Mortality After Revision Total Hip Arthroplasty.

Background: In counseling patients about the complications of revision total hip arthroplasty (revTHA), it is imperative that mortality be considered. The actual mortality rate by indication of revision is ill-defined. The purpose of this study is to determine the mortality rate after revTHA.

Long-term performance of oxidized zirconium on conventional and highly cross-linked polyethylene in total hip arthroplasty.

Introduction: Polyethylene wear and subsequent osteolysis remain obstacles to the long-term survivorship of total hip arthroplasty (THA). Highly cross-linked polyethylene (XLPE) with radical quenching represents a massive leap forward with dramatically improved wear rates compared to ultra-high molecular weight polyethylene (UHMWPE). In this study we evaluate the wear of UHMWPE and XLPE coupled with oxidized zirconium (OxZr) femoral heads.

Timing of Pavlik Harness Initiation: Can We Wait?

Background: Developmental dysplasia of the hip is effectively treated with a Pavlik harness (PH) within the first 6 months of life. Over 80% of unstable hips in the newborn period will naturally stabilize by 2 months of age. If there is no difference in the effectiveness of initiating PH treatment at 1 week compared with 4 weeks of age, waiting may allow the hips to naturally stabilize and avoid treatment.

Increased Orthopedic Specialization Lowers Costs and Improves Outcomes in Total Joint Arthroplasty.

Background: Total joint arthroplasty (TJA) volumes have risen in the past decade, resulting in increased national spending. Prior studies indicate that TJA performed at higher-volume hospitals result in better patient outcomes at lower costs. The purpose of this study is to determine whether increased orthopedic specialization has similar effects.

Socio-demographic factors impact time to discharge following total knee arthroplasty.

Aim: To determine social, logistical and demographic factors that influence time to discharge in a short stay pathway (SSP) by following total knee arthroplasty (TKA).

Methods: The study included primary TKA's performed in a high-volume arthroplasty center from January 2016 through December 2016. Potential variables associated with increased hospital length of stay (LOS) were obtained from patient medical records.

Clinical Outcomes Following the Use of Constrained Condylar Knees in Primary Total Knee Arthroplasty.

Background: Certain clinical or adverse intraoperative situations require the use of increased constraint in primary total knee arthroplasty (TKA). These include significant angular deformities causing incompetent collateral ligaments, or inadvertent intraoperative injury to collateral structures as well as the inability to achieve a balanced flexion and extension gap. Clinical success has been described with the use of constrained condylar knee arthroplasty in the primary setting in these situations.

Radiographically Silent Loosening of the Acetabular Component in Hip Arthroplasty.

Polyethylene wear and subsequent osteolysis are major obstacles to the long-term success of total hip arthroplasty (THA). We conducted a study to determine the incidence of loose acetabular components that did not show frank signs of loosening on either plain radiography or computed tomography (CT), or radiographically silent loosening (RSL). In this retrospective study, we evaluated patients who underwent revision THA and were evaluated with plain radiography and CT between 2000 and 2012.

Stem length in revision total knee arthroplasty.

Stems are intramedullary extensions of either the femoral or tibial component of a total knee arthroplasty (TKA) designed to increase the mechanical stability to decrease the risk of aseptic loosening. Biomechanical studies have shown that TKA stems increase the mechanical stability by transferring load over a larger area and thereby reduce strain at the bone-component interface [1-4]. The length of a revision TKA stem is determined by the patient's anatomy and the intended fixation, namely fully cemented or press-fit cortical contact.

Does Implant Design Influence the Accuracy of Patient Specific Instrumentation in Total Knee Arthroplasty?

PSI software adjusts preoperative planning to accommodate differences in implant design. Such adjustments may influence the accuracy of intraoperative jig placement, bone resection, or component placement. Our purpose was to determine whether implant design influences PSI accuracy.

Femoral component rotation in total knee arthroplasty: an MRI-based evaluation of our options.

Proper femoral component rotation is crucial in successful total knee arthroplasty. Rotation using anatomic landmarks has traditionally referenced the transepicondylar axis (TEA), Whiteside's Line (WSL), or posterior condylar axis (PCA). TEA is thought to best approximate the flexion-axis of the knee, however WSL or PCA are common surrogates in the operating room.

Aspirin and compression devices versus low-molecular-weight heparin and PCD for VTE prophylaxis in orthopedic oncology patients.

Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are possible sources of morbidity and mortality in patients with musculoskeletal neoplasms (MSN).

Objective: To compare the efficacy of aspirin (ASA) and pneumatic compression devices (PCD) to low-molecular-weight heparin (LMWH) and PCD in patients undergoing orthopedic procedures for MSN of the pelvis or lower extremity.

Methods: Of 348 patients who met the study criteria, 195 were treated with ASA/PCD and 153 with LMWH/PCD.