Total hip arthroplasty was found to be safe in Jehovah's Witness patients: a multi-centered matched study.

Background: Jehovah's Witness patients refuse blood transfusion because of their religious beliefs making total hip arthroplasty (THA) challenging. This study aims to determine the safety of THA in Jehovah's Witness patients using standard perioperative protocols as well as evaluate the effectiveness of tranexamic acid (TXA) in controlling blood loss.

Methods: Databases from two tertiary academic centers were queried from 2003 to 2021 to identify THA patients.

How do Patient-Reported Outcomes Correlate with Real-Time Objective Measures of Function after Total Knee Arthroplasty? A Prospective Study Using Daily Gait Metrics.

Introduction: Patient-reported outcome measures (PROs) are essential for evaluating patients undergoing total knee arthroplasty (TKA). While wearable technologies offer objective measures of physical function through Apple HealthKit, their relationship with PROs in TKA patients is not well understood. We investigated the association between commonly used PROs and objective measures of physical function in patients undergoing TKA.

Daily physical activity following unicompartmental knee arthroplasty: A pilot study.

Purpose: The purpose of this study was to understand how objective measures of daily activity change following unicompartmental knee arthroplasty (UKA). Objective data on post-operative changes in daily physical activity following UKA are limited, highlighting the need for studies using wearable technologies to provide real-time assessments of recovery.

Methods: This pilot study included a secondary analysis of a prospective study of 33 consecutive UKA patients, with data collected using an Apple Watch and a digital care management application.

Robotic Total Hip Arthroplasty for Traumatic Acetabular Fracture Using an Image-free Second-Generation System.

Complex traumatic acetabular fractures with concomitant hip dislocations are an orthopaedic emergency often requiring open reduction and internal fixation; however, total hip arthroplasty (THA) for acute acetabular fractures may be indicated in certain scenarios. This study reports the case of a 65-year-old male who had a motor vehicle collision that resulted in acetabular fracture dislocation with concomitant femoral head fracture. The patient underwent acute image-free robotic THA.

Tranexamic Acid Led to Improved Safety of Total Knee Arthroplasty in Jehovah's Witness Patients: A Multicentered Matched Study.

Background: This study aimed to evaluate the safety of total knee arthroplasty (TKA) in Jehovah's Witness patients compared to non-Jehovah's Witness patients using standard perioperative TKA protocols and assess the role of tranexamic acid (TXA) in managing blood loss in this population.

Methods: Patients undergoing TKA between 2011 and 2021 at 2 tertiary academic centers were retrospectively reviewed. Patient demographics, preoperative and postoperative hematologic laboratory values, intraoperative TXA use, 90-day postoperative complications, and subsequent revisions were collected.

Same-Day Discharge Total Knee Arthroplasty: Hospital Demonstrates Similar Outcomes to Ambulatory Surgery Center in a More Complex Patient Population.

Background: The purpose of this study was to compare outcomes between patients undergoing same-day discharge (SDD) total knee arthroplasty (TKA) at an ambulatory surgery center (ASC) versus a tertiary care university hospital setting.

Methods: A single tertiary academic center's institutional database was reviewed for patients who underwent primary TKA and were discharged the same day from August 2021 to January 2024. Patients who did not have at least 1 year of follow-up were excluded.

Native Joint Septic Arthritis.

Native joint septic arthritis (NJSA) is a severe and rapidly progressing joint infection, predominantly bacterial but also potentially fungal or viral, characterized by synovial membrane inflammation and joint damage, necessitating urgent and multidisciplinary management to prevent permanent joint damage and systemic sepsis. Common in large joints like knees, hips, shoulders, and elbows, NJSA's incidence is elevated in individuals with conditions like rheumatoid arthritis, diabetes, immunosuppression, joint replacement history, or intravenous drug use. This review provides a comprehensive overview of NJSA, encompassing its diagnosis, treatment, antibiotic therapy duration, and surgical interventions, as well as the comparison between arthroscopic and open debridement approaches.

Comparison of Two Previously Validated Risk Assessment and Prediction Tool Models in Extended Length of Stay Patients Following total Hip Arthroplasty.

Introduction: Previous studies have attempted to validate the risk assessment and prediction tool (RAPT) in primary total hip arthroplasty (THA) patients. The purpose of this study was to: (1) identify patients who had an extended length of stay (LOS) following THA; and (2) compare the accuracy of 2 previously validated RAPT models.

Methods: We retrospectively reviewed all primary THA patients from 2014 to 2021 who had a completed RAPT score.

Revision rate following unipolar versus bipolar hemiarthroplasty.

Introduction: There has been much debate on use of bipolar or unipolar femoral heads in hemiarthroplasty for the treatment of femoral neck fractures. The outcome of these implants should be studied in the America Joint Replacement Registry (AJRR).

Methods: All primary femoral neck fractures treated with hemiarthroplasty between January 2012 and June 2020 were searched in the AJRR.

Prevention of Prosthetic Joint Infection Prior to Incision.

Prosthetic joint infection (PJI) remains a major cause of failure in total joint arthroplasty. This complication begets an increase in morbidity and mortality along with significant costs to the healthcare system. The use of prophylactic antibiotics has significant decreased the incidence of this complication.

Salvage Options for the Failed Total Knee Arthroplasty.

Total knee arthroplasty (TKA) is one of the most popular and successful procedures of the past century. However, as the number of TKAs continues to increase, the volume of revision surgeries also will increase. Although revision TKAs are often successful, adult reconstruction surgeons will likely continue to see patients with limited arthroplasty options after multiple failed revision TKAs.

Opioid Consumption and Mobilization in Staged Bilateral Total Joint Arthroplasty: Did We Learn Our Lesson the First Time?

Background: In patients who require bilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA), staged procedures are a reasonable option for treatment of bilateral osteoarthritis. We sought to determine whether perioperative outcomes differed between first and second total joint arthroplasty (TJA).

Methods: This was a retrospective review of all patients who underwent staged, bilateral THA or TKA between January 30, 2017, and April 8, 2021.

Vaping Trends and Outcomes in Primary Total Joint Arthroplasty Patients: An Analysis of 21,341 Patients.

Introduction: The effect of vaping on outcomes after total joint arthroplasty (TJA) and its prevalence in this patient population remain unclear. The purpose of this study was twofold: (1) to investigate the trends of vaping in TJA patients compared with patients who underwent routine physical examination and (2) to examine the influence vaping has on outcomes after TJA.

Methods: Patients were classified as never vaped, former vape users, or whether they reported current vaping (CV).

Short-term outcomes of thin highly cross-linked polyethylene liners in primary total hip arthroplasty.

Introduction: The use of thin highly cross-linked polyethylene (HXLPE) liners in total hip arthroplasty (THA) allows utilisation of larger femoral heads. However, concern surrounding postoperative complications remains. This study aims to investigate rates of revision and re-admission associated with thin HXLPE liners at short-term follow-up.

Orthopedic Surgery Resident Development and Implementation of a Virtual High-School Mentorship Program During the COVID-19 Pandemic.

As the world continues to battle the COVID-19 pandemic, health care providers are committed to providing care not only to our patients but also to our community. Schools in New York City (NYC) went remote on March 15, 2020. This can prove detrimental to student development and education.

Intra-articular Distal Humerus Fractures: Parallel Versus Orthogonal Plating.

: Dual-plating osteosynthesis is the standard treatment for Orthopedic Trauma Association (OTA)-type 13-C distal humerus fractures. However, optimal plate position is debated. : The purpose of this study was to evaluate dual-plate positioning following intra-articular distal humerus fracture repair by comparing outcomes between patients plated in parallel and those plated orthogonally following open-reduction, internal-fixation (ORIF) of intra-articular distal humerus fractures.

Occupational Hazards of Orthopedic Surgery Exposures: Infection, Smoke, and Noise.

The orthopedic environment exposes surgeons and staff to infection, surgical smoke, and high levels of noise. It is helpful to understand how exposure increases the risk for adverse health consequences. Protective equipment, safety protocols, and instrument modification can reduce exposure to hazards.

Dual Mobility in Total Hip Arthroplasty.

Dual mobility designs in total arthroplasty allow for increased range of motion prior to impingement and dislocation. While valuable for reducing dislocation, dual mobility has its own unique complication profile that includes intraprosthetic dislocation, corrosion, and femoral notching. Despite these relatively rare complications, dual mobility articulations are valuable options for patients at higher risk of dislocation-both early and contemporary reports on dual mobility in total hip arthroplasty suggest that it can reduce the risk of dislocation without leading to unacceptable rates of complication or early revision.

Comparing Articulating Spacers for Periprosthetic Joint Infection After Primary Total Hip Arthroplasty: All-Cement Versus Real-Component Articulating Spacers.

Background: There are a variety of methods available to treat periprosthetic joint infection (PJI), including 2-stage revision with the use of an antibiotic spacer. This study compares the outcomes of real-component (RC) and all-cement (AC) articulating spacers for total hip arthroplasty (THA) PJI treatment.

Methods: This multicenter retrospective study assessed all articulating spacers placed for THA PJI between April 2011 and August 2020.

A Novel Machine Learning Predictive Tool Assessing Outpatient or Inpatient Designation for Medicare Patients Undergoing Total Knee Arthroplasty.

Background: Removal of total joint arthroplasty from the inpatient-only list has created significant confusion regarding which patients qualify for an inpatient designation. The purpose of this study is to develop and validate a novel predictive tool for assessing who will be an outpatient vs inpatient after total knee arthroplasty (TKA).

Methods: A cohort of Medicare patients undergoing primary TKA between January 2018 and September 2019 were retrospectively reviewed.

Self-Reported Feelings of Disability Following Lower Extremity Orthopaedic Trauma.

Background: Nearly 20% of Americans consider themselves disabled. A common cause of disability is unexpected orthopaedic trauma. The purpose of this current study, assessing common lower extremity trauma, is the following: to assess the prevalence of self-reported feelings of disability following these injuries, to determine if self-reported feelings of disability impact functional outcomes, and to understand patient characteristics associated with self-reported feelings of disability.

Cefazolin remains the linchpin for preventing acute periprosthetic joint infection following primary total knee arthroplasty.

Aims: Despite recent literature questioning their use, vancomycin and clindamycin often substitute cefazolin as the preoperative antibiotic prophylaxis in primary total knee arthroplasty (TKA), especially in the setting of documented allergy to penicillin. Topical povidone-iodine lavage and vancomycin powder (VIP) are adjuncts that may further broaden antimicrobial coverage, and have shown some promise in recent investigations. The purpose of this study, therefore, is to compare the risk of acute periprosthetic joint infection (PJI) in primary TKA patients who received cefazolin and VIP to those who received a non-cephalosporin alternative and VIP.

The standardized exploration of the radial nerve during humeral shaft fixation reduces the incidence of iatrogenic palsy.

Background: The purpose of this study is to determine if a standardized protocol for radial nerve handling during humeral shaft repair reduces the incidence of iatrogenic nerve palsy post operatively.

Methods: Seventy-three patients were identified who underwent acute or reconstructive humeral shaft repair with radial nerve exploration as part of the primary procedure for either humeral shaft fracture or nonunion. All patients exhibited intact radial nerve function pre-operatively.

Does racial background influence outcomes following total joint arthroplasty?

Background: The purpose of this study is to assess whether racial differences influence patient-reported outcome measures (PROMs) following primary total hip (THA) and knee (TKA) arthroplasty.

Methods: We retrospectively reviewed patients who underwent primary THA or TKA from 2016 to 2020 with available PROMs. Both THA and TKA patients were separated into three groups based on their ethnicity: Caucasian, African-American, and other races.