Diagnostic accuracy of SPECT/CT arthrography in patients with suspected aseptic joint prostheses loosening.

Purpose: To evaluate the diagnostic accuracy of SPECT/CT arthrography in patients with suspected aseptic prosthesis loosening following hip and knee arthroplasty.

Methods: A retrospective review of 63 SPECT/CT arthrogram studies (36 knees and 27 hips) between February 1, 2013, and July 1, 2018, was conducted. All patients underwent clinical and radiologic evaluation as part of their assessment for persistent pain following hip and knee arthroplasty.

A community-based pharmacist-led smoking cessation program, before elective total joint replacement surgery, markedly enhances smoking cessation rates.

Introduction: We compared smoking cessation outcomes between those who used a pharmacist-led community-based smoking cessation intervention and those who did not, prior to total joint replacement (TJR) surgery. Also, we examined intervention characteristics (e.g.

Analysis of four methods of measuring three-dimensional pelvic tilt in the lateral decubitus position.

Proper alignment of acetabular implantation is necessary for good patient outcomes and preventing complications or additional surgeries in total hip arthroplasty (THA). Rotation of the pelvis in lateral decubitus (LD) is typically not accounted for as surgeons use the surgery table as a reference plane to align implants. This study compared four techniques to measure 3D pelvic rotations in LD position using computer models.

Impact of a standardized referral to a community pharmacist-led smoking cessation program before elective joint replacement surgery.

Introduction: Smokers undergoing total joint replacement (TJR) are more likely to develop infections and be re-admitted than non-smokers. The primary purpose of this study was to evaluate the effectiveness of standardized preoperative referral to a community-based pharmacist-led smoking cessation program compared to usual care for patients undergoing TJR. Secondarily, we evaluated the use of the smoking cessation program.

Health-related quality of life with long-term retention of the PROSthesis of Antibiotic Loaded Acrylic Cement system following infection resolution in low demand patients.

Background: The study purpose was to (1) evaluate health-related quality of life (HRQL) with the PROSthesis of Antibiotic Loaded Acrylic Cement (PROSTALAC) in situ for infected total hip arthroplasty (THA), (2) determine infection resolution, and (3) compare subjects who underwent second stage surgery with those who retained the PROSTALAC on a longer term basis.

Methods: Demographics, physical demand level, and comorbidities were recorded prospectively in 29 subjects followed to at least 24 months after initial PROSTALAC insertion. HRQL was evaluated using the Western Ontario McMaster Osteoarthritis Index (WOMAC) and RAND 36-Item Health Survey.

The Accuracy of Single Photon Emission Computed Tomography/Computed Tomography Arthrography in Evaluating Aseptic Loosening of Hip and Knee Prostheses.

Aseptic loosening represents the most common complication associated with hip and knee arthroplasty and is a common indication for surgical revision in the post-arthroplasty population. The optimal imaging methodology in evaluating clinical suspected loosening is not well-defined. Our study retrospectively evaluated nuclear medicine arthrography with hybrid single photon emission computed tomography/computed tomography (SPECT/CT) in 38 patients (21 hip, 17 knee) compared with reference standards of surgical evaluation, spontaneous resolution of symptoms without revision, or a minimum of 1 year clinical and radiographic follow-up.

A randomized pilot study of a comprehensive postoperative exercise program compared with usual care following primary total hip arthroplasty in subjects less than 65 years of age: feasibility, selection of outcome measures and timing of assessment.

Background: Total Hip Arthroplasty (THA) is being used more commonly in younger higher demand patients. The purpose of this randomized pilot study was to explore a) feasibility of comprehensive postoperative rehabilitation compared to usual care following primary THA in subjects <65 years, b) appropriate outcome measures including performance-based measures and c) timing of assessments.

Methods: 21 subjects who underwent primary THA were randomized to receive a three-month out-patient rehabilitation program (Intervention) or usual postoperative care (Control).

Treatment of an infected total hip replacement with the PROSTALAC system. Part 2: Health-related quality of life and function with the PROSTALAC implant in situ.

Introduction: Infection after total hip replacement (THR) adversely affects patients' function and health-related quality of life (HRQL). A prosthesis with antibiotic-loaded acrylic cement (PROSTALAC) was designed to improve the function and quality of life of patients undergoing treatment for infected THR.

Methods: We assessed 23 patients with the PROSTALAC implant in situ for treatment of an infected THR for function and HRQL, using standardized outcome measures.

Treatment of an infected total hip replacement with the PROSTALAC system. Part 1: Infection resolution.

Introduction: Infection after total hip replacement (THR) is a serious medical complication with significant negative ramifications for both the patient and the health care system. The prosthesis of antibiotic-loaded acrylic cement (PROSTALAC) was designed to treat the joint infection while maintaining functional movement in the hip.

Methods: We identified 28 patients treated for infected THR with the PROSTALAC system, by retrospective chart review.