Robotic-assisted total knee arthroplasty reduces soft-tissue releases which improves functional outcomes: A retrospective study.

Background: There is increasing use of Robotic-Assisted (RA) and personalized alignment techniques in total knee arthroplasty (TKA). The hypothesis of this study was that RA TKA would result in fewer soft-tissue releases, and that fewer soft-tissue releases would be associated with improved clinical outcomes.

Methods: A retrospective review of an internal company registry was conducted for all primary TKAs performed from Jan 1, 2014, through a database extract date of Nov 4, 2022.

Five-Year Survivorship of Total Hip Arthroplasty With a Proximally Coated, Medially Collared, Triple-Tapered Femoral Stem: A Retrospective, Multicenter Registry Review.

Background The anterior approach for total hip arthroplasty (THA) has gained popularity in recent years. Some surgeons have been hesitant to adopt the approach due to concerns over increased complications such as intraoperative fracture, stem loosening, and stem revision. This study aims to evaluate the all-cause revision rate and survivorship of a collared, triple-tapered stem that was designed specifically for use with the anterior approach in THA to enhance outcomes and reduce adverse events.

Wear of Third-Generation Cross-Linked Polyethylene in Primary Total Hip Arthroplasty: A 10-Year Analysis.

Background: Sequential modifications to the manufacturing process of highly cross-linked polyethylene (HXLPE) have improved the wear resistance and implant survival of these liners in total hip arthroplasty (THA). However, no study has examined the long-term (mean 10 year) wear rates and clinical outcomes of third-generation HXLPE in THA. The aim of our study was to report the longest-to-date analysis of wear rates and clinical outcomes of a third-generation HXLPE liner.

Conversion Total Hip Arthroplasty in the Era of Bundled Care Payments: Impacts on Costs of Care.

Background: Conversion hip arthroplasty is defined as a patient who has had prior open or arthroscopic hip surgery with or without retained hardware that is removed and replaced with arthroplasty components. Currently, it is classified under the same diagnosis-related group as primary total hip arthroplasty (THA); however, it frequently requires a higher cost of care.

Methods: A retrospective study of 228 conversion THA procedures in an orthopaedic specialty hospital was performed.

A Short-Term Multicenter Analysis of Radiolucent Lines in a Single Uncemented Rotating Platform Implant for Total Knee Arthroplasty.

Background: Uncemented total knee arthroplasty is increasing as a potential solution for aseptic loosening via biologic fixation and to increase operative efficiency. However, postoperative radiolucent lines (RLLs) remain a concern for some clinicians. We report on a multicenter analysis of these RLLs over a 2-year period to identify their incidence, progression, and clinical significance.

Third-Generation Medium Cross-Linked Polyethylene Demonstrates Very Low Wear in Total Hip Arthroplasty.

Background: Cross-linked polyethylene (XLPE) liners have shown lower wear rates than conventional polyethylene liners in total hip arthroplasty. The primary aim of our study was to report our most recent analysis of wear rates and clinical outcomes of a third-generation XLPE liner. Secondary aims were to investigate the rate of adverse events related to mechanical failure or oxidation of this liner.

Opioid Use After Discharge Following Primary Unilateral Total Hip Arthroplasty: How Much Are We Overprescribing?

Background: The opioid crisis pressures orthopedic surgeons to reduce the amount of narcotics prescribed for postoperative pain management. This study sought to quantify postoperative opioid use after hospital discharge for primary unilateral total hip arthroplasty (THA) patients.

Methods: A prospective cohort of primary unilateral THA patients were enrolled at a single institution.

Use of Tetrahydrocannabinol and Cannabidiol Products in the Perioperative Period Around Primary Unilateral Total Hip and Knee Arthroplasty.

Background: Given the opioid crisis in America, patients are trying alternative medications including tetrahydrocannabinol (THC) and other cannabidiol (CBD) containing products in the perioperative period, especially in states where these products are legal. This study sought to analyze usage rates of CBD/THC products in the perioperative period for primary unilateral total hip and knee arthroplasty (THA/TKA) patients and identify a possible association with post-operative opioid use.

Methods: A prospective cohort of primary unilateral THA/TKA patients were enrolled at a single institution.

Opioid Use After Discharge Following Primary Unilateral Total Knee Arthroplasty: How Much Are We Over-Prescribing?

Background: The opioid crisis pressures orthopedic surgeons to reduce the amount of narcotics prescribed for post-operative pain management. This study sought to quantify post-operative opioid use after hospital discharge for primary unilateral total knee arthroplasty (TKA) patients.

Methods: A prospective cohort of primary unilateral TKA patients performed by one of 5 senior fellowship-trained arthroplasty surgeons were enrolled at a single institution.

Impact of Femoral Stem Design on Failure After Anterior Approach Total Hip Arthroplasty.

Background: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA.

Methods: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons.

Is the Anterior Approach Safe? Early Complication Rate Associated With 5090 Consecutive Primary Total Hip Arthroplasty Procedures Performed Using the Anterior Approach.

Background: Few publications have raised concern with the safety of the anterior approach (AA) to total hip arthroplasty (THA). The purpose of this study is to report the early complications with AA THA in a combined, multicenter patient population from three different institutions.

Methods: The study cohort consisted of 5090 consecutive primary procedures in 4473 patients who had undergone THA utilizing the anterior approach between August 2006 and July 2013.

Ten Year Follow-Up of Gap Balanced, Rotating Platform Total Knee Arthroplasty in Patients Under 60 Years of Age.

68 patients (91 primary total knee arthroplasties) were evaluated at a mean 10-year, minimum 5 year follow up in patients younger than sixty years of age utilizing the gap balanced, rotating platform design. Follow up assessment included implant survivorship, adverse events, x-rays, Knee Society rating system and clinical evaluation. Three revisions were performed with only one for aseptic loosening at 45 months.

Simultaneous Bilateral Anterior Approach Total Hip Arthroplasty.

Simultaneous bilateral total hip arthroplasty (THA) has been performed successfully, with good outcomes and low complication rates reported. Most published studies on the topic used anterolateral or posterior surgical approaches. The anterior approach is performed under live fluoroscopy with the patient supine, obviating the need for patient repositioning during bilateral surgery.

Use of stepped porous titanium metaphyseal sleeves for tibial defects in revision total knee arthroplasty: short term results.

Stepped porous titanium metaphyseal sleeves may provide an option for enhanced fixation in managing challenging tibial defects in revision total knee arthroplasty (TKA). We retrospectively reviewed data on 51 patients who underwent revision TKA utilizing a metaphyseal sleeve for Anderson Orthopaedic Research Institute (AORI) Type II and III tibial defects between June 2007 and July 2011. Of these 51 patients, 36 patients had complete clinical and radiographic data.

Day of surgery discharge after unicompartmental knee arthroplasty: an effective perioperative pathway.

Day of surgery (DOS) discharge after unicompartmental knee arthroplasty (UKA) allows for safe, efficient care of the appropriately selected patient. Refinement of our perioperative pathway over the last decade has allowed for successful DOS discharge of 160 consecutive patients. The cohort averaged 65 years and American Society of Anesthesiology class was 1-3 (mean, 1.

Why are total knee arthroplasties being revised?

Despite technical improvements, revision rates for total knee arthroplasties (TKAs) remain high. Our goal was to report the reason(s) for revision TKA in a large, current, multicenter series and compare those reasons with previously published reasons. We retrospectively identified 820 consecutive revision TKAs (693 patients, 2000-2012) from our 3 centers and recorded the primary reason for the revision.

Three- to six-year results with the Ultima metal-on-metal hip articulation for primary total hip arthroplasty.

One hundred seventy-one primary total hip arthroplasties were evaluated in a prospective, randomized study. Ninety-five involved a metal-backed cup with an all-metal liner and 76 involved a metal-backed polyethylene cup that was used as the control. All were implanted with an S-ROM cementless femoral component with a 28 mm head.

Edge loading of patellar components after total knee arthroplasty.

Patellofemoral joint kinematics, contact areas, contact pressures, and contact patterns were assessed after total knee arthroplasty (TKA) using human cadaver knees. Two contemporary TKA systems with anatomic patellofemoral joints were implanted and tested under anatomically based loading conditions. An electromagnetic tracking system was used to evaluate patellofemoral kinematics, and Fuji pressure-sensitive film was used to determine contact areas, pressures, and patterns.

Human articular cartilage storage in cell culture medium: guidelines for storage of fresh osteochondral allografts.

The viability of transplanted articular cartilage is one of the determinants of outcome following the transplantation of osteochondral allografts. Disappointing results from cryopreservation have led to the practice of fresh transplantation of articular segments, especially for posttraumatic defects. To date, no studies have demonstrated in vitro viability rates for refrigerated human cartilage awaiting transplantation.

The rationale for cementless revision total hip replacement with contemporary technology.

Undoubtedly, the number of revisions for failed cemented total hip arthroplasties will increase over time based on current survival statistics. Although contemporary cementing techniques may improve the outcome of some procedures, long-term results of cemented revisions are less than ideal. Poor bone quality with cortical deficiencies and endosteal sclerosis make long-term stability and implant survival less likely with cemented techniques.

Revision arthroplasty facilitated by ultrasonic tool cement removal. Part II: Histologic analysis of endosteal bone after cement removal.

This conclusion of a two-part series examines the effects of ultrasonic cement removal from canine femurs on the underlying endosteal bone. The purpose of the investigation was twofold: to qualitatively assess the immediate in vivo effects on bone of direct coupling as a method of ultrasonic prosthesis removal, and to determine the immediate and delayed histologic responses of cortical bone to ultrasonic cement removal as well as compare the response after cement removal by high-speed burr instrumentation. This histologic study of an in vivo model demonstrated no significant cortical bone damage with the use of ultrasonically driven tools.

Revision arthroplasty facilitated by ultrasonic tool cement removal. Part I: In vitro evaluation.

Ultrasonically driven tools (UDTs) have been developed to facilitate removal of bone cement and securely fixed cemented components during revision arthroplasty. A two-part study was performed to evaluate the efficacy and safety to these tools. Heat generation at the endosteal surface during prosthesis and cement removal with a UDT was examined in an in vitro human femoral revision model.

Screening for gestational diabetes in a high-risk population.

One hundred eighty-one pregnant Navajo women were screened for gestational diabetes. The 50-g oral glucose screening test was greater than 7.2 mmol/L (130 mg/dL) in 44 of 181 subjects (24.