Risk Factors for Periprosthetic Femoral Fracture in Non-cemented Total Hip Arthroplasty Through the Direct Anterior Approach.

Although total hip arthroplasty (THA) performed through the direct anterior (DA) approach is frequently marketed as superior to other approaches, there are concerns about increased risks of intraoperative and early postoperative femoral fracture. We sought to assess patient-specific and radiographic risk factors for intraoperative and early postoperative (90-day) periprosthetic femoral fracture (PPFx) following DA approach THA. We retrospectively reviewed 1107 consecutive, primary, non-cemented DA THAs, performed between April 2009 and January 2015, for intraoperative and early postoperative PPFx.

Iliopsoas Impingement After Direct Anterior Approach Total Hip Arthroplasty: Epidemiology, Risk Factors, and Treatment Options.

Background: The objective of this study is to evaluate the incidence, natural history, response to treatment, and risk factors for anterior iliopsoas impingement (AIPI) after direct anterior approach (DAA) total hip arthroplasty (THA).

Methods: Between January 1, 2009 and January 4, 2014, 600 patients (655 hips) who underwent primary DAA THA were retrospectively reviewed. AIPI incidence was calculated.

Brachial Plexus Birth Injury in the Preterm Infant: Suspecting the Unsuspected.

Background: Prematurity is usually considered as a protective factor for brachial plexus birth injury (BPBI). However, BPBI can occur in the preterm infant, and can cause significant dysfunction and morbidity. There is scant literature regarding this subgroup of patients with BPBI.

The Effect of Femoral Cutting Jig Design on Restoration of Femoral Offset in Posterior-Referenced Total Knee Arthroplasty.

Femoral component sizing and rotation in total knee arthroplasty (TKA) affects patellofemoral tracking and tibiofemoral mechanics. Posterior referencing is said to optimize restoration of posterior condylar offset. However, it typically allows the surgeon to select 3° to 5° of external rotation to the posterior condylar axis, inevitably changing the offset of one or both condyles.

Closed incision negative pressure therapy decreases complications after periprosthetic fracture surgery around the hip and knee.

Introduction: Periprosthetic fractures (PPFXs) are becoming increasingly common following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Patients sustaining PPFXs face considerable perioperative morbidity, with relatively increased rates of surgical site infection. We sought to evaluate the efficacy of closed-incision negative-pressure wound therapy (ciNPT) in decreasing perioperative wound complications following lower extremity periprosthetic fracture surgery.

Revision Arthroplasty for the Management of Stiffness After Primary TKA.

Background: The aim of this study was to evaluate the results of revision surgery for the treatment of stiffness after total knee arthroplasty (TKA).

Methods: An IRB-approved retrospective review was performed to identify patients who were revised due to stiffness after a primary TKA. Patients were included when at least one major component had to be revised due to stiffness after primary TKA with a minimum follow-up of 2 years.

Risk Factors for Wound Complications After Direct Anterior Approach Hip Arthroplasty.

Background: Previous studies have suggested that wound complications may be higher after direct anterior approach (DAA) hip arthroplasty, but, specific risk factors have not been closely examined.

Methods: We conducted a retrospective case-control study of 651 consecutive DAA hip arthroplasty surgeries performed by 2 surgeons over a 3-year period. Outcome measures included any postoperative wound problem (including prolonged drainage, wound dehiscence, wound necrosis, suture granuloma, and superficial infection) requiring additional intervention or reoperation.

Adoption of Robotic vs Fluoroscopic Guidance in Total Hip Arthroplasty: Is Acetabular Positioning Improved in the Learning Curve?

Background: Acetabulum positioning affects dislocation rates, component impingement, bearing surface wear rates, and need for revision surgery. Novel techniques purport to improve the accuracy and precision of acetabular component position, but may have a significant learning curve. Our aim was to assess whether adopting robotic or fluoroscopic techniques improve acetabulum positioning compared to manual total hip arthroplasty (THA) during the learning curve.

Differential Effect of Total Knee Arthroplasty on Valgus and Varus Knee Biomechanics During Gait.

Background: Total knee arthroplasty and its relation to gait abduction or adduction moment has not been fully described.

Methods: Gait analysis was performed on 25 patients (27 knees) preoperatively, 6 months and 1 year after total knee arthroplasty. Reflective markers were placed on the lower extremity, and motion data were collected at 60 Hz using 6 infrared cameras.

Closed-Incision Negative-Pressure Therapy Versus Antimicrobial Dressings After Revision Hip and Knee Surgery: A Comparative Study.

Background: This study evaluates the efficacy of closed-incision negative-pressure therapy (ciNPT) in decreasing wound complications and surgical site infections (SSIs) after revision hip and knee surgery.

Methods: A retrospective quality improvement analysis of 138 consecutive revision hip and knee operations performed by a single surgeon over a 34-month period was performed. ciNPT was used selectively in higher-risk patients with multiple risk factors for SSIs over the last 15 months of the study period.