Arthroplasty Today最新文献

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

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

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

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

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

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

{"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":"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}