complications of contemporary cemented bicompartmental TKA with/without patellar resurfacing for SOK.

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20-Year Minimum Outcomes and Survival Rate of High-Flexion Versus Standard Total Knee Arthroplasty

Young-Hoo Kim, Jang-Won Park, Young-Soo Jang

doi : 10.1016/j.arth.2020.07.084

VOLUME 36, ISSUE 2, P560-565, FEBRUARY 01, 2021

There are conflicting reports of early and mid-term results of the high-flexion total knee arthroplasties (TKAs). The purpose of the present long-term follow-up study was to determine the long-term (minimum 20 years) clinical and radiographic and CT scan results, and the survival rates of high-flexion versus standard TKAs.

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The 22 to 25-Year Survival of Cemented and Cementless Total Knee Arthroplasty in Young Patients

Young-Hoo Kim, Jang-Won Park, Young-Soo Jang

doi : 10.1016/j.arth.2020.08.001

VOLUME 36, ISSUE 2, P566-572, FEBRUARY 01, 2021

Despite cementless total knee arthroplasties (TKAs) have potential advantages over cemented TKAs, there are conflicting results. The purpose of the present study is to determine the long-term clinical and radiographic results, the survival rate, and the prevalence of osteolysis of cemented vs cementless TKAs.

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Machine Learning Predicts the Fall Risk of Total Hip Arthroplasty Patients Based on Wearable Sensor Instrumented Performance Tests

Jennifer S. Polus, Riley A. Bloomfield, Edward M. Vasarhelyi, Brent A. Lanting, Matthew G. Teeter

doi : 10.1016/j.arth.2020.08.034

VOLUME 36, ISSUE 2, P573-578, FEBRUARY 01, 2021

The prevalence of falls affects the wellbeing of aging adults and places an economic burden on the healthcare system. Integration of wearable sensors into existing fall risk assessment tools enables objective data collection that describes the functional ability of patients. In this study, supervised machine learning was applied to sensor-derived metrics to predict the fall risk of patients following total hip arthroplasty.

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The Association Between Surgeon Age and Early Surgical Complications of Elective Total Hip Arthroplasty: Propensity-Matched Cohort Study (122,043 Patients)

Hosam E. Matar, Richard Jenkinson, Daniel Pincus, Raj Satkunasivam, J. Michael Paterson, Bheeshma Ravi

doi : 10.1016/j.arth.2020.08.040

VOLUME 36, ISSUE 2, P579-585, FEBRUARY 01, 2021

The aim of this study was to examine the relationship between surgeon age and early surgical complications following primary total hip arthroplasty (THA), within a year, in Ontario, Canada.

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Home Discharge Has Increased After Total Hip Arthroplasty, However Rates Vary Between Large Databases

David E. DeMik, Christopher N. Carender, Natalie A. Glass, John J. Callaghan, Nicholas A. Bedard

doi : 10.1016/j.arth.2020.08.039

VOLUME 36, ISSUE 2, P586-592.E1, FEBRUARY 01, 2021

There have been significant advancements in perioperative total hip arthroplasty (THA) care and it is essential to quantify efforts made to better optimize patients and improve outcomes. The purpose of this study is to assess trends in discharge destination, length of stay (LOS), reoperations, and readmissions following THA.

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Good Functional Outcomes and Low Infection Rates in Total Hip Arthroplasty in HIV-Positive Patients, Provided There Is Strict Compliance With Highly Active Antiretroviral Therapy

Shahil Rajcoomar, Riona Rajcoomar, Michael Rafferty, Dick van der Jagt, Lipalo Mokete, Jurek R.T. Pietrzak

doi : 10.1016/j.arth.2020.08.021

VOLUME 36, ISSUE 2, P593-599, FEBRUARY 01, 2021

Patients with HIV are more likely to require a total hip arthroplasty (THA) because of an increase in life expectancy and complications with HIV. The purpose of this study is to describe the mid-term outcomes of THA in HIV-positive patients and risk factors for postoperative infections and poor outcomes.

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Prior Pelvic Osteotomy Affects the Outcome of Subsequent Total Hip Arthroplasty

Steven Yacovelli, Mohammad Abdelaal, Yale Fillingham, Ryan Sutton, Rachel Madding, Javad Parvizi

doi : 10.1016/j.arth.2020.07.080

VOLUME 36, ISSUE 2, P600-604, FEBRUARY 01, 2021

Although pelvic osteotomy (PO) is an important surgical procedure that can alleviate symptoms and potentially slow progression of osteoarthritis in patients with development dysplasia of the hip, some patients eventually require conversion to total hip arthroplasty (THA). This study aimed to determine the outcome of conversion THA in patients with prior PO.

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Outcomes of Total Hip Arthroplasty After Acetabular Open Reduction and Internal Fixation in the Elderly—Acute vs Delayed Total Hip Arthroplasty

Graeme M. Nicol, Ethan B. Sanders, Paul R. Kim, Paul E. Beaulé, Wade T. Gofton, George Grammatopoulos

doi : 10.1016/j.arth.2020.08.022

VOLUME 36, ISSUE 2, P605-611, FEBRUARY 01, 2021

Optimum management for the elderly acetabular fracture remains undefined. Open reduction and internal fixation (ORIF) in this population does not allow early weight-bearing and has an increased risk of failure. This study aimed to define outcomes of total hip arthroplasty (THA) in the setting of an acetabular fracture and compared delayed THA after acetabular ORIF (ORIF delayed THA) and acute fixation and THA (ORIF acute THA).

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Metal Artifact Reduction Sequence Magnetic Resonance Imaging Abnormalities in Asymptomatic Patients With a Ceramic-on-Ceramic Total Hip Replacement

Jason M. Jennings, Gregory J. Czuczman, Roseann M. Johnson, Douglas A. Dennis

doi : 10.1016/j.arth.2020.07.082

VOLUME 36, ISSUE 2, P612-615, FEBRUARY 01, 2021

Metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) has recently gained increased utilization as a screening modality in patients with a total hip arthroplasty (THA). Fluid collections have been documented in asymptomatic patients with various bearing surfaces. The purpose of this study is to determine the frequency and types of MARS MRI-documented abnormalities in asymptomatic patients with a ceramic-on-ceramic (CoC) THA.

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Long Term Performance of an Uncemented, Proximally Hydroxyapatite Coated, Double Tapered, Titanium-Alloy Femoral Stem: Results From 1465 Hips at 10 years Minimum Follow-Up

Jamie T. Griffiths, Leonidas Roumeliotis, David W. Elson, Zakk M. Borton, Simon Cheung, Geoffrey J. Stranks

doi : 10.1016/j.arth.2020.08.013

VOLUME 36, ISSUE 2, P616-622, FEBRUARY 01, 2021

We assessed the survivorship of a proximally hydroxyapatite coated, double tapered, titanium-alloy femoral stem in a single center, at an average follow up of 12.5 years (10.1-15.8). The majority of stems were inserted as part of a Metal on Metal (MoM) Total Hip Replacement (THR).

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Paget’s Disease in Primary Total Hip Arthroplasty Is Associated With Greater In-Hospital Lengths of Stay, Costs, and Complications

Nicholas M. Hernandez, Rushabh M. Vakharia, Michael A. Mont, William A. Jiranek, Michael P. Bolognesi, Thorsten M. Seyler

doi : 10.1016/j.arth.2020.08.017

VOLUME 36, ISSUE 2, P623-629, FEBRUARY 01, 2021

There are few well-powered studies investigating the association of Paget’s disease of bone on patients undergoing primary total hip arthroplasty (THA). This study utilized a nationwide database to determine whether Paget’s patients undergoing primary THA are associated with higher rates of (1) lengths of stay (LOS); (2) costs; and (3) complications (medical/surgical and implant-related).

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Long-Term Outcomes of Total Hip Arthroplasty With Transverse Subtrochanteric Shortening Osteotomy and Modular Stem in Crowe IV Developmental Dysplasia

Chang Sun, Yu Zhang, Lin Tao Li, Hao Ding, Ting Guo, Jian Ning Zhao

doi : 10.1016/j.arth.2020.08.031

VOLUME 36, ISSUE 2, P630-635, FEBRUARY 01, 2021

The reconstruction of high dislocation related to developmental dysplasia of the hip (DDH) remains challenging for joint surgeons. The aim of this study is to evaluate the rate of union, the revision rate, functional scores, and complications in patients with Crowe IV DDH treated with total hip arthroplasty, transverse subtrochanteric shortening osteotomy, and modular stem in an average 10-year follow-up.

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Evaluation of Dislocation Risk Factors With Total Hip Arthroplasty in Developmental Hip Dysplasia Patients: A Multivariate Analysis

Cem Yetkin, Timur Yildirim, Yakup Alpay, Suleyman K. Tas, Mehmet O. Buyukkuscu, Ferdi D?rvar

doi : 10.1016/j.arth.2020.08.043

VOLUME 36, ISSUE 2, P636-640, FEBRUARY 01, 2021

This study aimed to investigate the risk factors for dislocation in patients diagnosed with developmental dysplasia of the hip (DDH) who underwent total hip arthroplasty.

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Incidence and Characteristics of Osteolysis in HXLPE THA at 16-Year Follow up in Patients 50 Years and Less

Richard D. Rames, Travis J. Hillen, Gail E. Pashos, William J. Maloney, John C. Clohisy

doi : 10.1016/j.arth.2020.08.048

VOLUME 36, ISSUE 2, P641-646, FEBRUARY 01, 2021

Young patients present a challenge for total hip arthroplasty (THA) survivorship. Highly cross-linked polyethylene (HXLPE) liners have decreased the prevalence of osteolysis; however, concerns exist regarding the biologic activity of wear particles. The purpose of this study was to determine the incidence and characteristics of osteolytic lesions in young HXLPE THA patients at an average 16-year follow up and determine the ability to detect osteolysis.

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Minimum 10-Year Follow-Up of Cementless Total Hip Arthroplasty With a 32-mm Cobalt-Chromium Head on Highly Cross-Linked Polyethylene and a Tapered, Fiber Metal Proximally Coated Femoral Stem

Yohei Naito, Masahiro Hasegawa, Shine Tone, Hiroki Wakabayashi, Akihiro Sudo

doi : 10.1016/j.arth.2020.08.055

VOLUME 36, ISSUE 2, P647-652, FEBRUARY 01, 2021

The clinical and radiographic results of cementless total hip arthroplasty using a 32-mm cobalt-chromium head on remelted highly cross-linked polyethylene (HXLPE) and a tapered, fiber metal proximally coated femoral stem were evaluated at a mean follow-up of 12 years.

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Revision Total Knee Arthroplasty in Young Patients: Higher Early Reoperation and Rerevision

Rafael Walker-Santiago, Jason D. Tegethoff, William M. Ralston, James A. Keeney

doi : 10.1016/j.arth.2020.08.052

VOLUME 36, ISSUE 2, P653-656, FEBRUARY 01, 2021

Revision total knee arthroplasty (rTKA) rates are increasing in younger patients. Few studies have assessed outcomes of initial aseptic rTKA performed for younger patients compared with traditional-aged patients.

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Trabecular Metal Cones Combined With Short Cemented Stem Allow Favorable Outcomes in Aseptic Revision Total Knee Arthroplasty

Christophe Jacquet, Fabien Ros, Sylvain Guy, Sebastien Parratte, Matthieu Ollivier, Jean-Noel Argenson

doi : 10.1016/j.arth.2020.08.058

VOLUME 36, ISSUE 2, P657-663, FEBRUARY 01, 2021

The purpose of this study was to compare the functional outcomes and implant survivorship at a minimum of 5 years of follow-up of several reconstruction techniques with or without metaphyseal cone and stems of variable length.

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Clinical Outcome of Free Latissimus Dorsi Flaps for Coverage of Soft Tissue Defects in Multiply Revised Total Knee Arthroplasties

Antony C. Raymond, Alexander D. Liddle, Abtin Alvand, James R. Donaldson, Richard W.J. Carrington, Jonathan Miles

doi : 10.1016/j.arth.2020.08.030

VOLUME 36, ISSUE 2, P664-669, FEBRUARY 01, 2021

Multiply revised total knee arthroplasties (TKAs) may present with large anterior soft tissue defects, which can be challenging to reconstruct. In the rare cases where local flaps are insufficient, we use free latissimus dorsi (LD) myocutaneous flaps to achieve soft tissue coverage. This study looked to determine implant survivorship, infection status, and patient-reported outcomes of patients undergoing simultaneous revision TKA and LD flaps in a tertiary unit.

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Patellar Rebar Augmentation in Revision Total Knee Arthroplasty

Edward J. McPherson, Sherif M. Sherif, Matthew V. Dipane, Armin Arshi

doi : 10.1016/j.arth.2020.08.057

VOLUME 36, ISSUE 2, P670-675, FEBRUARY 01, 2021

In revision total knee arthroplasty, osteolysis, mechanical abrasion, and infection may leave patellar bone stock severely attenuated with cavitary and/or segmental rim deficiencies that compromise fixation of patellar implant pegs. The purpose of this study was to retrospectively review the use of cortical “rebar” screws to augment cement fixation in revision patelloplasty.

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Total Hip Arthroplasty Revision Surgery: Impact of Morbidity on Perioperative Outcomes

Michael J. Pflüger, Dara E. Fr?mel, Andrea Meurer

doi : 10.1016/j.arth.2020.08.005

VOLUME 36, ISSUE 2, P676-681, FEBRUARY 01, 2021

Primary and revision total hip arthroplasty (THA) is increasingly performed in patients with high comorbidity burden. Its predominantly negative effects on outcomes are well understood in primary THA; however, the effects of morbidity on revision THA are unknown. Since revision procedures account for about 10% of the total surgical volume, we set out to investigate the effects of physical health status on perioperative outcomes in this setting.

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Survival Analysis of Allografting and Antiprotrusio Cage in Treating Massive Acetabular Bone Defects

Cheh-Yung Chang, Chen-Ta Wu, Husam Numan, Feng-Chi Kuo, Jun-Wen Wang, Mel S. Lee

doi : 10.1016/j.arth.2020.08.050

VOLUME 36, ISSUE 2, P682-687, FEBRUARY 01, 2021

Massive acetabular bone defects reconstructed with allografting and antiprotrusio cage in revision hip arthroplasty is less reported in the literature. We here report a series of 84 antiprotrusio cages and analyze the risk factors associated with failure.

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Automated Detection of Periprosthetic Joint Infections and Data Elements Using Natural Language Processing

Sunyang Fu, Cody C. Wyles, Douglas R. Osmon, Martha L. Carvour, Elham Sagheb, Taghi Ramazanian, Walter K. Kremers, David G. Lewallen, Daniel J. Berry, Sunghwan Sohn, Hilal Maradit Kremers

doi : 10.1016/j.arth.2020.07.076

VOLUME 36, ISSUE 2, P688-692, FEBRUARY 01, 2021

Periprosthetic joint infection (PJI) data elements are contained in both structured and unstructured documents in electronic health records and require manual data collection. The goal of this study is to develop a natural language processing (NLP) algorithm to replicate manual chart review for PJI data elements.

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Development of a Preoperative Risk Calculator for Reinfection Following Revision Surgery for Periprosthetic Joint Infection

Christian Klemt, Venkatsaiakhil Tirumala, Evan J. Smith, Anand Padmanabha, Young-Min Kwon

doi : 10.1016/j.arth.2020.08.004

VOLUME 36, ISSUE 2, P693-699, FEBRUARY 01, 2021

A recent systematic review demonstrated that reinfection rates following eradication of hip and knee periprosthetic joint infection (PJI) may be as high as 29%. This study aimed to develop a preoperative risk calculator for assessing patient’s individual risk associated with reinfection following treatment of PJI in total joint arthroplasty (TJA).

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Preoperative Allergy Testing for Patients Reporting Penicillin and Cephalosporin Allergies is Cost-Effective in Preventing Infection after Total Knee and Hip Arthroplasty

Nicholas R. Pagani, Michael A. Moverman, Richard N. Puzzitiello, Mariano E. Menendez, C. Lowry Barnes, Joseph J. Kavolus

doi : 10.1016/j.arth.2020.08.045

VOLUME 36, ISSUE 2, P700-704, FEBRUARY 01, 2021

Routine preoperative allergy testing in patients reporting penicillin and cephalosporin allergies increases the number able to receive cefazolin, which should reduce the risk of infection after total knee and hip arthroplasty (TKA/THA), but it remains unclear whether this practice is cost-effective. Using a break-even analysis, we calculated the cost-effectiveness of routine preoperative allergy testing for infection prevention in total joint arthroplasty patients reporting penicillin and cephalosporin allergies.

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Is Preoperative Identification of the Infecting Organism Essential Before Single-Stage Revision Hip Arthroplasty for Periprosthetic Infection?

Benjamin J. Greenfield, Henry Wynn Jones, Paul D. Siney, Peter R. Kay, Bodo Purbach, Tim N. Board

doi : 10.1016/j.arth.2020.08.010

VOLUME 36, ISSUE 2, P705-710, FEBRUARY 01, 2021

It is commonly stated that identification of the infecting organism is a prerequisite to single-stage revision arthroplasty of the hip for deep infection. We have performed single-stage revision in a series of patients where the organism was not identified preoperatively. The aim of this study is to investigate whether the rate of infection eradication following single-stage revision was affected by preoperative knowledge of the infecting organism.

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High Rate of Reinfection With New Bacteria Following One-Stage Exchange for Enterococcal Periprosthetic Infection of the Knee: A Single-Center Study

Markus Rossmann, Thore Minde, Mustafa Citak, Thorsten Gehrke, Nemandra A. Sandiford, Till Orla Klatte, Hussein Abdelaziz

doi : 10.1016/j.arth.2020.08.015

VOLUME 36, ISSUE 2, P711-716, FEBRUARY 01, 2021

A wide range of success rates following the surgical management of enterococcal periprosthetic joint infection (PJI) with a tendency toward worse outcomes have been reported. However, the role of 1-stage exchange remains under-investigated. Therefore, we aimed to evaluate our results after the 1-stage knee exchange for enterococcal PJI.

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Acute Renal Failure After the First Stage of a 2-Stage Exchange for Periprosthetic Joint Infection

Christoph Theil, Rouven F. Riegel, Georg Gosheger, Jan Schwarze, Tom Schmidt-Braekling, Burkhard Moellenbeck

doi : 10.1016/j.arth.2020.08.028

VOLUME 36, ISSUE 2, P717-721, FEBRUARY 01, 2021

Two-stage exchange using antibiotic-loaded spacers is a common approach in treating periprosthetic joint infections. Acute kidney injury (AKIN) can be a systemic complication of this procedure. This study investigates the prevalence of AKIN and identifies potential risk factors.

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Concomitant Hip and Knee Periprosthetic Joint Infection in Periprosthetic Fracture: Diagnostic Utility of Serum and Synovial Fluid Markers

Janna van den Kieboom, Venkatsaiakhil Tirumala, Liang Xiong, Christian Klemt, Young-Min Kwon

doi : 10.1016/j.arth.2020.08.029

VOLUME 36, ISSUE 2, P722-727, FEBRUARY 01, 2021

Diagnosing periprosthetic joint infection (PJI) in patients with a periprosthetic fracture can be challenging due to concerns regarding the reliability of commonly used serum and synovial fluid markers. This study aimed at determining the diagnostic performance of serum and synovial fluid markers for diagnosing PJI in patients with a periprosthetic fracture of a total joint arthroplasty.

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Timing of Readmissions After Elective Total Hip and Knee Arthroplasty: Does a 30-Day All-Cause Rate Capture Surgically Relevant Readmissions?

Adam M. Ali, Mark D. Loeffler, Paul Aylin, Alex Bottle

doi : 10.1016/j.arth.2020.07.085

VOLUME 36, ISSUE 2, P728-733, FEBRUARY 01, 2021

Establishing clear risk factors for complications such as urinary tract infection (UTI) after arthroplasty procedures helps guide clinical practice and provides more information to both surgeons and patients. This study aims to assess selected preoperative patient characteristics as risk factors for postoperative UTI after primary total hip and knee arthroplasties (THA and TKA).

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Preoperative Risk Factors for Postoperative Urinary Tract Infection After Primary Total Hip and Knee Arthroplasties

Austin Q. Nguyen, Michael P. Foy, Anshum Sood, Mark H. Gonzalez

doi : 10.1016/j.arth.2020.08.002

VOLUME 36, ISSUE 2, P734-738, FEBRUARY 01, 2021

Establishing clear risk factors for complications such as urinary tract infection (UTI) after arthroplasty procedures helps guide clinical practice and provides more information to both surgeons and patients. This study aims to assess selected preoperative patient characteristics as risk factors for postoperative UTI after primary total hip and knee arthroplasties (THA and TKA).

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Biomechanical Study of Patellar Component Fixation with Varying Degrees of Bone Loss

Cameron M. Beck, Brian I. Nwannunu, Kari J. Teigen, Russell A. Wagner

doi : 10.1016/j.arth.2020.08.044

VOLUME 36, ISSUE 2, P739-743, FEBRUARY 01, 2021

The decision as to whether or not to resurface the patella in revision total knee arthroplasty (TKA) is affected by the amount of patellar bone stock remaining; however, the impact of the cancellous bone status on patellar component fixation has not been studied. Therefore, we conducted a biomechanical study of patellar component fixation with varying degrees of cancellous bone loss.

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Anthropometric Measurement About the Safe Zone for Transacetabular Screw Placement in Total Hip Arthroplasty in Asian Middle-Aged Women: In Vivo Three-Dimensional Model Analysis

Jun Young Park, Hyuck Min Kwon, Woo-Suk Lee, Ick Hwan Yang, Kwan Kyu Park

doi : 10.1016/j.arth.2020.08.035

VOLUME 36, ISSUE 2, P744-751, FEBRUARY 01, 2021

Although the pelvic vascular injury caused by a transacetabular screw is rare, it is a major local complication of total hip arthroplasty. We aimed to obtain anthropometric data about the safe zone for the placement of transacetabular screws by analyzing the three-dimensional (3D) reconstruction model and determine the safe length of transacetabular screws by performing the 3D simulated surgery.

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Is Preoperative Staphylococcus aureus Screening and Decolonization Effective at Reducing Surgical Site Infection in Patients Undergoing Orthopedic Surgery? A Systematic Review and Meta-Analysis With a Special Focus on Elective Total Joint Arthroplasty

Ana I. Ribau, Jamie E. Collins, Antonia F. Chen, Ricardo J. Sousa

doi : 10.1016/j.arth.2020.08.014

VOLUME 36, ISSUE 2, P752-766.E6, FEBRUARY 01, 2021

Staphylococcus aureus is a major pathogen implicated in orthopedic infections worldwide. Preoperative decolonization has been promoted but different strategies present mixed results. Thus, the goals of this study are to determine (1) whether S aureus screening and/or decolonization is effective at reducing surgical site infection in orthopedic surgery, (2) with a special focus on elective total joint arthroplasty (TJA), and (3) which preoperative S aureus screening/treatment strategy is most cost-effective for TJA.

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Clinical and Patient-Reported Outcomes of Medial Stabilized Versus Non–Medial Stabilized Prostheses in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

Reece Tso, Justin Smith, Kenji Doma, Andrea Grant, Peter McEwen

doi : 10.1016/j.arth.2020.07.086

VOLUME 36, ISSUE 2, P767-776.E2, FEBRUARY 01, 2021

The aim of this systematic review and meta-analysis was to compare the clinical and patient-reported outcome measures (PROMs) of medial stabilized total knee arthroplasty (TKA) with non–medial stabilized TKAs.

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Perioperative Mortality After Cemented or Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures—A Systematic Review and Meta-analysis

Christopher Fenelon, Evelyn P. Murphy, Eoghan Pomeroy, Robert P. Murphy, William Curtin, Colin G. Murphy

doi : 10.1016/j.arth.2020.08.042

VOLUME 36, ISSUE 2, P777-787.E1, FEBRUARY 01, 2021

Debate surrounds the use of cemented or uncemented prostheses for the treatment of displaced femoral neck fractures (FNF). Many guidelines recommend the use of the cemented hemiarthroplasty (CHA). Proponents of CHA point out the increased re-operation rate while proponents of uncemented hemiarthroplasty (HA) highlight the increased mortality rate in the perioperative period. The aim of this study was to systematically review the literature to evaluate perioperative mortality after HA for displaced FNFs.

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Letter to the Editor on “Combined Measurement of D-Dimer and C-Reactive Protein Levels: Highly Accurate for Diagnosing Chronic Periprosthetic Joint Infection”

Tejbir S. Pannu, Jesus M. Villa, Aldo M. Riesgo, Carlos A. Higuera

doi : 10.1016/j.arth.2020.09.031

VOLUME 36, ISSUE 2, E5, FEBRUARY 01, 2021

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Response to Letter to the Editor on “Combined Measurement of D-Dimer and C-Reactive Protein Levels: Highly Accurate for Diagnosing Chronic Periprosthetic Joint Infection”

Yuelong Chen, Leilei Qin, Xuan Gong, Jiawei Wang, Wei Huang, Ning Hu

doi : 10.1016/j.arth.2020.09.036

 VOLUME 36, ISSUE 2, E6, FEBRUARY 01, 2021

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Letter to the Editor on “How Can Patients With Mobile Hips and Stiff Lumbar Spines be Identified Prior to Total Hip Arthroplasty? A Prospective Diagnostic Cohort Study”

Taro Tezuka, Lawrence D. Dorr, Russell J. Bodner

doi : 10.1016/j.arth.2020.10.017

VOLUME 36, ISSUE 2, E7-E8, FEBRUARY 01, 2021

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Response to Letter to the Editor on “How Can Patients With Mobile Hips and Stiff Lumbar Spines Be Identified Prior to Total Hip Arthroplasty? – A Prospective, Diagnostic Cohort Study”

Moritz M. Innmann, Christian Merle, Philippe Phan, Paul E. Beaulé, George Grammatopoulos

doi : 10.1016/j.arth.2020.10.022

VOLUME 36, ISSUE 2, E9-E10, FEBRUARY 01, 2021

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Letter to the Editor on “Diagnosis of Osteonecrosis of the Femoral Head: Too Little, Too Late, and Independent of Etiology”

Ali Parsa, Maryam Mirzaie, Farzad Omidi-Kashani, Amir Shahriar Ariamanesh

doi : 10.1016/j.arth.2020.09.034

VOLUME 36, ISSUE 2, E11, FEBRUARY 01, 2021

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Response to Letter to the Editor on “Diagnosis of Osteonecrosis of the Femoral Head: Too Little, Too Late, and Independent of Etiology”

Krit Boontanapibul, Joshua T. Steere, Derek F. Amanatullah, James I. Huddleston III, William J. Maloney, Stuart B. Goodman

doi : 10.1016/j.arth.2020.09.037

VOLUME 36, ISSUE 2, E12-E13, FEBRUARY 01, 2021

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Letter to the Editor on “Clinical and Radiological Results of Crowe Type 3 or 4 Dysplasia Patients Operated on With Total Hip Arthroplasty Using a Cementless Rectangular Femoral Component Without Fixating or Grafting the Transverse Osteotomy Site”

Fatih ?zden

doi : 10.1016/j.arth.2020.10.013

VOLUME 36, ISSUE 2, E14, FEBRUARY 01, 2021

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Response to Letter to the Editor on “Clinical and Radiological Results of Crowe Type 3 or 4 Dysplasia Patients Operated on With Total Hip Arthroplasty Using a Cementless Rectangular Femoral Component Without Fixating or Grafting the Transverse Osteotomy Site”

Mahmut Enes Kayaalp, Gokhan Kaynak

doi : 10.1016/j.arth.2020.10.012

VOLUME 36, ISSUE 2, E15, FEBRUARY 01, 2021

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Letter to the Editor on “Total Hip Arthroplasty After Prior Acetabular Fracture: Infection Is a Real Concern”

Tomonori Shigemura

doi : 10.1016/j.arth.2020.10.032

VOLUME 36, ISSUE 2, E16, FEBRUARY 01, 2021

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Response to Letter to the Editor on ”Total Hip Arthroplasty After Prior Acetabular Fracture: Infection Is a Real Concern”

Arash Aali Rezaie, Kier Blevins, Feng-Chih Kuo, Jorge Manrique, Camilo Restrepo, Javad Parvizi

doi : 10.1016/j.arth.2020.10.029

VOLUME 36, ISSUE 2, E17, FEBRUARY 01, 2021

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Letter to the Editor on “The Anatomical Course of the Lateral Cutaneous Nerve in Relation to the Various Skin Incisions Used for Primary and Revision Total Hip Arthroplasty With the Direct Anterior Approach”

Hannes A. Rüdiger, Michael Leunig

doi : 10.1016/j.arth.2020.09.009

VOLUME 36, ISSUE 2, E18, FEBRUARY 01, 2021

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Response to Letter to Editor on “The Anatomical Course of the Lateral Femoral Cutaneous Nerve in Relation to Various Skin Incisions Used for Primary and Revision Total Hip Arthroplasty With the Direct Anterior Approach”

Martin Thaler

doi : 10.1016/j.arth.2020.09.001

VOLUME 36, ISSUE 2, E19, FEBRUARY 01, 2021

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Conflict of Interest

doi : 10.1016/S0883-5403(20)31265-1

VOLUME 36, ISSUE 2, P788, FEBRUARY 01, 2021

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Ed board

doi : 10.1016/S0883-5403(20)31262-6

VOLUME 36, ISSUE 2, PA1, FEBRUARY 01, 2021

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Masthead

doi : 10.1016/S0883-5403(20)31263-8

VOLUME 36, ISSUE 2, PA2, FEBRUARY 01, 2021

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Table of Contents

doi : 10.1016/S0883-5403(20)31264-X

VOLUME 36, ISSUE 2, PA5-A10, FEBRUARY 01, 2021

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