Arthroplasty Today最新文献

{"title":"Cefazolin Alone Versus Cefazolin With Tobramycin or Gentamicin as Intraoperative Antibiotic Prophylaxis for Total Joint Arthroplasty","authors":"Meera M. Dhodapkar MD, MHS,&nbsp;Scott J. Halperin MD, MHS,&nbsp;Zachary Radford MD,&nbsp;Lee E. Rubin MD, FAAOS, FAOA,&nbsp;Jonathan N. Grauer MD,&nbsp;Mengnai Li FAAOS, MD, PhD","doi":"10.1016/j.artd.2024.101613","DOIUrl":"10.1016/j.artd.2024.101613","url":null,"abstract":"<div><h3>Background</h3><div>Prosthetic joint infection is a serious complication of total knee arthroplasty (TKA) and total hip arthroplasty (THA). While cefazolin is the standard prophylactic antibiotic, some groups have considered adding aminoglycosides (gentamycin or tobramycin) to this regimen.</div></div><div><h3>Methods</h3><div>Adult primary THA and TKA patients were identified from 2010-2021 Q1 PearlDiver M151 database. Inclusion criteria were activity in the database ≥ 90 days postoperative and no infectious, neoplastic, or traumatic diagnoses within 90 days preoperative. Intraoperative antibiotic prophylaxis regimens were determined using Current Procedural Terminology J codes. For both THA and TKA, 2 subcohorts were created: (1) Patients who received cefazolin alone and (2) cefazolin and tobramycin or gentamicin. Differences in 90-day postoperative adverse outcomes were assessed with multivariable logistic regression controlling for age, sex, and Elixhauser Comorbidity Index. Five-year implant survival was assessed using Kaplan-Meier analysis and log-rank tests.</div></div><div><h3>Results</h3><div>For THA, 32,882 patients were identified, prophylactic cefazolin alone was given to 30,527 (92.8%), and cefazolin + gentamicin/tobramycin was given to 2355 (7.2%). For TKA, 119,611 patients were identified, prophylactic cefazolin alone was given to 110,469 (92.4%), and cefazolin + gentamicin/tobramycin was given to 9142 (7.6%). Overall SSI rate for THA was 1.1% and for TKA 0.8%. For both THA and TKA, antibiotic subgroups were clinically similar with regard to age, sex, and Elixhauser Comorbidity Index. On univariable and multivariable analysis, no 90-day outcomes varied significantly. Five-year implant survivals were not significantly different.</div></div><div><h3>Conclusions</h3><div>For THA and TKA, cefazolin alone vs cefazolin + gentamicin/tobramycin were not found to have differences in rates of perioperative adverse outcomes (including SSI/prosthetic joint infection) or 5-year revision rates.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101613"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162849","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":"Routine Pathologic Examination of Femoral Heads is Not Warranted","authors":"Brian Curtin MD,&nbsp;Brett Levine MD, MS,&nbsp;Sumon Nandi MD, MBA","doi":"10.1016/j.artd.2025.101624","DOIUrl":"10.1016/j.artd.2025.101624","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101624"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163659","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":"Ascorbic Acid Reduces the Blood Boss After Total Knee Arthroplasty: Insights From a Randomized Controlled Trial","authors":"Pooya Hosseini-Monfared MD ,&nbsp;Alireza Mirahmadi MD ,&nbsp;Mohammad Mehdi Sarzaeem MD ,&nbsp;Soheil Pourshahryari MD ,&nbsp;Parisa Aminnia MD ,&nbsp;Mohammad Poursalehian MD ,&nbsp;Seyed Morteza Kazemi MD","doi":"10.1016/j.artd.2025.101618","DOIUrl":"10.1016/j.artd.2025.101618","url":null,"abstract":"<div><h3>Background</h3><div>Blood loss is among the main complications of total knee arthroplasty (TKA) and oxidative stress, and hemolysis caused by reactive oxygen species are one of the causes of hemoglobin (Hb) drop. Ascorbic acid is a potent antioxidant that can protect against reactive oxygen species. In this study, we aim to explore the antioxidant effect of ascorbic acid on blood loss and patient-reported outcomes following outpatient TKA.</div></div><div><h3>Methods</h3><div>Patients scheduled for outpatient primary TKA were enrolled in this randomized, double-blind clinical trial and were assigned to 1 of the 2 groups. The patients in the ascorbic acid group received intravenous vitamin C perioperatively. Patients in the placebo group received only normal saline. We calculated the blood loss using the Hb drop. Patient-reported outcomes such as Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score, and Forgotten Joint Score were used to evaluate the postoperative pain and function in the 6-month follow-up.</div></div><div><h3>Results</h3><div>The patients who have received ascorbic acid had lower Hb drop (g/dL) (1.30 ± 0.72 vs 1.91 ± 0.84, <em>P</em> value &lt; .001) and total blood loss in the first postoperative day (463.60 ± 274.37 vs 732.11 ± 347.78, <em>P</em> value &lt; .001). Also, fewer patients reached the minimum clinically important difference level for Hb drop in the ascorbic acid group. The patients’ postoperative functional and pain scores were not different between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Our findings demonstrated that perioperative use of ascorbic acid can reduce blood loss by nearly 36% on the first postoperative day and should be considered as an effective blood-preserving agent in conjunction with tranexamic acid during TKA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101618"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092285","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":"Age- and Sex-Specific Risks of Major Cardiovascular Complications and All-Cause Mortality Following Elective Hip and Knee Arthroplasty in the Netherlands: A Dutch Hospital Data Registry Study","authors":"Mark J.R. Smeets MD ,&nbsp;Maaike G.J. Gademan PhD ,&nbsp;Rob G.H.H. Nelissen MD, PhD ,&nbsp;Suzanne C. Cannegieter MD, PhD ,&nbsp;Banne Nemeth MD, PhD","doi":"10.1016/j.artd.2024.101597","DOIUrl":"10.1016/j.artd.2024.101597","url":null,"abstract":"<div><h3>Background</h3><div>Age and sex are well-known risk factors for cardiovascular complications and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Yet, stratified up-to-date absolute risk estimates, which are needed to optimize prevention, are lacking.</div></div><div><h3>Methods</h3><div>All Dutch patients who had a first primary THA and TKA for osteoarthritis between 2015 and 2021 were included. Data on baseline characteristics, procedures, and outcomes were obtained from the Dutch Hospital Data and Population registries, after linkage. Overall risks for venous thromboembolism, arterial thromboembolism, bleeding, and all-cause mortality were estimated at 30 and 90 days following surgery. Time trends were assessed by plotting 90-day risks by year. Lastly, 90-day risks were stratified by age and sex categories.</div></div><div><h3>Results</h3><div>A total of 123,809 THA and 132,726 TKA patients were included. Females accounted for 63% and 65% of THA and TKA patients, respectively. At 90 days, overall risks were all below 1%. We observed no clear time trends in the risks over recent years. The stratified analysis showed that especially men older than 80 have a complication risk of at least 3%. Interestingly, the risk of venous thromboembolism and bleeding, following a THA, was observed to be relatively high in men and women in the youngest age category.</div></div><div><h3>Conclusions</h3><div>Generally, the 90-day incidence of cardiovascular complications and all-cause mortality is low but can be at least 3% for men in the highest age category. With this knowledge, perioperative preventive measures can be targeted more precisely, and shared decision-making improved.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101597"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029787","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":"Evaluation of Active Intraoperative Nerve Monitoring in Severe Developmental Dysplasia of the Hip Patients Undergoing Total Hip Arthroplasty","authors":"Alireza Manafi Rasi MD ,&nbsp;Sina Afzal Dr. MD ,&nbsp;Mojtaba Baroutkoub MD ,&nbsp;Hasan Shakiba MD ,&nbsp;Pooya Kalani MD ,&nbsp;Mehdi Tavassoli MD ,&nbsp;Reza Zarei MD","doi":"10.1016/j.artd.2024.101612","DOIUrl":"10.1016/j.artd.2024.101612","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) stands as the standard treatment in neglected developmental dysplasia of the hip (DDH), and its application in severe cases may be linked to debilitating outcomes, including nerve damage. Here, we aimed to report the results of intraoperative nerve monitoring (IONM) via an active method.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we recruited patients with Crowe types III and IV DDH, who underwent THA. The study comprised 2 cohorts: one without nerve monitoring and the other with active IONM under epidural anesthesia. The primary study outcomes included the incidence of neural complications, the extent of achieved leg lengthening, and the necessity for femoral osteotomy.</div></div><div><h3>Results</h3><div>A total of 183 patients were included in this study as the cases underwent THA under epidural anesthesia and IONM, along with 156 historical cohorts of controls. In the group with IONM, no clinically postoperative nerve injury was detected, while in the control group, 6 (3.8%) patients experienced neural complications (<em>P</em> = .08). The mean achieved limb lengthening was significantly greater in the monitoring group as 4.2 cm (range = 2.4-5.6) than in the control group as 3.56 cm (range = 2.2-5.6) (<em>P</em> = .04). The rate of femoral osteotomy was significantly lower in the monitoring group (13.6%, 25/183) compared to the control group (27.5%, 43/156) (<em>P</em> &lt; .005).</div></div><div><h3>Conclusions</h3><div>The utilization of active IONM in patients under epidural anesthesia during THA for severe DDH proves to be an effective approach. This method allows for real-time assessment of nerve function throughout the surgical procedure, demonstrating its potential to minimize postoperative complications.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101612"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081007","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":"Patient Perspective on Robotic-Assisted Total Joint Arthroplasty","authors":"Siddhartha Dandamudi BBA ,&nbsp;Kyleen Jan MD ,&nbsp;Madelyn Malvitz BS ,&nbsp;Anne DeBenedetti MSc ,&nbsp;Omar Behery MD, MPH ,&nbsp;Brett R. Levine MD, MS","doi":"10.1016/j.artd.2024.101598","DOIUrl":"10.1016/j.artd.2024.101598","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear. This study aims to assess patients' expectations on robotic technology in TJA.</div></div><div><h3>Methods</h3><div>A 9-question survey assessing patient understanding and expectations of the use of robotics in TJA was distributed to preoperative and postoperative hip and knee patients of five surgeons at a high-volume academic center. Responses were descriptively analyzed.</div></div><div><h3>Results</h3><div>A total of 498 responses were collected. Of all respondents, 69.1% are aware of robotic usage in TJA, 68.5% are interested but unsure of the benefits, and only 19.5% feel it is superior to manual surgery. Most patients did not consider robotic TJA as minimally invasive surgery, with 61.7% stating they are not the same. In addition, 52.3% were not comfortable with extra or longer incisions for robotic procedures. Regarding surgeon choice, 94.9% did not consider if the surgeon is able to perform robotic TJA, 74.4% wanted their surgeon proficient in manual TJA, and 72.4% felt that surgeons who use robotic technology are not more capable than manual surgeons.</div></div><div><h3>Conclusions</h3><div>Awareness and curiosity of robotic-assisted TJA exists; however, most patients did not appear to acknowledge superiority or benefits over manual surgery. Furthermore, patients appear to prefer surgeon proficiency in manual techniques, which may influence training programs in the future. Surgeons should weigh patient goals, expectations, outcomes, and costs when choosing to perform robotic TJA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101598"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984849","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":"Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis","authors":"Cale A. Pagan MD ,&nbsp;Theofilos Karasavvidis MD ,&nbsp;Breana Siljander MD ,&nbsp;Eytan M. Debbi MD, PhD ,&nbsp;Charles A. DeCook MD ,&nbsp;Jonathan Vigdorchik MD","doi":"10.1016/j.artd.2024.101588","DOIUrl":"10.1016/j.artd.2024.101588","url":null,"abstract":"<div><h3>Background</h3><div>Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system.</div></div><div><h3>Methods</h3><div>The study analyzed the first 80 RA-TKA and the last 80 M-TKA cases performed by a single surgeon using the VELYS robotic system after transitioning from M-TKA. Cases were subdivided into groups of 20 and compared to M-TKA cases. A cumulative summation analysis identified the learning curve phases.</div></div><div><h3>Results</h3><div>Three phases were identified: Phase 1 (initial learning, cases 1-9), Phase 2 (increased competence, plateau from cases 10-52), and Phase 3 (post-learning, optimized performance from cases 53-80). Mean surgical time for RA-TKA was 42.4 ± 8.7 minutes, compared to 35.3 ± 7.0 minutes for M-TKA (<em>P</em> &lt; .001). Early RA-TKA cases (1-20) had significantly longer times than late RA-TKA cases (61-80) and M-TKA cases (<em>P</em> &lt; .05). Late RA-TKA times were comparable to M-TKA (<em>P</em> = .06).</div></div><div><h3>Conclusions</h3><div>RA-TKA is an enabling surgical tool that can be integrated efficiently into a surgical workflow with a rapid learning curve of 9 cases.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101588"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984743","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":"Distal Femoral Replacement With a Metaphyseal Sleeve: Outcomes and Risk Factors for Subsidence","authors":"David Alexander George MBChB, BMedSc, FRCS (Tr & Orth),&nbsp;Christopher Lee Buckle MBBS, BSc, MSc (Oxon), FRCS (Tr & Orth),&nbsp;Abtin Alvand BSc (Hons), MBBS, DPhil (PhD), FRCS (Tr & Orth),&nbsp;William Jackson MBBS, BSc, FRCS (Tr & Orth),&nbsp;Adrian Taylor MBBS, FRCS (Orth),&nbsp;Ben Kendrick DPhil (PhD), FRCS (Tr & Orth)","doi":"10.1016/j.artd.2024.101403","DOIUrl":"10.1016/j.artd.2024.101403","url":null,"abstract":"<div><div>In this study, we report on the outcomes of our experience using a metaphyseal sleeve with a distal femoral replacement (DFR) and review the risk factors for sleeve subsidence over a 3 year period.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101403"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349617","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":"Postoperative Pain and Opiate Requirement is Increased Following Second-Side Surgery Among Patients Undergoing Staged Total Knee Arthroplasty","authors":"Vivek P. Chadayammuri MD,&nbsp;Shuvalaxmi D. Haselton MS,&nbsp;Elizabeth Diaz PA-C,&nbsp;Roger H. Emerson MD","doi":"10.1016/j.artd.2024.101591","DOIUrl":"10.1016/j.artd.2024.101591","url":null,"abstract":"<div><h3>Background</h3><div>Primary total knee arthroplasty (TKA) continues to grow exponentially, with a significant subset of patients requiring staged bilateral procedures. The optimal interval between staged procedures and effective strategies to minimize postoperative pain to enhance rehabilitation and mobility remain poorly understood.</div></div><div><h3>Methods</h3><div>160 consecutive patients undergoing staged bilateral TKA between August 2017 and January-2021 was retrospectively reviewed. Patients with a history of chronic opioid dependency were excluded. Baseline demographics, primary outcome measures, including visual analog scale (VAS) pain scores, perioperative opioid utilization (MME/day), and surgical satisfaction were evaluated. All patients had a minimum follow-up of 1-year-postoperatively. All univariate and multivariate statistical analyses were performed with significance given by <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The mean interval between staged TKA was 8-weeks (standard deviation, 4.9-weeks). Preoperative VAS pain scores were significantly higher for the initial TKA, confirming that the more symptomatic knee was addressed first. Despite this, VAS pain scores were significantly increased following second-side TKA at 6-months postoperatively (<em>P</em> = .001). Multivariate analysis identified weekly interval duration between staged procedures as the single-most predictive factor of increased pain following second-side TKA (β = −0.106; <em>P</em> &lt; .01). Female patients were increasingly susceptible to elevated pain levels following second-side TKA (β = 0.372; <em>P</em> = .057).</div></div><div><h3>Conclusions</h3><div>Postoperative pain increases after second-side TKA in staged-bilateral procedures, despite the more symptomatic side being addressed first. Our study identified weekly interval between staged procedures as the single-most predictive factor of pain, and female patients being predisposed to heightened pain following second-side TKA; implicating nociceptive pathways require weeks to normalize, necessitating gender-specific pain management and extended intervals.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101591"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972513","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":"What Is the Prevalence of Hip Abductor Pathology in Patients Undergoing Total Hip Arthroplasty?","authors":"David A. Brethouwer DO ,&nbsp;Matthew L. Brown MD ,&nbsp;Julie C. McCauley MPH ,&nbsp;William D. Bugbee MD ,&nbsp;Eric Y. Chang MD ,&nbsp;Alecio F. Lombardi MD ,&nbsp;Brian J. Rebolledo MD","doi":"10.1016/j.artd.2024.101601","DOIUrl":"10.1016/j.artd.2024.101601","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is generally considered a successful operation for patients with advanced hip arthritis. Hip abductor pathology can lead to diminished outcomes. The prevalence of hip abductor pathology in patients undergoing THA is not well described.</div></div><div><h3>Methods</h3><div>Our institution’s arthroplasty registry was queried to identify patients undergoing THA who had preoperative magnetic resonance imaging (MRI) of the hip or pelvis. MRIs were reviewed for presence of abductor (gluteus medius or gluteus minimus) tendon injury. Dysfunction of the abductor musculotendinous units was assessed by grading fatty infiltration of the muscle bellies using the Goutallier/Fuchs classification.</div></div><div><h3>Results</h3><div>A total of 1090 primary THAs were performed during the study period, and 118 (10.8%) patients had a preoperative MRI of the hip or pelvis ≤12 months prior to surgery. Among the 118 patients who had an MRI, abductor tendon tears were diagnosed in 33 patients (28.0%), and tendinosis was noted in 106 patients (89.8%).</div></div><div><h3>Conclusions</h3><div>There is a high prevalence of hip abductor pathology in patients presenting for THA. Clinicians should evaluate patients for signs of abductor tendon pathology when presenting for consideration of THA. Careful examination and MRI may be helpful to further evaluate the status of the gluteus minimus and gluteus medius musculotendinous units.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101601"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984783","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}