Results of Cemented vs Cementless Primary Total Knee Arthroplasty Using the Same Implant Design.

Background: Although cemented total knee arthroplasty (TKA) continues to be the gold standard, there are patient populations with higher failure rates with cemented TKAs such as the obese, morbidly obese, and younger active males. Cementless TKA usage continues to increase because of the potential benefits of long-term biologic fixation similar to the rise in cementless total hip arthroplasty. The purpose of this study was to evaluate the clinical and radiographic results of cementless TKA using a novel highly porous cementless tibial baseplate.

Estimating minimally important differences for the PROMIS pain interference scales: results from 3 randomized clinical trials.

Minimally important difference (MID) refers to the smallest meaningful difference that carries implications for patient care. Minimally important differences are necessary to help interpret patient-reported pain outcomes in research and clinical practice. The PROMIS pain interference scales were validated across diverse samples; however, more information about their MIDs could improve their interpretability.

Should Medicare Remove Total Knee Arthroplasty From Its Inpatient Only List? A Total Knee Arthroplasty Is Not a Partial Knee Arthroplasty.

Background: The Centers for Medicare and Medicaid Services have solicited comments to consider removing total knee arthroplasty (TKA) from the Inpatient Only list, as it has done for unicompartmental knee arthroplasty (UKA). The purpose of this study is to determine whether Medicare-aged patients undergoing TKA had comparable outcomes to those undergoing UKA.

Methods: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for all patients aged 65 years or older who underwent elective TKA or UKA from 2014 and 2015.

Examining the Effect of Medication Adherence on Risk of Subsequent Fracture Among Women with a Fragility Fracture in the U.S. Medicare Population.

Background: In the United States, osteoporosis affects approximately 10 million people, of whom 80% are women, and it contributes a significant clinical burden to the community. Poor adherence to osteoporosis medications adds to the overall burden of illness.

Objective: To examine the association of osteoporosis medication adherence and the risk of a subsequent fracture among Medicare-enrolled women with a previous fragility fracture.

Internet Promotion of Direct Anterior Approach Total Hip Arthroplasty by Members of the American Association of Hip and Knee Surgeons.

Background: The direct anterior approach (DAA) in total hip arthroplasty is of significant interest to both patients and surgeons, largely due to intense marketing. This study addressed the question, "What is the level of promotion of DAA total hip arthroplasty on the internet by American Association of Hip and Knee Surgeons (AAHKS) members?"

Methods: An internet search was performed to identify surgeon-specific websites for each member of the AAHKS using the members' full name and a previously published set of criteria. Each website was evaluated utilizing a questionnaire to systematically identify claims made regarding proposed DAA-specific risks, benefits, as well as the presence/absence of supporting data.

Validation of Gait Characteristics Extracted From Raw Accelerometry During Walking Against Measures of Physical Function, Mobility, Fatigability, and Fitness.

Background: Data collected by wearable accelerometry devices can be used to identify periods of sustained harmonic walking. This report aims to establish whether the features of walking identified in the laboratory and free-living environments are associated with each other as well as measures of physical function, mobility, fatigability, and fitness.

Methods: Fifty-one older adults (mean age 78.

Design, recruitment outcomes, and sample characteristics of the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial.

This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded.

Clinician-Friendly Physical Performance Tests for the Hip, Ankle, and Foot.

Unlabelled: Reference:  Hegedus EJ, McDonough SM, Bleakley C, Baxter D, Cook CE. Clinician-friendly lower extremity physical performance tests in athletes: a systematic review of measurement properties and correlation with injury. Part 2: the tests for the hip, thigh, foot, and ankle including the Star Excursion Balance Test.

Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?

Background: The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs.

Methods: The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA.

Patient Perceptions Regarding Outpatient Hip and Knee Arthroplasties.

Background: There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting.

Methods: We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA.

Physical Activity Assessment with the ActiGraph GT3X and Doubly Labeled Water.

Purpose: To compare the degree to which four accelerometer metrics-total activity counts per day (TAC per day), steps per day (steps per day), physical activity energy expenditure (PAEE) (kcal·kg·d), and moderate- to vigorous-intensity physical activity (MVPA) (min·d)-were correlated with PAEE measured by doubly labeled water (DLW). Additionally, accelerometer metrics based on vertical axis counts and triaxial counts were compared.

Methods: This analysis included 684 women and 611 men age 43 to 83 yr.

Safe Selection of Outpatient Joint Arthroplasty Patients With Medical Risk Stratification: the "Outpatient Arthroplasty Risk Assessment Score".

Background: Current patient selection criteria and medical risk stratification methods for outpatient primary total joint arthroplasty (TJA) surgery are unproven. This study assessed the predictive ability of a medically based risk assessment score in selecting patients for outpatient and short stay surgery.

Methods: A retrospective review of 1120 consecutive primary TJAs in an early discharge program was performed.

Bone mineral density reductions after tenofovir disoproxil fumarate initiation and changes in phosphaturia: a secondary analysis of ACTG A5224s.

Background: It is unknown if the greater reductions in bone mineral density (BMD) associated with initiation of tenofovir disoproxil fumarate compared with abacavir in previously untreated HIV-infected participants in the ACTG A5224s clinical trial were associated with potentially worsening tenofovir-related phosphaturia.

Methods: We correlated changes in BMD at the hip and spine with changes in phosphaturia [transtubular reabsorption of phosphorus (TRP) and tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR)] from entry through week 96 in those initiating tenofovir ( n  =   134) versus abacavir ( n  =   135) with efavirenz or atazanavir/ritonavir in A5224s. We also correlated changes in BMD with tenofovir AUC measured between weeks 4 and 24.

The effect of dairy intake on bone mass and body composition in early pubertal girls and boys: a randomized controlled trial.

Calcium retention increases with increasing body mass index (BMI) on recommended calcium intakes. Dairy foods are an excellent source of essential nutrients that are needed to increase bone mineral content (BMC) and potentially decrease fracture. We compared children who were overweight with children who were healthy weight for the accrual of bone mass in response to an extra 3 servings dairy/d compared with usual intake.

Effectiveness of Constrained Liner Use During Harrington Hip Reconstruction in Oncology Patient.

Background: Patients with destructive acetabular lesions are at high risk for morbidity. Harrington described reinforcing acetabular diseased bone with methylmethacrylate, supplemented by metal fixation, to allow total hip reconstruction. However, all published studies using this technique report dislocations.

Three-Year Results with a Ringless Third-Generation Porous Plasma Sprayed Acetabular Component in Primary Total Hip Arthroplasty.

Introduction: We previously reported promising early results in patients undergoing primary total hip arthroplasty (THA) with a third-generation cementless acetabular system that has a porous plasma-sprayed coating on a titanium alloy substrate shell, a ringless barb and groove locking mechanism, and a vitamin E-infused highly crosslinked polyethylene insert. The purpose of this study was to examine the outcomes and need for revision in a subset of patients previously reviewed who now have potential for three-year follow-up.

Patients And Methods: A query of our practice registry revealed 235 consented patients (241 hips) who underwent cementless primary THA performed by three surgeons with the G7® Acetabular System (Zimmer Biomet, Warsaw, Indiana) between April 2013 and September 2013.

Stride variability measures derived from wrist- and hip-worn accelerometers.

Many epidemiological and clinical studies use accelerometry to objectively measure physical activity using the activity counts, vector magnitude, or number of steps. These measures use just a fraction of the information in the raw accelerometry data as they are typically summarized at the minute level. To address this problem, we define and estimate two measures of temporal stride-to-stride gait variability based on raw accelerometry data: Amplitude Deviation (AD) and Phase Deviation (PD).

Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review.

Unlabelled: Reference/Citation: Hamstra-Wright KL, Bliven KC, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med.

Cementless Tapered Wedge Femoral Stems Decrease Subsidence in Obese Patients Compared to Traditional Fit-and-Fill Stems.

Background: Femoral component stability and resistance to subsidence is critical for osseointegration and clinical success in cementless total hip arthroplasty. The purpose of this study was to radiographically evaluate the anatomic fit and subsidence of 2 different proximally tapered, porous-coated modern cementless femoral component designs.

Methods: A retrospective cohort study of 126 consecutive cementless total hip arthroplasties was performed.

Correlation Between Hip Arthroscopy Outcomes and Preoperative Anesthetic Hip Joint Injections, MR Arthrogram Imaging Findings, and Patient Demographic Characteristics.

Objective: The purpose of this study is to determine whether the preoperative response to intraarticular hip anesthetic injection correlates with the outcome of hip arthroscopy. A secondary aim is to determine whether the outcome of arthroscopy correlates with intraarticular pathologic findings or patient demographic characteristics.

Materials And Methods: Ninety-three patients who underwent MR arthrography (MRA), preoperative injections of anesthetic into the hip joint (with pain scores documented), and subsequent hip arthroscopy (with a modified Harris Hip Score [mHHS] determined at 1 year after arthroscopy) were included in the study.

Will Medicare Readmission Penalties Motivate Hospitals to Reduce Arthroplasty Readmissions?

Background: The Centers for Medicare & Medicaid Services (CMS) recently imposed penalties against hospitals with above-average 30-day readmission rates following total joint arthroplasty (TJA). Hospitals must decide whether investments in readmission prevention are worthwhile. This study examines the financial incentives associated with unplanned readmissions before and after invocation of these penalties.

Leukocyte mitochondrial DNA copy number, anthropometric indices, and weight change in US women.

Objectives: To examine the association between leukocyte mitochondrial DNA copy number (mtCN) and different anthropometric indices as well as weight changes; and to compare mtCN and telomere length with respect to their associations with BMI and age.

Design: Population based cohort study.

Setting: Nurses' Health Study, an ongoing prospective cohort study of 121,700 nurses enrolled in 1976; in 1989-1990 a subset of 32,826 women provided blood samples.

Association between body composition and hip fractures in older women with physical frailty.

Aim: We sought to determine the extent to which higher lean and fat mass as measured by dual X-ray absorptiometry in older adults with frailty are related to total hip bone mass density (BMD) index and the rate of hip fractures.

Methods: The data are from the Women's Health Initiative Observational Study. We identified 872 participants aged ≥65 years with body composition measures and positive frailty.

Hospital, Patient, and Clinical Factors Influence 30- and 90-Day Readmission After Primary Total Hip Arthroplasty.

Background: The purpose of this study was to analyze the hospital, clinical, and patient factors associated with inpatient readmission after total hip arthroplasty (THA) in the Medicare population and to understand the primary reasons for readmission.

Methods: The Medicare 100% national hospital claims database was used to identify 442,333 older patients (65+) with a primary THA in 3730 hospitals between 2010 and 2013. A multilevel logistic regression analysis with a clustered data structure was used to investigate the risk of all-cause 30- and 90-day readmission, incorporating hospital, clinical, and patient factors.