The Effect of Sex, Race/Ethnicity, and Neighborhood Socioeconomic Disadvantage on Total Hip Arthroplasty Utilization: A Multicenter Cohort Study.

Introduction: Disparities in the management of hip osteoarthritis (OA) exist across sex, race/ethnicity, and socioeconomic status, but their combined effect on total hip arthroplasty (THA) utilization remains unclear. This study evaluates differences in presentation, nonsurgical treatments, and THA rates across two academic centers.

Methods: Patients with primary hip OA seen in 2002 at two tertiary academic centers were included.

Poor Clinical Outcomes Following Total Knee Arthroplasty-Associated Revisions of Extensor Mechanism Allograft Reconstructions.

Background: Extensor mechanism rupture following total knee arthroplasty is a formidable complication frequently limiting limb function. Multiple reconstruction techniques are described, but the extensor mechanism allograft (EMA) that is utilized for complex reconstruction has notable failure rates. Rarer is a second attempt at EMA reconstruction.

Outcomes of Nonoperative versus Operative Treatment of Iliopsoas Impingement after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Background: Iliopsoas impingement (IPI) is a rare cause of persistent groin pain after primary total hip arthroplasty (THA). Treatment options include conservative management such as corticosteroid injections into the tendon sheath, iliopsoas tenotomy, and acetabular revision. The purpose of this systematic review is to compare outcomes of nonoperative versus operative treatment options for IPI after THA by assessing symptom resolution rate, patient-reported outcomes, complications, and revision surgery rate.

Antibiotic-Loaded Calcium Sulphate Beads for Treatment of Acute Periprosthetic Joint Infection in Total Knee Arthroplasty: Results Based on Risk Stratification.

A post-operative or late acute periprosthetic joint infection (PJI) after Total Knee Arthroplasty (TKA) requires a protocol of aggressive joint Debridement, modular implant Exchange, Component Retention, and post-operative Antimicrobial therapy (DECRA). Recently, the novel addition of intra-articular Antimicrobial Loaded Calcium Sulphate (AL-CaSO) beads during DECRA has been utilized to improve microbial eradication. This study reviews a consecutive series of DECRA TKA procedures with AL-CaSO beads with a standardized antimicrobial regimen.

Automated Versus Manual Femoral Component Rotation Planning in Robotic-Assisted and Conventional Total Knee Arthroplasty: A Retrospective Comparison.

Background: The purpose of this study was to determine if using automated femoral rotation planning in robotic-assisted total knee arthroplasty (RA-TKA) was associated with differences in functional outcomes compared to patients who underwent manually set femoral rotation in RA-TKA or conventional TKA (C-TKA).

Methods: This was a retrospective multicenter study of patients who underwent TKA utilizing conventional methods with femoral component rotation set to 3° externally (C-TKA) [n = 108 knees], RA-TKA with automated femoral rotation planning intrinsic to the system (A-RA-TKA) [n = 111], and RA-TKA with femoral rotation manually set by the surgeon (M-RA-TKA) [n = 152], at least one year before follow-up. Outcome measures included the range of motion, Knee Injury and Osteoarthritis Joint Replacement (KOOS-JR), and Forgotten Joint Score (FJS).

Point-of-Care Coating of Revision Femoral Stems With Antibiotic-Loaded Calcium Sulfate: Reduction in Infection After 2nd Stage Reimplantation but Not With Aseptic Revisions.

Background: Infection rates in revision total hip arthroplasty are lower when antibiotic loaded cemented stems are utilized. Inspired by this technique, a point-of-care coating of antibiotic-loaded calcium sulfate (CaSO) was applied to cementless revision stems in aseptic revision and 2nd stage reimplantation total hip arthroplasty.

Methods: One hundred eleven consecutive femoral stems were coated.

Prosthetic Limb Attachment via Electromagnetic Attraction Through a Closed Skin Envelope.

Objective: Current socket-based methods of prosthetic limb attachment are responsible for many of the dominant problems reported by persons with amputation. In this work, we introduce a new paradigm for attachment via electromagnetic attraction between a bone-anchored ferromagnetic implant and an external electromagnet. Our objective was to develop a design framework for electromagnetic attachment, and to evaluate this framework in the context of transfemoral amputation.

MELD score predicts short-term outcomes after surgical management of proximal humerus fractures: a matched analysis.

Objective: We aimed to evaluate the difference in 30-day outcomes after surgical management of proximal humerus fractures (PHFs) between patients with and without chronic liver disease as defined by a MELD score greater than 10.

Design: This was a retrospective database review.

Setting: All centers participating in the American College of Surgeons National Surgical Quality Improvement Program database were included.

Monoclonal Antibody Disrupts Biofilm Structure and Restores Antibiotic Susceptibility in an Orthopedic Implant Infection Model.

Bacterial biofilms on orthopedic implants are resistant to the host immune response and to traditional systemic antibiotics. Novel therapies are needed to improve patient outcomes. TRL1068 is a human monoclonal antibody (mAb) against a biofilm anchoring protein.

Renal Transplant Patients Have a Lower Risk of Complications and Mortalities After Total Knee Arthroplasty Compared to Those on Hemodialysis: A Large National Database Study.

Background: Total knee arthroplasty (TKA) in end-stage renal disease is associated with complications. Controversy exists whether elective TKA should be performed while patients are on hemodialysis (HD) or following renal transplant (RT). This study compares TKA outcomes in HD versus RT patients.

Geriatric Distal Femur Fractures: Equivalent Long-Term Reoperation Rates Between Fixation and Primary Arthroplasty.

Objective: Our primary objectives were to (1) determine the rate of requiring conversion to arthroplasty after open reduction internal fixation (ORIF) of geriatric distal femur fractures and (2) compare 10-year reoperation rates after ORIF versus primary arthroplasty for geriatric distal femur fractures.

Design: Propensity-matched retrospective cohort study.

Setting: All centers participating in the California Office of Statewide Health Planning and Development (OSHPD) database.

Biphasic bone graft substitute in revision total hip arthroplasty with significant acetabular bone defects : a retrospective analysis.

Aims: Large acetabular bone defects encountered in revision total hip arthroplasty (THA) are challenging to restore. Metal constructs for structural support are combined with bone graft materials for restoration. Autograft is restricted due to limited volume, and allogenic grafts have downsides including cost, availability, and operative processing.

Platelet-rich plasma use for hip and knee osteoarthritis in the United States.

Background: Hip and knee osteoarthritis (OA) are rising in prevalence and increasingly affecting younger patients. There is a rising demand for therapeutics to address its growing disease burden. Platelet-rich plasma (PRP) therapy has been used to treat various musculoskeletal conditions, but its role in OA treatment is not well understood.

Strategies for Pertrochanteric Fracture Reduction and Intramedullary Nail Placement: Technical Tips and Tricks.

The incidence of pertrochanteric hip fractures continues to rise as the aging population expands. Despite advancements in techniques and implants, failure rates remain up to 16% in the literature. The recognition of challenging fracture patterns and the use of meticulous preoperative planning can help to avoid common pitfalls.

Subsidence of monoblock and modular titanium fluted tapered stems in revision hip arthroplasty: A retrospective multicentre comparison study.

Background: Tapered, fluted, titanium (TFT) stems have shown good clinical outcomes in revision total hip arthroplasty (rTHA), however concerns exist regarding early subsidence. This study compares subsidence between a modern monoblock 3-degree and a modular 2-degree TFT stem in rTHA.

Methods: A retrospective, international multicentre comparative study was conducted including 64 rTHA in 63 patients.

Renal disease is a risk factor for complications and mortality after open reduction internal fixation of proximal humerus fractures.

Background: Renal osteodystrophy predisposes renal disease patients to fracture. Proximal humerus fractures (PHFs) frequently undergo open reduction internal fixation (ORIF); however, the effect of renal disease on outcomes is unknown.

Methods: A retrospective review of the Nationwide Readmissions Database used International Classification of Diseases, 9th Revision, codes to identify patients who underwent ORIF for closed PHF from 2010 to 2014 with no renal disease, predialysis chronic renal disease (CRD), and end-stage renal disease (ESRD).

Epidemiology of Revision Total Knee Arthroplasty in the United States, 2012 to 2019.

Background: As primary total knee arthroplasty volume continues to increase, so will the number of revision total knee arthroplasty (rTKA) procedures. The purpose of this study is to provide an updated perspective on the incidence, indications, and financial burden of rTKA in the United States.

Material And Methods: This was a retrospective epidemiologic analysis using the National Inpatient Sample.

Comparison of total hip arthroplasty outcomes between haemodyalisis and renal transplant patients.

Introduction: Total hip arthroplasty (THA) in end-stage renal disease (ESRD) patients is associated with increased complications. Controversy exists whether elective THA should be performed while these patients are on haemodialysis (HD) or following renal transplant (RT). This study seeks to compare THA outcomes in HD versus RT patients.

Navigated and Robot-Assisted Technology in Total Knee Arthroplasty: Do Outcome Differences Achieve Minimal Clinically Important Difference?

Background: In total knee arthroplasty (TKA), computer-assisted navigation (N-TKA) and robotic-assisted methods (RA-TKA) are intended to increase precision of mechanical and component alignment. However, the clinical significance of published patient-reported outcome measure (PROM) differences in comparison to conventional TKA (C-TKA) is unknown.

Methods: A systematic review was performed to identify all studies reporting perioperative PROMs for either primary N-TKA or RA-TKA with a C-TKA comparison cohort with a minimum 1-year follow-up.

Comparison of Total Knee Arthroplasty Outcomes Between Renal Transplant and End Stage Renal Disease Patients.

Introduction: Patients with end-stage renal disease (ESRD) have increased risk for periprosthetic joint infection (PJI) due to their predisposition for bacteremia and subsequent implant inoculation secondary to dialysis. PJI risk is also elevated in transplant patients secondary to chronic immunosuppressive therapy. The purpose of this study was to compare medical and surgical complications after primary total knee arthroplasty (TKA) in patients with ESRD or renal transplant (RT).

Outcomes of Modular Knee Arthrodesis for Challenging Periprosthetic Joint Infections.

Background: Modular knee arthrodesis (MKA) is a salvage treatment option for patients with challenging periprosthetic joint infections (PJI). The purpose of this study was to investigate the outcomes of patients who underwent MKA for PJI with a single technique and determine if specific factors are associated with MKA failure.

Methods: This was a retrospective review of 81 patients who underwent MKA at a single institution.

Revision Total Hip Arthroplasty in Solid Organ Transplant Patients: A Propensity Score-Matched Cohort Study for Aseptic and Infected Revisions.

Background: Previous studies have demonstrated that solid organ transplant (SOT) patients undergoing primary total hip arthroplasty (THA) are at an increased risk of postoperative complications. The purpose of this study is to use a large, national database to investigate revision THA (rTHA) outcomes in SOT patients.

Methods: Nationwide Readmissions Database (NRD) from 2010-2018 was used, and ICD-9 and ICD-10 codes were used to identify all patients who underwent rTHA, including those with history of SOT.

Revision total knee arthroplasty outcomes in solid organ transplant Patients, a matched cohort study of aseptic and infected revisions.

Background: Previous studies have demonstrated that solid organ transplant (SOT) patients undergoing primary total knee arthroplasty (TKA) are at an increased risk of postoperative complications. The purpose of this study is to utilize a large, national database to investigate revision TKA (rTKA) outcomes in SOT patients.

Methods: This was a retrospective review utilizing the Nationwide Readmissions Database (NRD) and ICD-9 codes to identify patients who underwent rTKA from 2010-2014 with a history of at least one SOT.

Hip Arthroplasty Outcomes for Femoral Neck Fractures in Transplant Patients.

Background: The purpose of this study was to compare the short-term complications between transplant and nontransplant patients who undergo hip arthroplasty for femoral neck fractures (FNFs). Additionally, we sought to further compare the outcomes of total hip arthroplasty (THA) versus hemiarthroplasty (HA) within the transplant group.

Methods: This was a retrospective review utilizing the Nationwide Readmissions Database.