Surgical Treatment of Severe Heterotopic Ossification After Total Hip Arthroplasty Over the Last 25 Years: A Systematic Review of the Literature and a New Case Series.

Background: Severe heterotopic ossification (HO) (grades III and IV) after total hip arthroplasty (THA) over the last 25 years requiring excision is very uncommon. We performed a systematic review of the literature and reported a new case series with operative treatment after primary uncemented THA.

Methods: A systematic review identified papers describing patients who had excision of HO after THA performed after 1988.

Periarticular Injection and Peripheral Nerve Blocks With Standard Agents.

The block of sensory nerves in the ipsilateral limb or locally is an integral part of the multimodal pain management protocol after primary total knee arthroplasty. The 2022 clinical practice guidelines published by the American Association of Hip and Knee Surgeons, the American Society of Regional Anesthesia and Pain Medicine, and the American Academy of Orthopaedic Surgeons describe various strengths of recommendations concerning the use of nerve blocks and periarticular injection. There is also experimental and clinical evidence to support a technique for the surgeon to perform both the periarticular injection and an intra-articular saphenous nerve block.

Treating Sleep Disorders After Total Hip and Total Knee Arthroplasty.

Disorders of sleep are common after total hip and knee arthroplasty and may contribute to patient dissatisfaction and poorer outcomes in the early postoperative period. Multiple factors contribute to sleep disorders, including poorly controlled pain, opioid medication, perioperative stress, and anxiety. Both pharmacologic and nonpharmacologic methods have been used for perioperative sleep disorders, but there is no consensus on the optimal treatment.

Failure of a Femoral Revision Knee Component with Chemical Corrosion and Elevated Metal Ions: A Case Report and Literature Review.

Case: Failure of the modular junction in revision total knee arthroplasty is a rare complication. We report a patient with late, atraumatic failure of a modern, modular revision femoral component, with preoperative elevation of serum cobalt and chromium levels. Retrieval analysis showed extensive chemical corrosion.