Extended Oral Antibiotic Prophylaxis in High-Risk Patients Substantially Reduces Primary Total Hip and Knee Arthroplasty 90-Day Infection Rate.

Background: Total joint arthroplasty (TJA) episodic payment models shift risk and cost of periprosthetic joint infection (PJI) to surgeons and hospitals, causing some to avoid treating high-risk patients. Furthermore, there are little data to support optimization of host factors preoperatively to decrease PJI, and recent literature supports using extended antibiotic prophylaxis following reimplantation TJA. The purpose of this study was to evaluate whether extended oral antibiotic prophylaxis minimized PJI after primary TJA in high-risk patients.

Does an Anterior-Lipped Tibial Insert Adequately Substitute for a Post-Cam Articulation in Total Knee Arthroplasty.

Introduction: Newer tibial inserts with enhanced conformity (cruciate stabilizing anterior lip; CS) to obviate the need for a posteriorly stabilized (PS) post-cam articulation in posterior cruciate ligament-deficient knees have been recently introduced in modern total knee arthroplasty (TKA). The purpose of this study was to evaluate whether clinical and functional outcomes differ in TKA cohorts without a posterior cruciate ligament (PCL) utilizing either CS anterior-lipped or PS post-cam articulation.

Materials And Methods: Prospectively collected outcomes were compared in matched cohorts of modern TKAs implanted with either CS anterior-lipped tibial inserts or PS post-cam articulations.

Liposomal Bupivacaine Injection Technique in Total Knee Arthroplasty.

Liposomal bupivacaine has gained popularity for pain control after total knee arthroplasty (TKA), yet its true efficacy remains unproven. We compared the efficacy of two different periarticular injection (PAI) techniques for liposomal bupivacaine with a conventional PAI control group. This retrospective cohort study compared consecutive patients undergoing TKA with a manufacturer-recommended, optimized injection technique for liposomal bupivacaine, a traditional injection technique for liposomal bupivacaine, and a conventional PAI of ropivacaine, morphine, and epinephrine.

Multicenter Study of Highly Cross-linked vs Conventional Polyethylene in Total Knee Arthroplasty.

Background: Despite substantial interest and use of highly cross-linked polyethylene (HXLPE) in total knee arthroplasty (TKA), outcomes remain largely unknown. The purpose of this study is to compare HXLPE and conventional polyethylene at 4- to 5-year follow-up.

Methods: A prospective multicenter study of 307 posterior-stabilized TKAs (168 conventional and 139 HXLPE) was performed.

Highly Cross-Linked Versus Conventional Polyethylene in Posterior-Stabilized Total Knee Arthroplasty at a Mean 5-Year Follow-up.

Concerns of highly cross-linked polyethylene (XLPE) in total knee arthroplasty (TKA) exist regarding fatigue resistance and oxidation, particularly in posterior-stabilized (PS) designs. A prospective cohort study of 114 consecutive PS TKAs utilized conventional polyethylene in 50 knees and second-generation annealed XLPE in 64 TKAs. Clinical (Short-Form 36, Knee Society Scores, and LEAS) and radiographic outcomes were evaluated at a mean of 5 years in 103 TKAs.

Single-use instrumentation, cutting blocks, and trials decrease contamination during total knee arthroplasty: a prospective comparison of navigated and nonnavigated cases.

The purpose of this prospective controlled trial was to determine whether decrease in contamination could be achieved in nonnavigated and navigated total knee arthroplasties by replacing traditional saws, cutting blocks, and trials with specialized saws and single-use cutting blocks and trials. Various tray wrapping metrics during total knee arthroplasty were measured in 400 procedures performed by 8 different surgeons at 6 institutions. Instrumentation contamination was determined by counting the number of tray sterility indicators, pans, and instruments that were compromised.

Intermediate results of a cemented femoral stem with a PMMA premantle.

This retrospective study evaluated the intermediate clinical results ot a series of 143 patients after total hip arthroplasty using the Definition PM femoral component. One hundred twenty-two patients had a mean follow-up of 5 years (range, 23-77 months), died (mean 30 months; range, 6-56 months), or were revised (mean 20 months; range, 9-40 months). The mechanical failure rate of the femoral stem was 0.