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Journal of Arthroplasty

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https://www.readbyqxmd.com/read/28917617/change-in-acetabular-cup-orientation-from-supine-to-standing-position-and-its-effect-on-wear-of-highly-crosslinked-polyethylene
#1
Matthew G Teeter, Prateek Goyal, Xunhua Yuan, James L Howard, Brent A Lanting
BACKGROUND: The purpose of this study is to measure acetabular cup position and wear of the highly crosslinked polyethylene liner in the supine and standing position for patients at a minimum of 10 years after the operation. METHODS: A total of 38 patients were recruited at a mean of 12.5 years after the operation. All patients received a single acetabular cup design with a highly crosslinked liner and a 28-mm cobalt-chromium femoral head. Patients underwent supine and standing radiostereometric examinations in which the X-ray sources and detectors were positioned to obtain an anterior-posterior and cross-table lateral radiograph...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28917616/opioid-use-following-total-hip-arthroplasty-trends-and-risk-factors-for-prolonged-use
#2
Nicholas A Bedard, Andrew J Pugely, S Blake Dowdle, Kyle R Duchman, Natalie A Glass, John J Callaghan
BACKGROUND: The purpose of this study is to answer the following questions: (1) What is the prevalence of opioid use prior to primary total hip arthroplasty (THA)? (2) What is the typical trend in opioid use following THA over the first post-operative year? (3) What are the risk factors for prolonged opioid use following primary THA? METHODS: Primary THA patients were identified in the Humana database from 2007 to 2015. Pre-operative and post-operative opioid use was measured by monthly prescription refill rates...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28899593/radiographic-findings-in-patients-with-catastrophic-varus-collapse-after-total-knee-arthroplasty
#3
J Ryan Martin, Keith A Fehring, Chad D Watts, Bryan D Springer, Thomas K Fehring
BACKGROUND: Catastrophic varus collapse is an uncommon mechanism of failure in primary total knee arthroplasty (TKA). Varus collapse has been associated with obesity and smaller implant sizes. However, to our knowledge, preoperative radiographic characterization of this cohort has not been performed. Therefore, the following study evaluated preoperative alignment and how this correlates with the degree of eventual varus collapse identified in this patient population prior to revision...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28917619/a-chlorhexidine-solution-reduces-aerobic-organism-growth-in-operative-splash-basins-in-a-randomized-controlled-trial
#4
Kevin E Lindgren, Christopher E Pelt, Mike B Anderson, Christopher L Peters, Emily S Spivak, Jeremy M Gililland
BACKGROUND: Despite recommendations against the use of splash basins, due to the potential of bacterial contamination, our observation has been that they continue to be used in operating theaters. In hopes of decontaminating the splash basin, we sought to determine if the addition of chlorhexidine gluconate (CHG) would eliminate aerobic bacterial growth within the splash basin. METHODS: After Institutional Review Board approval, we began enrollment in a randomized controlled trial comparing 2 splash basin solutions...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28917618/gap-balancing-sacrifices-joint-line-maintenance-to-improve-gap-symmetry-5-year-follow-up-of-a-randomized-controlled-trial
#5
Sina Babazadeh, Michelle M Dowsey, Michael G Vasimalla, James D Stoney, Peter F M Choong
BACKGROUND: Gap balancing (GB) has been noted to sacrifice joint-line maintenance to improve gap symmetry. This study aims to determine whether this change affects function or quality of life in the midterm. METHODS: A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or GB (n = 51). Primary outcome measured was femoral component rotation. Secondary outcomes measured were joint-line change, gap symmetry, and function and quality-of-life outcomes...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28844633/corrigendum-to-a-comparison-of-modular-tapered-versus-modular-cylindrical-stems-for-complex-femoral-revisions-journal-of-arthroplasty-28-suppl-%C3%A2-1-2013-71-73
#6
(no author information available yet)
No abstract text is available yet for this article.
August 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28887021/improving-value-in-total-joint-arthroplasty-a-comprehensive-patient-education-and-management-program-decreases-discharge-to-post-acute-care-facilities-and-post-operative-complications
#7
Christopher E Pelt, Jeremy M Gililland, Jill A Erickson, Dory E Trimble, Mike B Anderson, Christopher L Peters
BACKGROUND: A step-by-step approach to creating a comprehensive patient education, expectation, and management program is described with the aim of reducing discharges to post-acute care centers (PACs) following total joint arthroplasty (TJA). We hypothesized that by lowering discharges to PACs, readmissions and reoperations would also decrease. METHODS: Following the implementation of a multi-faceted patient education and management program, we retrospectively reviewed 927 TJAs who underwent surgery 12 months before (n = 465) and after (n = 462) the program was implemented...
August 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#8
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28887020/narcotic-use-and-total-knee-arthroplasty
#9
Jourdan M Cancienne, Kishan J Patel, James A Browne, Brian C Werner
BACKGROUND: Although the United States is in the midst of a narcotic epidemic, risk factors for use and the impact of perioperative narcotic use on total knee arthroplasty (TKA) outcomes is ill-defined. METHODS: A national database was queried for patients who underwent primary TKA from 2007 to 2015. Patients taking narcotics in the preoperative, and for a prolonged period of time postoperatively, were identified. The risk factors for prolonged narcotic use were analyzed with a regression analysis, in addition to evaluating preoperative and prolonged postoperative use as independent risk factors for short-term and long-term complications...
August 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28887022/additive-influence-of-hip-offset-and-leg-length-reconstruction-on-postoperative-improvement-in-clinical-outcome-after-total-hip-arthroplasty
#10
Moritz M Innmann, Michael W Maier, Marcus R Streit, George Grammatopoulos, Thomas Bruckner, Tobias Gotterbarm, Christian Merle
BACKGROUND: There is a lack of prospective studies investigating the additive effect of both acetabular and femoral reconstruction parameters on the functional outcome following total hip arthroplasty (THA). METHODS: The aim of this prospective cohort study was to determine the combined influence of hip geometry reconstruction and component positioning on the clinical outcome following primary THA for unilateral osteoarthritis. We prospectively assessed the clinical outcome and radiographic parameters for hip geometry reconstruction, component position, and orientation using validated measurements for the operated hip compared to the contralateral native hip in a consecutive series of 113 patients with primary unilateral cementless THA...
August 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28870746/incidence-risk-factors-and-impact-of-clostridium-difficile-colitis-following-primary-total-hip-and-knee-arthroplasty
#11
Patawut Bovonratwet, Daniel D Bohl, Rohil Malpani, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: An improved understanding of Clostridium difficile is important as it is used as a measure of hospital quality and is associated with substantial morbidity. This study utilizes the National Surgical Quality Improvement Program to determine the incidence, timing, risk factors, and clinical implications of C difficile colitis in patients undergoing primary total hip or knee arthroplasty (THA or TKA). METHODS: Patients who underwent primary THA or TKA as part of the 2015 National Surgical Quality Improvement Program were identified...
August 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28870743/accuracy-of-cup-positioning-with-the-computed-tomography-based-two-dimensional-to-three-dimensional-matched-navigation-system-a-prospective-randomized-controlled-study
#12
Kazuki Yamada, Hirosuke Endo, Tomonori Tetsunaga, Takamasa Miyake, Tomoaki Sanki, Toshifumi Ozaki
BACKGROUND: The accuracy of various navigation systems used for total hip arthroplasty has been described, but no publications reported the accuracy of cup orientation in computed tomography (CT)-based 2D-3D (two-dimensional to three-dimensional) matched navigation. METHODS: In a prospective, randomized controlled study, 80 hips including 44 with developmental dysplasia of the hips were divided into a CT-based 2D-3D matched navigation group (2D-3D group) and a paired-point matched navigation group (PPM group)...
August 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28887023/chronic-kidney-diseases-among-patients-undergoing-elective-arthroplasty-risk-groups-and-the-value-of-serum-creatinine
#13
Pyry P Jämsä, Niku K J Oksala, Antti P Eskelinen, Esa R Jämsen
BACKGROUND: In arthroplasty clinics, we tend to evaluate patient's kidney function looking at serum creatinine (SCr), while estimated glomerular filtration rate (eGFR) is recommended. We reported the prevalence of chronic kidney disease (CKD; eGFR <60 mL/min/1.73 m(2)) in different patient groups and investigated whether CKD is missed by evaluation based on SCr. METHODS: Preoperative SCr values were used to calculate eGFR in 20,575 consecutive hip or knee arthroplasties...
August 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28870745/failed-two-stage-exchange-factors-leading-to-unachievable-endoprosthetic-reconstruction-after-multiple-revision-surgeries
#14
Kevin Staats, Christoph Boehler, Stephan Frenzel, Stephan E Puchner, Johannes Holinka, Reinhard Windhager
BACKGROUND: Information about the outcome after failed 2-stage exchange is scarce. The aim of this study is to determine possible influencing factors leading to multiple revisions, resulting in a failed endoprosthetic joint reconstruction. METHODS: Medical records of patients (15 hip and 29 knee joints) who had undergone additional revision surgeries due to a failed 2-stage exchange were reviewed concerning infection parameters, number and type of procedure(s), current state of the revised joint, and whether failure of endoprosthetic reconstruction had occurred...
August 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28870744/total-joint-arthroplasty-in-ambulatory-surgery-centers-analysis-of-disqualifying-conditions-and-the-frequency-at-which-they-occur
#15
Matthew T Kingery, Germaine E Cuff, Lorraine H Hutzler, Jovan Popovic, Roy I Davidovitch, Joseph A Bosco
BACKGROUND: The frequency of total joint arthroplasties (TJAs) performed in ambulatory surgery centers (ASCs) is increasing. However, not all TJA patients are healthy enough to safely undergo these procedures in an ambulatory setting. We examined the percentage of arthroplasty patients who would be eligible to have the procedure performed in a free-standing ASC and the distribution of comorbidities making patients ASC-ineligible. METHODS: We reviewed the charts of 3444 patients undergoing TJA and assigned ASC eligibility based on American Society of Anesthesiologists (ASA) status, a set of exclusion criteria, and any existing comorbidities...
August 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28864031/comparison-of-wound-complications-and-deep-infections-with-direct-anterior-and-posterior-approaches-in-obese-hip-arthroplasty-patients
#16
Richard L Purcell, Nancy L Parks, John P Cody, William G Hamilton
BACKGROUND: The purpose of this study was to compare the posterior approach (PA) with the direct anterior approach (DAA) among obese and nonobese total hip arthroplasty patients to determine if obese DAA patients have a higher risk of infection or wound complications compared with obese PA patients. METHODS: We retrospectively evaluated 4651 primary total hip cases performed via anterior approach or PA between 2009 and 2015. Patients were divided into 4 study groups based on approach and body mass index (BMI): (1) DAA <35 kg/m(2), (2) DAA ≥35 kg/m(2), (3) PA <35 kg/m(2), and (4) PA ≥35 kg/m(2)...
August 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28887024/are-trends-in-total-hip-arthroplasty-bearing-surface-continuing-to-change-2007-2015-usage-in-a-large-database-cohort
#17
Nicholas A Bedard, Robert A Burnett, David E DeMik, Yubo Gao, Steve S Liu, John J Callaghan
BACKGROUND: Bearing surface issues related to trunnionosis or metal-on-metal (MoM) articulations have likely impacted recent trends in bearing surface choice. The purpose of this study is to evaluate trends in total hip arthroplasty (THA) bearing surface use, including 2015 data, with respect to the date of operation and patient demographics. METHODS: The Humana dataset was reviewed from 2007 through 2015 to analyze bearing surface usage in primary THA. Four bearing surface types were identified by International Classification of Disease, 10th Revision codes and trended throughout the years: metal-on-polyethylene (MoP), ceramic-on-ceramic (CoC), ceramic-on-polyethylene (CoP), and MoM...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28869115/wound-discharge-after-pharmacological-thromboprophylaxis-in-lower-limb-arthroplasty
#18
Christopher W Jones, S Spasojevic, G Goh, Z Joseph, D J Wood, Piers J Yates
BACKGROUND: The benefits vs risk of pharmacological prophylaxis for thromboembolic disease in orthopedic patients remain controversial. Pharmacological thromboprophylaxis regimes are commonly used in this patient group. Few studies specifically examine wound complications attributable to this therapy. In this prospective trial, we investigated the effect of various regimens on postoperative wounds. METHODS: A prospective, observational, multicenter study involving patients undergoing elective hip or knee arthroplasty was undertaken...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28869114/multidrug-resistant-organisms-in-the-setting-of-periprosthetic-joint-infection-diagnosis-prevention-and-treatment
#19
REVIEW
Matthew P Siljander, Ali H Sobh, Kevin C Baker, Erin A Baker, Lige M Kaplan
BACKGROUND: Periprosthetic joint infection (PJI) is a rare yet challenging problem in total hip and knee arthroplasties. The management of PJI remains difficult primarily due to the evolution of resistance by the infecting organisms. METHODS: This review profiles acquired mechanisms of bacterial resistance and summarizes established and emerging techniques in PJI diagnosis, prevention, and treatment. RESULTS: New techniques in PJI diagnosis and prevention continue to be explored...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28847665/short-term-results-of-ultra-short-anatomic-vs-ultra-short-non-anatomic-proximal-loading-uncemented-femoral-stems
#20
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
BACKGROUND: Question arises as to whether rigid fixation of ultra-short anatomic or ultra-short non-anatomic proximal loading uncemented femoral stem can be obtained without diaphyseal stem fixation. The purpose of this study is to compare the short-term clinical results, radiographic results, revision and survival rates, and complication rates of ultra-short anatomic versus ultra-short non-anatomic uncemented femoral stems. METHODS: This study consisted of 50 patients (56 hips) in the ultra-short anatomic uncemented stem group (mean age 61...
August 3, 2017: Journal of Arthroplasty
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