Arthroplasty Today最新文献

{"title":"Total Hip Arthroplasty for Avascular Necrosis in a Patient With Hemophilia B","authors":"Siddhartha Dandamudi BBA ,&nbsp;Joyee Tseng BS ,&nbsp;John Ratz BS ,&nbsp;Lisa Boggio MD, MS ,&nbsp;Brett R. Levine MD, MS","doi":"10.1016/j.artd.2024.101482","DOIUrl":"10.1016/j.artd.2024.101482","url":null,"abstract":"<div><div>Avascular necrosis (AVN) of the femoral head accounts for up to 10% of all total hip arthroplasties performed annually. Typically associated with intravascular coagulation, AVN is extremely rare in patients with bleeding disorders such as hemophilia B. In this report, we describe the therapeutic management of a 46-year-old male with hemophilia B, presenting with chronic left hip pain and AVN of the femoral head. He presented with progressive groin pain for 6 months and was unable to ambulate without the assistance of crutches. Radiographs showed evidence of degenerative joint disease secondary to AVN of the femoral head. After exhausting treatment options, the patient elected to proceed with an elective total hip arthroplasty. Intricate preoperative planning and hemophilia management were required by a multidisciplinary team to mitigate bleeding risks and promote success of the surgery. Postoperatively, the patient experienced a short-term rise in creatinine, but experienced no bleeding complications. The long-term follow-up revealed significant functional improvement without any complications of hemophilia B. There are no reports outlining AVN in hemophilia B (factor IX deficiency) or step-by-step treatment strategies for successful hip replacement in these patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101482"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427485","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":"Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study","authors":"Christian DeMaio BS ,&nbsp;Conner Patrick MD ,&nbsp;Grayson Domingue MD ,&nbsp;Jake Fox MD ,&nbsp;Justin Dvorak PhD ,&nbsp;Rishi Thakral MD","doi":"10.1016/j.artd.2024.101512","DOIUrl":"10.1016/j.artd.2024.101512","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article seeks to better characterize the complication risks in patients undergoing THA with SCD when compared to osteoarthritis (OA) using a large database from the National Inpatient Sample.</div></div><div><h3>Methods</h3><div>National Inpatient Sample data from 2006 through the third quarter of 2015 were analyzed using International Classification of Diseases, Ninth Revision codes. A weighted frequency of 4,350,961 THAs were recorded for OA and 4279 for SCD. These were compared using a Rao-Scott chi-squared test, and the prespecified complications were given sampling weights to approximate national estimates.</div></div><div><h3>Results</h3><div>The following complications were found to occur at a significantly increased frequency in patients with OA with SCD vs OA only: wound infection (0.69% vs 0.36%), dislocation (1.68% vs 0.80%), and urinary complications (3.61% vs 2.35%). SCD, when evaluated independent of avascular necrosis, was reported with higher frequency wound infection (0.86% vs 0.36%), and overall complications (7.25% vs 5.06%). Additionally, multiple comorbidities were significantly more prevalent in the SCD population compared to OA patients.</div></div><div><h3>Conclusions</h3><div>This study illustrates that patients with SCD have increased complication rates when compared to OA patients. This information benefits orthopaedic surgeons in preoperative and postoperative planning and counseling patients for realistic expectations. Furthermore, this study provides data that could benefit decision-making on bundled reimbursement for this specific patient population.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101512"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427048","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":"Evaluating the Quality and Reliability of Total Knee Arthroplasty Rehabilitation Exercises on the Social Media Platform TikTok","authors":"Sarah Welch BS ,&nbsp;Kian Bagheri DO ,&nbsp;Mikhail Bethell MS ,&nbsp;Albert T. Anastasio MD ,&nbsp;Troy Q. Tabarestani MD ,&nbsp;Michael Bolognesi MD","doi":"10.1016/j.artd.2024.101486","DOIUrl":"10.1016/j.artd.2024.101486","url":null,"abstract":"<div><h3>Background</h3><div>The utilization of social media for health-related purposes has surged, especially during the COVID-19 pandemic. TikTok, a short-form video platform, has seen substantial growth, becoming a prominent medium for health information dissemination. However, the lack of regulation poses challenges in evaluating the validity of TikTok content.</div></div><div><h3>Methods</h3><div>This cross-sectional study assesses TikTok videos related to total knee arthroplasty rehabilitation exercises. Search terms identified 84 videos, with 64 meeting the inclusion criteria. Engagement metrics and quality scores were analyzed, utilizing the DISCERN tool and the Total Knee Replacement Exercises Education Score.</div></div><div><h3>Results</h3><div>The analyzed videos accumulated nearly 6 million views, with a median of 10,293.5 (interquartile range = 4139.3-26,100.0). Health-care professionals contributed 48% of the content. Despite higher engagement metrics for health-care professional videos, the overall quality, as indicated by DISCERN and Total Knee Replacement Exercises Education scores, remained poor. No videos achieved an “excellent” rating, with the majority categorized as “poor.”</div></div><div><h3>Conclusions</h3><div>This study underscores TikTok’s substantial role in total knee arthroplasty rehabilitation information dissemination but reveals a critical deficit in content quality and reliability. Health-care professionals marginally outperformed general users but displayed overall inadequacy. The study emphasizes the necessity for improving the quality of health-related content on emerging social media platforms, especially within the realm of orthopaedic surgery.</div></div><div><h3>Level of Evidence</h3><div>Level III, Cross-sectional study.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101486"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427477","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-Reported Outcomes in Robotic-Assisted vs Manual Cementless Total Knee Arthroplasty","authors":"Michael J. Stoltz MD ,&nbsp;Nolan S. Smith MD ,&nbsp;Sarag Abhari MD ,&nbsp;John Whitaker MD ,&nbsp;James F. Baker MD ,&nbsp;Langan S. Smith BS ,&nbsp;Rohat Bhimani MD ,&nbsp;Madhusudhan R. Yakkanti MD ,&nbsp;Arthur L. Malkani MD","doi":"10.1016/j.artd.2024.101488","DOIUrl":"10.1016/j.artd.2024.101488","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted total knee arthroplasty (RA-TKA) was introduced to provide surgeons with virtual preoperative planning and intraoperative information to achieve the desired surgical goals in an effort to improve patient outcomes. The purpose of this study was to compare clinical outcomes and patient-reported outcome measures following primary TKA using RA-TKA vs manual instrumentation.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort review study comparing 393 primary RA-TKAs vs 312 manual TKAs at a minimum 2-year follow-up. The same cementless implant design was utilized in all cases at a single institution. There were no significant differences in age or gender between groups. Outcome measures included range-of-motion, Knee Society (KSS), Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score-12, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and overall patient satisfaction scores along with complications and survivorship.</div></div><div><h3>Results</h3><div>Compared to manual TKA, the RA-TKA group had significant higher postoperative KSS Function and Knee scores, Western Ontario and McMaster Universities Osteoarthritis Index, and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores (<em>P</em> &lt; .001). A total percentage of 95.0% of RA-TKA vs 87.4% of manual TKAs were very satisfied or satisfied (<em>P</em> = .001). Survivorship with all-cause failure as the endpoint at 3 years was 96.9% in the RA-TKA group compared to 95.8% in the manual group (<em>P</em> = .54).</div></div><div><h3>Conclusions</h3><div>RA-TKA demonstrated significant improvement over manual jig-based instruments in KSS Function, KSS Knee, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and patient satisfaction scores following primary TKA with no differences in complications and revision incidence. RA-TKA provided a virtual 3-dimensional preoperative plan along with intraoperative information for adjustments to approximate the patients' native joint line and achieve a well-balanced soft-tissue sleeve about the knee for primary TKA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101488"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427041","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":"Robotic-Assistance in Total Hip Arthroplasty Is Associated With Decreased Dislocation Rates","authors":"Gabrielle N. Swartz BS ,&nbsp;Sandeep S. Bains MD, DC, MBA ,&nbsp;Jeremy A. Dubin BA ,&nbsp;Reza Katanbaf MD, MBA ,&nbsp;Hunter Hayes DO ,&nbsp;James Nace DO, MPT ,&nbsp;Michael A. Mont MD ,&nbsp;Ronald E. Delanois MD","doi":"10.1016/j.artd.2024.101473","DOIUrl":"10.1016/j.artd.2024.101473","url":null,"abstract":"<div><h3>Background</h3><div>As the use of robotics in total hip arthroplasty (THA) continues to gain popularity, differences in clinical outcomes when compared to manual techniques have remained unclear. This study aimed to compare postoperative complications between patients undergoing robotic-assisted techniques and manual THA for primary osteoarthritis at 90 days, 1 year, and 2 years.</div></div><div><h3>Methods</h3><div>Using an all-payer national database, we identified 405,048 patients who underwent either robotic-assisted or manual THA for primary osteoarthritis. A propensity match was performed for age, sex, a comorbidity index, chronic kidney disease, obesity, and diabetes, resulting in 7652 patients in each cohort. We assessed postoperative outcomes, including surgical site infections, pulmonary emboli, venous thromboemboli, wound complications, dislocations, aseptic revisions, periprosthetic joint infections, and periprosthetic fractures. We completed bivariate analyses via <em>chi</em>-square tests to assess categorical variables. We utilized student’s <em>t</em>-tests to compare continuous variables, including ages and comorbidities. Odds ratios (ORs) were calculated for complications using 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The robotic-assisted cohort had lower rates of dislocation at 90 days (0.93 vs 1.41%, OR 0.65, 95% CI 0.48-0.88, <em>P</em> = .007), 1 year (1.32 vs 1.92%, OR 0.68, 95% CI 0.53-0.88, <em>P</em> = .004), and 2 years (1.66 vs 2.1%, OR 0.79, 95% CI 0.62-0.99, <em>P</em> = .049). Total surgical complications were significantly lower in the robotic-assisted cohort at 1 year (5.29 vs 6.16%, OR 0.85, 95% CI 0.74-0.98, <em>P</em> = .0205), but were similar at 90 days and 2 years. At 90 days, the rates of medical complications, including surgical site infections, pulmonary emboli, venous thromboemboli, and wound complications, were similar (all <em>P</em> &gt; .05). The rates of periprosthetic joint infections, aseptic revision, periprosthetic fractures, and aseptic loosening were similar at all time points (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Patients who underwent robotic-assisted THA had lower rates of dislocation at 90 days, 1 year, and 2 years. This finding supports the use of robotic assistance in THA, though further research is needed to confirm and strengthen these findings.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101473"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427499","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":"Qualitative Comparison of Cultured Skin Microbiota From the Inguinal Region of Obese and Nonobese Patients Eligible for Hip Arthroplasty","authors":"Philip Mark Anderson MD ,&nbsp;Thiemo Frank ,&nbsp;Michaela Herz MD ,&nbsp;Oliver Kurzai MD ,&nbsp;Maximilian Rudert MD ,&nbsp;Tizian Heinz MD ,&nbsp;Thiên-Trí Lâm MD","doi":"10.1016/j.artd.2024.101483","DOIUrl":"10.1016/j.artd.2024.101483","url":null,"abstract":"<div><h3>Background</h3><div>With the rising prevalence of obesity, surgeons are frequently confronted with the problem of treating osteoarthritis of the hip via arthroplasty (total hip arthroplasty) in severely obese patients. To reduce the surgical impact, minimal-invasive approaches are often chosen. For this reason, the direct anterior approach has gained popularity but is suspected of leading to more wound complications in obese patients, especially by Gram-negative pathogens. Causative differences of the skin microbiome have been suspected but not yet proven.</div></div><div><h3>Methods</h3><div>Patients scheduled for total hip arthroplasty via direct anterior approach were screened for inclusion. The study group was defined as patients with a body mass index ≥35 and an abdominal pannus hanging over the incision site, whereas nonobese patients served as the control group. Samples of the microbiome were taken 2-3 cm distal and lateral to the superior anterior iliac spine using plates and swabs. Species identification was carried out by mass spectrometric analysis.</div></div><div><h3>Results</h3><div>The study group consisted of 28 patients, the control group of 36 patients. The most frequent potential pathogen on the skin was <em>Staphylococcus epidermidis</em> in both the groups. Microbiota found in obese patients showed significantly higher prevalence of Gram-negative bacteria from the order Enterobacterales. Wound complications were more frequent in the study group, but this was not statistically significant.</div></div><div><h3>Conclusions</h3><div>Obese patients with abdominal pannus present higher rates of colonization with Enterobacterales at the incision site of the direct anterior approach. Modifications of the antibiotic regime and the incision should be considered in this special patient population.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101483"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426815","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":"Factors Affecting Successful Restricted Kinematic Alignment With Robotic Assisted Total Knee Arthroplasty in Patients With Severe Varus Preoperative Alignment","authors":"Samuel Yan Jin Fang MBBS (HK) ,&nbsp;Kwong Yuen Chiu MBBS (HK), FRCSEd (Orth), FHKCOS, FHKAM ,&nbsp;Wai Kiu Thomas Liu MBBS (HK) ,&nbsp;Amy Cheung MBBS (HK), FRCSEd (Orth), FHKCOS, FHKAM ,&nbsp;Ping Keung Chan MBBS, MRCSEd, FHKCOS, FHKAM, FRCSEd (Orth) ,&nbsp;Henry Fu MBBS (HK), MMedSc (HK), FRCSEd (Orth), FHKCOS, FHKAM","doi":"10.1016/j.artd.2024.101490","DOIUrl":"10.1016/j.artd.2024.101490","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) remains challenging in severe varus knees. We evaluated the impact of hip-knee-ankle varus deformity and osteophyte size on achieving restricted kinematic alignment (rKA) in robotic-arm-assisted TKA.</div></div><div><h3>Methods</h3><div>This retrospective study included 244 knees (194 patients) that underwent robotic-arm-assisted TKA for varus primary knee osteoarthritis at an academic institution. Intraoperative hip-knee-ankle angle (HKA) and soft tissue balance were monitored to assess the success of rKA with osteophyte resection alone. For those that failed, medial collateral ligament needle pie-crusting was performed.</div></div><div><h3>Results</h3><div>Mean age was 65.3 years (range, 48-83). Mean preoperative HKA was 11.9° varus (range, 1.0°-32.0°), and HKA after osteophyte resection was 5.1° varus (range, 0°-19.0°). Mean HKA correction was 6.8° (range, 0°-18.0°). rKA was achieved in 36.9% at a boundary of ≤3° varus and up to 72.1% at ≤6° varus. Preoperative varus HKA was lower in successful cases across all target alignments (<em>P</em> &lt; .05). Medial tibial osteophyte size was 6.1% ± 2.9% and was smaller in all groups that achieved rKA (<em>P</em> &lt; .05). Both were positively correlated with degree of deformity correction, <em>r</em> = 0.718 (<em>P</em> &lt; .01) and <em>r</em> = 0.281 (<em>P</em> &lt; .01), respectively.</div></div><div><h3>Conclusions</h3><div>This study highlighted the importance of varus deformity and medial tibial osteophytes when adopting rKA. They were associated with increased failure to achieve rKA. rKA was reliably achieved in minimal varus deformities (HKA ≤ 5°), we recommend an expanded protocol of HKA ≤ 6° varus for mild deformities (HKA 6°-10°), and consider medial soft tissue release for moderate (HKA 11°-15°) and severe deformities (HKA ≥ 16°).</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101490"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427476","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":"A Handheld, Portable Image-Based System May Outperform Computer Navigation or Robotic Platforms in Providing Accurate Acetabular Component Positioning","authors":"Eric M. Slotkin DO ,&nbsp;Francesca Coxe MD ,&nbsp;Tristan Jones BaSC, MPT, MBA ,&nbsp;Thomas Morton PA-C ,&nbsp;Stefan Kreutzer MD ,&nbsp;Allejandro Della-Valle MD","doi":"10.1016/j.artd.2024.101511","DOIUrl":"10.1016/j.artd.2024.101511","url":null,"abstract":"<div><h3>Background</h3><div>Malposition of the acetabular component during total hip arthroplasty (THA) is a leading cause of complications and need for revision. Robotic-assisted THA purports to improve accuracy of component positioning with many reports demonstrating over 92% of components within 10° of inclination and anteversion compared to intraoperative system output. This study aimed to evaluate the intraoperative accuracy output of acetabular cup position values using a handheld miniaturized portable navigation system (Naviswiss, AG) compared to postoperative computed tomography (CT) scans.</div></div><div><h3>Methods</h3><div>A total of 108 direct anterior approach THA surgeries using the intraoperative navigation device were performed over a 6-month period. Intraoperative device output for measured acetabular component inclination and anteversion were recorded and compared with values derived from postoperative CT scans.</div></div><div><h3>Results</h3><div>Postoperative CT analysis of acetabular component positioning demonstrated 97.22% and 94.44% were within 5° of intraoperative inclination and anteversion, respectively, compared to intraoperative values from the navigation unit. No CT demonstrated an absolute inclination or anteversion measurement difference more than 8° from the intraoperative navigation unit value. Overall, 92.59% of components were within 5° and 100% were within 8° for both inclination and anteversion compared to postoperative CT measurements.</div></div><div><h3>Conclusions</h3><div>This handheld portable navigation system yielded highly accurate intraoperative component positioning values confirmed by postoperative CT scans during direct anterior THA, possibly superior to reported robotic-assisted THA values. These smaller, portable, and more accessible intraoperative units may provide surgeons improved accuracy and availability in a number of surgical settings for use in THA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101511"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427047","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":"Failure of the Femoral and Tibial Components Following Anterior Cruciate Ligament Injury After Robotic-Assisted Bicruciate-Retaining Total Knee Arthroplasty","authors":"Kosuke Shiga MD ,&nbsp;Takao Kaneko MD, PhD ,&nbsp;Ayakane Yamamoto MD ,&nbsp;Kazuki Amemiya PT ,&nbsp;Masaru Omata PT","doi":"10.1016/j.artd.2024.101523","DOIUrl":"10.1016/j.artd.2024.101523","url":null,"abstract":"<div><div>We report a case of failure of the femoral and tibial components due to anterior cruciate ligament (ACL) injury after robotic-assisted bicruciate-retaining total knee arthroplasty. A 70-year-old woman with osteoarthritis underwent robotic-assisted bicruciate-retaining total knee arthroplasty. At 8 months after surgery, persistent knee pain and swelling of the knee joint were noted after fall in knee. We diagnosed a failure between the femoral and tibial components following an ACL injury. Proximal ACL injury and spin out of ultra-high molecular weight polyethylene were confirmed. We selected a constrained condylar knee prosthesis due to large bone attribution after femoral and tibial component removal. Postoperative three-dimensional computed tomography images suggested that excessive internal rotational alignment of the tibial component caused stress on the ACL.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101523"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427482","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":"Conversion of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty for Cement Allergy","authors":"Alexander Edelstein MD ,&nbsp;Andrew Lachance MD ,&nbsp;Coleman Cush BS ,&nbsp;Jeffrey Lutton MD","doi":"10.1016/j.artd.2024.101496","DOIUrl":"10.1016/j.artd.2024.101496","url":null,"abstract":"<div><div>Despite the success of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA), complications leading to loosening and eventual failure can arise. While infection, instability, and aseptic loosening are some of most common causes of UKA and TKA failure, one of the less common reasons is delayed hypersensitivity reactions. While most allergic reactions are hypersensitivity reactions to metal, hypersensitivity reactions to other materials used in the procedure, such as polymethylmethacrylate bone cement, have begun to gain more attention in recent years. In this case report, we explore the unique instance of a patient who required a revision of a cemented UKA to TKA due to severe pain likely caused by a confirmed polymethylmethacrylate allergy.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101496"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427484","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}