The Impact of Experience Versus Decision Aids on Patient Preference Toward Virtual Care.

Introduction: Virtual care utilization has increased in recent years bringing questions of how to best inform patients regarding their use. Decision aids (DAs) are tools created to assist patients in making informed decisions about their health care. This study seeks to determine whether a DA or previous experience could better educate and influence patient's preference on virtual care.

The AAHKS Clinical Research Award: Oral Dexamethasone Following Total Knee Arthroplasty: A Double-Blind, Randomized Controlled Trial.

Background: Intravenous dexamethasone has been shown to reduce pain in total joint arthroplasty. This double-blind, randomized, placebo-controlled trial investigated the postoperative effects and safety of oral dexamethasone as a potential augment to multimodal pain management in outpatient knee arthroplasty.

Methods: The authors prospectively randomized 109 consecutive patients undergoing primary total knee arthroplasty.

Increased Accuracy in Templating for Total Knee Arthroplasty Using 3D Models Generated from Radiographs.

Templating prior to total hip arthroplasty is a widely adopted practice that aims to improve operative efficiency and reduce clinical outliers. Predicting implant size before total knee arthroplasty (TKA), although less common, could increase operating room efficiency by reducing necessary equipment needed for the procedure. This study compared templating accuracy in TKA using two-dimensional (2D) digital radiographs to a novel imaging technology that generates a three-dimensional (3D) model from these 2D radiographs.

Preoperative Patient-Reported Outcomes Measurement Information System Global Health Scores Predict Patients Achieving the Minimal Clinically Important Difference in the Early Postoperative Time Period After Total Knee Arthroplasty.

Introduction: The patient-specific factors influencing postoperative improvement after total knee arthroplasty (TKA) are important considerations for the surgeon and patient. The primary purpose of this study was to determine which patient demographic factors influence the postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health (GH) scores. In addition, we aimed to compare the prognostic utility of preoperative PROMIS-GH scores and the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) in predicting postoperative improvement.

Minimal Clinically Important Difference in Robotic-Assisted Total Knee Arthroplasty Versus Standard Manual Total Knee Arthroplasty.

Background: The purpose of this study was to determine whether robotic total knee arthroplasty (R-TKA) demonstrated evidence of improvement in minimal clinically important difference (MCID) in early (<4 weeks) and intermittent (4-8 month) patient-reported outcomes compared with manual total knee arthroplasty (M-TKA).

Methods: A prospectively collected database was reviewed of 1160 consecutive patients undergoing R-TKA or M-TKA from December 2017 to October 2019. Primary outcomes consisted of Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and Patient-Reported Outcomes Measurement Information System Global Health Measures of Physical Health (PH) and Mental Health (MH).

Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Short Forms Demonstrate Responsiveness in Patients Undergoing Knee Arthroplasty.

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is an alternative to legacy outcome metrics. We investigated the relationship between Knee Injury and Osteoarthritis Outcomes Score for Joint Replacement (KOOS-JR) and PROMIS Global Health forms of Physical Health (PH) and Mental Health (MH) in knee arthroplasty patients.

Methods: This is a retrospective cohort study of knee arthroplasty patients from December 2017 through April 2019 who had surveys collected preoperatively and postoperatively.

Peer-to-Peer Collaboration Adds Value for Surgical Colleagues.

Background: Peer-to-peer advisory among colleagues in orthopedic surgery is commonplace in academic medical centers. In the private practice setting, however, it becomes more difficult for surgeons to discuss complex cases among peers.

Purpose/questions: We sought to study the effect of peer-to-peer mentorship on surgeons' decision-making and on patient care across academic and private adult joint reconstruction practices via the use of group secured messages.

Intraocular Pressure Increases After Intraarticular Knee Injection With Triamcinolone but Not Hyaluronic Acid.

Background: Intraarticular steroid injections are a common first-line therapy for severe osteoarthritis, which affects an estimated 27 million people in the United States. Although topical, oral, intranasal, and inhalational steroids are known to increase intraocular pressure in some patients, the effect of intraarticular steroid injections on intraocular pressure has not been investigated, to the best of our knowledge. If elevated intraocular pressure is sustained for long periods of time or is of sufficient magnitude acutely, permanent loss of the visual field can occur.

Septic Arthritis of the Nonoperated Knee: A Case Report.

, a gram-positive bacillus with low pathogenicity, is an uncommon but known cause of prosthetic joint infections, particularly related to shoulder surgery. , however, is an extremely rare pathogen in the nonoperated knee joint. This report details an uncommon case of septic knee arthritis after multiple intra-articular steroid injections in a 56-year-old male patient.

Preoperative predictors of postoperative opioid usage, pain scores, and referral to a pain management service in total knee arthroplasty.

Background: Little is known about preoperative predictors of postoperative pain and referral to a recuperative pain management service after total knee arthroplasty (TKA).

Questions/purposes: We sought to identify the preoperative predictors of postoperative pain scores, referral to a pain management service, and narcotic usage in patients undergoing primary total knee arthroplasty.

Methods: We performed a prospective cohort study of 97 TKAs from a single surgeon.

Early intraprosthetic dislocation in a revision dual-mobility hip prosthesis.

This article presents a case of early intraprosthetic dislocation of a dual-mobility hip prosthesis after revision total hip arthroplasty for instability. A 70-year-old woman was revised to a dual-mobility cup for multiple hip dislocations. She dislocated the dual-mobility construct twice, which was closed reduced.

Clinical outcomes of patients with non-fatal VTE after total knee arthroplasty.

Venous thromboembolism (VTE) continues to be one of the most important, and highly controversial, topics in orthopaedics. While many surgeons have discussed the incidence and treatment of this potentially life-threatening complication, little has been published about the clinical outcomes of patients who receive treatment and recover from these conditions. We evaluated the clinical outcomes of patients who suffered non-fatal VTE and compared them to a matched cohort with no complications after total knee arthroplasty using our institution's joint arthroplasty registry.

2011 Mid-America Orthopaedic Association Dallas B. Phemister Physician in Training Award: Can musculoskeletal tumors be diagnosed with ultrasound fusion-guided biopsy?

Background: Percutaneous biopsy for musculoskeletal tumors commonly relies on imaging adjuncts including ultrasound (US), CT, or MRI. These modalities however have disadvantages (US) or are cumbersome, not universally available, and costly (CT and MRI). US fusion is a novel technique that fuses previously obtained CT or MRI data with real-time US, which allows biopsies to be performed in an US suite.