Arthroplasty Today最新文献

{"title":"Tranexamic Acid is Safe and Effective in Reducing Blood Loss and Transfusion Rates in Nearly all Patients Undergoing Total Hip and Knee Arthroplasty","authors":"Joshua P. Rainey MD, Yale A. Fillingham MD, Charles P. Hannon MD, MBA","doi":"10.1016/j.artd.2025.101868","DOIUrl":"10.1016/j.artd.2025.101868","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"38 ","pages":"Article 101868"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147612525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Greater Trochanteric Fractures on Patient Reported Outcomes After Direct Anterior Total Hip Arthroplasty","authors":"Daniel R. Baka BS ,&nbsp;Cayla M. Kalani BS ,&nbsp;Jong Hyun Choi MD ,&nbsp;Nicholas D’Antonio MD ,&nbsp;Pietro M. Gentile BS ,&nbsp;Matthew L. Brown MD","doi":"10.1016/j.artd.2026.101954","DOIUrl":"10.1016/j.artd.2026.101954","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) via the direct anterior approach (DAA) is favored for avoiding gluteal muscle disruption and promoting faster recovery. A known complication of DAA is greater trochanteric fracture (GTFX). This study compared patient-reported outcomes (PROs) between patients who sustained GTFX and those who did not following THA using DAA.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of patients who underwent THA via DAA. Primary outcomes included Mental and Physical Patient-Reported Outcomes Measurement Information System scores, Hip Osteoarthritis Outcome Score for Joint Replacement (HOOS JR), and Forgotten Joint Score. Secondary outcomes included ambulation status, disposition, length of stay, complications, emergency department visits, and return to the operating room within 1 year. Patients without at least baseline and 6-month or 1-year PROs were excluded.</div></div><div><h3>Results</h3><div>Ninety-two THAs were analyzed; 13 patients (14%) sustained a GTFX. Baseline characteristics and preoperative PROs were similar between groups. At 6 months, the GTFX group had significantly lower HOOS JR scores (68.5 ± 18.1) compared to the non-GTFX group (79.8 ± 18.0; <em>P</em> = .0472). No significant differences in PROs were observed at 1-year. Two patients (15%) with GTFX and 2 (3%) without GTFX returned to the operating room (<em>P</em> = .0943). No other significant differences in secondary outcomes were noted.</div></div><div><h3>Conclusions</h3><div>GTFX following THA via DAA are associated with worse HOOS JR scores at 6 months, suggesting a temporary delay in recovery. However, these differences resolve by 1 year, indicating GTFX may not impact long-term functional outcomes.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"38 ","pages":"Article 101954"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pay It Forward, Please","authors":"Brett R. Levine MD, MS (Editor-in-Chief)","doi":"10.1016/j.artd.2026.102015","DOIUrl":"10.1016/j.artd.2026.102015","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"38 ","pages":"Article 102015"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147612524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology-assisted Total Hip Arthroplasty: A Contemporary Analysis of Regional Trends, National Trends, and 90-day Outcomes in a Nationwide Cohort","authors":"Amy Y. Zhao BA ,&nbsp;Alex Gu MD ,&nbsp;Gireesh Reddy MD ,&nbsp;Bryant M. Song MD ,&nbsp;Ilya Bendich MD, MBA ,&nbsp;Andrew M. Schneider MD","doi":"10.1016/j.artd.2025.101949","DOIUrl":"10.1016/j.artd.2025.101949","url":null,"abstract":"<div><h3>Background</h3><div>Technology-assisted total hip arthroplasty (THA)—including computer-navigated and robotic-assisted techniques—has emerged as a strategy to enhance component alignment and potentially improve postoperative outcomes. Although prior studies have described increasing utilization, contemporary trends and associated complication rates remain underexplored.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using a large national database to identify patients who underwent primary elective THA between 2010 and 2023. Patients were stratified into conventional vs technology-assisted THA groups, with the latter defined by the use of computer navigation or robotic assistance. Annual utilization trends were evaluated using linear regression, and 90-day postoperative complications were compared using multivariate logistic regression after adjusting for demographic, clinical, and regional factors.</div></div><div><h3>Results</h3><div>Among 1,062,597 patients undergoing primary elective THA, 4% received technology-assisted procedures. Utilization increased from 1.2% in 2010 to 12% in 2023—a 927% relative increase. Regional variation was notable, with highest utilization in the Northeast and the lowest in the Midwest. Technology-assisted THA was associated with lower odds of 90-day complications (5.36% vs 6.26%; adjusted odds ratio [OR]: 0.77; 95% confidence interval [CI]: 0.75-0.80), particularly reduced odds of dislocation (OR: 0.64; 95% CI: 0.60-0.69) and periprosthetic joint infection, though with higher odds of wound dehiscence (OR: 1.15; 95% CI: 1.07-1.23).</div></div><div><h3>Conclusions</h3><div>Utilization of technology-assisted THA has increased substantially across the United States, accompanied by improved short-term outcomes, most notably decreased dislocation. These findings support the potential clinical benefits of surgical technology in THA, while underscoring the need for ongoing evaluation of long-term results.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"38 ","pages":"Article 101949"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stabilizing the Unstable: Cone Hemiarthroplasty in Geriatric Intertrochanteric Fractures","authors":"Arcot Reddy Vamsi Krishna,&nbsp;Babaji Sitaram thorat,&nbsp;Avtar Singh Kamboj,&nbsp;Abhijit das,&nbsp;Kshitij Srivastav,&nbsp;Arshid H. Wani","doi":"10.1016/j.artd.2025.101935","DOIUrl":"10.1016/j.artd.2025.101935","url":null,"abstract":"<div><h3>Background</h3><div>Unstable intertrochanteric fractures in the elderly pose a significant treatment challenge due to poor bone quality, comminution, and associated comorbidities. Bipolar hemiarthroplasty offers the advantage of early mobilization and reduced fixation-related complications. This study evaluates short-term outcomes of bipolar hemiarthroplasty using an uncemented titanium fluted, tapered cone femoral prosthesis in such fractures.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 43 consecutive elderly patients treated with uncemented bipolar hemiarthroplasty using a tapered, fluted cone stem between June 2023 and July 2024. Radiographic parameters—including stem subsidence, greater trochanter union, and limb-length discrepancy—were assessed at serial follow-ups. Functional outcomes were evaluated using the Harris Hip Score.</div></div><div><h3>Results</h3><div>Of the 43 patients operated on, 40 completed a minimum of 12 months follow-up. Greater trochanteric union was observed in 97.7% of cases, with one persistent nonunion causing abductor weakness and early dislocation. Mean stem subsidence was 3.5 mm (0.5–20 mm), with all settling occurring within the first 3 postoperative months; 4 patients (9.3%) experienced subsidence of 5 mm or more, including one requiring revision. The mean limb-length discrepancy was 4.7 mm (1–10 mm). At final follow-up, the mean Harris Hip Score among surviving patients was 91.28, with 29 patients (72.5%) achieving excellent outcomes and 11 patients (27.5%) achieving good outcomes.</div></div><div><h3>Conclusions</h3><div>Bipolar hemiarthroplasty using a tapered, fluted cone stem appears to be a reliable option for carefully selected elderly patients with unstable intertrochanteric fractures, offering predictable fixation, early weight-bearing, and favorable short-term functional results.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101935"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Striving for LGBTQI+ Health Equity in Arthroplasty","authors":"Lauren A. Ross MBChB, BMSc, MRCS ,&nbsp;Jaime L. Bellamy DO, MS ,&nbsp;Chloe EH. Scott MD, MSc, FRCS (Tr&Ortho)","doi":"10.1016/j.artd.2025.101916","DOIUrl":"10.1016/j.artd.2025.101916","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101916"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title Page","authors":"","doi":"10.1016/j.artd.2026.102019","DOIUrl":"10.1016/j.artd.2026.102019","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 102019"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147539263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Rurality on Total Joint Arthroplasty Access and Outcomes: A Systematic Review","authors":"Sean L. Agrodnia BA ,&nbsp;Catherine M. Call MD ,&nbsp;Andrew D. Lachance MD ,&nbsp;John C. McDonald MD ,&nbsp;Adam J. Rana MD ,&nbsp;Brian J. McGrory MD, MS","doi":"10.1016/j.artd.2025.101884","DOIUrl":"10.1016/j.artd.2025.101884","url":null,"abstract":"<div><h3>Background</h3><div>Total joint arthroplasty (TJA) is one of the most frequent orthopaedic surgeries in the United States; however, disparities in utilization and outcomes based on race, sex, and socioeconomic level have been well documented. The impact of rural geographic location, a characteristic that may impact access to TJA care and postoperative outcomes, remains understudied. This systematic review investigated associations between rural location and several metrics in total hip arthroplasty and total knee arthroplasty to investigate whether disparities are present based on rural geographic location.</div></div><div><h3>Methods</h3><div>In November 2024, PubMed, Web of Science, Scopus, EMBASE, and Cochrane Review databases were queried. Ten studies investigating TJA utilization and outcomes that included patients in a rural location were included. Study quality was assessed using a modified Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>Ten articles were included in the final analysis. Differences in complications, readmission rates, and length of stay due to rural location of patient and/or hospital were reported. Results indicate urban TJA patients more frequently discharge to rehab. Patient-reported outcome measures following TJA do not appear different between rural and urban patient groups.</div></div><div><h3>Conclusions</h3><div>Rural geographic location is associated with different TJA utilization and outcomes and may point to disparities in care. Continued efforts dedicated to eliminating inequalities in TJA care should consider the impact geographic location may have on exacerbating other forms of inequity. The reporting of urban-rural classification of patients in arthroplasty research is important for advancing this area of study. Access to care for all patients should be prioritized.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101884"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroplasty Surgeons Taking Care of the Highest Social Risk Populations Are More Often Osteopathic Trained, Less Experienced, and More Likely to be Penalized by the Merit Based Incentive Payment System","authors":"Alejandro M. Holle BS ,&nbsp;Vikram S. Gill BS ,&nbsp;Eugenia Lin MD ,&nbsp;Joshua S. Bingham MD ,&nbsp;Mark J. Spangehl MD ,&nbsp;Henry D. Clarke MD","doi":"10.1016/j.artd.2025.101744","DOIUrl":"10.1016/j.artd.2025.101744","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to examine how hip and knee arthroplasty surgeon Merit-based Incentive Payment System (MIPS) performance, surgeon demographics, practice characteristics, and patient population varied based on the social risk of their caseload in 2017 and 2021.</div></div><div><h3>Methods</h3><div>Multiple databases published by the Centers for Medicare and Medicaid Services were combined and utilized to examine all US hip and knee arthroplasty surgeons. Surgeons were placed into quintiles of social risk based on the proportion of dual-eligible Medicare–Medicaid patients in their patient population. Demographics, Distressed Community Index scores, patient population information, and MIPS performance were compared between quintiles in years 2017 and 2021.</div></div><div><h3>Results</h3><div>In 2017, arthroplasty surgeons with the highest social risk caseloads scored lower on MIPS (70.0 vs 73.5, <em>P</em> = .012) and were more likely to receive a negative payment adjustment (odds ratio: 1.64; 95% confidence interval: 1.01-2.68, <em>P</em> = .046) compared to surgeons with the lowest social risk caseload. In 2021, arthroplasty surgeons with the highest social risk caseloads scored higher on MIPS (86.2 vs 82.4, <em>P</em> &lt; .001), but remained more likely to receive a negative payment adjustment (odds ratio: 3.98; 95% confidence interval: 1.63-10.53, <em>P</em> = .003) compared to those with low social risk caseloads.</div></div><div><h3>Conclusions</h3><div>These findings suggest that while policy adjustments have started to address inequities in performance assessments, they are not sufficient. More work needs to be done to ensure equitable reimbursements for hip and knee arthroplasty surgeons providing care to the most vulnerable patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101744"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weathering the Storm","authors":"","doi":"10.1016/j.artd.2026.101976","DOIUrl":"10.1016/j.artd.2026.101976","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101976"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}