Determinants of Salary Variation and the Gender Pay Gap: A Survey of the American Association of Hip and Knee Surgeons (AAHKS) Surgeon Member Workforce.

Background: The increased emphasis on reimbursement, diversity, and burnout in hip and knee arthroplasty necessitates a foundational understanding of the surgeon workforce. The purpose of the study was to cross sectionally survey a representative sample of the AAHKS surgeon membership on the subject of salary, practice patterns, and demographic factors to establish a baseline framework for future advocacy efforts and initiatives.

Methods: An online survey was sent to AAHKS members between December 20, 2022 and January 19, 2023.

Robotic Arm-Assisted Total Knee Arthroplasty Results in Smaller Femoral Components and Larger Tibial Baseplates Than the Manual Technique.

Background: Robotic systems for total knee arthroplasty (TKA) may utilize computed tomography three-dimensional modeling and intraoperative ligamentous balancing data to assist surgeons with implant size and position. This study evaluated the effect of such robotic systems on implant selection.

Methods: We reviewed 645 TKAs performed with a single prosthetic design at 2 academic medical centers between 2016 and 2022.

The Utility of a Comprehensive Hip Fracture Program: Readmission Rates May Not Be a Reasonable Marker of Success.

Introduction This study evaluates the effectiveness of a comprehensive hip fracture protocol, with a focus on specific readmission reasons. Methods A retrospective cohort study of hip fracture patients aged 60 and older who underwent surgery before (control) and after (intervention) implementation of a comprehensive hip fracture program. Objectives included identifying readmission reasons and rates, time to operating room (TOR), length of stay (LOS), reoperation, and mortality rates.

The Practice Experience of an Adult Reconstruction Surgeon: A Cross-Sectional Analysis and Survey of the American Association of Hip and Knee Surgeons Membership.

Background: As demand for total hip arthroplasty and total knee arthroplasty increases, more surgeons have pursued subspecialty training in adult reconstruction. However, little information is available regarding the practice environment in which these fellowship-trained surgeons practice. The purpose of this study was to describe the practice environments of contemporary adult reconstruction surgeons.

Cemented vs Cementless Robotic-Assisted Total Knee Arthroplasty Yield Similar Short-Term Clinical Outcomes.

Background: In primary total knee arthroplasty (TKA), there is ongoing controversy about optimal fixation (cemented vs cementless). Cemented TKA remains the gold standard, with the largest body of long-term evidence available to support it. However, cementless TKA implants are gaining popularity due to potential biomechanical advantages and a growing body of literature supporting survivorship.

The Utilization of Press-Fit Total Knee Arthroplasty is Not Evenly Distributed: A National Registry Review.

Background: This study evaluates trends of cemented versus press-fit total knee arthroplasty (TKA). We hypothesized that press-fit TKA is more common in younger and obese patients. There may also be racial, geographic, and institutional variation.

Off-the-Shelf Tibial Cone Sizes May Not Accommodate All Patients' Bone Morphology and May Lead to Cortical Breaches in Revision Total Knee Arthroplasty: A 3D Modeling Study.

Background: In revision total knee arthroplasty, tibial cones have demonstrated improved longevity and reduced incidence of aseptic loosening. Several currently available "off-the-shelf" (OTS) cone systems may not have sizes to accommodate all patient bone morphologies.

Methods: Computed tomographies from one hundred primary total knee arthroplasty patients and dimensions of 4 OTS cones were obtained.

Regional Trends in Unicondylar and Patellofemoral Knee Arthroplasty: An Analysis of the American Joint Replacement Registry.

Background: As the popularity of unicondylar knee arthroplasty (UKA) and patellofemoral arthroplasty (PFA) have expanded, more patients who have limited arthritis are undergoing partial knee arthroplasty. No studies have evaluated if any regional differences in the United States (U.S.

Factors That Influence Orthopedic Women Residents' Selection of Adult Reconstruction.

Background: Stereotypes may discourage women from going into the historically male-dominated field of Adult Reconstruction. Other factors such as interest, confidence, and a sense of belonging may influence subspecialty choice. The objective of this study was to survey orthopedic surgery residents regarding their perceptions about Adult Reconstruction.

Incidence, Risk Factors, and Subsequent Complications of Postoperative Hematomas Requiring Reoperation After Primary Total Hip Arthroplasty.

Background: Studies analyzing the incidence and clinical implications of postoperative hematomas after total hip arthroplasty (THA) remain limited. The purpose of the present study was to use the National Surgical Quality Improvement Program (NSQIP) dataset to determine rates, risk factors, and subsequent complications of postoperative hematomas requiring reoperation after primary THA.

Methods: Study population included patients who underwent primary THA (CPT code: 27130) from 2012-2016 recorded in NSQIP.

Comparing Venous Thromboembolism Prophylactic Agents After Hip Fracture Surgery: A National Database Study.

Introduction: Although the use of venous thromboembolism (VTE) chemoprophylaxis has markedly reduced VTE rates after hip fracture surgery, few studies have directly compared the efficacy of different anticoagulant agents in this setting. The purpose of this study was to compare outcomes of Lovenox, Eliquis, or Coumadin as VTE prophylaxis after hip fracture surgery.

Methods: The PearlDiver MHip national database was queried for patients older than 60 years undergoing first-time hip fracture surgery with no concurrent pelvic or distal femoral fractures.

Personalizing Revision Tibial Baseplate Position and Stem Trajectory With Custom Implants Using 3D Modeling to Optimize Press-fit Stem Placement.

Background: A common tibial construct for revision total knee arthroplasty includes a long diaphyseal engaging press-fit stem. Due to tibial canal bowing, compromises are often necessary to match patient anatomy when choosing stemmed implants. The objective of this study is to determine through 3-D modeling whether current implant press-fit options appropriately fit patient anatomy, or whether an alternative angle between the stem and baseplate could increase the cortical engagement of long press-fit tibial stems.

Prosthetic Joint Infections of the Hip and Knee Among the Elderly: A Retrospective Study.

Background: As the population ages and demand for total joint arthroplasty increases, rates of periprosthetic joint infection are expected to increase in the geriatric population. Studies comparing prevalence of risk factors, etiology, management, and mortality of prosthetic joint infection in older patients are lacking.

Methods: We compared clinical characteristics, management, and mortality of patients <75 vs ≥75 years of age with first prosthetic joint infection of the hip or knee admitted to a tertiary medical center between September 2017 and December 2019.

Movement if Life-Optimizing Patient Access to Total Joint Arthroplasty: Alcohol and Substance Abuse Disparities.

Alcohol use disorders (AUDs) and substance use disorders (SUDs) place patients undergoing total joint arthroplasty at notable risk for complications. AUD and SUD disproportionately affect vulnerable communities and often coexist. Following is a discussion of the presence of these disorders in vulnerable populations and approaches to screening for them to optimize care and reduce the risks of joint arthroplasty surgery.

Movement Is Life-Optimizing Patient Access to Total Joint Arthroplasty: Malnutrition Disparities.

Malnutrition can negatively affect clinical outcomes in total hip and knee arthroplasty. Food security plays an important and complex role in nutritional status, and 10.5% of American households are currently food insecure.

Do preoperative intra-articular corticosteroid and hyaluronic acid injections affect time to total joint arthroplasty?

Introduction: Intra-articular corticosteroid (CSI) or hyaluronic acid (HAI) injections alleviate symptoms of osteoarthritis in patients who may be candidates for total hip or total knee arthroplasty (THA/TKA). However, their effect on time to total joint arthroplasty (TJA) and complications remains uncertain. We sought to evaluate (1) delay in time to surgery for patients receiving injections prior to THA/TKA (2) incidence of patients that receive injections, (3) type and number of injections, and (4) compare complication rates between patients with and without injections.

Gender Representation in Speaking Roles at the American Association of Hip and Knee Surgeons Annual Meeting: 2012-2019.

Background: The American Association of Hip and Knee Surgeons (AAHKS) has one of the lowest percentages of women members among orthopedic surgery subspecialty societies, having increased from 1.3% to 3.1% since 2012.

Patellar Tracking in Revision Total Knee Arthroplasty: Does Retaining a Patella From a Different Implant System Matter?

Background: Patellar maltracking is a potential surgical complication following total knee arthroplasty (TKA) and can result in anterior knee pain, recurrent patellar dislocation, and damage to the medial patellar soft tissue stabilizers. Data remain unclear as to whether the patellar button should be revised during a revision TKA (rTKA) if changing the component implant system. Our study examines whether retaining the original patellar button during an rTKA using a different implant system affects patellar tracking.

Comparing the Efficacy of Articulating Spacer Constructs for Knee Periprosthetic Joint Infection Eradication: All-Cement vs Real-Component Spacers.

Background: The most common treatment for periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a 2-stage revision. Few studies have compared different articulating spacer constructs. This study compares the outcomes of real-component and all-cement articulating spacers for TKA PJI treatment.

The Basic Knee Revision.

The number of revision total knee arthroplasties (TKAs) is greatly increasing. It is important to know how to approach the painful and malfunctioning TKA to determine the etiology and establish surgical plan, and also how to perform a basic revision TKA. Following the conclusion of this chapter, the reader should feel familiar with the full spectrum of treatment for patients who may be indicated for revision TKA.

An Academic Orthopaedic Specialty Hospital Provides the Shortest Operative Times within a Single Health System for Primary and Revision Total Knee Arthroplasty.

The study aimed to optimize value-based health care practices in total joint arthroplasty (TJA), and we need to understand how the surgical setting can influence efficiency of care. While this has previously been investigated, the purpose of this study was to clarify if these findings are generalizable to an institution with an orthopaedic specialty hospital. A retrospective review was conducted of 6,913 patients who underwent primary or revision total knee arthroplasty (TKA) at one of four hospitals within a single, urban, and academic health system: a high volume academic (HVA) hospital, a low volume academic (LVA) hospital, a high volume community (HVC) hospital, or a low volume community (LVC) hospital.