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Journal of Arthroplasty

Jacob Matz, James L Howard, David J Morden, Steven J MacDonald, Matthew G Teeter, Brent A Lanting
BACKGROUND: Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA...
September 14, 2016: Journal of Arthroplasty
Satoru Tamura, Shunsaku Nishihara, Masaki Takao, Takashi Sakai, Hidenobu Miki, Nobuhiko Sugano
BACKGROUND: Functional anteversion and inclination of the cup change as the pelvic sagittal inclination (PSI) changes. The purposes of this study were to investigate the chronological changes of PSI during a 10-year follow-up period after total hip arthroplasty (THA) and to report the characteristics of patients who showed a greater than 10° change in the PSI from the supine to the standing position. METHODS: The subjects were 70 patients who were followed up for 10 years after THA...
September 9, 2016: Journal of Arthroplasty
Lauren A Beaupre, B Sharifi, D W C Johnston
BACKGROUND: This 10-year follow-up compares health-related quality of life (HRQL) and reoperations in 100 subjects who were randomized to receive posterior cruciate ligament substituting (PS) or posterior cruciate ligament retaining (CR) total knee arthroplasty. We previously reported 2-year results. METHODS: Subjects were enrolled preoperatively and randomized at surgery. Subjects completed HRQL questionnaires at all evaluation points. Subjects were re-evaluated at 2 and 10 years with reoperations determined through regional medical record review and patient report...
September 8, 2016: Journal of Arthroplasty
Shahid A Punwar, Daniel P Fick, Riaz J K Khan
BACKGROUND: Obtaining adequate exposure while maintaining the integrity of the extensor mechanism is crucial to the success of revision knee arthroplasty. This is particularly important in infected cases where staged procedures are necessary. While the use of a long, tibial tubercle osteotomy (TTO) is an established method to improve exposure, controversy still exists concerning complication rates and sequential use. METHODS: Forty-two TTOs were performed in revision knee arthroplasties between 2009 and 2015...
September 3, 2016: Journal of Arthroplasty
Abdulemir Ali, Anders Lindstrand, Martin Sundberg, Gunnar Flivik
BACKGROUND: After more than 4 decades experience of total knee arthroplasty (TKA), there is still a group of patients who are not satisfied with the outcome. In spite of the improvement of many aspects around the procedure, for unexplainable reasons, patient dissatisfaction is still approximately the same. We conducted this study to analyze correlations between preoperative psychological aspects and dissatisfaction after TKA. METHODS: A total of 186 patients were operated with a primary TKA...
September 3, 2016: Journal of Arthroplasty
Ran Schwarzkopf, Garwin Chin, Kelvin Kim, Dermot Murphy, Antonia F Chen
BACKGROUND: The incidence of hip fractures is growing with the increasing elderly population. Typically, hip fractures are treated with open reduction internal fixation, hemiarthroplasty, or total hip arthroplasty (THA). Failed hip fracture fixation is often salvaged by conversion THA. The total number of conversion THA procedures is also supplemented by its use in treating different failed surgical hip treatments such as acetabular fracture fixation, Perthes disease, slipped capital femoral epiphysis, and developmental dysplasia of the hip...
September 1, 2016: Journal of Arthroplasty
Joshua C Rozell, P Maxwell Courtney, Jonathan R Dattilo, Chia H Wu, Gwo Chin Lee
BACKGROUND: Improved pain management and early mobilization protocols have increased interest in the feasibility of short stay (<24 hours) or outpatient total hip (THA) and total knee (TKA) arthroplasty. However, concerns exist regarding patient safety and readmissions. The purposes of this study were to determine the incidence of in-hospital complications following THA/TKA, to create a model to identify comorbidities associated with the risk of developing major complications >24 hours postoperatively, and to validate this model against another consecutive series of patients...
September 1, 2016: Journal of Arthroplasty
R Carter Clement, Caitlin M Gray, Michael M Kheir, Peter B Derman, Rebecca M Speck, L Scott Levin, Lee A Fleisher
BACKGROUND: The Centers for Medicare & Medicaid Services (CMS) recently imposed penalties against hospitals with above-average 30-day readmission rates following total joint arthroplasty (TJA). Hospitals must decide whether investments in readmission prevention are worthwhile. This study examines the financial incentives associated with unplanned readmissions before and after invocation of these penalties. METHODS: Financial data were reviewed for 2028 consecutive primary TJAs performed on Medicare beneficiaries over a 2-year period at an urban academic health system...
August 31, 2016: Journal of Arthroplasty
Tze E Cheng, Jason A Wallis, Nicholas F Taylor, Chris T Holden, Paul Marks, Catherine L Smith, Michael S Armstrong, Parminder J Singh
BACKGROUND: We report a prospective randomized study comparing early clinical results between the direct anterior approach (DAA) and posterior approach (PA) in primary hip arthroplasty. METHODS: Surgeries were performed by 2 senior hip arthroplasty surgeons. Seventy-two patients with complete data were assessed preoperatively 2, 6, and 12 weeks postoperatively. The primary outcomes were the Western Ontario McMasters Arthritis Index and Oxford Hip Scores. Secondary outcome measures included the EuroQoL, 10-meter walk test, and clinical and radiographic parameters...
August 31, 2016: Journal of Arthroplasty
Jeong Lae Kim, Jong-Hoon Park, Seung-Beom Han, Il Youp Cho, Ki-Mo Jang
BACKGROUND: Blood loss occurs significantly more frequently during total hip and knee arthroplasty than among any other type of orthopedic operation, which can sometimes lead to requiring a blood transfusion. Although allogeneic blood transfusion has been identified as a risk factor for postoperative surgical-site infection following arthroplasty, results are inconclusive. The purpose of this study was to conduct a systematic meta-analysis to investigate whether having an allogeneic blood transfusion significantly increases the risk for surgical-site infection, particularly after total hip and knee arthroplasty...
August 31, 2016: Journal of Arthroplasty
Nam Y Choi, Yong In, Jae-Ho Bae, Jung-Hoon Do, Seung J Chung, In J Koh
BACKGROUND: Both rotating-platform (RP) mobile-bearing and medial-pivot (MP) fixed-bearing prostheses allow axial femorotibial rotation using a highly conforming polyethylene insert. However, limited comparative data are available between the 2 designs. This study was performed to compare the midterm clinical outcomes and patient-reported outcome measures (PROMs) of RP and MP prostheses. METHODS: We retrospectively reviewed the records of 52 total knee arthroplasties using RP mobile-bearing prosthesis and 49 total knee arthroplasties using MP fixed prosthesis with a minimum follow-up period of 5 years...
August 31, 2016: Journal of Arthroplasty
Harshvardhan Chawla, Hassan M Ghomrawi, Jelle P van der List, Ashley A Eggman, Hendrik A Zuiderbaan, Andrew D Pearle
BACKGROUND: Improved survivorship has contributed to the increased use of unicompartmental knee arthroplasty (UKA) as an alternative to total knee arthroplasty (TKA) for unicompartmental knee osteoarthritis. However, heterogeneity among cost-effectiveness analysis studies comparing UKA to TKA has prevented the derivation of discrete implant survivorship targets. The aim of this meta-analysis was to determine the age-stratified annual revision rate (ARR) threshold for UKA to become consistently cost-effective for unicompartmental knee osteoarthritis...
August 28, 2016: Journal of Arthroplasty
Monther A Gharaibeh, Gandhi N Solayar, Ian A Harris, Darren B Chen, Samuel J MacDessi
BACKGROUND: Accelerometer-based, portable navigation devices have been introduced as a less invasive and simpler technique to perform navigated surgical implantation of knee prostheses. They have been postulated to have better accuracy than conventional instruments in restoration of alignment in total knee arthroplasty. METHODS: A total of 190 patients were enrolled in this prospective, randomized controlled trial and underwent total knee arthroplasty using either the KneeAlign or conventional guides...
August 27, 2016: Journal of Arthroplasty
Ki-Mo Jang, Jong-Hee Lee, Il Youp Cho, Bong-Kyung Park, Seung-Beom Han
BACKGROUND: The purpose of this study was to assess the reliability of pre-, intra operative, and postoperative limb alignment measurements and investigate the correlation between the measurements in biplanar medial opening-wedge high tibial osteotomy. METHODS: This study enrolled 59 knees undergoing biplanar opening-wedge high tibial osteotomy for primary medial osteoarthritis with varus deformity. Preoperative and postoperative standing lower leg radiographs and intraoperative fluoroscopic images were taken...
August 27, 2016: Journal of Arthroplasty
Jun-Wen Wang, Bradley Chen, Po-Chun Lin, Shih-Hsiang Yen, Chung-Cheng Huang, Feng-Chih Kuo
BACKGROUND: Tranexamic acid (TXA) was reportedly to decrease postoperative blood loss after standard total knee arthroplasty (TKA). However, the blood-conservation effect of TXA in minimally invasive TKA, in particular, receiving a direct oral anticoagulant was unclear. The aim of the study was to investigate the efficacy of combined use of TXA and rivaroxaban on postoperative blood loss in primary minimally invasive TKA. METHODS: In a prospective, randomized, controlled trial, 198 patients were assigned to placebo (98 patients, normal saline injection) and study group (100 patients, 1g TXA intraoperative injection) during primary unilateral minimally invasive TKA...
August 27, 2016: Journal of Arthroplasty
Yusuke Osawa, Yukiharu Hasegawa, Toshiaki Okura, Daigo Morita, Naoki Ishiguro
BACKGROUND: We performed periacetabular osteotomy (PAO) combined with intertrochanteric valgus osteotomy (TVO) to obtain better congruity for patients with acetabular dysplasia and nonspherical femoral head. These patients with PAO-combined TVO demonstrate long-term progression of osteoarthritis, thereby, needing conversion to total hip arthroplasty (THA) and is difficult due to morphological changes. The objective of the present study was to investigate outcomes of patients who underwent THA after PAO-combined TVO...
August 26, 2016: Journal of Arthroplasty
J Joseph Gholson, Andrew J Pugely, Nicholas A Bedard, Kyle R Duchman, Christopher A Anthony, John J Callaghan
BACKGROUND: Postoperative discharge to a skilled nursing facility after total joint arthroplasty (TJA) is associated with increased costs, complications, and readmission. The purpose of this study was to identify the risk factors for discharge to a location other than home to build a calculator to predict discharge disposition after TJA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2011 to 2013 to identify patients who underwent primary total hip or total knee arthroplasty...
August 25, 2016: Journal of Arthroplasty
Ming Han Lincoln Liow, Kshitijkumar Agrawal, David W Anderson, Andrew A Freiberg, Harry E Rubash, Young-Min Kwon
BACKGROUND: Routine femoral head histopathology during primary total hip arthroplasty (THA) has been recently reported as a potentially useful screening tool for bone- and bone marrow-associated malignancies. However, cost-effectiveness of routine histopathology during THA remains unclear due to low prevalence of significant medical findings which alter patient management. The aim of this study was to evaluate the cost-effectiveness of routine histopathology in diagnosing unsuspected malignancy in patients undergoing primary THA...
August 24, 2016: Journal of Arthroplasty
Jelle P van der List, Harshvardhan Chawla, Jordan C Villa, Andrew D Pearle
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are both viable treatment options for medial osteoarthritis (OA). However, it remains unclear when to choose for which arthroplasty treatment. Goals of this study were therefore to (1) compare outcomes after both treatments and (2) assess which treatment has superior outcomes in different patient subgroups. METHODS: In this retrospective cohort study, 166 patients received the RESTORIS MCK Medial UKA and 63 patients the Vanguard TKA and were radiographically matched on isolated medial OA...
August 24, 2016: Journal of Arthroplasty
Kenichi Oe, Hirokazu Iida, Kohei Tsuda, Tomohisa Nakamura, Naofumi Okamoto, Yusuke Ueda
BACKGROUND: The purpose of this study was to identify the long-term durability of the Kerboull-type reinforcement device (KT plate) in acetabular reconstruction for massive bone defects, assessing the remodeling of structural bone grafts. METHODS: This study retrospectively evaluated 106 hips that underwent acetabular reconstruction using a KT plate between November 2000 and December 2010. Thirty-eight primary total hip arthoplasties (THAs) and 68 revised THAs were performed, and the mean duration of clinical follow-up was 8 years (5-14 years)...
August 24, 2016: Journal of Arthroplasty
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