Early Patient-Reported Outcome Measures Following Computer Navigated Total Hip Arthroplasty: A Study From the Australian Orthopaedic Association National Joint Replacement Registry.

Background: Total hip arthroplasty (THA) is a well-established treatment for symptomatic hip osteoarthritis (OA). The use of computer navigation in THA aims to achieve the reconstruction of the joint more consistently and precisely. The aim of this study was to contrast patient-reported outcome measures (PROMs) for THA procedures with and without commercially available navigation technologies.

Understanding immune-mediated titanium allergy to in situ orthopaedic implants: a narrative review of the current literature.

Introduction: Clinical recognition of potential immune-mediated allergic responses to implanted metal devices is increasing. For orthopaedic implants, while 'pure' compounds are used in specific circumstances, the majority of components are alloys - a combination of two or more distinct metals. Titanium is found commonly in many orthopaedic devices and is often championed as a 'hypoallergenic' option or inclusion.

Gender differences in unintended anterior pelvic roll during primary THA in the lateral position.

Background: Fundamental morphologic differences between male and female pelvises are historically recognised. Despite this, little consideration has been given as to whether or not conventional positioning supports used for primary total hip arthroplasties (THAs) performed in the lateral position do an equally effective job of maintaining the intended set up position when comparing genders. Given that recent research has highlighted that unintended pelvic roll occurs commonly during hip surgery, and that such movement may have a mechanically-deleterious consequence upon final construct performance and complication rates, this study was undertaken to explore the differences in pelvic roll between genders.

Understanding immune-mediated cobalt/chromium allergy to orthopaedic implants: a meta-synthetic review.

Background: The frequency of primary joint replacement surgery continues to increase worldwide. While largely considered biologically inert entities, an increasing body of evidence continues to validate a not insignificant incidence of allergic reactions to such implants. Little previous work has explored genuinely immune-mediated reactivity in this context.

Corrigendum to "Early Revision Rates of Total Hip Arthroplasty Using the Intellijoint HIP Computer Navigation System: A Study From the Australian National Joint Replacement Registry of 1911 Procedures." [Arthroplasty Today 18 (2022) 149-156].

[This corrects the article DOI: 10.1016/j.artd.

Quantifying anterior pelvic roll during total hip arthroplasty in the lateral decubitus position.

Background: Unintended pelvic positional change is an acknowledged intra-operative problem for hip arthroplasty, seen commonly with procedures performed in the lateral position. If unrecognised, such changes can dramatically alter final acetabular component anteversion potentially resulting in suboptimal construct performance. It has previously been suggested that pelvic roll of just 13° may be enough to place an otherwise perfectly orientated cup outside of conventional ± 10° safe zones.

A role for artificial intelligence applications inside and outside of the operating theatre: a review of contemporary use associated with total knee arthroplasty.

Background: Artificial intelligence (AI) has become involved in many aspects of everyday life, from voice-activated virtual assistants built into smartphones to global online search engines. Similarly, many areas of modern medicine have found ways to incorporate such technologies into mainstream practice. Despite the enthusiasm, robust evidence to support the utility of AI in contemporary total knee arthroplasty (TKA) remains limited.

The Diagnostic Utility of Serum Metal Ion Markers for High-Grade Aseptic Lymphocyte-Dominated Vasculitis-Associated Lesions (ALVALs) in Revision Hip and Knee Arthroplasty: An International Multicenter Study.

Background: Aseptic lymphocyte-dominated vasculitis-associated lesions (ALVALs) are typically described in the context of metal-on-metal (MoM) hip bearings. This study explores the diagnostic utility of preoperative serum cobalt and chromium ion levels in determining the histological grade of ALVAL in revision hip and knee arthroplasty.

Methods: This was a multicenter retrospective review of 26 hips and 13 knees assessing the correlation between preoperative ion levels (mg/L (ppb)) and the histological grade of ALVAL from intraoperative specimens.

Early Revision Rates of Total Hip Arthroplasty Using the Intellijoint HIP Computer Navigation System: A Study From the Australian National Joint Replacement Registry of 1911 Procedures.

Background: Total hip arthroplasty (THA) is an effective treatment for symptomatic hip osteoarthritis. The aim of this study was to determine the revision outcome of commercially available navigation technologies.

Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry from January 2016 to December 2020 included all primary THA procedures performed for osteoarthritis.

Clinical Impact of Pelvic Malrotation on Radiograph-Based Preoperative Planning for Total Hip Arthroplasty: A Proof-of-Concept and Prudent Prediction of Acceptable Rotation.

Introduction: Pelvic rotation (PR) on preoperative radiograph templating can affect various critical measured acetabular angles and potentially outcomes of successful total hip arthroplasty (THA). Optimising anatomical reconstruction of the joint is essential to achieve function, longevity and prevention of complications following surgery. There is limited literature that standardises the degree of acceptable PR on radiograph or its effects on the fitting of acetabular prostheses.

Patellar button compatibility in the conversion of Patellofemoral Arthroplasty to a Total Knee Arthroplasty: A review of the contemporary literature.

Background: Compared to total knee arthroplasty (TKA), patellofemoral arthroplasty (PFA) is a far less commonly performed operation. However, in carefully selected cohorts, PFA continues to be an appropriate treatment option for end-stage isolated patellofemoral joint osteoarthritis. In the later situation whereby a PFA is considered for conversion to a TKA - often due to disease progression - uncertainty remains regarding optimal management of the in situ patellar button.

Artificial intelligence in orthopedic surgery: evolution, current state and future directions.

Technological advances continue to evolve at a breath-taking pace. Computer-navigation, robot-assistance and three-dimensional digital planning have become commonplace in many parts of the world. With near exponential advances in computer processing capacity, and the advent, progressive understanding and refinement of software algorithms, medicine and orthopaedic surgery have begun to delve into artificial intelligence (AI) systems.

Eradicating Fungal Periprosthetic TKA "Super-infection": Review of the Contemporary Literature and Consideration of Antibiotic-Impregnated Dissolving Calcium Sulfate Beads as a Novel PJI Treatment Adjunct.

Fungal periprosthetic joint infections are an uncommon but potentially devastating complication of arthroplasty surgery. The concurrent presence of a coexistent bacterial pathogen-a so called "super-infection"-adds further complexity. With delays to definitive diagnosis and a large number of procedures before cure, the associated physical and psychological morbidity is considerable.

Is there an indication to utilize intravenous iron in acute trauma patients? Why, how, and when.

Purpose Of Review: Traumatic injury has been described as a growing pandemic which has significant implications for global health. In the trauma setting, anemia is a common occurrence and is frequently inadequately addressed. It is associated with significant morbidity and incurs great cost - both to the patient and to the health system.

Gabapentoids in knee replacement surgery: contemporary, multi-modal, peri-operative analgesia.

Pain remains a significant barrier to rapid patient recovery and rehabilitation post-surgery, particularly after joint replacement surgery. Historically, protocols used for peri-operative pain management have been largely reactive and dependent on opioid use, with adjunctive non-steroidal and other simple analgesia. This review explores the evidence supporting the use of gabapentoids (eg.

Pseudotumors and High-Grade Aseptic Lymphocyte-Dominated Vasculitis-Associated Lesions Around Total Knee Replacements Identified at Aseptic Revision Surgery: Findings of a Large-Scale Histologic Review.

Background: Aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) development (including pseudotumors) secondary to metal debris generation around total hip arthroplasties is a well-recognized histopathologic phenomenon. Emerging data have highlighted a similar potential concern around TKAs although the body-of-knowledge has largely been limited to individual case reports or small retrospective case series. This study sought to establish the prevalence of pseudotumors or high-grade ALVALs seen at the revision of primary TKAs and to establish the correlation between histologic ALVAL grade and patient-reported functional outcome measures.

Frank Stinchfield Award: Identification of the At-risk Genotype for Development of Pseudotumors Around Metal-on-metal THAs.

Background: Once touted as the future of hip arthroplasty, metal-on-metal (MoM) bearing surfaces have fallen sharply from favor with the emergence of a strong body of evidence demonstrating unacceptably high premature implant failure rates. The previously unpredictable development of adverse local tissue reactions (ALTRs) has been a substantive contributor to this. Although the underlying pathophysiology of these so-called "pseudotumors" is now well understood, the fundamental predisposing patient risk factors have remained elusive.

The effect of nonsteroidal anti-inflammatory drug administration on acute phase fracture-healing: a review.

Background: The analgesic efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) is well established, and these agents often form an integral part of posttraumatic pain management. However, potentially deleterious effects of resulting prostaglandin suppression on fracture-healing have been suggested.

Methods: A systematic literature review involving searches of electronic databases and online sources was performed to identify articles exploring the influence of NSAIDs on fracture-healing.

In vitro evaluation of a manganese chloride phantom-based MRI technique for quantitative determination of lumbar intervertebral disc composition and condition.

The application of MRI as a non-invasive, quantitative tool for diagnosing lumbar intervertebral disc degeneration is currently an area of active research. The objective of this study was to examine, in vitro, the efficacy of a manganese chloride phantom-based MRI technique for quantitatively assessing lumbar disc composition and degenerative condition. Sixteen human lumbar discs were imaged ex vivo using T2-weighted MRI, and assigned a quantitative grade based on the relative signal intensities of nine phantoms containing serial concentrations of manganese chloride.