Perioperative and short-term outcomes of cemented versus cementless total hip arthroplasty: a retrospective propensity-matched analysis.

Background: Cement fixation for total hip arthroplasty (THA) remains a controversial topic. While cemented stems are associated with lower risk of periprosthetic fractures (PPF), cementless stems may offer superior biological fixation. This study analyzed peri-operative and short-term outcomes of cemented vs.

Dual Mobility Versus Fixed Bearing Implants in Primary Total Hip Arthroplasty in Patients Under 55 Years of Age.

Introduction: Prosthetic dislocation after total hip arthroplasty (THA) is one of the most common causes of revision THA. Dual-mobility (DM) bearings were introduced to mitigate complications; however, there is minimal data on their performance in younger patients. This study compared results of patients who were under 55 years of age undergoing primary THA with DM or fixed-bearing (FB) implants.

Blood Transfusion in the Age of Tranexamic Acid: Who Needs a Type and Screen Before Total Hip Arthroplasty?

Background: Modern surgical protocols, particularly the use of tranexamic acid (TXA), have reduced, but not eliminated, blood transfusions surrounding total hip arthroplasty (THA). Identifying patients at risk for transfusion remains important for risk reduction and to determine type and screen testing.

Methods: We reviewed 6,405 patients who underwent primary, unilateral THA between January 2014 and January 2023 at a single academic institution, received TXA, and had preoperative hemoglobin (Hgb) values.

Periprosthetic fracture following arthroplasty for femoral neck fracture: is a cemented stem protective?

Background: Periprosthetic femoral fractures (PFF) carry significant morbidity following arthroplasty for femoral neck fracture (FNF). This study assessed fracture complications following arthroplasty for FNF and the effect of cement fixation of the femoral component on intraoperative and post-operative PFF.

Methods: Between February 2014 and September 2021, 740 patients with a FNF who underwent arthroplasty were analyzed for demographics, surgical management, use of cement for fixation of the femoral component, and subsequent PFF.

Does Melatonin Improve Sleep Following Primary Total Knee Arthroplasty? A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Sleep impairment following total knee arthroplasty (TKA) is common and may decrease patient satisfaction and recovery. Standardized postoperative recommendations for sleep disturbances have not been established. We aimed to assess whether melatonin use could promote healthy sleep and reduce sleep disturbance in the acute period following TKA.

Are We Moving in the Right Direction? Demographic and Outcome Trends in Same-day Total Hip Arthroplasty From 2015 to 2020.

Introduction: Understanding the trends among patients undergoing same-day discharge (SDD) total hip arthroplasty (THA) is imperative to highlight the progression of outpatient surgery and the criteria used for enrollment. The purpose of this study was to identify trends in demographic characteristics and outcomes among patients who participated in an academic hospital SDD THA program over 6 years.

Methods: We retrospectively reviewed all patients who enrolled in our institution's SDD THA program from January 2015 to October 2020.

Genicular Artery Embolization for Treatment of Knee Osteoarthritis: Interim Analysis of a Prospective Pilot Trial Including Effect on Serum Osteoarthritis-Associated Biomarkers.

Purpose: To characterize the safety, efficacy, and potential role of genicular artery embolization (GAE) as a disease-modifying treatment for symptomatic knee osteoarthritis (OA).

Materials And Methods: This is an interim analysis of a prospective, single-arm clinical trial of patients with symptomatic knee OA who failed conservative therapy for greater than 3 months. Sixteen patients who underwent GAE using 250-μm microspheres and had at least 1 month of follow-up were included.

Patient Designation Prior to Total Knee Arthroplasty: How Can Preoperative Variables Impact Postoperative Status?

Background: Removal of total knee arthroplasty (TKA) from the inpatient only list has led to a greater focus on outpatient (OP) procedures. However, the impact of OP-centered models in at-risk patients is unclear. Therefore, the current analysis investigated the effect of conversion from OP to inpatient (IP) status on postoperative outcomes and determined which factors put patients at risk for status change postoperatively.

Pain-management protocol aimed at reducing opioids following total knee arthroplasty does not negatively impact patient satisfaction.

Background: Prior research has demonstrated that the prescription of opioid medications may be associated with the desire to treat pain in order to achieve favorable patient satisfaction. The purpose of the current study was to investigate the effect of decreased opioid prescribing following total knee arthroplasty (TKA) on survey-administered patient satisfaction scores.

Method: This study is a retrospective review of prospectively collected survey data for patients who underwent primary elective TKA for the treatment of osteoarthritis (OA) between September 2014 and June 2019.

Projections and Epidemiology of Revision Hip and Knee Arthroplasty in the United States to 2040-2060.

Background: National projections of future joint arthroplasties are useful in understanding the changing burden of surgery and related outcomes on the health system. The aim of this study is to update the literature by producing Medicare projections for revision total joint arthroplasty procedures from 2040 through 2060.

Methods: The study uses 2000-2019 data from the CMS Medicare Part-B National Summary and combines procedure counts using CPT codes for revision total joint arthroplasty procedures.

Selective Use of Dual-Mobility Did Not Significantly Reduce 90-Day Readmissions or Reoperations After Total Hip Arthroplasty.

Background: Selective use of dual mobility (DM) implants in total hip arthroplasty (THA) patients at high dislocation risk has been proposed. However, evidence-based utilization thresholds have not been defined. We explored whether surgeon-specific rates of DM utilization correlate with rates of readmission and reoperation for dislocation.

Opioid Use During Hospitalization Following Total Knee Arthroplasty: Trends in Consumption From 2016 to 2021.

Background: In response to physician and patient concerns, many institutions have adopted protocols aimed at reducing postoperative opioid consumption after total knee arthroplasty (TKA). Thus, this study sought to examine how consumption of opioids has changed following TKA in the past 6 years.

Methods: We conducted a retrospective review of all 10,072 patients who received primary TKA at our institution from January 2016 to April 2021.

Genicular artery embolization for treatment of knee osteoarthritis pain: Systematic review and meta-analysis.

Objective: Genicular artery embolization (GAE) is a novel, minimally invasive procedure for treatment of knee osteoarthritis (OA). This meta-analysis investigated the safety and effectiveness of this procedure.

Design: Outcomes of this systematic review with meta-analysis were technical success, knee pain visual analog scale (VAS; 0-100 scale), WOMAC Total Score (0-100 scale), retreatment rate, and adverse events.

Fluctuation of visual analog scale pain scores and opioid consumption before and after total hip arthroplasty.

Background: Patients who undergo orthopedic procedures are often given excess opioid medication. Understanding the relationship between pain and opioid consumption following total hip arthroplasty (THA) is key to creating safe and effective opioid prescribing guidelines.

Aim: To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.

Patient Satisfaction and Risk of Falls with the Use of Intermittent Pneumatic Compression Devices Following Total Joint Arthroplasty.

Introduction: Patients who undergo total joint arthroplasty (TJA) are at a high risk for the development of thromboembolic complications. The rate at which venous thromboembolism occurs following TJA has been reported to be between 0.5% to 1.

Hospital Revenue, Cost, and Contribution Margin in Inpatient Versus Outpatient Primary Total Joint Arthroplasty.

Background: Removal of primary total knee arthroplasty (TKA) and primary total hip arthroplasty (THA) from the inpatient-only list has financial implications for both patients and institutions. The aim of this study was to evaluate and compare financial parameters between patients designated for inpatient versus outpatient total joint arthroplasty.

Methods: We reviewed all patients who underwent TKA or THA after these procedures were removed from the inpatient-only list.

Dual-mobility versus Fixed-bearing in Primary Total Hip Arthroplasty: Outcome Comparison.

Purpose: Use of dual mobility (DM) articulations can reduce the risk of instability in both primary and revision total hip arthroplasty (THA). Knowledge regarding the impact of this design on patient-reported outcome measures (PROMs) is limited. This study aims to compare clinical outcomes between DM and fixed bearing (FB) prostheses following primary THA.

Preoperative Patient Expectation of Discharge Planning is an Essential Component in Total Knee Arthroplasty.

Purpose: A better understanding of total knee arthroplasty (TKA) candidate expectations within the perioperative setting will enable clinicians to promote patient-centered practices, optimize recovery times, and enhance quality metrics. In the current study, TKA candidates were surveyed pre- and postoperatively to elucidate the relationship between patient expectations and length of stay (LOS).

Material And Methods: This is a prospective study of patients undergoing TKA between December 2017 and August 2018.

The Effect of Femoral Head Size on Groin Pain in Total Hip Arthroplasty.

Background: Although increased femoral head size reduces the risk of instability in total hip arthroplasty (THA), it may lead to iliopsoas irritation and increased anterior groin pain. The purpose of this study is to compare outcomes between non-modular dual-mobility (NDM) implants and small (≤32 mm) and large (≥36 mm) fixed-bearing (FB) constructs.

Methods: A retrospective review of all primary total hip arthroplasties from 2011 to 2021 was conducted at a single, urban academic institution.

Cemented Stems in Total Hip Arthroplasty What is Old and What is New Again?

Cement fixation of the femoral stem in total hip arthroplasty, first popularized in the 1960s following the success of Sir John Charnley's design, remains a prevalent topic in arthroplasty literature today. Though this technique is still widely used among European surgeons, since the 1980s many American surgeons have shifted to the use of cementless, press-fit stems except for particular cases such as those at increased risk for periprosthetic fracture. In this article we review the history and literature regarding the use of cemented stems in total hip arthroplasty in the United States and Europe over the past 70 years.

Comparison of Operating Room Air Quality in Primary Versus Revision Total Knee Arthroplasty.

Background: Airborne biologic particles (ABPs) can be measured intraoperatively to evaluate operating room (OR) sterility. Particulate matter (PM) up to 2.5 microns can contain microbial species which may increase infection risk.

Evaluation of Emergency Department Visits Following Total Joint Arthroplasty: Same-Day Discharge vs Non-Same-Day Discharge.

Background: Traditionally, most efforts have focused on readmission rates while little has been reported on emergency department (ED) presentation. This study aims to analyze the difference between same-day discharge (SDD) and non-SDD primary total hip and knee arthroplasty cases to determine the rate and reasons associated with 90-day ED presentations.

Methods: We retrospectively reviewed all patients who underwent primary total hip arthroplasty and total knee arthroplasty between 2011 and 2021.

Failure to Meet Same-Day Discharge is Not a Predictor of Adverse Outcomes.

Introduction: As more centers introduce same-day discharge (SDD) total joint arthroplasty (TJA) programs, it is vital to understand the factors associated with successful outpatient TJA and whether outcomes vary for those that failed SDD. The purpose of this study is to compare outcomes of patients that are successfully discharged home the day of surgery to those that fail-to-launch (FTL) and require a longer in-hospital stay.

Materials And Methods: We retrospectively reviewed all patients who enrolled in our institution's SDD TJA program from 2015 to 2020.