Key factors for successful 24-h discharge following Enhanced Recovery After Surgery protocols in total knee arthroplasty.

Introduction: Total knee arthroplasty (TKA) remains the gold standard treatment for end-stage knee osteoarthritis. With rising TKA numbers, effective resource management, such as reducing length of stay, is crucial. While prior studies have focused on patient characteristics, this study aimed to investigate the influence of demographics and pre- and immediate postoperative patient-reported outcome measures (PROMs) on successful 24-h discharge using Enhanced Recovery After Surgery (ERAS) protocols.

Successful 24-hour discharge for total knee arthroplasty: importance of timing of surgery and physiotherapy in enhanced recovery after surgery protocol.

Introduction: The current literature is mixed on which patient factors, if any, predict the rate of successful discharge within 24 h of enhanced recovery after surgery (ERAS) total knee arthroplasty (TKA). This study aimed to investigate the influence of timing of surgery and physiotherapy on the rate of successful 24-h discharge.

Methods: All 342 patients who underwent ERAS day surgery TKA from August 2020 to July 2021 were followed up prospectively.

Enhanced recovery after surgery day surgery for MAKO® robotic-arm assisted TKA; better outcome for patients, improved efficiency for hospitals.

Introduction: Robotic-assisted Total Knee Arthroplasty (TKA) was designed to improve implant position accuracy by providing surgeons with real-time intra-operative data to tailor the operation to the patient. Proponents of robotic-assisted TKA believe that this translates into meaningful improvements in outcomes. However, there are concerns that the longer surgical duration associated with robotic-assisted TKA leads to longer length of stay (LOS).

Postponement of total knee arthroplasties due to pandemic causes significant deterioration on patients' preoperative knee and quality of life scores.

Introduction: Elective surgeries were postponed during the COVID-19 pandemic to alleviate healthcare strains, affecting majority of elective orthopaedic surgeries such as total knee arthroplasties (TKAs). The aim of this study is to evaluate the impact on knee function and quality of life of patients who had their planned TKA postponed due to the pandemic.

Methods: This is a retrospective analysis of data collected in a tertiary hospital.

Gap patterns and radiographic follow-up of newer-generation cementless total knee arthroplasty designs.

Background: Interest in cementless total knee arthroplasty (TKA) has increased with advancement of biomaterials and implant design and associated improved longevity. We sought to evaluate the gap patterns and radiolucent zones radiographically for 2 newer-generation cementless TKA designs.

Methods: We retrospectively reviewed our single-institution database between January 2017 and December 2019.

Minimum 5-Year Clinical Outcomes and Survivorship for a Single Revision Total Knee Arthroplasty System Using Hybrid Fixation and Press-Fit Stems.

Background: Hybrid fixation, utilizing diaphyseal press-fit stems and cement fixation in the tibial and femoral metaphyseal areas, has long been a strategy for revision total knee arthroplasty (rTKA). The purpose of this study was to evaluate the clinical outcomes and survivorships of hybrid fixation using a single rTKA revision system with a minimum of 5 years follow-up.

Methods: We reviewed our prospectively collected database to identify 281 patients who underwent rTKA using a single revision system with hybrid fixation and press-fit stems between July 2006 and August 2016.

No Difference in Subsidence Between Modern Monoblock and Modular Titanium Fluted Tapered Femoral Stems.

Background: Subsidence remains a concern when utilizing tapered fluted titanium (TFT) femoral stems and may lead to leg length discrepancy, impingement, instability, and failure to obtain osseointegration. This study aims to compare stem subsidence across 3 modern TFT stems. Our secondary aim was to investigate the influence of bicortical contact or "scratch fit" on subsidence, as well as the role of intraoperative imaging in maximizing bicortical contact and preventing stem subsidence.

Adductor Canal Block Does not Confer Better Immediate Postoperative Pain Relief after Total Knee Arthroplasty.

The adductor canal block (ACB) is a useful adjunct to control postoperative pain in total knee arthroplasty (TKA). The aim of our study was to compare postoperative day 1 (POD1) pain scores, ambulation distance, range of motion, active straight leg raise (SLR), and length of stay (LOS) in TKA patients receiving no ACB (NACB), ACB by surgeon (ACBS), or ACB by anesthetist (ACBA). After obtaining institutional ethics approval, a retrospective review of 135 patients who underwent TKA between September 2020 and March 2021 was performed.

Improving Acetabular Component Positioning in Supine Direct Anterior Total Hip Arthroplasty with a Transparency Template: A Novel, Simple, and Cost-effective Technique.

Purpose: A novel and simple method to ensure accurate acetabular component anteversion and inclination intraoperatively with the use of a transparency template is described.

Materials And Methods: Patients who underwent total hip arthroplasty (THA) via direct anterior approach (DAA) from June 2019 to January 2020 were included. A transparency template that can be placed over the image intensifier monitor to allow surgeons an accurate reading of the acetabular component position intraoperatively was designed, developed and utilized to determine effectiveness.

Clinical outcomes and patient satisfaction following revision of failed unicompartmental knee arthroplasty to total knee arthroplasty are as good as a primary total knee arthroplasty.

Background: With unicompartmental knee arthroplasty (UKA) being increasingly performed for medial compartment osteoarthritis (OA) of the knee, revision total knee arthroplasty (TKA) for failed UKA is expected to increase. Our primary aim is to evaluate patients in our tertiary institution who underwent revision of failed UKA to TKA to compare their pre-operative clinical scores (patient-reported outcome measures, PROMs) to those of primary TKA.

Methods: Retrospective review of our institutional arthroplasty registry between 2001 and 2014 was performed.

Sacral chordoma: clinical experience of a series of 11 patients over 18 years.

Sacral chordoma are rare low-to-intermediate grade malignant tumours that occur most commonly within the sacrum. Sacrectomy with wide resection margins seems to offer the best long-term prognosis.  This study aims to review the management of sacral chordomas including the duration of symptoms, features, treatment, complications and local recurrence rate following surgery at a tertiary centre.

Preoperative Leg Pain Score Predicts Patient Satisfaction After Transforaminal Lumbar Interbody Fusion Surgery.

Study Design: Retrospective cohort study.

Objectives: This study aims to determine the preoperative predictors of postoperative satisfaction in transforaminal lumbar interbody fusion (TLIF) surgery in order to improve management of patient groups at high risk of dissatisfaction. We retrospectively reviewed prospectively collected data on patients who underwent open TLIF in a tertiary hospital between 2008 and 2012 with 2-year follow-up and performed multivariate analysis for their preoperative variables.

Intra-articular Loose Body with Concomitant Bankart Lesion after a Traumatic Shoulder Dislocation: A Case Report.

Introduction: The spectrum of pathoanatomic lesions encountered in anterior shoulder dislocation is broad. There could be a presence of loose bodies, chondral and osteochondral, in the shoulder joint and also concomitant rotator cuff partial tears resulting from acute and chronic shoulder instability.

Case Report: We present one case report of a 46-year-old male Chinese with an uncommon case of Bankart lesion, with a full thickness chondral defect over the superior glenoid articular surface manifesting as a large intra-articular loose cartilaginous body.

What Are the Preoperative Outcome Measures That Predispose to Periprosthetic Fractures After Primary Total Knee Arthroplasty?

Background: There is little known in the literature about whether preoperative patient-reported outcome measures (PROMs) would affect the risk of periprosthetic fractures (PPFs) after primary total knee arthroplasty (TKA). Our study aims to evaluate the predictive values of PROMs on PPF after primary TKA. We hypothesize that poorer PROMs are associated with a higher risk of PPF after primary TKA.

Is clinical evaluation alone sufficient for the diagnosis of a Bankart lesion without the use of magnetic resonance imaging?

Background: Imaging modalities such as magnetic resonance arthrogram (MRA) offer great utility in diagnosing Bankart lesions but they are associated with a high degree of intra and interobserver variability. This study aims to evaluate the diagnostic accuracy of clinical evaluation and imaging modalities in Bankart lesions such as magnetic resonance imaging (MRI) and MRA of the shoulder.

Methods: Between February 2004 to January 2015, a retrospectively review of the surgical records at a tertiary hospital identified a total of 250 patients treated with a shoulder arthroscopy for Bankart repair.

History of previous knee surgery does not affect the clinical outcomes of primary total knee arthroplasty in an Asian population.

Background: Patients with a history of previous knee surgeries, such as anterior cruciate ligament reconstruction (ACLR) and high tibial osteotomy (HTO), often have a higher likelihood of requiring a subsequent total knee arthroplasty (TKA). However, there is relatively limited data, especially in the Asian population, on how previous knee surgery could affect the clinical outcomes of TKA. Therefore, this study aims to evaluate the impact of previous knee surgeries on the clinical outcomes of future TKA.

Are patients more satisfied and have better functional outcome after bilateral total knee arthroplasty as compared to total hip arthroplasty and unilateral total knee arthroplasty surgery? A two-year follow-up study.

This study aims to review the quality of life and physical improvement achieved by total joint arthroplasty surgery, namely unilateral TKA, bilateral TKA and THA. We hypothesize that patients who undergo bilateral TKA should have greater improvement in patient-reported outcome measures, as compared to patients who had unilateral TKA, and their outcomes may be comparable to that of THA. We analyzed prospectively collected data of all patients who underwent unilateral TKA, bilateral TKA and THA (5291, 187 and 529 patients respectively) for end-stage osteoarthritis at a tertiary hospital during the 5-year period.

Gender difference in outcome after total knee replacement.

Purpose: To compare the outcome after primary total knee replacement (TKR) for end-stage knee osteoarthritis (OA) in men versus women.

Methods: Records of 214 men and 1040 women who underwent primary TKR for end-stage knee OA and were followed up for a minimum of 2 years were reviewed. Knee flexion, Oxford Knee Score, Knee Society Score (KSS), and 8 subscores of Short Form 36 (SF-36) were recorded preoperatively and at postoperative 6 months and 2 years.

Gender-specific total knee arthroplasty in Singaporean women.

Purpose: To compare the outcome of 145 women who underwent conventional total knee arthroplasty (TKA) with 77 women who underwent gender-specific TKA.

Methods: Records of 222 women who underwent primary TKA using a conventional (n=145) or gender-specific (n=77) size E or F prosthesis for end-stage osteoarthritis were reviewed. The gender-specific prosthesis has a narrower mediolateral dimension.

Comparison of patient quality of life scores and satisfaction after common orthopedic surgical interventions.

Patient quality of life scores are commonly used to assess patient-reported satisfaction following orthopedic interventions. Our main aim was to review the satisfaction scores of four common orthopedic interventions in our tertiary institution, primary hallux valgus (HV) corrective surgery, primary single-level transforaminal lumbar interbody fusion (TLIF), primary unilateral total knee arthroplasty (TKA) and primary total hip arthroplasty (THA). We retrospectively reviewed prospectively collected data on patients who underwent four different types of orthopedic surgeries using the SF-36 score and two questions adopted from North American Spine Society Questionnaire.

Primary osteosarcoma of the spine: a review of 10 cases.

The authors describe 10 cases of osteosarcoma of the spine treated between January 1951 and December 2010, and obtained from the Tumour Registry of their hospital. The mean age at presentation was 38.8 years (range: 16-73 years); the mean duration of symptoms was 5.

A positive hip arthrogram may predict lower function in patients with primary hip arthroplasty.

Background: A local anesthetic hip arthrogram is a simple test mainly used as an adjunct to define the origin of hip pain. Temporary pain relief (a positive response) following an injection may lead to a surgeon recommending hip surgery. However, it is unclear whether relief of pain corresponds to better postoperative pain relief or function.

Aneurysmal bone cysts of the vertebrae.

Purpose: To review records of 14 patients with aneurysmal bone cysts (ABCs) of the spine.

Methods: Using the Scottish Bone Tumour Registry for the period of October 1952 to November 2005, records of 9 females and 5 males aged 8 to 63 (mean, 25.3) years who had ABCs of the spine and were followed up for a mean of 7.