Clinical and Computational Evaluation of an Anatomic Patellar Component.

Background: Anatomic patellar components for total knee arthroplasty (TKA) have demonstrated favorable in vivo kinematics. A novel failure mechanism in TKA patients with an anatomic patellar component was observed prompting an investigation to identify patient- and implant-related factors associated with suboptimal performance.

Methods: A retrospective evaluation was performed comparing 100 TKA patients with an anatomic patellar component to 100 gender-, age-, and body mass index-matched patients with a medialized dome component.

Perioperative Sleep Quality Disturbances in Total Joint Arthroplasty is Multifactorial.

Background: Sleep quality following arthroplasty procedures is important for patient recovery and satisfaction, but remains poorly understood. The purpose of this study was to report risk factors for sleep disturbances in the perioperative period in patients undergoing primary total joint arthroplasty procedures.

Methods: Sleep surveys were prospectively collected on 751 consecutive patients undergoing total joint arthroplasty at our institution between June 2019 and February 2021 at their preoperative and postoperative visits (2 and 6 weeks).

High Incidence of Recurrent Patellofemoral Crepitus in Total Knee Arthroplasty Patients Following Arthroscopic Debridement.

Background: Patellofemoral crepitus is an unfavorable complication following total knee arthroplasty (TKA) with a posterior-stabilized (PS) implant. The purpose of this study was to study patellar crepitus recurrence and reoperation rates following arthroscopic debridement in patients with a PS-TKA.

Methods: Our institution database was used to identify patients with a PS-TKA who underwent arthroscopic debridement for patellofemoral crepitus at our institution.

Alpha-Defensin Is Not Superior to Traditional Diagnostic Methods for Detection of Periprosthetic Joint Infection in Total Hip Arthroplasty and Total Knee Arthroplasty Patients.

Background: Synovial fluid alpha-defensin (AD) may improve diagnostic accuracy of periprosthetic joint infection (PJI) following total knee (TKA) and hip (THA) arthroplasty but is only available as send-out test. This study evaluated laboratory result accuracy between send-out test vs hospital labs and if AD made a difference in treatment plan.

Methods: A retrospective review was performed of 152 consecutive patients with a TKA or THA joint aspiration for painful or clinically concerning joint.

A Prophylactic Tibial Stem Reduces Rates of Early Aseptic Loosening in Patients with Severe Preoperative Varus Deformity in Primary Total Knee Arthroplasty.

Background: Patients with a preoperative varus deformity >8 degrees are at increased risk of aseptic loosening after total knee arthroplasty. This study analyzes the effect of a tibial stem on the rate of aseptic loosening in patients with a severe preoperative varus deformity.

Methods: Patients with a preoperative varus deformity of >8 degrees and 2-year minimum follow-up with a stemmed tibial component (n = 67) were matched 1:2 to patients with a similar preoperative varus deformity with a standard tibial component (n = 134).

Alpha-Defensin Offers Limited Utility in Routine Workup of Periprosthetic Joint Infection.

Background: Alpha-defensin (AD) is a synovial biomarker included as a minor criterion in the scoring system for diagnosing periprosthetic joint infection (PJI). The purpose of this study is to study the impact of AD on diagnosis and management of PJI.

Methods: Synovial fluid from 522 patients after total knee and hip arthroplasty was retrospective reviewed.

Can an OA Knee Brace Effectively Offload the Medial Condyle? An In Vivo Fluoroscopic Study.

Background: Previous studies evaluating the effectiveness of OA offloading knee braces focused on qualitative results. The objective of this study was to analyze the effectiveness of an off-loading knee brace with respect to in vivo three-dimensional knee kinematics to quantitatively measure the changes in medial joint space and relative bone alignment when wearing the brace.

Methods: Twenty subjects diagnosed with medial compartmental joint space narrowing and varus deformity due to OA were recruited.

Reliability of Spinopelvic Measurements That May Influence the Cup Position in Total Hip Arthroplasty.

Background: Spinopelvic pathology has been identified as a potential risk factor for instability after total hip arthroplasty. Spinopelvic radiographic parameters used to diagnose spinopelvic disease may also impact optimal cup placement. The purpose of this study was to assess the arthroplasty surgeon accuracy in making spinopelvic measurements.

Recurrent Dislocation After Total Hip Arthroplasty: Controversies and Solutions.

Instability remains one of the most common complications after total hip arthroplasty and a notable cause of patient morbidity as well as patient and surgeon dissatisfaction. Isolated dislocations can often be managed successfully with closed reduction; however, recurrent instability poses a substantial diagnostic and therapeutic challenge. The causes are varied and may be related to patient, surgical, and implant factors.

Medicinal Cannabis in Orthopaedic Practice.

Cannabis has gained widespread public advocacy since its legalization in several states with recent evidence suggesting that its self-reported use has increased in patients undergoing a primary total joint arthroplasty. The endocannabinoid system has been proposed to play a role in decreasing the inflammatory cascade and enhancing pain management. For these reasons, interest has emerged in the orthopaedic community as a potential treatment or adjunct to treatment in many musculoskeletal conditions.

Medial Unicompartmental Arthroplasty of the Knee.

Indications for medial unicompartmental knee arthroplasty (UKA) have expanded over the past two decades. Proposed advantages include faster recovery, improved kinematics, and better functional outcomes compared with total knee arthroplasty (TKA) in age-matched control subjects. A focused preoperative examination and imaging is essential to identify appropriate surgical candidates.