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X Q Wang, C S Wu, S Sun, J Wang, W Li, W Zhang
Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
X L Wang, J Wang, D L Mu, D X Wang
Objective: To investigate the effect of dexmedetomidine adding to ropivacaine for continuous femoral nerve block on the improvement of postoperative sleep quality in elderly patients after total knee arthroplasty. Methods: One hundred and sixty patients aged 60 years or older in Jishuitan Hospital scheduled for single total knee arthroplasty between Nov. 2016 and Jun. 2017 were recruited. All patients received spinal anesthesia and were randomized to receive either combined ropivacaine and dexmedetomidine (0...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Pierre H M Pechon, Rhys Pullin, Mark J Eaton, Stephan A Jones, Sam Evans
During uncemented hip arthroplasty the femoral prosthesis can be fitted too tightly into the femoral canal, causing a hoop-stress fracture of the proximal femur. The research undertaken evaluated Acoustic Emission (AE) technology as a potential method of detecting a fracture forming in this manner, in an attempt to assess whether this technology may be used as a means of early warning of impending fracture during surgery. Deer femora were prepared in a manner similar to surgery and uncemented hip arthroplasty broaches were inserted until fracture occurred...
March 21, 2018: Journal of Medical Engineering & Technology
Chi Zhang, Bo Xu, Guanzhao Liang, Xianshang Zeng, Chen Yang, Fan Zhang, Zi Wan, Weiguang Yu, Deng Chen, Zhe Ge, Xinchao Zhang
Objective This study was performed to evaluate the efficacy of rivaroxaban versus nadroparin for preventing deep venous thrombosis (DVT) in elderly patients with osteoporosis undergoing initial total hip arthroplasty (THA) for femoral neck fractures. Methods Prospectively maintained databases were reviewed to retrospectively compare elderly patients with osteoporosis who underwent initial THA for femoral neck fractures from 2007 to 2015. The patients received peroral rivaroxaban at 10 mg/day for 2 weeks or subcutaneous injections of nadroparin at 0...
January 1, 2018: Journal of International Medical Research
Yves Gramlich, Oliver Neun, Alexander Klug, Johannes Buckup, Thomas Stein, Arvid Neumann, Sebastian Fischer, Hans-Peter Abt, Reinhard Hoffmann
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months)...
March 20, 2018: International Orthopaedics
Marco A Marra, Marta Strzelczak, Petra J C Heesterbeek, Sebastiaan A W van de Groes, Dennis Janssen, Bart F J M Koopman, Nico Verdonschot, Ate B Wymenga
PURPOSE: When downsizing the femoral component to prevent mediolateral overhang, notching of the anterior femoral cortex may occur, which could be solved by flexing the femoral component. In this study, we investigated the effect of flexion of the femoral component on patellar tendon moment arm, patellofemoral forces and kinematics in posterior-referencing CR-TKA. Our hypothesis was that flexion of the femoral component increases the patellar tendon moment arm, reduces the patellofemoral forces and provides stable kinematics...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Adolph J Yates
The Center for Disease Control and Prevention recently released their 2017 Guideline for the Prevention of Surgical Site Infection. One of their recommendations is the ordering of a single dose of preoperative prophylactic antibiotics with no subsequent postoperative dosing; this recommendation includes perioperative antibiotics for patients undergoing total joint arthroplasty. At this time, the American Association of Hip and Knee Surgeons (AAHKS) does not agree with this recommendation vis-a-vis total joint arthroplasty because it contradicts current international standards of care with limited evidence and study...
March 2018: Arthroplasty Today
Kevin K Chen, Ameer M Elbuluk, Jonathan M Vigdorchik, William J Long, Ran Schwarzkopf
Background: The use of perioperative surgical wound dressings is an important factor in the mitigation of infection following total joint arthroplasty (TJA). Few studies have been published comparing wound dressings and infection rates after TJA. Methods: MEDLINE, PubMed, and EMBASE were searched for studies published between 2006 and 2016 reporting infection rates in patients using various wound dressings after undergoing TJA. All studies comparing Hydrofibre dressings to Standard dressings or Absorbent dressings were included in this meta-analysis...
March 2018: Arthroplasty Today
Florian F Dibra, Hernan A Prieto, Chancellor F Gray, Hari K Parvataneni
Background: Hip osteoarthritis typically manifests with groin or thigh pain. Other atypical pain patterns, including knee pain, have been described. Except for 2 case reports, there is no literature on this subject. Methods: From our institutional database, between 2011 and 2016, we identified 21 patients who were referred for treatment of knee pain but ultimately diagnosed with hip pathology as the cause of their pain. This group was evaluated for duration of symptoms prior to diagnosis, previous interventions, presence of walking aids, and symptom resolution after treatment of the hip pathology...
March 2018: Arthroplasty Today
Allicia Imada, Nathaniel Nelms, David Halsey, Michael Blankstein
Background: Following total knee and hip arthroplasty, patient progress can be assessed with patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs). The American Joint Replacement Registry 2016 guide recommends collecting several measures, including Patient Reported Outcome Measure Information System Global, Knee Injury and Osteoarthritis Outcome Score Jr, and Hip Injury and Osteoarthritis Outcome Score Jr. This study aimed to assess the current and anticipated use of PROMs and PBOMs by New England physical therapists...
March 2018: Arthroplasty Today
Blair S Ashley, Paul Maxwell Courtney, Daniel J Gittings, Jenna A Bernstein, Gwo Chin Lee, Eric L Hume, Atul F Kamath
Background: The validated Arthroplasty Risk Score (ARS) predicts the need for postoperative triage to an intensive care setting. We hypothesized that the ARS may also predict hospital length of stay (LOS), discharge disposition, and episode-of-care cost (EOCC). Methods: We retrospectively reviewed a series of 704 patients undergoing primary total hip and knee arthroplasty over 17 months. Patient characteristics, 90-day EOCC, LOS, and readmission rates were compared before and after ARS implementation...
March 2018: Arthroplasty Today
Ted Sueyoshi, Gen Emoto, Toru Yato
Background: There are numerous subjective rating scales available to evaluate outcomes of total knee arthroplasty (TKA). Single Assessment Numerical Evaluation (SANE) score was developed to reduce the burden of patients or clinicians to evaluate patients' status by asking patients to simply rate the current status of their injured body part on a scale of 0-100. The purpose of this study is to investigate the correlation between SANE score and Lysholm score in patients who underwent primary TKA...
March 2018: Arthroplasty Today
Sachiyuki Tsukada, Motohiro Wakui
Background: Although studies have supported the utility of perioperative continuation of antiplatelet drugs, vasodilators, and cerebral ameliorators in most procedures, no study compared total volume of blood loss after total knee arthroplasty (TKA) in patients continuing and discontinuing these drugs. Methods: We retrospectively reviewed 266 consecutive patients undergoing TKA, and included 67 patients (25.2%) taking antiplatelet drugs, vasodilators, or cerebral ameliorators in this study...
March 2018: Arthroplasty Today
Paolo Adravanti, Eleonora Di Salvo, Giuseppe Calafiore, Sebastiano Vasta, Aldo Ampollini, Michele Attilio Rosa
Background: Studies on the use of tranexamic acid (TXA) to improve clinical outcomes after joint arthroplasty have reported contrasting results between intravenous (IV) TXA alone and combined IV and intraarticular (IA) administration. We compared the effectiveness of the 2 methods in providing higher postoperative hemoglobin (Hb) levels in patients undergoing primary total knee arthroplasty (TKA). Methods: A total of 100 TKA patients were randomly assigned to receive either IV TXA alone (group 1) or combined IV and topical IA TXA (group 2)...
March 2018: Arthroplasty Today
Chong Meng Lee, Malkit K Dhillon, Mohd Amin Sulaiman
Background: The use of navigation for total knee arthroplasty (TKA) improves limb alignment in the coronal and sagittal planes. However, similar improvements in femoral and tibial component rotation have not yet been realized using currently available systems. Methods: We developed a modified navigated TKA technique in which femoral rotation was set using the resected tibial plane as the reference with the aim of achieving a rectangular flexion gap. Limb alignment was assessed in a cohort of 30 knees using the navigation system...
March 2018: Arthroplasty Today
Matthew J Grosso, David P Trofa, Jonathan R Danoff, Thomas R Hickernell, Taylor Murtaugh, Akshay Lakra, Jeffrey A Geller
Background: The purpose of this study was to investigate the influence of tranexamic acid (TXA) on functional outcomes in the immediate postoperative period after total knee arthroplasty (TKA). We hypothesized that the known benefits of TXA would confer measurable clinical improvements in physical therapy (PT) performance, decrease pain, and decrease hospital length of stay (LOS). Methods: We retrospectively analyzed 560 TKA patients, including 280 consecutive patients whose surgery was performed before the initiation of a standardized TXA protocol and the first 280 patients who received TXA after protocol initiation...
March 2018: Arthroplasty Today
Colin D Canham, Christopher P Walsh, Stephen J Incavo
Simultaneous prosthetic joint infection of ipsilateral hip and knee arthroplasties is often accompanied by significant bone loss and presents a challenging reconstructive problem. Two-stage reconstruction is favored and requires the placement of a total femur spacer, which is not a commercially available device. We describe a surgical technique, reporting on 2 cases in which a customized total femur antibiotic impregnated spacer was created by combining an articulating knee spacer and an articulating hip spacer with a reinforced cement dowel construct connecting the 2 spacers...
March 2018: Arthroplasty Today
Ahmed Siddiqi, Carl T Talmo, James V Bono
Dislodgment of trial femoral heads and migration into the pelvis during total hip arthroplasty is a rarely reported complication with limited published cases. There are three primary mechanisms of femoral head separation: dislodgement during reduction attempt, disassociation from anterior dislocation while assessing anterior stability, and during dislocation after implant trialing. If the trial femoral migrates beyond the pelvic brim, it is safer to finish the total hip arthroplasty and address the retained object after repositioning or in a planned second procedure with a general surgeon...
March 2018: Arthroplasty Today
Andrew Konopitski, Anthony Boniello, Patrick Wang, Mitesh Shah, Andrew Old, Kevin Gingrich
We present a unique case of bladder perforation occurring intraoperatively during primary total hip arthroplasty. It is suspected that the patient's aberrant bladder anatomy, with idiopathic erosion of the quadrilateral space, predisposed the patient to bladder injury. Several preoperative risk factors for bladder injury were identified in the literature. These factors include cemented acetabular components, previous history of hip arthroplasty, history of pelvic trauma or intrapelvic surgery, and poor bone quality...
March 2018: Arthroplasty Today
Erin Honcharuk, Stephen Kayiaros, Lee E Rubin
Addressing acetabular bone defects can be difficult and depends on the amount of bone loss. Augments, either with bone or highly porous metals, are options that still allow the use of a hemispherical cup. Almost all previous research and publication on acetabular augments have focused on revision hip arthroplasty utilizing either a modified lateral or a posterolateral surgical approach. We describe 3 cases of augmenting acetabular bone defects through a direct anterior approach for primary total hip arthroplasty...
March 2018: Arthroplasty Today
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