Leg-length discrepancy in revision total hip arthroplasty : computer-assisted navigation improves the discrepancy when compared with manual techniques.

Aims: Leg-length discrepancy (LLD) following total hip arthroplasty (THA) is a source of patient dissatisfaction and morbidity. The objectives of this study were to characterize LLD following revision THA (rTHA) and evaluate the difference in LLD between navigated and non-navigated rTHA.

Methods: This retrospective cohort study included 202 patients treated with rTHA performed between 2017 and 2021.

Closed-Incision Negative Pressure Wound Therapy Improves Outcomes in Obese Aseptic Revision Total Hip and Knee Arthroplasty.

Background: The burden of revision total joint arthroplasty (rTJA) is increasing. Revision procedures are associated with an increased risk of perioperative complications. Obese patients undergoing rTJA may have a higher risk of wound complications due to their soft-tissue envelope.

Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium.

The evaluation, classification, and treatment of significant bone loss after total knee arthroplasty (TKA) continue to be a complex and debated topic in revision TKA (rTKA). Despite the introduction of new evidence and innovative technologies aimed at addressing the approach and care of severe bone loss in rTKA, there is no single document that systematically incorporates these newer surgical approaches. Therefore, a comprehensive review of the treatment of severe bone loss in rTKA is necessary.

High Rates of Early Septic Failure, but Low Rates of Aseptic Loosening After Revision Total Knee Arthroplasty With Contemporary Rotating-Hinge Prostheses.

Background: The purpose of this study was to determine implant survivorship and functional outcomes for revision total knee arthroplasty (rTKA) with contemporary rotating-hinge knee implants.

Methods: A retrospective review identified 115 rTKAs using contemporary rotating-hinge implants from 2014 to 2018 for the treatment of instability (34, 30%), reimplantation after periprosthetic joint infection (PJI) (33, 29%), aseptic loosening (25, 22%), arthrofibrosis (14, 12%), periprosthetic fracture (4, 3%), osteolysis (4, 3%), and femoral component fracture (1, 1%). There were 70 women (61%), and the mean age was 67 years (range, 27 to 94).

A novel quantitative grading system for implant fixation in revision total knee arthroplasty.

Aims: Obtaining solid implant fixation is crucial in revision total knee arthroplasty (rTKA) to avoid aseptic loosening, a major reason for re-revision. This study aims to validate a novel grading system that quantifies implant fixation across three anatomical zones (epiphysis, metaphysis, diaphysis).

Methods: Based on pre-, intra-, and postoperative assessments, the novel grading system allocates a quantitative score (0, 0.

Tibial bone defect prediction based on preoperative artefact-reduced CT imaging is superior to standard radiograph assessment.

Purpose: The purpose of this study was to evaluate the accuracy of preoperative CT-based Anderson Orthopaedic Research Institute (AORI)-grading and to correlate Computed tomography (CT)-based volumetric defect measurements with intraoperative AORI findings.

Methods: 99 patients undergoing revision total knee arthroplasty (rTKA) with preoperative CT-images were identified in an institutional revision registry. CT-image segmentation with 3D-Slicer Software was used to create 3D tibial bone defects which were then graded according to the AORI-classification.

Which Combination is the Best? A Comparison of the Predictive Potential of Serum Biomarker Combinations to Diagnose Periprosthetic Joint Infection.

Background: Without a gold-standard test, recent periprosthetic joint infections (PJI) literature has explored the utility of combining serological results, with promising findings. However, previous studies evaluated fewer than 200 patients and often studied only 1 to 2 test combinations. The purpose of this study was to accumulate a large single-institution cohort of revision total joint arthroplasty (rTJA) patients to determine the diagnostic utility of combination serum biomarkers to identify PJI.

Subsidence of a Single-Taper Femoral Stem in Primary Total Hip Arthroplasty: Characterization, Associated Factors, and Sequelae.

Background: We characterized subsidence of an uncemented single-taper femoral stem in primary total hip arthroplasty (THA), determined factors associated with subsidence, and evaluated the impact of subsidence on outcome.

Methods: This retrospective study included 502 primary THAs performed using a single-taper stem in Dorr type-A and type-B femora between 2014 and 2018. Subsidence was measured based on distance from the greater trochanter to stem shoulder on calibrated X-rays.

Does Acetabular Bone Loss Severity Associate With Patient-Reported Outcome Measures and Reoperation Rate in Revision Total Hip Arthroplasty?

Background: Acetabular bone loss is a challenging clinical problem when performing revision total hip arthroplasty (rTHA). This study aimed to evaluate how acetabular bone loss severity influences (1) clinical outcomes and (2) patient-reported outcome measures (PROMs) in rTHA patients.

Methods: Patients who underwent rTHA with acetabular component revision from January 2016 to February 2022 were included.

Leg-Length Discrepancy Variability on Standard Anteroposterior Pelvis Radiographs: An Analysis Using Deep Learning Measurements.

Background: Leg-length discrepancy (LLD) is a critical factor in component selection and placement for total hip arthroplasty. However, LLD radiographic measurements are subject to variation based on the femoral/pelvic landmarks chosen. This study leveraged deep learning (DL) to automate LLD measurements on pelvis radiographs and compared LLD based on several anatomically distinct landmarks.

Relative Sagittal Alignment of the Medial and Lateral Articular Surfaces of the Tibial Plateau Using Radiographic Parameters: A Radiographic Cadaveric Study.

Objectives: To characterize anatomic slope (sagittal alignment) of medial and lateral articular surfaces of the tibial plateau using x-ray and computed tomography (CT).

Methods: Fluoroscopy was used to acquire "perfect" anteroposterior (AP) images of 8 cadaveric knees by tilting a C-arm through a 30-degree cranial/caudal arc in 0.5-degree increments.

Hardware complications and reoperations following precontoured plate fixation of the olecranon: a population-based study.

Background: Several fixation techniques have been described to treat acute olecranon fractures. Plate fixation is often used because of its superior mechanical properties. The reported rates of reoperation after olecranon plate fixation have been quite heterogeneous.

Surgical Technique: Abductor Reconstruction With Gluteus Maximus and Tensor Fascia Lata in Revision Total Hip Arthroplasty.

Background: Abductor deficiency in revision total hip arthroplasty (THA) is a common problem that can lead to pain, limping, and instability. Repair and reconstruction of the abductors is challenging, with a high rate of failure reported in the literature. The purpose of this study is to describe a simplified technique of abductor repair augmented with the transfer of gluteus maximus (Gmax) and the tensor fascia lata (TFL).

Proximal tibia fracture dislocations: Management and outcomes of a severe and under-recognized injury.

Introduction: Proximal tibia fracture dislocations (PTFDs) are a subset of plateau fractures with little in the literature since description by Hohl (1967) and classification by Moore (1981). We sought to evaluate reliability in diagnosis of fracture-dislocations by traumatologists and to compare their outcomes with bicondylar tibial plateau fractures (BTPFs).

Methods: This was a retrospective cohort study at 14 level 1 trauma centers throughout North America.

The effect of calcar femoral neck plating on vascularity of the femoral head and neck.

Aims: Surgical treatment of young femoral neck fractures often requires an open approach to achieve an anatomical reduction. The application of a calcar plate has recently been described to aid in femoral neck fracture reduction and to augment fixation. However, application of a plate may potentially compromise the regional vascularity of the femoral head and neck.

Surgical outcomes of dual-plate fixation for periprosthetic femur fractures around a stable hip arthroplasty stem.

Introduction: The incidence of periprosthetic femur fractures is increasing. Multiple treatment methods exist to treat fractures surrounding stable hip arthroplasty implants including locking plate fixation, cable fixation, allograft augmentation, and revision arthroplasty. No consensus regarding optimal treatment has been reached, and significant complications remain.

Analysis of a generic talar prosthetic with a biological talus: A cadaver study.

Treatment for talar avascular necrosis is challenging. This study evaluates the feasibility of a generic talar implant by cadaveric assessment. Ten cadaveric ankles were CT-scanned to determine talar implant size.

Articular Cartilage Repair with Mesenchymal Stem Cells After Chondrogenic Priming: A Pilot Study.

Bone marrow-derived mesenchymal stromal stem cells (BMSCs) are a promising cell source for treating articular cartilage defects. The objective of this study was to assess a protocol that involved autologous transplantation of BMSCs into full-thickness cartilage defects in sheep following isolation, expansion, and a short period (4 days) of chondrogenic priming. The impact of oxygen tension during preimplantation culture was investigated.

Porous Scaffold Seeding and Chondrogenic Differentiation of BMSC-seeded Scaffolds.

Bone marrow-derived mesenchymal stromal stem cells (BMSCs) are a promising cell source for treating articular cartilage defects (Bornes ., 2014). BMSCs can be seeded within porous biomaterial scaffolds that support three-dimensional cell organization, chondrogenic differentiation and extracellular matrix deposition for the creation of engineered cartilage.

Optimal Seeding Densities for In Vitro Chondrogenesis of Two- and Three-Dimensional-Isolated and -Expanded Bone Marrow-Derived Mesenchymal Stromal Stem Cells Within a Porous Collagen Scaffold.

Bone marrow-derived mesenchymal stromal stem cells (BMSCs) are a promising cell source for treating articular cartilage defects. The objective of this study was to assess the impact of cell seeding density within a collagen I scaffold on in vitro BMSC chondrogenesis following isolation and expansion in two-dimensional (2D) and three-dimensional (3D) environments. It was hypothesized that both expansion protocols would produce BMSCs capable of hyaline-like chondrogenesis with an optimal seeding density of 10 × 10(6) cells/cm(3).

Imaging methods for quantifying glenoid and Hill-Sachs bone loss in traumatic instability of the shoulder: a scoping review.

Background: Glenohumeral instability is a common problem following traumatic anterior shoulder dislocation. Two major risk factors of recurrent instability are glenoid and Hill-Sachs bone loss. Higher failure rates of arthroscopic Bankart repairs are associated with larger degrees of bone loss; therefore it is important to accurately and reliably quantify glenohumeral bone loss pre-operatively.

Hypoxic culture of bone marrow-derived mesenchymal stromal stem cells differentially enhances in vitro chondrogenesis within cell-seeded collagen and hyaluronic acid porous scaffolds.

Introduction: The quality of cartilaginous tissue derived from bone marrow mesenchymal stromal stem cell (BMSC) transplantation has been correlated with clinical outcome. Therefore, culture conditions capable of modulating tissue phenotype, such as oxygen tension and scaffold composition, are under investigation. The objective of this study was to assess the effect of hypoxia on in vitro BMSC chondrogenesis within clinically approved porous scaffolds composed of collagen and hyaluronic acid (HA).