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Journal of Arthroplasty

Alexander B Christ, Andrew D Pearle, David J Mayman, Steven B Haas
BACKGROUND: Unicompartmental knee arthroplasty is a successful treatment for unicompartmental knee osteoarthritis that has lower complication rates, faster recovery, and a more natural feeling knee compared to total knee arthroplasty. However, long-term survival has been a persistent concern. As more surgeon-controlled variables have been linked to survival, interest in robotic-assisted surgery has continued to grow. Robotic-assisted surgery has demonstrated the ability. METHODS: A review and synthesis of the literature on the subject of robotic-assisted unicompartmental knee arthroplasty was performed...
March 16, 2018: Journal of Arthroplasty
Paul K Edwards, James R Kee, Simon C Mears, C Lowry Barnes
No abstract text is available yet for this article.
March 10, 2018: Journal of Arthroplasty
Fiachra E Rowan, Biju Benjamin, Jurek R Pietrak, Fares S Haddad
BACKGROUND: Prevention of dislocation after primary total hip arthroplasty (THA) begins with patient preoperative assessment and planning. METHODS: We performed a literature search to assess historical perspectives and current strategies to prevent dislocation after primary THA. The search yielded 3458 articles, and 154 articles are presented. RESULTS: Extremes of age, body mass index >30 kg/m2 , lumbosacral pathology, surgeon experience, and femoral head size influence dislocation rates after THA...
March 7, 2018: Journal of Arthroplasty
Stephen A Jones
BACKGROUND: Dislocation remains one of the most common complications after total hip arthroplasty. Constrained acetabular liners were developed to address the problem of recurrent instability. They have been in clinical use since the mid 1980s and function by capturing the femoral head. METHOD: The aim of this review is to highlight the mechanism of action, development, and advances in constrained liner design, together with an emphasis on the modes of failure and the authors' opinion on the current indications for the use of these implants...
March 7, 2018: Journal of Arthroplasty
Fares S Haddad
No abstract text is available yet for this article.
March 6, 2018: Journal of Arthroplasty
R Michael Meneghini
The investigation of recurrent instability after total hip arthroplasty requires a thorough history and physical examination focused on characterizing the dislocation events and the patient factors that contribute to instability. Radiographic studies include plain radiographs, in particular a cross-table lateral, and computed tomography to accurately assess the implant orientation relative to the patient's native anatomy. More advanced imaging such as magnetic resonance imaging may be useful to assess abductor tendon integrity...
March 6, 2018: Journal of Arthroplasty
Rinne M Peters, Loes W A H van Beers, Liza N van Steenbergen, Julius Wolkenfelt, Harmen B Ettema, Bas L E F Ten Have, Paul C Rijk, Martin Stevens, Sjoerd K Bulstra, Rudolf W Poolman, Wierd P Zijlstra
BACKGROUND: Patient-reported outcome measures (PROMs) are used to evaluate the outcome of total hip arthroplasty (THA). We determined the effect of surgical approach on PROMs after primary THA. METHODS: All primary THAs, with registered preoperative and 3 months postoperative PROMs were selected from the Dutch Arthroplasty Register. Based on surgical approach, 4 groups were discerned: (direct) anterior, anterolateral, direct lateral, and posterolateral approaches...
March 1, 2018: Journal of Arthroplasty
Craig J Della Valle, Tyler E Calkins, Joshua J Jacobs
There has been an increasing use of modularity at the head-neck junction in total hip arthroplasty to more closely mimic the native anatomy, allowing for optimal leg length and stability. Corrosion at this junction in metal-on-polyethylene bearings can lead to an adverse local tissue reaction (ALTR). This increasingly prevalent condition should be considered in the differential diagnosis of hip pain and difficulty ambulating. A recent symposium by the American Academy of Hip and Knee Surgeons described the diagnosis, etiology, management, and prevention of taper corrosion...
March 1, 2018: Journal of Arthroplasty
Jaiben George, Jared M Newman, Alison K Klika, Evan M Miller, Timothy L Tan, Javad Parvizi, Carlos A Higuera
BACKGROUND: Staphylococcus aureus is the predominant cause of periprosthetic joint infection (PJI) and can persist at the time of planned second stage of 2-stage revision arthroplasty, despite antibiotic cement spacer insertion and parenteral antibiotic therapy. Given the rapid emergence of antibiotic resistance, it is important to determine whether the antibiotic susceptibility of microorganisms changes between the stages of a 2-stage revision. METHODS: A total of 1614 2-stage revision hip/knee arthroplasties performed for PJI at 2 academic institutions from 2000 to 2015 were identified...
March 1, 2018: Journal of Arthroplasty
Raju Vaishya, Vipul Vijay, Amit K Agarwal
No abstract text is available yet for this article.
February 28, 2018: Journal of Arthroplasty
Michiaki Miura, Shigeo Hagiwara
No abstract text is available yet for this article.
February 28, 2018: Journal of Arthroplasty
Monti Khatod
BACKGROUND: Total joint arthroplasty is a successful operation with increasing prevalence in the United States. Kaiser Permanente has been using multiple tools to optimize patient outcomes while keeping health-care expenditures in check. METHODS: We describe the patient, surgeon, and hospital perspective toward the delivery of sustainable arthroplasty care for a growing elderly population. Quality metrics for each stakeholder are presented. RESULTS: Kaiser Permanente optimizes value for the patient, surgeon, and hospital with the use of evidence-based integrated care pathways and a national joint arthroplasty registry...
February 28, 2018: Journal of Arthroplasty
Michael A Mont, David J Backstein, Viktor E Krebs, J Bohannon Mason, Michael J Taunton, John J Callaghan
No abstract text is available yet for this article.
February 27, 2018: Journal of Arthroplasty
Matthew P Abdel
Dislocation after revision total hip arthroplasty (THA) continues to be one of the most common and concerning complications after the procedure. As with every hip arthroplasty, it is essential to optimize component positioning, minimize impingement, and maintain the integrity of the abductor complex during the revision THAs. However, in several revision circumstances, additional strategies are required to mitigate the risk of dislocation, particularly those being revised for instability or those with cognitive or neuromuscular disorders...
February 27, 2018: Journal of Arthroplasty
Javad Parvizi, Timothy L Tan, Karan Goswami, Carlos Higuera, Craig Della Valle, Antonia F Chen, Noam Shohat
BACKGROUND: The introduction of the Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection (PJI) in 2011 resulted in improvements in diagnostic confidence and research collaboration. The emergence of new diagnostic tests and the lessons we have learned from the past 7 years using the MSIS definition, prompted us to develop an evidence-based and validated updated version of the criteria. METHODS: This multi-institutional study of patients undergoing revision total joint arthroplasty was conducted at 3 academic centers...
February 26, 2018: Journal of Arthroplasty
James M Hartford, Bradley P Graw, Sara B Knowles, Dominick L Frosch
BACKGROUND: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach. METHODS: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified. Radiographs were evaluated for femoral neck angle, femoral neck cut ratio (FNCR), and DORR ratio...
February 21, 2018: Journal of Arthroplasty
Yale A Fillingham, Brian Darrith, Jess H Lonner, Chris Culvern, Meredith Crizer, Craig J Della Valle
BACKGROUND: The purpose of this randomized clinical trial was to compare formal outpatient physical therapy (PT) and unsupervised home exercises after unicompartmental knee arthroplasty (UKA). METHODS: Fifty-two patients were randomized to 6 weeks of outpatient PT or an unsupervised home exercise program after UKA. The primary outcome was change in range of motion at 6 weeks with secondary outcomes including total arc of motion, Knee Society Score, Knee Injury and Osteoarthritis Outcome Score Jr, Lower Extremity Functional Scale, and Veterans Rands-12 score...
February 21, 2018: Journal of Arthroplasty
Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Santiago Gonzalez-Parreño, Luis Marco-Gomez, Francisco A Miralles Muñoz, Fernando A Lopez-Prats
BACKGROUND: Few studies have analyzed the outcomes of total knee arthroplasty (TKA) in patients with prior anterior cruciate ligament (ACL) reconstruction, and the reported outcomes are controversial. The purpose of this study is to assess if prior ACL reconstruction had any impact on the outcome of subsequent TKA. METHODS: A matched case-control study was conducted in patients who underwent TKA, including 37 with prior ACL reconstruction and 37 patients without ACL reconstruction...
February 21, 2018: Journal of Arthroplasty
Evan S Nielsen, Albert Hsu, Shantanu Patil, Clifford W Colwell, Darryl D D'Lima
BACKGROUND: Knee instability is emerging as a major complication after total knee arthroplasty (TKA), with ligament laxity and component alignment listed as important contributory factors. Knee balancing remains an art and is largely dependent on the surgeon's subjective "feel." The objectives were to measure the accuracy of an electronic balancing device to document the magnitude of correction in knee balance after soft-tissue releases and measure change in knee laxity after medial release...
February 21, 2018: Journal of Arthroplasty
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