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Journal of Arthroplasty

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https://www.readbyqxmd.com/read/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#1
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089184/bone-wax-is-effective-in-reducing-blood-loss-after-total-knee-arthroplasty
#2
Ing H Moo, Jerry Y Q Chen, Eric H Pagkaliwaga, See W Tan, Kein B Poon
BACKGROUND: Total knee arthroplasty (TKA) is associated with major blood loss and blood transfusion is often required. This study aimed to evaluate the efficacy of bone wax in reducing blood loss and transfusion rates after TKA. METHODS: A prospective randomized controlled study that included 100 patients undergoing primary unilateral TKA with cement was conducted in a tertiary center between March 2014 and June 2014. The bone wax group received 2.5 g of bone wax, applied onto the uncovered bone around the prostheses and the nail holes before the tourniquet was released, whereas the control group had hemostasis achieved using electrocautery only...
December 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28082044/the-efficacy-of-liposomal-bupivacaine-using-periarticular-injection-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#3
Ming-Jie Kuang, Yuren Du, Jian-Xiong Ma, Weiwei He, Lin Fu, Xin-Long Ma
BACKGROUND: Total knee arthroplasty (TKA) is gradually emerging as the treatment of choice for end-stage osteoarthritis. In the past, the method of liposomal bupivacaine by periarticular injection (PAI) showed better effects on pain reduction and opioid consumption after surgery. However, some recent studies have reported that liposomal bupivacaine by PAI did not improve pain control and functional recovery in patients undergoing TKA. Therefore, this meta-analysis was conducted to determine whether liposomal bupivacaine provides better pain relief and functional recovery after TKA...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28065624/outcome-of-unicondylar-knee-arthroplasty-vs-total-knee-arthroplasty-for-early-medial-compartment-arthritis-a-randomized-study
#4
Vikas Kulshrestha, Barun Datta, Santhosh Kumar, Gaurav Mittal
BACKGROUND: With increasing number of patients with early osteoarthritis of knee opting for total knee arthroplasty (TKA), there has been increase in patients dissatisfied with surgical outcomes. It is being presumed that offering unicondylar knee arthroplasty (UKA) to them would improve outcomes. METHODS: Primary objective of our study was to look for any difference in patient-reported outcome and function at 2-year follow-up in patients undergoing UKA as compared to TKA...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089470/conversion-hip-arthroplasty-in-failed-fixation-of-intertrochanteric-fracture-a-propensity-score-matching-study
#5
Young-Kyun Lee, Jung Taek Kim, Awad Abdalla Alkitaini, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Conversion hip arthroplasty is a salvage procedure for failed internal fixation of intertrochanteric fractures. However, the technical difficulties and perioperative morbidity of conversion arthroplasty are uncertain. METHODS: We compared the type of arthroplasty (total hip arthroplasty or hemiarthroplasty), operative parameters, perioperative morbidity, 1-year mortality, implant stability, and clinical results of 33 conversion hip arthroplasties due to a failed internal fixation of intertrochanteric fracture with those of a matched control group of 33 primary hip arthroplasties due to the same fracture...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089186/predictors-of-same-day-discharge-in-primary-total-joint-arthroplasty-patients-and-risk-factors-for-post-discharge-complications
#6
Alex Sher, Aakash Keswani, Dong-Han Yao, Michael Anderson, Karl Koenig, Calin S Moucha
BACKGROUND: Same-day (<24 h) discharge total joint arthroplasty (TJA) may be a safe and effective option for certain patients with end-stage osteoarthritis. Given the growing pressure to improve quality and lower TJA episode costs, surgeons must identify which TJA patients can be appropriately discharged home quickly and safely. This study identifies characteristics associated with same-day discharge post-TJA as well as assesses risk factors for complications in this select patient population...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28087159/the-direct-anterior-approach-for-complex-primary-total-hip-arthroplasty-the-extensile-acetabular-approach-on-a-regular-operating-room-table
#7
Ben Molenaers, Ronald Driesen, Guy Molenaers, Kristoff Corten
BACKGROUND: The direct anterior approach on a regular operating room table has been reported with low dislocation rates. This might be beneficial for complex primary total hip arthroplasty (THA) such as in patients with cerebral palsy or following femoral or pelvic osteotomies. Extending the approach is often required to overcome problems such as acetabular deformities or severe contractures. METHODS: We retrospectively evaluated the results and complications of 29 patients with 37 complex primary THA in which an extensile approach was used...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28082043/superior-survivorship-of-cementless-vs-cemented-diaphyseal-fixed-modular-rotating-hinged-knee-megaprosthesis-at-7-years-follow-up
#8
Chih-Chien Hu, Szu-Yuan Chen, Chun-Chieh Chen, Yu-Han Chang, Steve Wen-Neng Ueng, Hsin-Nung Shih
BACKGROUND: Total knee arthroplasty in the presence of a huge bone and soft-tissue defect is always a challenge. A rotating-hinged (RH) megaprosthesis is indicated for extensive soft-tissue loss with a huge bone defect such as a primary or metastatic neoplasm of the bone, repeat periprosthetic joint infection, or extensive trauma of the knee. However, the reported survivorship of RH megaprostheses is unsatisfactory. The aim of this study was to evaluate the survivorship of megaprostheses and the factors that contribute to implant survival...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28082042/cementless-vs-cemented-tibial-fixation-in-primary-total-knee-arthroplasty
#9
Omar A Behery, Sean M Kearns, Justin M Rabinowitz, Brett R Levine
BACKGROUND: The ideal fixation for modern tibial components in total knee arthroplasty (TKA) remains controversial with uncertainty on whether cementless implants can yield equivalent outcomes to cemented fixation in early follow-up. METHODS: A series of 70 consecutive cases with reverse hybrid cementless fixation were matched to 70 cemented cases from 2008 to 2015 based on implant design and patient demographics. RESULTS: Cementless TKA demonstrated greater aseptic loosening (7 vs 0, P = ...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28065623/an-anatomic-investigation-into-the-relationship-between-posterior-condylar-offset-and-posterior-tibial-slope-of-one-thousand-one-hundred-thirty-eight-cadaveric-knees
#10
Douglas S Weinberg, Jeremy J Gebhart, Glenn D Wera
BACKGROUND: Posterior condylar offset (PCO) and posterior tibial slope (PTS) have critical consequences in total knee arthroplasty, especially with regards to sagittal plane balancing. However, there has only been limited investigation into the functional consequences of each, and there have only been anecdotal observations regarding any associations between PCO and PTS. METHODS: In a large osteological study of 1138 knees, standardized measurements of PCO and PTS were taken using previously described techniques on specimens of different age, race, and gender...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28017573/corrigendum-to-minimum-10-year-follow-up-of-cementless-total-hip-arthroplasty-using-a-contemporary-triple-tapered-titanium-stem-journal-of-arthroplasty-31-2016-2231-2236
#11
Samuel W Carlson, Devon D Goetz, Steve S Liu, Justin J Greiner, John J Callaghan
No abstract text is available yet for this article.
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#12
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089185/joint-replacement-volume-positively-correlates-with-improved-hospital-performance-on-centers-for-medicare-and-medicaid-services-quality-metrics
#13
Rachel A Sibley, Vanessa Charubhumi, Lorraine H Hutzler, Albit R Paoli, Joseph A Bosco
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) is transitioning Medicare from a fee-for-service program into a value-based pay-for-performance program. In order to accomplish this goal, CMS initiated 3 programs that attempt to define quality and seek to reward high-performing hospitals and penalize poor-performing hospitals. These programs include (1) penalties for hospital-acquired conditions (HACs), (2) penalties for excess readmissions for certain conditions, and (3) performance on value-based purchasing (VBP)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28057394/metal-ion-levels-in-young-active-patients-receiving-a-modular-dual-mobility-total-hip-arthroplasty
#14
Denis Nam, Rondek Salih, Katherine M Brown, Ryan M Nunley, Robert L Barrack
BACKGROUND: Dual mobility total hip arthroplasty (THA) components improve stability, yet use of a modular cobalt alloy acetabular liner may be associated with metal ion release. This study's purpose was to measure blood metal ion levels in young, active patients receiving a dual mobility THA prosthesis. METHODS: This is a prospective study of young, active patients undergoing primary THA. Twenty-six patients received a 22-mm cobalt alloy (n = 10) or a 28-mm ceramic (n = 16) femoral head, a modular cobalt chrome acetabular liner, with a highly cross-linked polyethylene insert (dual mobility)...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28057395/driving-after-microinvasive-total-hip-arthroplasty
#15
Suleman Qurashi, Jason Chinnappa, Sarah J Lord, Alan Nazha, Jonathan Gordon, James Chow
BACKGROUND: Patients undergoing total hip arthroplasty (THA) are often advised to avoid driving for 6 weeks postoperation. This is based on patients having to maintain postoperative hip precautions and studies investigating brake reaction time (BRT) following THA using conventional techniques. The aim of this study was to assess patients' ability to drive in the early postoperative period following microinvasive THA by assessing BRT. METHODS: Hundred consecutive patients undergoing SuperPATH(®) THA in 2015 who drove automobiles preoperatively were included in this prospective cohort study...
December 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28065626/choosing-a-femoral-head-a-survey-study-of-academic-adult-reconstructive-surgeons
#16
Sumon Nandi, Matthew S Austin
BACKGROUND: Our aim was to examine how academic adult reconstructive surgeons have interpreted evidence on femoral head material in total hip arthroplasty (THA). METHODS: A 16-question survey to evaluate attitudes toward ceramic and cobalt-chrome head use was emailed to 274 faculty at 42 US adult reconstruction fellowship programs. RESULTS: With 116 respondents, the response rate was 42.2%. Faculty use ceramic heads 72.9% of the time. The most common reason why respondents do not use ceramic heads is cost (44...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28062151/comparable-results-with-porous-metal-augments-in-combination-with-either-cemented-or-uncemented-cups-in-revision-hip-arthroplasty-an-analysis-of-one-hundred-forty-seven-revisions-at-a-mean-of-five-years
#17
Ahmed Nageeb Mahmoud, Martin Sundberg, Gunnar Flivik
BACKGROUND: Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. The purpose of this study was to retrospectively review and compare the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution. METHODS: Using our institutional clinical databases, the clinical and radiological outcomes of 104 cemented and 43 uncemented acetabular revisions with metal augments, performed between 2006 and 2015, were studied and compared...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28043711/total-hip-arthroplasty-with-a-fully-hydroxyapatite-coated-stem-a-cohort-study-during-23-28-years
#18
Olav Reikerås
BACKGROUND: Long-term results of a hydroxyapatite (HA)-coated stem are sparse. We have followed a cohort of patients operated with a grit-blasted titanium stem designed for press-fit insertion and entirely plasma-sprayed with HA up to 28 years. METHODS: In the years 1988-1993, we performed 323 primary total hip arthroplasties in 276 patients (189 women). Their mean age was 48 (15-79) years. During the following years, 83 patients with 88 hips have died, and 18 patients did not attend the follow-up examination, but had no major symptoms according to telephone interviews and control examination...
December 18, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089467/the-evolution-of-implant-design-decreases-the-incidence-of-lateral-release-in-primary-total-knee-arthroplasty
#19
Jonathan E Webb, Heidi Y Yang, Jamie E Collins, Elena Losina, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Appropriate balancing of the patellofemoral joint (PFJ) using a lateral release can help to prevent patellar instability in total knee arthroplasty (TKA). Contemporary total knee implant designs are characterized by enhanced trochlear geometry more similar to native knee anatomy to minimize instability and reduce utilization of a lateral release. METHODS: We retrospectively reviewed consecutive TKA cases from a single senior surgeon's practice with 3 successive total knee designs: the Press-Fit Condylar (PFC), the Sigma, and the ATTUNE (DePuy, Warsaw, IN)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28087161/effect-of-acetabular-position-on-polyethylene-liner-wear-measured-using-simultaneous-biplanar-acquisition
#20
Prateek Goyal, James L Howard, Xunhua Yuan, Matthew G Teeter, Brent A Lanting
BACKGROUND: Studies that have previously examined the relationship between acetabular component inclination angle and polyethylene wear have shown increased wear of conventional polyethylene with high inclination angles. To date, there are no long-term in vivo studies examining the correlation between cup position and polyethylene wear with highly crosslinked polyethylene. METHODS: An institutional arthroplasty database was used to identify patients who had metal-on-highly crosslinked polyethylene primary total hip arthroplasty using the same component design with a minimum follow-up of 10 years...
December 14, 2016: Journal of Arthroplasty
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