Scholars@Duke
Michael Paul Bolognesi

Michael Paul Bolognesi

Virginia Flowers Baker Distinguished Professor of Orthopaedic Surgery
Orthopaedic Surgery
michael.bolognesi@duke.edu
DUMC Box 104002, Durham, NC 27710
311TRENT Drive, Durham, NC 27710
Office hours

Selected Publications

Management of Intraoperative Acetabular Fractures During Total Hip Arthroplasty.

Journal Article Orthop Clin North Am · January 2024 Intraoperative fractures of the acetabulum are a rare but serious complication during total hip arthroplasty. Acute fractures generally require attention with plating, whereas chronic acetabular fractures may be approached with distraction, a Burch-Schneid ... Full text Link to item Cite

Does Preoperative Weight Loss Within 6 Months or 1 Year Change the Risk of Adverse Outcomes in Total Knee Arthroplasty by Initial Body Mass Index Classification?

Journal Article J Arthroplasty · December 2023 BACKGROUND: High body mass index (BMI) is associated with adverse outcomes after total knee arthroplasty (TKA). Thus, many patients are advised to lose weight before TKA. This study examined how weight loss before TKA is associated with adverse outcomes de ... Full text Link to item Cite

Higher Risk of Reoperation after Total Knee Arthroplasty in Young and Elderly Patients.

Journal Article Materials (Basel) · November 2, 2023 As outcomes and survivorship improve, total knee arthroplasty (TKA) has expanded into broader age groups. The purpose of this study is to analyze the impact of age on TKA outcomes using the National Surgical Quality Improvement Program (NSQIP) database fro ... Full text Link to item Cite

Preoperative Optimization for Orthopaedic Surgery: Steps to Reduce Complications.

Journal Article J Am Acad Orthop Surg · November 1, 2023 As the population ages and patients maintain higher levels of activity, the incidence of major and minor orthopaedic procedures continues to rise. At the same time, health policies are incentivizing efforts to improve the quality and value of musculoskelet ... Full text Link to item Cite

Do You PROMIS (Patient Reported Outcomes Measurement Information System)? Physical Function and Pain Interference Scores After Total Knee and Hip Arthroplasty.

Journal Article Arthroplast Today · October 2023 BACKGROUND: Physical function and pain outcomes vary after arthroplasty. We investigated differences in postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) scores for patients un ... Full text Link to item Cite

Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty.

Journal Article J Arthroplasty · September 2023 BACKGROUND: Recently, some payers have limited access to total knee arthroplasty (TKA) to patients who have Kellgren-Lawrence (KL) grade 4 osteoarthritis only. This study compared the outcomes of patients who have KL grade 3 and 4 osteoarthritis after TKA ... Full text Link to item Cite

Inferior Outcomes for Patients Transferred Between Surgical Stages for Knee Periprosthetic Joint Infection.

Journal Article J Arthroplasty · August 22, 2023 BACKGROUND: Periprosthetic joint infection (PJI) in total knee arthroplasty may result in 2-stage revision surgery. There are limited data describing outcomes when the first stage is completed at an outside hospital and the patient is referred to a tertiar ... Full text Link to item Cite

Does Medically Supervised Weight Loss Prior to Total Knee Arthroplasty Improve Patient-Reported Pain and Physical Function?

Journal Article J Arthroplasty · August 18, 2023 BACKGROUND: Weight loss is commonly recommended before total knee arthroplasty (TKA) despite inconsistent evidence for better outcomes. This study sought to examine the impacts of preoperative weight loss on patient-reported and adverse outcomes among TKA ... Full text Link to item Cite

A Permanent Articulating Spacer Versus Two-Stage Exchange for Chronic Periprosthetic Joint Infection: A Propensity Score-Matched Study.

Journal Article J Arthroplasty · August 2023 BACKGROUND: Although 2-stage revision has been proposed as gold standard for periprosthetic joint infection treatment, limited evidence exists for the role of articulating spacers as definitive management. The purpose of this study was to compare clinical ... Full text Link to item Cite

The Removal of Total Hip Arthroplasty From the Inpatient-Only List has Improved Patient Selection and Expanded Optimization Efforts.

Journal Article J Arthroplasty · July 2023 BACKGROUND: On January 1, 2020, the Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the Inpatient-Only (IPO) list. This study evaluated patient demographics and comorbidities, preoperative optimization efforts, and 30-d ... Full text Link to item Cite

Does Order of Operation Matter in Patients Who Have Concomitant Hip and Spine Pathology?

Journal Article J Arthroplasty · July 2023 BACKGROUND: In patients, who have coexisting lumbar spine and degenerative hip disease, there remains uncertainty regarding whether hip or spine surgery should be performed first. We hypothesized that undergoing total hip arthroplasty (THA) would protect a ... Full text Link to item Cite

Can Patient-Reported Outcome Measurement Information System Measures Estimate High Impact Chronic Pain After Total Joint Arthroplasty?

Journal Article J Arthroplasty · June 2023 BACKGROUND: High impact chronic pain (HICP) is not typically measured following orthopedic surgeries, but has a substantial negative impact on postoperative quality of life. This analysis determined which Patient-Reported Outcome Measurement Information Sy ... Full text Link to item Cite

Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs.

Journal Article J Orthop Surg Res · June 1, 2023 BACKGROUND: Flexion instability is a common cause for revision after total knee arthroplasty (TKA); however, little objective criteria exist to determine excessive laxity in flexion. This study sought to determine the reliability of stress radiographs for ... Full text Link to item Cite

Risk Factors for Early Readmission and Reoperation After Outpatient Total Hip Arthroplasty.

Journal Article Orthopedics · May 2, 2023 Outpatient total hip arthroplasty (THA) is a safe option for select patients. The purpose of this study was to analyze a national database and understand risk factors that lead to unplanned early readmission and reoperation after outpatient THA. The Nation ... Full text Link to item Cite

A Validated Pre-operative Risk Prediction Tool for Extended Inpatient Length of Stay Following Primary Total Hip or Knee Arthroplasty.

Journal Article J Arthroplasty · May 2023 BACKGROUND: As value-based reimbursement models mature, understanding the potential trade-off between inpatient lengths of stay and complications or need for costly postacute care becomes more pressing. Understanding and predicting a patient's expected bas ... Full text Link to item Cite

Opioid Legislation Decreases Opioid Prescribing in Total Knee Arthroplasty.

Journal Article Orthopedics · May 2023 The purpose of this study was to evaluate the impact of opioid-limiting legislation on perioperative opioid prescriptions in total knee arthroplasty. The hypothesis was that opioid legislation has reduced opioid prescription filling above levels anticipate ... Full text Link to item Cite

Outcome Disparities in Total Knee and Total Hip Arthroplasty among Native American Populations.

Journal Article J Racial Ethn Health Disparities · April 10, 2023 BACKGROUND: No prior racial disparities studies in total knee arthroplasty (TKA) and total hip arthroplasty (THA) have specifically evaluated outcomes among American Indian or Alaska Native (AIAN) patients. We hypothesized that AIAN patients have worse out ... Full text Link to item Cite

Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes.

Journal Article J Arthroplasty · March 2023 BACKGROUND: Perioperative advancements have made outpatient primary total hip arthroplasty (THA) a viable option for patients. This study evaluated the feasibility of expedited discharge after revision THA and compared 30-day outcomes to patients who had p ... Full text Link to item Cite

Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty?

Journal Article J Knee Surg · January 2023 Well-powered studies evaluating the effects of Paget's disease on patient outcomes following primary total knee arthroplasty (TKA) are limited. The objective of this study was to determine whether Paget's disease patients undergoing primary TKA have higher ... Full text Link to item Cite

Management of Intraoperative Acetabular Fractures During Total Hip Arthroplasty.

Journal Article Orthop Clin North Am · January 2024 Intraoperative fractures of the acetabulum are a rare but serious complication during total hip arthroplasty. Acute fractures generally require attention with plating, whereas chronic acetabular fractures may be approached with distraction, a Burch-Schneid ... Full text Link to item Cite

Does Preoperative Weight Loss Within 6 Months or 1 Year Change the Risk of Adverse Outcomes in Total Knee Arthroplasty by Initial Body Mass Index Classification?

Journal Article J Arthroplasty · December 2023 BACKGROUND: High body mass index (BMI) is associated with adverse outcomes after total knee arthroplasty (TKA). Thus, many patients are advised to lose weight before TKA. This study examined how weight loss before TKA is associated with adverse outcomes de ... Full text Link to item Cite

Higher Risk of Reoperation after Total Knee Arthroplasty in Young and Elderly Patients.

Journal Article Materials (Basel) · November 2, 2023 As outcomes and survivorship improve, total knee arthroplasty (TKA) has expanded into broader age groups. The purpose of this study is to analyze the impact of age on TKA outcomes using the National Surgical Quality Improvement Program (NSQIP) database fro ... Full text Link to item Cite

Preoperative Optimization for Orthopaedic Surgery: Steps to Reduce Complications.

Journal Article J Am Acad Orthop Surg · November 1, 2023 As the population ages and patients maintain higher levels of activity, the incidence of major and minor orthopaedic procedures continues to rise. At the same time, health policies are incentivizing efforts to improve the quality and value of musculoskelet ... Full text Link to item Cite

Do You PROMIS (Patient Reported Outcomes Measurement Information System)? Physical Function and Pain Interference Scores After Total Knee and Hip Arthroplasty.

Journal Article Arthroplast Today · October 2023 BACKGROUND: Physical function and pain outcomes vary after arthroplasty. We investigated differences in postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) scores for patients un ... Full text Link to item Cite

Patients Who Have Kellgren-Lawrence Grade 3 and 4 Osteoarthritis Benefit Equally From Total Knee Arthroplasty.

Journal Article J Arthroplasty · September 2023 BACKGROUND: Recently, some payers have limited access to total knee arthroplasty (TKA) to patients who have Kellgren-Lawrence (KL) grade 4 osteoarthritis only. This study compared the outcomes of patients who have KL grade 3 and 4 osteoarthritis after TKA ... Full text Link to item Cite

Inferior Outcomes for Patients Transferred Between Surgical Stages for Knee Periprosthetic Joint Infection.

Journal Article J Arthroplasty · August 22, 2023 BACKGROUND: Periprosthetic joint infection (PJI) in total knee arthroplasty may result in 2-stage revision surgery. There are limited data describing outcomes when the first stage is completed at an outside hospital and the patient is referred to a tertiar ... Full text Link to item Cite

Does Medically Supervised Weight Loss Prior to Total Knee Arthroplasty Improve Patient-Reported Pain and Physical Function?

Journal Article J Arthroplasty · August 18, 2023 BACKGROUND: Weight loss is commonly recommended before total knee arthroplasty (TKA) despite inconsistent evidence for better outcomes. This study sought to examine the impacts of preoperative weight loss on patient-reported and adverse outcomes among TKA ... Full text Link to item Cite

A Permanent Articulating Spacer Versus Two-Stage Exchange for Chronic Periprosthetic Joint Infection: A Propensity Score-Matched Study.

Journal Article J Arthroplasty · August 2023 BACKGROUND: Although 2-stage revision has been proposed as gold standard for periprosthetic joint infection treatment, limited evidence exists for the role of articulating spacers as definitive management. The purpose of this study was to compare clinical ... Full text Link to item Cite

The Removal of Total Hip Arthroplasty From the Inpatient-Only List has Improved Patient Selection and Expanded Optimization Efforts.

Journal Article J Arthroplasty · July 2023 BACKGROUND: On January 1, 2020, the Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the Inpatient-Only (IPO) list. This study evaluated patient demographics and comorbidities, preoperative optimization efforts, and 30-d ... Full text Link to item Cite

Does Order of Operation Matter in Patients Who Have Concomitant Hip and Spine Pathology?

Journal Article J Arthroplasty · July 2023 BACKGROUND: In patients, who have coexisting lumbar spine and degenerative hip disease, there remains uncertainty regarding whether hip or spine surgery should be performed first. We hypothesized that undergoing total hip arthroplasty (THA) would protect a ... Full text Link to item Cite

Can Patient-Reported Outcome Measurement Information System Measures Estimate High Impact Chronic Pain After Total Joint Arthroplasty?

Journal Article J Arthroplasty · June 2023 BACKGROUND: High impact chronic pain (HICP) is not typically measured following orthopedic surgeries, but has a substantial negative impact on postoperative quality of life. This analysis determined which Patient-Reported Outcome Measurement Information Sy ... Full text Link to item Cite

Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs.

Journal Article J Orthop Surg Res · June 1, 2023 BACKGROUND: Flexion instability is a common cause for revision after total knee arthroplasty (TKA); however, little objective criteria exist to determine excessive laxity in flexion. This study sought to determine the reliability of stress radiographs for ... Full text Link to item Cite

Risk Factors for Early Readmission and Reoperation After Outpatient Total Hip Arthroplasty.

Journal Article Orthopedics · May 2, 2023 Outpatient total hip arthroplasty (THA) is a safe option for select patients. The purpose of this study was to analyze a national database and understand risk factors that lead to unplanned early readmission and reoperation after outpatient THA. The Nation ... Full text Link to item Cite

A Validated Pre-operative Risk Prediction Tool for Extended Inpatient Length of Stay Following Primary Total Hip or Knee Arthroplasty.

Journal Article J Arthroplasty · May 2023 BACKGROUND: As value-based reimbursement models mature, understanding the potential trade-off between inpatient lengths of stay and complications or need for costly postacute care becomes more pressing. Understanding and predicting a patient's expected bas ... Full text Link to item Cite

Opioid Legislation Decreases Opioid Prescribing in Total Knee Arthroplasty.

Journal Article Orthopedics · May 2023 The purpose of this study was to evaluate the impact of opioid-limiting legislation on perioperative opioid prescriptions in total knee arthroplasty. The hypothesis was that opioid legislation has reduced opioid prescription filling above levels anticipate ... Full text Link to item Cite

Outcome Disparities in Total Knee and Total Hip Arthroplasty among Native American Populations.

Journal Article J Racial Ethn Health Disparities · April 10, 2023 BACKGROUND: No prior racial disparities studies in total knee arthroplasty (TKA) and total hip arthroplasty (THA) have specifically evaluated outcomes among American Indian or Alaska Native (AIAN) patients. We hypothesized that AIAN patients have worse out ... Full text Link to item Cite

Accelerated Discharge After Aseptic Revision Total Hip Arthroplasty Does Not Predict Inferior 30-Day Outcomes.

Journal Article J Arthroplasty · March 2023 BACKGROUND: Perioperative advancements have made outpatient primary total hip arthroplasty (THA) a viable option for patients. This study evaluated the feasibility of expedited discharge after revision THA and compared 30-day outcomes to patients who had p ... Full text Link to item Cite

Do Patients with Paget's Disease Have Worse Outcomes following Primary Total Knee Arthroplasty?

Journal Article J Knee Surg · January 2023 Well-powered studies evaluating the effects of Paget's disease on patient outcomes following primary total knee arthroplasty (TKA) are limited. The objective of this study was to determine whether Paget's disease patients undergoing primary TKA have higher ... Full text Link to item Cite

An analysis of 90-day emergency department visits after peripherally inserted central catheter (PICC) placement for prosthetic joint infection.

Journal Article Infect Control Hosp Epidemiol · December 2022 OBJECTIVE: Research on complications with peripherally inserted central catheter (PICC) lines that are placed for the treatment of prosthetic joint infection (PJI) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is scarce. We investiga ... Full text Link to item Cite

Total joint arthroplasty following solid organ transplants: complications and mid-term outcomes.

Journal Article Int Orthop · December 2022 PURPOSE: Survival after solid organ transplant (SOT) is improving, and demand for total joint arthroplasty (TJA) among SOT recipients is rising. Outcomes including revision, periprosthetic joint infection, and survivorship based on SOT type are variable. W ... Full text Link to item Cite

Primary Total Knee Arthroplasty in Patients Aged 45 Years or Younger: 162 Total Knee Arthroplasties With a Mean Follow-up Duration of 7 Years.

Journal Article Arthroplast Today · December 2022 BACKGROUND: There are few large studies evaluating total knee arthroplasty (TKA) in young patients. Therefore, we sought to evaluate patients aged 45 years or younger undergoing a primary TKA. METHODS: This was a retrospective, single-institution study, fr ... Full text Link to item Cite

Outcomes and Cost Analysis of a Surgical Care Unit for Outpatient Total Joint Arthroplasties Performed at a Tertiary Academic Center.

Journal Article Arthroplast Today · December 2022 BACKGROUND: Total joint arthroplasty (TJA) has shifted toward being an outpatient surgery with advances in perioperative protocols and patient selection. Most literature on outpatient arthroplasty focuses on the surgery performed in ambulatory centers. Thi ... Full text Link to item Cite

Accelerated discharge after aseptic revision knee arthroplasty is not associated with early readmission and reoperation.

Journal Article Bone Joint J · December 2022 AIMS: In the last decade, perioperative advancements have expanded the use of outpatient primary total knee arthroplasty (TKA). Despite this, there remains limited data on expedited discharge after revision TKA. This study compared 30-day readmissions and ... Full text Link to item Cite

Commercial Claims Data Sources: PearlDiver and Individual Payer Databases.

Journal Article J Bone Joint Surg Am · October 19, 2022 Individual or pooled commercial claims data sources such as the IBM MarketScan and PearlDiver provide information from health-care encounters by individuals enrolled in participating health insurance plans. These data sources contain deidentified data on d ... Full text Link to item Cite

Sleep disturbance, dyspnea, and anxiety following total joint arthroplasty: an observational study.

Journal Article J Orthop Surg Res · August 19, 2022 BACKGROUND: Patient-Reported Outcomes Measurement Information System (PROMIS) domains for sleep disturbance, anxiety, and dyspnea have been under-reported for total joint arthroplasty (TJA). The aims of this study were to report postoperative differences f ... Full text Open Access Link to item Cite

Short-Stay Arthroplasty is Not Associated With Increased Risk of 90-Day Hospital Returns.

Journal Article J Arthroplasty · August 2022 BACKGROUND: With the removal of total hip arthroplasty (THA) and total knee arthroplasty (TKA) from the inpatient-only list, medical centers are faced with challenging transitions to outpatient surgery. We investigated if short-stay arthroplasty, defined a ... Full text Link to item Cite

Racial and Ethnic Disparities in the Imaging Workup and Treatment of Knee and Hip Osteoarthritis.

Journal Article J Arthroplasty · August 2022 BACKGROUND: There is limited evidence on sociodemographic differences in osteoarthritis management, particularly in non-African American (AA) minorities. We sought to identify differences in imaging modalities, administration of intra-articular injections, ... Full text Link to item Cite

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

Journal Article J Knee Surg · August 2022 Concomitant cruciate and meniscus injuries of the knee are generally associated with acute trauma and commonly treated with surgical intervention. Comorbidities (simultaneous presence of two or more medical conditions) may be acquired from changes in activ ... Full text Link to item Cite

Risk Factors for Delayed Discharge and Adverse Outcomes Following Outpatient Billed Total Knee Arthroplasty.

Journal Article J Arthroplasty · June 2022 BACKGROUND: The volume of outpatient total knee arthroplasty (TKA) has increased with advances in perioperative protocols, patient selection, and recent policy changes regarding insurance authorization. This study analyzed 30-day outcomes from a national d ... Full text Link to item Cite

Can Patient-Reported Outcome Measurement Information System Measures Differentiate Patients Who Will Undergo Hip and Knee Total Joint Arthroplasty: A Retrospective Case-Control Study.

Journal Article J Arthroplasty · June 2022 BACKGROUND: The Patient-Reported Outcome Measurement Information System (PROMIS) can be used to monitor patients in population-health-based programs. However, it is unknown which measures are most appropriate to differentiate patients who will undergo hip ... Full text Link to item Cite

Prosthetic Knee Infection With Coagulase-Negative Staphylococcus: A Harbinger of Poor Outcomes.

Journal Article J Arthroplasty · June 2022 BACKGROUND: Coagulase-negative staphylococci (CoNS) are biofilm-producing pathogens whose role in periprosthetic joint infection (PJI) is increasing. There is little data on the prognosis and treatment considerations in the setting of PJI. We sought to eva ... Full text Link to item Cite

Erratum to 'Corynebacterium Total Hip and Knee Arthroplasy Prosthetic Joint Infections' [Arthroplasty Today 6 (2020) 163-168].

Journal Article Arthroplast Today · June 2022 [This corrects the article DOI: 10.1016/j.artd.2020.03.008.]. ... Full text Link to item Cite

Chronic Pain Prevalence and Factors Associated With High Impact Chronic Pain following Total Joint Arthroplasty: An Observational Study.

Journal Article J Pain · March 2022 Hip, knee, and shoulder arthroplasty are among the most frequently performed orthopaedic procedures in the United States. High impact and bothersome chronic pain rates following total joint arthroplasty (TJA) are unknown; as are factors that predict these ... Full text Link to item Cite

The Diagnosis and Treatment of Acetabular Bone Loss in Revision Hip Arthroplasty: An International Consensus Symposium.

Journal Article HSS J · February 2022 Despite growing evidence supporting the evaluation, classification, and treatment of acetabular bone loss in revision hip replacement, advancements have not been systematically incorporated into a single document, and therefore, a comprehensive review of t ... Full text Link to item Cite

Postoperative changes in cognition and cerebrospinal fluid neurodegenerative disease biomarkers.

Journal Article Ann Clin Transl Neurol · February 2022 OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ... Full text Open Access Link to item Cite

Total Knee Arthroplasty in Patients with Dementia.

Journal Article J Knee Surg · January 2022 There are few studies evaluating total knee arthroplasty (TKA) in patients with dementia. The purpose of this study was to evaluate the rate of revision, complication, emergency department (ED) visitation, and discharge disposition in patients with dementi ... Full text Link to item Cite

Ultrasound-guided genicular nerve blocks following total knee arthroplasty: a randomized, double-blind, placebo-controlled trial.

Journal Article Reg Anesth Pain Med · October 2021 INTRODUCTION: Local anesthetic blockade of the genicular nerves, known targets of radiofrequency ablative techniques for knee pain, has not previously been studied in a randomized controlled trial evaluating acute pain after knee arthroplasty. We hypothesi ... Full text Link to item Cite

Use of Patient-Reported Outcomes Measurement Information System (PROMIS) measures to characterise health status for patients seeking care from an orthopaedic provider: a retrospective cohort study.

Journal Article BMJ Open · September 2, 2021 OBJECTIVES: Characterise the health status of patients newly consulting an orthopaedic specialist across eight clinical subspecialties. DESIGN: Retrospective cohort. SETTING: 18 orthopaedic clinics, including 8 subspecialties (14 ambulatory and 4 hospital ... Full text Open Access Link to item Cite

Flash Sterilization and Component Reimplantation Is a Viable Option for Articulating Antibiotic Spacers in Periprosthetic Knee Infections.

Journal Article J Knee Surg · August 2021 The articulating antibiotic spacer is a treatment utilized for two-stage revision of an infected total knee arthroplasty. The original femoral component is retained and reused in one described variation of this technique. The purpose of this study is to de ... Full text Link to item Cite

Can PROMIS measures be used to create subgroups for patients seeking orthopaedic care?

Journal Article Bone Jt Open · July 2021 AIMS: Patient-reported outcome measures have become an important part of routine care. The aim of this study was to determine if Patient-Reported Outcomes Measurement Information System (PROMIS) measures can be used to create patient subgroups for individu ... Full text Open Access Link to item Cite

Mid-term results of tibial cones : reasonable survivorship but increased failure in those with significant bone loss and prior infection.

Journal Article Bone Joint J · June 2021 AIMS: Tibial cones are often utilized in revision total knee arthroplasty (TKA) with metaphyseal defects. Because there are few studies evaluating mid-term outcomes with a sufficient cohort, the purpose of this study was to evaluate tibial cone survival an ... Full text Link to item Cite

Cost of Aseptic Revision Total Knee Arthroplasty at a Tertiary Medical Center.

Journal Article J Arthroplasty · May 2021 BACKGROUND: Revision total knee arthroplasty (TKA) involves varying levels of case complexity and costs depending on the following: (1) number of components revised, (2) duration of operating room time, and (3) length of hospital stay. However, the cost as ... Full text Link to item Cite

Body Mass Index, American Society of Anesthesiologists Score, and Elixhauser Comorbidity Index Predict Cost and Delay of Care During Total Knee Arthroplasty.

Journal Article J Arthroplasty · May 2021 BACKGROUND: Body mass index (BMI), American Society of Anesthesiologists (ASA) score, and Elixhauser Comorbidity Index are measures that are utilized to predict perioperative outcomes, though little is known about their comparative predictive effects. We a ... Full text Link to item Cite

A Preoperative Risk Prediction Tool for Discharge to a Skilled Nursing or Rehabilitation Facility After Total Joint Arthroplasty.

Journal Article J Arthroplasty · April 2021 BACKGROUND: Discharge to rehabilitation or a skilled nursing facility (SNF) after total joint arthroplasty remains a primary driver of cost excess for bundled payments. An accurate preoperative risk prediction tool would help providers and health systems i ... Full text Link to item Cite

Paget's Disease in Primary Total Hip Arthroplasty Is Associated With Greater In-Hospital Lengths of Stay, Costs, and Complications.

Journal Article J Arthroplasty · February 2021 BACKGROUND: There are few well-powered studies investigating the association of Paget's disease of bone on patients undergoing primary total hip arthroplasty (THA). This study utilized a nationwide database to determine whether Paget's patients undergoing ... Full text Link to item Cite

Synergistic Roles of Macrophages and Neutrophils in Osteoarthritis Progression.

Journal Article Arthritis Rheumatol · January 2021 OBJECTIVE: To evaluate the role of immune cells and their effector cytokines in the pathogenesis and progression of knee osteoarthritis (OA) in matched OA synovial fluid (SF) and synovial tissue samples. METHODS: Cells from matched samples of synovial tiss ... Full text Link to item Cite

The Calpain Gene is Correlated With Metal-on-Metal Hip Replacement Failures.

Journal Article J Arthroplasty · January 2021 BACKGROUND: Metal-on-metal (MOM) total hip arthroplasty is associated with unacceptable failure rates secondary to metal ion reactions. Efforts to identify which patients will go on to failure have been limited; recently, there has been a suggestion for a ... Full text Link to item Cite

A Case Complexity Modifier Is Warranted for Primary Total Knee Arthroplasty.

Journal Article J Arthroplasty · January 2021 BACKGROUND: The Center for Medicare and Medicaid Services is faced with a challenge of decreasing the cost of care for total knee arthroplasty (TKA) but must make efforts to prevent patient selection bias in the process. Currently, no appropriate modifier ... Full text Link to item Cite

All-Polyethylene Tibia: An Opportunity for Value-Based Care in Bundled Reimbursement Initiatives.

Journal Article Orthopedics · January 1, 2021 Surgeons play a critical role in making cost-effective decisions that maintain high-quality patient outcomes, which is the current focus of the Centers for Medicare & Medicaid Services. All-polyethylene tibial (APT) components often cost less during total ... Full text Link to item Cite

Angiotensin Receptor Blockers Were Not Associated With Decreased Arthrofibrosis After Total Knee Arthroplasty.

Journal Article Orthopedics · 2021 Stiffness after total knee arthroplasty (TKA) remains a challenging problem. Angiotensin receptor blockers (ARBs) have been associated with decreased muscle fibrosis. The aim of this study was to evaluate whether perioperative use of ARBs was associated wi ... Full text Link to item Cite

Next-generation sequencing not superior to culture in periprosthetic joint infection diagnosis.

Journal Article Bone Joint J · January 2021 AIMS: Use of molecular sequencing methods in periprosthetic joint infection (PJI) diagnosis and organism identification have gained popularity. Next-generation sequencing (NGS) is a potentially powerful tool that is now commercially available. The purpose ... Full text Link to item Cite

Revision Total Joint Arthroplasty: Final Stop Tertiary Referral Center.

Journal Article Orthopedics · 2021 High complication rates associated with revision total knee arthroplasty (TKA) and total hip arthroplasty (THA) may unequally burden tertiary referral centers, which manage medically complex patients. The authors aimed to quantify TKA and THA referral patt ... Full text Link to item Cite

Post-Traumatic Arthritis

Chapter · January 1, 2021 Post-traumatic arthritis (PTA) can be a painful and debilitating sequela of periarticular knee injuries including any combination of fractures of the tibia, femur, and patella, as well as surrounding soft tissue structures. Total knee arthroplasty (TKA) is ... Full text Cite

Patient Preferences for Surgical Treatment of Knee Osteoarthritis: A Discrete-Choice Experiment Evaluating Total and Unicompartmental Knee Arthroplasty.

Journal Article J Bone Joint Surg Am · December 2, 2020 BACKGROUND: Total knee arthroplasty (TKA) is a common treatment for end-stage knee osteoarthritis but is associated with increased complication rates compared with unicompartmental knee arthroplasty (UKA). UKA offers better functional outcomes but is assoc ... Full text Link to item Cite

A Specific Capsular Repair Technique Lowered Early Dislocations in Primary Total Hip Arthroplasty Through a Posterior Approach.

Journal Article Arthroplast Today · December 2020 BACKGROUND: Dislocation is a challenging problem after total hip arthroplasty (THA). We sought to evaluate the incidence of early dislocation with 2 different posterior repair techniques after THA using a posterior approach. METHODS: From September of 2008 ... Full text Link to item Cite

Commercially Available Polymerase Chain Reaction Has Minimal Utility in the Diagnosis of Periprosthetic Joint Infection.

Journal Article Orthopedics · November 1, 2020 The use of genetic sequencing modalities in the diagnosis of periprosthetic joint infection (PJI) and the identification of organisms has gained popularity recently. Polymerase chain reaction (PCR) offers timely results for common organisms. The purpose of ... Full text Link to item Cite

The Removal of Total Hip and Total Knee Arthroplasty From the Inpatient-Only List Increases the Administrative Burden of Surgeons and Continues to Cause Confusion.

Journal Article J Arthroplasty · October 2020 BACKGROUND: Several studies have shown that the removal of total knee arthroplasty (TKA) from the Centers for Medicare and Medicaid Services (CMS) inpatient-only (IPO) list has caused confusion among surgeons, hospitals, and patients. The purpose of this s ... Full text Link to item Cite

Arthroplasty Surgeons Do Not Improve Acute Outcomes for Patients With Hip Fracture Relative to Other Subspecialists.

Journal Article Orthopedics · September 1, 2020 As bundled reimbursement models continue to evolve, there is a continued effort to increase the value of care for patients undergoing arthroplasty. The authors sought to evaluate the effect of surgeon specialization (arthroplasty vs non-arthroplasty) on ac ... Full text Link to item Cite

Patient Risk Profile for Unplanned 90-Day Emergency Department Visits Differs Between Total Hip and Total Knee Arthroplasty.

Journal Article Orthopedics · September 1, 2020 Numerous studies have explored 90-day readmissions following total joint arthroplasty; however, there is a paucity of literature concerning 90-day emergency department (ED) visits. The authors aimed to characterize the risk factors for ED presentations and ... Full text Link to item Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

American Association of Hip and Knee Surgeons Advocacy Efforts in Response to the SARS-CoV-2 Pandemic.

Journal Article J Arthroplasty · July 2020 As soon as it became clear that our economy was going to be paralyzed by the SARS-CoV-2 pandemic, the American Association of Hip and Knee Surgeons leadership acted swiftly to ensure that our members were going to be eligible for the anticipated federal ec ... Full text Link to item Cite

In Vivo Knee Kinematics for a Cruciate Sacrificing Total Knee Arthroplasty Having Both a Symmetrical Femoral and Tibial Component.

Journal Article J Arthroplasty · June 2020 BACKGROUND: Early total knee arthroplasty (TKA) designs were symmetrical, but lead to complications due to over-constraint leading to loosening and poor flexion. Next-generation TKAs have been designed to include asymmetry, pertaining to the trochlear groo ... Full text Link to item Cite

Total Hip Arthroplasty in Patients With Dementia.

Journal Article J Arthroplasty · June 2020 BACKGROUND: There are few studies evaluating total hip arthroplasty (THA) in patients with dementia. The purpose of this study is to evaluate the rate of revision, complication, emergency department (ED) visitation, and discharge disposition in patients wi ... Full text Link to item Cite

Practice Management Strategies Among Current Members of the American Association of Hip and Knee Surgeons.

Journal Article J Arthroplasty · June 2020 BACKGROUND: At the 2019 Annual Meeting of the American Association of Hip and Knee Surgeons (AAHKS), a survey was conducted to assess current practice management strategies by AAHKS members. METHODS: AAHKS members used an audience response system to respon ... Full text Link to item Cite

Corynebacterium Total Hip and Knee Arthroplasy Prosthetic Joint Infections.

Journal Article Arthroplast Today · June 2020 Prosthetic joint infections (PJIs) are typically caused by Staphylococcus aureus and coagulase-negative Staphylococci species. Corynebacterium species are microorganisms of the human skin and mucous membranes that are often considered contaminants when gro ... Full text Link to item Cite

Anti-inflammatory effects of naproxen sodium on human osteoarthritis synovial fluid immune cells.

Journal Article Osteoarthritis Cartilage · May 2020 OBJECTIVE: To evaluate the anti-inflammatory effects of clinically relevant naproxen sodium (Nx) concentrations on human monocyte-derived macrophages in a controlled in vitro system and human primary synovial fluid (SF) cells. DESIGN: Using phorbol 12-myri ... Full text Link to item Cite

Impact of Patent Foramen Ovale on Total Knee Arthroplasty Cerebrovascular Accident Perioperative Management.

Journal Article Orthopedics · May 1, 2020 Venous thromboembolism and ischemic stroke are major complications following total knee arthroplasty (TKA) and potentially are associated with a patent foramen ovale (PFO). Although this association has been shown in other surgical disciplines, it has not ... Full text Link to item Cite

Use and Cost of Reverse Shoulder Arthroplasty Versus Hemiarthroplasty for Acute Proximal Humerus Fractures.

Journal Article Orthopedics · March 1, 2020 Although reverse total shoulder arthroplasty (RTSA) may outperform hemiarthroplasty (HSA) for acute proximal humerus fractures (PHF), both the RTSA implant and the procedure are more expensive. The goal of this study was to compare the use and longitudinal ... Full text Link to item Cite

Overview: Value-based Care for Orthopedic Surgery

Conference Techniques in Orthopaedics · January 1, 2020 An overview of health care value definitions, the current health care paradigm and brief history of the origins of value-based care in orthopedics are presented. The 4 pillar strategic approach for achieving high-value musculoskeletal services includes (1) ... Full text Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns.

Journal Article J Orthop Surg (Hong Kong) · 2020 PURPOSE: Bilateral total knee arthroplasty (TKA) can be performed in patients with bilateral knee arthritis. Outside of nationwide database studies, which have limitations, few studies have compared outcomes for same-day versus staged TKA. We sought to com ... Full text Link to item Cite

Undersedation During Total Hip Arthroplasty Reduction Results in Worse Patient Outcomes.

Journal Article J Arthroplasty · December 2019 BACKGROUND: Total hip arthroplasty (THA) dislocation is a common reason for presentation to the emergency department (ED) postoperatively. Prior literature has shown that propofol conscious sedation provides the fewest complications and the shortest time t ... Full text Link to item Cite

Perioperative Selective Serotonin Reuptake Inhibitor Use Is Associated With an Increased Risk of Transfusion in Total Hip and Knee Arthroplasty.

Journal Article J Arthroplasty · December 2019 BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have been shown in both orthopedic and general surgery literature to be associated with an increased risk of blood loss, and this is thought to occur via diminished platelet serotonin reuptake and ... Full text Link to item Cite

The Role of Malnutrition in Ninety-Day Outcomes After Total Joint Arthroplasty.

Journal Article J Arthroplasty · November 2019 BACKGROUND: Research has linked malnutrition to more complications in total joint arthroplasty (TJA) patients. The role of preoperative albumin in predicting length of stay (LOS) and 90-day outcomes remains understudied. Often, an albumin cut-off ≤3.5 g/dL ... Full text Link to item Cite

Analysis of "old" proteins unmasks dynamic gradient of cartilage turnover in human limbs.

Journal Article Sci Adv · October 2019 Unlike highly regenerative animals, such as axolotls, humans are believed to be unable to counteract cumulative damage, such as repetitive joint use and injury that lead to the breakdown of cartilage and the development of osteoarthritis. Turnover of insol ... Full text Link to item Cite

Value-Based Care Has Not Resulted in Biased Patient Selection: Analysis of a Single Center's Experience in the Care for Joint Replacement Bundle.

Journal Article J Arthroplasty · September 2019 BACKGROUND: Bundled reimbursement models for total knee arthroplasty (TKA) by the Center for Medicare and Medicaid Services have resulted in an effort to decrease the cost of care. However, these models may incentivize bias in patient selection to avoid ex ... Full text Link to item Cite

Patients at Risk for Exceeding CJR Cost Targets After Total Ankle Arthroplasty.

Journal Article Foot Ankle Int · September 2019 BACKGROUND: The Comprehensive Care for Joint Replacement (CJR) model includes total ankle arthroplasty (TAA), under which a target reimbursement is established. Whether this reimbursement is sufficient to cover average cost remains unknown. We hypothesized ... Full text Link to item Cite

Tranexamic acid or epsilon-aminocaproic acid in total joint arthroplasty? A randomized controlled trial.

Journal Article Bone Joint J · September 2019 AIMS: Antifibrinolytic agents, including tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA), have been shown to be safe and effective for decreasing perioperative blood loss and transfusion following total hip arthroplasty (THA) and total knee arth ... Full text Link to item Cite

No Changes in Patient Selection and Value-Based Metrics for Total Hip Arthroplasty After Comprehensive Care for Joint Replacement Bundle Implementation at a Single Center.

Journal Article J Arthroplasty · August 2019 BACKGROUND: Alternative payment models for total hip arthroplasty (THA) were initiated by the Center for Medicare and Medicaid Services to decrease overall healthcare cost. The associated shift of financial risk to participating institutions may negatively ... Full text Link to item Cite

Preoperative Optimization Checklists Within the Comprehensive Care for Joint Replacement Bundle Have Not Decreased Hospital Returns for Total Knee Arthroplasty.

Journal Article J Arthroplasty · July 2019 BACKGROUND: The Comprehensive Care for Joint Replacement (CJR) model has resulted in the evolution of preoperative optimization programs to decrease costs and hospital returns. At the investigating institution, one center was not within the CJR bundle and ... Full text Link to item Cite

Is There a Difference in Infection Risk Between Single and Multiple Doses of Prophylactic Antibiotics? A Meta-analysis.

Journal Article Clin Orthop Relat Res · July 2019 BACKGROUND: The prevention of surgical site infection guidelines issued by the Centers for Disease Control and Prevention (CDC) recently recommended that only a single dose of preoperative antibiotics be administered to patients undergoing clean-contaminat ... Full text Link to item Cite

Conversion Total Knee Arthroplasty: A Distinct Surgical Procedure With Increased Resource Utilization.

Journal Article J Arthroplasty · July 2019 BACKGROUND: Current Procedural Terminology coding currently makes no distinction between primary total knee arthroplasty (TKA) and conversion TKA, in which periarticular hardware components must be removed prior to or during TKA. We hypothesize that conver ... Full text Link to item Cite

Clinical Impact of Routine Complete Blood Counts Following Total Knee Arthroplasty.

Journal Article J Arthroplasty · July 2019 BACKGROUND: Routine laboratory studies are generally obtained following total knee arthroplasty (TKA), and often continued daily until discharge. This study aims to investigate the utility and cost-effectiveness of complete blood count (CBC) tests followin ... Full text Link to item Cite

Continuous adductor canal blockade facilitates increased home discharge and decreased opioid consumption after total knee arthroplasty.

Journal Article Knee · June 2019 BACKGROUND: There is a growing interest in avoiding discharging patients to rehab to maximize outcome and minimize complications after total knee arthroplasty (TKA). In addition, use of postoperative pain pathways that minimize opioid use is critical amids ... Full text Link to item Cite

Comparing Standard Versus Extended Culture Duration in Acute Hip and Knee Periprosthetic Joint Infection.

Journal Article J Am Acad Orthop Surg · May 1, 2019 INTRODUCTION: Periprosthetic joint infection (PJI) is a devastating complication of hip and knee arthroplasties. Surgical cultures are essential for the diagnosis and treatment of PJI. Yet, the ideal culture duration remains unclear. This study compares cu ... Full text Link to item Cite

A Weighted Index of Elixhauser Comorbidities for Predicting 90-day Readmission After Total Joint Arthroplasty.

Journal Article J Arthroplasty · May 2019 BACKGROUND: Evolving reimbursement models increasingly compel hospitals to assume costs for 90-day readmission after total joint arthroplasty. Although risk assessment tools exist, none currently reach the predictive performance required to accurately iden ... Full text Link to item Cite

The INTUIT Study: Investigating Neuroinflammation Underlying Postoperative Cognitive Dysfunction.

Journal Article J Am Geriatr Soc · April 2019 BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of ... Full text Open Access Link to item Cite

A Novel Risk Calculator Predicts 90-Day Readmission Following Total Joint Arthroplasty.

Journal Article J Bone Joint Surg Am · March 20, 2019 BACKGROUND: A reliable prediction tool for 90-day adverse events not only would provide patients with valuable estimates of their individual risk perioperatively, but would also give health-care systems a method to enable them to anticipate and potentially ... Full text Link to item Cite

Medial Unicompartmental Arthroplasty of the Knee.

Journal Article J Am Acad Orthop Surg · March 1, 2019 Indications for medial unicompartmental knee arthroplasty (UKA) have expanded over the past two decades. Proposed advantages include faster recovery, improved kinematics, and better functional outcomes compared with total knee arthroplasty (TKA) in age-mat ... Full text Link to item Cite

Predicting Costs Exceeding Bundled Payment Targets for Total Joint Arthroplasty.

Journal Article J Arthroplasty · March 2019 BACKGROUND: The Center for Medicare and Medicaid Services has instituted bundled reimbursement models for total joint arthroplasty (TJA), which includes target prices for each procedure. Some patients exceed these targets; however, currently there are no t ... Full text Link to item Cite

Medicaid Insurance Correlates With Increased Resource Utilization Following Total Hip Arthroplasty.

Journal Article J Arthroplasty · February 2019 BACKGROUND: With increased restraints and efforts to contain costs in total hip arthroplasty (THA), an emphasis has been placed on risk stratification. The purpose of this study was to determine whether Medicaid patients have increased resource utilization ... Full text Link to item Cite

Treatment of Prosthetic Joint Infection: Established Patient Relationships May Impact Medical Decision-Making.

Journal Article J Arthroplasty · February 2019 BACKGROUND: Choosing the intervention for prosthetic joint infections, whether debridement, antibiotics, and implant retention (DAIR), or explant and antibiotic spacer placement, is multifactorial. One characteristic that may influence this decision is a p ... Full text Link to item Cite

Outcomes of Conversion Total Hip Arthroplasty From Free Vascularized Fibular Grafting.

Journal Article J Arthroplasty · January 2019 BACKGROUND: Conversion total hip arthroplasties (THAs) from prior free vascularized fibular grafting (FVFG) are infrequently reported in the literature. We characterized the perioperative outcomes of patients undergoing conversion THA and compared them wit ... Full text Link to item Cite

A Geometric Model to Determine Patient-Specific Cup Anteversion Based on Pelvic Motion in Total Hip Arthroplasty.

Journal Article Adv Orthop · 2019 INTRODUCTION: Cup position is critical to stability in total hip arthroplasty and is affected by pelvis motion during positions of daily life. The purpose of this study was to explicitly define the relationship between sagittal pelvic motion and resultant ... Full text Link to item Cite

Preoperative Blood Management Strategy for Elective Hip and Knee Arthroplasty.

Journal Article J Healthc Qual · 2019 To improve quality and outcomes, a preoperative anemia clinic (PAC) was established to screen, evaluate, and manage preoperative anemia. A retrospective review of primary and revision hip and knee arthroplasty patients from August 2013 to September 2017 wa ... Full text Link to item Cite

Skilled Nursing Facilities After Total Knee Arthroplasty: The Time for Selective Partnerships Is Now!

Journal Article J Arthroplasty · December 2018 BACKGROUND: Bundled payment initiatives for total knee arthroplasty (TKA) patients are dramatically impacted by discharges to skilled nursing facilities (SNFs), making target prices set by the Center for Medicare and Medicaid Services difficult to achieve. ... Full text Link to item Cite

Impact of lumbar arthrodesis on outcomes after elective total hip arthroplasty

Journal Article Seminars in Arthroplasty JSES · December 1, 2018 Background: Acetabular component malpositioning has been associated with major complications including dislocation, edge-loading, stripe wear and squeaking. Anteversion is determined by pelvic orientation; flexion of the pelvis increases and extension decr ... Full text Cite

Albumin Versus American Society of Anesthesiologists Score: Which Is More Predictive of Complications Following Total Joint Arthroplasty?

Journal Article Orthopedics · November 1, 2018 Malnutrition is not uncommon in arthroplasty patients, and hypoalbuminemia has been shown to be predictive of postoperative complications. The authors sought to compare albumin concentration with a global assessment of physical health, the American Society ... Full text Link to item Cite

Preoperative Hypoalbuminemia Predicts Poor Short-term Outcomes for Hip Fracture Surgery.

Journal Article Orthopedics · November 1, 2018 Hip fractures are common in elderly patients, and which surgical modality to pursue is often debated. Malnutrition, which cannot be corrected preoperatively in this population, is often not considered. Therefore, the authors sought to investigate the assoc ... Full text Link to item Cite

When Should Complete Blood Count Tests Be Performed in Primary Total Hip Arthroplasty Patients?

Journal Article J Arthroplasty · October 2018 BACKGROUND: Routine laboratory studies are often obtained following total hip arthroplasty (THA). Moreover, laboratory studies are often continued daily until the patient is discharged regardless of medical management. The purpose of this study was to inve ... Full text Link to item Cite

The Impact of Electronic Medical Record Implementation on Labor Cost and Productivity at an Outpatient Orthopaedic Clinic.

Journal Article J Bone Joint Surg Am · September 19, 2018 BACKGROUND: Widespread adoption of electronic medical record (EMR) systems is increasing. EMR implementation can be costly and typically requires workflow redesign. To our knowledge, no studies to date have examined the impact of EMR implementation using a ... Full text Link to item Cite

Dislocation rate increases with bariatric surgery before total hip arthroplasty.

Journal Article Hip Int · September 2018 INTRODUCTION: Annually in the USA, 113,000 patients with refractory obesity undergo bariatric surgery (BS), and a subset does so in order to lower body mass index to become a more desirable total hip arthroplasty (THA) candidate. This study aims to evaluat ... Full text Link to item Cite

Preoperative Patient Profile in Total Hip and Knee Arthroplasty: Predictive of Increased Medicare Payments in a Bundled Payment Model.

Journal Article J Arthroplasty · September 2018 BACKGROUND: The shift toward value-based bundled payment models in total joint arthroplasty highlights the need for identification of modifiable risk factors for increased spending as well as opportunities to mitigate perioperative treatment of chronic dis ... Full text Link to item Cite

The Utility of Basic Metabolic Panel Tests After Total Joint Arthroplasty.

Journal Article J Arthroplasty · September 2018 INTRODUCTION: Routine laboratory studies are often obtained daily after total joint arthroplasty (TJA) regardless of medical management. The purpose of this study was to investigate the utility of routine basic metabolic panel (BMP) tests after TJA. Furthe ... Full text Link to item Cite

Management of the Implant With Taper Corrosion: What to Change and What to Change It to?

Journal Article J Arthroplasty · September 2018 Management of implant corrosion remains a challenge for the revision arthroplasty surgeon. Our field continues to gain insight in to how to manage this clinical scenario but there are still gaps in what is known to be considered to be the standard of care. ... Full text Link to item Cite

Outcomes of Articulating Spacers With Autoclaved Femoral Components in Total Knee Arthroplasty Infection.

Journal Article J Arthroplasty · August 2018 BACKGROUND: In 2-stage revision of total knee arthroplasty (TKA) infection, articulating antibiotic spacers show similar eradication rates and superior range of motion compared with static spacers. This study evaluated infection control and other outcomes ... Full text Link to item Cite

Trends in Opioid Utilization Before and After Total Knee Arthroplasty.

Journal Article J Arthroplasty · July 2018 BACKGROUND: Opioids are a mainstay in perioperative pain management among patients undergoing total knee arthroplasty (TKA). However, patterns in opioid use before and after TKA have not been well-studied. The objectives of this study are to characterize p ... Full text Link to item Cite

Short and Long-Term Postoperative Complications Following Total Joint Arthroplasty in Patients With Human Immunodeficiency Virus, Hepatitis B, or Hepatitis C.

Journal Article J Arthroplasty · July 2018 INTRODUCTION: Due to advancement in treatment against human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), the prevalence of this patient population electing to undergo total joint arthroplasty (TJA) is increasing. Curr ... Full text Link to item Cite

Association Between Pseudotumor Formation and Patient Factors in Metal-on-Metal Total Hip Arthroplasty Population.

Journal Article J Arthroplasty · July 2018 BACKGROUND: Pseudotumor formation from metal-on-metal (MoM) hip implants is associated with implant revision. The relationship between pseudotumor type and patient outcomes is unknown. METHODS: We retrospectively reviewed patients with a MoM total hip arth ... Full text Link to item Cite

Comparison of Postoperative Complications Following Metal-on-Metal Total Hip Arthroplasty With Other Hip Bearings in Medicare Population.

Journal Article J Arthroplasty · June 2018 BACKGROUND: The use of metal-on-metal (MoM) hip bearings has declined in the recent years due to strong evidence of their high complication rates and early failure. Hip implants with highly cross-linked polyethylene liners and ceramic bearings have become ... Full text Link to item Cite

Dual Diagnosis and Total Hip Arthroplasty.

Journal Article Orthopedics · May 1, 2018 The co-occurrence of a mental illness and a substance abuse disorder (SUD) is common and has been referred to as a "dual diagnosis" (DD). Although studies have independently investigated mental illness alone and SUD alone, few have examined the effects of ... Full text Link to item Cite

The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator Has a Role in Predicting Discharge to Post-Acute Care in Total Joint Arthroplasty.

Journal Article J Arthroplasty · January 2018 BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Qu ... Full text Link to item Cite

Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty.

Journal Article J Arthroplasty · January 2018 BACKGROUND: Knee stiffness requiring manipulation under anesthesia (MUA) is an undesirable outcome following total knee arthroplasty (TKA), but risk factors for, and optimal timing of, MUA remain unclear. METHODS: Primary TKAs performed at a single center ... Full text Link to item Cite

Positive Blood Cultures in Periprosthetic Joint Infection Decrease Rate of Treatment Success.

Journal Article J Arthroplasty · January 2018 BACKGROUND: Blood cultures are often obtained at the time of periprosthetic joint infection (PJI) diagnosis yet they are not considered part of the diagnostic criteria and the effects of a positive result on surgical outcome are unknown. The purposes of th ... Full text Link to item Cite

Primary knee arthroplasty

Chapter · January 1, 2018 Cite

Comparison of postoperative complications after total hip arthroplasty among patients receiving aspirin, enoxaparin, warfarin, and factor Xa inhibitors.

Journal Article J Orthop · December 2017 Optimal prophylaxis for prevention of venous thromboembolism (VTE) after total joint arthroplasty (TJA) remains debated. The purpose of this study was to compare postoperative complications in patients receiving different VTE chemoprophylactic regimens. Us ... Full text Link to item Cite

Utility of Radiographs, Computed Tomography, and Three Dimensional Computed Tomography Pelvis Reconstruction for Identification of Acetabular Defects in Residency Training.

Journal Article Hip Pelvis · December 2017 PURPOSE: The Paprosky classification system of acetabular defects is complex and its reliability has been questioned. The purpose of this study was to evaluate the effectiveness of different radiologic imaging modalities in classifying acetabular defects i ... Full text Link to item Cite

What Should Define Preoperative Anemia in Primary THA?

Journal Article Clin Orthop Relat Res · November 2017 BACKGROUND: The use of tranexamic acid (TXA) in THA decreases the risk of transfusion after surgery. However, nearly 10% of patients still undergo a transfusion, which has been independently associated with an increased risk of complications. Preoperative ... Full text Link to item Cite

Postoperative Impact of Diabetes, Chronic Kidney Disease, Hemodialysis, and Renal Transplant After Total Hip Arthroplasty.

Journal Article J Arthroplasty · September 2017 BACKGROUND: The prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), hemodialysis (HD), and renal transplantation (RT) is increasing. This study assessed postoperative complications among diabetic patients with CKD, HD, or post-RT after tota ... Full text Link to item Cite

Outcomes of Modular Dual Mobility Acetabular Components in Revision Total Hip Arthroplasty.

Journal Article J Arthroplasty · September 2017 BACKGROUND: There is a high rate of dislocation after revision total hip arthroplasty. This study evaluated the outcomes of 1 modular dual mobility component in revision total hip arthroplasty in patients at high risk of dislocation. METHODS: We reviewed 6 ... Full text Link to item Cite

Common Medical Comorbidities Correlated With Poor Outcomes in Hip Periprosthetic Infection.

Journal Article J Arthroplasty · September 2017 BACKGROUND: Periprosthetic infection has been linked to risk factors such as diabetes, obesity, and smoking among others. This study examined the relationship between common patient comorbidities and hip periprosthetic infection outcomes. METHODS: We retro ... Full text Link to item Cite

Ankylosing Spondylitis Increases Perioperative and Postoperative Complications After Total Hip Arthroplasty.

Journal Article J Arthroplasty · August 2017 BACKGROUND: Ankylosing spondylitis (AS) is a chronic autoimmune spondyloarthropathy that primarily affects the axial spine and hips. Progressive disease leads to pronounced spinal kyphosis, positive sagittal balance, and altered biomechanics. The purpose o ... Full text Link to item Cite

Analysis of complication rates following perioperative transfusion in shoulder arthroplasty.

Journal Article J Shoulder Elbow Surg · July 2017 BACKGROUND: Postoperative anemia requiring a blood transfusion is not uncommon following anatomic total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA). However, the potential complications in patients undergoing transfusion after ... Full text Link to item Cite

A randomised trial of peri-operative positive airway pressure for postoperative delirium in patients at risk for obstructive sleep apnoea after regional anaesthesia with sedation or general anaesthesia for joint arthroplasty.

Journal Article Anaesthesia · June 2017 Previous pilot work has established an association between obstructive sleep apnoea and the development of acute postoperative delirium , but it remains unclear to what extent this risk factor is modifiable in the 'real world' peri-operative setting. In a ... Full text Link to item Cite

Specific Infectious Organisms Associated With Poor Outcomes in Treatment for Hip Periprosthetic Infection.

Journal Article J Arthroplasty · June 2017 BACKGROUND: Periprosthetic hip infection treatment remains a significant challenge for orthopedics. Some studies have suggested that methicillin resistance and gram-negative organism type are associated with increased treatment failure. The aim of this res ... Full text Link to item Cite

What Factors Drive Inpatient Satisfaction After Knee Arthroplasty?

Journal Article J Arthroplasty · June 2017 BACKGROUND: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, developed by the Centers for Medicare & Medicaid Services, is directly tied to hospital reimbursement. The purpose of this study is to analyze survey response ... Full text Link to item Cite

Complications of total hip arthroplasty following solid organ transplantation.

Journal Article J Orthop Sci · March 2017 PURPOSE: Solid organ transplants (SOT) continue to increase with recipients living longer than ever before. The lifelong immunosuppression in these patients also may place them at increased risk for postoperative complications. The efficacy of total hip ar ... Full text Link to item Cite

Ultrasound-guided percutaneous peripheral nerve stimulation for analgesia following total knee arthroplasty: a prospective feasibility study.

Journal Article J Orthop Surg Res · January 13, 2017 BACKGROUND: Peripheral nerve stimulation has been used for decades to treat chronic pain but has not been used for postoperative analgesia due to multiple limitations, beginning with invasive electrode placement. With the development of small-diameter/gaug ... Full text Link to item Cite

Total shoulder arthroplasty in patients with HIV infection: complications, comorbidities, and trends.

Journal Article J Shoulder Elbow Surg · December 2016 BACKGROUND: Patients with human immunodeficiency virus (HIV) infection were previously at substantial risk for immunosuppression-related complications. As a result of highly active antiretroviral therapy, HIV-infected patients are living longer and are pre ... Full text Link to item Cite

Complications Are Not Increased With Acetabular Revision of Metal-on-metal Total Hip Arthroplasty.

Journal Article Clin Orthop Relat Res · October 2016 BACKGROUND: Isolated revision of the acetabular component in the setting of total hip arthroplasty has an increased risk of dislocation. With local soft tissue destruction frequently associated with failed metal-on-metal (MoM) bearings, it is presumed that ... Full text Link to item Cite

Psychiatric disorders increase complication rate after primary total knee arthroplasty.

Journal Article Knee · October 2016 BACKGROUND: Psychiatric disease is difficult to screen preoperatively and the incidence of mental health disorders in patients undergoing total knee arthroplasty (TKA) may be underappreciated. The purpose of this study is to evaluate the perioperative comp ... Full text Link to item Cite

Should We Think Twice About Psychiatric Disease in Total Hip Arthroplasty?

Journal Article J Arthroplasty · September 2016 BACKGROUND: Psychiatric disease (PD) is common, and the effect on complications in total hip arthroplasty (THA) is poorly understood. The purpose of this study was to evaluate the medical and surgical postoperative complication profile in patients with PD, ... Full text Link to item Cite

Is Metal-On-Metal Total Hip Arthroplasty Associated With Neurotoxicity?

Journal Article J Arthroplasty · September 2016 BACKGROUND: Isolated case reports in the literature describe systemic neurologic side effects associated with metal-on-metal (MOM) bearing surfaces, yet the incidence of these effects have not been evaluated beyond individual cases. The purpose of this stu ... Full text Link to item Cite

Lingering Risk: Bariatric Surgery Before Total Knee Arthroplasty.

Journal Article J Arthroplasty · September 2016 BACKGROUND: Obesity continues to increase in the United States with an estimated 35% obesity and 8% bariatric (body mass index >40) rate in adults. Bariatric patients seek advice from arthroplasty surgeons regarding the temporality of bariatric surgery (BS ... Full text Link to item Cite

Cervical Myelopathy Doubles the Rate of Dislocation and Fracture After Total Hip Arthroplasty.

Journal Article J Arthroplasty · September 2016 BACKGROUND: Cervical spondylotic myelopathy (CSM) is a common and underdiagnosed cause of gait dysfunction, rigidity, and falls in the elderly. Given the frequent concurrency of CSM and hip osteoarthritis, this study is designed to evaluate the relative ri ... Full text Link to item Cite

Perioperative Dexamethasone Administration Does Not Increase the Incidence of Postoperative Infection in Total Hip and Knee Arthroplasty: A Retrospective Analysis.

Journal Article J Arthroplasty · August 2016 BACKGROUND: Dexamethasone is frequently used for the treatment of postoperative nausea and vomiting and as an adjunct in multimodal postoperative analgesia after total joint arthroplasty; however, the incidence of periprosthetic joint infection (PJI) after ... Full text Link to item Cite

Computer-Navigated Total Knee Arthroplasty Utilization.

Journal Article J Knee Surg · July 2016 Computer-navigated total knee arthroplasty (CN-TKA) has been used to improve component alignment, though the evidence is currently mixed on whether there are clinically significant differences in long-term outcomes. Given the established increased costs an ... Full text Link to item Cite

Percent Body Fat Is More Predictive of Function After Total Joint Arthroplasty Than Body Mass Index.

Journal Article J Bone Joint Surg Am · May 18, 2016 BACKGROUND: Obesity has an important impact on the future of total joint arthroplasty; however, the definition and influence of obesity on surgical risks and outcomes remain controversial. Our hypothesis was that percent body fat was better than body mass ... Full text Link to item Cite

Are Range of Motion Measurements Needed When Calculating the Harris Hip Score?

Journal Article J Arthroplasty · April 2016 BACKGROUND: Often the patient-reported outcome (PRO) component of the Harris Hip Score (HHS) is completed, but the physician-assessed range of motion (ROM) component is not. The PRO component only is called a modified Harris Hip Score (mHHS). The purpose o ... Full text Link to item Cite

How Do Previous Solid Organ Transplant Recipients Fare After Primary Total Knee Arthroplasty?

Journal Article J Arthroplasty · March 2016 INTRODUCTION: Total knee arthroplasty (TKA) has been proven to increase knee outcome scores after solid organ transplantation (SOT), but many authors are concerned about a higher complication rate. The purpose of this study is to evaluate the complication ... Full text Link to item Cite

Aspartic acid racemization reveals a high turnover state in knee compared with hip osteoarthritic cartilage.

Journal Article Osteoarthritis Cartilage · February 2016 OBJECTIVE: We investigated tissue turnover in healthy and osteoarthritic cartilage. We challenge long held views that osteoarthritis (OA) is dominated by a similar turnover process in all joints and present evidence that hip and knee cartilage respond very ... Full text Link to item Cite

How do we develop and implement a preoperative anemia clinic designed to improve perioperative outcomes and reduce cost?

Journal Article Transfusion · February 2016 Treatment of anemia is one of the four pillars of patient blood management programs. Preoperative anemia is common and associated with increased perioperative morbidity after surgery and increased rates of blood transfusion. Effective treatment of preopera ... Full text Link to item Cite

The Impact of Lumbar Spine Disease and Deformity on Total Hip Arthroplasty Outcomes.

Journal Article Orthop Clin North Am · January 2016 Concurrent spine and hip disease is common. Spinal deformities can restrict lumbar range of motion and lumbar lordosis, leading to pelvic obliquity and increased pelvic tilt. A comprehensive preoperative workup and component templating ensure appropriate c ... Full text Link to item Cite

Cementless total knee arthroplasty

Chapter · January 1, 2016 The cementless total knee has gained increasing interest as an alternative fixation to cemented implants for younger, more active patient populations. Unlike cemented implants that rely on the use of cement to make small corrections in alignment and positi ... Full text Cite

Opioid-Based Analgesia: Impact on Total Joint Arthroplasty.

Journal Article J Arthroplasty · December 2015 The objective of this study was to characterize the impact of opioid-based analgesia in total joint arthroplasty. The primary outcomes were incidence of in-hospital complications, length of stay, and discharge destination. Six hundred and seventy-three pri ... Full text Link to item Cite

Metal-on-Metal Total Hip Arthroplasty: Patient Evaluation and Treatment.

Journal Article J Am Acad Orthop Surg · December 2015 Metal-on-metal (MoM) hip articulations were thought to represent a biologic and biomechanically favorable alternative to conventional metal-on-polyethylene total hip arthroplasty implants. However, concerns emerged when registry data reported significantly ... Full text Link to item Cite

Outcomes after Total Knee Arthroplasty for post-traumatic arthritis.

Journal Article Knee · December 2015 INTRODUCTION: Total Knee Arthroplasty (TKA) is an important treatment for posttraumatic arthritis (PTA), but evidence on outcomes is sparse. The purpose of this study was to evaluate the impact of PTA versus primary osteoarthritis (OA) on postoperative out ... Full text Link to item Cite

Current Evidence Does Not Support Medicare's 3-Day Rule in Primary Total Joint Arthroplasty.

Journal Article Am J Orthop (Belle Mead NJ) · October 2015 Patients who undergo total joint arthroplasty and are destined for discharge to an extended-care facility--particularly Medicare beneficiaries--are required to have an inpatient stay of at least 3 consecutive days. The primary objective of this study was t ... Link to item Cite

Medicare's 3-Day Rule: Time for a Rethink.

Journal Article J Arthroplasty · September 2015 A pilot study was undertaken to examine the impact of Medicare's 3-day rule on length of stay (LOS). One hundred consecutive patients who underwent primary total joint arthroplasty and were discharged to extended care facilities were retrospectively review ... Full text Link to item Cite

Multimodal Analgesia for Total Joint Arthroplasty.

Journal Article Orthopedics · July 1, 2015 Optimal perioperative pain control for total joint arthroplasty remains a challenge. Whereas traditional regimens have relied heavily on opioids, newer multimodal pathways are increasingly gaining popularity as safer and more effective alternatives. The ma ... Full text Link to item Cite

Arthroplasty in organ transplant patients.

Journal Article Arthroplast Today · June 2015 The number of solid organ transplants performed in the United States continues to increase annually as does survival after transplant. These unique patients are increasingly likely to present to arthroplasty surgeons for elective hip or knee replacement se ... Full text Open Access Link to item Cite

Impact of liposomal bupivacaine administration on postoperative pain in patients undergoing total knee replacement.

Journal Article Pharmacotherapy · May 2015 STUDY OBJECTIVE: To determine whether liposomal bupivacaine, a long-acting anesthetic indicated for single-dose wound infiltration to produce postoperative analgesia, has an impact on postoperative pain in patients undergoing total knee arthroplasties (TKA ... Full text Link to item Cite

In reply.

Journal Article J Arthroplasty · May 2015 Full text Link to item Cite

Preoperative pain level and patient expectation predict hospital length of stay after total hip arthroplasty.

Journal Article J Arthroplasty · April 2015 The purpose of this study was to identify preoperative predictors of length of stay after primary total hip arthroplasty in a patient population reflecting current trends toward shorter hospitalization and using readily obtainable factors that do not requi ... Full text Open Access Link to item Cite

Patient expectation is the most important predictor of discharge destination after primary total joint arthroplasty.

Journal Article J Arthroplasty · April 2015 The purpose of this study was to identify preoperative predictors of discharge destination after total joint arthroplasty. A retrospective study of three hundred and seventy-two consecutive patients who underwent primary total hip and knee arthroplasty was ... Full text Open Access Link to item Cite

Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.

Journal Article Clin Infect Dis · April 1, 2015 BACKGROUND: The timing of diagnosis of invasive surgical site infection (SSI) following joint replacement surgery is an important criterion used to determine subsequent medical and surgical management. METHODS: We compared time to diagnosis of invasive SSI ... Full text Link to item Cite

Preoperative predictors of extended hospital length of stay following total knee arthroplasty.

Journal Article J Arthroplasty · March 2015 The purpose of this study was to identify the preoperative predictors of hospital length of stay after primary total knee arthroplasty in a patient population reflecting current trends toward shorter hospitalization and using readily obtainable factors tha ... Full text Open Access Link to item Cite

Unipedal balance is affected by lower extremity joint arthroplasty procedure 1 year following surgery.

Journal Article J Arthroplasty · February 2015 Lower Extremity Joint Arthroplasty (LEJA) surgery is an effective way to alleviate painful osteoarthritis. Unfortunately, these surgeries do not normalize the loading asymmetry during the single leg stance phase of gait. Therefore, we examined single leg b ... Full text Open Access Link to item Cite

Cost-effectiveness analysis of the diagnosis of meniscus tears.

Journal Article Am J Sports Med · January 2015 BACKGROUND: Diagnostic imaging represents the fastest growing segment of costs in the US health system. This study investigated the cost-effectiveness of alternative diagnostic approaches to meniscus tears of the knee, a highly prevalent disease that tradi ... Full text Open Access Link to item Cite

Bilateral symmetry in lower extremity mechanics during stair ascent and descent following a total hip arthroplasty: a one-year longitudinal study.

Journal Article Clin Biomech (Bristol, Avon) · January 2015 BACKGROUND: Total hip arthroplasty is the standard treatment to reduce pain and improve function in people with advanced hip osteoarthritis; however, persisting asymmetrical gait patterns have been identified in level walking. Therefore, this study evaluat ... Full text Link to item Cite

Total hip arthroplasty in very young bone marrow transplant patients.

Journal Article J Surg Orthop Adv · 2015 Concerns remain about total hip arthroplasty (THA) performed in very young patients, especially those with complex medical history such as allogeneic bone marrow transplantation (ABMT). This study retrospectively reviews the perioperative courses and funct ... Full text Link to item Cite

Percent body fat more associated with perioperative risks after total joint arthroplasty than body mass index.

Journal Article J Arthroplasty · September 2014 Understanding the impact of obesity on elective total joint arthroplasty (TJA) remains critical. Perioperative outcomes were reviewed in 316 patients undergoing primary TJA. Higher percent body fat (PBF) was associated with postoperative blood transfusion, ... Full text Open Access Link to item Cite

Risk versus reward: total joint arthroplasty outcomes after various solid organ transplantations.

Journal Article J Arthroplasty · August 2014 Clinical outcomes were retrospectively reviewed for 76 primary total hip (THA) and total knee arthroplasties (TKA) performed after kidney, liver, cardiac, and lung transplantation with follow-up of 30.2 and 41.2 months, respectively. For the THA and TKA co ... Full text Link to item Cite

Custom intramedullary intercalating device for treatment of supracondylar fracture between constrained total knee arthroplasty and well-fixed total hip arthroplasty.

Journal Article Knee · March 2014 Management of periprosthetic fractures between ipsilateral total knee arthroplasty (TKA) and total hip arthroplasty (THA) is difficult, and is further complicated in the setting of poor femoral bone stock. We present a case of supracondylar fracture betwee ... Full text Link to item Cite

Total hip arthroplasty surgical approach does not alter postoperative gait mechanics one year after surgery.

Journal Article PM R · March 2014 OBJECTIVE: To investigate the differences in gait biomechanics on the basis of surgical approach 1 year after surgery. DESIGN: This was a descriptive laboratory study to investigate the side-to-side differences in walking mechanics at a self-selected walki ... Full text Open Access Link to item Cite

Impact of perioperative allogeneic and autologous blood transfusion on acute wound infection following total knee and total hip arthroplasty.

Journal Article J Bone Joint Surg Am · February 19, 2014 BACKGROUND: Patients undergoing total hip or knee arthroplasty frequently receive blood transfusions. The relationship between transfusion and the risk of infection following total joint arthroplasty is unclear. In this study, we sought to examine the impa ... Full text Link to item Cite

Prevention of late PJI.

Journal Article J Arthroplasty · February 2014 Full text Link to item Cite

Economic evaluation of access to musculoskeletal care: the case of waiting for total knee arthroplasty.

Journal Article BMC Musculoskelet Disord · January 18, 2014 BACKGROUND: The projected demand for total knee arthroplasty is staggering. At its root, the solution involves increasing supply or decreasing demand. Other developed nations have used rationing and wait times to distribute this service. However, economic ... Full text Open Access Link to item Cite

Prevention of late PJI.

Journal Article J Orthop Res · January 2014 Full text Link to item Cite

Outcomes of primary total joint arthroplasty after lung transplantation.

Journal Article J Arthroplasty · January 2014 Lung transplantation is increasingly common with improving survival rates. Post-transplant patients can be expected to seek total hip (THA) and knee arthroplasty (TKA) to improve their quality of life. Outcomes of 20 primary total joint arthroplasties (15 ... Full text Link to item Cite

Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009.

Journal Article J Bone Joint Surg Am · November 20, 2013 BACKGROUND: Unicompartmental knee arthroplasty is a less-invasive alternative to total knee arthroplasty for patients with arthritis affecting only the medial or lateral compartment. However, little is known about recent trends in the use of these procedur ... Full text Link to item Cite

Does surgical approach during total hip arthroplasty alter gait recovery during the first year following surgery?

Journal Article J Arthroplasty · October 2013 Multiple surgical approaches exist for total hip arthroplasty (THA). Each approach has risks and benefits in regard to complications and changes in postoperative gait. This study examined the effect of three surgical approaches on postoperative gait mechan ... Full text Link to item Cite

Simultaneous vs staged bilateral total knee arthroplasty among Medicare beneficiaries, 2000-2009.

Journal Article J Arthroplasty · September 2013 Simultaneous bilateral total knee arthroplasty (TKA) reportedly has higher postoperative complication rates than staged procedures, but little is known about recent trends and outcomes among Medicare patients. In a 5% national sample of Medicare beneficiar ... Full text Link to item Cite

Why are total knees failing today? Etiology of total knee revision in 2010 and 2011.

Journal Article J Arthroplasty · September 2013 Revision knee data from six joint arthroplasty centers were compiled for 2010 and 2011 to determine mechanism of failure and time to failure. Aseptic loosening was the predominant mechanism of failure (31.2%), followed by instability (18.7%), infection (16 ... Full text Link to item Cite

Developing a high-efficiency operating room for total joint arthroplasty in an academic setting.

Journal Article Clin Orthop Relat Res · June 2013 BACKGROUND: Developing a high-efficiency operating room (OR) for total joint arthroplasty (TJA) in an academic setting is challenging given the preexisting work cultures, bureaucratic road blocks, and departmental silo mentalities. Also, academic instituti ... Full text Link to item Cite

Stair ascending and descending in hip resurfacing and large head total hip arthroplasty patients.

Journal Article J Arthroplasty · April 2013 Large head total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) are alternatives to standard THA that generally have head sizes larger than 36mm. This study examined 20 patients (10 large head THA and 10 HRA), at an average of 18months posto ... Full text Link to item Cite

Creation of a femoral cortical window to facilitate total hip arthroplasty in patients with sickle cell hemoglobinopathies.

Journal Article J Arthroplasty · February 2013 Patients with sickle cell hemoglobinopathies often have femoral head osteonecrosis with collapse, and can benefit greatly from total hip arthroplasty. However, numerous procedural challenges and perioperative complications make these cases difficult. More ... Full text Link to item Cite

The withdrawn ASR™ THA and hip resurfacing systems: how have our patients fared over 1 to 6 years?

Journal Article Clin Orthop Relat Res · February 2013 BACKGROUND: The Articular Surface Replacement™ (ASR™) metal-on-metal hip arthroplasty system (DePuy Orthopaedics, Inc, Warsaw, IN, USA) reportedly has a higher than anticipated early failure rate leading to a voluntary recall. This prompted us to evaluate ... Full text Link to item Cite

Open-label milnacipran for patients with persistent knee pain 1 year or longer after total knee arthroplasty: a pilot study.

Journal Article Prim Care Companion CNS Disord · 2013 OBJECTIVE: The current study investigates whether milnacipran is effective in reducing pain and improving function in patients with persistent pain ≥ 1 year after total knee arthroplasty. METHOD: This was a 12-week open-label study of flexibly dosed milnac ... Full text Link to item Cite

Total knee arthroplasty in osteopetrosis using patient-specific instrumentation.

Journal Article J Arthroplasty · September 2012 Osteopetrosis is an uncommon endocrine disease characterized by defective osteoclast resorption of bones. This causes a hard, sclerotic, and brittle bone throughout the skeleton. Fractures and unforgiving subchondral bone are common in this condition, both ... Full text Link to item Cite

DIO2 modifies inflammatory responses in chondrocytes.

Journal Article Osteoarthritis and cartilage · May 2012 ObjectiveSelenium neutralizes interleukin-1β (IL-1β) induced inflammatory responses in chondrocytes. We investigated potential mechanisms for this through in vitro knock down of three major selenoproteins, Iodothyronine Deiodinase-2 (DIO2), Glutat ... Full text Cite

Differences in Walking Mechanics between End-stage Ankle and Hip Osteoarthritis

Journal Article MEDICINE AND SCIENCE IN SPORTS AND EXERCISE · May 1, 2012 Link to item Cite

Late liner disassociation of a Pinnacle system acetabular component.

Journal Article Orthopedics · April 2012 This article describes a case of late locking mechanism failure and disassociation of a Pinnacle acetabular cup (DePuy, Warsaw, Indiana) and Marathon polyethylene liner (DePuy) 53 months after routine primary total hip arthroplasty in an active patient. Fo ... Full text Link to item Cite

Obstructive sleep apnea and incidence of postoperative delirium after elective knee replacement in the nondemented elderly.

Journal Article Anesthesiology · April 2012 BACKGROUND: Postoperative delirium, a common complication in the elderly, can occur following any type of surgery and is associated with increased morbidity and mortality; it may also be associated with subsequent cognitive problems. Effective therapy for ... Full text Link to item Cite

Protein modification by deamidation indicates variations in joint extracellular matrix turnover.

Journal Article J Biol Chem · February 10, 2012 As extracellular proteins age, they undergo and accumulate nonenzymatic post-translational modifications that cannot be repaired. We hypothesized that these could be used to systemically monitor loss of extracellular matrix due to chronic arthritic disease ... Full text Link to item Cite

Global metabolic profiling of human osteoarthritic synovium.

Journal Article Osteoarthritis Cartilage · January 2012 Osteoarthritis (OA) is a debilitating disease associated with pain and loss of function in numerous diarthrodial joints of the body. Assessments of the severity and/or progression of OA are commonly based on radiographic stages and pain level, which aren't ... Full text Link to item Cite

Computer-assisted reduction method for periprosthetic distal femur fracture.

Journal Article J Surg Orthop Adv · 2012 The purpose of this case report is to describe a novel use of computer assistance in identifying and restoring the mechanical axis in the treatment of a periprosthetic distal femur fracture in a 76-year-old female patient with a total knee arthroplasty. ... Full text Link to item Cite

The Withdrawn ASR™ THA and Hip Resurfacing Systems: How Have Our Patients Fared Over 1 to 6 Years?

Journal Article Clinical Orthopaedics and Related Research · 2012 Background: The Articular Surface Replacement™ (ASR™) metal-on-metal hip arthroplasty system (DePuy Orthopaedics, Inc, Warsaw, IN, USA) reportedly has a higher than anticipated early failure rate leading to a voluntary recall. This prompted us to evaluate ... Cite

Can tantalum cones provide fixation in complex revision knee arthroplasty?

Journal Article Clin Orthop Relat Res · January 2012 BACKGROUND: The best method for managing large bone defects during revision knee arthroplasty is unknown. Metaphyseal fixation using porous tantalum cones has been proposed for severe bone loss. Whether this approach achieves osseointegration with low comp ... Full text Link to item Cite

Role of diabetes type in perioperative outcomes after hip and knee arthroplasty in the United States.

Journal Article J Surg Orthop Adv · 2012 The objective of this study was to determine whether the type of diabetes mellitus (DM) affected the incidence of immediate perioperative complications following joint replacement. From 1988 to 2003, the Nationwide Inpatient Sample recognized 65,769 patien ... Full text Link to item Cite

The effect of total hip arthroplasty surgical approach on postoperative gait mechanics.

Journal Article J Arthroplasty · September 2011 Surgical approach for total hip arthroplasty (THA) is determined by clinician preference from limited prospective data. This study aimed to examine the effect of surgical approach (direct lateral, posterior, and anterolateral) on 6-week postoperative gait ... Full text Link to item Cite

Citrobacter koseri as a cause of early periprosthetic infection after primary total hip arthroplasty.

Journal Article J Arthroplasty · September 2011 Periprosthetic joint infection in the acute setting is usually caused by gram-positive species and remains a major problem facing total joint surgeons. We report a case of a 53-year-old male who presented with drainage 3 weeks after primary total hip arthr ... Full text Link to item Cite

Gait symmetry: a comparison of hip resurfacing and jumbo head total hip arthroplasty patients.

Journal Article J Arthroplasty · August 2011 Proponents of large femoral head total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) have touted the potential for restoration of more normal hip kinematics. This study examined 20 patients (10 THA and 10 HRA patients) approximately 18 mont ... Full text Link to item Cite

Selenomethionine inhibits IL-1β inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX2) expression in primary human chondrocytes.

Journal Article Osteoarthritis Cartilage · January 2011 OBJECTIVE: Several lines of evidence show that selenium (Se) has potential protective effects in osteoarthritis (OA), however the exact mechanism is still unclear. As interleukin-1β (IL-1β) is one of the key proinflammatory cytokines contributing to the pr ... Full text Link to item Cite

Greater trochanteric osteoplasty in revision hip arthroplasty: two case reports.

Journal Article Am J Orthop (Belle Mead NJ) · January 2011 Proximal migration of the greater trochanter can make revision hip arthroplasty challenging, particularly in regard to surgically exposing the joint, establishing leg length, avoiding postoperative impingement and instability, and achieving a functional hi ... Link to item Cite

Tissue sparing total femoral arthroplasty: technical note.

Journal Article J Surg Orthop Adv · 2011 It is predicted that the number of revision hip and knee arthroplasties will double by the years 2026 and 2015, respectively. As the burden of end-stage prosthetic disease increases, there will be a greater potential need for total femoral arthroplasty. Th ... Link to item Cite

Cost-effectiveness analysis of free vascularized fibular grafting for osteonecrosis of the femoral head.

Journal Article J Surg Orthop Adv · 2011 Management of symptomatic pre-collapse osteonecrosis of the femoral head continues to be controversial. Patients are often young and active, therefore hip-preserving procedures such as free vascularized fibular grafting (FVFG) have been developed to reliev ... Link to item Cite

Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty.

Journal Article J Surg Orthop Adv · 2011 Recently, patient-specific approaches to total knee arthroplasty (TKA) have been introduced that utilize preoperative magnetic resonance imaging data to manufacture custom cutting jigs specific to a patient's bony anatomy. These approaches intend to provid ... Link to item Cite

A comparison of perioperative outcomes in patients with and without rheumatoid arthritis after receiving a total shoulder replacement arthroplasty.

Journal Article J Shoulder Elbow Surg · January 2011 HYPOTHESIS: The long-term survival rate of total shoulder arthroplasty (TSA) is comparable to hip and knee arthroplasty. Although TSA is considered a safe and effective procedure with low complications in patients with osteoarthritis and rheumatoid arthrit ... Full text Link to item Cite

Can Tantalum Cones Provide Fixation in Complex Revision Knee Arthroplasty?

Journal Article Clinical Orthopaedics and Related Research · 2011 Cite

Aseptic lymphocyte-dominated vasculitis-associated lesion: a clinicopathologic review of an underrecognized cause of prosthetic failure.

Journal Article Am J Clin Pathol · December 2010 It is estimated that 35% of total hip arthroplasties (THAs) involve a second-generation metal-on-metal (MOM) prosthesis. A novel complication has appeared in a subset of patients with MOM THAs that is described as an aseptic, lymphocyte-dominated vasculiti ... Full text Link to item Cite

Fracture of highly cross-linked all-polyethylene patella after total knee arthroplasty.

Journal Article J Knee Surg · December 2010 Recent advances in polyethylene fabrication have led to the introduction of highly cross-linked polyethylene tibial and patellar components for use in total knee arthroplasty (TKA) with the goal of reducing wear-related osteolysis. However, some reports su ... Full text Link to item Cite

Aging is not associated with bone marrow-resident progenitor cell depletion.

Journal Article J Gerontol A Biol Sci Med Sci · October 2010 Changes in progenitor cell biology remain at the forefront of many theories of biologic aging, but there are limited studies evaluating this in humans. Aging has been associated with a progressive depletion of circulating progenitor cells, but age-related ... Full text Link to item Cite

Lack of radiographic loosening signs in a hip resurfacing that failed by stem fracture.

Journal Article Arch Orthop Trauma Surg · July 2010 Fracture of the femoral stem is a rare manifestation of femoral component loosening in hip resurfacing. The patient had undergone successful hip resurfacing 3 years prior to presentation, presenting with complaints of groin pain, but without radiographic e ... Full text Link to item Cite

Spatial mapping of the biomechanical properties of the pericellular matrix of articular cartilage measured in situ via atomic force microscopy.

Journal Article Biophys J · June 16, 2010 In articular cartilage, chondrocytes are surrounded by a narrow region called the pericellular matrix (PCM), which is biochemically, structurally, and mechanically distinct from the bulk extracellular matrix (ECM). Although multiple techniques have been us ... Full text Link to item Cite

Image-guided total knee arthroplasty

Journal Article Minerva Ortopedica e Traumatologica · June 1, 2010 Over the past decade, image guided technology in total knee arthroplasty (TKA) has made gains in both acceptance and use by orthopaedic surgeons. This technology has quickly expanded with the development of several computer-based navigation systems, patien ... Cite

Cost effectiveness analysis of hemiarthroplasty and total shoulder arthroplasty.

Journal Article J Shoulder Elbow Surg · April 2010 BACKGROUND: Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are two viable surgical treatment options for glenohumeral osteoarthritis. Recent systematic reviews and randomized trials suggest that TSA, while more costly initially, may have super ... Full text Link to item Cite

Postoperative morbidity and mortality following total knee arthroplasty with computer navigation.

Journal Article Knee · March 2010 The incidence of postoperative complications following computer navigated total knee arthroplasty is unknown. There is no published evidence to support decreased morbidity compared to standard conventional technique. The Nationwide Inpatient Sample databas ... Full text Link to item Cite

Activity scale for arthroplasty patients after total hip arthroplasty.

Journal Article J Arthroplasty · January 2010 The purpose of the Activity Scale for Arthroplasty Patients (ASAP) is to develop and validate a self-report questionnaire that demonstrated discrimination of functional gains, low burden, appropriate concurrent validity, and was not limited by ceiling effe ... Full text Link to item Cite

The inhomogeneous mechanical properties of the pericellular matrix of articular cartilage measured in situ by atomic force microscopy

Journal Article Proceedings of the ASME Summer Bioengineering Conference 2009, SBC2009 · December 1, 2009 Full text Cite

Hip resurfacing after failed free vascularized fibular graft.

Journal Article J Arthroplasty · October 2009 Metal-on-metal resurfacing of the hip is a bone sparing arthroplasty that may be an option when a head-sparing nonarthroplasty option fails. We present the first published report of 5 cases of failed free vascularized fibular graft treated with modern hip ... Full text Link to item Cite

Posterior capsular injections of ropivacaine during total knee arthroplasty: a randomized, double-blind, placebo-controlled study.

Journal Article J Arthroplasty · September 2009 We investigated the hypothesis that a posterior capsular injection of ropivacaine would improve pain and accelerate functional recovery after total knee arthroplasty in a randomized, double-blind, placebo-controlled study design. Sixty-six patients receive ... Full text Link to item Cite

Resident duty-hour reform associated with increased morbidity following hip fracture.

Journal Article J Bone Joint Surg Am · September 2009 BACKGROUND: The Accreditation Council for Graduate Medical Education implemented resident duty-hour reform for orthopaedic resident surgeons in the United States on July 1, 2003. This study sought to determine whether the change in duty-hour regulations wa ... Full text Link to item Cite

The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty.

Journal Article J Bone Joint Surg Am · July 2009 BACKGROUND: As the prevalence of diabetes mellitus in people over the age of sixty years is expected to increase, the number of diabetic patients who undergo total hip and knee arthroplasty should be expected to increase accordingly. In general, patients w ... Full text Link to item Cite

Cementless femoral prostheses cost more to implant than cemented femoral prostheses.

Journal Article Clin Orthop Relat Res · June 2009 UNLABELLED: Prosthetic cost contributes greatly to the overall expense of THA. A key question, therefore, in the selection of implant technique is whether any price difference exists between a cementless and a cemented femoral prosthesis. We evaluated the ... Full text Link to item Cite

Managing risk and liability associated with hip and knee implants

Journal Article Current Orthopaedic Practice · April 1, 2009 Hip and knee replacement surgery has proven to be among the great success stories of twentieth century medicine and technology. Orthopaedic surgeons and their patients expect and demand near perfect outcomes after hip and knee replacements. However, not ev ... Full text Cite

Comparison of perioperative complications in patients with and without rheumatoid arthritis who receive total elbow replacement.

Journal Article J Shoulder Elbow Surg · 2009 Total elbow replacement is a well-recognized surgical treatment for patients with advanced rheumatoid arthritis (RA) of the elbow. At present, there is minimal literature outlining the perioperative complications associated with total elbow replacement. We ... Full text Link to item Cite

Post-translational aging of proteins in osteoarthritic cartilage and synovial fluid as measured by isomerized aspartate.

Journal Article Arthritis Res Ther · 2009 INTRODUCTION: Aging proteins undergo non-enzymatic post-translational modification, including isomerization and racemization. We hypothesized that cartilage with many long-lived components could accumulate non-enzymatically modified amino acids in the form ... Full text Open Access Link to item Cite

Cementless porous-coated anatomic total hip arthroplasty at Duke: 18- to 24-year follow-up.

Journal Article J Surg Orthop Adv · 2009 The porous-coated anatomic (PCA) total hip was a first-generation cementless implant system introduced in 1983 for both primary and revision total hip arthroplasty. Between February 1983 and June 1989, 219 uncemented PCA total hips were implanted in 194 pa ... Link to item Cite

The impact of diabetes on perioperative patient outcomes after total hip and total knee arthroplasty in the United States.

Journal Article J Arthroplasty · September 2008 The purpose of this study was to determine whether patients with diabetes mellitus (DM) have a higher likelihood of immediate, inpatient complications following primary and revision total hip (THA) and total knee arthroplasty (TKA) than patients without DM ... Full text Link to item Cite

Two-year outcomes in primary THA in obese male veterans administration medical center patients.

Journal Article Rheumatol Int · September 2008 The objective of this study was to examine the influence of obesity on the rate of infection, dislocation, and overall complications in a group of male patients undergoing primary total hip arthroplasty (THA). The study involved a retrospective review of t ... Full text Link to item Cite

Clinical outcomes and costs among patients with Staphylococcus aureus bacteremia and orthopedic device infections.

Journal Article Scand J Infect Dis · 2008 We evaluated costs and outcomes of patients with S. aureus bacteremia and orthopedic device infections (ODI). Patients with ODI had higher relapse of S. aureus infection, compared to bacteremic patients without ODI. Costs and outcomes were similar among OD ... Full text Link to item Cite

Minimizing leg-length inequality in total hip arthroplasty: use of preoperative templating and an intraoperative x-ray.

Journal Article Am J Orthop (Belle Mead NJ) · January 2008 Leg-length inequality after total hip arthroplasty remains a controversial issue. In the study reported here, we sought to determine whether significant leg-length discrepancies (> 6 mm) can be minimized with use of an intraoperative x-ray. In each case, p ... Link to item Cite

Navigated total knee arthroplasty and the ORTHOsoft navitrack system

Journal Article · December 1, 2007 The Navitrack® TotalKnee™ (Orthosoft, Montreal, Quebec, Canada) imageless application from ORTHOsoft allows the surgeon to determine mechanical and rotational axis of a patient's leg during total knee replacement surgery. The Navitrack TotalKnee imageless ... Full text Cite

AOA-JOA Traveling Fellowship 2006: The Fellows' Travel Log.

Journal Article J Bone Joint Surg Am · October 2007 Full text Link to item Cite

Clinical and radiographic analysis of accurate restoration of the joint line in revision total knee arthroplasty.

Journal Article J Arthroplasty · December 2006 A clinical and radiographic analysis was performed on 89 consecutive revision total knee arthroplasties. The postoperative joint line position was evaluated and correlated with the clinical outcome. The joint line position was evaluated radiographically. A ... Full text Link to item Cite

Surgical site infection in the elderly following orthopaedic surgery. Risk factors and outcomes.

Journal Article J Bone Joint Surg Am · August 2006 BACKGROUND: Risk factor and outcomes data pertaining to surgical site infection in the elderly following orthopaedic operations are lacking. The aim of this study was to identify risk factors for surgical site infections and to quantify the impact of these ... Full text Link to item Cite

Computer navigation versus standard instrumentation for TKA: a single-surgeon experience.

Journal Article Clin Orthop Relat Res · November 2005 UNLABELLED: Component alignment errors in total knee arthroplasty greater than 3 degrees can be associated with poorer outcomes. This retrospective study seeks to determine if computer navigation can improve accuracy of component alignment in comparable pa ... Full text Link to item Cite

Comparison of a hydroxyapatite-coated sleeve and a porous-coated sleeve with a modular revision hip stem. A prospective, randomized study.

Journal Article J Bone Joint Surg Am · December 2004 BACKGROUND: Bone ingrowth into a cementless prosthesis can be achieved by both porous and hydroxyapatite coatings. The purpose of this study was to compare the performance of a hydroxyapatite-coated proximal sleeve and a porous bead-coated sleeve in patien ... Full text Link to item Cite

Blockade of L-selectin attenuates reperfusion injury in a rat model.

Journal Article J Reconstr Microsurg · April 2000 Ischemia/reperfusion (I/R) injury appears to be a significant neutrophil-dependent component and may be ameliorated by blocking leukocyte-endothelial adhesion. Using a rat extensor digitorum longus (EDL) muscle model, the present study tested the hypothesi ... Full text Link to item Cite

Dimensions of the intercondylar notch of the knee.

Journal Article Am J Knee Surg · 1997 This study evaluates the three-dimensional contour of the intercondylar notch of the knee along its entire length. Forty-one distal femora, from human cadavers with a mean age of 45 years (range: 23 to 70 years) at the time of death were studied. The speci ... Link to item Cite

Protective effect of hypothermia on contractile force in skeletal muscle.

Journal Article J Orthop Res · May 1996 The clinical success of limb replantation and tissue transfer is partly dependent on the duration of ischemia experienced by the amputated part. This study focused primarily on the damage that occurs during this ischemic period. An experimental system was ... Full text Link to item Cite