Comparing Facility Costs, Patient-Reported Outcome Measures, and Revision Rates in Cementless and Cemented Primary Total Knee Arthroplasty: Findings From a Propensity Score-Matched Patient-Level Value Analysis of 380 Procedures With a Mean 4.3-Year Follow-Up.

Background: Health care value accounts for clinical outcomes and cost. A methodology for more accurate cost accounting is time-driven activity-based costing. No prior study has evaluated the value of cementless total knee arthroplasty (TKA) using time-driven activity-based costing.

Venous Thromboembolism Prophylaxis After Revision Hip Arthroplasty: A Multicenter Analysis of Anticoagulant Choice and Weight-Bearing Status.

Background: Aspirin (ASA) is a reliable prophylactic agent for venous thromboembolism (VTE) in revision total hip arthroplasty (THA). While several studies have compared ASA to other anticoagulants, to our knowledge, none have evaluated its effectiveness in patients who have restricted weight-bearing status (WBS). Limited mobilization after surgery increases the risk of VTE complications.

Patients Undergoing Multilevel Thoracolumbar Fusions With Prior Total Hip Arthroplasty Are at Higher Risk for Prosthetic Dislocations.

Background: As the number of patients undergoing both total hip arthroplasty (THA) and lumbar spinal fusion rises, clinicians must gain a stronger understanding of the biomechanical and clinical associations between these two procedures. This study compared single versus multilevel spinal fusion on spinopelvic parameters, clinical outcomes, and THA dislocation rates in patients with existing THAs.

Methods: Patients with an existing THA undergoing elective spinal fusion were retrospectively identified at a single academic center.

Does the Use of Tranexamic Acid in Patients Who Have Preoperative Coagulopathy Undergoing Total Joint Arthroplasty Normalize Their Risk of Complications? A Matched Equivalence Analysis.

Background: While patients who have a preoperative coagulopathy have an increased risk of perioperative blood loss, tranexamic acid (TXA) has been shown to decrease the risk of complications in this subset. However, a direct comparison of the use of TXA in coagulopathic and noncoagulopathic patients has not been performed. In addition to comparing differences in decreases in hemoglobin, transfusions, and complications, this study examined whether the use of TXA in coagulopathic patients normalized the risk of blood loss relative to matched noncoagulopathic patients.

Routine Use of Closed Suction Drains Following Revision Arthroplasty May Not be Necessary.

Background: There are numerous studies demonstrating that closed suction drainage (CSD) usage after primary total joint arthroplasty (TJA) has little to no benefit. There are little data on the role of CSDs after revision TJA. The purpose of our study was to evaluate whether there is any clinical advantage to CSD usage after revision TJA.

Activity Measure for Post-acute Care Mobility Scoring System: Comparison of Nursing and Physical Therapy Evaluation for Primary Hip and Knee Arthroplasty Patients.

Background: Optimizing resource utilization after total joint arthroplasty (TJA) has become increasingly vital. The Activity Measure for Post-acute Care (AM-PAC) "6-clicks" scoring system is a validated, physical therapist (PT)-administered metric of patient basic mobility and predicts discharge disposition. This study aimed to determine whether the use of AM-PAC scoring by nurses in the postoperative period could (1) substitute for AM-PAC scoring by therapists and (2) predict 90-day outcomes in TJA patients.

The Ability of Robot-Assisted Total Knee Arthroplasty in Matching the Efficiency of Its Conventional Counterpart at an Orthopaedic Specialty Hospital.

Background: Robot-assisted total knee arthroplasty (RA-TKA) has become a popular technology. Studies have investigated the learning curve for surgeons incorporating RA-TKA into practice, but less is known regarding the change in operative efficiency when introducing RA-TKA into a facility. The purpose of this study was to investigate the effects of RA-TKA on operative and turnover time at an orthopaedic specialty hospital.

Intermediate-Term Survivorship of Metaphyseal Cones and Sleeves in Revision Total Knee Arthroplasty.

Background: Both cones or sleeves have been developed to address metaphyseal bone loss in revision total knee arthroplasty (TKA), but few studies have directly compared the outcomes. The purpose of this study was to compare the survivorship and aseptic revision rates between metaphyseal cones and sleeves at intermediate follow-up.

Methods: We reviewed a consecutive series of 1,172 revision TKA patients between 2009 and 2018 with a minimum two-year follow-up on all patients.

Myelin breakdown mediates age-related slowing in cognitive processing speed in healthy elderly men.

Background: To assess the hypothesis that in a sample of very healthy elderly men selected to minimize risk for Alzheimer's disease (AD) and cerebrovascular disease, myelin breakdown in late-myelinating regions mediates age-related slowing in cognitive processing speed (CPS).

Materials And Methods: The prefrontal lobe white matter and the genu of the corpus callosum myelinate later in brain development (late-myelinating white matter; LMWM) and are more vulnerable to breakdown due to the effects of normal aging. An in vivo MRI biomarker of myelin integrity (transverse relaxation rates; R(2)) of LMWM was obtained for 38 very healthy elderly adult men (mean age=66.