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Journal of Arthroplasty

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https://www.readbyqxmd.com/read/28811109/the-risk-of-acute-infection-following-intra-articular-corticosteroid-injection-into-a-pre-existing-total-knee-arthroplasty
#1
Emily S Mills, Michael B Elman, Jared R H Foran
BACKGROUND: No previous studies have investigated the risk of infection following intra-articular corticosteroid injection (IACI) into a pre-existing total knee arthroplasty (TKA). The aim of this study is to determine the risk of acute infection following IACI into a pre-existing TKA. METHODS: A retrospective chart review identified all patients at a single institution between October 2009 and May 2015 that had an ipsilateral knee injection subsequent to a TKA...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28807469/hip-fractures-appropriate-timing-to-operative-intervention
#2
Chris A Anthony, Kyle R Duchman, Nicholas A Bedard, James J Gholson, Yubo Gao, Andrew J Pugely, John J Callaghan
BACKGROUND: The purpose of this study is to (1) identify the incidence of surgical delay in hip fractures, (2) evaluate the time point surgical delay puts patients at increased risk for complications, and (3) identify risk factors for surgical delay in the setting of surgical management of hip fractures. METHODS: A multi-center database was queried for patients of 60 years of age or older undergoing surgical treatment of a hip fracture. Surgical delay was defined by days from admission until surgical intervention...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28807468/are-revision-hip-arthroplasty-patients-at-higher-risk-for-venous-thromboembolic-events-than-primary-hip-arthroplasty-patients
#3
P Maxwell Courtney, Anthony J Boniello, Brett R Levine, Neil P Sheth, Wayne G Paprosky
BACKGROUND: The purpose of this study is to determine whether revision total hip arthroplasty (THA) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) when compared to primary THA. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database for all primary and revision THA cases from 2011 to 2014. Demographic data, medical comorbidities, and venous thromboembolic rates within 30 days of surgery were compared between the primary and revision THA groups...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803815/patient-specific-contact-stress-does-not-predict-polyethylene-wear-rate-in-a-specific-pressfit-cup
#4
Georg Matziolis, Linda Krakow, Frank Layher, Klaus Sander, Joerg Bossert, Steffen Brodt
BACKGROUND: The most common reason for revision total hip arthroplasty remains polyethylene wear. Development dysplasia of the hip and revision situations requires a conscious compromise of implant position. The surgeon should know about the consequence on wear via a possible change in hip contact force. The objective of this study is to investigate whether annual wear is dependent on hip contact force. METHODS: Forty-five inserts (DuraLoc, DePuy) that were explanted in our department were included...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802777/local-infiltration-analgesia-with-liposomal-bupivacaine-improves-pain-scores-and-reduces-opioid-use-after-total-knee-arthroplasty-results%C3%A2-of-a-randomized-controlled-trial
#5
Michael A Mont, Walter B Beaver, Stanley H Dysart, John W Barrington, Daniel J Del Gaizo
BACKGROUND: Local infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. METHODS: Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed with bupivacaine HCl 0...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28811108/methylene-blue-guided-debridement-as-an-intraoperative-adjunct-for-the-surgical-treatment-of-periprosthetic-joint-infection
#6
Jeremy D Shaw, Steve Miller, Anna Plourde, Daniel L Shaw, Rosanna Wustrack, Erik N Hansen
BACKGROUND: Current methods to identify infected tissue in periprosthetic joint infection (PJI) are inadequate. The purpose of this study was (1) to assess methylene blue-guided surgical debridement as a novel technique in PJI using quantitative microbiology and (2) to evaluate clinical success based on eradication of infection and infection-free survival. METHODS: Sixteen total knee arthroplasty patients meeting Musculoskeletal Infection Society criteria for PJI undergoing the first stage of 2-stage exchange arthroplasty were included in this prospective study...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28811107/local-efficacy-of-periarticular-morphine-injection-in-simultaneous-bilateral-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#7
Kentaro Iwakiri, Yoichi Ohta, Akio Kobayashi, Yukihide Minoda, Hiroaki Nakamura
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to reduce postoperative pain following total knee arthroplasty (TKA). Despite its analgesic effect, it frequently causes nausea, which is an adverse effect of opioids. It is inconclusive whether the intraoperative injection of periarticular morphine is effective peripherally. The aim of this study was to assess whether the addition of morphine to unilateral periarticular knee injections improves postoperative pain, range of motion, and swelling in patients undergoing simultaneous bilateral TKA...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802778/cryotherapy-treatment-after-unicompartmental-and-total-knee-arthroplasty-a-review
#8
REVIEW
Morad Chughtai, Nipun Sodhi, Michael Jawad, Jared M Newman, Anton Khlopas, Anil Bhave, Michael A Mont
BACKGROUND: Cryotherapy is widely utilized to enhance recovery after knee surgeries. However, the outcome parameters often vary between studies. Therefore, the purpose of this review is to compare (1) no cryotherapy vs cryotherapy; (2) cold pack cryotherapy vs continuous flow device cryotherapy; (3) various protocols of application of these cryotherapy methods; and (4) cost-benefit analysis in patients who had unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). METHODS: A search for "knee" and "cryotherapy" using PubMed, EBSCO Host, and SCOPUS was performed, yielding 187 initial reports...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28781017/differences-in-femoral-head-penetration-between-highly-cross-linked-polyethylene-cemented-sockets-and-uncemented-liners
#9
Daigo Morita, Taisuke Seki, Yoshitoshi Higuchi, Yasuhiko Takegami, Naoki Ishiguro
BACKGROUND: This study aimed at investigating differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets and uncemented liners during 5 years postoperatively. METHODS: Ninety-six patients (106 hips) with a mean age of 64.4 (range, 35-83) years underwent total hip arthroplasty using a HXLPE cemented socket or liner and were respectively divided into cemented (35 patients [37 hips]) and uncemented (61 patients [69 hips]) groups...
July 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28781016/blood-metal-ion-levels-have-limited-utility-in-the-surveillance-of-asymptomatic-large-head-metal-on-metal-total-hip-arthroplasties
#10
Manish Kiran, Deepak Shivarathre, Viju K Peter
BACKGROUND: Blood cobalt (Co) and chromium (Cr) ion levels have been used as surveillance tools for adverse reaction to metal debris (ARMD) in metal-on-metal (MoM) articulations with varying thresholds in different countries. The aim of our study is to present the serial 12-year blood Co and Cr levels in a cohort of MoM total hip arthroplasties (THAs) with femoral head size ≥36 mm and analyze their utility in asymptomatic patients at current thresholds. METHODS: A total of 256 patients with unilateral MoM THA with femoral head size ≥36 mm were included in this study with data collected prospectively...
July 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28811110/characterizing-the-diagnosis-and-treatment-of-allergic-contact-dermatitis-to-2-octyl-cyanoacrylate-used-for-skin-closure-in-elective-orthopedic-surgery
#11
Brian P Chalmers, Heath P Melugin, Peter K Sculco, Jennifer J Schoch, Rafael J Sierra, Mark W Pagnano, Michael J Stuart, Michael J Taunton
BACKGROUND: While studies have shown that postoperative wound complications can predispose to deep infection following orthopedic surgery, the best form of skin closure has not been elucidated. Furthermore, the unique risks and benefits of each type of wound closure have not been studied. The goal of this study is to present the diagnosis and treatment of patients with allergic contact dermatitis (ACD) from 2-octyl cyanoacrylate, a skin adhesive commonly used in wound closure. METHODS: Twenty-nine patients with ACD to 2-octyl cyanoacrylate (Prineo, Ethicon, NJ) following elective orthopedic surgeries from 2013 to 2016 were retrospectively reviewed; this occurred in 29 of 6088 units of Prineo used at our institution, for an estimated incidence of 0...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28800858/diagnostic-value-of-synovial-white-blood-cell-count-and-serum-c-reactive-protein-for-acute-periprosthetic-joint-infection-after-knee-arthroplasty
#12
Sang-Gyun Kim, Jae-Gyoon Kim, Ki-Mo Jang, Seung-Bum Han, Hong-Chul Lim, Ji-Hoon Bae
BACKGROUND: The diagnosis of periprosthetic joint infection (PJI) remains difficult, particularly in acute postoperative stage. The purpose of this study was to investigate the optimal cutoff value of synovial white blood cell (WBC) count, percentage of polymorphonuclear cells, erythrocyte sedimentation rate, and C-reactive protein (CRP) for diagnosing early postoperative infection after knee joint arthroplasty. METHODS: We retrospectively reviewed primary total knee arthroplasties and unicompartmental knee arthroplasties, with a knee aspiration within 3 weeks of surgery, from January 2006 to November 2016...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780226/cementing-constrained-liners-into-secure-cementless-shells-a%C3%A2-minimum-15-year-follow-up-study
#13
Grant H Young, Matthew P Abdel, Richard L Amendola, Devon D Goetz, David G Lewallen, John J Callaghan
BACKGROUND: The authors and others have previously described the technique of cementing constrained liners into secure cementless acetabular shells and reported the short-term, average 3.9-year follow-up, using that technique. The purpose of the present study was to report the minimum 15-year follow-up of this same cohort. METHODS: Between 1988 and 2000, 31 consecutive constrained liners of one design were cemented into well-fixed, well-positioned cementless acetabular shells at 3 institutions...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28781015/incidence-and-risk-factors-for-postoperative-urinary-retention-in-total-hip-arthroplasty-performed-under-spinal-anesthesia
#14
Charles M Lawrie, Alvin C Ong, Victor H Hernandez, Samuel Rosas, Zachary D Post, Fabio R Orozco
BACKGROUND: The objective of this study is to determine the risk factors for postoperative urinary retention (POUR) following total hip arthroplasty (THA) under spinal anesthesia. METHODS: Consecutive patients who underwent a primary THA without preoperative catheterization under spinal anesthesia were identified in a prospectively collected institutional patient database. All patients were monitored postoperatively for urinary retention on the basis of symptoms and the use of bladder ultrasound scans performed by a hospital technician...
July 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780225/post-cam-design-and-contact-stress-on-tibial-posts-in-posterior-stabilized-total-knee-prostheses-comparison-between-a-rounded-and-a-squared-design
#15
Toshifumi Watanabe, Hideyuki Koga, Masafumi Horie, Hiroki Katagiri, Ichiro Sekiya, Takeshi Muneta
BACKGROUND: The post-cam mechanism in posterior stabilized (PS) prostheses plays an important role in total knee arthroplasty (TKA). The purpose of this study is to clarify the difference of the contact stress on the tibial post between a rounded post-cam design and a squared design during deep knee flexion and at hyperextension using the three-dimensional (3D) finite element models. METHODS: We created 2 types of 3D, finite element models of PS prostheses (types A and B), whose surfaces were identical except for the post-cam geometries: type A has a rounded post-cam design, while type B has a squared design...
July 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28781020/comparative-effectiveness-of-intra-articular-hyaluronic-acid-and-corticosteroid-injections-on-the-time-to-surgical-knee-procedures
#16
Anand R Shewale, C Lowry Barnes, Lori A Fischbach, Songthip T Ounpraseuth, Jacob T Painter, Bradley C Martin
BACKGROUND: Use of intra-articular hyaluronic acid (HA) injections to manage knee osteoarthritis (OA) remains controversial because of weak and conflicting evidence. The objective was to evaluate the effectiveness of intra-articular HA injections for knee OA management. METHODS: A nested cohort of persons with knee OA seeing a specialist was created using a 10% random sample of LifeLink Plus claims (2010-2015) to compare the risk of composite (any) knee surgical interventions, total (TKA)/unicompartmental knee arthroplasty (UKA) and TKA only among HA users and 2 comparison groups: corticosteroid (CS) users and HA/CS nonusers...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#17
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780224/does-multiple-sclerosis-affect-the-inpatient-perioperative-outcomes-after-total-hip-arthroplasty
#18
Jared M Newman, Qais Naziri, Morad Chughtai, Anton Khlopas, Thomas J Kryzak, Suparna M Navale, Carlos A Higuera, Michael A Mont
BACKGROUND: There is a paucity of studies evaluating the short-term perioperative outcomes of total hip arthroplasty (THA) in multiple sclerosis (MS) patients. Therefore, this study evaluated (1) patient factors; and (2) patient outcomes in MS THA patients compared to non-MS THA patients. METHODS: The Nationwide Inpatient Sample from 2002 to 2013 identified 5899 MS and 2,723,652 non-MS THA patients. Yearly trends, demographics, and comorbidities were compared, and then non-MS THA patients were matched (3:1) to MS THA patients by age, gender, race, comorbidity score, and surgery year...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780223/modifiable-risk-factors-are-common-in-early-revision-hip-and-knee%C3%A2-arthroplasty
#19
James R Kee, Simon C Mears, Paul K Edwards, C Lowry Barnes
BACKGROUND: Obesity, smoking, uncontrolled diabetes, and poor dental health are modifiable risk factors for revision total joint arthroplasty. To protect patients from revision surgery while also reducing cost, some joint arthroplasty practices use these conditions as contraindications until they are improved. However, this practice is variable among joint arthroplasty surgeons. We hypothesize that a relatively high rate of revision arthroplasty patients had modifiable risk factors at the time of primary surgery...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780222/posterolateral-vs-direct-anterior-approach-in-total-hip-arthroplasty-polada-trial-a-randomized-controlled-trial-to-assess-differences-in-serum-markers
#20
Kyrill Rykov, Inge H F Reininga, Maurits S Sietsma, Bas A S Knobben, Bas L E F Ten Have
BACKGROUND: The direct anterior approach (DAA) for total hip arthroplasty has claimed to be a true tissue-sparing minimally invasive approach that has less tissue damage and a faster recovery when compared to the posterolateral approach (PLA). The aim of this randomized controlled trial is to measure the differences in serum markers and functional outcomes between the DAA and PLA for total hip arthroplasty. METHODS: Forty-six patients were prospectively included and randomized for either the DAA (n = 23) or PLA (n = 23)...
July 14, 2017: Journal of Arthroplasty
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