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William Arthur Jiranek

Professor of Orthopaedic Surgery
Orthopaedic Surgery
DUMC Box 104002, Durham, NC 27710
5601 Arringdon Park Drive, Suite 300, Morrisville, NC 27560

Selected Publications


What Are the Underlying Mental Health Constructs Associated With Level of Capability in People With Knee and Hip Osteoarthritis?

Journal Article Clin 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 text Link to item Cite

Patient Perceptions and Interest in Robotic-Assisted Total Joint Arthroplasty.

Journal Article Arthroplast 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 text Link to item Cite

Continuation of Oral Antidiabetic Medications Was Associated With Better Early Postoperative Blood Glucose Control Compared to Sliding Scale Insulin After Total Knee Arthroplasty.

Journal Article J Arthroplasty · February 28, 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 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 · 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 text Link to item Cite

Inertial Sensor Gait Analysis of Trendelenburg Gait in Patients Who Have Hip Osteoarthritis.

Journal Article J Arthroplasty · January 26, 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 text Link to item Cite

Risk factors for failure after rotational muscle flap coverage for prosthetic knee infections.

Journal Article J 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 text Link to item Cite

Assessing the Diagnostic Accuracy of Next-Generation Sequencing in Patients With Antibiotic Spacers Before Reimplantation.

Journal Article Orthopedics · 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 text Link to item Cite

Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium

Journal Article HSS Journal · January 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 text 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

Cost Savings Associated With Implementing 4 Total Joint Replacement Electronic Clinical Quality Measures Nationally: 2020-2040.

Journal Article J 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 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

Cutibacterium positive cultures in total joint arthroplasty: a comparison of the hip, knee, and shoulder.

Journal Article Int 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 text Link to item Cite

Periarticular Injection in Total Knee Arthroplasty.

Journal Article J 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 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

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

D-Dimer, Erythrocyte Sedimentation Rate, and C-Reactive Protein Sensitivities for Periprosthetic Joint Infection Diagnosis.

Journal Article J 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 ... 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

Cutibacterium Positive Cultures in Total Hip Arthroplasty: Contaminant or Pathogen?

Journal Article J 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 ... Full text Link to item Cite

What Are the Underlying Mental Health Constructs Associated With Level of Capability in People With Knee and Hip Osteoarthritis?

Journal Article Clin 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 text Link to item Cite

Patient Perceptions and Interest in Robotic-Assisted Total Joint Arthroplasty.

Journal Article Arthroplast 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 text Link to item Cite

Continuation of Oral Antidiabetic Medications Was Associated With Better Early Postoperative Blood Glucose Control Compared to Sliding Scale Insulin After Total Knee Arthroplasty.

Journal Article J Arthroplasty · February 28, 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 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 · 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 text Link to item Cite

Inertial Sensor Gait Analysis of Trendelenburg Gait in Patients Who Have Hip Osteoarthritis.

Journal Article J Arthroplasty · January 26, 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 text Link to item Cite

Risk factors for failure after rotational muscle flap coverage for prosthetic knee infections.

Journal Article J 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 text Link to item Cite

Assessing the Diagnostic Accuracy of Next-Generation Sequencing in Patients With Antibiotic Spacers Before Reimplantation.

Journal Article Orthopedics · 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 text Link to item Cite

Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium

Journal Article HSS Journal · January 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 text 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

Cost Savings Associated With Implementing 4 Total Joint Replacement Electronic Clinical Quality Measures Nationally: 2020-2040.

Journal Article J 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 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

Cutibacterium positive cultures in total joint arthroplasty: a comparison of the hip, knee, and shoulder.

Journal Article Int 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 text Link to item Cite

Periarticular Injection in Total Knee Arthroplasty.

Journal Article J 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 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

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

D-Dimer, Erythrocyte Sedimentation Rate, and C-Reactive Protein Sensitivities for Periprosthetic Joint Infection Diagnosis.

Journal Article J 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 ... 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

Cutibacterium Positive Cultures in Total Hip Arthroplasty: Contaminant or Pathogen?

Journal Article J 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 ... 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

Patterns and Predictors of Weight Change Before and After Total Hip Arthroplasty in Class 2 and 3 Obese Patients.

Journal Article J 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 ... Full text Link to item Cite

Recommendations from the ICM-VTE: General.

Journal Article J Bone Joint Surg Am · March 16, 2022 Full text Link to item Cite

Recommendations from the ICM-VTE: Hip & Knee.

Journal Article J Bone Joint Surg Am · March 16, 2022 Full text 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

The Effect of Medical Education on Patient Satisfaction: An Asset or a Liability?

Journal Article Orthopedics · 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 ... Full text Link to item Cite

Population Health Trends in the Delivery of High Value Care for Knee Osteoarthritis

Journal Article Operative 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 ... Full text Cite

Varus-Valgus Constrained Implants in Revision Total Knee Arthroplasty: Mean Clinical Follow-Up of Six Years.

Journal Article J 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 ... Full text Link to item Cite

Outpatient Total Joint Arthroplasty: The New Reality.

Journal Article J 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 ... Full text Link to item Cite

Do Fixed or Mobile Bearing Implants Have Better Survivorship in Medial Unicompartmental Knee Arthroplasty? A Study From the Australian Orthopaedic Association National Joint Replacement Registry.

Journal Article Clin 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 ... Full text Link to item Cite

Deep learning-based algorithm for assessment of knee osteoarthritis severity in radiographs matches performance of radiologists.

Journal Article Comput 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 ... 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

Resilience and pain catastrophizing among patients with total knee arthroplasty: a cohort study to examine psychological constructs as predictors of post-operative outcomes.

Journal Article Health 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 ... 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

1.5-Stage Exchange Arthroplasty for Total Knee Arthroplasty Periprosthetic Joint Infections.

Journal Article J 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 ... 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

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

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

Diagnosis of Prosthetic Joint Infection.

Journal Article J 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 ... Link to item Cite

What General and Pain-associated Psychological Distress Phenotypes Exist Among Patients with Hip and Knee Osteoarthritis?

Journal Article Clin 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 ... 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

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

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

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

Disparity of health services in patients with knee osteoarthritis before total knee arthroplasty.

Journal Article Arthroplast 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 ... Full text Link to item Cite

Development of a Comprehensive, Nonsurgical Joint Health Program for People With Osteoarthritis: A Case Report.

Journal Article Phys 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, ... Full text Link to item Cite

Automatic Kellgren-Lawrence grade estimation driven deep learning algorithms

Conference Progress 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 ... Full text Cite

Automatic estimation of knee joint space narrowing by deep learning segmentation algorithms

Conference Progress 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 ... Full text 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

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

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

Should Medical Severity-Diagnosis Related Group Classification Be Utilized for Reimbursement? An Analysis of Elixhauser Comorbidities and Cost of Care.

Journal Article J 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 ... Full text Link to item Cite

Traditional Laboratory Markers Hold Low Diagnostic Utility for Immunosuppressed Patients With Periprosthetic Joint Infections.

Journal Article J 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 ... Full text Link to item Cite

Inflammatory demyelinating polyneuropathy after total hip arthroplasty

Journal Article Arthroplasty Today · March 1, 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 ... Full text 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

Safety and side-effect profile of intrathecal morphine in a diverse patient population undergoing total knee and hip arthroplasty.

Journal Article Eur 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 ... 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

Immediate Physical Therapy following Total Joint Arthroplasty: Barriers and Impact on Short-Term Outcomes.

Journal Article Adv 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 ... Full text Open Access Link to item Cite

Automated femoral version estimation without the distal femur.

Journal Article J 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 ... Full text Link to item Cite

Conversion vs Primary Total Hip Arthroplasty: Increased Cost of Care and Perioperative Complications.

Journal Article J 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 ... Full text Link to item Cite

Association of rapidly destructive osteoarthritis of the hip with intra-articular steroid injections

Journal Article Arthroplasty 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 ... Full text Cite

Appropriateness Criteria for Total Knee Arthroplasty: Additional Comments and Considerations.

Journal Article J 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 ... Full text Link to item Cite

Biomechanics of the knee

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 ... Cite

Surgical approaches and bearing surfaces

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 ... Cite

Periarticular Injections in Knee and Hip Arthroplasty: Where and What to Inject.

Journal Article J 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 ... Full text Link to item Cite

Oral Multimodal Analgesia for Total Joint Arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

Determining the Threshold for HbA1c as a Predictor for Adverse Outcomes After Total Joint Arthroplasty: A Multicenter, Retrospective Study.

Journal Article J 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 ... Full text Link to item Cite

Novel potential marker for native anteversion of the proximal femur.

Journal Article J 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 ... Full text Link to item Cite

Initial Stability of Cemented vs Cementless Tibial Components Under Cyclic Load.

Journal Article J 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: ... Full text Link to item Cite

The Effect of Prophylactic Cerclage Wires in Primary Total Hip Arthroplasty: A Biomechanical Study.

Journal Article J 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 ... Full text Link to item Cite

External Validation of a Prognostic Model for Predicting Nonresponse Following Knee Arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

Comprehensive Care for Joint Replacement (CJR), a mandatory program with winners and losers

Journal Article Seminars 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 ... Full text Cite

Acetabular Dysplasia in Middle-Aged Patients: Periacetabular Osteotomy or Total Hip Arthroplasty?

Journal Article J 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 ... Full text Link to item Cite

Patient Optimization-Strategies That Work: Malnutrition.

Journal Article J 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 ... Full text Link to item Cite

Patient Radiation Exposure During Fluoro-Assisted Direct Anterior Approach Total Hip Arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

Long-Term Mortality Trends After Total Hip and Knee Arthroplasties: A Population-Based Study.

Journal Article J 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 ... Full text Link to item Cite

Does Increased Coefficient of Friction of Highly Porous Metal Increase Initial Stability at the Acetabular Interface?

Journal Article J 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 ... Full text Link to item Cite

Depression Moderates the Relationship Between Pain and the Nonmedical Use of Opioid Medication Among Adult Outpatients.

Journal Article J 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 ... Full text Link to item Cite

Porous Tantalum Buttress Augments for Severe Acetabular Posterior Column Deficiency.

Journal Article Surg 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 ... Link to item Cite

Metal on polyethylene

Chapter · October 13, 2015 Cite

Prevalence of Total Hip and Knee Replacement in the United States.

Journal Article J 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 ... Full text Link to item Cite

Surgical Treatment of Prosthetic Joint Infections of the Hip and Knee: Changing Paradigms?

Journal Article J 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 ... Full text Link to item Cite

Revision TKA for Flexion Instability Improves Patient Reported Outcomes.

Journal Article J 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 ... Full text Link to item Cite

Knee osteoarthritis radiographic progression and associations with pain and function prior to knee arthroplasty: a multicenter comparative cohort study.

Journal Article Osteoarthritis 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 ... Full text Link to item Cite

Using surgical appropriateness criteria to examine outcomes of total knee arthroplasty in a United States sample.

Journal Article Arthritis 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 ... Full text Link to item Cite

Reply: To PMID 24974958.

Journal Article Arthritis Rheumatol · February 2015 Full text Link to item Cite

Complex primary total knee arthroplasty: Management of extra-articular deformity

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 ... Full text Cite

Implementation of patient-reported outcome measures in U.S. Total joint replacement registries: rationale, status, and plans.

Journal Article J 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 ... Full text Link to item Cite

Metal ion levels in maternal and placental blood after metal-on-metal total hip arthroplasty.

Journal Article Am 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 ... Link to item Cite

A novel approach for determining three-dimensional acetabular orientation: results from two hundred subjects.

Journal Article J 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 ... Full text Link to item Cite

The host response: Toll-like receptor expression in periprosthetic tissues as a biomarker for deep joint infection.

Journal Article J 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 ... Full text Link to item Cite

Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study.

Journal Article Arthritis 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 ... Full text Link to item Cite

Loosely implanted cementless stems may become rotationally stable after loading.

Journal Article Clin 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 ... Full text Link to item Cite

Initial stability of press-fit acetabular components under rotational forces.

Journal Article J 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 ... Full text Link to item Cite

Inhibition of Methicillin-resistant Staphylococcus aureus-induced cytokines mRNA production in human bone marrow derived mesenchymal stem cells by 1,25-dihydroxyvitamin D3.

Conference BMC 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 ... Full text Link to item Cite

One-stage vs two-stage exchange.

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

One-stage versus two-stage exchange.

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

Progressing toward, and recovering from, knee replacement surgery: a five-year cohort study.

Journal Article Arthritis 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 ... Full text Link to item Cite

Validity and reliability of radiographic knee osteoarthritis measures by arthroplasty surgeons.

Journal Article Orthopedics · 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 ... Full text Link to item Cite

Failure of irrigation and débridement for early postoperative periprosthetic infection.

Conference Clin 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 ... Full text Link to item Cite

Save the torn labrum in hips with borderline acetabular coverage.

Conference Clin 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 ... Full text Link to item Cite

Unicompartmental knee arthroplasty: factors influencing the outcome.

Journal Article J 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 ... Full text Link to item Cite

Extent of tibiofemoral osteoarthritis before knee arthroplasty: multicenter data from the osteoarthritis initiative.

Journal Article Clin 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 ... Full text Link to item Cite

Factors associated with rapid progression to knee arthroplasty: complete analysis of three-year data from the osteoarthritis initiative.

Journal Article Joint 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 ... Full text Link to item Cite

Approaches for revision total hip replacement.

Journal Article Instr 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 ... Link to item Cite

Recommendations of the OARSI FDA Osteoarthritis Devices Working Group.

Journal Article Osteoarthritis 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 ... Full text Link to item Cite

Irrigation and debridement for periprosthetic infections: Does the organism matter?

Journal Article Journal 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 ... Full text Cite

Major depression, generalized anxiety disorder, and panic disorder in patients scheduled for knee arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty.

Journal Article Clin 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 ... Full text Link to item Cite

Does femoral component loosening predispose to femoral fracture?: an in vitro comparison of cemented hips.

Conference Clin 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 ... Full text Link to item Cite

Sports after knee arthroplasty: partial versus total knee arthroplasty.

Journal Article Phys 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 ... Full text Link to item Cite

Factors predicting the failure of Bernese periacetabular osteotomy: a meta-regression analysis.

Journal Article Int 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 ... Full text Link to item Cite

Two-year incidence and predictors of future knee arthroplasty in persons with symptomatic knee osteoarthritis: preliminary analysis of longitudinal data from the osteoarthritis initiative.

Journal Article Knee · 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 ... Full text Link to item Cite

Metal hypersensitivity: can it mimic infection?

Journal Article J 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 ... Full text Link to item Cite

Yearly incidence of unicompartmental knee arthroplasty in the United States.

Journal Article J 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 ... Full text Link to item Cite

The effects of medications on bone.

Journal Article J 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 ... Full text Link to item Cite

Expression of RANKL in osteolytic membranes: association with fibroblastic cell markers.

Journal Article J 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 ... Full text Link to item Cite

Antibiotic-loaded bone cement for infection prophylaxis in total joint replacement.

Journal Article J 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 ... Full text Link to item Cite

Effect of pigmentation on the mechanical and polymerization characteristics of bone cement.

Journal Article J 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 ... Full text Link to item Cite

Thermal manipulation of bone cement.

Journal Article Orthopedics · 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 ... Full text Link to item Cite

Antibiotic-loaded cement in total hip replacement: current indications, efficacy, and complications.

Journal Article Orthopedics · 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 ... Full text Link to item Cite

Simultaneous labeling of mast cell proteases and protease mRNAs at the bone-implant interface of aseptically loosened hip implants.

Journal Article J 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 ... Full text Link to item Cite

Mechanical effects of the extended trochanteric osteotomy.

Journal Article J 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 ... Full text Link to item Cite

The role of computer assisted surgery in minimally invasive joint replacement surgery

Journal Article Seminars 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. ... Full text Cite

Dynamic confirmation of fixation techniques of the tibial tubercle osteotomy.

Journal Article Clin 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 ... Full text Link to item Cite

The incidence of heterotopic ossification after total knee arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

The results of tibial tubercle osteotomy for revision total knee arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

Late loosening of press-fit cementless acetabular components.

Journal Article Clin 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 ... Full text Link to item Cite

Acetabular liner fixation by cement.

Conference Clin 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 ... Full text Link to item Cite

The long-term outcome of total knee patients with moderate loss of motion.

Journal Article J 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 ... Link to item Cite

pN collagen type III within tendon grafts used for anterior cruciate ligament reconstruction.

Journal Article J 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 ... Full text Link to item Cite

Mechanical comparison of fixation techniques for the tibial tubercle osteotomy.

Journal Article Clin 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 ... Full text Link to item Cite

Differences in mRNA expression patterns between patellar tendons and anterior cruciate ligaments of immature pigs.

Journal Article J 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 ... Full text Link to item Cite

A comparison of the midvastus and paramedian approaches for total knee arthroplasty.

Journal Article J 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 ... Full text Link to item Cite

Differential messenger ribonucleic acid expression in aggressive versus linear periprosthetic osteolysis.

Conference Clin 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 ... Link to item Cite

Macrophage activation results in bone resorption.

Journal Article Clin 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 ... Link to item Cite

Biochemical and molecular homogeneity in the patellar tendon of the immature pig.

Journal Article J 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 ... Full text Link to item Cite

Periprosthetic femoral osteolysis around an uncemented nonmodular Moore prosthesis.

Journal Article J 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 ... Full text Link to item Cite

Transforming growth factor-beta 1 and 2 in the synovial-like interface membrane between implant and bone in loosening of total hip arthroplasty.

Journal Article J 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 ... Link to item Cite

Tissue response to particulate polymethylmethacrylate in mice with various immune deficiencies.

Journal Article J 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, ... Full text Link to item Cite

Mechanical, histological and molecular biological studies on latissimus dorsi muscles conditioned for myocardioplasty

Conference Southern 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 ... Cite

Platelet-derived growth factor in fibrous musculoskeletal disorders: a study of pathologic tissue sections and in vitro primary cell cultures.

Journal Article J 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 ... Full text Link to item Cite

The expression of platelet-derived growth-factor gene in Dupuytren contracture.

Journal Article J 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 ... Full text Link to item Cite

Etiology of osteolysis around porous-coated cementless total hip arthroplasties.

Journal Article Clin 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 ... Link to item Cite

Osteolysis around uncemented acetabular components of cobalt-chrome surface replacement hip arthroplasty.

Journal Article Clin 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 ... Link to item Cite

Production of cytokines around loosened cemented acetabular components. Analysis with immunohistochemical techniques and in situ hybridization.

Journal Article J 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 ... Full text Link to item Cite

Acrylic fragmentation in total hip replacements and its biological consequences.

Journal Article Clin 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 ... Link to item Cite

Long-term results after Russe bone-grafting: the effect of malunion of the scaphoid.

Journal Article J 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 ... Link to item Cite