The Cost of Robot-assisted Total Hip Arthroplasty: Comparing Safety and Hospital Charges to Conventional Total Hip Arthroplasty.

Introduction: Utilization of robotic assistance is increasing for total hip arthroplasty (THA). However, few studies have directly examined the efficacy of this technique at reducing complications. This research aims to compare the rates of perioperative complications of robotic-assisted THA (RA-THA) with conventional THA (C-THA).

The Cost-Effectiveness of Vancomycin Powder in Lumbar Laminectomy.

Study Design: Break-even cost analysis.

Objective: The goal of this study is to examine the cost-effectiveness of vancomycin powder for preventing infection following lumbar laminectomy.

Methods: The product cost of vancomycin powder was obtained from our institution's purchasing records.

Socioeconomic Status Is Associated With the Risk of Girdlestone Resection Arthroplasty After Periprosthetic Infection of the Hip.

Introduction: Girdlestone resection arthroplasty (GRA) is a radical but sometimes necessary treatment of periprosthetic joint infection (PJI) of the hip. The purpose of this of this study was to identify the independent risk factors for GRA after PJI of the hip.

Methods: This is a retrospective, cross-sectional analysis of the National (Nationwide) Inpatient Sample from 2010 to 2014.

In Hospital Outcomes of Total Hip Arthroplasty in the Medicaid Population.

Total hip arthroplasty (THA) is one of the most common orthopaedic procedures. This study's purpose was to evaluate national trends, patient demographics and hospital outcomes for Medicaid patients who underwent a primary THA. The National Hospital Discharge Survey (NHDS) database was queried for patients undergoing THA from 2001-2010.

Socioeconomic Status Is Associated with Risk of Above-knee Amputation After Periprosthetic Joint Infection of the Knee.

Background: Above-knee amputation (AKA) is a severe but rare complication of TKA. Recent evidence suggests there are sex and racial disparities with regard to AKA after TKA. However, whether lower socioeconomic status is associated with an increased risk of AKA after TKA has not been conclusively established.

The Cost Effectiveness of Dilute Betadine Lavage for Infection Prophylaxis in Total Joint Arthroplasty.

Background: This article presents a break-even analysis for intraoperative Betadine lavage for the prevention of infection in total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: Protocol costs, baseline infection rates after arthroplasty, and average revision costs were obtained from institutional records and the literature. The break-even analysis determined the absolute risk reduction (ARR) in infection rate required for cost effectiveness.

Location of the Popliteal Artery in Knee Extension on Magnetic Resonance Imaging.

The goal of this study was to define the course of the popliteal artery (PA) and determine any variability among different patient demographics; by identifying risk factors for injury, surgeons can decrease patient morbidity and mortality. Ninety-four adult magnetic resonance imaging studies of the knee were reviewed. In extension, the artery is at most 7.

Recent National Trends and Outcomes in Total Ankle Arthroplasty in the United States.

Total ankle arthroplasty (TAA) is an evolving option for treating ankle arthritis. We assessed the national trends in usage and perioperative outcomes of TAA in the United States. International Classification of Diseases, 9th revision (ICD-9), codes were used to search the National Hospital Discharge Survey database for TAA from 1997 to 2010.

The Cost-Effectiveness of Preoperative Staphylococcus aureus Screening and Decolonization in Total Joint Arthroplasty.

Background: This article presents a break-even analysis for preoperative Staphylococcus aureus colonization screening and decolonization protocols in total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: Protocol costs, baseline infection rates after arthroplasty, and average revision costs were obtained from institutional records and the literature. The break-even analysis determined the absolute risk reduction (ARR) in infection rate required for cost-effectiveness.

Total Hip Arthroplasty and Hemiarthroplasty: US National Trends in the Treatment of Femoral Neck Fractures.

There is controversy regarding whether total hip arthroplasty (THA) or hemiarthroplasty (HA) is the treatment preferred for displaced intracapsular femoral neck fractures (FNFs). Using the US National Hospital Discharge Survey, we found that, of 12,757 patients admitted for FNF between 2001 and 2010, 4.6% underwent THA and 52.

Radiolucencies surrounding acetabular components with three-dimensional coatings: artifact or real?

Background: Several 2-dimensional and 3-dimensional surfaces are available for cementless acetabular fixation. Plain radiographs are used to assess osseointegration; however, the radiographs are limited by their inability to capture the bone fixation process occurring over the 3-dimensional cup surface. In this cadaveric study, we compared the bone apposition between 2-dimensional and 3-dimensional cups.

Surgical Approaches for Total Hip Arthroplasty.

Total hip arthroplasty (THA) has become one of the most reliable and patient-requested surgical interventions in all medicine. The procedure can be performed using a variety of surgical approaches, but the posterior approach, direct lateral approach, and direct anterior approach are by far the most common across the globe. This article highlights the history and technique for each of these common approaches.

Glenoid version and size: does gender, ethnicity, or body size play a role?

Introduction: Variations in glenoid morphology among patients of different gender, body habitus, and ethnicity have been of interest for surgeons. Understanding these anatomical variations is a critical step in restoring normal glenohumeral structure during shoulder reconstruction surgery.

Methods: Retrospective review of 108 patient shoulder CT scans was performed and glenoid version, AP diameter and height were measured.

Total Knee Arthroplasty in Obesity: In-Hospital Outcomes and National Trends.

Background: Both the prevalence of obesity and the utilization rate of total knee arthroplasty are increasing. The rate and proportion of total knee arthroplasty (TKA) performed in the setting of obesity/morbid obesity is increasing significantly over time.

Methods: Using International Classification of Diseases-Ninth Revision codes, we searched the National Hospitals Discharge Survey national database for patients admitted for primary TKA between 2001 and 2010.

The Evolution of Image-Free Robotic Assistance in Unicompartmental Knee Arthroplasty.

Semiautonomous robotic technology has been introduced to optimize accuracy of bone preparation, implant positioning, and soft tissue balance in unicompartmental knee arthroplasty (UKA), with the expectation that there will be a resultant improvement in implant durability and survivorship. Currently, roughly one-fifth of UKAs in the US are being performed with robotic assistance, and it is anticipated that there will be substantial growth in market penetration of robotics over the next decade. First-generation robotic technology improved substantially implant position compared to conventional methods; however, high capital costs, uncertainty regarding the value of advanced technologies, and the need for preoperative computed tomography (CT) scans were barriers to broader adoption.

National trends and in hospital outcomes for total hip arthroplasty in avascular necrosis in the United States.

Purpose: While a majority of total hip arthroplasty (THA) is performed for osteoarthritis (OA), a significant portion is performed in the setting of avascular necrosis (AVN). The purpose of this study is to evaluate recent trends, patient demographics, and in hospital outcomes for primary THA in the setting of AVN in the United States.

Methods: The National Hospital Discharge Survey database was searched for patients admitted to US hospitals after a primary THA for the years 2001-2010.

Repair techniques for acute distal biceps tendon ruptures: a systematic review.

Background: There is a lack of consensus regarding the optimal surgical approach and fixation method for distal biceps tendon ruptures. The purpose of this study was to conduct a systematic review comparing the results of the various surgical approaches and repair techniques for acute distal biceps tendon ruptures.

Methods: We searched the MEDLINE, Cochrane, and Embase databases for all published randomized controlled trials, prospective cohort studies, or case series that involved primary repairs of acute distal biceps tendon ruptures with use of a cortical button, intraosseous screws, suture anchors, or bone tunnels for fixation.

Variability in locations of hip neurovascular structures and their proximity to hip arthroscopic portals.

Purpose: To measure the distances of pertinent neurovascular structures from bony landmarks used during hip arthroscopy and compare them among different demographic groups.

Methods: The distances from neurovascular structures to bony landmarks often used during hip arthroscopy were measured on magnetic resonance images of the hip in 100 patients. The structures studied include the lateral femoral cutaneous nerve (LFCN), sciatic nerve, femoral nerve, and femoral artery.

Tendon sheath fibroma in the thigh.

Tendon sheath fibromas are rare, benign soft tissue tumors that are predominantly found in the fingers, hands, and wrists of young adult men. This article describes a tendon sheath fibroma that developed in the thigh of a 70-year-old man, the only known tendon sheath fibroma to form in this location. Similar to tendon sheath fibromas that develop elsewhere, our patient's lesion presented as a painless, slow-growing soft tissue nodule.

Perioperative infection rate in patients with osteosarcomas treated with resection and prosthetic reconstruction.

Background: The incidence of perioperative infection after segmental tumor endoprosthetic replacement in previous reports varies from a high of 7.4% to a low of 2.6%.

Impact of close surgical margin on local recurrence and survival in osteosarcoma.

Purpose: Whether neoadjuvant chemotherapy safely allows close margins in osteosarcoma patients is still unknown. This study investigates the impact of close margins on local recurrence (LR) and overall survival (OS) for osteosarcoma patients treated with neoadjuvant chemotherapy.

Methods: We retrospectively reviewed 47 cases of conventional osteosarcoma who were treated at our institution.

The relation of tumour necrosis and survival in patients with osteosarcoma.

Purpose: We investigated whether tumour necrosis was associated with disease-free survival (DFS) and overall survival (OS) of osteosarcoma patients treated in our institution.

Methods: We retrospectively studied the predictive value of percentage of necrosis in 40 cases of IIB osteosarcoma treated from 1999 to 2008 in our institution. Patient and treatment factors such as age, gender, tumour site, surgery type, pathological type, tumour size, margin status, percentage of tumour necrosis, chemotherapy regimens and cycles were recorded.

Early outcomes for malignant peripheral nerve sheath tumor treated with chemotherapy.

Objectives: Malignant peripheral nerve sheath tumors (MPNST) are rare soft-tissue sarcomas with a tendency for recurrence and metastasis. Treatment using chemotherapy is controversial, but benefit with some agents has been described. This study aimed to analyze early survival outcomes using doxorubicin and ifosfamide chemotherapy for MPNST.

Recurrent lipoma-like hibernoma.

This is the fifth report of the rare lipoma-like variant of hibernoma, the 19th case reported, and the first documented as recurring after excision. Our patient was a 56-year-old man whose painful lipoma-like hibernoma (LLH) in the pelvis/buttock was initially treated with marginal excision 15 years earlier. Nine years after treatment, the LLH recurred locally.

Early pleomorphic hyalinizing angiectatic tumor: precursor or distinct lesion?

Early pleomorphic hyalinizing angiectatic tumor is a rare and recently described soft tissue lesion. Originally believed to be a precursor lesion to neoplastic pleomorphic hyalinizing angiectatic tumor, and possibly identical to hemosiderotic fibrohistiocytic lipomatous lesion/tumor, there have been recent suggestions that it is distinct from pleomorphic hyalinizing angiectatic tumor and is instead a reactive process. This article reports a case of a mass in the foot of a 45-year-old woman, which is 1 of only 15 published cases of early pleomorphic hyalinizing angiectatic tumor and is the first case to describe its radiographic appearance.