Utility of prophylactic closed suction drainage in open reduction and internal fixation for tibial plateau fracture.

Purpose: The usefulness of closed suction drains (CSD) after open reduction and internal fixation (ORIF) of tibial plateau fractures is a contested topic. The purpose of this study was to examine the impact of CSD in postoperative outcomes after tibial plateau fracture.

Methods: Data were retrospectively collected from patients who underwent primary repair of closed tibial plateau fractures via an anterolateral approach between June 2021 to May 2022 at a single academic center.

Minimal stress shielding with a Mallory-Head titanium femoral stem with proximal porous coating in total hip arthroplasty.

Background: As longevity of cementless femoral components enters the third decade, concerns arise with long-term effects of fixation mode on femoral bone morphology. We examined the long-term consequences on femoral remodeling following total hip arthroplasty with a porous plasma-sprayed tapered titanium stem.

Methods: Clinical data and radiographs were reviewed from a single center for 97 randomly selected cases implanted with the Mallory-Head Porous femoral component during primary total hip arthroplasty.

Survivorship of 2000 tapered titanium porous plasma-sprayed femoral components.

Unlabelled: Tapered titanium porous plasma-sprayed components have performed well in primary THA. To confirm the literature at longer followup we retrospectively reviewed all 1639 patients who underwent 2000 THAs in which a specific porous femoral component was used. One hundred fourteen patients (134 hips) were lost to followup leaving a cohort of 1525 patients (1866 THAs).

A lateralized tapered titanium cementless femoral component does not increase thigh or trochanteric pain.

Increased femoral component lateralization has been reported to recreate femoral offset accurately, and should provide better function. Concerns exist that negative effects may occur such as increased thigh pain, trochanteric bursitis, and loosening. The current study aims to examine whether a lateralized femoral component design is associated with increase in thigh pain, trochanteric pain, or implant failure when used to recreate hip soft tissue balance and stability.

Modular calcar replacement prosthesis with strengthened taper junction in total hip arthroplasty.

Whereas femoral component modularity allows the surgeon to address a variety of femoral defects in complex total hip arthroplasty (THA), breakage of modular stems is a known complication that typically occurs at the taper junction. In response, a proprietary process of taper roller-hardening that increases taper strength by a factor of 3.5 was introduced in 1999.

Hydroxyapatite-coated titanium porous plasma spray tapered stem: experience at 15 to 18 years.

Advocates of hydroxyapatite in primary total hip arthroplasty report enhanced fixation and early improvements in pain and function. Others report no difference in long-term outcomes with hydroxyapatite application to an already proven fixation surface. We previously reported more rapid clinical improvement with a proximally porous, plasma-sprayed titanium, tapered geometry stem.

A simple and accurate method for determining leg length in primary total hip arthroplasty.

Reconstruction of appropriate leg length is an important part of soft-tissue balance in total hip arthroplasty (THA). Leg length discrepancy (LLD) is one of the more common reasons for litigation after otherwise successful THA. The purpose of the study reported here was to analyze the accuracy of using preoperative templating and intraoperative referencing of the well leg to determine postoperative leg length in unilateral primary THA.

Manipulation with prolonged epidural analgesia for treatment of TKA complicated by arthrofibrosis.

Inability to achieve adequate range of motion (ROM) after total knee arthroplasty (TKA) represents a frustrating complication for both patient and surgeon. Manipulation under anesthesia is indicated in TKA having less than 90 degrees ROM after six weeks, with no progression or regression in ROM. A modified technique has evolved for patients with chronic regional pain syndrome (CRPS) symptoms or persistent stiffness after standard manipulation.

Tapered titanium porous plasma-sprayed femoral component in patients aged 40 years and younger.

Total hip arthroplasty (THA) in patients aged 40 years and younger requires decades of increased activity demands. Between 1987 and 2000, 249 primary THAs in patients 40 years of age or younger were performed with the Mallory-Head component. The average age at THA was 34.

Intramedullary total femoral replacement for salvage of the compromised femur associated with hip and knee arthroplasty.

Severely compromised femora because of prosthetic loosening, osteolysis, or periprosthetic fracture around total hip and knee arthroplasties are increasing. Two approaches that create an intramedullary total femoral (IMTF) replacement are reported. Twenty-three IMTF replacements in 22 patients were performed at 2 institutions.

Acute hip arthroplasty for the treatment of intertrochanteric fractures in the elderly.

Arthroplasty for intertrochanteric fractures in elderly patients may allow early weightbearing and avoid fixation failure. Clinical results are reviewed in a consecutive group of acute arthroplasties (5 hemiarthroplasties and 29 total hip arthroplasties) performed via the anterolateral approach for intertrochanteric fractures. Age averaged 80.

Isolated liner exchange using the anterolateral approach is associated with a low risk of dislocation.

Unlabelled: Authors of reports on the outcome of isolated liner exchange for osteolysis and wear have reported high dislocation rates. Twenty-six patients (27 hips) with a minimum of 2 years of followup had isolated liner exchange for wear and osteolysis done using the abductor splitting anterolateral approach. The mean followup was 41 months.

Metal-on-metal total hip arthroplasty with large heads may prevent early dislocation.

Unlabelled: Postoperative dislocation is one of the major causes of morbidity and failure of total hip arthroplasty. We reviewed 327 patients (377 hips) retrospectively with varying diagnoses and indications but all of whom received large-diameter metal-on-metal prostheses. Two surgical approaches were used: the anterolateral abductor splitting (342 procedures) and a mini-incision posterior approach (35 procedures).

Early failure of minimally invasive unicompartmental knee arthroplasty is associated with obesity.

Unlabelled: There has been increasing use of and expanding indications for unicompartmental knee arthroplasty using minimally invasive techniques. We sought to define contraindications by examining failures. We retrospectively reviewed the early results of a consecutive series of minimally invasive medial unicompartmental knee arthroplasty using two implant designs.

The long-term outcome of 755 consecutive constrained acetabular components in total hip arthroplasty examining the successes and failures.

Constrained acetabular components can treat or prevent instability after total hip arthroplasty (THA). We examine long-term results of 755 consecutive constrained THA in 720 patients (1986-1993; 62 primary, 59 conversion, 565 revision, 60 reimplantation, and 9 total femur). Eighty-three patients (88 THAs) were lost before 10-year follow-up, leaving 639 patients (667 THAs) available for study.

Pop-top tibial component: elimination of back-side wear with potential modularity.

Survivorship analysis has demonstrated the excellent long-term clinical success of total knee arthroplasty (TKA). Despite multiple attempts to enhance fixation with cementless technology, cemented TKA continues to be the "gold standard." The rate of loosening has diminished as the accuracy of implantation has been improved through sophisticated instrumentation and enhanced experience.

Rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients.

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most successful procedures performed in terms of quality-of-life years gained. The long-term goals of arthroplasty, to relieve pain, increase function, provide stability, and obtain durability, are accomplished in the vast majority of cases. The short-term goals, however, have become the target of aggressive peri-operative programs that aim to speed recovery, reduce morbidity and complications, and create a program of efficiency while maintaining the highest level of patient care.

Total femoral arthroplasty for salvage of end-stage prosthetic disease.

The complications and outcomes in patients who had total femoral arthroplasty for salvage of a severely compromised femur were studied. The clinical scenarios included numerous revision total hip or knee arthroplasties, failed periprosthetic fractures, or recurrent infection treated with multiple radical debridement surgeries. Fifty-nine patients (average age, 73.

Soft tissue and intra-articular injection of bupivacaine, epinephrine, and morphine has a beneficial effect after total knee arthroplasty.

The purpose of this study was to determine if an intraoperative intraarticular and soft-tissue injection of local anaesthetic, epinephrine, and morphine has a beneficial effect for total knee arthroplasty. A control group of 138 patients (181 knees) received no intraoperative injection. The study group of 171 patients (197 knees) received intraoperative injection of 0.

Mid-term results of a polyethylene-free metal-on-metal articulation.

Beginning in December 1995, 193 patients (195 hips) were enrolled into this prospective, randomized, controlled multicenter investigational device exemption study. Ninety-eight patients (99 hips) with 46 polyethylene liners and 53 metal liners had minimum 5-year follow-up (mean, 5.7 years).

Cerclage wires or cables for the management of intraoperative fracture associated with a cementless, tapered femoral prosthesis: results at 2 to 16 years.

Initial stability is critical for fixation and survival of cementless total hip arthroplasty. Occasionally, a split of the calcar occurs intraoperatively. A review of 1,320 primary total hip arthroplasties with 2-year follow-up, performed between August 1985 and February 2001 using the Mallory-Head Porous tapered femoral component, revealed 58 hips in 55 patients with an intraoperative calcar fracture managed with single or multiple cerclage wires or cables and immediate full weight bearing.