Complication rates are not higher after outpatient compared to inpatient fast-track total hip arthroplasty: a propensity-matched prospective comparative study.

Purpose: Concerns remain with regards to safety of fast-track (FT) and especially outpatient procedures. The purpose of this study was to compare complication rates and clinical outcomes of propensity-matched patients who received FT total hip arthroplasty (THA) in outpatient versus inpatient settings. The hypothesis was that 90-day postoperative complication rates of outpatient FT THA would not be higher than after inpatient FT THA.

No differences in clinical and radiographic outcomes between standard versus high offset collared stems for primary total hip arthroplasty at five years follow-up.

Purpose: To compare clinical and radiographic outcomes of propensity-matched patients undergoing THA using standard versus high offset stems at five years.

Methods: The authors retrospectively reviewed a consecutive series of primary THAs performed between 01/09/2015-31/12/2017 using a fully-hydroxyapatite coated collared stem, with either a standard (n = 365) or high (n = 110) offset. Outcomes collected included: modified Harris Hip Score (mHHS), Oxford Hip Score (OHS), Forgotten Joint Score (FJS), and radiographic measurements including limb length discrepancy (LLD), stem subsidence, and stem radiolucencies.

Survival and Clinical Outcomes at 30 to 35 Years Following Primary Total Hip Arthroplasty With a Cementless Femoral Stem Fully Coated With Hydroxyapatite.

Background: The purpose of the present study was to update and report clinical outcomes and survival of primary total hip arthroplasty using a cementless double-tapered titanium fully hydroxyapatite-coated stem at a follow-up > 30 years.

Methods: The outcomes of this series of 347 primary total hip arthroplasties were already published at a follow-up > 25 years, during which only 12 stems were revised. Since then, there were two additional stem revisions, bringing the total to 14 stem revisions (all of which also required cup revision).

MTHFR (methylenetetrahydrofolate reductase: EC 1.5.1.20) SNPs (single-nucleotide polymorphisms) and homocysteine in patients referred for investigation of fertility.

Purpose: MTHFR, one of the major enzymes in the folate cycle, is known to acquire single-nucleotide polymorphisms that significantly reduce its activity, resulting in an increase in circulating homocysteine. Methylation processes are of crucial importance in gametogenesis, involved in the regulation of imprinting and epigenetic tags on DNA and histones. We have retrospectively assessed the prevalence of MTHFR SNPs in a population consulting for infertility according to gender and studied the impact of the mutations on circulating homocysteine levels.

Bleeding and thromboembolism risk of standard antithrombotic prophylaxis after hip or knee replacement within an enhanced recovery program.

Introduction: Prevention of venous thromboembolism (VTE) generally consists of low molecular weight heparin (LMWH) or direct oral anticoagulants (DOACs) after total hip arthroplasty (THA) or total knee arthroplasty (TKA). Enhanced recovery after surgery (ERAS) protocols may reduce the VTE risk after these procedures. The aim of this study was to compare the risk of VTE and the risk of bleeding complications in a non-selected population of primary THA and TKA cases done within an ERAS protocol.

Absence of instabilities and intra-prosthetic dislocations at 7 to 11 years following THA using a fourth-generation cementless dual mobility acetabular cup.

Purpose: Dual-mobility (DM) cups are increasingly used in total hip arthroplasty (THA) but there lacks literature on their long-term results. We aimed to investigate outcomes of a fourth-generation cementless DM acetabular cup at 7-11 years.

Methods: We retrospectively evaluated 240 consecutive hips that received cementless THA using the same dual mobility cup (Novae Sunfit TH) and femoral stem (Corail).

[Importance of the determination of MTHFR SNPs (Methylene Tetrahydrofolate Reductase Single Nucleotide Polymorphisms) in couple infertility].

Objective: MTHFR SNPs (Methylene Tetrahydrofolate reductase Single Nucleotide polymorphisms) are biochemical modifications decreasing the capacity to form 5 MTHF 5 methyltetrahydrofolate (5MTHF). Their presence reduces the capacity of the One Carbon cycle, and so the regeneration of Homocysteine (Hcy) and in fine strongly perturbs all the methylation processes. As methylation processes are major regulators in gametogenesis and embryogenesis.

Midterm Clinical and Radiographic Outcomes of a Contemporary Monoblock Dual-Mobility Cup in Uncemented Total Hip Arthroplasty.

Background: The efficacy of contemporary monoblock dual-mobility (DM) cups to prevent dislocations in total hip arthroplasty (THA) is well reported, but there is little published data on their mid- to long-term outcomes. The authors aimed at reporting the 10-year survival of a contemporary DM cup as well as its clinical and radiographic outcomes.

Methods: From a retrospective consecutive multicentric series of 516 patients (541 hips) that received uncemented THA between June 2007 and June 2010, 6 patients (6 hips) had cup and stem revisions, 5 patients (5 hips) had isolated stem revision, and 2 patients (2 hips) had isolated insert revision.

Uncemented total hip arthroplasty in octogenarian and nonagenarian patients.

Purpose: While uncemented THA has proven benefits over cemented THA, the use of uncemented components in the elderly remains controversial. The purpose of this study was to compare functional outcomes and complication rates of uncemented THA in patients aged > 80 to patients aged < 80, and determine factors that independently influence functional outcomes.

Methods: The authors evaluated 411 consecutive uncemented THAs at a follow-up of 3.

Can Patients Practice Strenuous Sports After Uncemented Ceramic-on-Ceramic Total Hip Arthroplasty?

Background: Patients are often concerned about returning to sports after total hip arthroplasty (THA).

Purpose: To (1) evaluate sports participation and motivation rates in a large cohort of patients who underwent uncemented THA with ceramic-on-ceramic bearings and (2) determine whether patients' participation was associated with their motivation for each sport, preoperative demographics, or patient-reported outcomes.

Study Design: Case-control study; Level of evidence, 3.

Supporting the One-Carbon Cycle Restores Ovarian Reserve in Subfertile Women: Absence of Correlation with Urinary Bisphenol A Concentration.

Environmental endocrine disrupting chemicals (EDCs), including bisphenol A (BPA), induce DNA methylation errors and oxidative stress, and alter fertility. Animal studies have demonstrated that supporting the one-carbon cycle (1-CC) with appropriate dietary supplements can reduce the effects of EDCs. Anti-Mullerian hormone (AMH), a marker of ovarian functionality, has been tested in subfertile female patients, to control this hypothesis in humans.

Clinical and Radiographic Outcomes at 25-30 Years of a Hip Stem Fully Coated With Hydroxylapatite.

Background: Little is known about the survival of total hip arthroplasty implants with bioactive coatings beyond the first 20 years. The authors aimed to report survival of a tapered hip stem fully coated with hydroxylapatite (HA) at follow-up of 25-30 years.

Methods: Of the original series of 320 patients (347 hips), 12 patients (12 hips) had stem and cup revisions, 54 patients (55 hips) had cup revisions, 17 patients (17 hips) had liner exchange.

Surgical reconstruction of the medial patellofemoral ligament.

Various treatments for patellofemoral instability have been proposed, such as lowering or medialization of the tibial tubercle, division of the lateral retinaculum, plication of the medial retinaculum, lowering of the vastus medialis, and trochleoplasty. However, it has been difficult to analyze the outcomes of each technique because they are often performed in combination. Recent anatomical and biomechanical studies have shown that the medial patellofemoral ligament (MPFL) is the primary stabilizer of the patella between full extension and 30° flexion.

Influence of preoperative factors on the gain in flexion after total knee arthroplasty.

Unlabelled: Final flexion mobility after a total knee arthroplasty is an important factor in patient comfort. Some patients gain in flexion mobility, others do not. Is it possible to identify the clinical factors related to the patient that predicted the final gain in flexion?

Materials And Methods: A multicenter retrospective study directed by the Société française de la hanche et du genou (SFHG) was conducted on 1601 cases of total knee arthroplasty that had presented no complications and a minimal follow-up of 2 years.

Mitochondrial Targeted Endonuclease III DNA Repair Enzyme Protects against Ventilator Induced Lung Injury in Mice.

The mitochondrial targeted DNA repair enzyme, 8-oxoguanine DNA glycosylase 1, was previously reported to protect against mitochondrial DNA (mtDNA) damage and ventilator induced lung injury (VILI). In the present study we determined whether mitochondrial targeted endonuclease III (EndoIII) which cleaves oxidized pyrimidines rather than purines from damaged DNA would also protect the lung. Minimal injury from 1 h ventilation at 40 cmH2O peak inflation pressure (PIP) was reversed by EndoIII pretreatment.

Axial MRI index of patellar engagement: a new method to assess patellar instability.

Introduction: The aim of this study was to define a new index to measure lateral patellar displacement (LPD) using nuclear magnetic resonance imaging (MRI), an axial index of engagement of the patella (AEI) obtained from two different axial MRI views then to validate its use in a prospective series of patients presenting an objective patellar instability (OPI).

Materials And Methods: One hundred and thirty-five patients with OPI and no history of surgery of the patella were included in a prospective study organized by the French Society of Arthroscopy performed between June 2010 and August 2012. All patients underwent axial and sagittal MRI.

The introduction of a new MRI index to evaluate sagittal patellofemoral engagement.

Introduction: Patella alta is one of the primary factors of patellofemoral instability and its importance lies in the reduced engagement between patella and trochlea during the early degrees of flexion. The evaluation of patellar height is based on conventional x-rays, CT scan and, more recently, MRI. The objective of this multicentric prospective study is to describe a novel index to assess in the sagittal plane the functional engagement between patella and trochlea.

Patellar tendon autograft reconstruction of the anterior cruciate ligament with and without lateral plasty in advanced-stage chronic laxity. A clinical, prospective, randomized, single-blind study using passive dynamic X-rays.

Purpose: A prospective randomized study was performed to assess the influence of extra-articular ilio-tibial band tenodesis on the results of arthroscopic anterior cruciate ligament (ACL) reconstruction in patients with advanced-stage chronic anterior laxity of the knee.

Methods: Preoperatively, the two constituent groups of our series of 120 patients: group 1 (Kenneth Jones) and group 2 (Kenneth Jones+extra-articular ilio-tibial band tenodesis) were strictly comparable with regard to demographic data, activity level, interval between the injury and the operation, and even objective laxity. Through radiological measurements made by passive dynamic X-rays, we studied the evolution of the objective laxity on the two compartments (medial and lateral) of the knee before the surgery and in review.

Survival analysis of total knee arthroplasty at a minimum 10 years' follow-up: a multicenter French nationwide study including 846 cases.

Introduction: Survivorship for modern total knee arthroplasties (TKA) is not precisely known from large series, other than registries. The present retrospective study therefore analyzed 846 TKAs at a minimum 10 years' follow-up.

Hypothesis: Ten-year survivorship for TKAs in a multicenter study exceeds 90%, independently of design and level of prosthetic constraint.

Mitochondrial-targeted DNA repair enzyme 8-oxoguanine DNA glycosylase 1 protects against ventilator-induced lung injury in intact mice.

This study tested the hypothesis that oxidative mitochondrial-targeted DNA (mtDNA) damage triggered ventilator-induced lung injury (VILI). Control mice and mice infused with a fusion protein targeting the DNA repair enzyme, 8-oxoguanine-DNA glycosylase 1 (OGG1) to mitochondria were mechanically ventilated with a range of peak inflation pressures (PIP) for specified durations. In minimal VILI (1 h at 40 cmH(2)O PIP), lung total extravascular albumin space increased 2.

Osteolysis of the tibial plateau after meniscal repair with hybrid suture anchor.

Unlabelled: Preservation of the meniscus and consideration for repair is important when treating meniscal tears. Many techniques for repair have been described. At present, all-inside, suture anchor-based meniscal repair systems are widely used.

Metasul vs Cerasul bearings: a prospective, randomized study at 9 years.

The aims of our study were to compare metal-on-metal (Metasul) and ceramic-on-ceramic (Cerasul) bearings and to evaluate the clinical and radiographic results of these 2 different hard-on-hard bearings. We conducted a prospective, randomized study on a series of 250 cementless primary total hip arthroplasties. The prostheses were similar in all aspects except for the bearing surfaces: 50% of Metasul bearing and 50% of Cerasul bearing.

Reproducibility of an optical measurement system for the clinical evaluation of active knee rotation in weight-bearing, healthy subjects.

Introduction: A knee is typically evaluated passively by a clinician during an office visit, without using dedicated measurement tools. When the knee is evaluated with the patient standing and actively participating in the movement, the results will differ than when the knee is passively moved through its range-of-motion by the surgeon. If a precise measurement system was available, it could provide additional information to the clinician during this evaluation.

Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction.

Purpose: The aim of our study was to evaluate knee rotational laxity and proprioceptive function 2 years after partial anterior cruciate ligament (ACL) reconstruction. According to our hypothesis, partial ACL reconstruction could restore knee laxity and function to the intact level.

Methods: We conducted a study in fifteen consecutive patients undergoing partial ACL reconstruction.