Journal ArticleJ Arthroplasty · August 2024
BACKGROUND: This study evaluated blood glucose (BG), creatinine levels, metabolic issues, length of stay (LOS), and early postoperative complications in diabetic primary total knee arthroplasty (TKA) patients. It examined those who continued home oral anti ...
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Journal ArticleJ Arthroplasty · July 2024
BACKGROUND: Gait abnormalities such as Trendelenburg gait (TG) in patients who have hip osteoarthritis (OA) have traditionally been evaluated using clinicians' visual assessment. Recent advances in portable inertial gait sensors offer more sensitive, quant ...
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Journal ArticleBone Joint J · June 1, 2024
AIMS: This study aims to assess the relationship between history of pseudotumour formation secondary to metal-on-metal (MoM) implants and periprosthetic joint infection (PJI) rate, as well as establish ESR and CRP thresholds that are suggestive of infectio ...
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Journal ArticleJ Am Acad Orthop Surg · May 8, 2024
INTRODUCTION: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only list but continued to classify admissions as inpatient if they include two midnights, complicating care if an outpatient THA requires ...
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Journal ArticleHSS Journal · May 1, 2024
The evaluation, classification, and treatment of significant bone loss after total knee arthroplasty (TKA) continue to be a complex and debated topic in revision TKA (rTKA). Despite the introduction of new evidence and innovative technologies aimed at addr ...
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Journal ArticleClin Orthop Relat Res · April 25, 2024
BACKGROUND: Treatment with a static or an articulating antibiotic-containing spacer is a common strategy for treating periprosthetic joint infection (PJI), yet many patients have persistent infections after spacer treatment. Although previous studies have ...
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Journal ArticleJ Am Acad Orthop Surg · April 25, 2024
INTRODUCTION: On January 1, 2018, the Centers for Medicare and Medicaid Services removed total knee arthroplasty (TKA) from the inpatient-only (IPO) list, expanding outpatient TKA (oTKA) to include patients with insurance coverage through their programs. T ...
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Journal ArticleClin Orthop Relat Res · April 1, 2024
BACKGROUND: Mental health characteristics such as negative mood, fear avoidance, unhelpful thoughts regarding pain, and low self-efficacy are associated with symptom intensity and capability among patients with hip and knee osteoarthritis (OA). Knowledge g ...
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Journal ArticleArthroplast Today · April 2024
BACKGROUND: Robotic-assisted total joint arthroplasty (rTJA) has growing interest among patients and surgeons. However, patient interest in and perceptions of rTJA have not been well explored. We sought to investigate the influence of patient demographics ...
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Journal ArticleJ Arthroplasty · February 2024
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 ...
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Journal ArticleJ Orthop Surg (Hong Kong) · 2024
INTRODUCTION: Soft tissue defects are a devastating complication of prosthetic joint infections (PJI) after total knee arthroplasty (TKA). Rotational flaps are commonly utilized to address these defects with variable reports of success. This study aimed to ...
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Journal ArticleOrthopedics · 2024
Use of molecular sequencing modalities in periprosthetic joint infection diagnosis and organism identification has gained popularity recently. To date, there is no diagnostic test that reliably predicts infection eradication in patients with antibiotic spa ...
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Journal ArticleJ 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 ...
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Journal ArticleJ Patient Saf · December 1, 2023
BACKGROUND: Digital transformation using widely available electronic data is a key component to improving health outcomes and customer choice and decreasing cost and measurement burden. Despite these benefits, existing information on the potential cost sav ...
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Journal ArticleJ 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 ...
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Journal ArticleInt Orthop · August 2023
PURPOSE: Cutibacterium spp. (formerly Propionibacterium) is a slow growing, Gram-positive, anaerobic bacteria and is an emerging clinical entity in prosthetic joint infection (PJI). This study compares the presentation, surgical management, and post-operat ...
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Journal ArticleJ Am Acad Orthop Surg · June 15, 2023
Optimal pain management after total knee arthroplasty (TKA) can expedite postoperative recovery, improve perioperative outcomes, and increase patient satisfaction. Periarticular injections (PAIs) have become increasingly used to improve pain management aft ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ Arthroplasty · May 2023
BACKGROUND: There is contradicting evidence on the diagnostic value of inflammatory biomarkers for periprosthetic joint infection (PJI). We sought to quantify the sensitivity of D-dimer for acute and chronic PJI diagnosis and evaluate D-dimer lab values in ...
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Journal ArticleJ Arthroplasty · August 2024
BACKGROUND: This study evaluated blood glucose (BG), creatinine levels, metabolic issues, length of stay (LOS), and early postoperative complications in diabetic primary total knee arthroplasty (TKA) patients. It examined those who continued home oral anti ...
Full textLink to itemCite
Journal ArticleJ Arthroplasty · July 2024
BACKGROUND: Gait abnormalities such as Trendelenburg gait (TG) in patients who have hip osteoarthritis (OA) have traditionally been evaluated using clinicians' visual assessment. Recent advances in portable inertial gait sensors offer more sensitive, quant ...
Full textLink to itemCite
Journal ArticleBone Joint J · June 1, 2024
AIMS: This study aims to assess the relationship between history of pseudotumour formation secondary to metal-on-metal (MoM) implants and periprosthetic joint infection (PJI) rate, as well as establish ESR and CRP thresholds that are suggestive of infectio ...
Full textLink to itemCite
Journal ArticleJ Am Acad Orthop Surg · May 8, 2024
INTRODUCTION: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only list but continued to classify admissions as inpatient if they include two midnights, complicating care if an outpatient THA requires ...
Full textLink to itemCite
Journal ArticleHSS Journal · May 1, 2024
The evaluation, classification, and treatment of significant bone loss after total knee arthroplasty (TKA) continue to be a complex and debated topic in revision TKA (rTKA). Despite the introduction of new evidence and innovative technologies aimed at addr ...
Full textCite
Journal ArticleClin Orthop Relat Res · April 25, 2024
BACKGROUND: Treatment with a static or an articulating antibiotic-containing spacer is a common strategy for treating periprosthetic joint infection (PJI), yet many patients have persistent infections after spacer treatment. Although previous studies have ...
Full textLink to itemCite
Journal ArticleJ Am Acad Orthop Surg · April 25, 2024
INTRODUCTION: On January 1, 2018, the Centers for Medicare and Medicaid Services removed total knee arthroplasty (TKA) from the inpatient-only (IPO) list, expanding outpatient TKA (oTKA) to include patients with insurance coverage through their programs. T ...
Full textLink to itemCite
Journal ArticleClin Orthop Relat Res · April 1, 2024
BACKGROUND: Mental health characteristics such as negative mood, fear avoidance, unhelpful thoughts regarding pain, and low self-efficacy are associated with symptom intensity and capability among patients with hip and knee osteoarthritis (OA). Knowledge g ...
Full textLink to itemCite
Journal ArticleArthroplast Today · April 2024
BACKGROUND: Robotic-assisted total joint arthroplasty (rTJA) has growing interest among patients and surgeons. However, patient interest in and perceptions of rTJA have not been well explored. We sought to investigate the influence of patient demographics ...
Full textLink to itemCite
Journal ArticleJ Arthroplasty · February 2024
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 textLink to itemCite
Journal ArticleJ Orthop Surg (Hong Kong) · 2024
INTRODUCTION: Soft tissue defects are a devastating complication of prosthetic joint infections (PJI) after total knee arthroplasty (TKA). Rotational flaps are commonly utilized to address these defects with variable reports of success. This study aimed to ...
Full textLink to itemCite
Journal ArticleOrthopedics · 2024
Use of molecular sequencing modalities in periprosthetic joint infection diagnosis and organism identification has gained popularity recently. To date, there is no diagnostic test that reliably predicts infection eradication in patients with antibiotic spa ...
Full textLink to itemCite
Journal ArticleJ 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 textLink to itemCite
Journal ArticleJ Patient Saf · December 1, 2023
BACKGROUND: Digital transformation using widely available electronic data is a key component to improving health outcomes and customer choice and decreasing cost and measurement burden. Despite these benefits, existing information on the potential cost sav ...
Full textLink to itemCite
Journal ArticleJ 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 textLink to itemCite
Journal ArticleInt Orthop · August 2023
PURPOSE: Cutibacterium spp. (formerly Propionibacterium) is a slow growing, Gram-positive, anaerobic bacteria and is an emerging clinical entity in prosthetic joint infection (PJI). This study compares the presentation, surgical management, and post-operat ...
Full textLink to itemCite
Journal ArticleJ Am Acad Orthop Surg · June 15, 2023
Optimal pain management after total knee arthroplasty (TKA) can expedite postoperative recovery, improve perioperative outcomes, and increase patient satisfaction. Periarticular injections (PAIs) have become increasingly used to improve pain management aft ...
Full textLink to itemCite
Journal ArticleJ 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 textLink to itemCite
Journal ArticleJ 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 textLink to itemCite
Journal ArticleJ Arthroplasty · May 2023
BACKGROUND: There is contradicting evidence on the diagnostic value of inflammatory biomarkers for periprosthetic joint infection (PJI). We sought to quantify the sensitivity of D-dimer for acute and chronic PJI diagnosis and evaluate D-dimer lab values in ...
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Journal ArticleInfect 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 ...
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Journal ArticleJ Arthroplasty · July 2022
BACKGROUND: Cutibacterium spp. is an emerging pathogen in total hip arthroplasty (THA) that is not well evaluated in the literature. This study reported on the presentation and management of THA complicated by positive intraoperative Cutibacterium cultures ...
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Journal ArticleJ 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 ...
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Journal ArticleJ Arthroplasty · May 2022
BACKGROUND: This study aimed to better understand body mass index (BMI) change patterns and factors associated with BMI change before and after total hip arthroplasty (THA) in Class 2 and 3 obese patients, and assess if preoperative or postoperative BMI ch ...
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Journal ArticleJ 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 ...
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Journal ArticleOrthopedics · 2022
Few studies have investigated the influence of trainee involvement on inpatient satisfaction scores in the postoperative joint arthroplasty setting. This study compares Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores ...
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Journal ArticleOperative Techniques in Orthopaedics · December 1, 2021
Osteoarthritis (OA) of the knee is a common and disabling condition that represents around 20% of the global burden of musculoskeletal disease with a lifetime risk estimated at 13%-26%. The escalation in cases is associated with a rise in ageing and obese ...
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Journal ArticleJ Arthroplasty · July 2021
BACKGROUND: There is scant literature evaluating varus-valgus constrained (VVC) prostheses in contemporary revision total knee arthroplasty (TKA). Therefore, we aimed to evaluate the durability of VVC revision TKA with selective use of cones. METHODS: A re ...
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Journal ArticleJ Arthroplasty · July 2021
As perioperative protocols have improved, there has been a reduction in the rates of key complications after hip and knee arthroplasty. Likewise, as we have been able to make patients more comfortable postoperatively, hospital length of stay has decreased ...
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Journal ArticleClin Orthop Relat Res · July 1, 2021
BACKGROUND: During the last 5 years, there has been an increase in the use of unicompartmental knee arthroplasty (UKA) to treat knee osteoarthritis in Australia, and these account for almost 6% of annual knee replacement procedures. However, there is debat ...
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Journal ArticleComput Biol Med · June 2021
UNLABELLED: A fully-automated deep learning algorithm matched performance of radiologists in assessment of knee osteoarthritis severity in radiographs using the Kellgren-Lawrence grading system. PURPOSE: To develop an automated deep learning-based algorith ...
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Journal ArticleJ 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 ...
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Journal ArticleHealth Qual Life Outcomes · May 1, 2021
BACKGROUND: Patients' psychological health may influence recovery and functional outcomes after total knee arthroplasty (TKA). Pain catastrophizing, known to be associated with poor function following TKA, encompasses rumination, magnification, and helples ...
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Journal ArticleJ 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 ...
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Journal ArticleJ Arthroplasty · March 2021
BACKGROUND: Periprosthetic joint infection (PJI) in total knee arthroplasty (TKA) is a challenging problem. The purpose of this study was to outline a novel technique to treat TKA PJI. We define 1.5-stage exchange arthroplasty as placing an articulating sp ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleOrthopedics · 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 ...
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Journal ArticleBone 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 ...
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Journal ArticleJ Surg Orthop Adv · 2021
An 81-year-old male with an infected aortic valve presents to the orthopaedic service with a painful total knee of unclear chronicity and several weeks of intravenous antibiotics. While some prosthetic joint infections (PJI) present very clearly, many come ...
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Journal ArticleClin Orthop Relat Res · December 2020
BACKGROUND: Psychological distress can negatively influence disability, quality of life, and treatment outcomes for individuals with hip and knee osteoarthritis (OA). Clinical practice guidelines recommend a comprehensive disease management approach to OA ...
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Journal ArticleOrthopedics · 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleArthroplast 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 ...
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Journal ArticleOrthopedics · 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 ...
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Journal ArticleArthroplast Today · March 2020
BACKGROUND: Recent evidence describes which interventions are driving insurance payments in the management of osteoarthritis (OA) before total knee arthroplasty (TKA); however, relatively little is known about how these costs are distributed among patients ...
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Journal ArticlePhys Ther · January 23, 2020
BACKGROUND AND PURPOSE: Existing osteoarthritis (OA) care models often fall short in addressing the many biological, psychological, social, and behavioral characteristics that contribute to disability. As US health care shifts towards value-based payment, ...
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ConferenceProgress in Biomedical Optics and Imaging - Proceedings of SPIE · January 1, 2020
Knee osteoarthritis (OA) is a prevalent and disabling degenerative joint disease. Objectively identifying knee OA severity is challenging given significant inter-reader variability due to human interpretation factors. The Kellgren-Lawrence (KL) grading sys ...
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ConferenceProgress in Biomedical Optics and Imaging - Proceedings of SPIE · January 1, 2020
Evaluating the severity of knee osteoarthritis (OA) accounts for significant plain film workload and is a crucial component of knee radiograph interpretation, which informs surgical decision-making for costly and invasive procedures such as knee replacemen ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ 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 ...
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Journal ArticleJ Arthroplasty · July 2019
BACKGROUND: The Center for Medicare and Medicaid Services (CMS) classifies reimbursement for total hip arthroplasty (THA) and total knee arthroplasty (TKA) based on Medical Severity-Diagnosis Related Groups (MS-DRGs) 469 (with major complication/comorbidit ...
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Journal ArticleJ Arthroplasty · July 2019
BACKGROUND: Although predictive laboratory markers and cutoffs for immunocompetent patients are well-studied, similar reference ranges and decision thresholds for immunosuppressed patients are less understood. We investigated the utility of typical laborat ...
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Journal ArticleArthroplast Today · March 2019
Inflammatory demyelinating polyneuropathy is a rare but devastating condition. Guillain-Barré syndrome is the most common cause with acute inflammatory demyelinating polyneuropathy being the most common subtype that follows a monophasic course and does not ...
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Journal ArticleJ 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 ...
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Journal ArticleEur J Orthop Surg Traumatol · January 2019
Intrathecal morphine (ITM) can be useful for postoperative analgesia following lower extremity joint arthroplasty, but concerns exist regarding potential dose-related side effects. In this study, we examined the safety and efficacy of ITM in patients under ...
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Journal ArticleJ 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 ...
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Journal ArticleAdv Orthop · 2019
BACKGROUND: Recent evidence suggests benefit to receiving physical therapy (PT) the same day as total joint arthroplasty (TJA), but relatively little is known about barriers to providing PT in this constrained time period. We address the following question ...
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Journal ArticleJ Orthop Res · December 2018
Femoral version impacts the long-term functioning of the femoroacetabular joint. Accurate measurements of version are thus required for success in total hip arthroplasties and hip reconstructive surgeries. These are impossible to obtain without visualizati ...
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Journal ArticleJ Arthroplasty · August 2018
BACKGROUND: With the increasing incidence of hip fractures and hip preservation surgeries, there has been a concomitant rise in the number of conversion total hip arthroplasties (THAs) performed. Prior studies have shown higher complication rates in conver ...
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Journal ArticleArthroplasty Today · June 1, 2018
Background: To assess the relationship between rapidly destructive osteoarthritis (RDOA) of the hip and intra-articular steroid injections. Methods: Coding records from 2000 to 2013 were used to identify all subjects who had a fluoroscopy-guided intra-arti ...
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Journal ArticleJ Bone Joint Surg Am · February 21, 2018
Appropriateness classification for total knee arthroplasty (TKA) has received substantial attention recently, and Katz and colleagues published an Orthopaedic Forum on the topic in The Journal of Bone & Joint Surgery in February 2017. Classifications of ap ...
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Chapter · January 1, 2018
Key biomechanical characteristics of the knee joint include the tibiofemoral and patellofemoral articulations, their kinematics, and associated soft-tissue mechanics. Recent data report on alterations in biomechanics of the osteoarthritic knee and differen ...
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Chapter · January 1, 2018
The many surgical approaches to the hip continue to evolve and progress has been made over the past 10 years. Perioperative patient management has helped optimize outcomes. Advances in component design have led to the generation of improved bearing surface ...
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Journal ArticleJ Arthroplasty · September 2017
BACKGROUND: Periarticular injections have become a valuable adjunct to multimodal pain control regimens after knee and hip arthroplasties. Injection techniques vary greatly among surgeons with little standardization of practice. METHODS: We performed an ex ...
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Journal ArticleJ Arthroplasty · September 2017
BACKGROUND: Oral multimodal analgesia for hip and knee arthroplasty is increasingly used as part of enhanced recovery protocols designed to minimize early postoperative pain and to facilitate early discharge, while minimizing undesirable side effects relat ...
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Journal ArticleJ Arthroplasty · September 2017
BACKGROUND: Although HbA1c is commonly used for assessing glycemic control before surgery, there is no consensus regarding its role and the appropriate threshold in predicting adverse outcomes. This study was designed to evaluate the potential link between ...
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Journal ArticleJ Orthop Res · August 2017
Identifying native femoral version from proximal femoral landmarks would be of benefit both for preoperative assessment as well as intraoperatively. To identify potential markers for femoral anteversion, an empirical framework was developed for orientation ...
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Journal ArticleJ Arthroplasty · August 2017
BACKGROUND: Cement fixation of total knee components remains the gold standard despite resurgence in cementless fixation with the goal of long-term durable fixation. Initial stability is paramount to achieve bony ingrowth of cementless components. METHODS: ...
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Journal ArticleJ Arthroplasty · June 2017
BACKGROUND: Despite literature to support the use of various cerclage techniques to address intraoperative femoral fractures in total hip arthroplasty, there are limited data to support prophylactic cerclage wiring of the femur during cementless implant pl ...
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Journal ArticleJ Arthroplasty · April 2017
BACKGROUND: Instruments designed to predict the extent of pain and function following knee arthroplasty (KA) recovery has strong potential to guide patients and clinicians in shared decision making. Our purpose was to test the external validity of a recent ...
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Journal ArticleSeminars in Arthroplasty JSES · September 1, 2016
The Centers for Medicare and Medicaid (CMS) have continued to explore ways to decrease cost and increase quality in the provision of medical services. There is increasing concern that the current “fee-for-service” payment structure of American medicine may ...
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Journal ArticleJ Arthroplasty · September 2016
BACKGROUND: Treatment of middle-aged patients with acetabular dysplasia is challenging because of mild osteoarthritis, long life span, high activity level, and sports participation. Both periacetabular osteotomy (PAO) and total hip arthroplasty (THA) provi ...
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Journal ArticleJ Arthroplasty · August 2016
BACKGROUND: Patient optimization is receiving increasing attention as outcomes monitoring and bundled payments have been introduced in joint arthroplasty. Optimization of nutrition is an important aspect of perioperative management. METHODS: This manuscrip ...
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Journal ArticleJ Arthroplasty · June 2016
BACKGROUND: This study sought to quantify the total patient radiation exposure during fluoro-assisted direct anterior approach (DAA) total hip arthroplasty (THA). We hypothesized that the patient radiation exposure would fall within acceptable published li ...
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Journal ArticleJ Arthroplasty · June 2016
BACKGROUND: Mortality after total hip and knee arthroplasty is lower than that in the general population, but it is unknown whether there are differences by surgery type, demographics, and calendar year. Our objective was to evaluate trends and determinant ...
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Journal ArticleJ Arthroplasty · March 2016
BACKGROUND: Highly porous metal acetabular components illustrate a decreased rate of aseptic loosening in short-term follow-up compared with previous registry data. This study compared the effect of component surface roughness at the bone-implant interface ...
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Journal ArticleJ Addict Med · 2016
BACKGROUND: The nonmedical use of prescription medication among US adults is a growing public health problem. Healthcare providers should proactively address this problem in outpatient encounters. OBJECTIVE: We sought to understand the interactive effects ...
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Journal ArticleSurg Technol Int · November 2015
In revision total hip arthroplasty (THA), consensus is lacking regarding the optimal method for reconstruction of the most severe acetabular defects. Porous tantalum (TM) buttress augments were designed for the most severe postero-superior defects. The pur ...
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Journal ArticleJ Bone Joint Surg Am · September 2, 2015
BACKGROUND: Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our o ...
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Journal ArticleJ Arthroplasty · June 2015
Prosthetic joint infection (PJI) of the hip and knee remains one of the most common and feared arthroplasty complications. The impact and cost of PJI is significant, both to the patient and to the health care system. Recent reports of results of different ...
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Journal ArticleJ Arthroplasty · May 2015
UNLABELLED: Instability is a major cause of early revision of total knee arthroplasty (TKA), of which flexion instability is a major subset. We analyzed radiologically evident corrections, patient reported outcome and complications associated with revision ...
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Journal ArticleOsteoarthritis Cartilage · March 2015
OBJECTIVES: We determined the radiographic osteoarthritic worsening rate prior to knee arthroplasty (TKA) and whether this worsening was associated with worsening pain and function as compared to a non-surgical matched sample. METHODS: We used the Osteoart ...
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Journal ArticleArthritis Care Res (Hoboken) · March 2015
OBJECTIVE: We determined outcomes for patients classified as appropriate, inconclusive, or inappropriate for total knee arthroplasty (TKA) using a modified version of a validated appropriateness algorithm. Outcome measurement was conceptualized as short-te ...
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Chapter · January 1, 2015
Total knee arthroplasty (TKA) in the setting of extra-articular deformity is a challenging problem, on scale with revision TKA. Exhaustive preoperative planning is imperative for a successful outcome, and to determine if intra-articular correction is possi ...
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Journal ArticleJ Bone Joint Surg Am · December 17, 2014
BACKGROUND: In the U.S. and abroad, the use of patient-reported outcome measures to evaluate the impact of total joint replacement surgery on patient quality of life is increasingly common. Analyses of patient-reported outcomes have documented substantial ...
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Journal ArticleAm J Orthop (Belle Mead NJ) · December 2014
There is concern regarding elevated metal ion levels in the blood during pregnancy and the potential fetal effects in women with metal-on-metal (MOM) implants. We obtained maternal and umbilical cord blood samples from 3 patients with a MOM hip arthroplast ...
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Journal ArticleJ Bone Joint Surg Am · November 5, 2014
BACKGROUND: The inherently complex three-dimensional morphology of both the pelvis and acetabulum create difficulties in accurately determining acetabular orientation. Our objectives were to develop a reliable and accurate methodology for determining three ...
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Journal ArticleJ Bone Joint Surg Am · October 15, 2014
BACKGROUND: Toll-like receptors (TLRs) 1 and 6 are consistent molecular indicators of the host inflammatory response against bacterial infection. Our aims were to determine whether TLR elevation could be detected in infected periprosthetic tissues and to a ...
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Journal ArticleArthritis Rheumatol · August 2014
OBJECTIVE: In previous studies conducted outside the US, ∼20% of total knee arthroplasty (TKA) surgeries were judged to be inappropriate. The present study was undertaken to determine the prevalence rates of TKA surgeries classified as appropriate, inconcl ...
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Journal ArticleClin Orthop Relat Res · July 2014
BACKGROUND: Experimental studies have suggested that initial micromotion of cementless components may lead to failure of osteointegration. Roentgen stereophotogrammetric analyses have shown durable implant fixation can be achieved long-term even when initi ...
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Journal ArticleJ Arthroplasty · May 2014
The primary goal of this study was to determine the initial press-fit stability in acetabular components without screw fixation. Mechanical testing was performed with the implantation of press-fit acetabular components in cadaveric specimens. No significan ...
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ConferenceBMC Cell Biol · March 25, 2014
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is the predominant cause of bone infection. Toll like receptors (TLRs) are an important segments of host response to infection and are expressed by a variety of cells including human mesenchyma ...
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Journal ArticleArthritis Rheum · December 2013
OBJECTIVE: To determine the trajectories of preoperative worsening and postoperative recovery for both the index knee and the contralateral knee of patients undergoing knee replacement surgery. METHODS: Of the 4,796 subjects in the Osteoarthritis Initiativ ...
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Journal ArticleOrthopedics · January 2013
Most orthopedic surgeons do not routinely use radiographic classification systems to grade the extent of joint space narrowing in patients considered for total knee arthroplasty. The authors compared the validity and reliability of radiographic measures of ...
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ConferenceClin Orthop Relat Res · January 2013
BACKGROUND: Irrigation and débridement (I&D) of periprosthetic infection (PPI) is associated with infection control ranging from 16% to 47%. Mitigating factors include organism type, host factors, and timing of intervention. While the influence of organism ...
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ConferenceClin Orthop Relat Res · December 2012
BACKGROUND: Hip arthroscopy for labral tears improves short-term function, but reoperations occur in 5% to 47% of patients. The effect of borderline acetabular coverage on reoperation rate has been debated. Labral repair rather than débridement has been pr ...
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Journal ArticleJ Knee Surg · November 2012
Currently, the outcome and indications of unicompartmental knee arthroplasty (UKA) are still controversial. We retrospectively reviewed a consecutive case series of UKA done by a single surgeon between 2004 and 2007 including 178 knees (140 patients). Ther ...
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Journal ArticleClin Orthop Relat Res · October 2012
BACKGROUND: Knee arthroplasty traditionally is recommended for persons with substantial disability and disabling pain attributable to moderate or severe osteoarthritis (OA). Pain and functional status after arthroplasty may be influenced by the extent of k ...
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Journal ArticleJoint Bone Spine · May 2012
OBJECTIVES: Only a few studies have identified prognostic factors indicating risk of future knee arthroplasty in patients with osteoarthritis (OA) of the knee. The Osteoarthritis Initiative (OAI) is a National Institutes of Health and privately funded coho ...
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Journal ArticleInstr Course Lect · 2012
Choosing the approach for revision total hip replacement is an essential part of surgical planning and should be done well before the patient enters the operating room. Planning includes selecting patient positioning, the location of the incision, techniqu ...
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Journal ArticleOsteoarthritis Cartilage · May 2011
Osteoarthritis (OA) is the most common type of arthritis and a major cause of chronic musculoskeletal pain and functional disability. While both pharmacologic and non-pharmacologic modalities are recommended in the management of OA, when patients with hip ...
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Journal ArticleJournal of Arthroplasty · January 1, 2011
Irrigation and debridement (I&D) is an attractive treatment alternative for periprosthetic joint infection (PJI). Irrigation and debridement failure rates average 64% (range, 10.5%-84%) and may be associated with causative organism type and virulence. The ...
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Journal ArticleJ Arthroplasty · June 2010
The aim of this study is to determine the prevalence and correlates of major depression, generalized anxiety disorder, and panic disorder in patients scheduled for knee arthroplasty. Three hundred nine patients completed questionnaires and validated self-r ...
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Journal ArticleClin Orthop Relat Res · March 2010
UNLABELLED: Psychologic status is associated with poor outcome after knee arthroplasty yet little is known about which specific psychologic disorders or pain-related beliefs contribute to poor outcome. To enhance the therapeutic effect of a psychologic int ...
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ConferenceClin Orthop Relat Res · February 2010
The incidence of femur fracture around total hip arthroplasties continues to increase at substantial cost to society. These fractures are frequently associated with a loose femoral component. Consequently, we sought to test whether femoral component loosen ...
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Journal ArticlePhys Sportsmed · December 2009
Osteoarthritis becomes more prevalent with increasing age, and currently is occurring more frequently in the "baby boomer" generation (ages 44-66 years). However, many individuals may be reluctant to undergo arthroplasty procedures because potential activi ...
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Journal ArticleInt Orthop · December 2009
There is no clear evidence regarding the outcome of Bernese periacetabular osteotomy (PAO) in different patient populations. We performed systematic meta-regression analysis of 23 eligible studies. There were 1,113 patients of which 61 patients had total h ...
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Journal ArticleKnee · December 2009
OBJECTIVE: There is little evidence to guide physicians when discussing future likelihood of knee arthroplasty with patients who have symptomatic knee osteoarthritis. Data from Osteoarthritis Initiative (OAI) was used to determine the incidence of and pred ...
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Journal ArticleJ Arthroplasty · August 2009
Metal hypersensitivity leading onto hardware rejection is reported as a rare phenomenon. If not suspected, it can be a harrowing experience for the patient because it can lead to a seemingly never-ending cycle of tests and procedures. This case highlights ...
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Journal ArticleJ Arthroplasty · April 2008
Our purpose was to estimate the incidence of unicompartmental knee arthroplasty in the United States. Three major implant manufacturers provided data over an 8-year period from 1998 to 2005. In addition, a database from 44 hospitals was used to derive nati ...
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Journal ArticleJ Am Acad Orthop Surg · August 2007
Medications taken for the treatment of arthritis and psychotropic and epileptic disorders, as well as anticoagulants, antacids, bisphosphonates, corticosteroids, and antineoplastic drugs, can profoundly affect bone metabolism. In some scenarios (eg, osteop ...
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Journal ArticleJ Bone Joint Surg Am · April 2007
BACKGROUND: Aseptic loosening is often mentioned as the primary reason for costly revision of total joint arthroplasties. Receptor activator of nuclear factor-kappaB ligand (RANKL) appears to be a major factor in the bone resorption observed in periprosthe ...
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Journal ArticleJ Bone Joint Surg Am · November 2006
Use of antibiotic-loaded bone cement for prophylaxis against infection is not indicated for patients not at high risk for infection who are undergoing routine primary or revision joint replacement with cement. The mechanical and elution properties of comme ...
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Journal ArticleJ Arthroplasty · June 2006
The impact on performance of additives to bone cement must be assessed before clinical use of the modified product. This study performed several standard acrylic bone cement tests on 3 commercially available products: Endurance, Surgical Simplex P, and Pig ...
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Journal ArticleOrthopedics · August 2005
Many factors affect the rate of polymerization of polymethylmethacrylate (PMMA) and, therefore, the working time of bone cement. Surgeons may control some factors, but not all. A surgeon may change the temperature of the powder and the monomer, whereas the ...
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Journal ArticleOrthopedics · August 2005
Antibiotic-loaded bone cement has been used since the 1960s, and its advantages in the treatment of existing prosthetic infections have been repeatedly demonstrated. Care should be taken to match the antibiotic to the infecting organism, and cement intende ...
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Journal ArticleJ Orthop Res · July 2005
Human mast cells (MC) exhibit two distinct phenotypes based on the protease content of their secretory granules. MC(TC) cells express tryptase, chymase, cathepsin G, and mast cell carboxypeptidase, while MC(T) cells express only tryptase. Both mast cell ph ...
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Journal ArticleJ Bone Joint Surg Am · March 2005
BACKGROUND: The extended trochanteric osteotomy was introduced as a safe and effective exposure technique for revision hip surgery; however, intraoperative iatrogenic femoral fractures have been reported. This study examined the effects of the extended tro ...
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Journal ArticleSeminars in Arthroplasty JSES · January 1, 2005
A review of the current orthopedic literature reveals some evidence that a limited incision approach may be associated with a higher complication rate, particularly in the learning phase of the minimally invasive joint replacement surgery (MIS) techniques. ...
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Journal ArticleClin Orthop Relat Res · July 2004
The tibial tubercle osteotomy is gaining popularity for revision total knee arthroplasty; however, the potential for tubercle displacement has been a concern. This study compared the mechanical behavior of the tibial tubercle osteotomy after screw and cerc ...
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Journal ArticleJ Arthroplasty · June 2004
Five hundred consecutive patients undergoing primary cemented knee arthroplasties were prospectively followed up and evaluated for the presence of heterotopic ossification. Of the patients studied, 95% had osteoarthritis and 5% had inflammation. A radiogra ...
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Journal ArticleJ Arthroplasty · February 2004
Tibial tubercle osteotomy was used in the surgical exposure of 67 knees in 64 patients undergoing revision total knee arthroplasty. The clinical and radiographic results were reviewed retrospectively. The mean follow-up time was 30 months (range, 5-60 mont ...
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Journal ArticleClin Orthop Relat Res · January 2004
Between January 1987 and September 1990, 67 consecutive cementless total hip arthroplasties were implanted in 59 patients by one surgeon. The mean age of the patients at surgery was 57 years (range, 23-80 years). All acetabular components were plasma-spray ...
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ConferenceClin Orthop Relat Res · December 2003
Many situations in revision THA require the exchange of a PE liner in the setting of a well-fixed cementless acetabular shell. Unfortunately, a replacement liner is not always available, the locking mechanism of the metal shell may be damaged or incompatib ...
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Journal ArticleJ Knee Surg · October 2003
This study determined the outcome of total knee replacement (TKR) patients with moderate loss of motion who received no particular treatment. Twenty patients with an average arc of motion of 8 degrees-91 degrees of flexion 3 months postoperatively underwen ...
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Journal ArticleJ Orthop Res · September 2001
This study measured the amount of immature collagen type III present in tendon rafts obtained from anterior cruciate ligament (ACL) reconstructions. These values were compared with those obtained from control grafts typically used for reconstruction--Achil ...
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Journal ArticleClin Orthop Relat Res · November 2000
Tibial tubercle osteotomies currently are used as an exposure technique for revision total knee arthroplasty and for distal patellofemoral realignment. A review of the literature reveals no biomechanical studies that evaluate methods of osteotomy fixation ...
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Journal ArticleJ Orthop Res · November 1999
The patellar tendon is the most commonly used graft source in reconstruction of the anterior cruciate ligament. The performance of a patellar tendon graft in such a reconstruction is largely related to the structural and functional differences between pate ...
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Journal ArticleJ Arthroplasty · January 1999
This prospective, double-blinded evaluation of 24 osteoarthritic patients undergoing bilateral total knee replacement compared the midvastus and standard parapatellar approaches. The midvastus approach was found to offer an early advantage in terms of less ...
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ConferenceClin Orthop Relat Res · July 1998
Osteolysis is a radiographic term used to describe bone resorption adjacent to prosthetic implants. This process involves a spectrum of radiographic presentations, from small generalized linear patterns (linear osteolysis) to larger erosive patterns (aggre ...
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Journal ArticleClin Orthop Relat Res · July 1998
Monocytes or macrophages from important accessory cells in the regulation of bone metabolism and destruction. Cells of the mononuclear phagocyte lineage form the precursor cells of the osteoclasts. Soluble products produced by activated macrophages regulat ...
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Journal ArticleJ Orthop Res · September 1997
Patellar tendon is widely used for reconstruction of the anterior cruciate ligament. However, few studies have investigated the tendon's homogeneity, a characteristic often assumed of it in experiments. In this study, the assumption that the patellar tendo ...
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Journal ArticleJ Arthroplasty · April 1997
Periprosthetic osteolysis is a major problem in total joint arthroplasty surgery today. The particulate debris from ultrahigh-molecular-weight polyethylene, polymethyl methacrylate, and corrosion products from modular connections have been implicated in th ...
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Journal ArticleJ Rheumatol · April 1997
OBJECTIVE: Development of a synovial-like membrane in the implant-bone or cement-bone interface has been linked to aseptic loosening of total hip arthroplasties (THA). This tissue consists of a fibrous stroma containing blood vessels and macrophages, but w ...
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Journal ArticleJ Bone Joint Surg Am · November 1995
We examined the tissue response to subcutaneous injections of particulate polymethylmethacrylate powder in fully immunocompetent C3Hf/Sed mice as well as three strains of mice with different levels of lymphocyte dysfunction. Five weeks after the injection, ...
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ConferenceSouthern Biomedical Engineering Conference - Proceedings · January 1, 1995
Canine latissimus dorsi (LD) muscles were conditioned by electrical stimulation for myocardioplasty study. Changes in maximum force, rate of force development, Phospholamban mRNA (messenger ribonucleic acid) and collagen contents in the conditioned muscles ...
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Journal ArticleJ Orthop Res · January 1995
Despite the great variability in the clinical behavior of fibrous lesions of the musculoskeletal system, they are composed of cytologically similar fibrocytes. Receptors for estrogen or progesterone, or both, are present in some of these lesions and some i ...
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Journal ArticleJ Bone Joint Surg Am · January 1995
Dupuytren contracture is a disease of the palmar fascia characterized by nodular fibroblastic proliferation; its etiology and pathogenesis are poorly understood. Growth factors are polypeptides that regulate cell growth and differentiation and extracellula ...
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Journal ArticleClin Orthop Relat Res · November 1994
The prosthetic components and tissues retrieved from 12 hips with osteolysis in association with well-fixed cementless porous-coated total hip prostheses (5 Porous Coated Anatomic, 6 Harris-Galante Porous, and 1 Omniflex) were examined using a variety spec ...
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Journal ArticleClin Orthop Relat Res · January 1994
Ten cases of major osteolysis were identified in patients with hemispherical cobalt chrome acetabular components of cementless resurfacing total hip prostheses at follow-up examinations ranging from two to five years. All components were porous coated with ...
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Journal ArticleJ Bone Joint Surg Am · June 1993
The chronic inflammatory response to wear particles from orthopaedic joint implants is believed to cause osteolysis and to contribute to prosthetic loosening. Previous in vitro experiments have demonstrated that particulate debris from joint implants cause ...
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Journal ArticleClin Orthop Relat Res · December 1992
Loosening of total joint prostheses is in part related to the fragmentation of the acrylic cement mantle surrounding the prosthesis and the biologic consequences to the particulate acrylic. Fractographic studies of femoral cement mantles retrieved at revis ...
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Journal ArticleJ Bone Joint Surg Am · September 1992
Twenty-five patients had Russe anterior corticocancellous bone-grafting between 1973 and 1984 for twenty-six symptomatic established non-unions of the scaphoid. The mean duration of follow-up was eleven years (range, seven to eighteen years). Twenty-one (8 ...
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