Publications by authors named "Anton Khlopas"

Article Synopsis
  • * Researchers reviewed data on 1,148 shoulder surgeries, correlating Area Deprivation Index (ADI) scores from zip codes with patients' functional outcomes before and after surgery.
  • * Results indicated a weak negative correlation between higher ADI (representing greater area deprivation) and poorer preoperative and postoperative function; however, there was no significant difference in outcome achievement among socioeconomic groups for anatomic TSA.
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Background: Stilting is a novel technique used in reverse shoulder arthroplasty (RSA) in patients with significant glenoid bone loss. This technique utilizes peripheral locking screws placed behind an unseated portion of the baseplate to transmit forces from the baseplate to the cortical surface of the glenoid, without the need for bone grafting. The stilted screw, once locked, provides a fixed angle point of support for this unseated aspect of a baseplate.

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Basal cell carcinoma (BCC) is the most common form of skin cancer but rarely presents on the finger with few cases described in the literature. We present the case of a 77-year-old female with a nine-month history of biopsy-proven BCC on the dorsal aspect of her left index finger. Following the complete surgical excision of the tumor, a two-stage reverse cross-finger flap was performed, resulting in minimal impact on mobility and aesthetics and prompting a discussion on the efficacy of this approach in treating BCC of the hand.

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Background: Low socioeconomic status and neighborhood context has been linked to poor health care outcomes after total knee arthroplasty (TKA). The area deprivation index (ADI) addresses this relationship by ranking neighborhoods by socioeconomic disadvantage. We examined the following relationships of the ADI among TKA recipients: (1) patient demographics, (2) lengths of stay (LOS), (3) nonhome discharges, and (4) 90-day readmissions, emergency department visits, and reoperations.

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Introduction: The purpose of this study was to investigate the cost-effectiveness of robotic-assisted total knee arthroplasty (TKA) versus conventional manual TKA in patients with knee osteoarthritis.

Methods: A Markov model simulated the lifetime outcomes of TKA of patients at average age 60 years. Costs of robotic-assisted TKA included a preoperative CT scan and the costs for acquisition and use of robotic equipment (average $706,250).

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Background: We systematically reviewed the radiological outcomes of studies comparing robotic-assisted (RA-THA) and manual total hip arthroplasty (mTHA).

Methods: The PubMed, Embase, and Cochrane databases were queried from 1994-2021 for articles comparing radiographic outcomes between RA-THA and mTHA cohorts. A meta-analysis was conducted whenever sufficient data was present for common outcomes.

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The purpose of this study was to compare (1) operative time, (2) in-hospital pain scores, (3) opioid medication use, (4) length of stay (LOS), (5) discharge disposition at 90-day postoperative, (6) range of motion (ROM), (7) number of physical therapy (PT) visits, (8) emergency department (ED) visits, (9) readmissions, (10) reoperations, (11) complications, and (12) 1-year patient-reported outcome measures (PROMs) in propensity matched patient cohorts who underwent robotic arm-assisted (RA) versus manual total knee arthroplasty (TKA). Using a prospectively collected institutional database, patients who underwent RA- and manual TKA were the nearest neighbor propensity score matched 3:1 (255 manual TKA:85 RA-TKA), accounting for various preoperative characteristics. Data were compared using analysis of variance (ANOVA), Kruskal-Wallis, Pearson's Chi-squared, and Fisher's exact tests, when appropriate.

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 Distal radius fractures (DRFs) are increasingly managed surgically among fragility fractures due to prolonged life expectancy and surgical advancements. Yet, malnutrition can impact postoperative outcomes and complications. We sought to determine the impact of malnutrition on open reduction and internal fixation (ORIF) of DRFs during the perioperative and 30-day postoperative periods.

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Study Design: Retrospective comparative cohort study.

Objective: To evaluate: (1) pain relief efficacy; (2) opioid consumption; (3) length of stay (LOS); (4) discharge disposition (DD); and (5) safety and adverse effects of liposomal bupivacaine (LB) in pediatric patients who underwent spinal deformity correction.

Summary Of Background Data: LB is a long-acting, locally injectable anesthetic.

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Purpose: No definite treatment option with reasonable outcome has been presented for old and refractory flexion contracture after total knee arthroplasty (TKA). We describe a surgical technique for 21 refractory cases of knee flexion contracture, including 12 patients with history of failed manipulation under anesthesia (MUA).

Methods: Retrospective review was conducted for procedures performed by a single surgeon between 2005 and 2016.

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The management of AO/OTA (AO Foundation/Orthopaedic Trauma Association) 33-C3 complex distal femoral fractures presents challenges for orthopaedic surgeons. The extensile anterior approach may be an appropriate alternative treatment technique. The purpose of this systematic review is to (1) evaluate the Olerud approach (extensile anterior approach) for the treatment of 33-C3 complex distal femoral fractures and (2) evaluate postoperative patient outcomes.

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Introduction: The current value-driven healthcare system encourages physicians to continuously optimize the value of the services they provide. Relative value units (RVUs) serve as the basis of a reimbursement model linking the concept that as the effort and value of services provided to patient's increases, physician reimbursement should increase proportionately. Spine surgery is particularly affected by these factors as there are multiple ways to achieve similar outcomes, some of which require more time, effort, and risk.

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Introduction: This study sought to determine the effect that malnutrition, defined as hypoalbuminemia, has on hip fracture patients treated with total hip arthroplasty (THA). Specifically, we evaluated: (1) demographics and perioperative data; (2) postoperative complications; and (3) re-operation rates.

Methods: The National Surgical Quality Improvement Program database was utilised to identify hip fracture patients who underwent THA from 2008 to 2015.

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Ankle osteoarthritis constitutes a large burden to society and is a leading cause of chronic disability in the United States. Most commonly, it is post-traumatic, occurs in younger individuals, and is associated with obesity. This entity presents similarly to osteoarthritis of the other joints, with the typical nonspecific symptoms of stiffness, swelling, and pain.

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Acetabular bone loss is common during revision total hip arthroplasty (THA). A new acetabular shell was developed with a goal of maintaining native hip center-of-rotation (COR) while achieving good fixation with standard instrumentation and technique. Previous radiographic studies have demonstrated the efficacy of this shell in lowering hip COR.

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Background: The purpose of this study was to evaluate hospital admissions for revision surgeries associated with robotic arm-assisted unicompartmental knee arthroplasty (rUKA) vs manually instrumented UKA (mUKA) procedures.

Methods: Patients ≥18 years of age who received either a mUKA or a rUKA procedure were candidates for inclusion and were identified by the presence of appropriate billing codes. Procedures performed between March 1, 2013 and July 31, 2015 were used to calculate the rate of surgical revisions occurring within 24-months of the index procedure.

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Background: The aims of this study were to investigate the following questions: (I) what are the mortality rates in patients age 55 years and younger who underwent a hip resurfacing arthroplasty (HRA) versus a standard total hip arthroplasty (THA)? (II) is the type of operation independently associated with mortality?

Methods: The database of a single high-volume surgeon was reviewed for patient's age 55 years and younger who underwent a hip arthroplasty between 2002 and 2010. This yielded 505 HRA patients and 124 THA patients. Chi-square analysis was performed to identify a 5-year mortality rate difference between the two cohorts.

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Several conditions may predispose patients to development of antero-lateral acetabular bone deficiency, including developmental dysplasia of the hip, osteonecrosis, or septic arthritis, among others. This may compromise the ability to gain acetabular component stability and impair reliable fixation. Large acetabular shells have often been used to achieve adequate fixation in scenarios of severe bone loss, however, these techniques have been shown to elevate the center of rotation (COR) of the hip and alter hip biomechanics.

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Background: Relative value units (RVUs) are a physician reimbursement model based on the effort required, or value, in providing a procedure or service for a patient. Procedures such as conversion total hip arthroplasties (THAs) can be compared to primary THAs, but many studies have revealed increased difficulties in conversion cases. Despite the increased time and effort for conversion THA, it is unknown if this is reflected in the RVU compensation model.

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Overuse injuries of the extensor mechanism of the knee are common in both athletes and non-athletes and usually occur during activities associated with repetitive loading, stress, and knee extension. Numerous reports have been published describing extensor mechanism injuries in athletes, but there is a paucity of studies that focus on quadriceps tendinopathy in the non-athlete population. In addition, there is no universally accepted classification system for tendon pathology.

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Overuse injuries of the extensor mechanism of the knee are common in both athletes and non-athletes and usually occur during activities associated with repetitive loading, stress, and knee extension. Historically, they have been labeled as Jumper's knee due to the high prevalence seen in the athletic community. In many published reports, the name "patellar tendinopathy" is used to describe this disorder of the quadriceps tendon at the patellar insertion, and the names are often used interchangeably.

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Soft tissue dysfunction can result from the degeneration of tissues as in the case of degenerative tendinopathy or from the build-up of problematic scar tissue, which can be the result of several aggravating factors, including overuse injuries, acute or chronic trauma, or as a result of surgery. This dysfunction often results in impaired movement, pain, and swelling of the affected area, which can lead to patient dissatisfaction and a lower quality of life. These soft tissue dysfunctions also have a marked economic impact.

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Background: Multiple surgical and non-surgical modalities are available for patients suffering from shoulder elbow, forearm, wrist, knee and ankle stiffness. For most patients, bracing can provide optimal therapy to restore functional range of motion (ROM). Three commonly used bracing mechanisms include static progressive stretch (SPS), turnbuckle, and dynamic bracing.

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The purpose of this study was to perform a 3-month interim comparative analysis on outcomes between robotic-arm-assisted total knee arthroplasty (RATKA) and manual TKA patients. Specifically, we evaluated (1) patient self-reported symptoms, (2) expectations and satisfaction, and (3) functional activities, based on the 2011 Knee Society Scoring System. Between June 1, 2016, and March 31, 2018, 252 patients (102 manual and 150 robotic) were enrolled into a prospective, nonrandomized, open-label, multicenter comparative cohort study.

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