Automatic annotation of hip anatomy in fluoroscopy for robust and efficient 2D/3D registration.

Purpose: Fluoroscopy is the standard imaging modality used to guide hip surgery and is therefore a natural sensor for computer-assisted navigation. In order to efficiently solve the complex registration problems presented during navigation, human-assisted annotations of the intraoperative image are typically required. This manual initialization interferes with the surgical workflow and diminishes any advantages gained from navigation.

Correction to: Mechanically Induced Periprosthetic Osteolysis: A Systematic Review.

[This corrects the article DOI: 10.1007/s11420-018-9641-5.].

Mechanically Induced Periprosthetic Osteolysis: A Systematic Review.

Background: Peri-prosthetic bone loss can result from chemical, biological, and mechanical factors. Mechanical stimulation via fluid pressure and flow at the bone-implant interface may be a significant cause. Evidence supporting mechanically induced osteolysis continues to grow, but there is no synthesis of published clinical and basic science data.

Pose Estimation of Periacetabular Osteotomy Fragments With Intraoperative X-Ray Navigation.

Objective: State-of-the-art navigation systems for pelvic osteotomies use optical systems with external fiducials. In this paper, we propose the use of X-ray navigation for pose estimation of periacetabular fragments without fiducials.

Methods: A two-dimensional/three-dimensional (2-D/3-D) registration pipeline was developed to recover fragment pose.

Ceramic Femoral Heads for All Patients? An Argument for Cost Containment in Hip Surgery.

Trunnionosis and taper corrosion have recently emerged as problems in total hip arthroplasty (THA). No longer restricted to metal-on-metal bearings, these phenomena now affect an increasing number of metal-on-polyethylene THAs and are exacerbated by modularity. Resulting increases in metal toxicity and patient morbidity, and the added costs of toxicity surveillance and revision surgery, will place a substantial economic burden on many health systems.

Anteroposterior Radiographs Are More Accurate than Cross-Table Lateral Radiographs for Acetabular Anteversion Assessment: a Retrospective Cohort Study.

Background: Measuring acetabular anteversion is relevant to routine follow-up of total hip arthroplasties (THAs) and for malfunctioning THAs. Imageless navigation facilitates acetabular component orientation relative to the anterior pelvic plane (APP) or to the APP adjusted for sagittal pelvic tilt (PT). The optimal plain radiographic method for the postoperative assessment of anteversion is not agreed upon.

Radiation Exposure during Fluoroscopic Guided Direct Anterior Approach for Total Hip Arthroplasty.

Fluoroscopic guidance is commonly utilized during direct anterior total hip arthroplasty (DA THA). The purpose of this study was to measure patient and surgeon exposure utilizing this technique. Fifty-one consecutive patients who underwent primary DA THA by a single surgeon were prospectively studied.

Results of custom-fit, noncemented, semiconstrained total elbow arthroplasty for inflammatory arthritis at an average of eighteen years of follow-up.

Background: The literature available on the results after noncemented total elbow arthroplasty (TEA) in inflammatory arthritis is limited.

Methods: Ten patients (7 women, 3 men; 14 elbows total) who underwent custom, noncemented TEA from 1988 to 1995 were retrospectively reviewed. The average age was 28 years (range, 17-45 years).

Acetabular component orientation in total hip arthroplasty: the impact of obesity.

Introduction: Acetabular component position can be an important determinant of joint stability and bearing surface wear after THA. Nonetheless, the incidence of malpositioning is high. Patient obesity, low surgeon volume, and minimally invasive approaches are known risk factors for malposition.

The management of extensor mechanism complications in total knee arthroplasty. AAOS exhibit selection.

Complications involving the knee extensor mechanism and patellofemoral joint occur in 1% to 12% of patients following total knee arthroplasty and have major negative effects on patient outcomes and satisfaction. The surgeon must be aware of intraoperative, postoperative, and patient-related factors that can increase the rate of these problems. This review focuses on six of the most commonly encountered problems: patellar tendon disruption, quadriceps tendon rupture, patellar crepitus and soft-tissue impingement, periprosthetic patellar fracture, patellofemoral instability, and osteonecrosis of the patella.

Dual-mobility acetabular components in total hip arthroplasty.

With dislocation being one of the most serious complications of total hip arthroplasty, prevention of recurrent instability has been the driving force behind several implant designs, including large-diameter heads, metal-on-metal bearing surfaces, and constrained acetabular components. Dual-articulation acetabular component design was similarly conceived in an effort to reduce postoperative dislocation risk. This design, developed in France in 1975 and popularized in Europe, was recently approved in the United States and represents a new surgical option for United States orthopedic surgeons performing total hip arthroplasty.

Preoperative templating and its intraoperative applications for hip resurfacing arthroplasty.

Hip resurfacing arthroplasty (HRA) is a viable alternative to total hip arthroplasty (THA) in the younger, active adult with degenerative hip disease. However, hip resurfacing has proven to be technically demanding, as accurate component positioning is crucial for success, yet difficult to obtain. Risks of malpositioning of the femoral head include femoral neck notching, varus/valgus malalignment, and femoral neck fracture, while malpositioning of either component may lead to increased edge loading and metal ion levels.

Long term safety, efficacy, and patient acceptability of hyaluronic acid injection in patients with painful osteoarthritis of the knee.

The increasing prevalence of painful knee osteoarthritis has created an additional demand for pharmacologic management to prevent or delay surgical management. Viscosupplementation, via intraarticular injection of hyaluronic acid (HA), aims to restore the favorable milieu present in the nonarthritic joint. The safety profile of intraarticular HA injections for painful knee osteoarthritis is well established, with the most common adverse effect being a self-limited reaction at the injection site.

Patient-specific instrumentation in total knee arthroplasty: a review.

Recently, patient-specific approaches to total knee arthroplasty (TKA) have been introduced, in which preoperative imaging (plain radiographs, computed tomography, and magnetic resonance imaging) are used to manufacture cutting blocks specific to a patient's anatomy. Proposed benefits of patient-matched cutting blocks include a decrease in operative time, instrument trays required, and the ability to preoperatively plan a patient's component size, position, and alignment. In addition, an improvement in postoperative mechanical alignment is expected, without violation of the intramedullary canal.