Thromboembolic risks after knee arthroplasty in patients with severe obesity: A large-scale analysis using Japanese medical claims data.

Background: Obesity is associated with an increased risk of complications after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA), particularly in Western populations. However, the effect of severe obesity (body mass index [BMI] ≥ 35 kg/m) on postoperative complications in Japanese patients remains unclear.

Methods: We conducted a retrospective cohort study using Japan's Diagnosis Procedure Combination (DPC) database, including patients who underwent TKA or UKA between April 2016 and March 2023.

Comparison of Cup Position and Perioperative Characteristics in Total Hip Arthroplasty Following Three Types of Pelvic Osteotomy.

: Total hip arthroplasty (THA) following pelvic osteotomy for developmental dysplasia of the hip (DDH) is technically challenging due to altered acetabular morphology. This study aimed to compare radiographic cup position and perioperative characteristics of THA after three common pelvic osteotomies-periacetabular osteotomy (PAO), shelf procedure, and Chiari osteotomy-with primary THA in Crowe type I DDH. A retrospective review identified 25 hips that underwent conversion THA after pelvic osteotomy (PAO = 12, shelf = 8, Chiari = 5) and 25 primary THAs without prior osteotomy.

Impact of ongoing glucocorticoid use on postoperative complications following Total knee arthroplasty: a Japanese Nationwide propensity score-matched cohort study.

Background: Glucocorticoid use poses perioperative concerns in orthopaedic surgery, but its impact on postoperative outcomes following total knee arthroplasty (TKA) remains unclear.

Methods: This retrospective cohort study utilized the Japanese Diagnosis Procedure Combination (DPC) database to examine postoperative complications in patients undergoing TKA between April 2016 and March 2023. Patients receiving continuous glucocorticoid therapy (≥5 mg/day prednisolone equivalent) were identified and matched 1:1 with non-glucocorticoid users using propensity score matching based on age, sex, body mass index, anaesthesia type, simultaneous bilateral surgery, and Charlson Comorbidity Index.

Increased Risks of Surgical Site Infection and In-Hospital Mortality Following Knee Arthroplasty in Dialysis Patients: Insights From a Japanese Nationwide Cohort.

Background: Dialysis patients often develop advanced knee osteoarthritis, necessitating knee arthroplasty. Although total knee arthroplasty is commonly performed, limited data exist on perioperative complications among Japanese dialysis patients. This study uses a Japanese nationwide medical claims database to investigate the incidence of perioperative complications and mortality in dialysis versus nondialysis patients undergoing knee arthroplasty.

High risk of postoperative complications in dialysis patients undergoing total hip arthroplasty: a database study of Japanese nationwide medical claims.

Dialysis patients who develop degenerative hip disease or femoral neck fractures may require total hip arthroplasty, and their comorbidities predispose them to complications. This study aimed to evaluate whether dialysis was associated with early postoperative complications using a large database of Japanese. In this cohort study, using the Japanese National Administrative Diagnosis Procedure Combination database on THA for patients on hemodialysis or not from December 2011 to March 2023, we assessed the surgical-related complications, medical complications, and mortality during hospitalization after propensity score matching by age, sex, BMI, and comorbidities.

Postoperative risks of type 2 diabetes in elderly hip fracture patients: a propensity score-matched study.

Introduction: Type 2 diabetes is associated with an increased risk of fragility fractures, even in individuals with normal or high bone mineral density. However, the impact of type 2 diabetes on postoperative outcomes after hip fracture surgery in elderly Japanese patients remains unclear. This study evaluated the association between type 2 diabetes and postoperative complications, including in-hospital mortality, using a nationwide database in Japan.

Increased complications of proximal femur fractures during the COVID-19 pandemic: a nationwide medical claims database study in Japan.

Introduction: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderly patients with proximal femur fractures during the COVID-19 pandemic or countermeasure periods.

Materials And Methods: The proximal femur fractures undergoing surgery during the COVID-19 pandemic or countermeasure period were compared with the pre-pandemic in a Japanese national inpatient data.

Increased risk of deep vein thrombosis and surgical site infection in cemented total knee arthroplasty: A nationwide propensity score-matched study in Japan.

Introduction: Total knee arthroplasty (TKA) is a widely used treatment for advanced knee osteoarthritis. While cemented fixation is the standard technique, cementless fixation has demonstrated comparable long-term outcomes. However, the association between cement use and postoperative complications, including venous thromboembolism and surgical site infections, remains unclear, particularly in Japanese patients.

Effectiveness of Stress Shielding Prevention Using a Low Young's Modulus Ti-33.6Nb-4Sn Stem: A 7-Year Follow-Up Study.

Background: Stress shielding (SS) after total hip arthroplasty (THA) leads to proximal femoral bone loss and increases the risk of complications such as implant loosening and periprosthetic fracture. While various low-stiffness stems have been developed to prevent SS, they often compromise mechanical stability. A novel femoral stem composed of Ti-33.

Biomechanical Comparison of Transverse Capsulotomy Versus Longitudinal Capsulotomy of the Hip: A Cadaveric Study.

Background: Biomechanical effect on hip joint stability between the transverse interportal capsulotomy and the longitudinal capsulotomy in arthroscopy has not been fully investigated.

Purpose: To evaluate whether rotational stability and distraction resistance differ between the 2 capsulotomy directions using fresh-frozen cadavers.

Study Design: Controlled laboratory study.

Thromboembolic and infectious complication risks in TKA and UKA: evidence from a Japanese nationwide cohort.

Introduction: Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are widely used to treat knee osteoarthritis. TKA significantly contributes to long-term pain relief and joint function improvement, while UKA offers faster recovery and reduced early complications. However, TKA and UKA complication risks, aside from conditions such as deep vein thrombosis, have not been thoroughly investigated.

Comparison of outcomes and cost-effectiveness of simultaneous and staged total hip arthroplasty using the anterolateral-supine approach.

Background: To date, no study has compared simultaneous bilateral total hip arthroplasty (simBTHA) with staged BTHA (stgBTHA) using the anterolateral-supine approach (ALSA). This study compared the outcomes and cost-effectiveness of simBTHA and stgBTHA using ALSA.

Methods: This retrospective cohort study was conducted on patients who required bilateral ALSA THA at the time of their initial medical evaluation between August 2015 and January 2023.

Increased Periprosthetic Joint Infection Rate Following Total Knee Arthroplasty in Rheumatoid Arthritis Patients: Insights From a Japanese Nationwide Medical Claims Database Study.

Introduction: Advances in pharmacological treatments have reduced joint deformities in rheumatoid arthritis (RA), leading to a decline in total knee arthroplasty (TKA) among RA patients. However, RA remains associated with higher risks of postoperative complications. This study compares postoperative complications during hospitalization in patients with RA and osteoarthritis (OA) undergoing TKA in Japan.

Increased early complication rates following total hip arthroplasty in rheumatoid arthritis patients based on a Japanese nationwide medical claims database study.

Although the rate of total hip arthroplasty (THA) is declining among rheumatoid arthritis (RA) patients, the complex etiology of RA and associated immunomodulatory therapies may contribute to elevated risks of postoperative complications. This study aimed to evaluate in-hospital complications following THA in RA patients compared to osteoarthritis (OA) patients using a Japanese nationwide database. This retrospective study analyzed data from the Diagnosis Procedure Combination database, including THA patients between December 2011 and March 2023.

Preoperative Osteoporosis Treatment Reduces Stress Shielding in Total Hip Arthroplasty.

Total hip arthroplasty (THA) is a widely used surgical intervention for hip osteoarthritis (HOA), with a rising demand driven by an aging population. Osteoporosis is associated with increased risks of bone loss and implant loosening after THA. While medications such as bisphosphonates and denosumab have shown promise in mitigating these risks, the impact of preoperative osteoporosis treatment on postoperative outcomes remains unclear.

Does Osteonecrosis of the Femoral Head Increase Early Complication Rates After Total Hip Arthroplasty? A Japanese Nationwide Medical Claims Database Study.

Background: Osteonecrosis of the femoral head (ONFH) and osteoarthritis (OA) are two common diagnoses for patients undergoing total hip arthroplasty (THA). The early surgical complications in THA for ONFH compared to OA are inconsistently reported. Therefore, this study aimed to evaluate whether THA for ONFH was associated with early postoperative complications in comparison to THA for OA using a large database of Japanese patients.

TiNbSn alloy plates with low Young's modulus modulates interfragmentary movement and promote osteosynthesis in rat femur.

Orthopedic implants such as arthroplasty prostheses, fracture plates, and intramedullary nails often use materials like Ti6Al4V alloy and commercially pure titanium (CP-Ti), which have Young's modulus significantly higher than that of human cortical bone, potentially causing stress shielding and inhibiting effective fracture healing. TiNbSn alloy, a β-type titanium alloy with a lower Young's modulus (40-49 GPa), has shown promise in reducing stress shielding and enhancing bone healing by promoting effective load sharing with bone. This study used 5-hole plates made from TiNbSn alloy and CP-Ti to investigate their effects on bone healing in a rat femoral fracture model.

Total Knee Arthroplasty in Patients With Ankle Osteoarthritis Affects Contralateral Ankle Alignment and Postoperative Outcome of Total Knee Arthroplasty.

Background: This study investigated the impact of total knee arthroplasty (TKA) on the alignment of the ankle joint, focusing on changes in coronal alignment of both ankles.

Methods: This retrospective study, conducted at our hospital, included 64 patients older than 70 years who underwent TKA for varus knee osteoarthritis (OA). Using full-length standing radiographs of both lower extremities taken preoperatively and 6 months postoperatively, we assessed ankle OA grading based on the Takakura-Tanaka classification and measured mechanical hip-knee-ankle (mHKA) and the tibiotalar angle (TTA) on both the surgical and contralateral side.

Surgery within Two Days of Admission Reduces Complications and Mortality of Patients with Trochanteric Femur Fractures: A Japanese DPC Study.

An early surgery for older adult patients with hip fractures is recommended to avoid perioperative complications in existing clinical guidelines. Few studies have analyzed only transtrochanteric fractures. The purpose of this study was to assess whether surgery within two days of admission reduces the incidence of pneumonia, deep vein thrombosis, pulmonary embolism, pressure ulcers, and mortality during hospitalization in patients with older adult transtrochanteric femur fractures.

Surgery on admission and following day reduces hip fracture complications: a Japanese DPC study.

Introduction: The efficacy of early surgery in preventing complications among Japanese elderly patients with hip fractures requires further investigation. This study aims to use a comprehensive Japanese hip fracture case database to determine whether surgery within the day of admission and the following day reduces the incidence of complications and mortality during hospitalization in elderly hip fracture patients.

Materials And Methods: We retrospectively analyzed the Japanese National Administrative DPC (Diagnosis Procedure Combination) database from April 2016 to March 2022.