Chitranjan S. Ranawat Award: Motion During Total Knee Cementing Significantly Decreases Tibial Implant Fixation Strength.

Background: Aseptic tibial loosening following primary total knee arthroplasty persists despite technique and device-related advancements. The mechanisms for this mode of failure are not well understood. We hypothesized that knee movement while the cement was curing dispersed lipids at the implant-cement interface and would result in decreased tibial fixation strength.

Outpatient Total Joint Arthroplasty: A Review of the Current Stance and Future Direction.

Introduction: The purpose of this review is to outline some of the major considerations when transitioning to performing total hip and knee arthroplasty in the out- patient setting. The review will discuss patient selections, peri-operative management pathways, and outcomes related to outpatient total joint arthroplasty (TJA).

Patient Selection: Appropriate patient selection is key to successful outpatient TJA.

Patient-reported outcomes after above-knee amputation for prosthetic joint infection.

Background: Prosthetic joint infection (PJI) is a challenging complication after total knee arthroplasty (TKA). Above-knee amputation (AKA) is a salvage procedure that may be performed after revision TKAs fail to eradicate PJI. Few studies have investigated patient-reported outcomes.

Occurrence and Natural History of Clinically Silent Episodes of Atrial Fibrillation in Hypertrophic Cardiomyopathy.

Overt symptomatic atrial fibrillation (AF) occurs in over 20% of patients with hypertrophic cardiomyopathy (HC) leading to impaired quality of life, loss of productivity, and the risk for embolic stroke. However, the overall burden presented by AF in the HC population is unresolved due to the unknown frequency of silent asymptomatic episodes that do not necessarily achieve clinical recognition but nevertheless may have important disease-related implications. Therefore, stored electrograms were analyzed retrospectively for AF in 75 consecutive patients with HC (without AF history) implanted with dual-chamber cardioverter-defibrillators.

A Survey of Physicians' Attitudes toward Decision-Making Authority for Initiating and Withdrawing VA-ECMO: Results and Ethical Implications for Shared Decision Making.

Objective: Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians' attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus.

Design, Setting, Participants: A survey of resident/fellow physicians and internal medicine attendings at an academic medical center, May to August 2013.