Radiographic Accuracy of Malseated Dual-Mobility Liners Varies Based on Implant Design.

Background: Dual-mobility constructs have gained popularity to mitigate dislocations after high-risk primary and revision total hip arthroplasties. Contemporary data have indicated that malseating of modular dual-mobility liners occurs in up to 6% of cases. The purpose of this cadaveric-based radiographic study was to determine the ability to accurately determine if modular dual-mobility liners were seated.

Collarless Taper Slip and Collared Composite Beam Stems Differ in Failure Modes and Reoperation Rates.

Background: Cemented femoral components are used in older patients based on lower risk of periprosthetic fracture and implant loosening. This study reports the survivorship free of periprosthetic femoral fracture (PPFX), femoral loosening, all-cause revision, and reoperation between 2 philosophies of cemented stems.

Methods: In total, 1,306 primary hybrid total hip arthroplasties were performed for osteoarthritis between 2000 and 2018 in a retrospective single center study.

Incidence and Characteristics of Osteolysis in HXLPE THA at 16-Year Follow up in Patients 50 Years and Less.

Introduction: Young patients present a challenge for total hip arthroplasty (THA) survivorship. Highly cross-linked polyethylene (HXLPE) liners have decreased the prevalence of osteolysis; however, concerns exist regarding the biologic activity of wear particles. The purpose of this study was to determine the incidence and characteristics of osteolytic lesions in young HXLPE THA patients at an average 16-year follow up and determine the ability to detect osteolysis.

Impact of Tourniquet Strategy on Perioperative Results of Modern TKA.

Recent changes in perioperative management of total knee patients including tranexamic acid, multimodal pain management, and periarticular injection make previous data on tourniquet use during total knee arthroplasty (TKA) less relevant. The purpose of this study was to evaluate the effect of tourniquet use on short-term postoperative outcomes in the era of modern TKA. Our institutional database was utilized to retrospectively identify three cohorts (long, short, and no tourniquet) of consecutive patients after unilateral TKA with a single surgeon.

Effect of Adductor Canal Block on Acute Perioperative Pain and Function in Total Knee Arthroplasty.

Background: Multimodal pain management strategies are commonplace in perioperative management of total knee arthroplasty (TKA), although controversy remains regarding the role of adductor canal blocks (ACB) in this algorithm. The purpose of this study is to independently evaluate the effect of ACB on short-term postoperative outcomes including (1) length of stay (LOS), (2) postoperative narcotic utilization, and (3) function with physical therapy in the era of modern TKA.

Methods: We retrospectively identified a cohort of consecutive patients from January 2014 to January 2018 who had undergone unilateral primary TKA using a single-shot ACB in addition to a standardized multimodal pain regimen vs those who only received a multimodal pain regimen.

Fifteen-Year Results of Total Hip Arthroplasty With Cobalt-Chromium Femoral Heads on Highly Cross-Linked Polyethylene in Patients 50 Years and Less.

Background: Highly cross-linked polyethylene (HXLPE) is the most commonly used bearing surface in total hip arthroplasty (THA) because of its superior wear properties, but long-term results in young patients are limited. Mid-term survivorship has been promising; however, polyethylene wear rates and need for revision surgeries remain a concern in this population. The purpose of our study is to investigate polyethylene wear rates, implant survivorship, wear-related revisions, and patient-reported outcomes in a young patient cohort at 15-year follow-up.

Conventional Polyethylene in Total Hip Arthroplasty in Young Patients: Survivorship, Wear Analysis, and Clinical Outcomes Between 15 and 20 Years.

Background: Total hip arthroplasty (THA) remains a successful procedure for most patients. However, there is a paucity of information regarding the long-term performance of conventional polyethylene (CPE) bearings in young patients undergoing THA.

Methods: After accounting for incomplete follow-up of a prospective cohort of 123 THAs in patients ≤50 years, we performed a retrospective review of 101 hips in 84 patients (82.

Clinical Management of Osteoporotic Fractures.

Purpose Of Review: This review examines recent literature regarding the clinical management of fragility fractures, provides insight into new practice patterns, and discusses controversies in current management.

Recent Findings: There are declining rates of osteoporosis management following initial fragility fracture. Management of osteoporotic fractures via a multidisciplinary team reduces secondary fracture incidence and improves overall osteoporotic care.

No impact of under-correction and joint line obliquity on clinical outcomes of total knee arthroplasty for the varus knee.

Purpose: It has been hypothesized that under-correction of a preoperative varus deformity may be more natural and improve outcomes after total knee arthroplasty (TKA). This study's purpose was to assess the impact of hip-knee-ankle (HKA) alignment and joint line obliquity on TKA outcomes for the varus knee.

Methods: All patients with a preoperative varus deformity received both preoperative and postoperative standing, full-length radiographs from which two independent observers performed radiographic measurements including the HKA axis and mechanical medial proximal tibial angle (mMPTA).

Perioperative and Early Postoperative Comparison of a Modern Cemented and Cementless Total Knee Arthroplasty of the Same Design.

Background: Cementless total knee arthroplasty (TKA) designs that incorporate a highly porous, titanium surface have the potential to achieve biologic fixation and improve component survivorship. This study's purpose was to compare perioperative and early postoperative outcomes of a cemented vs cementless TKA of the same design.

Methods: This was a retrospective review of a consecutive series of TKAs performed at a single institution using a cemented or cementless TKA of the same design (Triathlon, Stryker Inc, Mahwah, NJ).

Is the Direct Superior, Iliotibial Band-Sparing Approach Associated With Decreased Pain After Total Hip Arthroplasty?

Background: Recently, the direct superior approach (DSA) has been introduced in total hip arthroplasty (THA) with the goal of limiting soft tissue dissection. This study's purpose was to use a visual pain diagram questionnaire to determine the location and severity of pain in patients undergoing THA via a DSA vs miniposterior approach (MPA).

Methods: This was a prospective, Institutional Review Board (IRB)-approved investigation from 3 centers.