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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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).
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.
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.
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.
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).
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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
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
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
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
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
doi : 10.1016/S0883-5403(21)00177-7
EDITORIAL BOARD| VOLUME 36, ISSUE 4, PA1, APRIL 01, 2021
doi : 10.1016/S0883-5403(21)00179-0
CONTENTS LIST| VOLUME 36, ISSUE 4, PA5-A8, APRIL 01, 2021
doi : 10.1016/S0883-5403(21)00180-7
MISCELLANEOUS| VOLUME 36, ISSUE 4, PA9, APRIL 01, 2021
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