Improved Walking Steadiness Following total Hip Arthroplasty Compared to Total Knee Arthroplasty.

Background: Total knee (TKA) and hip arthroplasty (THA) effectively treat end-stage osteoarthritis by restoring mobility and reducing pain; however, it is unclear how balance and steadiness compare between TKA and THA patients. This study utilized wearable technology to objectively compare functional recovery between TKA and THA patients.

Methods: Two Hundred Nine patients underwent TKA (n = 152) or THA (n = 57) and were followed for 1 year.

Risk Factors for Postoperative Infection and Associated Outcomes After Pilon Fracture Fixation: A Propensity-Matched Cohort Study.

Background: Pilon fractures are complex, often involving severe comminution and soft tissue compromise. Risk factors for infection after ankle fracture definitive fixation have been associated with open and/or comminuted fractures and poorly managed diabetes. However, infection risk following pilon fractures have not been well studied, and the effect of infection on other postoperative outcomes have not been widely discussed.

Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury.

(1) Background: Pain experiences are shaped by both physical injury and psychological distress, posing challenges for orthopedic care. While surgery may alleviate injury-related distress, the extent of psychological improvement post surgery remains unclear. Thus, the purpose of this study was to evaluate changes in general and pain-specific psychological distress after surgical intervention for musculoskeletal injury.

Clinical Characteristics, Complications, and Implant Survivorship Following Revision Total Ankle Arthroplasty: A Large Single-Center Study.

Background: As total ankle arthroplasty (TAA) rises in popularity nationwide, the incidence of revision TAA continues to increase. This study evaluates patient demographics, surgical techniques, complications, and implant survivorship following revision TAA.

Methods: This was a single-center, retrospective review of revision TAAs performed between September 2007 and September 2022.

Surgical site soft tissue thickness as a predictor of complications following arthroplasty.

Appreciation of soft-tissue thickness (STT) at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes. Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty, particularly infections, across procedures such as total knee, hip, shoulder, and ankle replacements. Several studies have indicated that increased STT is associated with a higher risk of complications, including infection and wound healing issues.

Indications and outcomes of revision total ankle arthroplasty.

Introduction: Total ankle arthroplasty (TAA) has emerged as an alternative to ankle arthrodesis for managing end-stage ankle arthritis. However, the long-term survival of TAA remains inferior to that of hip and knee replacements, leading to a higher rate of revision TAA. Understanding the indications and outcomes of revision procedures is critical for orthopedic surgeons managing complex ankle pathology.

The Impact of Total Hip Arthroplasty on Daily Ambulatory Function: A Prospective Study.

Background: Total hip arthroplasty (THA) significantly improves pain and function in patients who have end-stage hip osteoarthritis. However, patient expectations regarding recovery and functional outcomes are often unclear. This study aimed to describe the trajectory of daily physical activity in the first year following primary THA, using wearable technology to collect objective data on gait speed, step count, standing duration, and estimated performance on the 6-minute walk test.

The Impact of Health Policy on Total Ankle Arthroplasty Prices in the United States.

Background: Total ankle arthroplasty (TAA) is increasingly used due to advancements in surgical technology leading to promising results. Although TAA may have a higher upfront complication rate, its long-term benefits, including lower rates of adjacent joint arthritis and subsequent surgeries, may enhance its cost-effectiveness relative to ankle arthrodesis. Notable regional variability in TAA prices exists, influenced in part by state-level political dynamics and healthcare regulations.

Bridge-Enhanced Anterior Cruciate Ligament Restoration: Surgical Technique.

Background: Anterior cruciate ligament (ACL) repair has historically had poor outcomes and fell out of favor in the 1980s with the majority of surgeons opting to do an ACL reconstruction instead due to the high failure rate. The Bridge-Enhanced ACL Restoration or BEAR technique utilizes a de-cellularized, bovine-derived, type I collagen implant to aid in the ACL repair. The device is implanted to augment the healing of the ACL.

Outcomes of Bilateral Scandinavian Total Ankle Replacement: A Detailed Analysis of Implant Survivability and Patient-Reported Outcomes.

Background: Total ankle replacement (TAR) is an established treatment for end-stage ankle arthritis, offering pain relief and improved functionality. The Scandinavian Total Ankle Replacement (STAR) was first used in the United States in 1998 and although unilateral STAR has been extensively studied, there is limited documentation on the outcomes of simultaneous bilateral STAR procedures. This study aimed to evaluate the survivability and patient-reported outcomes of simultaneous bilateral STAR, focusing on implant survival rates and improvements in quality of life, function, and pain relief.

Association between work-from-home policies and United States public interest in foot surgery conditions during the COVID-19 pandemic: A Google Trends analysis.

BackgroundThe COVID-19 pandemic, marked by significant lifestyle changes and healthcare-seeking behavior shifts, prompted the implementation of widespread Work from Home (WFH) policies.ObjectiveThis study aimed to explore the impact of the COVID-19 pandemic and WFH policies on public interest in foot surgery by using Google Trends searches as a proxy for public interest in the United States.MethodsA comprehensive dataset of foot-related orthopaedic terms was compiled using Google Trends data from March 2018 to March 2022 and captured weekly, representing over 200 observations.

Perioperative Bleeding Risk in Lung Transplantation After Previous Cardiothoracic Surgery.

Introduction: Previous cardiothoracic surgery (CTS) is associated with a significant risk of perioperative bleeding in lung transplantation (LT). The types of prior surgery have not been well-defined. We aimed to quantify the risk of perioperative bleeding in LT based on a history of previous CTS.

State Healthcare Regulations and Total Knee Arthroplasty Prices Across the United States.

Background: The cost of healthcare services in the United States is subject to various regulatory influences, yet the impact of state-level healthcare policies and political affiliations on total knee arthroplasty (TKA) prices remains underexplored.

Methods: Using data from the Turquoise Health Database and publicly available sources, TKA prices were analyzed across states to examine the influence of Medicaid expansion, Certificate of Need (CON) laws, and state partisan lean. Multivariable regression models controlled for Gross Domestic Product per capita, Area Deprivation Index, and urbanization.

State Health Care Regulations and Political Affiliation Associated With Total Hip Arthroplasty Prices Across the United States.

Background: Given that total hip arthroplasty (THA) is an elective procedure with rapidly increasing volumes (projected increase of 350% by 2050) and predictable costs, it is uniquely suited to serve as a proxy for assessing price transparency of hospital services. This study investigated the association between THA pricing and state characteristics, including political affiliation, Medicaid expansion status, certificate of need (CON) status, and gross domestic product per capita. North Carolina Area Deprivation Index (ADI) as well as urbanization are also considered.

Wearable health technology finds improvements in daily physical activity levels following total knee arthroplasty: A prospective study.

Purpose: Wearable technologies, like the Apple Watch, offer new possibilities for collecting objective data on physical activity post-operatively following total knee arthroplasty (TKA). This study aims to describe changes in daily physical activity levels using objective metrics over different time points following TKA.

Methods: This study analyzed data from a prospective cohort of 152 patients undergoing a unilateral TKA.

Patient characteristics, postoperative protocols, and surgical outcomes in Haglund's resection: a single-institution retrospective cohort study.

Background: Haglund's syndrome represents a triad of posterosuperior calcaneal bony enlargement, retrocalcaneal bursitis, and Achilles tendinopathy. This study aims to improve the understanding of patient demographics, inform surgical and perioperative decision-making, and identify complications surrounding Haglund's resection.

Methods: Data were collected retrospectively from patients who received surgical treatment for Haglund's syndrome across 6 surgeons at an academic institution from January 2015 to July 2023.

Comparing Functional Recovery Between Total and Unicompartmental Knee Arthroplasty: A Prospective Health Kit Study.

Background: Both total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) have demonstrated excellent clinical outcomes for end-stage osteoarthritis. Although UKA has been shown to have lower survivorship, many patients are interested in a partial knee arthroplasty due to the perception of "better" function and a "quicker" recovery. The purpose of this study was to objectively compare and understand functional recovery between TKA and UKA through the utilization of cutting-edge technological health metrics.

Complications and Early-Term Radiographic Analysis of a Novel Active Compression Tibiotalocalcaneal Arthrodesis Nail With a Proximal Flexible Coil.

Background: Tibiotalocalcaneal (TTC) arthrodesis is used among other methods as a salvage procedure for complex foot/ankle deformity. Fixation is usually achieved through plate/screw constructs or intramedullary (IM) nailing. Although IM nailing uses smaller incisions, fusion rates are variable and complications rates ranging from 25% to 55.

Fall Prevention after Hip and Knee Arthroplasty.

Despite the success of total knee arthroplasty and total hip arthroplasty, patients face an increased risk of postoperative falls, often due to surgery-induced changes in muscle strength. Falls can lead to serious consequences, including fractures and reduced quality of life. The majority of falls related to total joint arthroplasty occurs outside the hospital.

Short-term Adverse Events Following Ankle Arthroplasty and Ankle Arthrodesis: A Matched Analysis of Recent Nationally Representative Data.

BackgroundSurgical management of ankle osteoarthritis (AOA) includes Ankle Arthrodesis (AA) or Total Ankle Arthroplasty (TAA). The purpose of this study was to analyze data from the National Surgical Quality Improvement Project (NSQIP) to elucidate differences in outcomes between TAA and AA.MethodsPatients who underwent TAA or AA from January 2010 to December 2020 were included in this analysis.

SegmentAnyBone: A universal model that segments any bone at any location on MRI.

Magnetic Resonance Imaging (MRI) is pivotal in radiology, offering non-invasive and high-quality insights into the human body. Precise segmentation of the MRIs into different organs and tissues would be very beneficial as it would allow more accurate measurements, which are essential for accurate diagnosis and effective treatment planning. Specifically, segmenting bones in MRI would allow for more quantitative assessments of musculoskeletal conditions, while such assessments are largely absent in current radiological practice.

Weightbearing Protocols and Outcomes in Open Surgical Management of Haglund Syndrome: A Large Retrospective Analysis.

Background: Following insertional Achilles tendinopathy debridement and Haglund prominence resection for Haglund syndrome, patients undergo varying degrees of weightbearing limitation (weightbearing as tolerated [WBAT], partial weightbearing [PWB], touchdown weightbearing [TDWB], and nonweightbearing [NWB]). Given the scarcity of large-scale literature on the topic, the purpose of this study is to evaluate the impact of postoperative weightbearing protocols on outcomes after open surgical management of Haglund syndrome.

Methods: This was a retrospective cohort study of patients who underwent open surgical management for Haglund syndrome between January 2015 and December 2023 at a single academic institution by fellowship-trained foot and ankle surgeons.

Fitting the Knee to the Patient, Not the Other Way Around: A Three-Dimensional Analysis of Total Knee Arthroplasty Implant Fit.

Background: Despite the growing interest in alternative alignment strategies, advancement in surgical technique, and implant design, several studies have demonstrated that a large number of patients continue to be dissatisfied following total knee arthroplasty (TKA). The purpose of this study was to outline differences in three-dimensional (3D) knee morphology associated with sex and deformity of the arthritic knee and compare these to available off-the-shelf (OTS) and patient-specific implants.

Methods: A total of 85,604 preoperative computed tomography scans of patients undergoing TKA were analyzed.

Radiographic soft tissue thickness is not a risk factor for infection after primary total ankle arthroplasty.

As the incidence of total ankle arthroplasty (TAA) for the management of end-stage arthritis is on the rise, identification of risk factors for periprosthetic joint infection (PJI) is essential. There has been limited research exploring the use of radiographic soft tissue thickness in TAA despite its predictive value in other forms of arthroplasty. This study evaluated the predictive capabilities of radiographic soft-tissue thickness for PJI following TAA.

Complications Following Surgical Treatment of Haglund's Syndrome With and Without Flexor Hallucis Longus Tendon Transfer.

Background: In the surgical treatment of Haglund syndrome, combining a flexor hallucis longus (FHL) tendon transfer with Achilles tendon may improve plantarflexion strength and reduce strain on the repaired Achilles tendon. However, there is limited research comparing complication rates between surgical approaches with or without concurrent FHL tendon transfer.

Methods: This was retrospective study of patients who underwent surgical management for Haglund syndrome between January 2015 and December 2023.