The aim of this study was to evaluate long-term quality and performance of cemented posterior-stabilized (PS) total knee arthroplasty (TKA) in young and active patients with gap balancing technique.
The increasing number of overdoses and deaths caused by opioids spotlights a complex public health crisis faced by the American society. Hence, concerns surrounding the dependence and abuse of narcotics have led to new laws and regulations of opioid prescriptions. In 2017, New York state implemented a Mandatory Prescriber Education for prescribers licensed to issue controlled substances, including opioids.
Total knee and hip arthroplasty is often performed for severe cases of osteoarthritis. It is generally performed on older patients, usually over 55 years of age, and is more common in obese patients (“Hip and Knee Replacement Surgery FAQs,” n.d.; Namba et al. 2005) It is well documented that joint arthroplasty population has a high number of comorbidities at the time of surgery, which can greatly affect surgical outcomes. The presence of multiple comorbid diseases has been shown to increase patient’s length of stay and lead to greater utilization of resources after a total knee arthroplasty (Pugely et al. 2014). It may also delay diagnosis, alter treatment, lead to complications, influence survival, and confound analysis of outcomes (Feinstein1970).
Choice of articulating spacer in selected Methicillin-resistant Staphylococcus aureus (MRSA) patients with instability that do not qualify for a second-stage revision (i.e., due to significant co-morbidities, multiple persistent infections, open wound ulcers) is challenging. To avoid a recurrent biofilm when using a cruciate-retaining (Cr/Cb) femoral implant, we have utilized a polymer femoral implant and constraint all-polyethylene (all-poly) tibia with stem extensions as a permanent spacer.
Hip dislocation is a devastating complication after total hip arthroplasty (THA), which is slightly higher when using the traditional posterior approach. The piriformis tendon is the most important dynamic posterior stabilizing structure. The piriformis-sparing technique provides a reproducible method for THA, greatly reducing the dislocation rate.
Periprosthetic fracture (PPF) after total hip arthroplasty (THA) is associated with adverse outcomes. Many studies have sought to determine risk factors for PPF, though controversy exists regarding several variables. This study sought to determine risk factors for early PPF using the National Surgical Quality Improvement Program (NSQIP) dataset. Patients with a primary current procedural terminology for THA were identified. The primary outcome was reoperation/readmission for PPF within 30 days. Multivariable logistic regression was utilized to adjust for confounding factors. A total of 159,234 patients were included in the study, of whom 195 patients (0.12%) had a PPF within 30 days, with a mean day of reoperation/readmission of 14.6 (standard deviation 7.7).
Large joint surgeries, hip and knee arthroplasties, are often performed in individuals with hepatitis C infection. Hepatitis C has been identified as one of risk factors for the post-operative complications. There is scarcity of the data about the role of pre-operative hepatitis C treatment in decreasing the post-operative complications for patients undergoing hip and knee arthroplasties.
While tranexamic acid (TXA) has been well shown to reduce blood loss after joint replacement surgery, little is known regarding its effectiveness in obese patients. The aim of this study was to evaluate the effect of TXA changes in hematocrit and hemoglobin levels as well as incidence of packed red blood cell (pRBC) transfusions in obese patients undergoing total joint arthroplasty (TJA).
The prevalence and demand for total joint arthroplasty (TJA) in patients with human immunodeficiency virus (HIV) and hepatitis C (HCV) have steadily increased. However, the relationship between these immunocompromising viruses and perioperative complications such as postoperative infection has yet to be fully established.
Proper positioning of the acetabular cup deters dislocation after total hip arthroplasty (THA) and is therefore a key focus for orthopaedic surgeons. The concept of a safe zone for acetabular component placement remains widely utilized in contemporary THA practice; however, components positioned in this safe zone still dislocate. The purpose of this study was to characterize trends in acetabular cup positioning and to determine if the surgical approaches used affected the rate at which the components were placed in the safe zones.
