Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty.

Purpose: Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA.

Methods: 1736 patients within a prospective observational study were categorized into BMI classes.

Impact of Chronic Opioid Use on Postoperative Mobility Recovery and Patient-Reported Outcomes: A Propensity-Matched Study.

Background: Opioid use prior to total joint arthroplasty may be associated with poorer postoperative outcomes. However, few studies have reported the impact on postoperative recovery of mobility. We hypothesized that chronic opioid users would demonstrate impaired objective and subjective mobility recovery compared to nonusers.

No Difference in Perioperative Complications for Bilateral Total Knee Arthroplasty Staged at 1 Week Compared With Delayed Staging.

Introduction: Controversy exists regarding the safety of simultaneous bilateral total knee arthroplasty (TKA) versus two TKA procedures staged months apart in patients with bilateral knee arthritis. Here, we investigated a third option: bilateral TKA staged 1 week apart. In this study, we examined the rate of complications in patients undergoing bilateral TKA staged at 1 week compared with longer time intervals.

Does Dual-Eligible Medicare/Medicaid Insurance Status as a Surrogate for Socioeconomic Status Compromise Total Knee Arthroplasty Outcomes?

Background: Medicare/Medicaid dual-eligible patients who undergo primary total knee arthroplasty (TKA) demonstrate poor outcomes when compared to patients with other payers. We compare Medicare/Medicaid dual-eligible patients vs Medicare and Medicaid only patients at a single hospital center.

Methods: All patients who underwent TKA for aseptic arthritis between August 9, 2016 and December 30, 2020 with either Medicare or Medicaid insurance were retrospectively reviewed.

Does the Preferred Study Source Impact Orthopedic In-Training Examination Performance?

Objective: This study examines the role of electronic learning platforms for medical knowledge acquisition in orthopedic surgery residency training. This study hypothesizes that all methods of medical knowledge acquisition will achieve similar levels of improvement in medical knowledge as measured by change in orthopedic in-training examination (OITE) percentile scores. Our secondary hypothesis is that residents will equally value all study resources for usefulness in acquisition of medical knowledge, preparation for the OITE, and preparation for surgical practice.

The accuracy of patient-reported weight prior to total joint arthroplasty and arthroscopy of the lower extremity.

Purpose: The accuracy of preoperative patient-reported weight was never evaluated in patients undergoing lower extremity procedures. The purpose of this study was to: (1) compare the disparity between patient-reported and measured weights in patients undergoing lower extremity total joint arthroplasty (LE-TJA) and arthroscopy; and (2) investigate the association between patient-specific factors (patient age, BMI, zip code, and psychiatric comorbidities) and the accuracy of patient-reported weight.

Methods: Preoperative self-reported weights were retrospectively compared to measured weights in 400 LE-TJA and 85 control arthroscopy patients.

Preoperative risk stratification minimizes 90-day complications in morbidly obese patients undergoing primary total knee arthroplasty.

Aims: It has been shown that the preoperative modification of risk factors associated with obesity may reduce complications after total knee arthroplasty (TKA). However, the optimal method of doing so remains unclear. The aim of this study was to investigate whether a preoperative Risk Stratification Tool (RST) devised in our institution could reduce unexpected intensive care unit (ICU) transfers and 90-day emergency department (ED) visits, readmissions, and reoperations after TKA in obese patients.

Analgesic efficacy of adding the IPACK block to a multimodal analgesia protocol for primary total knee arthroplasty.

Background And Objectives: Peripheral nerve blocks have been integrated into most multimodal analgesia protocols for total knee arthroplasty (TKA). The adductor canal block (ACB) has gained popularity because of its quadriceps muscle sparing. Similarly, local anesthetic injection between the popliteal artery and the posterior capsule of the knee, IPACK block, has been described to provide analgesia to the posterior capsule of the knee with motor-sparing qualities.

Prospective Study of Central versus Peripheral Obesity in Total Knee Arthroplasty.

Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA.

Materials And Methods: We prospectively enrolled 67 patients undergoing primary TKA.

Prophylactic Tibial Stem Fixation in the Obese: Comparative Early Results in Primary Total Knee Arthroplasty.

Purpose: Obesity is a risk factor for aseptic loosening after total knee arthroplasty (TKA). Prophylactic use of tibial stems may enhance tibial fixation in obese patients. The aim of this study was to determine whether a tibial stem extension decreases rates of early failure in obese patients.

Uncemented Tantalum Monoblock Tibial Fixation for Total Knee Arthroplasty in Patients Less Than 60 Years of Age: Mean 10-Year Follow-up.

Background: Although tibial component loosening has been considered a concern after total knee arthroplasty without cement, such implants have been used in younger patients because of the potential for ingrowth and preservation of bone stock. However, mid-term and long-term studies of modern uncemented implants are lacking. We previously reported promising prospective 5-year outcomes after using an uncemented porous tantalum tibial component in patients who underwent surgery before the age of 60 years.

Patient education and anesthesia choice for total knee arthroplasty.

Objectives: Spinal anesthesia (SA) for Total Knee Arthroplasty (TKA) may be associated with better patients' outcomes. This study aims to assess the association between preoperative education about the advantage of SA over general anesthesia (GA) for TKA and the likelihood of patient choice of NA.

Methods: Patients undergoing unilateral primary TKA were identified.

Selecting the Best and Brightest: A Structured Approach to Orthopedic Resident Selection.

Background: Resident selection is integral to the graduate medical educational process and the future of our profession. There is no consensus among residency directors as to how to systematically and consistently screen and select applicants who would perform well as residents. The purpose of this study was to introduce and assess a high volume application screening tool and semistructured interview process.

The Risk of Falls After Total Knee Arthroplasty with the Use of a Femoral Nerve Block Versus an Adductor Canal Block: A Double-Blinded Randomized Controlled Study.

Background: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk.

Surgical management of osteonecrosis of the femoral head in patients with sickle cell disease.

Sickle cell disease is a known risk factor for osteonecrosis of the hip. Necrosis within the femoral head may cause severe pain, functional limitations, and compromise quality of life in this patient population. Early stages of avascular necrosis of the hip may be managed surgically with core decompression with or without autologous bone grafting.

Is bilateral total knee arthroplasty staged at a one-week interval safe? A matched case control study.

Controversy surrounds the safety of bilateral total knee arthroplasty (TKA) and whether staging the procedures one week apart represents a safer option. A consecutive series of 234 patients underwent either a simultaneous (103 patients) or staged bilateral TKA (131 patients) from 2007 to 2012 and were compared to a matched control group of unilateral TKA (131 patients). Staged patients had no difference in one-year complication rate when compared to simultaneous bilateral TKA and the matched unilateral TKA control group (15% vs.

One-week staged bilateral total knee arthroplasty protocol: a safety comparison of intended and completed surgeries.

The number of patients requiring bilateral total knee arthroplasty (TKA) is expected to grow rapidly. While some trials have compared staged with simultaneous TKA, no literature characterizes the subset of staged TKA patients who cancel their second surgery. In this study, we report on the safety and utility of a one-week staged TKA protocol in a series of 145 patients who registered to undergo staged bilateral total knee arthroplasty one week apart.

Converting between high- and low-sensitivity C-reactive protein in the assessment of periprosthetic joint infection.

Although low-sensitivity CRP (Ls-CRP) is an important tool for evaluating infected orthopedic prostheses, no clinical studies have evaluated whether Hs-CRP is a suitable surrogate for Ls-CRP or other traditional infection biomarkers. The laboratory data of 98 arthroplasty patients with suspected prosthetic infection were reviewed. Hs-CRP was highly correlated with Ls-CRP (R = 0.

R-Spondin 1 promotes vibration-induced bone formation in mouse models of osteoporosis.

Unlabelled: Bone tissue adapts to its functional environment by optimizing its morphology for mechanical demand. Among the mechanosensitive cells that recognize and respond to forces in the skeleton are osteocytes, osteoblasts, and mesenchymal progenitor cells (MPCs). Therefore, the ability to use mechanical signals to improve bone health through exercise and devices that deliver mechanical signals is an attractive approach to age-related bone loss; however, the extracellular or circulating mediators of such signals are largely unknown.

Transfer of hip arthroplasty patients leads to increased cost and resource utilization in the receiving hospital.

Factors other than complexity of care often drive the transfer of orthopedic patients to tertiary centers. We sought to compare the demographics, diagnoses, insurance data, peri-operative outcomes and institutional costs of total hip arthroplasty patients transferred from outside facilities with those of patients derived from our clinics. We analyzed 419 consecutive patients as part of a prospective risk study.

Unplanned hip arthroplasty imposes clinical and cost burdens on treating institutions.

Background: Emergent surgery has been shown to be a risk factor for perioperative complications. Studies suggest that patient morbidity is greater with an unplanned hip arthroplasty, although it is controversial whether unplanned procedures also result in higher patient mortality. The financial impact of these procedures is not fully understood, as the costs of unplanned primary hip arthroplasties have not been studied previously.

Prospective study of unplanned admission to the intensive care unit after total hip arthroplasty.

The morbidity associated with elective total hip arthroplasty (THA) may result in intensive care unit (ICU) admission. A total of 175 consecutive THA patients were prospectively triaged to either an ICU bed or routine post-operative floor according to admission criteria based on a prior published study of 1259 THA patients. Primary end points were a reduction in unplanned ICU admission, as well as major complications.

Revision total knee arthroplasty after severe notching of the anterior femoral cortex.

Anterior femoral cortex notching is a known complication of total knee arthroplasty (TKA). In severe cases, notching may alter the mechanical properties of the distal femur. We report a patient with significant femoral notching and malpositioning of the femoral prosthesis after TKA, leading to unresolved postoperative pain, decreased range of motion, and functional disability.