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Journal of Arthroplasty

Thomas Zumbrunn, Rajan Patel, Michael P Duffy, Harry E Rubash, Henrik Malchau, Andrew A Freiberg, Orhun K Muratoglu, Kartik M Varadarajan
BACKGROUND: Joint dislocation is a major cause of failure in total hip arthroplasty. Dual-mobility implants provide a femoral head diameter that can match the native hip size for greater stability against dislocation. However, such large heads are prone to impingement against surrounding soft tissues. To address this concern, the concept of an anatomically contoured dual-mobility implant was evaluated using cadaver-specific finite-element analysis (FEA). METHODS: The stiffness of 10 iliopsoas tendons was measured and also 3D bone models, contact pressure, and iliopsoas tendon stress were evaluated for 2 implant designs according to a previous cadaveric experiment...
June 30, 2018: Journal of Arthroplasty
Jennifer I Etcheson, Chukwuweike U Gwam, Nicole E George, Alexander T Caughran, Michael A Mont, Ronald E Delanois
BACKGROUND: With legislative efforts aimed at optimizing value of care, surgeons performing total knee arthroplasty (TKA) are faced with increased responsibility of optimizing patient perception of care. However, pain after TKA may negatively influence patient perception of care, as measured by Press Ganey (PG) patient satisfaction surveys. While opioid-based medications are best suited for acute pain alleviation, awareness of a growing opioid epidemic has spurred efforts to reduce its administration...
June 30, 2018: Journal of Arthroplasty
Hannah Groff, Ibrahim Azboy, Javad Parvizi
BACKGROUND: There are numerous studies discussing thromboprophylaxis after total joint arthroplasty (TJA), with varying conclusions. Patient inclusion criteria may be different for each study, which may lead to selection bias and misrepresentation of data. This study aimed to investigate if industry funding impacted patient demographics and overall reported outcomes of studies analyzing venous thromboembolism (VTE) prevention after TJA. METHODS: Electronic searches were completed using Ovid, PubMed, and Embase databases...
June 28, 2018: Journal of Arthroplasty
Andrea Marcovigi, Luigi Ciampalini, Piergiuseppe Perazzini, Patrizio Caldora, Gianluca Grandi, Fabio Catani
BACKGROUND: Combined anteversion in total hip arthroplasty influences both dislocation risk and range of motion. One of its components, stem version (SV), could be dictated by many factors, from native femoral anatomy to stem geometry and surgeon's choice. In the present multicenter study, robotic technology was used to assess the influence of native femoral version on final SV and combined anteversion using a straight, uncemented stem. METHODS: Three hundred sixty-two patients undergoing total hip arthroplasty were enrolled from 3 different orthopedic centers from 2012 and 2016...
June 28, 2018: Journal of Arthroplasty
Mick P Kelly, Brian Darrith, Charles P Hannon, Denis Nam, P Maxwell Courtney, Craig J Della Valle
BACKGROUND: Synovial fluid alpha-defensin has shown to be a reliable diagnostic test for the diagnosis of periprosthetic joint infection (PJI), but its use in equivocal cases has yet to be established. The purpose of this study was to determine the reliability of alpha-defensin testing in patients, where the diagnosis of PJI was unclear. METHODS: A consecutive series of 41 synovial aspirations by a single surgeon that were sent for alpha-defensin testing in equivocal cases of PJI were retrospectively reviewed...
June 28, 2018: Journal of Arthroplasty
Neill Van der Walt, Lucy J Salmon, Benjamin Gooden, Matthew C Lyons, Michael O'Sullivan, Kaka Martina, Leo A Pinczewski, Justin P Roe
BACKGROUND: Commercial wrist-worn activity monitors have the potential to accurately assess activity levels and are being increasingly adopted in the general population. The aim of this study was to determine if feedback from a commercial activity monitor improves activity levels over the first 6 weeks after total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: One hundred sixty-three consecutive subjects undergoing primary TKA or THA were randomized into 2 groups...
June 28, 2018: Journal of Arthroplasty
Yale A Fillingham, Dipak B Ramkumar, David S Jevsevar, Adolph J Yates, Peter Shores, Kyle Mullen, Stefano A Bini, Henry D Clarke, Emil Schemitsch, Rebecca L Johnson, Stavros G Memtsoudis, Siraj A Sayeed, Alexander P Sah, Craig J Della Valle
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic agent commonly used to reduce blood loss in total hip arthroplasty (THA). The purpose of our study was to evaluate the efficacy of TXA in primary THA to support the combined clinical practice guidelines of the American Association of Hip and Knee Surgeons, American Academy of Orthopaedic Surgeons, Hip Society, Knee Society, and American Society of Regional Anesthesia and Pain Medicine on the use of TXA in primary total joint arthroplasty...
June 27, 2018: Journal of Arthroplasty
Chloe C Kimball, Christine I Nichols, Ryan M Nunley, Joshua G Vose, Jeffrey B Stambough
BACKGROUND: This study examined the correlation between publicly reported indicators of skilled nursing facility (SNF) quality and clinical outcomes after primary total knee arthroplasty (TKA) and total hip arthroplasty (THA). METHODS: This retrospective analysis used Medicare claims from the Centers for Medicare and Medicaid Services 100% Standard Analytic File (2014-2015) that were linked to SNF quality star ratings from the Centers for Medicare and Medicaid Services Nursing Home Compare database...
June 27, 2018: Journal of Arthroplasty
Prem N Ramkumar, Sergio M Navarro, William C Frankel, Heather S Haeberle, Ronald E Delanois, Michael A Mont
No abstract text is available yet for this article.
June 27, 2018: Journal of Arthroplasty
Karsten Keller, Lukas Hobohm, Martin Engelhardt
BACKGROUND: Atrial fibrillation/flutter (AF) is associated with increased mortality, thromboembolism, heart failure, and adverse perioperative outcomes. We aimed to investigate the impact of AF on adverse in-hospital outcomes of hospitalized patients who underwent knee endoprothetic surgery (KES). METHODS: The nationwide German inpatient sample of the years 2005-2015 was used for this analysis. Patients who underwent KES were identified based on the surgical and interventional procedural codes (surgery and procedure code [Operationen-und Prozedurenschl├╝ssel] 5-822), and patients were further stratified by AF (International Classification of Diseases and Related Health Problems code I48)...
June 26, 2018: Journal of Arthroplasty
Bryon J X Teo, Hwei-Chi Chong, William Yeo, Andrew H C Tan
BACKGROUND: Diabetes is implicated with poorer outcomes and more complications after total knee arthroplasty (TKA). We aim to determine whether diabetes affects infection risk, functional outcomes, patient-reported outcome measures, and patient satisfaction in Asian patients after TKA. METHODS: Prospectively collected data for 905 patients who underwent unilateral TKA by a single surgeon from February 2004 to July 2014 were reviewed, of which 123 (13.6%) patients suffered from diabetes...
June 23, 2018: Journal of Arthroplasty
Andrew J Luzzi, Meredith P Crizer, Andrew N Fleischman, Carol Foltz, Javad Parvizi
BACKGROUND: With the recent implementation of a bundled payment model for total joint arthroplasty, healthcare providers are financially responsible for management of complications throughout the 90-day perioperative period. Our aim was to assess the effectiveness of a surveillance system that was implemented to enhance communication during this period. METHODS: A retrospective study was conducted using a prospectively collected database of patients who underwent primary total joint arthroplasty from January 2015 to April 2016...
June 20, 2018: Journal of Arthroplasty
Anju Yadav, Pouya Alijanipour, Colin T Ackerman, Siddharth Karanth, William J Hozack, Edward J Filippone
BACKGROUND: Acute kidney injury (AKI) can complicate primary total joint arthroplasty (TJA) of the hip and knee, although the incidence of AKI following revision TJA including prosthetic joint infection (PJI) is poorly defined. We assessed the incidence and risk factors for AKI following revision TJA including surgical treatment of PJI with placement of an antibiotic-loaded cement (ALC) spacer. METHODS: We retrospectively reviewed 3218 consecutive failed TJAs. Patients with aseptic failure were compared to those with PJI...
June 20, 2018: Journal of Arthroplasty
James A Kennedy, Gulraj S Matharu, Thomas W Hamilton, Stephen J Mellon, David W Murray
BACKGROUND: National joint registries report increasing revision rates with decreasing patient age for all types of joint arthroplasty. This study aimed to explore the effect of age on function and revision risk in patients undergoing medial meniscal-bearing UKA. METHODS: A prospectively followed cohort of 1000 consecutive medial meniscal-bearing UKAs at a designer center was analyzed. All knees were implanted for recommended indications and had mean 10-year follow-up...
June 20, 2018: Journal of Arthroplasty
Evan R Deckard, Khalid A Azzam, R Michael Meneghini
No abstract text is available yet for this article.
June 19, 2018: Journal of Arthroplasty
Bertrand Boyer, Thomas Neri, Jean Geringer, Antoine Lamotte, Remi Philippot, Frederic Farizon
No abstract text is available yet for this article.
June 19, 2018: Journal of Arthroplasty
Sachiyuki Tsukada, Kenji Kurosaka, Masahiro Nishino, Naoyuki Hirasawa
BACKGROUND: Anterolateral skin incision can preserve the skin sensory of the anterior aspect of the knee and may improve kneeling ability after total knee arthroplasty (TKA). METHODS: This is a prospective, 2-arm, parallel-group, randomized, controlled trial involving patients scheduled for TKA. A total of 118 patients (162 knees) were randomly assigned to receive anterolateral skin incision or anteromedial skin incision with 1:1 treatment allocation. The surgical techniques other than skin incision were identical in both groups...
June 19, 2018: Journal of Arthroplasty
Lane Koenig, Chaoling Feng, Fang He, Jennifer T Nguyen
BACKGROUND: After the first year in the Comprehensive Care for Joint Replacement (CJR) model, hospitals must repay Medicare for spending above a target price. Hospitals are incentivized to reduce spending in a 90-day episode and generate internal cost savings through, for example, the use of lower-cost implants. METHODS: We used a Markov model to compare quality-adjusted life-years and lifetime costs of total hip arthroplasty, under Medicare fee-for-service (baseline) and under alternative revision rate assumptions (prospective CJR scenarios)...
June 18, 2018: Journal of Arthroplasty
Brian F Mayeda, Jonathan G Haw, Andrew K Battenberg, Thomas P Schmalzried
BACKGROUND: Cross-linked polyethylene (XLPE) has generally low rates of wear and osteolysis at 10 years, but component position may become important with longer follow-up. At 5-13 years, neither acetabular component lateral opening angle nor version were significantly correlated to wear. In the present study, we analyzed the effects of femoral anteversion and combined anteversion on XLPE wear. METHODS: Forty-two well-functioning primary total hip arthroplasties in 36 patients, performed by a single surgeon via a posterior approach, were followed for a minimum of 5 years (mean, 7...
June 13, 2018: Journal of Arthroplasty
Javahir A Pachore, Chaitanya T Waghchoure, Aditya R Daftary
BACKGROUND: Femoroacetabular impingement (FAI) is an overlooked entity in India, as primary osteoarthritis of hip is uncommon in Indian population. The purpose of this study is to find out the prevalence of radiographic morphology of FAI in young asymptomatic population in India. METHODS: This is a multicenter, cross-sectional study. Radiographs of 500 young asymptomatic volunteers were taken from 10 centers across India. Suboptimal imaging lead to exclusion of 48 radiographs...
June 12, 2018: Journal of Arthroplasty
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