A Systematic Review of Randomized Controlled Trials on Contemporary Cementless Total Knee Arthroplasty.

Background: The number of total knee arthroplasties (TKAs) continues to grow, and there is a renewed, growing interest in cementless fixation. The aim of this study was to perform a systematic review of recent randomized controlled trials (RCTs) evaluating contemporary cementless TKA survivorship and patient-reported outcome measures (PROMs).

Methods: A search of PubMed and Embase was performed.

Minimum 10-year follow-up of mobile bearing medial unicompartmental arthroplasty: Does the presence of preoperative radiographic patellofemoral arthritis influence patient outcomes?

Background: Medial unicompartmental knee arthroplasty (UKA) has become an accepted means of treating end stage anteromedial osteoarthritis of the knee. However, the presence of patellofemoral osteoarthritis on preoperative radiographs has proven to be confusing for orthopaedic surgeons in terms of candidacy for unicompartmental arthroplasty. The purpose of this study is to assess whether the presence of preoperative radiographic patellofemoral joint (PFJ) arthritis influences implant survivability or clinical outcomes at minimum 10-year follow-up.

High Early Failure Rate of a Novel Cementless Unicompartmental Knee Arthroplasty.

Background: Unicompartmental knee arthroplasty (UKA) is an accepted treatment for antero-medial osteoarthritis with low overall failure rates. In the United States, cementation remains the gold standard of implant fixation; however, multiple studies have shown potential benefits of increased survivorship with cementless fixation. The aim of this study was to evaluate clinical and radiographic outcomes of a novel cementless medial UKA implant.

Does Fluoroscopic-Aided Enabling Technology Improve Acetabular Component Position and Reduce Radiation Exposure in Direct Anterior Total Hip Arthroplasty?

Accurate acetabular component positioning is crucial for the success of total hip arthroplasty (THA). Malplacement of the acetabular component increases the risk of post-surgery complications, most notably dislocation.1 Furthermore, malposition can also result in wear of the polyethylene liner, limited range of motion, and osteolysis.

Use of a Novel Reverse Hip Replacement System to Address Dislocation and Instability.

While total hip arthroplasty (THA) is an enormously successful treatment for patients with end-stage degenerative arthritis of the hip, and surgeons have optimized existing hip implants and techniques, dislocation and instability persist as a leading cause of failure. Given the tremendous success of reverse total shoulder arthroplasty in enhancing the stability of shoulder reconstruction by reversing the anatomic seating of the ball and socket components, one manufacturer (Hip Innovation Technology, LLC, Woodstock, Georgia) has developed a novel Reverse Hip Replacement System (Reverse HRS) to address the need for greater stability in reconstruction of the arthritic hip joint. Rather than the traditional anatomic components that replace the head of the femur with a spherical ball and the acetabulum with a socket with polyethylene liner mounted into the pelvis, the Reverse HRS features a cup with polyethylene liner attached to the femoral stem and a spherical metal head attached to a central trunnion inside of the porous-coated acetabular shell fixed into the pelvis.

Tough Questions in Total Hip and Total Knee Arthroplasty.

Some of today's tough questions surrounding hip and knee arthroplasty involve modifiable risks, bilateral staging, physiotherapy, postoperative activity, venous thromboembolism and infection prophylaxis, pain management, and outpatient settings. The available literature is reviewed to provide answers to difficult questions facing the orthopaedic surgeon. Preoperative questions focus on patient selection, medical optimization, and appropriateness for outpatient surgery.