Early Aseptic Loosening with Increased Presence and Severity of Backside Burnishing in the Optetrak Logic Posterior-Stabilized Total Knee Arthroplasty Femoral Component.

Concerns persist that the Optetrak Logic posterior-stabilized (PS) total knee arthroplasty (TKA) femoral component might correlate with early failures due to aseptic loosening. The primary aim of this study was to examine if the use of the Optetrak Logic PS femoral component is associated with early (<5 years) and more extensive aseptic loosening compared with other PS femoral components. This is a single-institution retrieval analysis and revision registry study (based on prospectively collected data) of 27 failed primary PS TKA patients with loose femoral components that underwent revision TKAs between 2016 and 2019.

Birmingham Hip Resurfacing vs Total Hip Arthroplasty: A Matched-Pair Comparison of Clinical Outcomes.

Background: Birmingham hip resurfacing (BHR) has proven to be a good alternative for younger patients with osteoarthritis. Some have asserted that BHR may yield outcomes which are superior to total hip arthroplasty (THA), and that some studies which failed to show a difference were plagued by ceiling effects and lack of sensitivity of outcome measures. The purpose of this study is to compare outcomes of BHR and THA using the "Forgotten Joint" Score-12 (FJS), a more sensitive score with lesser vulnerability to the ceiling effect.

The Cost-Utility of Total Hip Arthroplasty: Earlier Intervention, Improved Economics.

We estimated the cost of Quality-Adjusted-Life-Years gained according to preoperative disease severity. We studied 159 primary unilateral THA, mean follow-up: 4 years. A median split of preoperative WOMAC scores was done to set apart a low (better) and a high (worse) score group.

Trunnion-Head Stresses in THA: Are Big Heads Trouble?

The effects of large heads on stresses at the THA trunnion-head junction and their impact on tribocorrosion/metal ion release remain controversial. A 12/14 3D-model of a stem with different head sizes was investigated. Material properties of titanium were assigned to the trunnion and cobalt-chrome/alumina to the heads.

What is the role of mental health in primary total knee arthroplasty?

Background: Psychological distress has been associated with inferior scores for pain after total knee arthroplasty (TKA). However, its relationships with scores and arthrofibrosis after TKA remain unclear.

Question/purposes: The objectives of this study were (1) to assess patient-reported outcomes (PROs), including Knee Society (KS) scores, of those patients who developed arthrofibrosis and underwent manipulation and compare them with a control group; and (2) in patients with arthrofibrosis who underwent manipulation, to determine PROs and KS scores of those with psychological distress and those without it.

Bone mineral density of the femur in autopsy retrieved total knee arthroplasties.

Bone mineral density (BMD), as measured by DEXA, can vary depending on bone rotation and fat content of soft tissues. We performed DEXA measurements, under controlled positioning, on 24 autopsy-retrieved femora from patients who had fully functional and asymptomatic successful TKA to determine periprosthetic BMD changes and compared results to 24 normal cadaveric femora. In TKA specimens, BMD was affected by gender, preoperative diagnosis, and zone under analysis.

Vitamin D insufficiency in patients with THA: prevalence and effects on outcome.

Background: The consequences of vitamin D insufficiency in the elderly remain controversial. The prevalence and potential effects of its chronic insufficiency on quality of life and physical function in patients undergoing THA have received little attention.

Question/purposes: We determined (1) prevalence of preoperative vitamin D insufficiency in patients undergoing THA and (2) relationships of insufficiency to patient-perceived outcomes (PPOs) and hip scores.

Readmission rates in the state of Florida: a reflection of quality?

Background: High readmission rates are viewed by the Centers for Medicare & Medicaid Services as a quality of care determinant but it is unclear whether readmission rates per se reflect quality and the drivers of readmissions after hip arthroplasty remain unclear.

Question/purposes: We therefore describe the effects of (1) insurance, discharge disposition, and mental health status as they relate to rates; (2) rehospitalization charges; and (3) reasons for readmissions.

Methods: We studied a cohort of all 27,019 patients who initially underwent hip arthroplasty in Florida (April 2009 to March 2010).