Optimizing total hip arthroplasty: the gripper table mounted system for enhanced soft tissue preservation and postoperative outcomes.

Background: In total hip arthroplasty (THA), soft tissue retraction is crucial, but traditional methods may cause damage. This study addresses the issue by introducing the Gripper Table Mounted System, a pulley-based retraction system. The research compares THA outcomes with and without the Gripper system, whether reducing soft tissue damage and postoperative pain.

Impact of the difference between preoperative planning and intraoperative femoral neck osteotomy level on stem alignment.

Background: The combined anteversion theory is used for implant placement in total hip arthroplasty (THA). While majority of the research emphasizes the precise placement of the acetabular cup, there's less focus on stem alignment. This study aimed to investigate the impact of the discrepancy between the preoperatively planned femoral neck osteotomy level and the actual osteotomy level during surgery on stem alignment.

Comparative analysis of patient-reported outcomes in total knee arthroplasty and total hip arthroplasty: adjusting for demographic influences.

Purpose: Total knee arthroplasty (TKA) has consistently demonstrated lower patient satisfaction compared to total hip arthroplasty (THA). However, prior investigations failed to account for the patients' demographic characteristics. This study aimed to conduct a comparative analysis of patient-reported outcomes between TKA and THA while adjusting for patient background.

Association Between Overhang of the Posterior Femoral Condyle and Restricted Postoperative Knee Flexion Related to Patient-Reported Stiffness in Medial-Pivot Total Knee Arthroplasty.

Background: The primary aim of this study was to investigate the association between the posterior longitudinal overhang in the femoral condyle (PLOF) in medial-pivot total knee arthroplasty (TKA) and a change in knee flexion angle (change in flexion).

Methods: This retrospective cohort study included 148 knees undergoing medial-pivot TKA for medial knee osteoarthritis. The primary outcome was the change in flexion (c-flexion) preoperatively and 1-year postoperatively.

Perioperative bleeding control in total hip arthroplasty: hemostatic powder vs. tranexamic acid-a prospective randomized controlled trial.

Background: Perioperative bleeding in total hip arthroplasty (THA) can lead to various problems, so effective management of blood loss is needed. This prospective, single-blind, randomized controlled trial aimed to compare the efficacy of topical administration of SURGICEL (a hemostatic agent of oxidized regenerated cellulose) powder (SP) and tranexamic acid (TXA) in controlling perioperative bleeding during THA.

Materials And Methods: In total, 114 patients undergoing THA for osteoarthritis were randomized to either group S (THA with SP) or group T (THA with TXA).

A Novel Device for Intraoperative Measurement of Stem Anteversion Angle in Total Hip Arthroplasty.

Background: Stem anteversion plays a crucial role in mitigating postoperative complications in total hip arthroplasty (THA). The application of the combined-anteversion theory in THA necessitates the intraoperative measurement of the stem anteversion angle (SAA). However, estimating SAA intraoperatively poses challenges for surgeons lacking a computer-assisted navigation system.

Stem Alignment With the Tapered Wedge Cementless Stem "Accolade II" Does Not Affect Bone Mineral Density Over 5 Years After Total Hip Arthroplasty.

Background: This study aimed to investigate the relationship between 3-dimensional (3D) alignment and postoperative bone mineral density (BMD) changes with Accolade II tapered wedge stems, which have a different proximal shape from other tapered wedge stems, up to 5 years after primary total hip arthroplasty.

Methods: We retrospectively analyzed the hips of 89 patients who underwent total hip arthroplasty using the second-generation proximally coated cementless stem (Accolade II; Stryker Orthopedics, Mahwah, NJ) at our institution from 2014 to 2018 over a 5-year follow-up. We evaluated the relationship between stem alignment, measured using 3D-templating software, and BMD changes in the 7 Gruen zones and compared the data with those from a former study using other short taper-wedge stems.

No Impact of Contact Between the Medial Collar of a Hydroxyapatite-Coated Triple-Tapered Stem and the Femoral Neck on Periprosthetic Bone Mineral Density.

Background: Hydroxyapatite-coated, triple-tapered, shorter-length stems with a medial collar have been reported with good results for a few years. We investigated whether contact between the medial collar and femoral neck affects clinical outcomes and changes in bone mineral density (BMD) in patients who have this type of stem in their total hip arthroplasty construct.

Methods: This was a retrospective, single-center study involving 62 patients scheduled for unilateral total hip arthroplasty using a hydroxyapatite-coated, triple-tapered, shorter-length stem who were followed for at least 1 year postoperatively.

Stem alignment with short tapered-wedge cementless stems affects bone mineral density continuously for at least 5 years after primary total hip arthroplasty.

Aim: This study aimed to assess the relationship between the three-dimensional (3D) alignment of short tapered-wedge cementless stems and bone mineral density (BMD) changes in patients followed up for 5 years after total hip arthroplasty (THA).

Methods: We retrospectively analysed the hips of 52 patients who underwent THA using short tapered-wedge cementless stems at our institution from 2013 to 2016 with complete 5-year follow-up data. We evaluated the relationship between stem alignment, measured using a 3D-templating software, and BMD changes in the 7 Gruen zones.

Measurement of spinopelvic sagittal alignment in the relaxed seated position rather than in the straight seated position is suitable for assessing spinopelvic mobility in patients before total hip arthroplasty.

Purpose: The relationship between spinopelvic mobility and dislocation in total hip arthroplasty (THA) has recently attracted attention. This study aimed to investigate the differences in sacral slope (SS) between two types of upright seated positions and to determine which seated position was appropriate for assessing spinopelvic mobility (change in SS from standing to sitting) before THA.

Materials And Methods: This prospective cohort study included 75 hips from 75 patients who had undergone primary THA.

A comparison of accuracy and safety between stem-first and cup-first total hip arthroplasty: a prospective randomised controlled trial.

Background: The combined anteversion theory to prevent impingement in total hip arthroplasty (THA) has been proposed. However, because stem-anteversion is influenced by the native femoral anteversion and the stem flexion/extension angle, it is often difficult to adjust stem anteversion during surgery. Therefore, the stem-first (combined anteversion) technique may be useful to adjust and achieve appropriate cup anteversion during surgery with respect to the implanted stem anteversion angle.

Is medial pivot total knee arthroplasty suitable for patients with valgus knee osteoarthritis?

Purpose: Medial pivot total knee arthroplasty (MP-TKA) is characterized by the ball-in-socket medial tibiofemoral articulation to achieve low wear and to reproduce the medial pivot motion similar to that in the normal knee, and there have been reports of favorable long-term postsurgical outcomes. However, most of these cases concerned varus knees, and the outcomes of MP-TKA in valgus knees are unknown. The objective of this study was to investigate the postoperative outcomes in end-stage valgus knee OA patients who underwent MP-TKA, through comparisons with those who underwent TKA using the same prosthesis for varus deformity.

Changes in patient-perceived leg length discrepancy following total hip arthroplasty.

Purpose: Leg length discrepancy (LLD) after total hip arthroplasty (THA) prevents functional recovery and reduces patient satisfaction. We investigated impact of changes in patient-perceived LLD on patient satisfaction and walking ability.

Methods: one hundred and forty-nine patients with unilateral hip osteoarthritis undergoing THA from 2014 to 2017, (125 women, 24 men; average age, 68.

Usefulness of an Accelerometer-Based Portable Navigation System for Total Knee Arthroplasty: A Multicenter Prospective Randomized Controlled Trial.

Background: An accelerometer-based portable navigation system was recently introduced to improve prosthetic alignment during total knee arthroplasty (TKA). The purpose of this multicenter prospective randomized controlled trial (RCT) was to evaluate the effects of this accelerometer-based portable navigation system for achieving more accurate alignment during TKA in the clinical setting.

Methods: One hundred patients with primary varus osteoarthritis of the knee were enrolled in this prospective RCT conducted in 5 hospitals.

Initiating range of motion exercises within 24 hours following total knee arthroplasty affects the reduction of postoperative pain: A randomized controlled trial.

Background: Postoperative limitations in the range of motion (ROM) after TKA may occur occasionally and restrict a patient's ADL. Although ROM exercise is a means of increasing the ROM after TKA, the optimal time of initiating ROM exercise is still unclear. The purpose of this study is to examine different initiation timings of postoperative ROM exercises after TKA and to compare the results in terms of postoperative pain, swelling, and ROM improvement to determine the optimal time of initiating ROM exercises following TKA.

Efficacy of continuous local cryotherapy following total hip arthroplasty.

Background: Cryotherapy is rarely reported on the usefulness of cryotherapy applied after total hip arthroplasty (THA), and there are no reports about patient satisfaction against the cryotherapy following THA. The aim of this study was whether cryotherapy can be useful for relieving pain, reducing blood loss, and swelling, and improving patient satisfaction after THA.

Methods: Thirty patients who had undergone THA were treated by a controlled cooling device for 72 h following THA (defined as the cryotherapy group).

Effect of periarticular morphine injection for total hip arthroplasty: a randomised, double-blind trial.

Background: The periarticular multimodal cocktail injection is currently commonly used to treat postoperative pain after total hip arthroplasty (THA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent THA.

Local Efficacy of Periarticular Morphine Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Trial.

Background: The periarticular multimodal cocktail injection including morphine is currently commonly used to reduce postoperative pain following total knee arthroplasty (TKA). Despite its analgesic effect, it frequently causes nausea, which is an adverse effect of opioids. It is inconclusive whether the intraoperative injection of periarticular morphine is effective peripherally.

Efficacy of a Pelvic Lateral Positioner With a Mechanical Cup Navigator Based on the Anatomical Pelvic Plane in Total Hip Arthroplasty.

Background: The acetabular component orientation in total hip arthroplasty (THA) is of critical importance to the good clinical results. However, traditional widely used cup alignment guides for cup placement are reported to be relatively unreliable. The present study aims at comparing a novel cup alignment guide, which can be attached to our anatomical pelvic plane (APP) pelvic lateral positioner for reducing discrepancies in sagittal pelvic tilt and indicate a targeted cup angle based on the APP, with a conventional cup alignment guide.

Waterless Hand Rub Versus Traditional Hand Scrub Methods for Preventing the Surgical Site Infection in Orthopedic Surgery.

Unlabelled: MINI: Fourteen hundred consecutive patients were investigated for evaluating the utility of waterless hand rub before orthopaedic surgery. The risk in the surgical site infection incidence was the same, but costs of liquids used for hand hygiene were cheaper and the hand hygiene time was shorter for waterless protocol, compared with traditional hand scrub.

Study Design: A retrospective cohort study with prospectively collected data.

Effect of Periarticular Morphine Injection for Total Knee Arthroplasty: A Randomized, Double-Blind Trial.

Background: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA.

Efficacy of the Anatomical-Pelvic-Plane Positioner in Total Hip Arthroplasty in the Lateral Decubitus Position.

Background: Total hip arthroplasty in the lateral position involves particularly large variance in the sagittal tilt of pelvis fixation, which affects the imprecision of the cup anteversion leading to poor outcomes. We have added an additional compression pad to an existing device, also to be used in the lateral position, but theoretically enabling fixation on the anatomical pelvic plane (APP) serving as the reference plane. The present study aims to evaluate the usefulness of this device in comparison with the conventional device.

Early biological fixation of porous implant coated with paste-retaining recombinant bone morphogenetic protein 2.

The aim of this study was to evaluate the period required for stable initial bone-implant fixation with recombinant human bone morphogenetic protein 2 (rhBMP-2) in the bone marrow of a rabbit model. The porous implants being coated with β-tricalcium phosphate/polylactide-polyethylene glycol paste with 15, 30, or 60 μg of rhBMP-2 (n = 10) were implanted into animals in 3 experimental groups. In 2 control groups, the test implants were coated without rhBMP or no paste.

In vivo comparison of wear particles between highly crosslinked polyethylene and conventional polyethylene in the same design of total knee arthroplasties.

Reduction of wear with highly crosslinked polyethylene (HXLPE) has been reported in in vitro and in vivo studies of total hip prostheses. However, use of HXLPE in total knee prostheses is still controversial. The aim of this study was to compare in vivo polyethylene wear particle generation of HXLPE with that of conventional polyethylene in total knee prostheses of the same design.