2021 Otto Aufranc Award: A simple Hip-Spine Classification for total hip arthroplasty : validation and a large multicentre series.

Aims: Patients with spinal pathology who undergo total hip arthroplasty (THA) have an increased risk of dislocation and revision. The aim of this study was to determine if the use of the Hip-Spine Classification system in these patients would result in a decreased rate of postoperative dislocation in patients with spinal pathology.

Methods: This prospective, multicentre study evaluated 3,777 consecutive patients undergoing THA by three surgeons, between January 2014 and December 2019.

Fate of Two-Stage Reimplantation After Failed Irrigation and Debridement for Periprosthetic Hip Infection.

Background: Irrigation and debridement is an attractive treatment option for acute perioperative and acute hematogenous periprosthetic hip infections. We ask the following questions: (1) What are the results of a two-stage reimplantation if preceded by debridement, antibiotics, and implant retention (DAIR) compared with two-stage reimplantation without an antecedent DAIR? and (2) Do McPherson Musculoskeletal Infection Society (MSIS) host criteria influence results?

Methods: A total of 114 patients were treated with two-stage exchange for periprosthetic hip infection. Sixty-five patients were treated initially with a two-stage exchange, whereas 49 patients underwent an antecedent DAIR before a two-stage exchange.

Posteromedial Approach to Tibial Plateau Fracture Nonunion.

Tibial plateau fractures can involve planes that require reduction and stabilization from a posterior approach. This includes posteromedial, posterolateral, and posterior column shear type injuries. This video outlines the prone posteromedial approach to the tibial plateau for posterior column fracture exposure, reduction, and fixation.

Thirty-Day Outcomes After Bilateral Total Hip Arthroplasty in a Nationwide Cohort.

Background: Approximately 42% of patients with end-stage osteoarthritis have bilateral disease. Although bilateral total hip arthroplasty (THA) is physiologically demanding, certain patients may benefit from simultaneous rather than staged bilateral procedures. This study examines the intraoperative differences and 30-day outcomes in patients receiving bilateral THA compared with those who underwent unilateral THA.

The Hip-Spine Relationship Simplified.

Much attention has recently been focused on the relationship between the hip and spine and its contribution to postoperative instability following total hip arthroplasty. However, the terminology can be confusing. Through an understanding of spinopelvic parameters, spinopelvic motion, and the interplay between the spine and pelvis, the surgeon can plan for and decrease the risk of instability after total hip arthroplasty.

Does femoral morphology and stem alignment influence outcomes of cementless total hip arthroplasty with proximally coated double-tapered titanium stems?

Introduction: Stem subsidence and thigh pain can cause significant patient dissatisfaction after cementless THA. The purpose of this study was to examine the effect of proximal-femoral morphology and stem alignment on clinical outcomes using a double-tapered, cementless titanium femoral component.

Methods: We retrospectively reviewed 281 consecutive, primary THAs from 2012 to 2014 with a mean follow-up of 4 years.

Evolution of an Opioid Sparse Pain Management Program for Total Knee Arthroplasty With the Addition of Intravenous Acetaminophen.

Background: Perioperative pain management for patients undergoing total knee arthroplasty (TKA) improves patient outcomes and facilitates recovery. In this study, we compared the effects of preoperative oral acetaminophen vs intravenous (IV) acetaminophen administered once intraoperatively and once postoperatively.

Methods: Two standardized, multimodal analgesia protocols were compared in patients undergoing primary, unilateral TKA.

When Can I Trust The Robot? An Algorithm for CT-Based Robotic-Assisted Total Hip Arthroplasty.

Introduction: Robotic-assisted total hip arthroplasty (THA) has been shown to demonstrate a variety of clinical benefits for patients, including reductions in dislocation rates, decreased impingement, and improved implant longevity. However, variability in surgeon experience with robotic systems can lead to inconsistent results. Mastery of the initial acetabular registration step is critical to performing a predictable and accurate robotic-assisted total hip replacement.

Hospital Consumer Assessment of Healthcare Providers and Systems: Do Patient Demographics Affect Outcomes in Total Hip Arthroplasty?

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's hospital experience. This study aims to assess whether HCAHPS scores vary by demographic or surgical factors in patients undergoing primary total hip arthroplasty.

Methods: Patients who completed an HCAHPS survey after a primary total hip arthroplasty between October 2011 and November 2016 were included in this study.

Hospital Consumer Assessment of Healthcare Providers and Systems: Do Patient Demographics Affect Outcomes in Total Knee Arthroplasty?

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a nationally standardized tool to assess patient experience between hospitals. The HCAHPS survey can affect hospital reimbursement. This study aims to determine if HCAHPS scores vary by a number of demographic variables in patients undergoing primary total knee arthroplasty (TKA).

Revision Versus Primary Hospital Consumer Assessment of Healthcare Providers and Systems Scores in Total Joint Arthroplasty.

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's inpatient experience. This study aims to assess whether HCAHPS scores differ between patients undergoing primary total joint arthroplasty (TJA) and patients undergoing revision TJA.

Methods: Patients who underwent primary or revision total hip or total knee arthroplasty (THA or TKA) and returned a completed HCAHPS survey were included in this study.

3D-MRI versus 3D-CT in the evaluation of osseous anatomy in femoroacetabular impingement using Dixon 3D FLASH sequence.

Objective: To determine if hip 3D-MR imaging can be used to accurately demonstrate femoral and acetabular morphology in the evaluation of patients with femoroacetabular impingement.

Materials And Methods: We performed a retrospective review at our institution of 17 consecutive patients (19 hips) with suspected femoroacetabular impingement who had both 3D-CT and 3D-MRI performed of the same hip. Two fellowship-trained musculoskeletal radiologists reviewed the imaging for the presence and location of cam deformity, anterior-inferior iliac spine variant, lateral center-edge angle, and neck-shaft angle.

American Spinal Injury Association A (sensory and motor complete) is not different from American Spinal Injury Association B (sensory incomplete, motor complete) in gunshot-related spinal cord injury.

Background Context: We receive a large number of patients with spinal cord injury (SCI) due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Although many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete because of sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from patients labeled ASIA A complete. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers.

Three-Dimensional Templating for Acetabular Component Alignment During Total Hip Arthroplasty.

Appropriate placement of the acetabular cup is an important determinant of implant stability and longevity. Malposition of acetabular cups negatively influences prosthesis survival and leads to an increased dislocation rate. The objective of the study was to determine the role of 3-dimensional templating in obtaining accurate acetabular component placement in total hip arthroplasty.

What Is the Association of Elite Sporting Activities With the Development of Hip Osteoarthritis?

Background: Male athletes participating in certain elite sporting activities may be at an increased risk for development of hip osteoarthritis (OA) later in life. However, the strength of the association of participation in sporting activities with the increased risk of hip OA has not been well summarized.

Purpose: To investigate the association of certain high-impact sporting activities with the risk of development of hip OA in elite athletes by conducting a systematic review of the available literature.

Surgical Management of Civilian Gunshot-Induced Spinal Cord Injury: Is It Overutilized?

Study Design: Retrospective chart review.

Objective: Assess appropriate utilization of surgery for civilian gunshot-induced spinal cord injuries (CGSWSCI) according to literature standards in a large cohort.

Summary Of Background Data: CGSWSCI are mechanically stable injuries that rarely require surgery.

Overutilization of bracing in the management of penetrating spinal cord injury from gunshot wounds.

OBJECTIVE Penetrating gunshot wounds (GSWs) to the spinal column are stable injuries and do not require spinal orthoses or bracing postinjury. Nonetheless, a high number of GSW-related spinal cord injury (SCI) patients are referred with a brace to national rehabilitation centers. Unnecessary bracing may encumber rehabilitation, create skin breakdown or pressure ulcers, and add excessive costs.