Utilization of Glucagon-Like Peptide-1 Receptor Agonist at the Time of Total Hip Arthroplasty for Patients Who Have Morbid Obesity.

Background: Morbid obesity negatively affects outcomes after total hip arthroplasty (THA). The optimal strategy for weight loss before THA has not been identified. Recently, glucagon-like peptide-1 receptor agonists (GLP-1 RA) have become increasingly popular as an effective pharmacologic weight loss agent.

Long-Term Treatment of Chronic Postamputation Pain With Bioelectric Nerve Block: Twelve-Month Results of the Randomized, Double-Blinded, Cross-Over QUEST Study.

Objective: The multicenter, randomized, double-blinded, active-sham controlled trial (high-freQUEncy nerve block for poST amputation pain [QUEST]) was conducted to show the safety and efficacy of a novel, peripherally placed high-frequency nerve block (HFNB) system in treating chronic postamputation pain (PAP) in patients with lower limb amputations. The primary outcomes from QUEST were reported previously. This study presents the long-term, single-cross-over, secondary outcomes of on-demand HFNB treatment for chronic PAP.

A Cost Analysis of Traditional Versus Robotic Total Knee Arthroplasty Performed With an Imageless, Second-generation Robotic System.

Background: This study compared perioperative outcomes as well as encounter and 90-day costs between patients undergoing traditional vs robotic total knee arthroplasty (rTKA).

Materials And Methods: A total of 430 TKAs (215 rTKAs, 215 traditional) were retrospectively reviewed. All rTKAs were performed with an imageless, second-generation robotic system.

The INVISION Talar Component in Revision Total Ankle Arthroplasty: Analysis of Early Outcomes.

Introduction: Launched in 2018 for revision total ankle arthroplasty (rTAA), the INVISION talar component addresses subsidence when poor talar bone stock is present. Due to the recency of the market-availability of the INVISION, studies evaluating its efficacy are lacking. This study presents the first analysis of early-term outcomes of patients undergoing rTAA with the INVISION talar component.

Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively.

Background: Tobacco use is a well-documented modifiable risk factor for perioperative complications.

Aim: To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty (TJA) procedure.

Methods: A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery.

Comparing a robotic imageless second-generation system to traditional instrumentation in total knee arthroplasty: A matched cohort analysis.

Introduction: Robotic-assisted total knee arthroplasty (rTKA) has gained interest from patients and surgeons alike. Robotic systems assist with gap balancing and bone cut accuracy, which can theoretically minimize post-operative pain by decreasing soft tissue damage. This study compared perioperative results, 30- and 90-day complications, patient-reported outcomes (PROs), and survivorship to all-cause revisions between patients undergoing traditional versus rTKA.

Primary 3-Month Outcomes of a Double-Blind Randomized Prospective Study (The QUEST Study) Assessing Effectiveness and Safety of Novel High-Frequency Electric Nerve Block System for Treatment of Post-Amputation Pain.

Purpose: This multicenter, randomized, double-blinded, active sham-controlled pivotal study was designed to assess the efficacy and safety of high-frequency nerve block treatment for chronic post-amputation and phantom limb pain.

Patients And Methods: QUEST enrolled 180 unilateral lower-limb amputees with severe post-amputation pain, 170 of whom were implanted with the Altius device, were randomized 1:1 to active-sham or treatment groups and reached the primary endpoint. Responders were those subjects who received ≥50% pain relief 30 min after treatment in ≥50% of their self-initiated treatment sessions within the 3-month randomized period.

Robotic-assisted total knee arthroplasty is associated with the use of thinner polyethylene liners compared to navigation-guided and manual techniques.

Purpose: The purpose of this study was to examine the effects of intraoperative technology use on the rate of using polyethylene liners 15 mm or greater during primary total knee arthroplasty (TKA).

Methods: There were 103,295 implants from 16,386 primary unilateral TKAs performed on 14,253 patients at a single institution between 1 January 2018, and 30 June 2022, included in the current study. Robotic assistance and navigation guidance were used in 1274 (8%) and 8345 (51%) procedures, respectively.

Risk Factors of Failure to Discharge Before "Two Midnights" in Outpatient-Designated Total Hip Arthroplasty.

Introduction: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only list but continued to classify admissions as inpatient if they include two midnights, complicating care if an outpatient THA requires extended hospitalization. This study evaluates risk factors of patients undergoing outpatient-designated THA with a length of stay (LOS) ≥ 2 days.

Methods: A total of 17,063 THA procedures designated as outpatient in the National Surgical Quality Improvement Program database between 2015 and 2020 were stratified by LOS < 2 days (n = 2,294, 13.

Timing of Renal Transplant Prior to Total Knee Arthroplasty Impacts 90-Day Postoperative Outcomes.

Background: Renal transplant (RT) patients are at increased risk for complications after total knee arthroplasty (TKA); however, it is unknown if the time from RT to TKA influences such risks. This study evaluated RT patients undergoing primary TKA at various time intervals after transplant. We hypothesized that increased time between RT and TKA would decrease the risk of complications after TKA.

The Posterior Approach is Associated With Lower Total Encounter and 90-Day Costs When Compared to the Direct Anterior Approach.

Background: The clinical impact of the surgical approach in total hip arthroplasty (THA) has been widely reviewed. This study evaluated the total encounter and 90-day costs of THA for 2 surgical approaches (posterior [P] and direct anterior [DA]) in 1 tertiary health system.

Methods: This is a retrospective review of 2,101 THAs (1,092 P and 1,009 DA) by 4 surgeons (2 with the highest volume of DA and P, respectively) from 2017 to 2022 at 1 academic center.

A Cost Analysis of Surgical Approach in Total Hip Arthroplasty.

Background: With pressures to decrease the financial burden of total hip arthroplasty (THA), it is imperative to understand the cost drivers of this procedure. This study evaluated operative and total encounter costs for two surgical approaches to THA-posterior (P) and direct anterior (DA).

Materials And Methods: A total of 233 THAs (134 P and 99 DA) performed by two fellowship-trained arthroplasty surgeons from 2017 to 2022 were reviewed.

Revision Total Ankle Arthroplasty Using the INBONE II System.

Background: The utilization of total ankle arthroplasty (TAA) for managing severe ankle osteoarthritis has become increasingly common, leading to a higher occurrence of revision TAA procedures because of failure of primary TAA. This study aims to examine the clinical results associated with revision TAA using the INBONE II system. Given the growing number of TAA revision procedures and a focus on motion-preserving salvage options, we evaluated our early experience with revision TAA.

Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System.

Background: Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arthroplasty (TKA). This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes.

Ultracongruent Polyethylene Liners Do Not Affect Survival of Total Knee Arthroplasty for Valgus Deformity.

Background: Valgus knee deformity is observed in nearly 10% of patients undergoing total knee arthroplasty (TKA). The degree of polyethylene constraint required to balance a valgus knee remains controversial, and historically, posterior-stabilized (PS) designs have been favored. This study evaluated the survivorship of TKA done in valgus knees based on implant design and specifically compared posterior-stabilized (PS) and ultracongruent (UC) liners.

Outcomes After Pseudomonas Prosthetic Joint Infections.

Background: Pseudomonas species are a less common but devastating pathogen family in prosthetic joint infections (PJIs). Despite advancements in management, Pseudomonas PJIs remain particularly difficult to treat because of limited antibiotic options and robust biofilm formation. This study aimed to evaluate Pseudomonas PJI outcomes at a single institution and review outcomes reported in the current literature.

Outcomes After Total Ankle Arthroplasty in Patients Aged ≤50 Years at Midterm Follow-up.

Background: Ankle arthritis differs from arthritis of the hip and knee in that 80% is posttraumatic and thus often occurs in a younger patient population. The literature supporting total ankle arthroplasty (TAA) in younger patients has increased over recent years and has bolstered the argument that in the short term, TAA in younger patients has successful outcomes that are comparable to older, lower-demand patients.The purpose of our study was to evaluate patient-reported outcomes (PROs) and implant survivorship at midterm after primary TAA in patients ≤ 50 years of age at the time of surgery.

Inertial Sensor Gait Analysis of Trendelenburg Gait in Patients Who Have Hip Osteoarthritis.

Background: Gait abnormalities such as Trendelenburg gait (TG) in patients who have hip osteoarthritis (OA) have traditionally been evaluated using clinicians' visual assessment. Recent advances in portable inertial gait sensors offer more sensitive, quantitative methods for gait assessment in clinical settings. This study sought to compare sensor-derived metrics in a cohort of hip OA patients when stratified by clinical TG severity.

Risk factors for failure after rotational muscle flap coverage for prosthetic knee infections.

Introduction: Soft tissue defects are a devastating complication of prosthetic joint infections (PJI) after total knee arthroplasty (TKA). Rotational flaps are commonly utilized to address these defects with variable reports of success. This study aimed to identify predictors of poor outcomes in rotational muscle flap placement after prosthetic knee infections.

Nationally Representative Trends in Incidence of Procedures Done Concomitantly With Primary and Revision Total Ankle From 2012 to 2020.

Background: As new literature emerges and practice patterns fluctuate, there is a significant potential for variation with regard to adjunctive procedures performed with primary total ankle arthroplasty (pTAA) and revision total ankle arthroplasty (rTAA). Our study aims to evaluate yearly trends in the incidence of concomitant procedures and compare the incidence of adjunctive procedures between pTAA and rTAA.

Methods: The 2012-2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all pTAA and rTAA.

Higher Risk of Reoperation after Total Knee Arthroplasty in Young and Elderly Patients.

As outcomes and survivorship improve, total knee arthroplasty (TKA) has expanded into broader age groups. The purpose of this study is to analyze the impact of age on TKA outcomes using the National Surgical Quality Improvement Program (NSQIP) database from 2015 to 2020. Patients were categorized into young (40-49 years), middle (50-79 years), and elderly (80-89 years) groups.

Younger Patients Undergoing Total Ankle Arthroplasty Experience Higher Complication Rates and Worse Functional Outcomes.

Background: Although many patients with posttraumatic ankle arthritis are of a younger age, studies evaluating the impact of age on outcomes of primary total ankle arthroplasty (TAA) have revealed heterogenous results. The purpose of the present study was to determine the effect of age on complication rates and patient-reported outcomes after TAA.

Methods: We retrospectively reviewed the records of 1,115 patients who had undergone primary TAA.