Early postoperative pain is similar after arthroscopic rotator cuff repair vs. short-stay shoulder arthroplasty: a prospective study.

Background: One of the barriers to counseling patients for shoulder arthroplasty (TSA) is the anticipated pain after surgery. This can be contrasted with the common perception of arthroscopic rotator cuff repair (RCR) surgery being less painful because of the less invasive nature of the procedure. We conducted a prospective study comparing postoperative pain levels and narcotic consumption after TSA to those after RCR.

Current Concepts Review: Large Language Models in Orthopaedics: Definitions, Uses, and Limitations.

➤ Large language models are a subset of artificial intelligence. Large language models are powerful tools that excel in natural language text processing and generation.➤ There are many potential clinical, research, and educational applications of large language models in orthopaedics, but the development of these applications needs to be focused on patient safety and the maintenance of high standards.

Factors associated with success of ream-and-run arthroplasty at a minimum of 5 years.

Background: Ream-and-run arthroplasty offers improvements in shoulder pain and function for patients with primary glenohumeral arthritis who wish to avoid limitations associated with a polyethylene glenoid component. Longer-term clinical outcome assessments of the ream-and-run procedure are sparse in the literature. This study aimed to present minimum 5-year functional outcomes in a large cohort following ream-and-run arthroplasty to determine factors associated with clinical success and reoperation.

Predictors of success following single-stage revision shoulder arthroplasty: results at a mean of five year follow-up in one hundred and twelve patients.

Purpose: The objective was to determine factors associated with a successful outcome at a minimum of two years after revision of a failed shoulder arthroplasty.

Methods: We conducted a retrospective study of revision shoulder arthroplasties performed over a ten year period and collected patient-reported outcome data and re-revision data. A successful outcome was defined by improvement greater than the minimal clinically important difference (MCID) for the Simple Shoulder Test (SST).

What is the optimal management of a loose glenoid component after anatomic total shoulder arthroplasty: a systematic review.

Background: Total shoulder arthroplasty (TSA) provides excellent long-term clinical outcomes in the treatment of glenohumeral arthritis. However, symptomatic glenoid polyethylene loosening can be seen at intermediate follow-up and can lead to shoulder pain and dysfunction. The purpose of this study was to perform a systematic review of the available literature to determine the optimal management of symptomatic glenoid loosening with regard to reoperation and patient satisfaction following various approaches to symptomatic glenoid loosening.

Association Between Serum Testosterone Levels and Cutibacterium Skin Load in Patients Undergoing Elective Shoulder Arthroplasty: A Cohort Study.

Unlabelled: Cutibacterium periprosthetic joint infections are important complications of shoulder arthroplasty. Although it is known that these infections are more common among men and that they are more common in patients with high levels of Cutibacterium on the skin, the possible relationship between serum testosterone levels and skin Cutibacterium levels has not been investigated.

Methods: In 51 patients undergoing shoulder arthroplasties, total serum testosterone, free testosterone, and sex hormone binding globulin levels obtained in the clinic before the surgical procedure were compared with the levels of Cutibacterium on the skin in clinic, on the skin in the operating room prior to the surgical procedure, and on the dermal wound edge of the incised skin during the surgical procedure.

Surface Roughness of Titanium Orthopedic Implants Alters the Biological Phenotype of Human Mesenchymal Stromal Cells.

Metal orthopedic implants are largely biocompatible and generally achieve long-term structural fixation. However, some orthopedic implants may loosen over time even in the absence of infection. fixation failure is multifactorial, but the fundamental biological defect is cellular dysfunction at the host-implant interface.

Direct Inpatient Medical Costs of Operative Treatment of Periprosthetic Hip and Knee Infections Are Twofold Higher Than Those of Aseptic Revisions.

Background: Periprosthetic joint infections (PJIs) following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are associated with substantial morbidity. A better understanding of the costs of PJI treatment can inform prevention, treatment, and reimbursement strategies. The purpose of the present study was to describe direct inpatient medical costs associated with the treatment of hip and knee PJI.

What Is the Survivorship After Hip Arthroscopy for Femoroacetabular Impingement? A Large-database Study.

Background: Patients with femoroacetabular impingement (FAI) may experience lasting clinical improvement after hip arthroscopy; however, some patients will still eventually undergo early conversion to THA due to unresolved symptoms and progression of arthritis. However, the risk of this has been only incompletely characterized in prior studies.

Questions/purposes: Using a large healthcare claims database over a 5-year period (2011-2016), we asked: (1) What is the survivorship free from THA after arthroscopic osteoplasty performed for FAI? (2) What identifiable demographic factors and patient characteristics are associated with early conversion to THA after hip arthroscopy performed for FAI?

Methods: We included all patients who underwent hip arthroscopy for FAI, between the ages of 12 years and 63 years, with 3 months of claims data before hip arthroscopy and minimum 2-year follow-up.

The Use and Adverse Effects of Oral and Intravenous Antibiotic Administration for Suspected Infection After Revision Shoulder Arthroplasty.

Background: When performing revision shoulder arthroplasty, surgeons do not have access to the results of intraoperative culture specimens and will administer empiric antibiotics to cover for the possibility of deep infection until the culture results are finalized. The purpose of this study was to report the factors associated with the initiation, modification, and adverse events of 2 different postoperative antibiotic protocols in a series of revision shoulder arthroplasties.

Methods: In this study, 175 patients undergoing revision shoulder arthroplasty were treated with either a protocol of intravenous (IV) antibiotics if there was a high index of suspicion for infection or a protocol of oral antibiotics if the index of suspicion was low.

Challenges in the Measurement and Interpretation of Serum Titanium Concentrations.

The measurement of circulating metal ion levels in total hip arthroplasty patients continues to be an area of clinical interest. National regulatory agencies have recommended measurement of circulating cobalt and chromium concentrations in metal-on-metal bearing symptomatic total hip arthroplasty patients. However, the clinical utility of serum titanium (Ti) measurements is less understood due to wide variations in reported values and methodology.

assessment of high-molecular-weight polyethylene core suture tape for intra-articular ligament reconstruction: an animal study.

Aims: Options for the treatment of intra-articular ligament injuries are limited, and insufficient ligament reconstruction can cause painful joint instability, loss of function, and progressive development of degenerative arthritis. This study aimed to assess the capability of a biologically enhanced matrix material for ligament reconstruction to withstand tensile forces within the joint and enhance ligament regeneration needed to regain joint function.

Materials And Methods: A total of 18 New Zealand rabbits underwent bilateral anterior cruciate ligament reconstruction by autograft, FiberTape, or FiberTape-augmented autograft.

Weight changes after total knee arthroplasty in Chinese patients: a matched cohort study regarding predictors and outcomes.

Background: The purpose of this study was to compare 2-year BMI changes between patients undergoing simultaneous bilateral total knee arthroplasty (TKA), staged bilateral TKA, and unilateral TKA. We also sought to determine the predictors of weight change and whether clinically meaningful weight changes affected outcomes.

Patients And Methods: This retrospective, single-institution study included 202 Chinese patients who received simultaneously bilateral TKA, staged bilateral TKA, or unilateral TKA from 2008 to 2015.

Revision Total Hip Arthroplasty for the Treatment of Fracture: More Expensive, More Complications, Same Diagnosis-Related Groups: A Local and National Cohort Study.

Background: Revision total hip arthroplasty (revision THA) occurs for a wide variety of indications and in the United States it is coded under Diagnosis-Related Groups (DRGs) 466, 467, and 468, which do not account for revision etiology, a potentially substantial driver of cost. This study investigates revision THA costs and 30-day complications by indication, both locally and nationally.

Methods: Hospitalization costs and complication rates for 1,422 aseptic revision THAs performed at a high-volume center between 2009 and 2014 were retrospectively reviewed.

Long-Term Mortality Trends After Revision Total Knee Arthroplasty.

Background: Long-term mortality following primary total knee arthroplasty (TKA) is lower than the general population. However, it is unknown whether this is true in the setting of revision TKA. We examined long-term mortality trends following revision TKA.

Perioperative Inpatient Use of Selective Serotonin Reuptake Inhibitors Is Associated With a Reduced Risk of THA and TKA Revision.

Background: Depression is common in the general population, and so it is likewise common among patients undergoing THA and TKA. Depression is associated with lower perioperative patient-reported outcomes and an increased risk of postoperative complications. Antidepressants are effective in managing symptoms of depression and may potentially contribute to better functional status and better clinical outcomes after THA and TKA.

Long-term Mortality After Revision THA.

Background: Long-term mortality after primary THA is lower than in the general population, but it is unknown whether this is also true after revision THA.

Questions/purposes: We examined (1) long-term mortality according to reasons for revision after revision THA, and (2) relative mortality trends by age at surgery, years since surgery, and calendar year of surgery.

Methods: This retrospective study included 5417 revision THAs performed in 4532 patients at a tertiary center between 1969 and 2011.

Local Cellular Responses to Titanium Dioxide from Orthopedic Implants.

We evaluated recently published articles relevant to the biological effects of titanium dioxide (TiO) particles on local endogenous cells required for normal bone homeostasis, repair, and implant osseointegration. Structural characteristics, size, stability, and agglomeration of TiO particles alter the viability and behavior of multiple bone-related cell types. Resulting shifts in bone homeostasis may increase bone resorption and lead to clinical incidents of osteolysis, implant loosening, and joint pain.

Patient-Reported Outcomes Can Be Used to Streamline Post-Total Hip Arthroplasty Follow-Up to High-Risk Patients.

Background: Patient-reported outcomes are increasingly used to capture the patients' perspective in total hip arthroplasty (THA). They can potentially be used to streamline post-THA follow-up to high-risk patients. We aimed to determine whether the long-term revision risk in THA relates to patient-reported measures at 2 and 5 years.

Intra-articular injection of a substance P inhibitor affects gene expression in a joint contracture model.

Substance P (SP), a neurotransmitter released after injury, has been linked to deregulated tissue repair and fibrosis in musculoskeletal tissues and other organs. Although SP inhibition is an effective treatment for nausea, it has not been previously considered as an anti-fibrotic therapy. Although there are extensive medical records of individuals who have used SP antagonists, our analysis of human registry data revealed that patients receiving these antagonists and arthroplasty are exceedingly rare, thus precluding a clinical evaluation of their potential effects in the context of arthrofibrosis.

Efficacy of a Four-Hour Drainage Clamping Technique in the Reduction of Blood Loss Following Total Hip Arthroplasty: A Prospective Cohort Study.

BACKGROUND During total hip arthroplasty (THA) drainage is used by most surgeons. However, the optimal drainage strategy remains controversial. The aim of this prospective cohort study was to determine the safety and efficacy of a four-hour drainage clamping technique in patients undergoing THA.

Digital Papillary Adenocarcinoma: Presentation, Natural History and Management.

Digital papillary adenocarcinoma (DPA) is a rare malignant tumor of the sweat glands that often presents as a solitary painless mass on the digits of the hands or feet. We present a rare case of DPA on the ankle in a 54 year-old African American man. Although the most common location for digital papillary adenocarcinoma is on the hands and feet, it can present in other locations.