Unveiling distinct kinematic profiles among total knee arthroplasty candidates through clustering technique.

Background: Characterizing the condition of patients suffering from knee osteoarthritis is complex due to multiple associations between clinical, functional, and structural parameters. While significant variability exists within this population, especially in candidates for total knee arthroplasty, there is increasing interest in knee kinematics among orthopedic surgeons aiming for more personalized approaches to achieve better outcomes and satisfaction. The primary objective of this study was to identify distinct kinematic phenotypes in total knee arthroplasty candidates and to compare different methods for the identification of these phenotypes.

Tibial Slope Is Not Associated With Implant Migration Following Cemented Total Knee Arthroplasty With a Single Implant Design.

Background: The influence of tibial slope on tibial component migration following total knee arthroplasty has not been widely studied, although excessive posterior slope has been implicated in some failures. As implant micromotion measured with radiostereometric analysis can indicate successful fixation, the purpose of this study was to determine the associations between tibial slope, tibial component migration, and inducible displacement.

Methods: Radiostereometric analyses at 6 visits over 2 years quantified implant migration for 200 cemented total knee arthroplasties.

6-month migration sufficient for evaluation of total knee replacements: a systematic review and meta-analysis.

Background And Purpose: This updated meta-analysis evaluates the migration pattern of the tibial component of primary total knee replacements measured with radiostereometric analysis (RSA). We aimed to evaluate whether 6-month maximum total point motion (MTPM) values could be used instead of 1-year MTPM for RSA threshold testing and to present the pooled migration patterns for different implant designs that can be used as a benchmark.

Patients And Methods: The search included all published RSA studies on migration patterns of tibial components until 2023.

A low-dose biplanar X-ray imager has RSA level precision in total knee arthroplasty.

Background And Purpose: The low radiation biplanar X-ray imager (EOS imaging, Paris, France) scans patients in a weight-bearing position, provides calibrated images, and limits radiation, an asset for serial radiostereometric analysis (RSA) studies. RSA in vivo precision values have not been published for this type of imaging system, thus the goal of this study was to assess the precision of RSA in vivo utilizing a low radiation biplanar imager.

Patients And Methods: At a mean of 5 years post-surgery (range 1.

Continuity of primary care and emergency department visits following knee and hip replacement surgery: a retrospective cohort study.

Background: Continuity of primary care (CPC) improves patient well-being, but the association between CPC and surgical outcomes has not been well studied. The numbers of joint replacement procedures are expected to rise considerably in the coming years, so it is crucial to identify factors related to successful outcomes. The purpose of this study was to examine the association between CPC and emergency department (ED) visits after knee and hip replacement surgery.

Patient appropriateness for total knee arthroplasty and predicted probability of a good outcome.

Objectives: One-fifth of total knee arthroplasty (TKA) recipients experience a suboptimal outcome. Incorporation of patients' preferences in TKA assessment may improve outcomes. We determined the discriminant ability of preoperative measures of TKA need, readiness/willingness and expectations for a good TKA outcome.

Patient acceptable symptom state (PASS): thresholds for the EQ-5D-5L and Oxford hip and knee scores for patients with total hip and knee replacement.

Purpose: To define patient acceptable symptom state (PASS) cut-off values for the EQ-5D-5L and Oxford hip (OHS) and knee (OKS) scores 6 and 12 months after total hip (THR) or knee (TKR) replacement. To compare PASS cut-off values for the EQ-5D-5L scored using: (1) the Canadian value set, (2) the crosswalk value set, and (3) the equal weighted Level Sum Score (LSS).

Methods: We mailed questionnaires to consecutive patients following surgeon referral for primary THR or TKR and at 6 and 12 months post-surgery.

Mid-Term Performance of the First Mass-Produced Three-Dimensional Printed Cementless Tibia in the United States as Reported in the American Joint Replacement Registry.

Background: Cementless tibial components have shown improvements in clinical performance compared to predicate designs, though evidence supporting mid-term performance and fixation is scarce. The purpose of this study is to determine the mid-term survivorships, revision rates, and reasons why 3-dimensional printed cementless tibial baseplates (3DTKAs) failed compared to other cementless as well as cemented tibial baseplates reported from the American Joint Replacement Registry (AJRR) data.

Methods: All primary total knee arthroplasty (TKA) cases performed in patients 65 years of age or older within the AJRR from January 2, 2012 through June 30, 2020 were queried.

Gait biomechanics phenotypes among total knee arthroplasty candidates by machine learning cluster analysis.

Knee osteoarthritis patient phenotyping is relevant to developing targeted treatments and assessing the treatment efficacy of total knee arthroplasty (TKA). This study aimed to identify clusters among TKA candidates based on demographic and knee mechanic features during gait, and compare gait changes between clusters postoperatively. TKA patients underwent 3D gait analysis 1-week pre (n = 134) and 1-year post-TKA (n = 105).

The associations of implant and patient factors with migration of the tibial component differ by sex : a radiostereometric study on more than 400 total knee arthroplasties.

Aims: Thresholds of acceptable early migration of the components in total knee arthroplasty (TKA) have traditionally ignored the effects of patient and implant factors that may influence migration. The aim of this study was to determine which of these factors are associated with overall longitudinal migration of well-fixed tibial components following TKA.

Methods: Radiostereometric analysis (RSA) data over a two-year period were available for 419 successful primary TKAs (267 cemented and 152 uncemented in 257 female and 162 male patients).

The Effect of Patient Age and Surgical Appropriateness and Their Influence on Surgeon Recommendations for Primary TKA: A Cross-Sectional Study of 2,037 Patients.

Background: Rising total knee arthroplasty (TKA) rates in younger patients raises concern about appropriateness. We asked: are younger individuals who seek consultation for TKA less likely to be appropriate for and, controlling for appropriateness, more likely to be recommended for surgery?

Methods: This cross-sectional study was nested within a prospective cohort study of knee osteoarthritis (OA) patients referred for TKA from 2014 to 2016 to centralized arthroplasty centers in Alberta, Canada. Pre-consultation, questionnaires assessed patients' TKA appropriateness (need, based on knee symptoms and prior treatment; readiness/willingness to undergo TKA; health status; and expectations) and contextual factors (for example, employment).

Association between surgical wait time and hospital length of stay in primary total knee and hip arthroplasty.

Aims: In countries with social healthcare systems, such as Canada, patients may experience long wait times and a decline in their health status prior to their operation. The aim of this study is to explore the association between long preoperative wait times (WT) and acute hospital length of stay (LoS) for primary arthroplasty of the knee and hip.

Methods: The study population was obtained from the provincial Patient Access Registry Nova Scotia (PARNS) and the Canadian national hospital Discharge Access Database (DAD).

Early Identification of Patient Satisfaction Two Years After Total Knee Arthroplasty.

Background: There are numerous reports of poor satisfaction after total knee arthroplasty (TKA), yet there is little known about when to use evidence-based models of care to improve patient outcomes.

Objective: This study aimed to characterize longitudinal changes in patient-reported satisfaction after TKA and to identify factors for early identification of poor satisfaction.

Methods: For a cohort of primary TKA surgeries (n = 86), patient-reported outcomes were captured one week before TKA and 6 weeks, 12 weeks, 6 months, and 1 and 2 years after TKA.

Tibial Component Migration After Total Knee Arthroplasty With High-Viscosity Bone Cement.

Background: High-viscosity (HV) bone cements have been formulated to offer potentially advantageous handling characteristics. However, alteration in the handling characteristics could influence implant fixation and survival. The primary objective of this study was to use radiostereometric analysis after total knee arthroplasty to assess the migration of the Triathlon tibial component fixed with HV cement (Simplex HV).

Relationship Between Patient-Reported Readiness for Total Knee Arthroplasty and Likelihood of a Good Outcome at One-Year Follow-Up.

Objective: To determine the relationship between patients' preoperative readiness for total knee arthroplasty (TKA) and surgical outcome at 1 year post-TKA.

Methods: This prospective cohort study recruited patients with knee osteoarthritis (OA) who were ≥30 years and were referred for TKA at 2 hip/knee surgery centers in Alberta, Canada. Those who underwent primary unilateral TKA completed questionnaires prior to TKA to assess pain using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), physical disability using the Knee Injury and Osteoarthritis Outcome Score physical function short form, perceived arthritis coping efficacy, general self-efficacy, depressed mood using the Patient Health Questionnaire 8, body mass index, comorbidities, and TKA readiness (patient acceptable symptom state; willingness to undergo TKA); these same individuals also completed the above questionnaires 1 year post-TKA to assess surgical outcomes.

Quantifying Achievable Levels of Improvement in Knee Joint Biomechanics During Gait After Total Knee Arthroplasty Relative to Osteoarthritis Severity.

Total knee arthroplasty (TKA) surgery improves knee joint kinematics and kinetics during gait for most patients, but a lack of evidence exists for the level and incidence of improvement that is achieved. The objective of this study was to quantify patient-specific improvements in knee biomechanics relative to osteoarthritis (OA) severity levels. Seventy-two patients underwent 3-dimensional (3D) gait analysis before and 1 year after TKA surgery, as well as 72 asymptomatic adults and 72 with moderate knee OA.

Individual Gait Features Are Associated with Clinical Improvement After Total Knee Arthroplasty.

Background: Over 20% of patients do not report clinically relevant pain relief or functional improvements after total knee arthroplasty (TKA). The aim of this study was to investigate the effect of demographics, pre-TKA knee-joint biomechanics, and postoperative changes in knee biomechanics on meaningful improvements in self-reported pain and function after TKA.

Methods: Forty-six patients underwent 3-dimensional gait analysis and completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire before and 1 year after TKA.

Patients' Preoperative Expectations of Total Knee Arthroplasty and Satisfaction With Outcomes at One Year: A Prospective Cohort Study.

Objective: To assess the relationship between patients' expectations for total knee arthroplasty (TKA) and satisfaction with surgical outcome.

Methods: This prospective cohort study recruited patients with knee osteoarthritis (OA) ages ≥30 years who were referred for TKA at 2 hip/knee surgery centers in Alberta, Canada. Those who received primary, unilateral TKA completed questionnaires pre-TKA to assess TKA expectations (17-item Hospital for Special Surgery [HSS] TKA Expectations questionnaire) and contextual factors (age, sex, Western Ontario and McMaster Universities Osteoarthritis Index pain score, Knee Injury and Osteoarthritis Outcome Score physical function short form [KOOS-PS], 8-item Patient Health Questionnaire depression scale, body mass index [BMI], comorbidities, and prior joint replacement), and 1-year post-TKA to assess overall satisfaction with TKA results.

Increased Mortality with the Use of Cementless Fixation for Femoral Neck Fractures: Analysis of 5883 Hip Arthroplasty Cases.

Background: The use of cemented fixation for hip arthroplasty for femoral neck fractures has been advocated to limit the postoperative and intraoperative risk of periprosthetic fractures. However, there are concerns with the potential effects of cementing on patient mortality, particularly at the time of cementation.

Methods: This study examined the mortality rates of cemented compared to cementless hip arthroplasty fixation in a group of 5883 femoral neck fracture patients from 2001 to 2017.

Total cost of surgical site infection in the two years following primary knee replacement surgery.

Objective: The disease burden of surgical site infection (SSI) following total knee (TKA) replacement is considerable and is expected to grow with increased demand for the procedure. Diagnosing and treating SSI utilizes both inpatient and outpatient services, and the timing of diagnosis can affect health service requirements. The purpose of this study was to estimate the health system costs of infection and to compare them across time-to-diagnosis categories.

Migration and Wear of a Dual Mobility Acetabular Construct at 3 Years Measured by Radiostereometric Analysis.

Background: The anatomic dual mobility (ADM) acetabular component was introduced because of previously described low dislocation rates for this type of construct. The shape of the anatomic cup and the motion of polyethylene liner may have implications for acetabular cup fixation and polyethylene liner wear; therefore, the purpose of this study was to assess the migration patterns and wear rates of the ADM component using radiostereometric analysis.

Methods: Uncemented ADM acetabular components were implanted in 27 patients.