Same Day Total Hip and Knee Arthroplasty Performed at Canada's First Academic Ambulatory Surgical Center Is Safe and Effective: Population Level Results.

Background: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are being increasingly performed as an outpatient procedure. Performing these procedures at an ambulatory surgical center (ASC) has been proposed as a way to create greater access to surgical care, improve efficiency, and contain costs. The purpose of this review was to analyze the introduction of a same-day THA and TKA program at Canada's first academic ASC.

Above-Knee Amputation Following Chronically Infected Total Knee Arthroplasty: Patient-Reported Satisfaction and Functional Outcomes.

Background: Periprosthetic joint infection (PJI) that arises following total knee arthroplasty (TKA) can usually be resolved through surgical and antimicrobial therapy. However, in approximately 5% of cases, an infection that is chronic and persistent will require treatment by above-knee amputation (AKA). This study seeks to provide an enhanced understanding of patient functionality and satisfaction following this devastating complication of one of the most commonly performed surgeries in the world.

Total Knee Arthroplasty With Robotic and Augmented Reality Guidance: A Hierarchical Task Analysis.

Background: Total knee arthroplasty (TKA) is a commonly performed procedure that has traditionally utilized reproducible steps using a set of mechanical instruments. The number of TKAs performed using robotic assistance is increasing, and augmented reality (AR) navigation systems are being developed. Hierarchical task analysis (HTA) aims to describe the steps of a specific task in detail to reduce errors and ensure reproducibility.

Intraoperative and Postoperative Outcomes of Patients Undergoing Total Knee Arthroplasty With Prior Anterior Cruciate Ligament Reconstruction: A Matched Cohort Analysis.

Background: Previous anterior cruciate ligament (ACL) injury is a risk factor for the development of knee osteoarthritis. Despite advances in ACL reconstruction (ACLR) techniques, many patients with history of ACLR develop end-stage osteoarthritis necessitating total knee arthroplasty (TKA). The purpose of this study was to investigate the impact of prior ACLR on intraoperative and postoperative outcomes of TKA.

Total Knee Arthroplasty Periprosthetic Joint Infection With Concomitant Extensor Mechanism Disruption and Soft-Tissue Defect: The Knee Arthroplasty Terrible Triad.

Background: Periprosthetic infection (PJI) with concomitant extensor mechanism disruption (EMD) and soft-tissue defect-hereinafter termed the "Terrible Triad"-is a devastating complication following total knee arthroplasty. The purpose of this study was to define the surgical and clinical outcomes following management of a cohort of patients who have the Terrible Triad.

Methods: From 2000 to 2022, 127 patients underwent operative management for PJI alone, 25 for PJI with soft-tissue defects (defined as defects requiring flap reconstruction or being a factor contributing to the decision of performing above-knee amputation or arthrodesis), 14 for PJI with EMD, and 22 for the Terrible Triad.

Good Short-Term Survivorship of Constrained Condylar Revision Knee Implants With Medial Pivot Kinematics: A Level IV Retrospective Study.

Background: The need for revision total knee arthroplasty surgery is increasing worldwide, and, in many cases, a constrained implant is required to provide joint stability. The purpose of this study was to examine the early loosening and functional outcome of a novel constrained condylar (CCK) revision total knee system designed to have medial pivot (MP) kinematics.

Methods: A retrospective cohort study was performed, collecting clinical data from all patients who underwent revision total knee arthroplasty using a novel MP CCK system with a minimum four-year clinical follow-up.

Long-term outcomes of the Nexgen posterior stabilized knee: minimum 15 year follow-safe and effective.

Purpose: Studying long-term survivorship and functional outcomes for specific prostheses is critical for elucidating areas in need of design improvement. This study reports the long-term of the NexGen Posterior Stabilized (PS) Total Knee implant (TKA) (Zimmer Biomet, Warsaw IN) Performed by a single surgeon.

Methods: Data from patients treated with the NexGen PS TKA between January 2003 and December 2005 with a minimal follow-up of 15 years was collected from a prospectively collected database.

Quality indicators in primary elective total hip and knee arthroplasty.

Purpose: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) represent a significant portion of healthcare spending and are high-priority for quality improvement initiatives. This study aims to develop quality indicators (QIs) in the care of primary elective THA and TKA patients. These QIs serve a number of purposes including documentation of the quality of care, objective comparisons of institutions/providers, facilitating pay-for-performance initiatives, and supporting accountability, regulation, and accreditation.

Comparison of Single-Radius with Multiple-Radius Femur in Total Knee Arthroplasty: A Meta-Analysis of Prospective Randomized Controlled Trials.

Background: Whether there was clinical superiority for the single-radius prosthesis over the multi-radius prothesis in total knee arthroplasty (TKA) still remains to be clarified. We updated a meta-analysis including prospective randomized controlled trials (RCTs) to compare the clinical prognosis of patients receiving single-radius TKA (SR-TKA) or multi-radius TKA (MR-TKA).

Methods: We searched the databases of PubMed, Web of Science, EMBASE, Cochrane Library, MEDLINE for eligible RCTs.

Clinical applications of augmented reality in orthopaedic surgery: a comprehensive narrative review.

Purpose: The development of augmented reality (AR) technology allows orthopaedic surgeons to incorporate and visualize surgical data, assisting the execution of both routine and complex surgical operations. Uniquely, AR technology allows a surgeon to view the surgical field and superimpose peri-operative imaging, anatomical landmarks, navigation guidance, and more, all in one view without the need for conjugate gaze between multiple screens. The aim of this literature review was to introduce the fundamental requirements for an augmented reality system and to assess the current applications, outcomes, and potential limitations to this technology.

Distal femoral replacement or internal fixation for management of periprosthetic distal femur fractures: A systematic review.

Background: The number of periprosthetic fractures above a total knee arthroplasty continues to increase. These fractures are associated with a high risk of morbidity and mortality. Techniques for addressing these fractures include open reduction internal fixation (ORIF) and revision arthroplasty, including distal femoral replacement (DFR).

Comparing Analgesia on an As-Needed Basis to Traditional Intravenous Patient-Controlled Analgesia Within Fast-Track Orthopedic Procedures: A Randomized Controlled Trial.

Background: The aim was to determine if the use of intravenous patient-controlled analgesia (IVPCA) in a fast-track joint replacement program is associated with increased use of perioperative opioid consumption and increased length of hospital stay.

Design: A prospective, double-blind, randomized controlled trial.

Settings: Academic hospital.

Nerve Injuries in Total Knee Arthroplasty.

Nerve injury is one of the potential complications of total knee arthroplasty. The extent of the injury includes motor and sensory dysfunction, either temporary or permanent. Although the consequences of nerve injury may be dramatic, the probability of occurrence during the course of primary knee arthroplasty is low, around 0.

Cemented Versus Hybrid Technique of Fixation of the Stemmed Revision Total Knee Arthroplasty: A Literature Review.

Stems are required during revision total knee arthroplasty to bypass damaged periarticular bone and transfer stress to healthier diaphyseal bone. The mode of stem fixation, whether fully cemented or hybrid, remains controversial. Improvements in surgical technique and implant and instrument technology have improved our ability to deal with many of the challenges of revision total knee arthroplasty.

A Comparison of Acute Complications and Mortality Between Geriatric Knee and Hip Fractures: A Matched Cohort Study.

Introduction: To compare acute complication and mortality rates for operatively treated, closed, isolated, low-energy geriatric knee fractures (distal femur [DFF] or tibial plateau [TPF]) with hip fractures (HFs).

Methods: This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program. We identified all patients ≥ 70 years from 2011 to 2016 who underwent surgery for DFF, TPF, or HF.

Outcomes of distal femoral arthroplasty after periprosthetic fractures : minimum 2-year follow-up.

Purpose: distal femoral periprosthetic fracture (DFPPF) is a serious complication following total knee arthroplasty (TKA). Recently, treatment of DFPPF with distal femoral arthroplasty (DFA) has gained popularity because of its posited benefits for both patients and the medical system. Short-term follow-up trials investigating DFA have demonstrated acceptable results with regards to function, pain relief and lower postoperative complications than ORIF in elderly patients.

Reducing Acute Hospitalization Length of Stay After Total Knee Arthroplasty: A Quality Improvement Study.

Background: The introduction of bundled funding for total knee arthroplasty (TKA) has motivated hospitals to improve quality of care while minimizing costs. The aim of our quality improvement project is to reduce the acute hospitalization length of stay to less than 2 days and decrease the percentage of TKA patients discharged to inpatient rehabilitation using an enhanced recovery after surgery bundle.

Methods: This study used a before-and-after design.