Journal of Joint Surgery and Research最新文献

{"title":"Soft tissue balance in total knee arthroplasty: Clinical value of intra-operative measurement","authors":"Tomoyuki Matsumoto ,&nbsp;Naoki Nakano ,&nbsp;Masanori Tsubosaka ,&nbsp;Hirotsugu Muratsu","doi":"10.1016/j.jjoisr.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.05.001","url":null,"abstract":"<div><h3>Purpose:</h3><p>Considering successful clinical outcomes, accurate osteotomy/implantation and soft tissue balancing are essential in total knee arthroplasty (TKA). However, intra-operative assessment of soft tissue balance remains difficult, and management is left much to the surgeon's subjective feel and experience. The aim of this paper was to review various soft tissue balance assessments and their relationship with pre- and intra-operative factors and clinical outcomes.</p></div><div><h3>Methods:</h3><p>Literature regarding the history of soft tissue balance measurement, various types of measurement tools, theory of recent measurement, influence of various factors on soft tissue balance, and influence of soft tissue balance on clinical outcomes in TKA was reviewed using the PubMed database.</p></div><div><h3>Results:</h3><p>Soft tissue balance measurement has switched from the unphysiological condition, i.e., with assessment between bone cut surfaces and patellar eversion, to the physiological condition, i.e. with femoral component placement and patellofemoral joint reduction. Type of prosthesis, implant design, surgical technique, and pre-operative factors affect intra-operative soft tissue balance. Intra-operative soft tissue balance also affects post-operative range of motion and patient-reported outcome measures.</p></div><div><h3>Conclusions:</h3><p>Intra-operative quantitative soft tissue balance measurement and management with physiological knee condition, which is closely influenced by various pre-operative and intra-operative factors, is important for the achievement of high knee function and patient satisfaction.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 3","pages":"Pages 85-93"},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000112/pdfft?md5=fb3ff533ef933a920f183cba4ca6e02a&pid=1-s2.0-S2949705124000112-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre- and post-operative knee alignment phenotypes in restricted kinematic alignment, mechanical alignment total knee arthroplasty, and unicompartmental knee arthroplasty","authors":"Shotaro Araki,&nbsp;Takafumi Hiranaka,&nbsp;Takaaki Fujishiro,&nbsp;Koji Okamoto","doi":"10.1016/j.jjoisr.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The coronal plane alignment of the knee (CPAK) classification has been introduced as a simple system to classify knee phenotypes based on leg alignment [hip–knee–ankle angle (HKA) and joint line obliquity (JLO)]. Differences in post-operative phenotype between mechanical alignment (MA) and kinematic alignment (KA) total knee arthroplasty (TKA) have been reported, but not the phenotypes after unicompartmental knee arthroplasty (UKA). Moreover, most studies have focused upon Western populations. This study compared pre- and post-operative knee phenotypes between MA-TKA, KA-TKA, and UKA in a Japanese cohort.</p></div><div><h3>Methods</h3><p>In this study, 230 knees in 165 patients who underwent UKA, 124 knees in 80 patients who underwent MA-TKA, and 80 knees in 51 patients who underwent restricted KA-TKA in Takatsuki General Hospital between March 2019 and January 2021 were retrospectively investigated. Pre- and post-operative lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were measured, and JLO (MPTA ​+ ​LDFA) and arithmetic HKA (aHKA) (MPTA – LDFA) were calculated and compared between the surgeries.</p></div><div><h3>Results</h3><p>Pre-operative JLO and aHKA did not significantly differ between the three groups (pre. JLO, <em>p</em> ​= ​0.164; pre. aHKA, <em>p</em> ​= ​0.13). Pre-operatively, 62.0% of knees were categorized as type I (varus leg alignment and medially sloped joint line). After UKA, 59.1% of type I inherited the pre-operative phenotype, whereas most cases were altered in MA-TKA and KA-TKA (4.8% and 30.0%, respectively, inherited the pre-operative phenotype).</p></div><div><h3>Conclusions</h3><p>The pre-operative phenotype was mostly inherited after UKA and to a lesser extent after KA-TKA, whereas it tended to be altered after MA-TKA.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 77-83"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000094/pdfft?md5=e5284da5a6b5c64404050b5fe95436de&pid=1-s2.0-S2949705124000094-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of prognostic nutritional index on the occurrence of post-operative delirium after total knee arthroplasty","authors":"Kensuke Hotta,&nbsp;Mitsuru Hanada,&nbsp;Yukihiro Matsuyama","doi":"10.1016/j.jjoisr.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Delirium has been reported to cause delayed functional recovery, prolonged hospitalization, future institutionalization, increased mortality, and increased healthcare costs. However, there are no reports on how prognostic nutritional index (PNI), Controlling Nutritional Status (CONUT) score, and geriatric nutritional risk index (GNRI) are related to delirium after total knee arthroplasty (TKA). This study aimed to identify risk factors for post-operative delirium after TKA using various pre-operative nutritional assessments (PNI, CONUT score, and GNRI).</p></div><div><h3>Methods</h3><p>In total, 289 patients who underwent primary TKA between September 2011 and April 2022 in our institute (Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan) were enrolled. Patients were divided into two groups: those who developed post-operative delirium (Group D), and those who did not (Group ND). Pre-operative risk factors, including nutritional indices, for post-operative delirium were evaluated.</p></div><div><h3>Results</h3><p>Group D comprised 16 participants, while Group ND comprised 273 participants. Comparisons between the two groups revealed significant differences in age, PNI, CONUT score, GNRI, and history of cerebrovascular disease. Multiple logistic regression analysis revealed that significant risk factors for delirium after TKA were age, PNI, and history of cerebrovascular disease. A receiver operating characteristic curve indicated that the cutoff values for delirium were 47.4 for PNI (sensitivity, 0.810; specificity, 0.875) and 78.5 years for age (sensitivity, 0.813; specificity, 0.722).</p></div><div><h3>Conclusions</h3><p>Risk factors for post-operative delirium after TKA were PNI &lt;47.4, age &gt;78.5 years, and history of cerebrovascular disease. Patients exceeding these pre-operative cutoff values or with a history of cerebrovascular disease should receive counseling about delirium before surgery.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 71-76"},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000100/pdfft?md5=4fc7f0e0e6dc526e38580c8fff16fbfa&pid=1-s2.0-S2949705124000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141068849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant improvement in locomotive functions after total knee arthroplasty but worse than those of independent ambulatory community dwellers","authors":"Seiya Miyamoto ,&nbsp;Takehiko Sugita ,&nbsp;Naohisa Miyatake ,&nbsp;Nozomi Itou ,&nbsp;Akira Sasaki ,&nbsp;Ikuo Maeda ,&nbsp;Masayuki Kamimura ,&nbsp;Takashi Aki ,&nbsp;Toshimi Aizawa","doi":"10.1016/j.jjoisr.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>This study investigated the adequacy of improvements in locomotive syndrome (LS) and other clinical outcomes after total knee arthroplasty (TKA) for medial knee osteoarthritis.</p></div><div><h3>Methods</h3><p>A total of 74 patients who underwent unilateral primary TKA were evaluated pre-operatively and 3, 6, and 12 months post-TKA using the 25-question Geriatric Locomotive Function Scale (GLFS-25) to evaluate the severity of LS, the Japanese Knee Osteoarthritis Measure (JKOM), the Knee Society Score (KSS), the timed up and go (TUG) test, and range of motion of the knee joint (ROM). The GLFS-25 score and the severity of LS were compared between these patients and independent ambulatory community dwellers (273 males and 477 females).</p></div><div><h3>Results</h3><p>The GLFS-25, JKOM, KSS, TUG scores, and ROM significantly improved post-operatively. The pre-operative incidence of LS stage 3, indicating the worst locomotive function, decreased from 81.1% to 24.3% at the final follow-up. However, the median (interquartile range) GLFS-25 score of 13 (6–23) seemed much worse, and the incidence of LS stage 3 of 24.3% seemed much higher even 12 months post-TKA compared with independent ambulatory community dwellers.</p></div><div><h3>Conclusions</h3><p>The GLFS-25 score and other clinical outcome scales significantly improved after TKA. However, improvements in locomotive functions were not adequate as approximately 25% of patients remained with LS stage 3. Besides ordinary rehabilitation programmes after TKA, some interventions, such as more rigorous muscle exercises, would be necessary to obtain greater improvements in LS.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 66-70"},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000070/pdfft?md5=c0bef383cc57bbd227e0c90559980b2f&pid=1-s2.0-S2949705124000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone substitute fracture in open wedge high tibial osteotomy: Comparison of two different bone substitutes","authors":"Ryuichi Nakamura ,&nbsp;Masaki Amemiya ,&nbsp;Kaori Matsumoto ,&nbsp;Ippei Yoshida ,&nbsp;Fumiyoshi Kawashima ,&nbsp;Tomoyuki Shimakawa ,&nbsp;Akira Okano","doi":"10.1016/j.jjoisr.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.04.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to retrospectively compare bone substitute fracture patterns and outcomes in patients who underwent open wedge high tibial osteotomy (OWHTO) with OSferion60 or OSferion60 Marvelous bone substitutes. Patients with and without bone substitute fractures were compared and risk factors for bone substitute fracture were identified.</p></div><div><h3>Methods</h3><p>Included patients were physically active non-smokers with knee osteoarthritis and deformity in the proximal tibia, persistent pain, and &lt;5° of flexion contracture. OWHTO was performed with a TriS plate and a target femorotibial angle (FTA) of 170°. Full weight-bearing began the day after surgery. Pre-, intra-, and post-operative evaluations of demographic, clinical, and radiological factors were performed. Regression analysis was performed to identify risk factors for bone substitute fracture.</p></div><div><h3>Results</h3><p>Data for 63 patients were analyzed (OSferion60, <em>n</em> ​= ​28 and Marvelous, <em>n</em> ​= ​35; bone substitute fracture, <em>n</em> ​= ​32 and non-bone substitute fracture, <em>n</em> ​= ​31). No significant differences were found between the bone substitute groups in patient characteristics and pre-operative and 2-year FTA, Japanese Orthopaedic Association (JOA) score, and flexion range. FTA and JOA scores improved significantly 2 years post-operatively (both <em>p</em> ​&lt; ​0.001). There were 32 bone substitute fractures (OSferion60, <em>n</em> ​= ​20; Marvelous, <em>n</em> ​= ​12); all occurred by the 1-month follow-up. Gap filling occurred significantly earlier in the Marvelous group versus the OSferion60 group (<em>p</em> ​&lt; ​0.001). Risk factors for bone substitute fracture were weaker bone substitute [odds ratio (OR) ​= ​8.34; <em>p</em> ​&lt; ​0.001] and lateral hinge fracture (OR ​= ​11.7; <em>p</em> ​= ​0.045).</p></div><div><h3>Conclusions</h3><p>Although bone substitute fracture was common in both bone substitute groups, this did not affect outcomes. However, lateral hinge fractures are a particular concern.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 58-65"},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000082/pdfft?md5=246ad172bee1d2a8f9b002f99a2ac6bc&pid=1-s2.0-S2949705124000082-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in ulnar and median nerve conduction velocity after reverse total shoulder arthroplasty: Correlation with distalization and lateralization","authors":"Kotaro Yamakado","doi":"10.1016/j.jjoisr.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.03.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to assess ulnar and median nerve injury after reverse total shoulder arthroplasty (RSA) by measuring the sensory nerve conduction velocity (SCV). The secondary objective was to evaluate the impact of lateralization and/or distalization on SCV changes.</p></div><div><h3>Methods</h3><p>Twenty consecutive cases were prospectively included and retrospectively reviewed. SCV of the ulnar and median nerves as well as humeral lateralization/distalization quantified by plain radiography were evaluated pre-operatively and at 1 week post-operatively. Changes in SCV were tested using the paired <em>t</em>-test, and correlations between humeral lateralization/distalization and SCV changes were tested using Kendall's rank correlation coefficient and maximal information coefficient (MIC).</p></div><div><h3>Results</h3><p>The SCV of the ulnar nerve was delayed from 55.4 ​m/s pre-operatively to 53.0 ​m/s post-operatively (<em>p</em> ​= ​0.021), whereas there was no significant change in the median nerve (<em>p</em> ​= ​0.17). There was a weak to moderate correlation between ulnar nerve SCV delay and lateralization (τ ​= ​−0.38; <em>p</em> ​= ​0.021; MIC ​= ​0.70) but no significant correlation with distalization (<em>p</em> ​= ​0.65; MIC ​= ​0.56).</p></div><div><h3>Conclusions</h3><p>Following RSA, a small but significant delay in SCV of the ulnar nerve was observed. A negative correlation was found between lateralization and SCV delay of the ulnar nerve.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 51-57"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000069/pdfft?md5=d87ce27d744f0bd771a2a9cb3277aace&pid=1-s2.0-S2949705124000069-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140543842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative factors associated with patient satisfaction after modified kinematically aligned total knee arthroplasty in varus knees","authors":"Kemmei Ikuta,&nbsp;Tomoyuki Matsumoto,&nbsp;Naoki Nakano,&nbsp;Yuichi Kuroda,&nbsp;Shinya Hayashi,&nbsp;Ryosuke Kuroda","doi":"10.1016/j.jjoisr.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.03.001","url":null,"abstract":"<div><h3>Purpose</h3><p>Kinematically aligned-total knee arthroplasty (KA-TKA) has recently attracted significant interest because it delivers better clinical outcomes than mechanically aligned (MA)-TKA. However, the optimal preoperative factors that maximize the effectiveness of KA-TKA remain controversial. Therefore, we aimed to determine the preoperative factors that are appropriate for and might benefit from modified KA-TKA, based on patient-reported outcome measures (PROMs).</p></div><div><h3>Methods</h3><p>The relationships between postoperative satisfaction and other variables in 84 patients with varus-type osteoarthritis of the knee who underwent primary modified KA-TKAs were investigated using stepwise multiple regression analysis. Patients were assigned to groups that were satisfied or dissatisfied with their outcomes after KA-TKA according to the 2011 Knee Society Scores. The cutoff for preoperative advanced activities scores (AASs) for excellent satisfaction were determined by analyzing receiver operating characteristic (ROC) curves. The variables correlated with excellent satisfaction were identified using logistic regression models.</p></div><div><h3>Results</h3><p>A preoperative variable relevant to patient satisfaction was AAS (β ​= ​0.465). The results of the ROC curve analysis revealed eight optimal cut-offs for preoperative AASs that predicted excellent satisfaction, with a sensitivity and specificity of 0.700 and 0.625, respectively. Logistic regression analysis revealed that AASs significantly contributed to excellent patient satisfaction (odds ratio, 1.181; p ​= ​0.001).</p></div><div><h3>Conclusions</h3><p>Individuals who were highly active preoperatively were good candidates for KA-TKA. This modified kinematically aligned surgical technique can satisfy the demands of highly active patients.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 46-50"},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000045/pdfft?md5=dc03514f33de8b51126635761b82dcd8&pid=1-s2.0-S2949705124000045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of deep medial collateral ligament release during high knee flexion movements","authors":"Kenichi Kono ,&nbsp;Shoji Konda ,&nbsp;Masashi Tamaki ,&nbsp;Sakae Tanaka ,&nbsp;Tetsuya Tomita","doi":"10.1016/j.jjoisr.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.03.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The medial preserving gap technique has recently been used in total knee arthroplasty. Generally, the deep medial collateral ligament (DMCL) is released using this technique. However, the effect of DMCL release on the kinematics and length of the ligaments remains unknown. This study aimed to clarify how DMCL release affects the kinematics and length change of the ligaments during high knee flexion movements.</p></div><div><h3>Methods</h3><p>Three cadaveric knees were examined using a computed tomography-based navigation system. The following parameters were evaluated: femoral rotation and varus-valgus angle relative to the tibia; anteroposterior translation of the sulcus distal to the medial epicondyle (medial side) and tip of the lateral epicondyle of the femur (lateral side); mediolateral translation of the medial and lateral sides of the plane perpendicular to the tibial mechanical axis; and kinematic pathways during non-weight-bearing knee flexion, cross-legged motion, and sideways motion.</p></div><div><h3>Results</h3><p>There were no significant differences in the kinematics and length change of the ligaments during all movements after DMCL release compared with that before DMCL release.</p></div><div><h3>Conclusion</h3><p>DMCL release did not affect the kinematics and length change of the ligaments.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 40-45"},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000057/pdfft?md5=9466264fb1c90c8420dad32354d67890&pid=1-s2.0-S2949705124000057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluoro HIP, a new software for intraoperative evaluation of the cup angles based on fluoroscopic images","authors":"Hiroki Kobayashi ,&nbsp;Hiroyuki Ogawa ,&nbsp;Kazuki Nakamura ,&nbsp;Taro Yamashita ,&nbsp;Keisuke Horiuchi ,&nbsp;Kazuhiro Chiba","doi":"10.1016/j.jjoisr.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.02.002","url":null,"abstract":"<div><h3>Purpose</h3><p>Despite its clinical benefits, intraoperative navigation is currently used only in approximately 20% of total hip arthroplasties (THA) partly due to the high cost of the systems and time-consuming preoperative preparation. By providing a simpler and less expensive alternative, the use of intraoperative navigation is likely to increase among surgeons. In this study, we sought to validate the accuracy and utility of Fluoro HIP, a newly developed cup angle measurement software that runs on iOS devices.</p></div><div><h3>Methods</h3><p>Twenty-seven patients who underwent primary total hip arthroplasty between June and September 2022 were included in the study. All patients underwent surgery in the supine position. Inclination and anteversion angles were determined using Fluoro HIP software based on the fluoroscopic images captured during surgery. Navigation errors were calculated by comparing with the values obtained from postoperative CT images.</p></div><div><h3>Results</h3><p>The inclination and anteversion angles measured were 38.7 ​± ​3.9 and 15.0 ​± ​3.1°, respectively. The absolute value errors were 2.7 ​± ​1.9 and 3.0 ​± ​2.1° for the inclination and anteversion, respectively. Although Fluoro HIP software-based system may not be as precise as the conventional CT-based or portable navigation systems, the intraoperative evaluation of the cup angles by this system was considered to have acceptable accuracy and reproducibility for most THA cases performed in the supine position. Most importantly, our system requires no preoperative preparation and is significantly less expensive than other types of navigation systems currently in use.</p></div><div><h3>Conclusion</h3><p>The Fluoro HIP software-based system is a highly cost-effective and affordable alternative to the conventional navigation systems.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 35-39"},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000033/pdfft?md5=832a7c8346dc67434e9bffaec38046b1&pid=1-s2.0-S2949705124000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve of minimally invasive anterolateral approach in supine position for total hip arthroplasty","authors":"Hiroshi Inui,&nbsp;Isao Nakasone,&nbsp;Takahito Kanazawa,&nbsp;Tetsu Yamashita,&nbsp;Yu Tanuma,&nbsp;Kazuo Saita","doi":"10.1016/j.jjoisr.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.jjoisr.2024.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Total hip arthroplasty (THA) using minimally invasive anterolateral approach in the supine position (ALS) is reported to achieve good clinical outcomes including lower dislocation rates and early clinical recovery. However, minimally invasive ALS THA is technically challenging, especially among surgeons who are newly introduced to these techniques. This study aimed to evaluate the learning curves associated with minimally invasive ALS THA.</p></div><div><h3>Methods</h3><p>This study divided 720 primary THAs with a minimally invasive ALS approach into three groups based on the number of previous procedures per surgeon (A:1–100, B:101–200, C: &gt;201). Surgical time and perioperative complications were compared among the three groups.</p></div><div><h3>Results</h3><p>Perioperative complications were seen in 8.0% of patients, including periprosthetic fractures (4.2%), surgical site infection (1.3%), stem subsidence (1.0%), nerve palsy (0.6%), dislocation (0.4%), major bleeding (0.4%), and liner malseating (0.1%). The rate of perioperative complications in each group was 8.6% (30 patients), 10.9% (22 patients), and 3.5% (6 patients) in groups A, B, and C, respectively. Group C has a significantly lower rate than other groups. Group B has significantly higher surgical site infection rate than other groups. No statistically significant difference was found in the surgical times among the three groups.</p></div><div><h3>Conclusion</h3><p>The learning curve associated with minimally invasive ALS THA was approximately 200 cases in terms of perioperative complications. Moderately experienced surgeons should always pay careful attention to avoid complications during ALS THA until they perform &gt;200 cases.</p></div>","PeriodicalId":100795,"journal":{"name":"Journal of Joint Surgery and Research","volume":"2 2","pages":"Pages 31-34"},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949705124000021/pdfft?md5=cb2c2d40758e6b9a33072b5fba7efe77&pid=1-s2.0-S2949705124000021-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}