Publications by authors named "Alejandro Della-Valle"

Background: Malposition of the acetabular component during total hip arthroplasty (THA) is a leading cause of complications and need for revision. Robotic-assisted THA purports to improve accuracy of component positioning with many reports demonstrating over 92% of components within 10° of inclination and anteversion compared to intraoperative system output. This study aimed to evaluate the intraoperative accuracy output of acetabular cup position values using a handheld miniaturized portable navigation system (Naviswiss, AG) compared to postoperative computed tomography (CT) scans.

View Article and Find Full Text PDF

Background: Weight optimization methods in morbidly obese patients with a body mass index (BMI) of ≥40 kg/m 2 undergoing total knee arthroplasty (TKA) have shown mixed results. The purpose of this study was to evaluate the effect of perioperative use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with a BMI of ≥40 kg/m 2 undergoing primary TKA.

Methods: Using an administrative claims database, patients with morbid obesity undergoing primary TKA were stratified into GLP-1 RA use for 3 months before and after the surgical procedure (treatment group) and GLP-1 RA non-use (control group), and were matched on the basis of patient age, gender, diagnosis of type-2 diabetes mellitus, and Charlson Comorbidity Index (CCI).

View Article and Find Full Text PDF

Background: Morbid obesity negatively affects outcomes after total hip arthroplasty (THA). The optimal strategy for weight loss before THA has not been identified. Recently, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become increasingly popular as an effective pharmacologic weight loss agent.

View Article and Find Full Text PDF

Recently, lifestyle medicine (LSM) application has shown feasibility for musculoskeletal pain patients with co-existing lifestyle-related chronic diseases. This study describes early results of a LSM program for musculoskeletal patients with goals to optimize health prior to orthopedic surgery. Fifty-four patients (age: 61 ± 11 years; 39 [72%] females) completed the program from 3/8/22-12/1/23.

View Article and Find Full Text PDF

Objective: The objective of this study is to outline the training of peer coaches in the Moving Well intervention, which was designed to reduce anxiety, depression, and pain catastrophizing in patients before and after total knee replacement (TKR).

Methods: Selected peer coaches had a history of knee osteoarthritis (KOA), a TKR of 12 months or more before training, and were 60 or older. Training was primarily conducted virtually, with a later addition of one in-person session.

View Article and Find Full Text PDF
Article Synopsis
  • The study focused on the learning curve associated with using a novel imageless navigation system in total hip arthroplasty (THA), particularly examining its impact on surgical time and accuracy.
  • The research involved 158 patients, measuring differences in acetabular angles during surgery and comparing them with follow-up X-rays to assess navigation accuracy.
  • Results showed average surgical time was 67.3 minutes with no significant learning period effect detected on either surgical time or navigation accuracy throughout the procedures.
View Article and Find Full Text PDF

Background: Patients who have spinal stiffness and deformity are at the highest risk for dislocation after total hip arthroplasty (THA). Previous reports of this cohort are limited to antero-lateral and postero-lateral (PL) approaches. We investigated the dislocation rate after direct anterior (DA) and PL approach THA with a contemporary high-risk protocol to optimize stability.

View Article and Find Full Text PDF

Background: Lumbar spine pathology frequently coexists in patients who have hip arthrosis. There is controversy on whether lumbar or hip pathology should be first addressed. The purpose of this study was to evaluate the outcomes of sequential lumbar spine (LSP) or hip arthroplasty (THA).

View Article and Find Full Text PDF

Background: While transfusion and clinically relevant anemia after elective primary total knee arthroplasty (TKA) are uncommon, there remains a question of who needs postoperative hemoglobin monitoring, especially in the setting of increasing incidence of outpatient TKA. The purpose of this study was to create predictive models for postoperative anemia and blood transfusion to guide clinical decision-making.

Methods: The records of consecutive TKA patients were reviewed from February 2016 to December 2020 at a single institution.

View Article and Find Full Text PDF

Objective: Qualitative assessment investigating patients' perceptions related to opioids including their role in pain control, risks, and handling and disposal prior to undergoing hip replacement.

Design: A prospective, cross-sectional survey study.

Setting: Large urban teaching hospital specializing in orthopedic surgery affiliated with Weill Cornell Medical College.

View Article and Find Full Text PDF

Background: Prior investigations of total hip arthroplasty (THA) have studied the effects of prosthetic femoral head size and stem offset on hip range of motion (ROM), impingement risk, and overall hip stability to optimize the return to activities of daily living. However, the relationship between femoral head length and hip ROM, specifically external rotation (ER), has not been evaluated. The aim of our study was to intraoperatively assess how femoral head length affects hip ROM during a posterior approach THA.

View Article and Find Full Text PDF

Introduction: In June 2020 when elective total knee arthroplasty (TKA) resumed after the initial COVID-19 surge, we adapted our TKA pathway focusing on a shorter hospitalization, increased home discharge, and use of post-discharge telemedicine and telerehabilitation. The purpose of this study was to evaluate if changes in postoperative care affected early TKA outcomes.

Materials And Methods: Five hundred and fifty-four patients who underwent elective primary unilateral TKA for primary osteoarthritis between June and August 2020 (study group) were matched 1:1 for age, sex, body mass index, and Charlson comorbidity index with control patients who underwent surgery between August and November 2019.

View Article and Find Full Text PDF

Introduction: In the United States, most hip arthroplasties for femoral neck fractures are done with a noncemented stem despite worldwide registry data suggesting that cemented fixation has improved long-term survivorship in patients older than 65 years. We, therefore, evaluated the effect of femoral fixation on the risk of revision, revision for periprosthetic fracture (PPFx), and mortality in patients undergoing hip arthroplasty for femoral neck fractures.

Methods: Seventeen thousand one hundred thirty-eight cases of cemented femoral stems were exactly matched to noncemented fixation cases in a 1:1 fashion based on age, sex, and Charlson Comorbidity Index as reported in the American Joint Replacement Registry.

View Article and Find Full Text PDF

Purpose: The recreational and medical use of cannabis is being legalized worldwide. Its use has been linked to an increased risk of developing opioid use disorders. As opioids continue to be prescribed after total hip arthroplasty (THA), the influence that preoperative cannabis use may have on postoperative opioid consumption remains unknown.

View Article and Find Full Text PDF

Aims: The volume of ambulatory total hip arthroplasty (THA) procedures is increasing due to the emphasis on value-based care. The purpose of the study is to identify the causes for failed same-day discharge (SDD) and perioperative factors leading to failed SDD.

Methods: This retrospective cohort study followed pre-selected patients for SDD THA from 1 August 2018 to 31 December 2020.

View Article and Find Full Text PDF

Background And Purpose: Elective total hip replacement (THR) was halted in our institution during the COVID-19 surge in March 2020. Afterwards, elective THR volume increased with emphasis on fast-track protocols, early discharge, and post-discharge virtual care. We compare early outcomes during this "return-to-normal period" with those of a matched pre-pandemic cohort.

View Article and Find Full Text PDF

Introduction: Elective orthopedic care, including in-person office visits and physical therapy (PT), was halted on March 16, 2020, at a large, urban hospital at the onset of the local COVID-19 surge. Post-discharge care was provided predominantly through a virtual format. The purpose of this study was to assess the impact of postoperative care disruptions on early total knee arthroplasty (TKA) outcomes, specifically 90-day complications, 120-day rate of manipulation under anesthesia (MUA) and 1-year patient-reported outcome measures (PROMs).

View Article and Find Full Text PDF

Anesthesia research using existing databases has drastically expanded over the last decade. The most commonly used data sources in multi-institutional observational research are administrative databases and clinical registries. These databases are powerful tools to address research questions that are difficult to answer with smaller samples or single-institution information.

View Article and Find Full Text PDF

Background: Robotic-assistance total hip arthroplasty (RA-THA) and computer navigation THA (CN-THA) have been shown to improve accuracy of component positioning compared to manual techniques; however, controversy exists regarding clinical benefit. Moreover, these technologies may expose patients to risks. The purpose of this study is to compare rates of intraoperative fracture and complications requiring reoperation within 1 year for posterior approach RA-THA, CN-THA, and THA with no technology (Manual-THA).

View Article and Find Full Text PDF

Introduction: Over the past decade, awareness about opioid abuse in the general community and among prescribers has increased. This study evaluated how opioid prescribing patterns before and after total hip arthroplasty (THA) and total knee arthroplasty (TKA) may have changed during a recent 5-year period.

Methods: The Truven Health MarketScan database were queried for patients who underwent elective THA and TKA for primary osteoarthritis between 2013 and 2017.

View Article and Find Full Text PDF

Introduction: The purpose was to compare robotic assisted (RA), computer navigated (CN), and conventional UKA techniques.

Methods: Databases were queried for data on study characteristics, UKA systems, complications, and tibiofemoral alignment.

Results: Four RA and six CN RCTs were identified.

View Article and Find Full Text PDF

Background: In response to the opioid epidemic, our arthroplasty service sequentially reduced the opioid quantities prescribed at primary total knee arthroplasty (TKA) discharge. However, its effect on postdischarge pain control and rehabilitation is unknown. We assessed if this decrease was associated with an increase in the risk of manipulation under anesthesia (MUA).

View Article and Find Full Text PDF

Background: Severe gastrointestinal (GI) complications after elective hip and knee arthroplasty (THA/TKA) are rare. Some of them can be life-threatening and/or require emergency abdominal surgery. We studied the epidemiology of severe GI complications after THA/TKA and associations with anesthesia- and/or analgesia-related factors.

View Article and Find Full Text PDF