Quality Assurance through EndoCert in Revision Hip and Knee Arthroplasty.

This study investigated the effects of EndoCert certification on outcome quality after hip and knee replacement surgery in Germany. The analysis was based on three data sets: AOK billing data, structured hospital quality reports and EndoCert data.Certified endoprosthesis centres (EPZ) were compared with non-certified clinics with regard to the primary endpoint "overall complications".

Threaded rods versus arthrodesis nail as a static spacer for two-stage revision total knee arthroplasty.

Introduction: A spacer is required to maintain limb length and alignment and to provide a stable limb for mobilisation in two-stage revision total knee arthroplasty (rTKA) for periprosthetic joint infection (PJI). Static spacers are indicated in cases of massive bone loss, compromised soft tissues, and ligamentous and/or extensor mechanism insufficiency. The aim of this study was to compare the use of Ilizarov rods to arthrodesis nails for static spacer constructs in first-stage rTKA for PJI.

Impact of Hospital Case Volume on the Complication Rate in Hip Arthroplasty: An Analysis of Nationwide AOK Data.

Due to demographic changes and the associated expected increases in the number of primary hip arthroplasty and revision surgeries, it is important to identify factors that can reduce complications and revisions. One such factor is the hospital volume. Studies have shown that hospitals with higher case numbers have lower morbidity and complication rates.

Minimal changes in patella height after aseptic revision from unicompartmental to total knee arthroplasty.

Introduction: If revision of a unicompartmental knee arthroplasty (UKA) is required, converting it to a total knee arthroplasty (TKA) remains the favored approach. However, worse functional outcomes after revision from UKA to TKA are reported compared to primary TKAs. One potential driver may be a decline in patella height, limiting knee flexion, and increasing patellofemoral stress.

[Return to Sports After Arthroplasty].

Arthroplasty of the hip has become one of the most successful surgical interventions and has seen significant advancements over the last century. With these developments, patient expectations have shifted from merely achieving pain-free daily mobility to anticipating a full recovery, including the ability to participate in sports. This shift has driven innovations in prosthetic materials and surgical techniques, such as the development of wear-resistant materials like highly cross-linked polyethylene and the adoption of minimally invasive procedures to enhance recovery.

No shortening of the patellar tendon during two-stage total knee arthroplasty revision using articulating spacers.

Background: Surgical techniques in two-stage revision total knee arthroplasty (rTKA) include the use of articulating spacers and static spacers. Shortening of the patellar tendon could be a reason for inferior functional outcomes in two-stage septic rTKA . The aim of this study was to determine if articulating spacers also have negative effects on the extensor mechanism in rTKA.

Impact of intra- and extramedullary alignment on blood loss in total knee arthroplasty: a retrospective study.

Background: There is a scarcity of scientific data regarding the correlation between alignment techniques during total knee arthroplasty (TKA) and blood loss as well as transfusion rates. This study's hypothesis posited that intramedullary-aligned (IM) TKA exhibits higher blood loss and transfusion rates when contrasted with extramedullary-aligned (EM) TKA.

Methods: We conducted a retrospective examination of 883 patients who underwent total knee arthroplasty (TKA) in 2021 at a solitary orthopedic center in Germany.

Predicting whether patients will achieve minimal clinically important differences following hip or knee arthroplasty.

Aims: A substantial fraction of patients undergoing knee arthroplasty (KA) or hip arthroplasty (HA) do not achieve an improvement as high as the minimal clinically important difference (MCID), i.e. do not achieve a meaningful improvement.

Cemented and hybrid total hip arthroplasty lead to lower blood loss in primary total hip arthroplasty: a retrospective study.

Background: Little scientific evidence exists on blood loss and transfusion rates depending on the fixation technique. The hypothesis of this study was that the blood loss and transfusion rate are lower in cemented and hybrid total hip arthroplasty (THA) compared to cementless THA.

Methods: We retrospectively compared a total of 1500 patients who received either cementless, cemented, hybrid or reverse hybrid THA.

Imageless robotic-assisted total knee arthroplasty is accurate in vivo: a retrospective study to measure the postoperative bone resection and alignment.

Purpose: Conventional instruments for total knee arthroplasty (TKA) have limited accuracy. The occurrence of outliers can negatively influence the clinical outcome and long-term survival of the implant. Orthopaedic robotic systems were developed to increase the accuracy of implant positioning and bone resections.

Blood transfusion and venous thromboembolism trends and risk factors in primary and aseptic revision total hip and knee arthroplasties: A nationwide investigation of 736,061 cases.

Background: Over the last years, new transfusion guidelines and pharmaceuticals have been introduced in primary and revision total hip and knee arthroplasty (P-THA, P-TKA, R-THA, R-TKA). In the US, a substantial decrease in transfusions has been observed in recent years. Little data exists on the subject in Europe.

No Major Functional Benefit After Bicompartmental Knee Arthroplasty Compared to Total Knee Arthroplasty at 5-Year Follow-Up.

Background: In case of isolated medial and patellofemoral joint arthritis, bicompartmental knee arthroplasty (BCA) is an alternative to total knee arthroplasty (TKA). The purpose of our prospective, randomized study is to compare the clinical outcome of BCA vs TKA.

Methods: Eighty patients with isolated medial and patellofemoral osteoarthritis were randomly assigned to either BCA or TKA.

Obesity Increases the Risk of Postoperative Complications and Revision Rates Following Primary Total Hip Arthroplasty: An Analysis of 131,576 Total Hip Arthroplasty Cases.

Background: The aim of our study is to evaluate the association of body mass index (BMI) and the risk of postoperative complications, mortality, and revision rates following primary total hip arthroplasty given other potentially confounding patient characteristics in a large cohort study.

Methods: Using nationwide billing data for inpatient hospital treatment of the biggest German healthcare insurance, 131,576 total hip arthroplasties in 124,368 patients between January 2012 and December 2014 were included. Outcomes were 90-day mortality, 1-year revision procedures (with and without removal or exchange of implants), 90-day surgical complications, 90-day femoral fractures, and overall complications.

[Impact of Case Numbers on the 5-Year Survival Rate of Unicondylar Knee Replacements in Germany].

Background: Reported survival rates of unicondylar knee arthroplasty (UKA) vary considerably. The influences of patient characteristics and the type of implant have already been examined. This analysis investigated the influence of hospital volume on 5-year-survival rate, using administrative claims data of Germany's largest health insurance provider.

Major acetabular defects treated with the Burch-Schneider antiprotrusion cage and impaction bone allograft in a large series: a 5- to 7- year follow-up study.

Introduction: Major bone defects are the greatest challenge in hip revision arthroplasty.

Methods: In a prospective, consecutive nonrandomised study we followed up 74 patients with Type III (AAOS) acetabular bone defects who underwent revision hip arthroplasty with bone grafting and implantation of a Burch-Schneider anti-protrusion cage (APC). The patients were examined pre- and postoperatively according to a standardised clinical and radiological protocol.

Loading of the knee joint during ergometer cycling: telemetric in vivo data.

Study Design: Within-subject, repeated-measures design.

Objectives: To measure tibiofemoral contact forces during cycling in vivo and to quantify the influences of power, pedaling cadence, and seat height on tibiofemoral contact forces.

Background: Cycling is usually classified as a low-demand activity for the knee joint and is therefore recommended for persons with osteoarthritis and rehabilitation programs following knee surgery.