Factors other than complexity of care often drive the transfer of orthopedic patients to tertiary centers. We sought to compare the demographics, diagnoses, insurance data, peri-operative outcomes and institutional costs of total hip arthroplasty patients transferred from outside facilities with those of patients derived from our clinics. We analyzed 419 consecutive patients as part of a prospective risk study. Transferred patients were older (P=0.01), less likely to have private insurance (P<0.0001), and more likely to be admitted on weekends (P=0.04). Both dislocation and fracture were more prevalent in transferred patients (P=0.04; P=0.003). Across all key metrics - including length of stay, mortality scoring, peri-operative complications, and direct and total costs - transferred patients more significantly strained the resources of our arthroplasty center.
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http://dx.doi.org/10.1016/j.arth.2013.07.009 | DOI Listing |
J Mech Behav Biomed Mater
January 2025
Laboratory for Biomechanics and Biomaterials (LBB), Department of Orthopedic Surgery, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625, Hannover, Germany. Electronic address:
In hip arthroplasty, relative movements between the femoral stem and bone can lead to implant loosening, resulting in extensive bone loss. Acoustic emission (AE) analysis is a promising technique for a nondestructive and noninvasive detection of these relative movements. To develop such a detection method, in vitro investigations using piezoelectric AE sensors on implant stems in artificial or human femora are required to characterize the AE signals induced by loosening.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Roth | McFarlane Hand & Upper Limb Center, St Joseph's Health Care London, London, ON, Canada.
Background: Precise and accurate glenoid preparation is important for the success of shoulder arthroplasty. Despite advancements in preoperative planning software and enabling technologies, most surgeons execute the procedure manually. Patient-specific instrumentation (PSI) facilitates accurate glenoid guide pin placement for cannulated reaming; however, few commercially available systems offer depth of reaming control.
View Article and Find Full Text PDFJ Mech Behav Biomed Mater
January 2025
Division of Orthopaedic Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address:
Background: The risk of early revision of total hip arthroplasty (THA) for polyethylene wear is now low, but there remains a need to perform wear measurements in patients for clinical surveillance. The gold standard of wear measurements has been radiostereometric analysis (RSA), which has limited availability. The use of computed tomography (CT) to perform THA wear measurement was described a decade ago and found to have acceptable accuracy and precision, but high radiation dose was a concern.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, USA.
Introduction: Knee alignment significantly impacts the outcome of total knee arthroplasty (TKA). Understanding patient perceptions of their knee alignment in relation to objective measurements is essential to ensure optimal surgical outcomes and to meet patients' expectations. This study reports patients' perception of pre- and postoperative knee alignment in relation to radiographic alignment measurements.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Centre Hospitalier Universitaire de Nîmes, Nîmes, France.
Purpose: The adoption of robotic-assisted total hip arthroplasty (THA) is increasingly widespread, yet its influence on outcomes in outpatient surgery remains uncertain. This study aimed to evaluate whether robotic assistance reduces the rate of 90-day postoperative events in patients undergoing outpatient THA, compared to those in inpatient procedures.
Methods: This historical-prospective cohort study analyzed 706 primary THA cases performed between January 2017 and January 2023 by three senior surgeons.
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