Publications by authors named "Joseph M Nessler"
Background: Instability has been the primary cause of failure following primary total hip arthroplasty (THA) leading to revision hip surgery. The purpose of this study was to determine if instability rates have further declined following advances in primary THA, including dual mobility articulations, direct anterior approaches, advanced technologies, and improved knowledge of the hip-spine relationships.
Methods: Using the 5% Medicare Part B claims data from 1999 to 2019, we identified 81,573 patients who underwent primary THA for osteoarthritis.
Article Synopsis
- Patients with a history of lumbar spine fusion (LSF) face higher dislocation risks after total hip arthroplasty (THA), prompting a study to analyze dislocation rates between dual mobility (DM) and non-DM constructs.
- A total of 15,572 patients were evaluated, revealing that the 90-day dislocation rates were significantly lower for DM constructs (0.68%) compared to non-DM constructs (1.17%).
- The findings suggest that utilizing DM constructs in high-risk patients with stiff spines can help reduce the likelihood of hip dislocation after THA, indicating a potential benefit for these individuals.
We report a case series of 5 patients who underwent revision total hip arthroplasty (THA) using a polypropylene mesh for capsular reconstruction for chronic THA instability. The average follow-up is 16.6 months (range, 9-20 months).
View Article and Find Full Text PDFBackground: Patients undergoing primary total hip arthroplasty (THA) with prior lumbar spine fusion (LSF) are a high-risk group for instability with reported incidence of dislocation as high as 8.3% using fixed bearing femoral heads. Purpose of this study was to determine risk of post-operative instability in patients undergoing primary THA with a history of prior LSF using dual mobility acetabular cups.
View Article and Find Full Text PDFBackground: Periprosthetic joint infection is the most common cause of readmissions after total joint arthroplasty (TJA). Intrawound vancomycin powder (VP) has reduced infection rates in spine surgery; however, there are no data regarding VP in primary TJA.
Methods: Thirty-four TJA patients received 2 g of VP intraoperatively to investigate VP's pharmacokinetics.