A Missed Opportunity? Osteoporosis Treatment Following Femoral Neck Fractures: Reducing the Risk of Secondary Hip Fracture.

Background: Hip fractures represent devastating injuries with extensive morbidity and mortality. Despite guidelines recommending osteoporosis pharmacotherapy after hip fracture, treatment rates remain low. This study sought to determine the effect of osteoporosis pharmacotherapy on the secondary hip fracture rate in patients undergoing operative treatment for femoral neck fracture (FNFx).

Does Approach Matter? Direct Anterior versus Posterior Approach in Conversion Total Hip Arthroplasty.

Background: Conversion total hip arthroplasty (THA) after prior hip surgery is generally associated with higher rates of complications when compared to primary THA. There is a paucity of evidence examining the influence of surgical approach on outcomes of conversion THA. This study compares complication rates between direct anterior approach (DAA) and posterior approach (PA) in patients with prior hip or acetabular fracture fixation undergoing conversion THA.

Chronic Anticoagulation is Associated With Significantly Increased Rates of Medical Complications, Periprosthetic Joint Infection, and Revision After Primary Total Knee Arthroplasty.

Background: The proportion of patients undergoing total knee arthroplasty (TKA) who are on chronic anticoagulation (CA) is increasing. As existing literature is limited, the purpose of this study was to compare complication rates after primary TKA among patients who were vs were not on CA.

Methods: This is a retrospective cohort study using the IBM MarketScan databases.

Extended Oral Antibiotic Prophylaxis and Periprosthetic Joint Infection-Free Survivorship After Primary Total Hip Arthroplasty.

Background: Several studies have presented findings in favor of using extended oral antibiotic (EOA) prophylaxis to reduce periprosthetic joint infection (PJI) after primary total hip arthroplasty (THA) in patients at high risk for infection. To date, there is a paucity of evidence examining this topic from large retrospective databases. This study explored 90-day complication rates and 2-year PJI-free survivorship in a large cohort of patients receiving EOA prophylaxis after primary THA.

Primarily Constraining Custom Triflange Patients: Weighing the Risks of Instability Versus Fixation?

Background: Custom triflange acetabular components (CTACs) can be used to manage patients with severe acetabular bone loss. However, instability remains one of the primary reasons for reoperation and revision for these patients. Primarily constraining these patients is an attractive option to minimize the risk of instability, but theoretically puts more stress on the implant fixation and leads to subsequent failure.

Extended oral antibiotic prophylaxis and PJI-free survivorship after primary total knee arthroplasty.

Introduction: Recent evidence has emerged supporting the use of extended oral antibiotic (EOA) prophylaxis after primary total knee replacement (TKA) to reduce periprosthetic joint infection (PJI) in high-risk patients. However, much of the evidence stems from single-institution series with limited sample sizes. This study aimed to explore the impact of EOA on complications and infection-free survivorship in a large cohort of patients after primary TKA.

The AAHKS Surgical Techniques and Technologies Award: Synovial Fluid Metal Ion Levels as a Biomarker for Aseptic Loosening Following Cemented Total Knee Arthroplasty: A Prospective Study.

Background: Implant loosening following primary total knee arthroplasty (TKA) remains the most common aseptic indication for revision. Aseptic loosening can be difficult to diagnose, as radiographic findings may be absent or difficult to detect or interpret. Commercially available bone cement contains either barium or zirconium to allow for radiographic detection.

The subjective hip value: a retrospective validation study in primary total hip arthroplasty.

Background: The hip dysfunction and osteoarthritis outcome score for joint replacement (HOOS JR) has been widely used to assess patient hip function. The subjective hip value (SHV) has become increasingly recognized as an efficient single-question survey for assessing hip joint function. This study aimed to determine the psychometric properties of the SHV in evaluating hip function in patients undergoing total hip arthroplasty (THA) in correlation with the traditional HOOS JR.

A randomized controlled trial to assess the effectiveness of a mobile application-based lifestyle change program (FASTer Way) on body composition, biochemical and hematological health markers, body image, and self-esteem in overweight women.

Background: Numerous mobile phone applications have been developed with the goal of producing behavior changes that lead to weight loss and enhanced health. However, the evidence basis for these applications is often lacking, which renders them ineffective for altering health behaviors. Therefore, the purpose of this study was to examine the potential benefits of a novel mobile application, The FASTer Way to Fat Loss (FW).

Administration of a Methylprednisolone Taper and Complication Rates Following Total Knee Arthroplasty: A Multicenter Retrospective Study.

Background: Most patients undergoing total knee arthroplasty (TKA) report moderate to severe pain in the acute postoperative period. Recent preliminary data have suggested that a short course of oral corticosteroid may improve early postoperative pain after various orthopedic operations, but the safety of this practice has not been rigorously evaluated in larger patient populations. The purpose of this study was to evaluate complication rates in patients receiving a methylprednisolone taper (MT) vs controls after primary TKA.

Characterizing the Cost Trends of Readmissions After Aseptic Revision Total Knee Arthroplasty.

Background: A rise in total knee arthroplasty (TKA) volume has led to an increased incidence of aseptic revision TKA (rTKA), resulting in major associated health care costs. This study evaluated the economic impact and clinical factors associated with readmission following aseptic rTKA, aiming to identify key drivers of cost and risk factors for readmission.

Methods: This retrospective analysis used data from a large national database from January 1, 2009, to June 30, 2022.

Glucagon-Like Peptide-1 Receptor Agonist Use is Not Associated With Increased Complications After Total Knee Arthroplasty in Patients With Type-2 Diabetes.

Background: Glucagon-like peptide-1 (GLP-1) agonists have emerged as a powerful diabetic treatment adjunct; however, its effects on outcomes following total knee arthroplasty (TKA) are not well known. The purpose of this study was to compare the risk of complications after TKA in patients with type-2 diabetes who were on GLP-1 agonists with those who were not.

Methods: In total, 34,696 type 2 diabetes patients undergoing primary TKA between 2016 and 2021 were retrospectively reviewed utilizing a large national database.

Coronal Malalignment Is Infrequently Present in Patients With Aseptic Tibial Loosening.

Background: Coronal lower extremity malalignment and improper implant position have been described as risk factors for aseptic tibial loosening following primary total knee arthroplasty (TKA). However, several prior studies have shown no association between alignment and implant loosening. Meanwhile, there is increasing interest in kinematic alignment.

Pain Management in Total Hip and Knee Arthroplasty: Evidence-Based and Controversial Practices in 2024.

Multimodal analgesia and anesthesia have become the gold standard in total joint arthroplasty to reduce postoperative pain and opioid consumption and minimize complications associated with opioid use. There are several elements in an effective multimodal protocol, including oral medications, periarticular injection, regional nerve blocks, and spinal and general anesthesia. Many nonopioid medications are often used, such as acetaminophen and NSAIDs.

Double-Butter: A Cementation Technique That Significantly Reduces Lipid Contamination of the Tibial Baseplate in Total Knee Arthroplasty.

Background: Aseptic loosening is the most common aseptic failure modality following total knee arthroplasty. Recent literature suggests that the implant-cement interface is the "weak-link" in fixation and lipid contamination may drive this debonding pattern. Therefore, the purpose of this study was to determine if the "double-butter" technique would significantly decrease lipid contamination of the tibial tray.

Outcomes Following Direct Anterior Approach Total Hip Arthroplasty: A Contemporary Multicenter Study.

Background: The direct anterior approach (DAA) is a popular approach for primary total hip arthroplasty (THA). However, the contemporary outcomes for DAA THA need further elucidation. Therefore, we aimed to describe implant survivorship, complications, and clinical outcomes after DAA THA.

Outpatient Total Joint Arthroplasty at an Ambulatory Surgical Center: An Analysis of Failure to Launch.

Background: There has been a tremendous increase in same-day discharge (SDD) following primary total joint arthroplasty (TJA). Although the concept of failure to launch (FTL) has been recently investigated in hospital settings, there is a paucity of data in the ambulatory surgical center (ASC) context. This study aimed to examine the incidence and underlying causes of FTL within an ASC at a major academic medical center.

Rates of Extended Oral Antibiotic Prophylaxis After Primary Total Knee Arthroplasty Among High-Risk and Standard-Risk Patients: 2009 to 2022.

Background: Recent evidence suggests extended courses of oral antibiotics (EOA) after total hip arthroplasty and total knee arthroplasty (TKA) may reduce the risk of periprosthetic joint infection in high-risk patients. EOA rates after total hip arthroplasty have risen significantly. However, there is a lack of epidemiologic data on EOA prophylaxis following TKA.

Glucagon-Like Peptide-1 Receptor Agonist Use Is Not Associated With Increased Complications After Total Hip Arthroplasty in Patients Who Have Type 2 Diabetes.

Background: Glucagon-like peptide-1 (GLP-1) agonists have emerged as a powerful diabetic treatment adjunct; however, their effects on outcomes following total hip arthroplasty (THA) are not well known. This study aimed to compare the risk of complications in patients who had type 2 diabetes mellitus (DM) who were on GLP-1 agonists with those who were not on these medications.

Methods: In total, 14,065 patients who had type 2 DM undergoing primary THA between 2016 and 2021 were retrospectively reviewed using a national database.

Socioeconomic Indices Are Associated With Increased Resource Utilizations, but Not 90-Day Complications Following Total Hip and Knee Arthroplasty.

Background: Socioeconomic disadvantage has been associated with negative outcomes following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The area deprivation index (ADI) and distressed communities index (DCI) are composite rankings that score socioeconomic status (SES) using patients' home addresses. The purpose of this study was to examine the association of ADI and DCI with outcomes following THA and TKA while controlling for potential confounding covariates.

Not so Fast: Extended Oral Antibiotic Prophylaxis Does Not Reduce 90-Day Infection Rate Following Joint Arthroplasty.

Background: Periprosthetic joint infection (PJI) is a devastating complication following both total hip (THA) and knee (TKA) arthroplasty. Extended oral antibiotic (EOA) prophylaxis has been reported to reduce PJI following TJA in high-risk patients. The purpose of this study was to determine if EOA reduces PJI in all-comers and high-risk THA and TKA populations.

Cemented dual-mobility constructs in uncemented revision acetabular components.

Aims: Dislocation remains a leading cause of failure following revision total hip arthroplasty (THA). While dual-mobility (DM) bearings have been shown to mitigate this risk, options are limited when retaining or implanting an uncemented shell without modular DM options. In these circumstances, a monoblock DM cup, designed for cementing, can be cemented into an uncemented acetabular shell.

Can ChatGPT Answer Patient Questions Regarding Total Knee Arthroplasty?

The internet has introduced many resources frequently accessed by patients prior to orthopaedic visits. Recently, Chat Generative Pre-Trained Transformer, an artificial intelligence-based chat application, has become publicly and freely available. The interface uses deep learning technology to mimic human interaction and provide convincing answers to questions posed by users.