Arthroplasty Today最新文献

{"title":"Alignment Philosophies in Total Knee Arthroplasty: A Comprehensive Narrative Review","authors":"Martin S. Davey MCh, MRCS, MD ,&nbsp;Andrew J. Hughes FRCS Tr&Orth ,&nbsp;Peter K. Sculco MD ,&nbsp;Andrew M. Star MD","doi":"10.1016/j.artd.2025.101940","DOIUrl":"10.1016/j.artd.2025.101940","url":null,"abstract":"<div><div>For many years, providing patients with a total knee arthroplasty (TKA) prosthesis which is stable with a neutrally aligned lower limb using a mechanical alignment philosophy has represented the primary technical goal of TKA. However, it has previously been reported that only 50% of patients have neutral mechanical axis. Furthermore, despite continuous engineering developments with respect to implants used in TKA, contemporary philosophies, computer-assisted navigation and robotic-assisted TKA, registry data suggest that 1 in 5 patients undergoing TKA report overall dissatisfaction with their procedure in the medium to long term. Therefore, the purpose of this review was to first describe and compare outcomes of current alignment philosophies in TKA. Additionally, the authors sought to review the outcomes of computer-assisted navigation and robotic-assisted TKA procedures, while also evaluating the role of sensors and tensioners with respect to TKA alignment. Finally, the authors aimed to review potential future developments within this ever-developing space in the literature.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101940"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077945","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":"Effects of Very Early versus Early Mobilization and Walking on Functional and Psychosocial Outcomes in Acute Phase After Total Hip Arthroplasty: A Prospective Observational Study","authors":"Davide De Leo PT ,&nbsp;Federico Temporiti PT, PhD ,&nbsp;Sofia Della Gatta PT ,&nbsp;Davide Conti PT ,&nbsp;Paola Adamo PT, MSc ,&nbsp;Roberto Gatti PT, MSc","doi":"10.1016/j.artd.2025.101933","DOIUrl":"10.1016/j.artd.2025.101933","url":null,"abstract":"<div><h3>Background</h3><div>Mobilization and walking after total hip arthroplasty (THA) are delivered as early as patients are able, but heterogeneity in administration timing has been reported. The study aimed to investigate the effects of very early (within 8 hours from surgery) vs early (between 12 and 24 hours from surgery) mobilization and walking on functional and psychosocial outcomes after THA.</div></div><div><h3>Methods</h3><div>In this prospective observational study, 237 patients with THA performed very early (n = 174) or early (n = 63) mobilization and walking. After collecting demographic (age, gender, body mass index) and clinical (osteoarthritis severity, preoperative functional status and comorbidities) characteristics at baseline, participants were assessed for mobility (Timed Up and Go) and pain (Numeric Pain Rating Scale) at baseline, first (T1) and third (T2) postoperative days. Fear of movement (Tampa Scale of Kinesiophobia) and anxiety (Visual Analog Scale for anxiety) were investigated at baseline and T2. Percentage of participants who achieved independent walking at T1, time to meet ambulatory discharge criteria, length of stay, adverse events and satisfaction (Visual Analog Patient Satisfaction Scale) were collected.</div></div><div><h3>Results</h3><div>No between-group differences were found for Timed Up and Go at T1 (MD -0.8s, CI₉₅ -4.7 to 6.2) and T2 (MD -1.3s, CI₉₅ -1.8 to 4.3). Numeric Pain Rating Scale, Tampa Scale of Kinesiophobia, walking independence at T1, time to meet ambulatory discharge criteria, length of stay, adverse events and Visual Analog Patient Satisfaction Scale showed no between-group differences (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Very early mobilization and walking were not superior to early mobilization and walking on functional and psychosocial outcomes after THA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101933"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885188","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":"Intraoperative Wound Irrigation in Orthopaedic Surgery: A Survey of Current Understanding and Practice Across the United States","authors":"Emma Woodmansey PhD ,&nbsp;Frank A. Buttacavoli MD ,&nbsp;Aldo Riesgo MD ,&nbsp;Christopher Bibbo DO ,&nbsp;Nicholas Tedesco DO ,&nbsp;David Rodriguez MD ,&nbsp;Eric Lebby MD ,&nbsp;Jonathan R. Danoff MD ,&nbsp;Alberto V. Carli MD","doi":"10.1016/j.artd.2025.101923","DOIUrl":"10.1016/j.artd.2025.101923","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic joint infections remain a serious complication following arthroplasty surgery, causing significant patient morbidity and economic burden to health-care systems. While surgical site infection (SSI) preventive measures have shown effectiveness, there remains a significant gap in literature regarding surgeon intraoperative practice, such as the use of intraoperative wound irrigation (IOWI). While studies highlight the potential in reducing SSIs, variability in clinical application and the lack of standardized, evidence-based guidelines necessitate a comprehensive understanding of current practices.</div></div><div><h3>Methods</h3><div>A 46-question survey was developed following literature review and validation with high-volume primary and revision arthroplasty surgeons. Deployed via online clinician engagement platform, the survey queried challenges of SSI in relation to IOWI, current IOWI practice, the role of biofilm in periprosthetic joint infections, and ideal properties of irrigation solutions.</div></div><div><h3>Results</h3><div>A total of 112 orthopaedic surgeons across the United States participated in the survey. Respondents indicated a high level of knowledge regarding the role of IOWI in SSI treatment and prevention. Key attributes of an ideal IOWI varied depending on procedural step (exposure, instrumentation, implantation, and closure) and procedure type (primary or revision). Variation in IOWI practice was evident in irrigant selection and decision rationale, with relatively lower alignment to contact time and residual antimicrobial activity.</div></div><div><h3>Conclusions</h3><div>This survey highlights the perception that IOWI is an important part of routine SSI reduction measures and suggests variation in practice interventions and solution preference. Our findings support the necessity for a rigorous, evidence-based consensus via expert guidance to address the key surgical challenges to improve consistency of IOWI solution utilization.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101923"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791637","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":"The Impact of Social Drivers of Health on Patient Portal Utilization for Total Joint Arthroplasty Patients: A Qualitative Study","authors":"Sophia S. Antonioli BS ,&nbsp;Zoe Alpert MS ,&nbsp;Shivani Mishra MPH ,&nbsp;Deborah Onakomaiya MPH ,&nbsp;Neel Vallurupalli MD ,&nbsp;Joseph A. Bosco III MD ,&nbsp;Toni McLaurin MD ,&nbsp;Claudette Lajam MD","doi":"10.1016/j.artd.2025.101803","DOIUrl":"10.1016/j.artd.2025.101803","url":null,"abstract":"<div><h3>Background</h3><div>Despite similar rates of osteoarthritis, minority populations undergo fewer hip and knee arthroplasties and have more complications. More than 90% of US hospitals have certified electronic health records, yet only 40% of patients utilize electronic patient portals (EPPs), with lower rates across some demographics. Adverse quality metrics and lower patient-reported outcome survey completion rates were noted for patients with inactive portals. Activation rates for EPPs can be lower among underrepresented groups, perpetuating existing disparities in access to care. Barriers to EPP activation must be identified to design interventions that improve portal utilization and, therefore, outcomes. We designed this study as there are no published reports analyzing factors which impede EPP utilization by total joint patients.</div></div><div><h3>Methods</h3><div>In this IRB-exempt qualitative study, sixty-six arthroplasty patients were interviewed using a questionnaire designed to reveal reasons for EPP nonusage. Demographic factors including language, age, sex, insurance type, and zip code were collected from the electronic health records. Dedoose, a qualitative research tool, was used to analyze data and abstract trends from interview notes and transcripts.</div></div><div><h3>Results</h3><div>We found arthroplasty patients’ demographics and social drivers of health influenced utilization of EPPs. Older adults struggled with digital literacy or lack of familiarity with technology. Limited internet access was cited as an obstacle to use. Patients with language barriers reported accessibility issues. Patients additionally reported concerns regarding personal information being online and perceptions that portals would not be useful.</div></div><div><h3>Conclusions</h3><div>EPPs are becoming the preferred method of patient-physician communication. Demographic and social factors impact patient willingness and ability to access EPPs. Certain patients are, therefore, at greater risk of ineffective communication with care teams, delayed follow-up appointments, or challenges with scheduling and managing rehabilitation. This may lead to suboptimal recovery and surgical outcomes. The current study investigated underlying issues impeding EPP usage to inform potential interventions.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101803"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554447","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":"Rural vs Urban Outcomes in Total Knee and Hip Arthroplasty: A Study of Patient-Reported Outcomes and Web-Based Tool Efficacy","authors":"Jeremiah M. Taylor MD,&nbsp;Matthew V. Dipane BA,&nbsp;Adam A. Sassoon MD","doi":"10.1016/j.artd.2025.101885","DOIUrl":"10.1016/j.artd.2025.101885","url":null,"abstract":"<div><h3>Background</h3><div>Rural patients in the United States often face higher tobacco use, obesity rates, and lower health literacy, impacting arthroplasty outcomes. This study investigates whether rural residency is directly associated with poorer patient-reported outcomes (PROs) following total knee (TKA) and total hip arthroplasty (THA). It also evaluates the effectiveness of web-based PRO tools across urban and rural populations. Understanding these relationships is crucial for addressing disparities in care and improving surveillance for rural populations.</div></div><div><h3>Methods</h3><div>From May 2021 to April 2023, TKA and THA patients at our institution were categorized based on their home zip codes, using the 2020 Census Bureau binary urban-rural classification. Web-based PROs were administered via text or email and assessed using the Knee Injury and Osteoarthritis Outcome Score, Joint Replacement; Hip Injury and Osteoarthritis Outcomes Score, Joint Replacement; University of California, Los Angeles Activity Score; Patient-Reported Outcomes Measurement Information System Global Physical and Mental Health Scores; and Forgotten Joint Scores. PROs were recorded preoperatively and at 6 weeks, 3 months, and 1 year postoperatively. Statistical analysis encompassed chi-square and independent samples t-tests.</div></div><div><h3>Results</h3><div>Among 781 THA and 1094 TKA cases, survey response rates (71.9%-83.8%) were consistent across urban and rural groups (all <em>P</em> &gt; .05). PROs were similar across all timepoints, except rural THA patients reported lower Patient-Reported Outcomes Measurement Information System Global Physical and Mental Health scores [(Mental:Urban 54.2 ± 8.5 vs Rural 50.7 ± 10.0, <em>P</em> = .021); (Physical: Urban 52.2 ± 8.6 vs Rural 48.9 ± 10.0, <em>P</em> = .029)] at the 1-year postoperative mark.</div></div><div><h3>Conclusions</h3><div>Rural patients report comparable arthroplasty-specific PROs following TKA and THA, with a similar response rate to web-based tools.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101885"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554456","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":"Excellent Short-Term Outcomes After Kinematic Alignment, Medial-Pivot Total Knee Arthroplasty for Isolated Patellofemoral Osteoarthritis","authors":"Emma N. Horton BS ,&nbsp;David F. Scott MD","doi":"10.1016/j.artd.2025.101921","DOIUrl":"10.1016/j.artd.2025.101921","url":null,"abstract":"<div><h3>Background</h3><div>The optimal treatment for isolated patellofemoral osteoarthritis (PFOA) remains controversial. Operative management for PFOA includes patellofemoral arthroplasty; however, concerns regarding tibiofemoral disease progression and high revision rates limit its use. Total knee arthroplasty (TKA) is another treatment option, but comparative outcomes between patients with isolated PFOA and those with tibiofemoral osteoarthritis (TFOA) undergoing TKA are not well established. This study compared postoperative outcomes in these 2 populations, hypothesizing that patients with isolated PFOA treated with TKA will achieve similar results to those with TFOA.</div></div><div><h3>Methods</h3><div>A total of 378 consecutive patients with isolated PFOA (n = 17) and TFOA (n = 361) underwent primary unrestricted caliper-verified kinematic alignment TKA with medial-pivot implants. Patients completed the Forgotten Joint Score, Knee Injury and Osteoarthritis Outcome Score (KOOS-JR), and Knee Society Score (KSS) at preoperative, 6-week, 6-month, and 1-year postoperative visits. Extension and flexion were measured at those visits.</div></div><div><h3>Results</h3><div>Patients with TFOA had superior KSS Function and Total Composite at 6 weeks (<em>P</em> = .017 and <em>P</em> = .007, respectively). Patients with PFOA had greater preoperative flexion (<em>P</em> = .006). No significant differences were observed in Forgotten Joint Score, KOOS-JR, KSS B Pain, or extension at any time point (<em>P</em> &gt; .05). All outcome measures equalized between groups at 6 months and 1-year postoperative.</div></div><div><h3>Conclusions</h3><div>Within the limits of the available sample size, patients with isolated PFOA achieved comparable 6-month and 1-year outcomes to those with TFOA following kinematic alignment-TKA with medial-pivot implants, supporting its use as an effective treatment option.</div></div><div><h3>Level of Evidence</h3><div>III.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101921"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747854","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":"Can’t Stop the Music? Musical Hallucinations From Postoperative Tramadol Use: Case Report and Literature Review","authors":"Austin G. Hughes MD,&nbsp;James Pate MD,&nbsp;Jordan Dunson MD,&nbsp;Mark G. Freeman MD","doi":"10.1016/j.artd.2025.101928","DOIUrl":"10.1016/j.artd.2025.101928","url":null,"abstract":"<div><div>Tramadol is an overall safe and increasingly used alternative to traditional opioid medications for pain relief in the acute postoperative period. However, it does have a set of common and rarer, possibly life altering, side effects including severe hallucinations, and more specifically, discrete musical hallucinations. A 79-year-old female status post revision hip arthroplasty was started on Tramadol so that she could stop taking oxycodone. Within 3 days of the initiation of this medication, symptoms of severe musical hallucinations began. The symptoms continued for multiple weeks, were too difficult to assess causation, and resolved within 7 days of the cessation of tramadol use. This case describes a rare adverse effect of Tramadol, musical hallucinations, which led to the patient developing severe anxiety, sleep deprivation, postoperative dissatisfaction, and an increased risk of falls and injury due to fatigue and confusion. Based on this report, the authors recommend that surgeons ensure clinic staff who manage patient calls and messages are familiar with both common and uncommon medication side effects, and that they are trained to discontinue the medication if unusual symptoms arise until appropriate evaluation can be completed.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101928"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841413","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":"Graft Incorporation and Cup Migration in Acetabular Impaction Bone Grafting for Revision Hip Arthroplasty: A Systematic Review and Meta-Analysis of 1093 Hips","authors":"Artsiom Klimko MD ,&nbsp;Octavian Andronic MD, PhD ,&nbsp;Victor Yan Zhe Lu MA MB BChir ,&nbsp;Dominik Kaiser MD ,&nbsp;Dimitris Dimitriou MD ,&nbsp;Armando Hoch MD ,&nbsp;Patrick O. Zingg MD","doi":"10.1016/j.artd.2025.101929","DOIUrl":"10.1016/j.artd.2025.101929","url":null,"abstract":"<div><h3>Background</h3><div>Acetabular impaction bone grafting (IBG) is used to address bone loss in revision total hip arthroplasty (rTHA). We evaluated graft incorporation and cup migration after acetabular IBG in rTHA.</div></div><div><h3>Methods</h3><div>Systematic search of MEDLINE, EMBASE, and Scopus from inception to June 30, 2024 (PROSPERO CRD42024557047). Studies of acetabular IBG in rTHA with ≥12-month follow-up were included. Outcomes were graft incorporation and horizontal (i.e., lateral to medial axis) and vertical cup migration. Prespecified subgroup analyses assessed bone-loss severity, graft type, additional fixation, and age. Random-effects meta-analyses were used; heterogeneity was quantified with I². Risk of bias was assessed with the Methodological Index for Non-Randomized Studies.</div></div><div><h3>Results</h3><div>Nineteen studies (1093 hips) were included; weighted follow-up was 8.0 years (range 2.0-16.9). Pooled graft incorporation was 89% (95% CI [confidence interval] 79-96; I² 85%). Mean lateral migration was 2.4 mm (95% CI 0.53-4.27) and mean superior migration 4.2 mm (95% CI 1.61-6.75); heterogeneity was high (I² 100% for both). Lateral migration was greater in cohorts with ≥5 years’ follow-up than &lt;5 years (3.65 vs 1.16 mm; <em>P</em> = .018). No significant differences in incorporation were detected by bone-loss severity, graft type, or age; however, subgroup analyses were frequently underpowered and exploratory.</div></div><div><h3>Conclusions</h3><div>Acetabular IBG can achieve mid- to long-term graft incorporation of 89%, but estimates are imprecise due to heterogeneous (I² = 85%), predominantly retrospective evidence. Migration occurs—most commonly cranial—and may accrue over time; values often remain within commonly accepted surveillance thresholds but warrant structured radiographic follow-up. Given high heterogeneity, variable outcome definitions, and potential small-study/publication bias, recommendations should be interpreted cautiously.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101929"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978538","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":"Health-Related Social Needs Are Associated With Worse Physical Function, Pain, and Mobility in Hip and Knee Osteoarthritis Patients at Presentation","authors":"Adam D. Winter MS ,&nbsp;Camila L. Hayashi BS ,&nbsp;Luis A. Túa-Vargas MS ,&nbsp;Nicholas Chau ,&nbsp;David H. Gibson MD ,&nbsp;Lee E. Rubin MD ,&nbsp;Ilda B. Molloy MD, MS ,&nbsp;Daniel H. Wiznia MD","doi":"10.1016/j.artd.2025.101871","DOIUrl":"10.1016/j.artd.2025.101871","url":null,"abstract":"<div><h3>Background</h3><div>Health-related social needs (HRSNs) are mandatory reporting measures per the Centers for Medicare &amp; Medicaid Services. We sought to assess the prevalence of HRSNs and associations with clinical presentation among preoperative hip and knee osteoarthritis patients.</div></div><div><h3>Methods</h3><div>This prospective single-institution cross-sectional study assessed HRSNs (living situation, food, transportation, utilities, safety, financial strain, substance use, and mental health); Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, Mobility, Pain Interference scores; and demographics (sex, race, education, income, household size, marital status) via in-person interviews in an academic arthroplasty practice. Kellgren-Lawrence Osteoarthritis Score, Charlson Comorbidity Index, and insurance were also determined. Odds of HRSNs by demographics were analyzed using logistic regression and relationship between HRSNs and PROMIS scores was determined by weighted least square linear regression.</div></div><div><h3>Results</h3><div>The study included 253 patients. Prevalences of each HRSN were 15% for living situation, 13% for food insecurity, 11% for transportation, 4% for utilities, 0.4% for safety, 58% for mental health, 31% for substance use, and 27% for financial strain. Black patients and patients on Medicaid had higher HRSN prevalences. PROMIS scores were significantly worse in patients with HRSNs, particularly for living situation, financial strain, and mental health domains (<em>P</em> &lt; .05 for Physical Function, Mobility, and Pain Interference scores in all these domains).</div></div><div><h3>Conclusions</h3><div>HRSNs are significant among hip and knee osteoarthritis patients and disproportionately high for Black and Medicaid patients. Patients with HRSNs presented with significantly worse PROMIS scores across Physical Function, Mobility, and Pain Interference domains, highlighting a healthcare disparity in this population.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101871"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554446","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":"Combined Patellofemoral Arthroplasty With Patellar Realignment: Surgical Technique and Clinical Outcomes in a Retrospective Case Series","authors":"Paul B. Walker MD,&nbsp;Lisa Su MD, MS,&nbsp;Mathangi Sridharan MD,&nbsp;Murray Wong MD, MSc,&nbsp;Matthew Dipane BA,&nbsp;Guillermo Araujo-Espinoza MD,&nbsp;Kristofer J. Jones MD,&nbsp;Adam A. Sassoon MD, MS","doi":"10.1016/j.artd.2025.101951","DOIUrl":"10.1016/j.artd.2025.101951","url":null,"abstract":"<div><h3>Background</h3><div>Isolated patellofemoral joint arthritis with patellar malalignment in young patients presents a unique challenge, as these patients typically wish to avoid early total knee arthroplasty. The purpose of this retrospective case series is to describe a standardized dual-surgeon technique for combined patellofemoral arthroplasty (PFA) with patellar realignment using medial patellofemoral ligament reconstruction or tibial tubercle osteotomy and to evaluate early clinical and patient-reported outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on patients who underwent combined PFA and patellar realignment by a fellowship-trained arthroplasty surgeon and fellowship-trained sports surgeon. Outcomes including implant survivorship, functional outcomes, complications, and patient-reported measures (Knee Injury and Osteoarthritis Outcome Score Joint Replacement, Patient Reported Outcomes Measurement Information System (PROMIS), Global Physical Health, PROMIS Global Mental Health, and Forgotten Joint Score) were assessed.</div></div><div><h3>Results</h3><div>Eleven knees in 9 patients were included (55.5% female; median age 41 ± 13.4 years; median body mass index 26 ± 6.2). All knees had isolated patellofemoral arthritis. Nine knees underwent PFA with medial patellofemoral ligament reconstruction for instability or dislocation, while 2 underwent PFA with tibial tubercle osteotomy for patella alta. Two patellae were chronically dislocated, additionally requiring lateral release. Six knees had prior failed stabilizing procedures. The mean operative time was 121 minutes (94–161), with a mean follow-up of 24.0 ± 11.5 months. One patient experienced a periprosthetic patellar fracture at 10 months, followed by a refracture at 14 months, requiring open reduction and internal fixation and extensor mechanism repair. No cases of re-dislocation, maltracking, infections, wound complications, or other medical issues occurred. Knee Injury and Osteoarthritis Outcome Score Joint Replacement scores improved by an average of 14.8 ± 11 points.</div></div><div><h3>Conclusions</h3><div>Combined PFA and patellar realignment surgery can be done efficiently and is associated with improved patient-reported outcomes, with complications limited to a single case of periprosthetic patellar fracture.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101951"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037995","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}