Arthroplasty Today最新文献

{"title":"Uncemented Total Knee Arthroplasty is on the Rise. A Report of Patient Demographics and Short-Term Outcomes From the Michigan Arthroplasty Registry Collaborative Quality Initiative","authors":"Sarah Roth MD ,&nbsp;Madeleine Grace DeClercq BS ,&nbsp;Michael Sacchetti MPH ,&nbsp;Jacob Keeley MS ,&nbsp;Mark Karadsheh MD ,&nbsp;Robert Runner MD","doi":"10.1016/j.artd.2024.101499","DOIUrl":"10.1016/j.artd.2024.101499","url":null,"abstract":"<div><h3>Background</h3><div>Cemented total knee arthroplasty (TKA) is the gold standard treatment for osteoarthritis, but uncemented TKA offers benefits like improved osseointegration and reduced complications from cement debris. This study aimed to investigate (1) if there has been a rise in uncemented TKA from 2017 to 2021 and (2) if there are differences in early complications between cemented and uncemented TKA.</div></div><div><h3>Methods</h3><div>A retrospective data review was performed on the Michigan Arthroplasty Registry Collaborative Quality Initiative database of TKA patients from 2017 to 2021 at 6 hospitals. Patients with revision or partial knee arthroplasty were excluded. Patients were divided into 2 groups: uncemented and cemented. Hybrid and reverse hybrid fixation data were collected for incidence, but not for demographics or complications. All patient demographics and 90-day postoperative events were collected and analyzed.</div></div><div><h3>Results</h3><div>A retrospective study of 18,749 primary TKAs found that 89.7% were cemented, 9.7% uncemented, and 0.7% hybrid or reverse hybrid. Uncemented patients were younger, men, heavier, current smokers, and diabetics than cemented patients (<em>P</em> &lt; .0001, <em>P</em> = .03). They also had a shorter length of stay (<em>P</em> ≤ .0001) and were on fewer preoperative medications: anticoagulants (<em>P</em> = .0059), antiplatelets (<em>P</em> ≤ .0001), opioids (<em>P</em> = .0091), and steroids (<em>P</em> = .0039). The rate of uncemented TKA increased from 3.3% to 17.1%, while the rate of cemented TKA fell from 96.2% to 81.9% (<em>P</em> = .0048). The readmission rate was higher in cemented TKAs (4.0%) than in uncemented TKAs (2.6%) (<em>P</em> = .0048).</div></div><div><h3>Conclusions</h3><div>The use of uncemented TKA increased from 3.3% in 2017 to 17.1% in 2021, while cemented fixation decreased from 96.7% to 81.9%. There were no significant differences in short-term complications between groups. Uncemented patients were younger, men, took fewer medications, had a shorter length of stay, and were less likely to be readmitted. However, they were more likely to have comorbidities than the cemented group.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101499"},"PeriodicalIF":1.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001845/pdfft?md5=df0d6b4454caa6103351f7457dd5f36d&pid=1-s2.0-S2352344124001845-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311294","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":"Comparison of the Unipolar Electrocautery and the Bipolar Sealer in Reducing Blood Loss in Total Knee Arthroplasty: A Prospective, Randomized, Noninferiority Study","authors":"Eugene S. Krauss MD ,&nbsp;Ayal Segal MD ,&nbsp;Barry G. Simonson MD ,&nbsp;Nancy Dengler NP ,&nbsp;MaryAnne Cronin PharmD","doi":"10.1016/j.artd.2024.101509","DOIUrl":"10.1016/j.artd.2024.101509","url":null,"abstract":"<div><h3>Background</h3><div>This was a noninferiority trial to evaluate blood loss during total knee arthroplasty (TKA) when using the unipolar electrocautery system compared to the saline coupled bipolar sealer system in primary TKA.</div></div><div><h3>Methods</h3><div>One hundred sixty-four patients were randomly assigned by a 1:1 ratio to either the unipolar electrocautery system (N = 82) or bipolar sealer system (N = 82). Inclusion criteria included patients scheduled for primary unilateral TKA, preoperative hemoglobin ≥11 mg/dL, preoperative platelet count ≥150,000, age &gt;18 years, and patient willing to complete all study-related procedures. The primary efficacy outcome was estimated blood loss on morning of postoperative day. Secondary efficacy outcomes were comparison between the preoperative hemoglobin and postoperative day 1 hemoglobin, and allogeneic blood transfusions. Additionally, the study collected objective and functional outcomes using the postoperative 2011 Knee Society Score.</div></div><div><h3>Results</h3><div>The unipolar electrocautery system was not found to be less efficacious than the bipolar sealer system. Mean blood loss for the unipolar electrocautery system was 1062.0 cubic centimeters (cc) (95% confidence limit for the mean: 985.2, 1138.7), and for the bipolar sealer system was 929.4 cc (95% confidence limit for the mean: 841.9, 1016.8). The mean difference in blood loss was 132.6 cc, below the margin of inferiority set at 200 cc. Additionally, there was no difference in patient outcomes as measured by the Knee Society Score.</div></div><div><h3>Conclusions</h3><div>The safety, efficacy, and outcomes profile of the unipolar electrocautery system compared to the bipolar sealer system were similar. Use of the bipolar sealer system significantly increases surgical cost without any added benefits.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101509"},"PeriodicalIF":1.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001948/pdfft?md5=ef8798728d34191e86ad877dc7d1bdef&pid=1-s2.0-S2352344124001948-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311295","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":"Analyzing Racial Differences in Imaging Joint Replacement Registries Using Generative Artificial Intelligence: Advancing Orthopaedic Data Equity","authors":"Bardia Khosravi MD, MPH, MHPE ,&nbsp;Pouria Rouzrokh MD, MPH, MHPE ,&nbsp;Bradley J. Erickson MD, PhD ,&nbsp;Hillary W. Garner MD ,&nbsp;Doris E. Wenger MD ,&nbsp;Michael J. Taunton MD ,&nbsp;Cody C. Wyles MD","doi":"10.1016/j.artd.2024.101503","DOIUrl":"10.1016/j.artd.2024.101503","url":null,"abstract":"<div><h3>Background</h3><div>Discrepancies in medical data sets can perpetuate bias, especially when training deep learning models, potentially leading to biased outcomes in clinical applications. Understanding these biases is crucial for the development of equitable healthcare technologies. This study employs generative deep learning technology to explore and understand radiographic differences based on race among patients undergoing total hip arthroplasty.</div></div><div><h3>Methods</h3><div>Utilizing a large institutional registry, we retrospectively analyzed pelvic radiographs from total hip arthroplasty patients, characterized by demographics and image features. Denoising diffusion probabilistic models generated radiographs conditioned on demographic and imaging characteristics. Fréchet Inception Distance assessed the generated image quality, showing the diversity and realism of the generated images. Sixty transition videos were generated that showed transforming White pelvises to their closest African American counterparts and vice versa while controlling for patients’ sex, age, and body mass index. Two expert surgeons and 2 radiologists carefully studied these videos to understand the systematic differences that are present in the 2 races’ radiographs.</div></div><div><h3>Results</h3><div>Our data set included 480,407 pelvic radiographs, with a predominance of White patients over African Americans. The generative denoising diffusion probabilistic model created high-quality images and reached an Fréchet Inception Distance of 6.8. Experts identified 6 characteristics differentiating races, including interacetabular distance, osteoarthritis degree, obturator foramina shape, femoral neck-shaft angle, pelvic ring shape, and femoral cortical thickness.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the potential of generative models for understanding disparities in medical imaging data sets. By visualizing race-based differences, this method aids in identifying bias in downstream tasks, fostering the development of fairer healthcare practices.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101503"},"PeriodicalIF":1.5,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001882/pdfft?md5=4b249b4a85fd37c1ec3f9ccffbaea7c1&pid=1-s2.0-S2352344124001882-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311296","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":"Liver Disease Increases the Risk of Postoperative Complications in Patients Undergoing Aseptic Revision Total Hip and Knee Arthroplasty","authors":"Matthew J. Kinnard MD ,&nbsp;Jordan S. Cohen MD ,&nbsp;Theodore Quan MD ,&nbsp;Jared R.H. Foran MD ,&nbsp;Neil P. Sheth MD, FACS","doi":"10.1016/j.artd.2024.101516","DOIUrl":"10.1016/j.artd.2024.101516","url":null,"abstract":"<div><h3>Background</h3><p>Due to the multiorgan effects of liver disease, surgical patients with liver disease have an increased risk of perioperative complications. With revision total hip and knee arthroplasty surgeries increasing, it is important to determine the effects of liver disease in this patient population. The purpose of this study was to evaluate the impact of underlying liver disease on postoperative outcomes following revision total joint arthroplasty (TJA).</p></div><div><h3>Methods</h3><p>The National Surgical Quality Improvement Program database was used to identify patients undergoing aseptic revision TJA from 2006-2019 and group them based on liver disease. The presence of liver disease was assessed by calculating the Model for End-Stage Liver Disease–Sodium score. Patients with a Model for End-Stage Liver Disease–Sodium score of &gt; 10 were classified as having underlying liver disease. In this analysis, differences in demographics, comorbidities, and postoperative complications were assessed.</p></div><div><h3>Results</h3><p>Of 7102 patients undergoing revision total hip arthroplasty, 11.6% of the patients had liver disease. Of 8378 patients undergoing revision total knee arthroplasty, 8.4% of the patients had liver disease. Following adjustment on multivariable regression analysis, patients with liver disease undergoing revision total hip arthroplasty or revision total knee arthroplasty had an increased risk of major complications, wound complications, septic complications, bleeding requiring transfusion, extended length of stay, and readmission compared to those without liver disease.</p></div><div><h3>Conclusions</h3><p>Patients with liver disease have an increased risk of complications following revision TJA. A multidisciplinary team approach should be employed for preoperative optimization and postoperative management of these vulnerable patients to improve outcomes and decrease the incidence and severity of complications.</p></div><div><h3>Level of evidence</h3><p>This is retrospective cohort study and is level 3 evidence.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101516"},"PeriodicalIF":1.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124002012/pdfft?md5=e8fce76849b933fe81011347c625069b&pid=1-s2.0-S2352344124002012-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274160","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 Comparison of Postoperative Outcomes Between Supine and Lateral Patient Positioning in Total Hip Arthroplasty Using the Anterior-Based Muscle Sparing Surgical Approach","authors":"Christian Pearsall MD, MS ,&nbsp;Michael Denham MD, MS ,&nbsp;Jeremy S. Frederick MD ,&nbsp;Omar K. Farah MD, MBA ,&nbsp;Jakub Tatka MD ,&nbsp;Roshan P. Shah MD JD ,&nbsp;Jeffrey A. Geller MD","doi":"10.1016/j.artd.2024.101515","DOIUrl":"10.1016/j.artd.2024.101515","url":null,"abstract":"<div><h3>Background</h3><p>To determine any differences in clinical outcomes between patients in the supine vs the lateral position during anterior-based muscle sparing (ABMS) total hip arthroplasty (THA).</p></div><div><h3>Methods</h3><p>A retrospective review was performed of 368 patients undergoing THA via the ABMS approach (201 lateral vs 167 supine position) at our institution (2015-2019) with a minimum follow-up of 12 months. Inclusion criteria were all patients undergoing primary THA. Exclusion criteria were any revision surgeries and patients who did not undergo the ABMS THA. Outcomes assessed were postoperative complication rates, ambulation distance, length of stay, and Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness, and physical function scores at 3 time periods (preoperative, 3 months postoperative, and 1 year postoperative).</p></div><div><h3>Results</h3><p>The supine group had significantly greater postoperative day 0 ambulation distance (150 vs 60 meters; <em>P</em> &lt; .001), while no difference was observed on postoperative day 1 (210 meters in supine vs 200 in lateral; <em>P</em> = .921). Median length of stay was significantly shorter in the supine group (1; interquartile range 0-1) with respect to the lateral group (1; interquartile range 0-2; <em>P</em> &lt; .001). The in-hospital complication rates (2.4% in supine vs 1.5% in lateral; <em>P</em> = .780), return to operating room rates (2.4% in supine vs 1.5% in lateral; <em>P</em> = .780), and readmission rates (5.4% in supine vs 5.0% in lateral; <em>P</em> = .631) were not significantly different between the groups. No significant differences were observed across any Western Ontario and McMaster Universities Osteoarthritis Index scores.</p></div><div><h3>Conclusions</h3><p>Both supine and lateral patient positioning provide acceptable early surgical outcomes, suggesting that satisfactory results can be obtained via both positions in THAs.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101515"},"PeriodicalIF":1.5,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124002000/pdfft?md5=0e617c0d09de8553d1718f1e0a4c4bee&pid=1-s2.0-S2352344124002000-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274128","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":"Fracture of an Exeter Femoral Stem With Extensive Ipsilateral Periacetabular Osteolysis","authors":"Ethan D. Ruhland DO ,&nbsp;Daniel G. Antonoff DO ,&nbsp;Daniel R. Mesko DO, FAAOS","doi":"10.1016/j.artd.2024.101436","DOIUrl":"10.1016/j.artd.2024.101436","url":null,"abstract":"<div><p>The Stryker Exeter stem (Stryker, Kalamazoo, MI) has been in service for over 50 years and remains the most widely used cemented stem. Stem fracture is a rare complication, with recently reported rates of 1 in 10,000. We present a case of Exeter stem fracture 25 years following initial implantation as well as a large periacetabular defect secondary to osteolysis. A revision total hip arthroplasty was performed, including periacetabular bone grafting for extensive osteolysis along with retention of a stable acetabular component. This case highlights the rare complication of Exeter stem fracture as well as the technique of bone grafting a large periacetabular defect with a retained acetabular component. This is of particular interest given the rarity of this event and the resurgence in North America of cemented femoral components in total hip arthroplasty.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101436"},"PeriodicalIF":1.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001213/pdfft?md5=1b9619d9e4e3543b9b4044e6fd558fe2&pid=1-s2.0-S2352344124001213-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274127","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":"Ninety-Day Outcomes in Primary Hypercoagulable Disease Patients Undergoing Total Joint Arthroplasty Vs Normal: A Matched Case-Control Series","authors":"Amir M. Boubekri MD ,&nbsp;Michael P. Murphy MD ,&nbsp;Nicolas Jozefowski BS ,&nbsp;Nicholas M. Brown MD ,&nbsp;Harold W. Rees MD","doi":"10.1016/j.artd.2024.101424","DOIUrl":"10.1016/j.artd.2024.101424","url":null,"abstract":"<div><h3>Background</h3><p>Perioperative complications of deep vein thrombosis are well described in the total joint arthroplasty (TJA) literature. Few studies have investigated short-term perioperative outcomes of patients with primary hypercoagulable diseases (PHDs). Optimal perioperative management of PHD patients remains unknown, and they are often referred to tertiary centers for care. We investigated the influence perioperative hematology consultation and anti-coagulation use had on PHD patient outcomes following TJA surgery within the 90-day postoperative period.</p></div><div><h3>Methods</h3><p>This retrospective cohort study examined perioperative outcomes of PHD patients undergoing TJA. Thirty-eight PHD patients were identified and compared to a 3:1 matched control group in a consecutive series of 6568 cases (2007-2019). Perioperative hematology consultations, use of anticoagulants (AC) or antiplatelet therapy, emergency department (ED) visits, readmissions, and complications within 90 days of surgery were determined.</p></div><div><h3>Results</h3><p>The PHD cohort exhibited more frequent hematology consultations (odds ratio 5.88, 95% confidence interval: 2.59-16.63) and AC use (odds ratio 7.9, 95% confidence interval: 3.38-23.80) than controls. PHD patients did not show significantly greater rates of deep vein thrombosis, transfusion, infection, ED visits, or need for operative intervention. Similarly, AC vs antiplatelet therapy yielded comparable ED visits and readmissions within 90 days postoperatively (11.0% vs 9.7%, <em>P</em> = .85 and 5.5% vs 5.5%, <em>P</em> = 1, respectively).</p></div><div><h3>Conclusions</h3><p>These findings suggest that despite increased hematology consultation and AC use, PHD patients do not demonstrate significantly elevated perioperative risks post-TJA, favoring careful preoperative workup and outpatient postoperative follow-up.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101424"},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001092/pdfft?md5=5bd718daf5a5abd7a6af2c4302654c94&pid=1-s2.0-S2352344124001092-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240348","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":"Preoperative Three-Dimensional Planning Using Computed Tomography Improves Screw Placement in Patients Undergoing Acetabular Revision Surgery","authors":"Jonathan Brandt MD ,&nbsp;Rolf Scheiderbauer BSc ,&nbsp;Daphne Wezenberg PhD ,&nbsp;Jörg Schilcher MD, PhD","doi":"10.1016/j.artd.2024.101431","DOIUrl":"10.1016/j.artd.2024.101431","url":null,"abstract":"<div><h3>Background</h3><p>Stable fixation of joint replacement implants is essential to achieve osseointegration in uncemented implants. In acetabular revisions, screws often need to be utilized in quadrants other than the historically so-called “safe” zones to attain sufficient stability. The primary aim of this study was to determine whether preoperative three-dimensional (3D) planning for acetabular revision surgery influences screw length, specifically in the superior pubic ramus (SPR).</p></div><div><h3>Methods</h3><p>Between March 2017 and December 2021, 20 patients underwent preoperative two-dimensional (2D) planning (<em>2D group</em>), and 30 patients underwent 3D planning following the implementation of a new 3D planning software into clinical practice in September 2019 (<em>3D group</em>). Two observers, blinded to the groups, measured the <em>total screw length</em>, <em>screw penetration depth</em>, and cup position on available postoperative computed tomography examinations. For statistical comparisons, the mean measurement from the 2 observers was used.</p></div><div><h3>Results</h3><p>The median <em>total screw lengths</em> in the SPR were 16 mm in the <em>2D group</em> and 25 mm in the <em>3D group</em> (<em>P</em> = .004) and 40.5 mm compared with 50.5 mm in the ilium (<em>P</em> = .019). Median <em>screw penetration depths</em> in the SPR were 0 mm in the <em>2D group</em> and 1.25 mm in the <em>3D group</em> (<em>P</em> = .049).</p></div><div><h3>Conclusion</h3><p>Longer screws were used in the SPR and ilium when preoperative 3D planning was conducted. Due to the study design, we were not able to evaluate whether longer screws lead to better fixation. Further studies are needed to elucidate this question.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101431"},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235234412400116X/pdfft?md5=6a14be5ac77c196a80993af8de27f6cc&pid=1-s2.0-S235234412400116X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240037","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":"Correlation of Acetabular Cup Placement Angles Between an Artificial Intelligence-Powered System Using a Smartphone and Human Measurements","authors":"Sachiyuki Tsukada MD, PhD,&nbsp;Hiroyuki Ogawa MD,&nbsp;Masayoshi Saito MD,&nbsp;Naoyuki Hirasawa MD, PhD","doi":"10.1016/j.artd.2024.101439","DOIUrl":"10.1016/j.artd.2024.101439","url":null,"abstract":"<div><h3>Background</h3><p>An automated measurement system for the placement angles of acetabular cup in total hip arthroplasty prostheses was developed utilizing artificial intelligence (AI) algorithms. The AI-powered system enables immediate measurement by capturing an anteroposterior pelvic X-ray through a smartphone camera.</p></div><div><h3>Methods</h3><p>While developing the AI-powered measurement system, we trained AI utilizing 100 labeled anteroposterior pelvic X-rays to recognize the hip joint and 483 labeled anteroposterior pelvic X-rays to identify anatomical landmarks and the acetabular cup. To validate the AI-powered system, we measured the acetabular cup placement angles of 126 unlabeled post-total hip arthroplasty anteroposterior pelvic X-rays with both the AI-powered system and conventional measurement methods and assessed the correlation between the 2 methods.</p></div><div><h3>Results</h3><p>The Pearson’s correlation coefficients for the acetabular cup placement angles measured using the AI-powered system and conventional method were 0.88 (95% confidence interval, 0.84-0.92, <em>P</em> &lt; .001) in inclination angle and 0.76 (95% confidence interval, 0.67-0.83, <em>P</em> &lt; .001) in anteversion angle, respectively.</p></div><div><h3>Conclusions</h3><p>Both inclination and anteversion angles measured using the AI-powered system showed a strong correlation with angles obtained through conventional methods.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101439"},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001249/pdfft?md5=aa9bd2aaa336f35d5d5799a6bab5ab99&pid=1-s2.0-S2352344124001249-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240347","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":"The Impact of Spinopelvic and Hip Mobility on Passive Hip Flexion Range of Motion Assessment","authors":"Hiroyuki Tokuyasu RPT ,&nbsp;Eiki Tsushima RPT, PhD ,&nbsp;Mitsuru Takemoto MD, PhD ,&nbsp;Claudio Vergari PhD ,&nbsp;Hiroshi Tada MD ,&nbsp;Youngwoo Kim MD, PhD","doi":"10.1016/j.artd.2024.101429","DOIUrl":"10.1016/j.artd.2024.101429","url":null,"abstract":"<div><h3>Background</h3><p>Measuring passive hip flexion range of motion (ROM) is challenging due to compensatory movements. Despite the interest in using functional lateral radiographs for assessing hip mobility, the relationship with passive hip flexion ROM remains unclear. This study aims to elucidate this relationship and clarify spinopelvic parameters and mobility factors influencing variations in passive and radiographic hip flexion ROM.</p></div><div><h3>Methods</h3><p>A retrospective cross-sectional study was conducted on 154 preoperative patients undergoing primary total hip arthroplasty. Passive and radiographic hip flexion ROM were assessed to clarify these relationships, and these differences were classified into 3 groups (O, A and U). Spinopelvic and hip parameters were assessed in standing, relaxed-seated and flexed-seated positions, as well as lumbar, pelvis, and hip mobility between each position to identify factors influencing differences.</p></div><div><h3>Results</h3><p>There was a moderate correlation between passive and radiographic hip flexion ROM (R² = 0.48, <em>P</em> &lt; .01). A significant difference was found in pelvic and hip alignment in the flexed-seated position between all groups. In postural changes, the O group, which had more patients with relatively low hip mobility, showed greater lumbar spine and pelvic movement, while the U group, which had more patients with relatively high hip mobility, showed less lumbar spine and pelvic movement.</p></div><div><h3>Conclusions</h3><p>This study confirmed that passive hip flexion ROM and radiographic hip flexion ROM correlate and that spinopelvic and hip alignment and mobility influence these differences. This result suggests that clinicians should consider lumbar and pelvic alignment and mobility in clinical practice to improve the accuracy of passive hip flexion ROM measurements.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"29 ","pages":"Article 101429"},"PeriodicalIF":1.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001146/pdfft?md5=7a83ba078718a5fa7577e6392fd50f37&pid=1-s2.0-S2352344124001146-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240349","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}