Arthroscopy Within Three Months Prior to Unicompartmental Knee Arthroplasty Is Associated With an Increased Rate of Periprosthetic Joint Infection.

Background: Arthroscopy remains a commonly performed procedure in patients who have meniscal or other osteochondral pathology prior to ultimately being indicated for unicompartmental knee arthroplasty (UKA). The purpose of this study was to examine the timing of knee arthroscopy prior to UKA and its association with 2-year periprosthetic joint infection (PJI) rates and medical and surgical complications.

Methods: Patients undergoing UKA who had history of ipsilateral arthroscopy within 2 years prior to the UKA were identified in a national insurance database.

Financial Conflicts of Interest and Industry Funding are Associated With Conclusions Favorable to New Technologies: A Review of Published Economic Analyses in Hip and Knee Arthroplasty.

Background: New technologies in hip and knee arthroplasty are commonly evaluated using cost-effectiveness analyses and similar economic assessments. There is a wide variation in the methodology of these studies, introducing the potential for bias. The purpose of this study was to evaluate associations between potential financial conflicts of interest (COI) and the outcomes of economic analyses.

Increased Rate of Complications Following Total Knee Arthroplasty in Patients Who Have Marfan Syndrome.

Background: Outcomes of Marfan syndrome (MFS) patients after total knee arthroplasty (TKA) are poorly documented in the literature. The purpose of this study was to evaluate MFS as a potential risk factor for complications after TKA.

Methods: Using a national private payer insurance database from 2010 to 2022, MFS patients undergoing primary TKA were identified and compared to 10:1 matched controls based on age, sex, obesity, diabetes mellitus, and a comorbidity index.

Risks Following Total Knee Arthroplasty in Patients Who Have Antiphospholipid Syndrome.

Background: Antiphospholipid syndrome (APS) is recognized as a thrombophilic autoimmune condition characterized by a tendency to develop venous thromboembolism. Total knee arthroplasty (TKA) is a prevalent procedure in patients who have advanced knee arthritis. Notably, TKA is unequivocally considered a thrombotic risk factor.

The impact of Behcet syndrome on total knee arthroplasty outcomes: a retrospective matched cohort study.

Purpose: Articu lar involvement is a common manifestation of Behcet syndrome (BS), which can eventually result in significant arthralgia and necessitate total knee arthroplasty (TKA). However, outcomes of BS patients after TKA are still poorly documented in the literature. The purpose of this study was to evaluate BS as a potential risk factor for complications after TKA.

The Impact of Robotic-Assisted Total Knee Arthroplasty on Resident Training.

Background: As robotic-assisted total knee replacement (rTKA) continues to gain popularity, the impact of this technology on resident education remains unknown. The purpose of this study was to describe trainee experience and perceptions of rTKA and its effect on surgical training.

Methods: Two hundred and twenty two senior orthopaedic residents attending a national board review course completed a 17-question survey regarding their experience and perceptions regarding rTKA.

Are We Training Surgeons to Cement a Femoral Component in Hip Arthroplasty? The Trainees' Perspective.

Background: The importance of surgical technique is widely recognized when cementing a femoral component in hip arthroplasty. Concern exists that surgeon trainees in the United States are not being adequately trained in cement technique. The purpose of this study is to describe recent trainees' perceived experience with their training in this skill.

Clinical Outcomes After Stage-One Antibiotic Coated Molded Hip Spacer.

Background: Two-stage exchange remains the gold standard for managing periprosthetic joint infection (PJI). We evaluated the outcomes of patients treated with a specific molded articulating antibiotic hip spacer for PJI at a tertiary referral center.

Methods: An institutional database was retrospectively queried for patients who underwent implantation of spacer between 2009-2019.

Fracture of a 40-mm BIOLOX Delta Femoral Head.

Ceramic bearing surfaces have gained popularity in total hip arthroplasty as a result of the favorable mechanical properties and low wear rates. Despite the recognition as an attractive articulation, problems such as ceramic head fracture persist. Smaller heads and higher body mass indices are touted as risk factors for ceramic head fracture and are often associated with antecedent trauma.

Arthroscopic Femoral Osteochondroplasty for Cam-type Femoroacetabular Impingement: Cortical-Cancellous Sclerotic Boundary Guides Resection Depth.

Hip arthroscopy and femoral osteochondroplasty are commonly used in the treatment of femoroacetabular impingement (FAI). Determining the correct resection depth of the femoral head-neck cam lesion intraoperatively can be challenging. Both inadequate resection and over-resection may result in complications, underlying the importance of using a consistent and accurate technique when resecting and reshaping the proximal femur.

Disassociation of a Cold-Welded Bimodular Titanium Femoral Stem by Intraoperative Ice Cooling.

Modularity in total hip arthroplasty allows a surgeon to have intraoperative versatility, allowing for fine adjustments of the femoral offset, leg length, and version. However, modularity can be a source of multiple complications. This case report describes a novel intraoperative solution for the problem of cold welding of a neck-stem junction using sterile ice to cryogenically disengage the modular components.

Higher incidence of manipulation under anesthesia following TKA associated with the periarticular infiltration of a liposomal bupivacaine cocktail compared to a modified Ranawat cocktail.

Background: The purpose of this study was to compare the frequency of postoperative stiffness requiring manipulation under anesthesia (MUA) before and after switching from the intraoperative use of liposomal bupivacaine (LB).

Methods: This was an institutional review board (IRB)-exempt retrospective cohort study (IRB#71733) on all patients who underwent primary total knee arthroplasty (TKA) by a single surgeon between April 2016 and December 2017. We compared 169 knees that received LB group to 167 knees that received a modified Ranawat cocktail (MR group).

Revisiting the role of isolated polyethylene exchange for aseptic failures in total knee arthroplasty.

Background: Controversy continues to exist regarding the advisability of isolated polyethylene exchange (IPE) following total knee arthroplasty (TKA) for aseptic indications. We sought to compare the difference in the cumulative incidence of reoperation after IPE specifically for aseptic failure and to evaluate risk factors for failure.

Methods: We performed a retrospective cohort study of 122 knees revised for aseptic failure.

Patients with Type-1 Diabetes Are at Greater Risk of Periprosthetic Joint Infection: A Population-Based, Retrospective, Cohort Study.

Background: The effect of diabetes type on the risk of periprosthetic joint infection is not well documented. We hypothesized that patients with diabetes mellitus type 1 would be at greater risk for periprosthetic joint infection than those with diabetes mellitus type 2 and that a history of diabetic complications would be associated with an increased risk of periprosthetic joint infection.

Methods: We performed a retrospective cohort study, within a statewide database, on all adult patients who underwent hip or knee arthroplasty, with follow-up of ≥2 years, from 1996 to 2013.

Open reconstruction with autologous spongiosa grafts and matrix-induced chondrogenesis for osteochondral lesions of the talus can be performed without medial malleolar osteotomy.

Purpose: To evaluate complication rates and postoperative outcomes in patients with osteochondral lesions of the talus who underwent an autologous matrix-induced chondrogenesis (AMIC) procedure with autologous spongiosa grafting without malleolar osteotomy.

Methods: A total of 23 patients with a mean age of 35.6 ± 13.

Adult metachromatic leukodystrophy. III. Clinical course, final stages and first biochemical results.

Continuing the previously published clinical development of a case of adult metachromatic leukodystrophy (MLD), we now describe the terminal phase and death (at 46 years of age) of our patient. The final phase was characterized clinically by progression of generalized peripheral neuropathy, advanced extrapyramidal and pyramidal tract symptomatology, dementia and brainstem dysfunction. First biochemical results show a moderate relative increase (3- to 5-fold) of sulfatides in the frontal lobe white matter but not in the cortex.

Adult metachromatic leukodystrophy. I. Clinical manifestation in a female aged 44 years, previously diagnosed in the preclinical state.

In a 5-year follow-up of a case of adult metachromatic leukodystrophy, already diagnosed in the preclinical stage, the development of the symptoms of this disease could be studied in detail: initially, lack of drive, emotional lability and depressive mood. At the same time, pain in the arms and beginning gait disturbance. Later, impairment of memory and concentration, disorientation, inadequate behavior and progression of gait disturbance.