Journal of Arthroplasty




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Time Required for Planned and Unplanned Episodes of Care in Primary Total Joint Arthroplasty: Has Anything Changed With a Growth in Outpatient Arthroplasty?

Andrew N. Vega,Mary Ziemba-Davis,Shelly A. Hicks,R. Michael Meneghini,Leonard T. Buller

doi : 10.1016/j.arth.2020.10.015

HEALTH POLICY & ECONOMICS| VOLUME 36, ISSUE 4, P1195-1203, APRIL 01, 2021

This study sought to determine the total amount of time committed to planned and unplanned episodes of care related to primary, unilateral total joint arthroplasty (TJA), relative to a growth in outpatient TJA.

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From Winners to Losers: The Methodology of Bundled Payments for Care Improvement Advanced Disincentivizes Participation in Bundled Payment Programs

Chad A. Krueger,Michael Yayac,Chris Vannello,John Wilsman,Matthew S. Austin,P. Maxwell Courtney

doi : 10.1016/j.arth.2020.10.034

HEALTH POLICY & ECONOMICS| VOLUME 36, ISSUE 4, P1204-1211, APRIL 01, 2021

The Bundled Payments for Care Improvement (BPCI) initiative improved quality and reduced costs following total hip (THA) and knee arthroplasty (TKA). In October 2018, the BPCI-Advanced program was implemented. The purpose of this study is to compare the quality metrics and performance between our institution’s participation in the BPCI program with the BPCI-Advanced initiative.

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A Preoperative Risk Prediction Tool for Discharge to a Skilled Nursing or Rehabilitation Facility After Total Joint Arthroplasty

Daniel E. Goltz,Sean P. Ryan,David E. Attarian,William A. Jiranek,Michael P. Bolognesi,Thorsten M. Seyler

doi : 10.1016/j.arth.2020.10.038

HEALTH POLICY & ECONOMICS| VOLUME 36, ISSUE 4, P1212-1219, APRIL 01, 2021

Discharge to rehabilitation or a skilled nursing facility (SNF) after total joint arthroplasty remains a primary driver of cost excess for bundled payments. An accurate preoperative risk prediction tool would help providers and health systems identify and modulate perioperative care for higher risk individuals and serve as a vital tool in preoperative clinic as part of shared decision-making regarding the risks/benefits of surgery.

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Reference Pricing Reduces Total Knee Implant Costs

Christopher J. Fang,Jonathan M. Shaker,Geoffrey E. Stoker,Andrew Jawa,David A. Mattingly,Eric L. Smith

doi : 10.1016/j.arth.2020.10.014

HEALTH POLICY & ECONOMICS| VOLUME 36, ISSUE 4, P1220-1223, APRIL 01, 2021

Reference pricing establishes a set price a hospital is willing to pay for total knee arthroplasty (TKA) components regardless of vendor. The hospital contracts with vendors that sell implants to the hospital at the hospital-dictated prices. Orthopedic surgeons are free to utilize any implant system that has met the reference price using their best clinical judgment. Our hypothesis is that vendors will meet the set price and selection of different vendors and technologies will not change.

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Modern Internet Search Analytics and Total Joint Arthroplasty: What Are Patients Asking and Reading Online?

Tony S. Shen,Daniel A. Driscoll,Wasif Islam,Patawut Bovonratwet,Steven B. Haas,Edwin P. Su

doi : 10.1016/j.arth.2020.10.024

PRIMARY HIP & KNEE ARTHROPLASTY| VOLUME 36, ISSUE 4, P1224-1231, APRIL 01, 2021

Patients considering total joint arthroplasty often search for information online regarding surgery; however, little is known about the specific topics that patients search for and the nature of the information provided. Google compiles frequently asked questions associated with a search term using machine learning and natural language processing. Links to individual websites are provided to answer each question. Analysis of this data may help improve understanding of patient concerns and inform more effective counseling.

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What Goes Bump in the Night: An Evaluation of Emergency Department Visits Following Total Joint Arthroplasty

Naomi Maldonado-Rodriguez,Rajiv Gandhi,Kala Sundararajan,Y. Raja Rampersaud,Nizar Mahomed,Timothy S. Leroux

doi : 10.1016/j.arth.2020.10.048

PRIMARY HIP & KNEE ARTHROPLASTY| VOLUME 36, ISSUE 4, P1232-1238, APRIL 01, 2021

Interest in postoperative healthcare utilization has increased following the implementation of episode-of-care funding for elective orthopedic surgery. Most efforts have focused on readmission; however, little has been reported on emergency department (ED) presentation. We analyzed elective, primary total hip or knee arthroplasty (THA and TKA) cases to determine the rate, reasons, risk factors, timing, and hospital cost associated with 30-day ED presentations.

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A Comparison of the Surgical Practice of Potential Revision Outlier Joint Replacement Surgeons With Non-outliers: A Case Control Study From the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man

Chris M. Penfold,Michael R. Whitehouse,Adrian Sayers,Yoav Ben-Shlomo,Andrew Judge,Ashley W. Blom

doi : 10.1016/j.arth.2020.10.026

PRIMARY HIP & KNEE ARTHROPLASTY| VOLUME 36, ISSUE 4, P1239-1245.E6, APRIL 01, 2021

The National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) has monitored the performance of consultant surgeons performing primary total hip (THR) or knee replacements (KR) since 2007. The aims of this study were: 1) To describe the surgical practice of consultant hip and knee replacement surgeons in the National Joint Registry for England and Wales (NJR), stratified by potential outlier status for revisions. 2) To compare the practice of revision outlier and non-outlier surgeons.

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A Fall Within 3 Months Before Total Joint Arthroplasty is Associated With Adverse Outcomes in Elderly Patients

Yash P. Chaudhry,Varun Puvanesarajah,Julius K. Oni,Robert S. Sterling,Harpal S. Khanuja

doi : 10.1016/j.arth.2020.10.025

PRIMARY HIP & KNEE ARTHROPLASTY| VOLUME 36, ISSUE 4, P1246-1250, APRIL 01, 2021

Falls are associated with morbidity and death in the elderly. The consequences of falls after total joint arthroplasty (TJA) are known, but the consequences of preoperative falls are unclear. We assessed associations between preoperative fall history and hospital readmission rates and discharge disposition after primary TJA.

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Are Patients More Susceptible to Viral Illness Immediately Following Hip and Knee Arthroplasty? An Analysis of Influenza Diagnoses Using Multiple Administrative Databases

Nicole D. Quinlan,Brian C. Werner,Wendy M. Novicoff,James A. Browne

doi : 10.1016/j.arth.2020.10.045

PRIMARY HIP & KNEE ARTHROPLASTY| VOLUME 36, ISSUE 4, P1251-1256.E5, APRIL 01, 2021

Elective surgery elicits a systemic immune response and may result in transient immunosuppression in certain patients. It is currently unknown whether patients are at increased risk for viral infection and associated illness in the immediate postoperative period following total joint arthroplasty (TJA).

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Routine Postoperative Complete Blood Counts Are Not Necessary After Most Primary Total Hip and Knee Arthroplasties

Alex K. Gilde,Katheryne L. Downes,Sherri Leverett,Michael A. Miranda

doi : 10.1016/j.arth.2020.10.047

PRIMARY HIP & KNEE ARTHROPLASTY| VOLUME 36, ISSUE 4, P1257-1261, APRIL 01, 2021

Routine postoperative complete blood count tests are commonplace after total joint arthroplasty. The goal of this study was to identify if these result in any clinically meaningful action and if it would be safe to forego this testing in a population without known risk factors for transfusion.

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Leg-Length Change After Unilateral Unicompartmental Knee Arthroplasty in Varus Knee and Its Clinical Implications

F.C. Zhao,L. Zheng,Z.G. Hui,S.Z. Xu,L. Liu,Y. Lu

doi : 10.1016/j.arth.2020.10.041

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1262-1268.E1, APRIL 01, 2021

To explore the magnitude of leg-length change after the unilateral index unicompartmental knee arthroplasty (UKA) in varus knee and its influence on clinical outcomes.

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Long-Term Functional Outcomes and Quality of Life at Minimum 10-Year Follow-Up After Fixed-Bearing Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty for Isolated Medial Compartment Osteoarthritis

Marcus Wei Ping Tan,Stacy Wei Ling Ng,Jerry Yongqiang Chen,Ming Han Lincoln Liow,Ngai Nung Lo,Seng Jin Yeo

doi : 10.1016/j.arth.2020.10.049

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1269-1276, APRIL 01, 2021

The aim of this study is to compare the long-term functional outcome and quality of life between total knee arthroplasty (TKA) and fixed-bearing unicompartmental knee arthroplasty (UKA) for the treatment of isolated medial compartment osteoarthritis.

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Patient-Reported Mental Health Score Influences Physical Function After Primary Total Knee Arthroplasty

Christopher M. Melnic,Aris Paschalidis,Akhil Katakam,Hany S. Bedair,Marilyn HengMGB Arthroplasty Patient-Reported Outcomes Writing Committee

doi : 10.1016/j.arth.2020.10.031

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1277-1283, APRIL 01, 2021

Despite the effectiveness of total knee arthroplasty (TKA), patients often have lingering pain and dysfunction. Recent studies have raised concerns that preoperative mental health may negatively affect outcomes after TKA. The primary aim of this study investigates the relationship between patient-reported mental health and postoperative physical function following TKA.

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Influence of Intraoperative Medial Collateral Ligament Bony Avulsion Injury on the Outcome of Primary Total Knee Arthroplasty

Natesan Rajkumar,Dhanasekaran Soundarrajan,Palanisami Dhanasekararaja,Shanmuganathan Rajasekaran

doi : 10.1016/j.arth.2020.10.051

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1284-1294, APRIL 01, 2021

The purpose of this study is (1) to find the clinical and radiological outcome of intraoperative bony avulsion of medial collateral ligament (MCL) treated with screw and washer construct and (2) to predict the preoperative factors which may contribute to the avulsion-type MCL injury during primary total knee arthroplasty (TKA).

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Patellar Denervation Reduces Postoperative Anterior Knee Pain After Patellar Resurfacing Total Knee Arthroplasty: A Randomized Controlled Trial

Satit Thiengwittayaporn,Pitch Tangtrakul,Natthapong Hongku,Revit Tunyasuwanakul

doi : 10.1016/j.arth.2020.10.046

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1295-1301, APRIL 01, 2021

The benefit of patellar denervation (PD) in patellar resurfacing total knee arthroplasty (TKA) is still debatable. This prospective, randomized controlled trial investigated whether circumferential PD should be performed in patellar resurfacing TKA.

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Is a Titanium Implant for Total Knee Arthroplasty Better? A Randomized Controlled Study

Jong-Keun Kim,In Woong Park,Du Hyun Ro,Bong-Su Mun,Hyuk-Soo Han,Myung Chul Lee

doi : 10.1016/j.arth.2020.11.010

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1302-1309, APRIL 01, 2021

Lighter weight and lower modulus are potential advantages of titanium (Ti) implants over cobalt chrome (CoCr) implants in total knee arthroplasty (TKA). This study was conducted to determine whether Ti implants in TKA resulted in better clinical outcomes and radiologic results.

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Bilateral vs Unilateral Total Knee Arthroplasty: Racial Variation in Utilization and In-Hospital Major Complication Rates

Bella Mehta,Kaylee Ho,Jennifer Bido,Linda Russell,Susan M. Goodman,Said Ibrahim

doi : 10.1016/j.arth.2020.10.057

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1310-1317, APRIL 01, 2021

We sought to examine bilateral total knee arthroplasty (BTKA) vs unilateral TKA (UTKA) utilization and in-hospital complications comparing African Americans (AAs) and Whites.

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Simultaneous Bilateral Primary Total Knee Arthroplasty With TXA and Restrictive Transfusion Protocols: Still a 1 in 5 Risk of Allogeneic Transfusion

Brian P. Chalmers,Mithun Mishu,Yu-fen Chiu,Peter K. Sculco,Friederich Boettner,Geoffrey H. Westrich

doi : 10.1016/j.arth.2020.10.042

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1318-1321, APRIL 01, 2021

Historically, there was up to a 60% risk of blood transfusion for patients undergoing simultaneous bilateral total knee arthroplasty (SBTKA). As such, the goal of this study was to analyze the rate and risk factors for allogeneic blood transfusions in patients undergoing SBTKA with tranexamic acid (TXA).

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Impact of Postoperative Zolpidem Use on Primary Total Knee Arthroplasty: A Retrospective Matched-Controlled Analysis of a Private Insurance Database

Andrew D. Ardeljan,Teja S. Polisetty,Joseph R. Palmer,Justin J. Toma,Rushabh M. Vakharia,Martin W. Roche

doi : 10.1016/j.arth.2020.10.058

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1322-1329, APRIL 01, 2021

Zolpidem has gained popularity as a pharmaceutical therapy for insomnia, being the most prescribed hypnotic in the United States today. However, it is associated with increased mortality and morbidity. Literature regarding zolpidem use in the total knee arthroplasty (TKA) population is limited. The aim of the study was to analyze postoperative zolpidem use in the TKA population regarding medical and implant complications, falls, and readmission.

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Long-Term (Up to 27 Years) Prospective, Randomized Study of Mobile-Bearing and Fixed-Bearing Total Knee Arthroplasties in Patients <60 Years of Age With Osteoarthritis

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

doi : 10.1016/j.arth.2020.10.050

PRIMARY KNEE| VOLUME 36, ISSUE 4, P1330-1335, APRIL 01, 2021

Our study determined long-term (up to 27 years) results of fixed-bearing vs mobile-bearing total knee arthroplasties (TKAs) in patients <60 years with osteoarthritis.

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Assessment of Psychological Factors in Short-Stay Total Hip Arthroplasty Protocol

Mark A. Oyer,Adam I. Edelstein,Nathan F. Arnett,Kevin D. Hardt,David W. Manning,Michael D. Stover

doi : 10.1016/j.arth.2020.10.056

PRIMARY HIP| VOLUME 36, ISSUE 4, P1336-1341, APRIL 01, 2021

Several variables are known to correlate with the successful completion of short-stay total hip arthroplasty (THA) protocols. The role of psychological factors remains unclear. We investigated the interaction between patient-reported measures of psychological fitness and successful completion of a short-stay THA protocol.

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Impact of Obesity on the Forgotten Joint Score Following Primary Total Hip Arthroplasty

Vivek Singh,David Yeroushalmi,Katherine A. Lygrisse,Ran Schwarzkopf,Roy I. Davidovitch

doi : 10.1016/j.arth.2020.10.027

PRIMARY HIP| VOLUME 36, ISSUE 4, P1342-1347, APRIL 01, 2021

Obesity is a growing public health concern. This study aims to identify the association of body mass index (BMI) on postoperative Forgotten Joint Score-12 (FJS-12) in patients undergoing primary total hip arthroplasty (THA).

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Prior Femoroacetabular Osteoplasty Does Not Compromise the Clinical Outcome of Subsequent Total Hip Arthroplasty

Hamed Vahedi,Steven Yacovelli,Arash Aali Rezaie,George Komnos,Javad Parvizi

doi : 10.1016/j.arth.2020.10.037

PRIMARY HIP| VOLUME 36, ISSUE 4, P1348-1351, APRIL 01, 2021

Total hip arthroplasty (THA) is the most effective treatment option for patients with symptomatic osteoarthritis after a prior femoroacetabular osteoplasty (FAO). This study evaluated clinical outcomes of THA after a prior FAO and compared the results with a matched group of patients who underwent THA with no prior surgical procedures in the affected hip.

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Total Hip Arthroplasty in Adolescents and Young Adults for Management of Advanced Corticosteroid-Induced Osteonecrosis Secondary to Treatment for Hematologic Malignancies

Meredith E. Bernhard,C. Lowry Barnes,Brian M. DeFeo,Xiaoqing Wang,Zhaohua Lu,Michael D. Neel

doi : 10.1016/j.arth.2020.10.019

PRIMARY HIP| VOLUME 36, ISSUE 4, P1352-1360, APRIL 01, 2021

Osteonecrosis of the femoral head (ONFH) is a potentially severe toxicity associated with glucocorticoid treatment for pediatric hematologic malignancy. We examined clinical outcomes of THA in adolescents and young adults treated for hematologic malignancies who developed advanced ONFH.

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Compensated Cirrhosis Is Associated With Increased Risk of Complications Following Total Hip Arthroplasty in a Large Medicare Database

Sean B. Sequeira,Lawal A. Labaran,Joshua E. Bell,Raj M. Amin,Sandesh S. Rao,Brian C. Werner

doi : 10.1016/j.arth.2020.10.008

PRIMARY HIP| VOLUME 36, ISSUE 4, P1361-1366.E1, APRIL 01, 2021

The aim of this study is to evaluate medical and surgical complications of liver cirrhosis patients following total hip arthroplasty (THA), with attention to different etiologies of cirrhosis and their financial burden following THA.

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Total Hip Arthroplasty in Patients With Osteopetrosis

Matthew P. Siljander,Robert T. Trousdale,Kevin I. Perry,Tad M. Mabry,Daniel J. Berry,Matthew P. Abdel

doi : 10.1016/j.arth.2020.10.018

PRIMARY HIP| VOLUME 36, ISSUE 4, P1367-1372, APRIL 01, 2021

Osteopetrosis is an inherited bone disease associated with high risk of osteoarthritis and fracture non-union, which can lead to total hip arthroplasty (THA). Bone quality and morphology are altered in these patients, and there are limited data on results of THA in these patients. The goals of this study were to describe implant survivorship, clinical outcomes, radiographic results, and complications in patients with osteopetrosis undergoing primary THA.

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Contemporary Mortality Rate and Outcomes in Nonagenarians Undergoing Primary Total Hip Arthroplasty

Louis Dagneaux,Adam W. Amundson,Dirk R. Larson,Mark W. Pagnano,Daniel J. Berry,Matthew P. Abdel

doi : 10.1016/j.arth.2020.10.040

PRIMARY HIP| VOLUME 36, ISSUE 4, P1373-1379, APRIL 01, 2021

Nonagenarians (90-99 years) have experienced the fastest percent growth in primary THA utilization recently. However, there are limited data on this population. This study aimed to determine the mortality rate, implant survivorship, clinical outcomes, and complications of primary THAs in nonagenarians.

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Predictive Factors for Revision and Survivorship Analysis of a Prevalent 36-mm Metal-on-Metal Total Hip Replacement System: A Large Single-Center Retrospective Cohort Study

Oliver Pearce,Gulraj S. Matharu,Ben J. Bolland

doi : 10.1016/j.arth.2020.10.028

PRIMARY HIP| VOLUME 36, ISSUE 4, P1380-1387, APRIL 01, 2021

To our knowledge, this is the largest single-center cohort of the 36-mm Corail-Pinnacle metal-on-metal total hip replacements system, aiming to determine 10-year survivorship and identify predictors of revision. We further assessed year of implantation given reports of manufacturing variations affecting shells made after 2006 predisposing these components to increasing wear.

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Long-Term Survival (up to 34 Years) of Retained Cementless Anatomic Femoral Stem in Patients <50 Years Old

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

doi : 10.1016/j.arth.2020.10.055

PRIMARY HIP| VOLUME 36, ISSUE 4, P1388-1392, APRIL 01, 2021

There is a paucity of studies longer than 30 years to determine clinical and radiographic results of retained cementless anatomic stem. The purpose of this study is to determine the long-term (up to 34 years) survival rate of the retained cementless anatomic femoral stem in patients <50 years of age.

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Minority Race and Ethnicity is Associated With Higher Complication Rates After Revision Surgery for Failed Total Hip and Knee Joint Arthroplasty

Christian Klemt,Paul Walker,Anand Padmanabha,Venkatsaiakhil Tirumala,Liang Xiong,Young-Min Kwon

doi : 10.1016/j.arth.2020.10.043

REVISION ARTHROPLASTY| VOLUME 36, ISSUE 4, P1393-1400, APRIL 01, 2021

Racial and ethnic disparities in access to hip and knee total joint arthroplasty (TJA) and postoperative outcomes have wide-reaching implications for patients and the health care system. The aim of this study is to evaluate the effect of ethnicity on clinical outcomes and complications following revision hip and knee TJA.

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Migration Patterns for Revision Total Hip Arthroplasty in the United States as Reported in the American Joint Replacement Registry

Richard L. Illgen,David G. Lewallen,Patrick J. Yep,Kyle J. Mullen,Kevin J. Bozic

doi : 10.1016/j.arth.2020.10.030

REVISION ARTHROPLASTY| VOLUME 36, ISSUE 4, P1401-1406, APRIL 01, 2021

Revision total hip arthroplasty (revTHA) is associated with higher rates of complications and greater costs than primary procedures. The aim of this study is to evaluate the effect of hospital size, teaching status, and indication for revTHA, on migration patterns in patients older than 65 years old.

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Risk Factors for Dislocation and Re-revision After First-Time Revision Total Hip Arthroplasty due to Recurrent Dislocation – A Study From the Danish Hip Arthroplasty Register

Lars L. Hermansen,Bjarke Viberg,Soeren Overgaard

doi : 10.1016/j.arth.2020.10.004

REVISION ARTHROPLASTY| VOLUME 36, ISSUE 4, P1407-1412, APRIL 01, 2021

Persistent instability after hip revision is a serious problem. Our aim was to analyze surgical and patient-related risk factors for both a new dislocation and re-revision after first-time hip revision due to dislocation.

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High Incidence of Irradiated Cortical Strut Allograft Resorption Following Revision of Femoral Stems

Imran Ilyas,Omar A. Al-Mohrej

doi : 10.1016/j.arth.2020.10.023

REVISION ARTHROPLASTY| VOLUME 36, ISSUE 4, P1413-1419, APRIL 01, 2021

Despite the widespread use of revision total hip arthroplasties using cementless stems and cortical strut allografts, graft resorption has not been explicitly studied.

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Variation in Inflammatory Biomarkers Among Demographic Groups Significantly Affects Their Accuracy in Diagnosing Periprosthetic Joint Infection

Fortunato G. Padua,Michael Yayac,Javad Parvizi

doi : 10.1016/j.arth.2020.10.036

COMPLICATIONS - INFECTION| VOLUME 36, ISSUE 4, P1420-1428, APRIL 01, 2021

Diagnosis of periprosthetic joint infection (PJI) is a multistep process that involves performing various tests including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). The latter two tests, despite being used at all times for PJI diagnosis, are known to be nonspecific and substantially affected by demographic characteristics, including age, gender, race, and body mass index. It is unknown how these variations affect the diagnostic utility of serological markers for PJI.

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Periprosthetic Tibial Fractures After Total Knee Arthroplasty: Early and Long-Term Clinical Outcomes

Tejbir S. Pannu,Jesus M. Villa,Eric M. Cohen,Roman A. Hayda,Carlos A. Higuera,Matthew E. Deren

doi : 10.1016/j.arth.2020.10.035

COMPLICATIONS - OTHER| VOLUME 36, ISSUE 4, P1429-1436, APRIL 01, 2021

Although periprosthetic fractures are increasing in prevalence, evidence-based guidelines for the optimal treatment of periprosthetic tibial fractures (PTx) are lacking. Thus, the purpose of this study is to assess the clinical outcomes in PTx after a total knee arthroplasty (TKA) which were treated with different treatment options.

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Oxidized Zirconium Components Maintain a Smooth Articular Surface Except Following Hip Dislocation

Noah B. Bonnheim,Douglas W. Van Citters,Michael D. Ries,Lisa A. Pruitt

doi : 10.1016/j.arth.2020.10.054

BASIC SCIENCE| VOLUME 36, ISSUE 4, P1437-1444, APRIL 01, 2021

Oxidized zirconium (OxZr) offers theoretical advantages in total hip and knee arthroplasty (THA and TKA, respectively) relative to other biomaterials by combining the tribological benefits of ceramics with the fracture toughness of metals. Yet, some studies have found that OxZr does not improve outcomes or wear rates relative to traditional bearing materials such as cobalt-chromium (CoCr). Separately, effacement of the thin ceramic surface layer has been reported for OxZr components, though the prevalence and sequelae are unclear.

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In Vivo Knee Kinematics: How Important Are the Roles of Femoral Geometry and the Cruciate Ligaments?

Lauren A. Smith,Jarrod Nachtrab,Michael LaCour,Harold Cates,Mark G. Freeman,Richard D. Komistek

doi : 10.1016/j.arth.2020.10.020

BASIC SCIENCE| VOLUME 36, ISSUE 4, P1445-1454, APRIL 01, 2021

While posterior cruciate-retaining (PCR) implants are a more common total knee arthroplasty (TKA) design, newer bicruciate-retaining (BCR) TKAs are now being considered as an option for many patients, especially those that are younger. While PCR TKAs remove the ACL, the BCR TKA designs keep both cruciate ligaments intact, as it is believed that the resection of the ACL greatly affects the overall kinematic patterns of TKA designs. The objectives of this study are to assess the in vivo kinematics for subjects implanted with either a PCR or BCR TKA and to compare the in vivo kinematic patterns to the normal knee during flexion. These objectives were achieved with an emphasis on understanding the roles of the cruciate ligaments, as well as the role of changes in femoral geometry of nonimplanted anatomical femurs vs implanted subjects having a metal femoral component.

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Can an OA Knee Brace Effectively Offload the Medial Condyle? An In Vivo Fluoroscopic Study

Garett M. Dessinger,Michael T. LaCour,Douglas A. Dennis,Lindsay T. Kleeman-Forsthuber,Richard D. Komistek

doi : 10.1016/j.arth.2020.10.044

BASIC SCIENCE| VOLUME 36, ISSUE 4, P1455-1461, APRIL 01, 2021

Previous studies evaluating the effectiveness of OA offloading knee braces focused on qualitative results. The objective of this study was to analyze the effectiveness of an off-loading knee brace with respect to in vivo three-dimensional knee kinematics to quantitatively measure the changes in medial joint space and relative bone alignment when wearing the brace.

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The Impact of Author Financial Conflicts on Robotic-Assisted Joint Arthroplasty Research

Michael J. DeFrance,Michael F. Yayac,P. Maxwell Courtney,Matthew W. Squire

doi : 10.1016/j.arth.2020.10.033

SYSTEMATIC REVIEW AND META ANALYSIS| VOLUME 36, ISSUE 4, P1462-1469, APRIL 01, 2021

Recent studies have suggested clinical superiority with robotic-assisted arthroplasty compared to traditional techniques. However, concerns exist regarding the author’s financial conflicts of interest (COI), which may influence research outcomes. This study aimed to determine whether COI relating to robotic-assisted arthroplasty influences the results of published outcomes following total hip (THA), total knee (TKA), and unicompartmental knee arthroplasty (UKA).

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Letter to the Editor on “High Incidence of Irradiated Cortical Strut Allograft Resorption Following Revision of Femoral Stems”

Zahraa I. Alghafli,Wael A. Rahman

doi : 10.1016/j.arth.2020.11.025

LETTER TO THE EDITOR| VOLUME 36, ISSUE 4, E23, APRIL 01, 2021

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Response to Letter to the Editor on “High Incidence of Irradiated Cortical Strut Allograft Resorption Following Revision of Femoral Stems”

Imran Ilyas,Omar A. Al-Mohrej

doi : 10.1016/j.arth.2020.11.027

LETTER TO THE EDITOR| VOLUME 36, ISSUE 4, E24-E25, APRIL 01, 2021

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Letter to the Editor on “Artificial Intelligence to Identify Arthroplasty Implants From Radiographs of the Hip”

Lingtong Kong,Xianzuo Zhang,Chen Zhu

doi : 10.1016/j.arth.2020.12.043

LETTER TO THE EDITOR| VOLUME 36, ISSUE 4, E26-E27, APRIL 01, 2021

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Response to Letter to the Editor on “Artificial Intelligence to Identify Arthroplasty Implants From Radiographs of the Hip”

Jaret M. Karnuta,Heather S. Haeberle,Bryan C. Luu,Prem N. Ramkumar

doi : 10.1016/j.arth.2020.12.046

LETTER TO THE EDITOR| VOLUME 36, ISSUE 4, E28-E29, APRIL 01, 2021

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Corrigendum to ‘Risk Classification for Primary Knee Arthroplasty’ [The Journal of Arthroplasty 24 (2009) 90-95]

Yassir Babiker Al-Arabi,Sergio Vargas-Prada,Sandeep Deo

doi : 10.1016/j.arth.2020.12.024

CORRIGENDUM| VOLUME 36, ISSUE 4, P1470, APRIL 01, 2021

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Ed board

doi : 10.1016/S0883-5403(21)00177-7

EDITORIAL BOARD| VOLUME 36, ISSUE 4, PA1, APRIL 01, 2021

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Masthead

doi : 10.1016/S0883-5403(21)00178-9

MISCELLANEOUS| VOLUME 36, ISSUE 4, PA2, APRIL 01, 2021

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Table of Contents

doi : 10.1016/S0883-5403(21)00179-0

CONTENTS LIST| VOLUME 36, ISSUE 4, PA5-A8, APRIL 01, 2021

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Conflict of Interest

doi : 10.1016/S0883-5403(21)00180-7

MISCELLANEOUS| VOLUME 36, ISSUE 4, PA9, APRIL 01, 2021

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