Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty.

Background: A not infrequent complication encountered with the direct anterior approach is perioperative fracture. The purpose of this study was to compare the incidence of perioperative fractures using a hybrid rasp-impaction broach vs an impaction broach for a similarly designed stem.

Methods: Retrospective study of 798 primary total hip replacements by 1 surgeon performed using noncollared dual tapered femoral stems, including 457 implanted using hybrid rasp-impaction broaching and 341 implanted using impaction broaching.

Perioperative Complications Stratified by Body Mass Index for the Direct Anterior Approach to Total Hip Arthroplasty.

Background: Previous studies have addressed the increased risk of perioperative complications in the obese and morbidly obese populations undergoing total hip arthroplasty. Over the last 15 years, the direct anterior approach has increased in popularity. The purpose of this study is to compare the 90-day perioperative complication rate of total hip arthroplasty performed through the direct anterior approach stratified by body mass index (BMI).

Isolated Greater Trochanteric Fracture and the Direct Anterior Approach Using a Fracture Table.

Background: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach.

Methods: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified.

MI TKA: a risk factor for early revision surgery.

Minimal incision total knee arthroplasty (MI TKA) was developed with the potential to decrease surgical trauma, pain, and recovery time. While this procedure has increased in popularity, some surgeons have questioned its safety and long-term efficacy. In this study 58 consecutive revision total knee arthroplasties (TKAs) (57 patients) performed at one academic medical center from 2006 to 2008 are reviewed.

Minimal incision surgery as a risk factor for early failure of total hip arthroplasty.

Background: Minimal incision total hip arthroplasty (MI THA) techniques were developed to decrease postoperative pain and recovery time. Although these techniques have increased in popularity, the long-term survivorship of these procedures is unknown.

Questions/purposes: We therefore investigated whether the time to revision in our referral practice was shorter for patients who underwent primary MI THA compared to primary traditional THA.

Rotational references for total knee arthroplasty tibial components change with level of resection.

Background: Various landmarks can guide tibial component rotational alignment in routine TKA, but with the deeper tibial resection levels common in complex primary and revision TKAs, it is unknown whether these landmarks remain reliable.

Questions/purposes: We asked whether three techniques for determining tibial component rotation based on local anatomic landmarks are reliable deeper tibial resection levels.

Patients And Methods: The femoral transepicondylar axis was identified by three independent reviewers on MR images of knees from 24 men and 24 women and transposed at a traditional tibial resection level and at the level of the proximal, middle, and distal parts of the proximal tibiofibular joint.

Bilateral knee arthrodesis in a patient with common variable immunodeficiency.

Patients with common variable immunodeficiency can present with debilitating arthritis. We present the case of a 42-year-old man with bilateral knee arthritis who underwent a right total knee arthroplasty that subsequently became infected. Five months after resection arthroplasty, his right leg spontaneously fused in extension, but his left knee was limited to an arc of motion between 90° and 110°.

Low back pain in the aging athlete.

Low back pain has an incidence between 1% and 30% in athletes. The natural history of low back pain is such that greater than 90% will improve without medical attention. Our treatment algorithm begins by ruling out nonspinal related causes of low back pain including neoplasm, infection, and serious medical conditions.