Perceptions and attitudes regarding robotic total hip arthroplasty: a patient stakeholder survey.

To describe the attitudes and preferences of patients pertaining to robotic-assisted total hip arthroplasty (RA-THA) with the long-term objective of designing a prospective randomized-controlled trial (RCT) to evaluate the efficacy of RA-THA compared to conventional technique. A cross-sectional survey of patients attending an outpatient high-volume academic arthroplasty clinic chosen was administered from December 2023 to May 2024. The survey comprised 31 items including patient demographic, patient reported factors of significance and perceptions surrounding RA-THA.

Neutrophil to Lymphocyte Ratio as an Indicator of Periprosthetic Joint Infection: A Retrospective Cohort Study.

Introduction: Periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) is a serious complication posing notable clinical implications for patients and substantial economic burdens. Neutrophil to lymphocyte ratio (NLR) is an emerging biomarker of inflammation, which may better predict PJI. The objective of this review was to evaluate NLR changes in patients with confirmed PJI, to compare NLR between an aseptic revision and a revision for PJI, and to establish whether an NLR of 2.

Routine use of antibiotic-laden bone cement in total knee arthroplasty is a cost-effective practice in the single-payer healthcare system.

Purpose: The purpose of this study was to determine the cost-effectiveness of antibiotic-laden bone cement (ALBC) in primary total knee arthroplasty (TKA) from the perspective of a single-payer healthcare system.

Methods: A cost-utility analysis (CUA) was performed over a 2-year time horizon comparing primary TKA with either ALBC or regular bone cement (RBC) from the perspective of the single-payer Canadian healthcare system. All costs were in 2020 Canadian dollars.

The quality of diagnostic studies used for the diagnostic criteria of periprosthetic joint infections.

Background: Although periprosthetic joint infection (PJI) is a serious complication following a total joint arthroplasty procedure, there remains uncertainty regarding the diagnosis of PJI due to the lack of a globally accepted, standardized definition. The goal of this review is to critically analyze the quality of the evidence used for the novel 2018 MSIS PJI definition and identify gaps and limitations with using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

Methods: References from the modified 2018 MSIS definition for PJI by Parvizi et al.

Causes and predictors of failed same-day home discharge following primary hip and knee total joint arthroplasty: a Canadian perspective.

Purpose: Same-day home (SDH) discharge in total joint arthroplasty (TJA) has increased in popularity in recent years. The objective of this study was to evaluate the causes and predictors of failed discharges in planned SDH patients.

Methods: A consecutive cohort of patients who underwent total knee (TKA) or total hip arthroplasty (THA) that were scheduled for SDH discharge between 01 April 2019 and 31 March 2021 were retrospectively reviewed.

Diagnosing Periprosthetic Joint Infection: a Scoping Review.

Purpose Of Review: The goal of this review is to provide an up to date understanding of the utility and limitations of the current tests utilized in the diagnosis of periprosthetic joint infection (PJI) in total knee and hip arthroplasty.

Recent Findings: Despite the growth in literature surrounding PJI diagnosis, there remains challenges in establishing a diagnosis of PJI. A combination of clinical, serum, and synovial tests and microbiologic and histologic examinations can yield a diagnosis in the majority of cases.

Are Functional Outcomes of a Total Hip Arthroplasty Predictive of a Contralateral Total Hip Arthroplasty: A Retrospective Cohort Study.

Background: Current literature suggests that 8%-35% of patients undergoing total hip arthroplasty (THA) undergo a subsequent contralateral THA. This study aims to determine if functional outcomes after primary THA predict outcomes in the subsequent primary THA of the contralateral side.

Methods: A retrospective cohort of patients undergoing staged bilateral primary THA was reviewed.

Is There a Role for Preclosure Dilute Betadine Irrigation in the Prevention of Postoperative Infection Following Total Joint Arthroplasty?

Background: Conflicting evidence exists surrounding the use of preclosure irrigation solutions in primary total joint arthroplasty (TJA). We aimed to determine the role of dilute betadine lavage in preventing early infection after primary TJA.

Methods: We retrospectively reviewed primary TJAs between 2010 and 2018.

Anatomic study on the blood supply to the femoral head following hip resurfacing using the posterior approach.

Objectives: The aim of this study was to investigate femoral head perfusion following cadaveric hip resurfacing using the posterior approach.

Methods: This cadaveric study involved injecting Higgins India ink into the common iliac arteries and evaluating the distribution of ink in the resurfaced heads using the modified Spalteholz technique. The study consisted of 2 parts.

Retractions in cancer research: a systematic survey.

Background: The annual number of retracted publications in the scientific literature is rapidly increasing. The objective of this study was to determine the frequency and reason for retraction of cancer publications and to determine how journals in the cancer field handle retracted articles.

Methods: We searched three online databases (MEDLINE, Embase, The Cochrane Library) from database inception until 2015 for retracted journal publications related to cancer research.

Comparison of Tibial Insert Polyethylene Damage in Rotating Hinge and Highly Constrained Total Knee Arthroplasty: A Retrieval Analysis.

This study compared the damage scores and damage patterns in 19 tibial inserts from rotating hinge (RH) implants with 19 inserts from highly constrained (HC) implants. Each insert was divided into 16 damage zones and each zone was subjectively graded from a scale of 0-3 for seven different damage modes. The overall damage scores were comparable for the two groups (RH: 64.

Backside Wear Is Not Dependent on the Acetabular Socket Design in Crosslinked Polyethylene Liners.

Background: Although it is understood that backside damage occurs in polyethylene acetabular liners, the effect of highly crosslinked polyethylene, which has completely replaced conventional polyethylene, has yet to be examined.

Questions/purposes: The purpose of this study was to answer the following questions: (1) With conventional polyethylene (CPE), did the acetabular design make a difference in backside wear? (2) Is there a difference in backside damage between CPE and crosslinked polyethylene (XLPE) liners? (3) With XLPE, is the difference in backside wear between designs still present? (4) Is there any difference in backside damage in various zones on backside of individual liners?

Methods: This single-institution retrieval analysis involved visual damage scoring on the backside of 233 polyethylene liners implanted between 2002 and 2011. The liners were retrieved from either polished/dovetail cups (PD) or roughened/wire cups (RW) made by two different manufacturers.

The innervation of the human acetabular labrum and hip joint: an anatomic study.

Background: The aim of the current study was to evaluate the innervation of the acetabular labrum in the various zones and to understand its potential role in nociception and proprioception in hips with labral pathology.

Methods: A total of twenty hip labrums were tagged and excised intraoperatively from patients undergoing a total hip replacement. After preparation, the specimens were cut to a thickness of 10 μm and divided into four quadrants (zones) using a clock face pattern.

Does bearing size influence metal ion levels in large-head metal-on-metal total hip arthroplasty? A comparison of three total hip systems.

Background: The purpose of the study was twofold: first, to determine whether there is a statistically significant difference in the metal ion levels among three different large-head metal-on-metal (MOM) total hip systems. The second objective was to assess whether position of the implanted prostheses, patient demographics or factors such as activity levels influence overall blood metal ion levels and whether there is a difference in the functional outcomes between the systems.

Methods: In a cross-sectional cohort study, three different metal-on-metal total hip systems were assessed: two monoblock heads, the Durom socket (Zimmer, Warsaw, IN, USA) and the Birmingham socket (Smith and Nephew, Memphis, TN, USA), and one modular metal-on-metal total hip system (Pinnacle, Depuy Orthopedics, Warsaw, IN, USA).

Glomus tumor of Hoffa's fat pad and its management by arthroscopic excision.

We present a rare case of glomus tumor of Hoffa's fat pad in a 42-year-old woman. Magnetic resonance imaging findings along with the characteristic clinical picture led us to suspect a glomus tumor as the possible etiology. An ischemia test was found to be positive and this further substantiated our diagnosis.

Cephalomedullary fixation for femoral neck/intertrochanteric and ipsilateral shaft fractures: surgical tips and pitfalls.

Objective: Surgical management options for femoral shaft fracture and ipsilateral proximal femur fracture vary from single-implant to double-implant fixation. Cephalomedullary fixation in such fractures has relative advantages over other techniques especially because of less soft tissue dissection and immediate postoperative weight bearing with accelerated rehabilitation. However, the surgery is technically demanding and there is a paucity of literature describing the surgical techniques for this fixation.

Bilateral four-part anterior fracture dislocation of the shoulder--a case report and review of literature.

Although bilateral anterior dislocation of shoulder is not that uncommon, there have been only 12 published reports on bilateral anterior fracture dislocation of shoulder. The associated fractures have mostly been greater tuberosity fractures with bilateral three part fractures being reported in only two cases. To our knowledge, a bilateral four part anterior fracture dislocation of the shoulder has not yet been reported in the English literature.

Primary malignant melanoma of proximal tibia.

Primary malignant melanoma (clear cell sarcoma) of bone is a very rare neoplasm. Although metastatic melanoma to bone is not uncommon, primary malignant melanoma of bone is extremely uncommon. To date, only nine cases have been reported in the English literature.

A 12-year-old Child with Trichinellosis, Pyomyositis and Secondary Osteomyelitis.

Trichinellosis is a parasitic infestation affecting the skeletal muscles. Cases of trichinellosis in humans have been reported from most regions of the world. However, a review of literature revealed only two reported cases of human trichinellosis in India.

Evaluation of outcomes in conservatively managed concomitant Type A and B posterolateral corner injuries in ACL deficient patients undergoing ACL reconstruction.

Introduction: There is paucity of literature regarding the outcomes of ACL reconstruction in ACL deficient knees with concomitant Type A and Type B PLC injuries.

Materials And Methods: A total of 102 patients undergoing isolated ACL reconstruction for an ACL injury were evaluated prospectively in this study. The patients with divided into three groups: group A with isolated ACL injury, group B1 with concomitant Type A PLC injury and group B2 with concomitant Type B PLC injury.

Hip hemiarthroplasty periprosthetic loosening caused by papillary ovarian carcinoma metastasis in a 78-year-old woman: a rare presentation and a literature review.

Hip arthroplasty failure secondary to septic or aseptic loosening is common, but periprosthetic loosening caused by metastasis of a distant primary lesion is unusual and seldom described in the literature. In this report, we present the case of a 78-year-old woman with bipolar hemiarthroplasty implant loosening secondary to metastatic spread of papillary ovarian carcinoma. We also review the literature and describe the factors that could possibly predispose to metastatic seeding in patients with hip arthroplasty.

Evaluation of echogenic emboli during total knee arthroplasty using transthoracic echocardiography.

Purpose: Tranesophageal echocardiography or direct sampling of arterial and/or right atrial blood with histological evaluation are invasive techniques used to evaluate embolic material entering the heart during total knee arthroplasty (TKA). The aim of this study was to develop a non-invasive method of detecting and quantifying the embolic matter using transthoracic echocardiography and to apply this method to compare the incidence and severity of embolism between computer-navigated (N) and conventional (C) TKA done under tourniquet.

Methods: Twenty-eight patients (15 N-TKA and 13 C-TKA) were enrolled.

Custom-fit total knee arthroplasty: our initial experience in 32 knees.

We share our initial experience of total knee arthroplasty (TKA) using customized cutting block technology in 32 TKAs from May 2010 to March 2011. Ten of these patients had prior TKA done on the other side using conventional or navigation-assisted TKA. Customized cutting blocks were generated for each of the knee using preoperative magnetic resonance imaging of knee and long-leg weight-bearing radiographs.

Differences among mechanoreceptors in healthy and injured anterior cruciate ligaments and their clinical importance.

Mechanoreceptors in an intact Anterior Cruciate Ligament (ACL) contribute towards functional stability of the knee joint. Injury to the ACL not only causes mechanical instability, but also leads to a disturbance in the neuromuscular control of the injured knee due to loss or damage to mechanoreceptors. ACL reconstruction restores proprioceptive potential of the knee to some extent, but the results vary.