Journal of Arthroplasty

BACKGROUND: To determine the association between socioeconomic status and patient-reported outcome measures in a Dutch cohort who have undergone total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: A retrospective national registry study of all patients who underwent primary THA or TKA between 2014-2020 in the Netherlands was performed. Linear mixed-effects regression models were used to assess the association between SES and PROMs for THA and TKA patients separately...

INTRODUCTION: Socioeconomic status (SES) has been demonstrated to be an important prognostic risk factor among patients undergoing total joint arthroplasty. We evaluated patients living near neighborhoods with higher socioeconomic risk undergoing total knee arthroplasty (TKA) and if they were associated with differences in: 1) medical complications; 2) emergency department (ED) utilizations; 3) readmissions; and 4) costs of care. METHODS: A query of a national database from 2010 to 2020 was performed for primary TKAs...

INTRODUCTION: As worldwide utilization of total knee arthroplasty (TKA) broadens, demographic trends can help make projections to inform access to care. This study aimed to assess the temporal trends in the socioeconomic and medical demographics of patients undergoing TKA. METHODS: A retrospective review of 15,848 patients who underwent primary, elective TKA at an urban, New York City-based, academic medical center between January 2013 and September 2022 was performed...

BACKGROUND: In patients undergoing total joint arthroplasty (TJA), the use of dexamethasone (DEX) may cause perioperative blood glucose (BG) disorders, leading to complications even in patients who do not have diabetes. We aimed to evaluate the effects of different DEX doses on perioperative BG levels. METHODS: A total of 135 patients who do not have diabetes were randomized into three groups: preoperative intravenous injection of normal saline (Group A, the placebo group), preoperative intravenous injection of 10 mg DEX (Group B), and preoperative intravenous injection of 20 mg DEX (Group C)...

BACKGROUND: The aim of this study was to present the clinical and radiologic results of primary total hip arthroplasty (THA) using the femoral shortening osteotomy technique described by Paavilainen in patients who have Crowe IV developmental dysplasia of the hip (DDH). METHODS: We retrospectively analyzed the results of primary THA using the Paavilainen technique in 335 hips. The mean follow-up was 10.2 years. The degree of limp, leg-length discrepancy, and patient satisfaction were assessed...

BACKGROUND: This study aimed to assess the association between the disease process of hip osteoarthritis and total hip arthroplasty (THA) outcomes; this is a critical issue, as rapid progression has been postulated to be responsible for patient dissatisfaction post-THA. METHODS: This retrospective case-control study included 255 patients who underwent THA and completed a mean follow-up duration of 42.1 months (range, 24.0 to 77.0). We classified patients into those who had (n = 26) and did not have (n = 229) rapidly progressive osteoarthritis of the hip (RPOA), defined as a narrowing rate of joint space ≥ 2 mm yearly or a ≥ 50% loss within 12 months, excluding any other cause of a destructive arthropathy...

BACKGROUND: The utilization of anterior-based approaches for total hip arthroplasty (THA) is increasing. Literature on the outcomes of revision THA (rTHA) through an anterior approach, however, is sparse. This study reports the survivorship and risk factors for re-revision in patients undergoing aseptic rTHA through an anterior approach. METHODS: This was a single-institution, retrospective cohort analysis of patients who underwent aseptic rTHA through an anterior approach (direct anterior [DA], anterior-based muscle sparing [ABMS]) from January 2017 to December 2021, regardless of the original surgical approach...

BACKGROUND: Robotic-arm assistance continues to gain popularity in total hip arthroplasty (THA) for its potential to improve component placement accuracy and patient outcomes. Nonetheless, there is limited data on the impact of robotic-assisted THA (RA-THA) on hospital length of stay (LOS) and discharge location. This study thus aimed to compare LOS, discharge location, and readmission rate for propensity-matched cohorts of RA-THA versus manual THA (M-THA). METHODS: A retrospective review of a multi-hospital database was performed to identify patients who underwent THA between January 2016 and December 2021 from surgeons who performed both RA-THA and M-THA at 77 geographically diverse hospitals...

INTRODUCTION: Patients often prefer one knee over the other following staged bilateral total knee arthroplasty (BTKA). Our study compared patient-reported outcomes scores (PROs) of each knee following BTKA and identified factors that may contribute to the identified discrepancies. METHODS: All patients who underwent staged BTKA between July 2014 and August 2022 were identified. The PROs were collected pre-operatively, at 2-weeks, 6-weeks, 1-year, and 2-years postoperatively...

INTRODUCTION: Wearable sensors and associated supporting technologies (i.e., patient applications) can provide both objective (joint position, step counts, etc.) and subjective data (i.e., pain scores and patient-reported outcome measures) to track a patient's episode of care. Establishing a subjective and objective baseline of a patient's experience may arguably be beneficial for multiple reasons, including setting recovery expectations for the patient and demonstrating the effectiveness or success of the intervention...

No abstract text is available yet for this article.

BACKGROUND: Agreement on success following surgical treatment for periprosthetic joint infection (PJI) is important for comparing the efficacy of different surgical approaches with varying consequences and outcomes and setting patient expectations. We compared success rates following two-stage exchange arthroplasty for knee PJI using two expert-consensus definitions of success. METHODS: Prospectively documented data for 57 knees treated by a single surgeon at an academic tertiary care center were retrospectively reviewed...

BACKGROUND: Tibial bone defects are commonly encountered in revision total knee arthroplasty (rTKA) and can be managed with metaphyseal cones or sleeves. Few studies have directly compared tibial cones and sleeves in rTKA, and none have limited this comparison to the most severe tibial defects. The purpose of this study was to evaluate and compare the outcomes of metaphyseal cones and sleeves for tibial reconstruction in rTKA with regards to implant fixation and clinical outcomes. METHODS: A retrospective review was conducted on patients undergoing rTKA in which metaphyseal cones or sleeves were utilized for addressing metaphyseal bone loss (34 cones and 18 sleeves)...

INTRODUCTION: Femoral neck fractures (FNF) in elderly patients are associated with major morbidity and mortality. The influence of postoperative discharge location on recovery and outcomes after arthroplasty for hip fractures is not well understood. METHODS: A multi-site retrospective cohort from nine academic centers identified patients who had FNF treated with hemiarthroplasty (HA) or total hip arthroplasty (THA) between 2010 and 2019. Patients who had diagnoses of dementia, stroke, age > 80 years, or high energy fracture were excluded...

INTRODUCTION: Arthrofibrosis is a debilitating postoperative complication, and a major cause of patient dissatisfaction following total knee arthroplasty (TKA). There is no consensus regarding the optimal treatment for stiffness after TKA. For cases not amenable to manipulation under anesthesia (MUA), one component or full revision are both suitable options. In a value-based healthcare era, maximizing cost-effectiveness with optimized clinical outcomes for patients remains the ultimate goal...

INTRODUCTION: Femur-first technique (FF) for mobile-bearing medial unicompartmental knee arthroplasty (UKA) has been described as an alternative to tibia first-technique (TF). The aim of this study was to compare the radiographic results in UKAs using FF or TF techniques and their influence on failure rates. MATERIALS AND METHODS: We retrospectively reviewed 288 UKAs with a minimum 2-year follow-up. There were 147 knees in the TF and 141 knees in the FF cohorts...

BACKGROUND: Lumbar spinal fusion (LSF) is a risk factor for dislocation following total hip arthroplasty (THA). The effect of the surgical approach on this association has not been investigated. This study examined the association between approach and dislocation following THA in patients who had prior LSF. METHODS: We retrospectively reviewed 16,223 primary elective THAs at our institution from June 2011 to September 2022. Patients who had LSF prior to THA were identified using International Classification of Diseases (ICD) codes...

INTRODUCTION: Systemic intravenous antimicrobials yield poor outcomes during the treatment of periprosthetic joint infection because systemic therapy is unable to obtain the minimum biofilm eradication concentration. Therefore, this study evaluated the safety of a novel method of optimized local delivery of intra-articular antibiotics (IAA) when compared to two-stage exchange arthroplasty. METHODS: This was a Phase II, multicenter, prospective randomized clinical trial of the safety of a seven-day two-stage exchange arthroplasty with IAA irrigation compared to a standard two-stage exchange...

BACKGROUND: The shift towards outpatient total knee arthroplasties (TKAs) has led to a demand for effective perioperative pain control methods. A surgeon-performed "low"-adductor canal block (ACB) technique, involving an intraoperative adductor canal block, is gaining popularity due to its efficiency and early pain control potential. This study examined the transition from traditional preoperative anesthesiologist-performed ultrasound-guided adductor canal blocks ("high-ACB") to low-ACB, evaluating pain control, morphine consumption, first physical therapy visit gait distance, hospital length-of-stay, and complications...

BACKGROUND: Periprosthetic Joint Infection (PJI) is a devastating complication in hip and knee joint arthroplasty. The "JS BACH" classification system was developed in 2021 to stratify the complexity of PJI, and more importantly, to act as a tool to guide referrals to specialist centers. The "JS BACH" classification has not been validated in an external cohort. This study aimed to do so using a large prospective cohort from Australia and New Zealand. METHODS: We applied the JS-BACH classification to the Prosthetic Joint Infection in Australia and New Zealand Observational (PIANO) cohort...