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Journal of Arthroplasty

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https://www.readbyqxmd.com/read/28185755/the-james-a-rand-young-investigator-s-award-administrative-claims-vs-surgical-registry-capturing-outcomes-in-total-joint-arthroplasty
#1
Joseph T Patterson, David Sing, Erik N Hansen, Bobby Tay, Alan Zhang
BACKGROUND: Administrative claims in total joint arthroplasty are used for observational studies and payment adjustments under the Comprehensive Care for Joint Replacement (CJR) legislation. Claims data have not been validated against prospective surgical outcome registries for primary total hip (THA) or knee arthroplasty (TKA). We hypothesized that significant differences in reported comorbidity and adverse event measures exist between administrative claims and prospective registry data relevant to payment adjudication under the CJR reimbursement model...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28202207/catastrophic-varus-collapse-of-the-tibia-in-obese-total-knee-arthroplasty
#2
Thomas K Fehring, Keith A Fehring, Lucas A Anderson, Jesse E Otero, Bryan D Springer
BACKGROUND: Mechanical complications have been underemphasized in reports on total knee arthroplasty (TKA) in obese patients. Noticing an increased prevalence of varus collapse of the tibia in obese total knee patients, we sought to determine if variability in proximal tibial cancellous bone strength played a role in failure. We attempted to define a cancellous threshold above which alternative methods of fixation should be used. METHODS: One thousand one hundred six revision TKAs from 2004-2014 identified 35 patients with varus collapse of the tibia, defined as a change in component position of >10°...
January 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28222919/specific-infectious-organisms-associated-with-poor-outcomes-in-treatment-for-hip-periprosthetic-infection
#3
Daniel J Cunningham, Joseph J Kavolus, Michael P Bolognesi, Samuel S Wellman, Thorsten M Seyler
BACKGROUND: Periprosthetic hip infection treatment remains a significant challenge for orthopedics. Some studies have suggested that methicillin resistance and gram-negative organism type are associated with increased treatment failure. The aim of this research is to determine if specific organisms were associated with poor outcomes in treatment for hip periprosthetic infection. METHODS: Records were reviewed of all patients between 2005 and 2015 who underwent treatment for infected partial or total hip arthroplasty...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28222918/receipt-of-pain-management-information-preoperatively-is-associated-with-improved-functional-gain-after-elective-total-joint-arthroplasty
#4
Celeste A Lemay, Courtland G Lewis, Jasvinder A Singh, Patricia D Franklin
BACKGROUND: Poorly controlled postoperative pain may adversely affect total joint arthroplasty (TJA) patients' outcomes and associated healthcare cost. Understanding effective pain management after surgery is important to patients, surgeons, and hospitals. We evaluated patient-reported receipt of preoperative pain management information in a national prospective cohort evaluating postoperative pain and function following elective TJA. METHODS: Preoperative and 2-week and 6-month postoperative survey data of 1609 TJA patients collected between June 2013 and December 2014 were analyzed...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28215967/leukocyte-esterase-strip-test-can-predict-subsequent-failure-following-reimplantation-in-patients-with-periprosthetic-joint-infection
#5
Michael M Kheir, Colin T Ackerman, Timothy L Tan, Andrea Benazzo, Eric H Tischler, Javad Parvizi
BACKGROUND: Leukocyte esterase (LE) strip test is an accurate marker for diagnosing periprosthetic joint infection (PJI). This study aims to determine if LE is a good predictor of persistent infection and/or subsequent failure in patients undergoing reimplantation. METHODS: This single-institution study prospectively recruited and retrospectively analyzed 109 patients who underwent two-stage exchange treatment of PJI, from 2009-2016, and had an LE test performed at time of reimplantation...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28215966/does-patient-perception-differ-following-adductor-canal-block-and-femoral-nerve-block-in-total-knee-arthroplasty-a-simultaneous-bilateral-randomized-study
#6
Hyun J Koh, In J Koh, Man S Kim, Keun Y Choi, Hyeon U Jo, Yong In
BACKGROUND: Femoral nerve block (FNB) has been used as part of the multimodal analgesia after total knee arthroplasty (TKA), but leads to weakness in the quadriceps muscles. Recently, adductor canal block (ACB) was reported to provide effective pain relief while sparing the strength of the quadriceps. This simultaneous bilateral randomized study investigated whether patients perceived differences between ACB and the FNB after same-day bilateral TKA. METHODS: We performed a prospective simultaneous bilateral randomized study in 50 patients scheduled to undergo same-day bilateral TKA...
January 26, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28215968/unicompartmental-knee-arthroplasty-vs-total-knee-arthroplasty-for-medial-compartment-arthritis-in-patients-older-than-75-years-comparable-reoperation-revision-and-complication-rates
#7
Homayoun Siman, Atul F Kamath, Nazly Carrillo, William S Harmsen, Mark W Pagnano, Rafael J Sierra
BACKGROUND: Prior studies comparing unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) in the elderly are limited by heterogeneity in arthritic disease patterns and patient selection. We report the results of UKA and TKA in patients 75 years and older with isolated medial compartmental arthritis, with special emphasis on immediate postoperative recovery, complications, reoperation rates, and implant survivorship at midterm follow-up. METHODS: A retrospective review was performed of all patients 75 years and older who underwent UKA or TKA at our institution between 2002 and 2012...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#8
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214256/is-there-a-threshold-value-of-hemoglobin-a1c-that-predicts-risk-of-infection-following-primary-total-hip-arthroplasty
#9
Jourdan M Cancienne, Brian C Werner, James A Browne
BACKGROUND: There remains little evidence to support a perioperative hemoglobin A1c (HbA1c) level that could serve as a threshold for a significantly increased risk of deep postoperative infection in patients with diabetes mellitus (DM) following total hip arthroplasty (THA). METHODS: A national administrative database was queried for patients who underwent primary THA with DM. Patients with an HbA1c level within 3 months of surgery were identified and were stratified based on HbA1c level in 0...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#10
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28202208/survivorship-analysis-of-eighty-revised-hip-arthroplasties-with-the-impaction-grafting-technique-using-whole-femoral-head-allografts-with-the-articular-cartilage
#11
Ahmed Fadulelmola, Efstathios Drampalos, John Hodgkinson, Mukesh Hemmady
BACKGROUND: Acetabular impaction bone grafting aims to restore anatomy in hip revision surgery. This is an effective but expensive and time-consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. We aimed to reproduce the same results retaining the cartilage of the allograft. METHODS: Eighty acetabular revisions using impacted morselized bone graft retaining the articular cartilage and a cemented cup were studied retrospectively...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209401/the-effect-of-prophylactic-cerclage-wires-in-primary-total-hip-arthroplasty-a-biomechanical-study
#12
Andrew C Waligora, John R Owen, Jennifer S Wayne, Shane R Hess, Gregory J Golladay, William A Jiranek
BACKGROUND: Despite literature to support the use of various cerclage techniques to address intraoperative femoral fractures in total hip arthroplasty, there are limited data to support prophylactic cerclage wiring of the femur during cementless implant placement. This study aims to evaluate the effect of prophylactic calcar cerclage wires on the biomechanical parameters required to produce periprosthetic femoral fractures and on the morphology of these fracture patterns in stable cementless femoral implants...
January 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209274/long-term-durability-of-ceramic-tri-condylar-knee-implants-a-minimum-15-year-follow-up
#13
Shinichiro Nakamura, Hiromu Ito, Kenji Nakamura, Shinichi Kuriyama, Moritoshi Furu, Shuichi Matsuda
BACKGROUND: Ceramic bearings are not commonly used in total knee arthroplasty (TKA). So far, little information is available about whether long-term survivorship and good clinical outcomes can be ensured with ceramic knee implants. The purposes of the present study were to evaluate the clinical and radiological outcomes, and to assess the long-term durability of a ceramic tri-condylar implant. METHODS: A total of 507 consecutive TKAs were carried out using a ceramic tri-condylar femoral implant...
January 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209272/midterm-clinical-and-radiographic-results-of-mobile-bearing-revision-total-knee-arthroplasty
#14
Raymond H Kim, J Ryan Martin, Douglas A Dennis, Charlie C Yang, Jason M Jennings, Gwo-Chin Lee
BACKGROUND: Constrained implants are frequently required in revision total knee arthroplasty (TKA) and are associated with an increase in aseptic component loosening and damage or wear to the constraining mechanisms, compared with primary TKA. The purpose of the following study was to evaluate the midterm clinical and radiographic results including the incidence of bearing complications in a group of patients undergoing revision TKA using mobile-bearing revision TKA implants. METHODS: We retrospectively reviewed 316 consecutive mobile-bearing revision TKAs performed at 2 centers between 2006 and 2010...
January 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209277/revision-arthroplasty-for-the-management-of-stiffness-after-primary-tka
#15
Joaquin Moya-Angeler, Marcel A Bas, H John Cooper, Matthew S Hepinstall, Jose A Rodriguez, Giles R Scuderi
BACKGROUND: The aim of this study was to evaluate the results of revision surgery for the treatment of stiffness after total knee arthroplasty (TKA). METHODS: An IRB-approved retrospective review was performed to identify patients who were revised due to stiffness after a primary TKA. Patients were included when at least one major component had to be revised due to stiffness after primary TKA with a minimum follow-up of 2 years. Patients with history of previous infection and those treated with isolated polyethylene exchange were excluded...
January 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28111122/corrigendum-to-factors-affecting-readmission-cost-after-primary-total-knee-arthroplasty-in-michigan-journal-of-arthroplasty-2016-1179-1182
#16
(no author information available yet)
No abstract text is available yet for this article.
January 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209276/the-aahks-clinical-research-award-what-are-the-costs-of-knee-osteoarthritis-in-the-year-prior-to-total-knee-arthroplasty
#17
Nicholas A Bedard, Spencer B Dowdle, Christopher A Anthony, David E DeMik, Michael A McHugh, Kevin J Bozic, John J Callaghan
BACKGROUND: Despite American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPGs) related to the non-arthroplasty management of osteoarthritis (OA) of the knee, non-recommended treatments remain in common use. We sought to determine the costs associated with non-arthroplasty management of knee OA in the year prior to total knee arthroplasty (TKA) and stratify them by CPG recommendation status. METHODS: The Humana database was reviewed from 2007 to 2015 for primary TKA patients...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28196619/development-and-verification-of-novel-porous-titanium-metaphyseal-cones-for-revision-total-knee-arthroplasty
#18
Ahmad Faizan, Manoshi Bhowmik-Stoker, Amanda E Kirk, Viktor E Krebs, Steven F Harwin, R Michael Meneghini
BACKGROUND: Porous metaphyseal cones are widely used in revision knee arthroplasty. A new system of porous titanium metaphyseal cones has been designed based on the femoral and tibial morphology derived from a computed tomography-based anatomical database. The purpose of this study is to evaluate the initial mechanical stability of the new porous titanium revision cone system by measuring the micromotion under physiologic loading compared with a widely-used existing porous tantalum metaphyseal cone system...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28189440/do-press-ganey-scores-correlate-with-total-knee-arthroplasty-specific-outcome-questionnaires-in-postsurgical-patients
#19
Morad Chughtai, Nirav K Patel, Chukwuweike U Gwam, Anton Khlopas, Peter M Bonutti, Ronald E Delanois, Michael A Mont
BACKGROUND: The purpose of this study was to assess whether Center for Medicaid and Medicare services-implemented satisfaction (Press Ganey [PG]) survey results correlate with established total knee arthroplasty (TKA) assessment tools. METHODS: Data from 736 patients who underwent TKA and received a PG survey between November 2009 and January 2015 were analyzed. The PG survey overall hospital rating scores were correlated with standardized validated outcome assessment tools for TKA (Short form-12 and 36 Health Survey; Knee Society Score; Western Ontario and McMaster Universities Arthritis Index; University of California, Los Angeles; and visual analog scale) at a mean follow-up of 1154 days post-TKA...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214254/normothermia-in-arthroplasty
#20
REVIEW
Mark W Allen, David J Jacofsky
Since the initial design of surgical theaters, the thermal environment of the operating suite itself has been an area of concern and robust discussion. In the 1950s, correspondence in the British Medical Journal discussed the most suitable design for a surgeon's cap to prevent sweat from dripping onto the surgical field. These deliberations stimulated questions about the effects of sweat-provoking environments on the efficiency of the surgical team, not to mention the effects on the patient. Although these benefits translate to implant-based orthopedic surgery, they remain poorly understood and, at times, ignored...
January 17, 2017: Journal of Arthroplasty
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