Intra-articular adductor canal block has equivalent analgesic effect to traditional ultrasound-guided adductor canal block after total knee arthroplasty: a prospective randomized controlled trial.

Introduction: An adductor canal block (ACB) is widely accepted as a regional nerve block for pain management following total knee arthroplasty (TKA). However, no consensus exists concerning whether the analgesic effect is greater when joint surgeons perform intra-articular ACBs (IA-ACBs) or when anesthesiologists perform ultrasound-guided ACBs (UG-ACBs). We hypothesized that intra-articular ACBs (IA-ACBs) performed by joint surgeons and UG-ACBs performed by anesthesiologists based on peri-articular injections (PAI) would yield equivalent analgesic effects.

Robotic-assisted differential total knee arthroplasty with patient-specific implants: surgical techniques and preliminary results.

Objective: In total knee arthroplasty (TKA), achieving soft-tissue balance while retaining acceptable lower limb alignment is sometimes difficult and may lead to patient dissatisfaction. Theoretically, patient-specific implants can bring great benefits, while the lack of precise surgical tools may hinder the improvement of outcomes. The objective of this study was to illustrate surgical techniques and evaluate kinematics and early clinical outcomes of robotic-assisted TKA using patient-specific implants.

Variety of femoral anteversion and its measurement in cementless total hip arthroplasty: Does robotic technology improve accuracy?

Background: High-performance total hip arthroplasty (THA) depends on the accurate position of components. However, femoral anteversion is variable, and current studies only used traditional instruments to evaluate it, such as protractor and spirit level with limited cases. This study aimed to identify the variability in the measured femoral native anteversion and intraoperative stem anteversion under different measurement methods, including intraoperative robotic method.

Using sequential bone cutting to titrate soft tissue balance in total knee arthroplasty effectively minimizes soft tissue release.

Background: Achieving soft tissue balance while maintaining limb alignment within acceptable boundaries is crucial for successful total knee arthroplasty (TKA). We proposed a sequential bone cutting (SBC) technique to titrate the soft tissue balance in robot-assisted TKA to achieve the desired balance with minimum soft tissue release.

Methods: In total, 106 robot-assisted TKAs using the SBC technique were included.

Management of soft tissues in patients with periprosthetic joint infection.

Background: Appropriate soft tissue management represents a critical step in treating periprosthetic joint infection (PJI). This review discusses relevant guidelines that surgeons should follow in the management of soft tissues in PJI treatment. BODY: It is imperative for arthroplasty surgeons to thoroughly debride and rebuild soft tissue with a good blood supply.

Medial wall reconstruction using metal disc augments in revision total hip arthroplasty.

Purpose: Medial acetabular bone defects are frequently encountered in revision total hip arthroplasty (THA), but few studies have focused on their reconstruction. This study aimed to report the radiographic and clinical results after medial acetabular wall reconstruction using metal disc augments in revision THA.

Methods: Forty consecutive revision THA cases using metal disc augments for medial acetabular wall reconstruction were identified.

Robotic-assisted revision total joint arthroplasty: a state-of-the-art scoping review.

Background: During the past decades, robotic-assisted technology has experienced an incredible advancement in the field of total joint arthroplasty (TJA), which demonstrated promise in improving the accuracy and precision of implantation and alignment in both primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, revision TJA remains a technically challenging procedure with issues of large-scale bone defects and damage to nearby anatomical structures. Thus, surgeons are trying to harness the abilities of robotic-assisted technology for revision TJA surgery.

Correlation between tibial valgus deformity and aspect ratio of resected tibial surface in female Chinese patients undergoing total knee arthroplasty.

Background: Morphology of the resected tibial surface is the reference for tibial component design, selection, and implantation in total knee arthroplasty (TKA). This comparative study sought to answer whether valgus deformity of the tibia would affect the morphology of the resected tibial surface in TKA.

Methods: Thirty-one female Chinese patients with valgus tibias were retrospectively and consecutively identified from a single-center registration database.

Better PROMs and higher return-to-sport rate after modular bicompartmental knee arthroplasty than after total knee arthroplasty for medial and patellofemoral compartment osteoarthritis.

Background: Theoretical advantages of bicompartmental knee arthroplasty (BKA) over total knee arthroplasty (TKA) for bicompartmental (medial combined with patellofemoral) osteoarthritis (OA) are still unclear. This study aimed to compare patient-reported outcome measures (PROMs) and return-to-sport (RTS) rate between modular BKA and TKA in early follow-up.

Methods: Twenty-five consecutive modular BKA cases with a minimum 2-year follow-up were matched with 50 TKA cases at 1:2 ratio.

Effect of blood lipids and lipid-lowering therapies on osteoarthritis risk: A Mendelian randomization study.

Background: We aimed to investigate the effects of blood lipids and lipid-lowering agents on osteoarthritis (OA) risk.

Materials And Methods: We performed Mendelian randomization (MR) analyses to estimate the causal effect of blood low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels on knee and hip OA. Single nucleotide polymorphisms (SNPs) were selected from large genome-wide association studies (GWASs) of individuals of European ancestry as genetic instruments for blood lipid levels.

Symptom duration is associated with failure of periprosthetic joint infection treated with debridement, antibiotics and implant retention.

Background: Debridement, antibiotics, and implant retention (DAIR) is an alternative treatment strategy for periprosthetic joint infection (PJI). However, no consensus exists regarding which patient population(s) may be most suitable for DAIR. This study aims to investigate the overall infection control rate and explore the prognostic factors associated with acute, hematogenous, and chronic PJIs treated with DAIR.

Which serum markers predict the success of reimplantation after periprosthetic joint infection?

Purpose: In clinical practice, serum C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels are routinely used to screen for periprosthetic joint infection (PJI), but the effectiveness of predicting the success of reimplantation is variable. This study aimed to evaluate the diagnostic effectiveness of serum CRP, ESR, plasma D-dimer, and fibrinogen values in groups achieving treatment success or failure for PJI.

Methods: A total of 119 PJI cases between January 2012 and January 2017 were identified and included in this study.

Extended Ischiopubic Fixation Using Porous Metal Augments in Cementless Acetabular Reconstruction during Revision Total Hip Arthroplasty.

Objectives: The aims of this study were to introduce the definition, indication, and surgical technique of extended ischiopubic fixation (EIF) and to investigate the early clinical, radiographic results and complications of hips revised with EIF.

Methods: Patients who underwent revision THA utilizing the technique of EIF which was defined as securing the porous metal augment >5 mm deep into the ischium and/or pubic ramus to gain adequate mechanical support and fresh host bone for bony ingrowth in a single institution from February 2015 to February 2020 were retrospectively reviewed. After applying the inclusion and exclusion criteria, a total of 30 hips (28 patients) were eligible for the study and were enrolled.

Greater trochanter fixed with a claw plate and cable system in complex primary and revision total hip arthroplasty: long-term follow-up.

Background: Maintaining continuity of the greater trochanter and restoring abductor function are of paramount importance in primary and revision total hip arthroplasty. Failure to rigidly fix the greater trochanter can lead to failure. Because of the lack of reports on the clinical results of greater trochanter fixation with a claw plate and cable system, we aimed to analyze the indications for the use of such a system that produces the best clinical results.

Predictors of a forgotten joint after medial fixed-bearing unicompartmental knee arthroplasty.

Background: A forgotten joint is considered the ultimate goal of joint replacement. We aim to explore the predictive factors of a forgotten joint after fixed-bearing unicompartmental knee arthroplasty (UKA).

Methods: This retrospective cohort study used prospectively collected data from 302 cases of medial-compartment UKA with a minimum of 2-year follow-up.

Total Hip Arthroplasties for Hartofilakidis Type C1 and C2 High Hip Dislocations Demonstrate Similar Survivorship and Clinical Function at Minimum 10-year Follow-up With Cementless Implants.

Background: This study aimed to determine the differences in survivorship, clinical function, and complications among patients who have Hartofilakidis Type C1 or C2 developmental dysplasia of the hips and underwent total hip arthroplasty (THA) with cementless implants.

Methods: This retrospective study identified 84 Hartofilakidis Type C hips that underwent THA between 2002 and 2011 with a minimum 10-year follow-up (mean, 13 years, range, 10 to 19 years). Survivorship, latest Harris Hip Scores and satisfaction levels, radiographic outcomes (eg, implant stability, rate and length of subtrochanteric shortening transverse osteotomy, leg-length discrepancy, cup position, and orientation), as well as complications (eg, dislocation, periprosthetic fracture, periprosthetic joint infection) were compared to analyze the differences between Hartofilakidis C1 and C2 hips.

Malposition of components and Femorotibial mechanical Axis changes on pressure distribution in Total knee arthroplasty.

Background: To the best of our knowledge, no report has analyzed the postoperative results of poor prosthesis position, particularly when the femoral and tibial components are abnormally positioned relative to neutral lower limb alignment. We aimed to investigate pressure distribution in the knee at different lower limb alignments with diverse positions of femoral and tibial components.

Methods: We established a three-dimensional model of the lower limb using computed tomography and simulated total knee arthroplasty.

Dexpanthenol attenuates inflammatory damage and apoptosis in kidney and liver tissues of septic mice.

Sepsis is capable of causing systemic infections resulting in multiple organ damage. Dexpanthenol (DXP) has been reported to protect against kidney and liver injury. Therefore, this paper attempts to explore the role of DXP in sepsis-induced kidney and liver injury.

Patient-perceived knee enlargement after total knee arthroplasty: prevalence, risk factors, and association with functional outcomes and radiological analysis.

Purpose: In clinical practice, many patients complained that their knees became larger after total knee arthroplasty (TKA), yet no studies have described this phenomenon. We named this as "patient-perceived enlargement of knee" (PPEK). This study aimed to investigate the prevalence of PPEK after TKA; assess the association between PPEK and demographics, surgical options, or component size; assess the influence of PPEK on patient satisfaction and functional outcomes; and determine whether there was radiological difference between patients with or without PPEK.

Different Deformity Origins and Morphological Features in Subtypes of Valgus Knees: A Radiological Classification System.

Objective: To analyze the deformity origins and distribution among valgus knees to individualize their morphological features.

Methods: Radiographic images of 105 valgus knees were analyzed. Long-film radiographs and computed tomography were collected for every knee.

Comparison of the success rate after debridement, antibiotics and implant retention (DAIR) for periprosthetic joint infection among patients with or without a sinus tract.

Background: The relevance between the presence of a sinus tract and the failure risk after debridement, antibiotics and implant retention (DAIR) for periprosthetic joint infection (PJI) after hip or knee arthroplasty is still unclear. This study aimed to compare the success rate of DAIR between patients with or without a sinus tract and to explore the possible risk factors for failure after DAIR in patients with a sinus tract.

Methods: Consecutive DAIR cases for PJI after hip or knee arthroplasty between January 2009 and June 2019 with a minimum 1-year follow-up in two tertiary joint arthroplasty centers were included.

Reliability and validity of commonly used patient-reported outcome measures (PROMs) after medial unicompartmental knee arthroplasty.

Introduction: Many patient-reported outcome measures (PROMs) have been utilized to assess outcomes after unicompartmental knee arthroplasty (UKA). However, most are not specifically designed for UKA and the measurement properties of these PROMs have never been elucidated in the setting of UKA. This study aimed to evaluate the reliability and validity of commonly used PROMs after UKA, which includes the Oxford knee score (OKS), Knee Society Score (KSS)-function score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS).

A Novel Endosteal Reconstruction of the Femur from Distal Femoral Remnant Using 3D-Printed Titanium Rings: A Two-Case Report.

Case: Femur reconstruction with only the distal femoral remnant is challenging because of poor bone volume required for stem fixation. Although proximal femoral replacement, total femur replacement, allograft prosthesis composite, and custom porous tantalum implants are options, hybrid fixation enhanced by endosteal reconstruction with three-dimensional (3D)-printed porous titanium rings to reconstruct the femur without supporting isthmus has not been described. We report 2 cases with satisfactory 34- and 22-month follow-up results of hybrid fixation enhanced by endosteal reconstruction with 3D-printed porous titanium rings.