Arthroplasty Today最新文献

{"title":"Differences in Perioperative Outcomes Between Conversion Total Hip Arthroplasty After Previous Proximal Femur Fracture and Primary Total Hip Arthroplasty","authors":"Brook Biniam BSc ,&nbsp;Jonathan Bourget-Murray MD ,&nbsp;Paul Beaulé MD ,&nbsp;Paul Kim MD ,&nbsp;Wade Gofton MD ,&nbsp;George Grammatopoulos MBBS, DPhil","doi":"10.1016/j.artd.2025.101715","DOIUrl":"10.1016/j.artd.2025.101715","url":null,"abstract":"<div><h3>Background</h3><div>This study compares outcomes between conversion total hip arthroplasty (THA) after proximal femur fracture (PFF) fixation and primary THA for osteoarthritis and examines whether fracture type affects results.</div></div><div><h3>Methods</h3><div>This is a retrospective review of prospectively collected data from a single academic center. Eighty-seven consecutive patients underwent conversion THA following surgical fixation of a PFF with a minimum 2-year follow-up. These patients were matched 1:1 with patients who underwent a primary THA for osteoarthritis, by the same arthroplasty surgeons, using propensity score technique. Outcomes measures included length of stay, complications, reoperation rates, and Oxford Hip Score (OHS). Subgroup analysis involved comparing outcome measures between patients who required conversion THA following an intracapsular and extracapsular PFF.</div></div><div><h3>Results</h3><div>The mean follow-up was 5.6 years (range, 2.3-13.1). Patients in the conversion THA group required longer length of stay (8.1 vs 1.4 days, <em>P</em> &lt; .001). There was no difference in complication rate (12.6% vs 16.1%, <em>P</em> = .491), reoperative rate (12.6% vs 5.7%, <em>P</em> = .243), or OHS (40.1 vs 37.2; <em>P</em> = .052) at final follow-up. There was no difference in outcomes between controls and conversion THA for a previous intracapsular PFF. Reoperation rate was significantly higher (18.2% vs 5.7%, <em>P</em> = .039) and OHS significantly lower (32.3 vs 40.0, <em>P</em> &lt; .001) for conversion THA following extracapsular PFF.</div></div><div><h3>Conclusions</h3><div>Conversion THA after extracapsular PPF is associated with higher reoperation rates and poorer functional outcomes than primary THA for osteoarthritis. In contract, intracapsular PPF show comparable results, underscoring the need to consider fracture type in treatment planning.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101715"},"PeriodicalIF":1.5,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130961","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":"Does Capsular Repair in Anterior Total Hip Arthroplasty Reduce the Incidence of Iliopsoas Tendonitis?","authors":"James M. Puleo DO,&nbsp;Kyaw Nyi-Rein BS,&nbsp;Randeep S. Chana BS,&nbsp;Jared T. Roberts MD","doi":"10.1016/j.artd.2025.101680","DOIUrl":"10.1016/j.artd.2025.101680","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is one of the most popular and successful operations in the United States. One of the known complications of THA is iliopsoas tendonitis (ITS), which is seen in 4.5% of all THAs. ITS can lead to extreme discomfort for the patient, requiring multiple interventions, with the most severe being revision of arthroplasty components. Thus, ITS is an important complication to prevent. This study looked to see if repairing the hip capsule after direct anterior approach (DAA) to the hip played a role in ITS development.</div></div><div><h3>Methods</h3><div>This was a retrospective study comparing the incidence of ITS symptoms for 5 different surgeons with the goal to further explore whether complete capsulectomy during DAA increases the incidence of ITS when compared to capsular repair. Telephone interviews and retrospective chart review were used to identify symptoms consistent with a diagnosis of ITS.</div></div><div><h3>Results</h3><div>Two hundred thirty-seven patients were studied: 187 in the DAA group, with 101 receiving capsular repair and 86 with capsulectomy; and then 50 patients received a posterior hip approach, and this was used as a control group. Overall, there was no significant difference in symptom incidence (9.9% vs 10.5%) between the capsular repair and capsulectomy groups. When analyzed for each surgeon individually, there were also no statistically significant differences.</div></div><div><h3>Conclusions</h3><div>There is no statistically significant difference in ITS incidence between patients receiving a direct anterior THA with capsulectomy vs those receiving a direct anterior THA with a capsular repair.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101680"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116483","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":"Influence of Femoral Component Flexion on Outcomes After Primary Total Knee Arthroplasty","authors":"Praharsha Mulpur MBBS, DNB (Ortho),&nbsp;Tarun Jayakumar MBBS, MS (Ortho),&nbsp;Mudidana Prudhvi MBBS, MS (Ortho),&nbsp;Krishna Raj Khanal MBBS, MS (Ortho),&nbsp;Kushal Hippalgaonkar MBBS, DNB (Ortho),&nbsp;A.V. Gurava Reddy MBBS, D.Ortho, DNB (Ortho), FRCS, MCh (Ortho)","doi":"10.1016/j.artd.2025.101718","DOIUrl":"10.1016/j.artd.2025.101718","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) improves pain relief and function in end-stage arthritis. While coronal alignment has been well studied, the impact of femoral component flexion in the sagittal plane on outcomes remains underexplored. This study examines the effect of femoral component flexion on patellofemoral outcomes, using the Kujala anterior knee pain scale, and overall functional results after robotic-assisted TKA.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 285 patients who underwent primary robotic-assisted TKA between January 2022 and January 2023. Femoral component flexion was classified as low (0°-2.5°), medium (2.6°-5.5°), and high (5.6°-8°). Outcomes were assessed preoperatively and 12 months postoperatively using the Kujala score, Oxford Knee Score (OKS), and Knee Society Score (KSS). Statistical analysis included analysis of variance for comparing groups and regression analysis to evaluate the impact of flexion on outcomes.</div></div><div><h3>Results</h3><div>A total of 57, 108, and 120 patients were categorized into low, medium, and high flexion groups, respectively. Kujala scores were significantly higher in the low flexion group (73.89 ± 12.68) compared to medium (63.08 ± 7.07) and high groups (63.12 ± 6.86, <em>P</em> &lt; .0001). Each additional degree of femoral flexion resulted in a 1.34-point decrease in Kujala score (<em>P</em> &lt; .0001). Postoperatively, the OKS and KSS improved significantly in all groups, with no statistically significant difference across flexion groups. Patient satisfaction was comparable across groups, with no significant difference.</div></div><div><h3>Conclusions</h3><div>Increased femoral component flexion was associated with poorer patellofemoral outcomes based on the Kujala score. However, the overall patient-reported functional outcome, as measured by the OKS and KSS, did not show a correlation with the flexion of the femoral component.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101718"},"PeriodicalIF":1.5,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107776","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":"Cementing Without Trialing is Safe and Efficient for Hip Hemiarthroplasty","authors":"Hari P. Bezwada MD ,&nbsp;Dilan Prasad BS ,&nbsp;Carter Levine BS","doi":"10.1016/j.artd.2025.101703","DOIUrl":"10.1016/j.artd.2025.101703","url":null,"abstract":"<div><div>Displaced femoral neck fractures most commonly occur in elderly patients as the result of low energy injuries. Surgical interventions for these fractures have included either bipolar or unipolar hip hemiarthroplasty. Furthermore, these procedures may be performed with either cemented or cementless implants. Despite compelling data suggesting lower reoperation rates and better outcomes with cemented implants, many surgeons still use cementless implants in these elderly patients according to registry data from the American Joint Replacement Registry. Additionally, the direct anterior approach has become increasingly popular as a surgical approach for hip arthroplasty. We describe an efficient surgical technique for cemented hemiarthroplasty via the direct anterior approach. In this technique, head trialing is only done after the stem is cemented, thereby reducing the risks of intraoperative fracture to an already osteoporotic bone.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101703"},"PeriodicalIF":1.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084644","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":"Highly Porous Tantalum Acetabular Components Without Ancillary Screws Are Non-inferior at 7 Years When Compared With Titanium Components With Ancillary Screw Fixation: A Randomized Controlled Trial","authors":"Thomas S. Robertson MBBS ,&nbsp;Lucian B. Solomon MD, PhD, FRACS ,&nbsp;Donald W. Howie MBBS, PhD, FRACS ,&nbsp;Oksana T. Holubowycz PhD ,&nbsp;Chan Hee Cho BHMS Hons ,&nbsp;Stuart A. Callary BAppSc, PhD","doi":"10.1016/j.artd.2025.101709","DOIUrl":"10.1016/j.artd.2025.101709","url":null,"abstract":"<div><h3>Background</h3><div>While porous tantalum components have shown to be advantageous in the revision setting, registry studies have identified tantalum components used in primary total hip arthroplasty (THA) to be associated with an increased risk of revision. The only study to examine the migration of tantalum acetabular components with radiostereometric analysis (RSA) beyond 2 years found continued migration. The aim of this 7-year follow-up RSA study was to determine if the mid-term migration of tantalum acetabular components without ancillary screw fixation is no greater than that of fiber metal titanium components with one ancillary screw fixation.</div></div><div><h3>Methods</h3><div>We prospectively reviewed the mid-term implant stability of patients who underwent primary THA and were randomized intra-operatively to receive either the tantalum or titanium acetabular component. Of the initial 66 patients enrolled, 51 (77.3%) were available at 7-year follow-up; 2 tantalum components were revised due to recurrent dislocation and infection, respectively, and 2 titanium components underwent open reduction internal fixation to treat femoral periprosthetic fracture. Acetabular component migration relative to the surrounding acetabular bone was measured using RSA at 4-6 days post-operatively and at 6 weeks, 3 months, 1, 2, 3, 5, and 7 years following THA.</div></div><div><h3>Results</h3><div>At 7 years, the mean proximal migration of tantalum components was 0.22 mm (95% confidence interval 0.08-0.35) and non-inferior to that of titanium components at 0.19 mm (95% confidence interval 0.07-0.32). In addition, the mean proximal migration of tantalum components was non-inferior to that of titanium at both 3 and 5 years. There were no significant differences noted between cohorts for any other axis of translation and rotation.</div></div><div><h3>Conclusions</h3><div>The continued mid-term stability of tantalum acetabular components without ancillary screw fixation is encouraging for long-term stability. The non-inferiority compared to titanium acetabular components with established excellent long-term survivorship provides reassurance to the operative surgeon using tantalum components in the primary setting.</div></div><div><h3>Level of Evidence</h3><div>I.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101709"},"PeriodicalIF":1.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070724","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":"Corrigendum to “A Case Series of Severe Mycobacterium Fortuitum Infections from a Single Ambulatory Surgery Center” [Arthroplasty Today 30 (2024) 101520]","authors":"Reece Vesperman MD ,&nbsp;J. Ryan Martin MD ,&nbsp;Logan Locascio BS ,&nbsp;Christina T. Fiske MD, MPH ,&nbsp;Jessica Rice MSN, FNP-C ,&nbsp;Stephen Engstrom MD, MBA","doi":"10.1016/j.artd.2025.101712","DOIUrl":"10.1016/j.artd.2025.101712","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101712"},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943298","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":"Imageless vs Image-Based Computer Navigation in Total Hip Arthroplasty: An Intracase Comparison Shows Variability Between Technologies","authors":"Joseph T. Gibian MD ,&nbsp;Ryan J. Cone MD ,&nbsp;Matthew Booth MD ,&nbsp;Ling Chen PhD ,&nbsp;Kimberly A. Bartosiak MD ,&nbsp;Charles P. Hannon MD, MBA ,&nbsp;Ilya Bendich MD, MBA","doi":"10.1016/j.artd.2025.101707","DOIUrl":"10.1016/j.artd.2025.101707","url":null,"abstract":"<div><h3>Background</h3><div>The use of computer navigation in total hip arthroplasty (THA) is on the rise. Computer navigation has 2 commonly utilized modalities, imageless (ILCN) and image-based (IBCN). The aim of this study was to compare ILCN and IBCN inclination and anteversion measurements when utilized in the same THA case.</div></div><div><h3>Methods</h3><div>One-hundred consecutive primary or revision posterior THAs in which both ILCN and IBCN were utilized in the same case were included. Intraoperative ILCN and IBCN acetabular component inclination and anteversion measurements were recorded. Mean inclination and anteversion measurements from intracase ILCN and IBCN were compared. Discordant cases (&gt;5° differences) were recorded; linear regression was used to determine if any confounding factors were associated with an increased risk of discordance.</div></div><div><h3>Results</h3><div>There was no significant difference in mean inclination or anteversion between ILCN and IBCN. However, in 21% and 32% of cases, inclination and anteversion measurements, respectively, were discordant between ILCN and IBCN. Body mass index (<em>P</em> = .007) and prior lumbar spine fusion (<em>P</em> = .012) were correlated with increased discordance of anteversion. There was no association between discordance and dislocation rate.</div></div><div><h3>Conclusions</h3><div>This intracase comparison of ILCN and IBCN demonstrates that in over 20% of cases, measurements between the 2 technologies are discordant. Risk factors for discordance include lumbar spine fusion and increased body mass index.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101707"},"PeriodicalIF":1.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937158","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":"Femoral Head Sizing and Guide Placement in Hueter Anterior Approach Hip Resurfacing: A Surgical Technique","authors":"Moritz Wagner MD, PhD,&nbsp;Chuan Kong Koh MD,&nbsp;George Grammatopoulos MBBS, DPhil Oxon, MRCS, FRCS,&nbsp;Paul E. Beaulé MD, FRCSC","doi":"10.1016/j.artd.2025.101706","DOIUrl":"10.1016/j.artd.2025.101706","url":null,"abstract":"<div><div>Hip resurfacing (HR) preserves the proximal femur in young and active patients as well as providing excellent survivorship. There is a growing interest with the Hueter anterior approach (HAA) allowing to preserve the blood supply to the femoral head as well as limiting soft tissue dissection. Surgical technique for HAA HR differs mainly from posterior HR as the superior neck is not visible making current guides impractical. As such, the fovea capitis is highlighted as a key anatomic landmark for femoral pin placement when performing HR through HAA. The purpose of this article is to describe the surgical technique for femoral head sizing and rationale for using the fovea capitis for HR using HAA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101706"},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927495","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":"Cefazolin Is the Most Effective Perioperative Antibiotic to Prevent Periprosthetic Joint Infection","authors":"Charles P. Hannon MD, MBA,&nbsp;Cody C. Wyles MD","doi":"10.1016/j.artd.2025.101708","DOIUrl":"10.1016/j.artd.2025.101708","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101708"},"PeriodicalIF":1.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927494","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":"Management and Outcomes of Breakage in Polyethylene-Ceramic Composite (Sandwich-type) Liners: Lessons From Long-term Follow-up","authors":"Daniel Rodríguez MD ,&nbsp;Thiago Carnaval MD, MSc ,&nbsp;Marcos-del-Carmen Rodríguez MD ,&nbsp;Antonio Coscujuela Maña MD ,&nbsp;José-Luis Agulló MD, PhD ,&nbsp;Sebastián Videla MD, PhD","doi":"10.1016/j.artd.2025.101698","DOIUrl":"10.1016/j.artd.2025.101698","url":null,"abstract":"<div><div>This case series reports the only 3 instances of ceramic liner breakage among patients who underwent total hip arthroplasty (THA) with polyethylene–ceramic composite (sandwich-type) liners at our center between 1999 and 2002. Breakages occurred at approximately 6 (n = 2) and 17 years (n = 1) after the primary THA. Symptoms included audible crepitation, pain, and restricted motion during normal activities. Surgical revisions utilized a polyethylene liner and third-generation alumina ceramic head, with synovectomy and irrigation to remove debris (preventing third-body wear). All patients achieved good long-term outcomes. Although infrequent, the risk of breakage increases over time, and several patients still carry these liners years after THA. This case series underscores the importance of vigilant follow-up, patient education, and timely intervention to manage this infrequent but potentially catastrophic complication.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"33 ","pages":"Article 101698"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927493","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}