Three Differing Methods of Treating Intraoperative Nondisplaced Calcar Fractures Demonstrate Similar Radiographic Stem Subsidence.

Background: Several management strategies have been described to treat intraoperative calcar fractures during total hip arthroplasty (THA), including retaining the primary implant and utilizing cerclage cables (CCs) or switching the implant to one that bypasses the fracture and achieves diaphyseal fixation. However, the radiographic and clinical outcomes of these differing strategies have never been described and compared.

Methods: We retrospectively identified 50 patients who sustained an intraoperative calcar fracture out of 9,129 primary total hip arthroplasties (0.

Low Risk of Acute Iatrogenic Periprosthetic Joint Infection After Prosthetic Joint Aspiration.

Background: Synovial fluid analysis is an essential tool in diagnosing periprosthetic joint infection (PJI) after total knee arthroplasty (TKA). However, concern exists that aspiration may introduce infection into a noninfected joint. Therefore, the purpose of this study was to evaluate the incidence of iatrogenic PJI following diagnostic knee aspiration done within 6 months of the primary TKA.

Augmented Reality in Orthopedic Practice and Education.

Augmented reality (AR) technology enhances a user's perception through the superimposition of digital information on physical images while still allowing for interaction with the physical world. The tracking, data processing, and display technology of traditional computer-assisted surgery (CAS) navigation have the potential to be consolidated to an AR headset equipped with high-fidelity cameras, microcomputers, and optical see-through lenses that create digital holographic images. This article evaluates AR applications specific to total knee arthroplasty, total hip arthroplasty, and the opportunities for AR to enhance arthroplasty education and professional development.

Conversion Total Knee Arthroplasty: Prior Fracture or Osteotomy Around the Knee Leads to Increased Resource Utilization.

Background: Prior knee surgery before total knee arthroplasty (TKA) puts patients at higher risk of inferior outcomes and increased care cost. This study compares intraoperative and postoperative variables including procedure duration, components, length of stay, readmission, complications, and reoperations among patients undergoing conversion TKA.

Methods: Primary TKA from a single-surgeon database identified 130 patients with prior knee surgery to form a "conversion" cohort.

Evaluation of Statistical Shape Modeling in Quantifying Femoral Morphologic Differences Between Symptomatic and Nonsymptomatic Hips in Patients with Unilateral Femoroacetabular Impingement Syndrome.

Purpose: To determine whether statistical shape modeling can detect subtle morphologic differences in the shape of the proximal femur that correlate with clinical findings of unilateral femoroacetabular impingement syndrome.

Methods: Patients who had diagnoses of unilateral femoroacetabular impingement syndrome and who had existing computed tomography scans of their pelvises were included. Three-dimensional shape models in the form of triangle meshes were generated from the computed tomography images.

Mirror Image Modeling of Acetabular Rim Thickness Differences in Patients With Unilateral Femoroacetabular Impingement Syndrome.

Purpose: To use mirror imaging to identify the location and magnitude of difference in acetabular rim morphology between the symptomatic and unaffected acetabula in patients with symptomatic unilateral pincer-type or mixed femoroacetabular impingement syndrome (FAIS) using 1-dimensional models created with computed tomography (CT).

Methods: CT scans of bilateral hips in 33 patients diagnosed with unilateral pincer-type or mixed FAIS were obtained. Three-dimensional bilateral hip models were constructed, and the unaffected hemipelvis was superimposed onto the symptomatic side to compare acetabular thickness.

Patients With Borderline Hip Dysplasia Achieve Clinically Significant Outcome After Arthroscopic Femoroacetabular Impingement Surgery: A Case-Control Study With Minimum 2-Year Follow-up.

Background: There is a growing trend for hip arthroscopists to treat patients with borderline hip dysplasia (BHD) for femoroacetabular impingement syndrome (FAIS) without addressing the acetabular coverage. However, the literature of outcomes and failure rates for these patients is conflicting.

Purpose: (1) To identify whether patients with BHD achieved 2-year similar patient-reported outcome, minimal clinically important difference (MCID), and patient acceptable symptomatic state (PASS) when compared with patients without BHD and (2) to identify predictors for achieving the MCID and PASS among patients with BHD who are undergoing hip arthroscopy for FAIS.

Anesthesia and Analgesia Practices in Total Joint Arthroplasty: A Survey of the American Association of Hip and Knee Surgeons Membership.

Background: The purpose of this study is to survey the current analgesia and anesthesia practices used by total joint arthroplasty surgeon members of the American Association of Hip and Knee Surgeons (AAHKS).

Methods: A survey of 28 questions was created and approved by the AAHKS Research Committee. The survey was distributed to all 2208 board-certified adult reconstruction surgeon members of AAHKS in November 2018.