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Digital arthroplasty

Mitchell C Weiser, Shai Shemesh, Darwin D Chen, Michael J Bronson, Calin S Moucha
INTRODUCTION: Door openings and increased foot traffic in operating rooms (ORs) during total joint arthroplasty are thought to increase the risk of surgical site infection. METHODS: Digital manometers were used to collect pressure data during off-hours at the thresholds of both the outer door (ie, the door to the common OR hallway) and the inner substerile door, which opens to the substerile hallway, of six empty ORs used for total joint arthroplasty. Airflow patterns were visualized with smoke studies to determine whether outside air entered the ORs during single or multiple door openings...
February 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
Scott F M Duncan, Anthony A Smith, Kevin J Renfree, Ross M Dunbar, Marianne V Merritt
BACKGROUND: Most hand surgeons use a dorsal approach for proximal interphalangeal (PIP) joint implant arthroplasty. However, a volar approach offers the advantage of no disturbance to the extensor mechanism, thus allowing early initiation of active range of motion. We examined our results in patients who underwent PIP joint arthroplasty via a volar approach. METHODS: Using a retrospective chart review, we evaluated the outcomes of patients undergoing PIP joint arthroplasty through a volar approach between 2001 and 2005 by 3 fellowship-trained hand surgeons at our institution...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Brad L Penenberg, Sanjum P Samagh, Sean S Rajaee, Antonia Woehnl, William W Brien
BACKGROUND: Obtaining the ideal acetabular cup position in total hip arthroplasty remains a challenge. Advancements in digital radiography and image analysis software allow the assessment of the cup position during the surgical procedure. This study describes a validated technique for evaluating cup position during total hip arthroplasty using digital radiography. METHODS: Three hundred and sixty-nine consecutive patients undergoing total hip arthroplasty were prospectively enrolled...
February 7, 2018: Journal of Bone and Joint Surgery. American Volume
Austin J Ramme, Nina D Fisher, Jonathan Egol, Gregory Chang, Jonathan M Vigdorchik
Background: Digital templating systems foster patient-specific measurements for preoperative planning. Questions/Purposes: We aim (1) to verify the accuracy of a templating system, (2) to describe the effects of scaling marker position on the accuracy of digital templating of the hip, and (3) to provide a practical guide for scaling marker position using patient body mass index (BMI). Methods: A scaling sphere was placed in five positions along the anterior-posterior axis of an acetabular implant and pelvis phantom, and x-rays were obtained...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Nils J Strøm, Olav Reikerås
Purpose: This study examines the accuracy of digital templating in uncemented total hip arthroplasty (THA), i.e., whether the templated components where actually inserted during surgery. The surgical outcome was evaluated on the basis of limb length equality. Methods: We retrospectively examined digital x-rays of 41 patients scheduled for uncemented THA. These were templated using templating software. The template was compared to the surgical choice of implant registered in the patients' journal...
March 2018: Journal of Orthopaedics
Shengjie Guo, Hao Tang, Yixin Zhou, Yong Huang, Hongyi Shao, Dejin Yang
BACKGROUND: Cementless hip arthroplasty is increasingly gaining popularity worldwide. Radiologic identification of osteointegration is key to confirming biologic fixation. We conducted the study reported here to determine the sensitivity and specificity of digital tomosynthesis with metal artifact reduction (TMAR), radiography, and conventional computed tomography in detecting osteointegration in cementless hip arthroplasty. METHODS: We prospectively included data for 24 patients who underwent revision hip arthroplasty in our hospital, with 13 femoral and 14 acetabular cementless components retrieved that contained solid evidence of biologic fixation...
December 29, 2017: Journal of Arthroplasty
N Taniguchi, T Jinno, R Takada, D Koga, T Ando, A Okawa, H Haro
BACKGROUND: The use of screws and the presence of screw holes may cause acetabular osteolysis and implant loosening in cementless total hip arthroplasty (THA) using conventional polyethylene. In contrast this issue is not fully understood using highly cross-linked polyethylene (HXLPE), particularly in large comparative study. Therefore, we performed a case-control study to assess the influence of screw usage and screw holes on: (1) implant fixation and osteolysis, and (2) polyethylene steady-state wear rate, using cases with HXLPE liners followed up for 7-10 years postoperatively...
January 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
B Kerens, A M Leenders, M G M Schotanus, B Boonen, W E Tuinebreijer, P J Emans, B Jong, N P Kort
PURPOSE: Patient-specific instrumentation (PSI) is a technique to plan and position the prosthesis components in unicompartmental knee arthroplasty (UKA) surgery. This study assesses whether the definitive component position in the frontal, sagittal and axial plane is according to the preoperative plan, based on the hypothesis that PSI is accurate. METHODS: Twenty-six patients who had PSI Oxford UKA surgery were included prospectively. The component position in vivo was determined with a postoperative CT-scan and compared with the planned component position using MRI-based digital 3D imaging...
December 27, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Benjamin I Rosner, Marc Gottlieb, William N Anderson
BACKGROUND: The impact of a new class of automated digital patient engagement (DPE) platforms on potentially avoidable costs, hospital admissions, and complications after discharge following hip and knee arthroplasties has not been established. METHODS: We conducted a multicenter observational cohort study comparing claims data for potentially avoidable costs, hospital admissions, and complications for 90 days after discharge following hip and knee arthroplasties at 10 practice sites in CA and NV...
December 2, 2017: Journal of Arthroplasty
A Atrey, S E Ward, A Khoshbin, N Hussain, E Bogoch, E H Schemitsch, J P Waddell
AIMS: We present the ten-year data of a cohort of patients, aged between 18 and 65 years (mean age 52.7 years; 19 to 64), who underwent total hip arthroplasty. Patients were randomised to be treated with a cobalt-chrome (CoCr) femoral head with an ultra-high molecular weight polyethylene (UHMWPE), highly cross-linked polyethylene (XLPE) or ceramic-on-ceramic (CoC) bearing surface. PATIENTS AND METHODS: A total of 102 hips (91 patients) were randomised into the three groups...
December 2017: Bone & Joint Journal
Feroz A Osmani, Savyasachi Thakkar, Austin Ramme, Ameer Elbuluk, Paul Wojack, Jonathan M Vigdorchik
Background: Preoperative total hip arthroplasty templating can be performed with radiographs using acetate prints, digital viewing software, or with computed tomography (CT) images. Our hypothesis is that 3D templating is more precise and accurate with cup size prediction as compared to 2D templating with acetate prints and digital templating software. Methods: Data collected from 45 patients undergoing robotic-assisted total hip arthroplasty compared cup sizes templated on acetate prints and OrthoView software to MAKOplasty software that uses CT scan...
December 2017: Arthroplasty Today
Jana Hornová, Pavel Růžička, Maroš Hrubina, Eduard Šťastný, Andrea Košková, Petr Fulín, Jiří Gallo, Matej Daniel
Preoperative planning for total hip arthroplasty includes templating on anteroposterior radiographs. It is necessary to consider radiographic magnification in order to scale templates accurately. Studies dealing with hip templating report different values of radiographic magnification. It is not clear if the observed difference in magnification between the studies is caused by variability in studied groups, methodology or instrumentation. We hypothesize that there is a difference in magnification between clinical workplaces...
2017: PloS One
Tsutomu Gomi, Rina Sakai, Masami Goto, Hidetake Hara, Yusuke Watanabe, Tokuo Umeda
To investigate methods to reduce metal artifacts during digital tomosynthesis for arthroplasty, we evaluated five algorithms with and without metal artifact reduction (MAR)-processing tested under different radiation doses (0.54, 0.47, and 0.33mSv): adaptive steepest descent projection onto convex sets (ASD-POCS), simultaneous algebraic reconstruction technique total variation (SART-TV), filtered back projection (FBP), maximum likelihood expectation maximization (MLEM), and SART. The algorithms were assessed by determining the artifact index (AI) and artifact spread function (ASF) on a prosthesis phantom...
October 2017: Physica Medica: PM
Wesley M Durand, Joseph R Johnson, Adam E M Eltorai, Alan H Daniels
Crowdfunding for medical expenses is growing in popularity. Through several websites, patients create public campaign profiles to which donors can contribute. Research on medical crowdfunding is limited, and there have been no studies of crowdfunding in orthopedics. Active medical crowdfunding campaigns for orthopedic trauma, total joint arthroplasty, and spine surgery were queried from a crowdfunding website. The characteristics and outcomes of crowdfunding campaigns were abstracted and analyzed. For this study, 444 campaigns were analyzed, raising a total of $1,443,528...
November 20, 2017: Orthopedics
Nathan T Morrell, Arnold-Peter C Weiss
PURPOSE: To demonstrate that silicone metacarpophalangeal (MCP) arthroplasty provides excellent long-term outcomes with a low complication rate in osteoarthritis patients. METHODS: A consecutive cohort of 35 patients with osteoarthritis of 1 or more MCP joints undergoing anatomically neutral silicone MCP arthroplasty was followed over a 15-year period. Functional outcomes including strength and range of motion (ROM), as well as complications, were recorded. All patients were available for long-term assessment including radiographs and outcomes questionnaire...
March 2018: Journal of Hand Surgery
Comron Saifi, Manish N Noticewala, R Michael Greiwe, Jonathan D Lester, Thomas R Gardner, Edwin Cadet, William N Levine, Louis U Bigliani, Christopher S Ahmad
Although implant-specific intraoperative targeting devices for glenoid sizing exist, a validated method for preoperatively templating glenoid component size in primary total shoulder arthroplasty (TSA) based on digital imaging does not. We conducted a study to determine if 3-dimensional (3-D) digital imaging could be used for preoperative templating of glenoid component size and to compare templated glenoid sizes with implanted glenoid sizes. We created 3-D digital models from 3 glenoid component implant sizes and preoperative scapular computed tomography scans of 24 patients who underwent primary TSA...
September 2017: American Journal of Orthopedics
Lars V von Engelhardt, Michael Manzke, Andreas Breil-Wirth, Timm J Filler, Joerg Jerosch
AIM: To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS system. METHODS: Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation (CoR) was assessed and compared to the CoR of the prosthesis by using the MediCAD(®) software. Additionally, the pre- and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus...
October 18, 2017: World Journal of Orthopedics
Bruno Jetté, Vladimir Brailovski, Charles Simoneau, Mathieu Dumas, Patrick Terriault
BACKGROUND: Dense and stiff metallic femoral stems implanted into femurs for total hip arthroplasties produce a stress shielding effect since they modify the original load sharing path in the bony structure. Consequently, in the long term, the strain adaptive nature of bones leads to bone resorption, implant loosening, and the need for arthroplasty revision. The design of new cementless femoral stems integrating open porous structures can reduce the global stiffness of the stems, allowing them a better match with that of bones and provide their firm fixation via bone ingrowth, and, thus reduce the risk of implantation failure...
October 16, 2017: Journal of the Mechanical Behavior of Biomedical Materials
Jack M Bert, Jessica Hooper, Sam Moen
PURPOSE OF REVIEW: Outpatient total joint arthroplasty (OTJA) allows for a safe, cost effective pathway for appropriately selected patients. With current pressures on arthroplasty surgeons and their associated institutions to reduce costs per episode of care, it is important to define the steps and challenges associated with establishing an outpatient arthroplasty program. RECENT FINDINGS: Several studies have outlined techniques of selecting patients suitable for this type of postoperative pathway...
December 2017: Current Reviews in Musculoskeletal Medicine
Morad Chughtai, Nicholas Piuzzi, George Yakubek, Anton Khlopas, Nipun Sodhi, Assem A Sultan, Salahuddin Nasir, Benjamin S T Yates, Anil Bhave, Michael A Mont
Patients suffering from quadriceps muscle weakness secondary to osteoarthritis or after surgeries, such as total knee arthroplasty, appear to benefit from the use of neuromuscular electrical stimulation (NMES), which can improve muscle strength and function, range of motion, exercise capacity, and quality of life. Several modalities exist that deliver this therapy. However, with the ever-increasing demand to improve clinical efficiency and costs, digitalize healthcare, optimize data collection, improve care coordination, and increase patient compliance and engagement, newer devices incorporating technologies that facilitate these demands are emerging...
October 12, 2017: Surgical Technology International
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