Incidence of and Risk Factors for Lateral Trochanteric Pain After Direct Anterior Approach Total Hip Arthroplasty.

Lateral trochanteric pain (LTP) is a common complication after total hip arthroplasty (THA). The goals of this study were to report the incidence of LTP after direct anterior approach (DAA) THA, describe the treatment course and outcomes, and examine patient-specific and implant-related potential risk factors. A retrospective review identified patients who underwent primary DAA THA with at least 1-year follow-up.

A Unique Complication of Femoral Broach Fracture and Incarceration During Total Hip Arthroplasty.

In recent years, total hip arthroplasty via the direct anterior approach has been gaining popularity. It offers potential early advantages for less pain and quicker return of hip function; however, compared to other surgical approaches, it is associated with a more difficult femoral reconstruction. Inadequate femoral exposure during the direct anterior approach can result in suboptimal press fit, implant malalignment, and intraoperative fracture.

Negative Online Ratings of Joint Replacement Surgeons: An Analysis of 6,402 Reviews.

Background: With the expanding accessibility of online health-care information, patients frequently report visiting physician rating websites before choosing a surgeon. As such, it is important to analyze patients' perception of arthroplasty surgeons as reflected on physician rating websites.

Methods: A total of 6402 online reviews of arthroplasty surgeons were extracted for analysis.

A Rare Case of Periprosthetic Joint Infection Caused by a Periodontal Pathogen, Slackia exigua: A Case Report.

Case: A 72-year-old woman with a history of right total hip arthroplasty and subsequent revision 18 years ago developed right hip periprosthetic joint infection with significant bone destruction caused by Slackia exigua. She underwent a dental cavity filling without prophylactic antibiotics before presentation that may have contributed to development of the infection. The patient required total hip revision and prolonged antibiotic therapy to eradicate the bacteria.

Single-Stage Bilateral Total Hip Arthroplasty in an Ambulatory Surgical Center: A Report of Three Cases.

In recent years, there has been increased interest in transitioning total joint arthroplasty procedures from inpatient settings to ambulatory surgical centers to decrease costs and eliminate the need for hospital stays. In addition, simultaneous bilateral total hip arthroplasty (THA) has been found to be favorable in certain patient populations when compared with staged bilateral THA. In this study, we report the results of a series of three patients who underwent single-stage bilateral THA in a free-standing ambulatory surgical center with excellent short-term outcomes and no 90-day complications.

Comparison Between the Attune and PFC Sigma in Total Knee Arthroplasty: No Difference in Patellar Clunk and Crepitus or Anterior Knee Pain.

Patellar crepitus and clunk (PCC) is a known complication in total knee arthroplasty (TKA) and the cause of dissatisfaction. Patellofemoral articulations have reportedly been optimized in newer TKAs. This study compared the incidence of PCC between a historical and modern TKA design.

Synthetic Mesh Allograft Reconstruction for Extensor Mechanism Insufficiency After Knee Arthroplasty.

Extensor mechanism (EM) insufficiency after knee arthroplasty is a rare but devastating complication resulting in severe disability. To date, primary repair and allograft reconstructive options have produced suboptimal results. A synthetic mesh allograft reconstruction technique has recently been introduced with promising outcomes.

Bundled Payments for Care Improvement in the Private Sector: A Win for Everyone.

Background: To help slow the rising costs associated with total joint arthroplasty (TJA), the Centers for Medicare and Medicaid Services introduced the Bundled Payments for Care Improvement (BPCI) initiative. The purpose of this study is to report our 1-year experience with BPCI in our 2 arthroplasty surgeon private practice.

Methods: In this series, a historical baseline group is compared with our first year under BPCI.

The direct anterior approach for acetabular augmentation in primary total hip arthroplasty.

Addressing acetabular bone defects can be difficult and depends on the amount of bone loss. Augments, either with bone or highly porous metals, are options that still allow the use of a hemispherical cup. Almost all previous research and publication on acetabular augments have focused on revision hip arthroplasty utilizing either a modified lateral or a posterolateral surgical approach.

Phlegmasia cerulea dolens and external iliac vein disruption after revision total hip arthroplasty.

We present a unique case of phlegmasia cerulea dolens and compartment syndrome secondary to external iliac vein disruption after revision total hip arthroplasty. To our knowledge, this complication has not yet been described following revision total hip arthroplasty. We conclude that although vascular complications are fortunately rare after hip arthroplasty, they can have significant morbidity and mortality.

Correlation of the Caprini Score and Venous Thromboembolism Incidence Following Primary Total Joint Arthroplasty-Results of a Single-Institution Protocol.

Background: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis, is a serious complication after total joint arthroplasty (TJA). Risk assessment models are increasingly used to provide patient-specific risk stratification. A recently implemented protocol mandates calculation of a Caprini Score for all surgical patients at our institution.

Spontaneous Fractures of a Modern Modular Uncemented Femoral Stem.

Background: Femoral stem fracture following total hip arthroplasty is an uncommon event that requires immediate revision surgery.

Questions/purposes: We report on four patients who experienced stem fractures of one design and a review of the US Food and Drug Administration adverse event reports on this design.

Methods: Fracture surfaces of four EMPERION™ (Smith & Nephew, Memphis, TN) femoral stems were analyzed under optical and scanning electron microscopy.

Total Joint Arthroplasty in a Stand-alone Ambulatory Surgical Center: Short-term Outcomes.

For decades, the average hospital stay following total joint arthroplasty (TJA) has been getting shorter. The historical standard was several weeks of hospitalization, yet improvements in perioperative care have reduced the average length of stay to a few days. Medicare recognizes a 3-day inpatient stay as the standard of care following hip or knee replacement.

Acute multiple flexor tendon injury and carpal tunnel syndrome after open distal radius fracture.

Although the rupture of extensor tendons after distal radius fractures is well described, acute flexor tendon ruptures are much less common. We report a case of acute rupture of the flexor pollicis longus and flexor carpi radialis tendons with acute carpal tunnel syndrome after a Gustilo-Anderson type II open distal radius fracture. We reviewed the literature to identify risk factors for tendon rupture and the development of carpal tunnel syndrome.

The Direct Anterior Approach for 1-Stage Bilateral Total Hip Arthroplasty: Early Outcome Analysis of a Single-Surgeon Case Series.

Background: One-stage bilateral total hip arthroplasty (B-THA) is rarely performed despite a 20% incidence of bilateral degenerative hip disease requiring surgical intervention.

Methods: We retrospectively evaluated functional outcomes in 22 consecutive patients undergoing B-THA with a matched cohort undergoing unilateral THA by the same surgeon using the direct anterior approach.

Results: Although there was a significant difference in blood loss (P < .

Primary knee arthrodesis for severe crystalline arthropathy.

Gout is a common form of inflammatory arthritis involving deposition of monosodium urate crystals within a diarthroidal joint. In this article, we report the case of a 54-year-old man who had severe, uncontrolled gout and presented with a 10-year history of knee pain. On consideration of all patient factors, including age, desired functional level, significant bone loss, periarticular soft-tissue masses, significant ligamentous instability, and difficult access to health care, knee arthrodesis was the surgery of choice.

Four common types of bursitis: diagnosis and management.

Bursitis is a common cause of musculoskeletal pain and often prompts orthopaedic consultation. Bursitis must be distinguished from arthritis, fracture, tendinitis, and nerve pathology. Common types of bursitis include prepatellar, olecranon, trochanteric, and retrocalcaneal.

Correction of metatarsus primus varus associated with hallux valgus deformity using the arthrex mini tightrope: a report of 44 cases.

Metatarsus primus varus must be addressed during correction of moderate to severe hallux valgus deformity. As an alternative to proximal osteotomy or first tarsometatarsal fusion for hallux valgus correction, this study presents a series of patients treated using the Arthrex Mini TightRope. A total of 36 patients (44 operations) with hallux valgus and metatarsus primus varus underwent correction using the Arthrex Mini TightRope.

Inappropriate transfer of patients with orthopaedic injuries to a Level I trauma center: a prospective study.

Objective: The objective of this study was to analyze the appropriateness of transfer of patients with orthopaedic injuries to a Level I trauma center from surrounding Level II to IV centers.

Design: A prospective study was conducted over a 5-month period by collecting data on all orthopaedic patients being transferred to our facility. All transfer diagnoses were designated as appropriate or inappropriate.