Arthroplasty Today最新文献

{"title":"Readability Analysis of Commonly Cited Patient-Reported Outcome Measures in the Orthopaedic Joint Literature","authors":"Harjot Uppal MBA,&nbsp;Daniel Garcia BS,&nbsp;Kevin Rezzadeh MD,&nbsp;Nikhil Sahai MD,&nbsp;Andrew McGinniss MD,&nbsp;Arash Emami MD,&nbsp;Aiman Rifai DO","doi":"10.1016/j.artd.2025.101922","DOIUrl":"10.1016/j.artd.2025.101922","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported outcome measures (PROMs) are vital for assessing surgical effectiveness and capturing patient perspectives on function, symptoms, and quality of life. To ensure patients can accurately complete these tools, readability is essential. The National Institutes of Health and American Medical Association recommend patient materials be written at or below a 6th-grade reading level. This study evaluated the readability of commonly cited PROMs in the orthopaedic joint literature to assess compliance with these standards.</div></div><div><h3>Methods</h3><div>Thirty-five PROMs were analyzed using 2 validated readability metrics: the Flesch Reading Ease Score (FRES) and the Simple Measure of Gobbledygook (SMOG) Index. A FRES ≥80 or SMOG &lt;7 indicated 6th-grade readability. Scores were calculated using an online readability calculator and compared to National Institutes of Health and American Medical Association guidelines.</div></div><div><h3>Results</h3><div>The average FRES was 67 (range, 21–90), and the average SMOG Index was 8 (range, 6–12), indicating an overall 8th- to 9th-grade reading level. Only 6 PROMs (17%) met the readability threshold. Among the least readable were the University of California, Los Angeles Activity Score, Modified Cincinnati Knee Rating System, Hamilton Depression Rating Scale, Western Ontario and McMaster Universities Osteoarthritis Index, Kujala Score, International Knee Documentation Committee score, and Tampa Scale of Kinesiophobia.</div></div><div><h3>Conclusions</h3><div>Most PROMs commonly cited in the orthopaedic joint literature are written above the recommended 6th-grade level, which may compromise patient understanding and data quality. Improving readability through revision or development of new tools may enhance patient accessibility and the accuracy of reported outcomes.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101922"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791638","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":"Short-term Outcomes of Unrestricted Kinematic Alignment: Total Knee Arthroplasty With a Medial Pivot Implant: A Japanese Multicenter Study","authors":"Mitsuhiro Nakamura MD, PhD ,&nbsp;Yoshinori Soda MD, PhD ,&nbsp;Takao Yamamoto MD ,&nbsp;Shigenobu Fukushima MD ,&nbsp;Takanori Hayashi MD ,&nbsp;Kazutaka Sugimoto MD ,&nbsp;Shinji Satake MD ,&nbsp;Shigeru Nakagawa MD, PhD ,&nbsp;Kazuhiko Michishita MD","doi":"10.1016/j.artd.2025.101882","DOIUrl":"10.1016/j.artd.2025.101882","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the short-term postoperative radiological and clinical results of unrestricted kinematic alignment (unKA)-total knee arthroplasty (TKA) using medial pivot (MP) knee prosthesis in a Japanese population.</div></div><div><h3>Methods</h3><div>This multicenter prospective study included 1950 knees (from 384 males and 1566 females; mean age 74.7 years) with complete radiographs, range of motion (ROM) measurements, and minimum 1-year follow-up from a cohort of 2388 knees (462 males and 1926 females; mean age 74.3 years) that underwent unKA-MP-TKA. We classified all patients into the R group (n = 876) within safe ranges (177°≤ hip–knee–ankle angle ≤183°; 85°≤ medial proximal tibial angle ≤95°; 85°≤ lateral distal femoral angle ≤95°) and O group (n = 1074) outside those ranges. Postoperative radiographic and clinical outcomes were compared.</div></div><div><h3>Results</h3><div>The coronal plane alignment of the knee classification changed in 1053 knees (53.1%) preoperatively and postoperatively. Type I to type II was most common (350 knees; 33.8%). ROM significantly improved from −9.2 ± 7.7° and 120.6 ± 16.2° preoperatively to −1.2 ± 3.1° and 122.5 ± 11.8° at the 1-year follow-up. Three knees required reoperation because of patellofemoral joint problems within 1-year postoperatively. ROM outcomes were similar in both groups. Revision surgery owing to tibiofemoral joint complications was not required.</div></div><div><h3>Conclusions</h3><div>UnKA-MP-TKA resulted in the femoral component being placed in valgus, the tibial component in varus, and lower-limb alignment in varus. No revision surgery owing to tibiofemoral joint complications was needed. The short-term postoperative outcomes of unKA-MP-TKA in the Japanese population, who exhibit a high prevalence of varus knee alignment, were favorable whether within or outside the safe ranges. However, the follow-up period was only 1-year, and continued long-term observation is crucial and necessary.</div></div><div><h3>Level of Evidence</h3><div>IV.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101882"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791639","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 Effect of Subcutaneous Fat Tissue Length and Area on Postoperative Wound Drainage in Patients Undergoing Hemiarthroplasty for Femoral Neck Fracture","authors":"Mehmet Önüt MD ,&nbsp;Olgun Bingöl MD ,&nbsp;Güzelali Özdemir MD ,&nbsp;Mehmet Fatih Savaş MD ,&nbsp;Barış Yağbasan MD ,&nbsp;Enver Kılıç MD ,&nbsp;Utku Eren Özkaya MD","doi":"10.1016/j.artd.2025.101932","DOIUrl":"10.1016/j.artd.2025.101932","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to investigate whether subcutaneous adipose tissue (SAT) length by radiograph and SAT area by computed tomography (CT) before femoral neck fracture surgery are associated with surgical wound drainage (SWD) in elderly female patients.</div></div><div><h3>Methods</h3><div>We prospectively evaluated 87 female patients who underwent hemiarthroplasty surgery at a level 1 trauma center between May 2024 and January 2025. The patients were classified into 2 groups: those with SWD within 90 days after surgery (group 1) and those without (group 2). SAT area and SAT length were evaluated using CT and hip radiograph imaging, respectively, and the differences between the 2 groups were analyzed. Additionally, we compared demographic data, body mass index, the Charlson comorbidity index, monocyte-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, neutrophil-to-albumin ratio, albumin values and surgical incision length.</div></div><div><h3>Results</h3><div>No statistically significant difference in the length of the peritrochanteric SAT was found between fractured and nonfractured hips across the groups. However, CT scans revealed that the SAT area around the greater trochanter was 102.5 cm² (range: 25–175.4) in group 1 and 71.1 cm² (range: 20–190) in group 2, indicating a statistically significant difference (<em>P</em> &lt; .001). Similarly, the SAT area around the anterior superior iliac spine was found to be 132.4 cm² (81.6–172 cm²) in group 1 and 82.3 cm² (17–179 cm²) in group 2; this difference was also statistically significant (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The area of SAT is an effective predictor of postoperative SWD in elderly female patients undergoing hemiarthroplasty due to a femoral neck fracture.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101932"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978535","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":"Perioperative Mindfulness Training Does Not Improve Sleep Quality in Patients Undergoing Total Knee Arthroplasty","authors":"Jessica L.H. Phillips MD ,&nbsp;Makenna R. Hemmerle MS ,&nbsp;Roseann M. Johnson BS ,&nbsp;Hayley E. Ennis MD ,&nbsp;Jason J. Jennings MD, DPT","doi":"10.1016/j.artd.2025.101918","DOIUrl":"10.1016/j.artd.2025.101918","url":null,"abstract":"<div><h3>Background</h3><div>Sleep quality declines in the immediate postoperative period following total knee arthroplasty (TKA). No prior study has prospectively analyzed the impact of mindfulness meditation (MM) on sleep quality following TKA. The purpose of this study was to determine whether MM administered in conjunction with TKA results in any improvement in Pittsburgh Sleep Quality Index (PSQI) at 2, 6, or 12 weeks postoperatively.</div></div><div><h3>Methods</h3><div>Patients undergoing primary unilateral TKA were prospectively enrolled and randomized into 3 cohorts. The perioperative MM cohort received MM at the preoperative visit, the day preceding surgery, 3 days postoperatively, and 2 weeks postoperatively. The preoperative MM group only received MM at the preoperative visit. Controls received no MM. MM consisted of a video of 2 licensed professional psychologists guiding viewers through a 15-minute MM. Demographic data were collected and questionnaires completed at 2, 6, and 12 weeks postoperatively. Patients were excluded on the basis of prior alcohol/drug dependence and inability to present to in-person visits. An a priori analysis required 75 patients per cohort to achieve 80% power.</div></div><div><h3>Results</h3><div>Two hundred eighty-two patients were enrolled and randomized to 3 groups: control (n = 94), preoperative MM (n = 94), and perioperative MM (n = 94). There were no differences between cohorts in age (<em>P</em> = .24), sex (<em>P</em> = .77), body mass index (<em>P</em> = .18), American Society of Anesthesiologists (<em>P</em> = .17), or length of stay (<em>P</em> = .18). No differences between cohorts in preoperative PSQI scores were noted (8.4 ± 4.1 control, 7.9 ± 3.8 preoperative MM, 7.8 ± 4.3 perioperative MM; <em>P</em> = .58). Two weeks postoperatively, there remained no PSQI differences between groups (10.7 ± 4.3 control, 10.8 ± 4.4 preoperative MM, 9.9 ± 4.4 perioperative MM; <em>P</em> = .33). This persisted at 6 weeks (10.1 ± 4.2 control, 10.0 ± 3.9 preoperative MM, 9.5 ± 4.4 perioperative MM; <em>P</em> = .62). At 12 weeks, PSQI returned to preoperative levels and there remained no difference among cohorts (8.7 ± 4.4 control, 8.3 ± 4.2 preoperative MM, 7.8 ± 4.1 perioperative MM; <em>P</em> = .264).</div></div><div><h3>Conclusions</h3><div>Mindfulness training did not improve postoperative sleep quality at any time point following TKA. Further studies are warranted, as improving sleep quality may enhance TKA rehabilitation.</div></div><div><h3>Level of Evidence</h3><div>Therapeutic Level II.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101918"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791572","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":"Identification of Combined Anteversion Targets to Optimize Impingement-free Range of Motion Across Femoral Head Sizes: A Simulation Study","authors":"Sergio F. Guarin Perez MD ,&nbsp;Heather J. Roberts MD ,&nbsp;Diego J. Restrepo MD ,&nbsp;Timothy L. Rossman MS ,&nbsp;Ta-Wei Tai MD, PhD ,&nbsp;Mark W. Pagnano MD ,&nbsp;Rafael J. Sierra MD","doi":"10.1016/j.artd.2025.101925","DOIUrl":"10.1016/j.artd.2025.101925","url":null,"abstract":"<div><h3>Background</h3><div>Dislocation remains a risk following total hip arthroplasty (THA). While prior studies have proposed optimal combined anteversion (CA) ranges to maximize impingement-free range of motion (IFROM), the influence of bony impingement and femoral head size remains underexplored. This study utilized computed tomography–based robotic planning software to identify a target CA that optimized IFROM and to evaluate the effect of head size.</div></div><div><h3>Methods</h3><div>Five patients (mean age: 63.2 years) who underwent robotic-assisted THA were included. Using computed tomography–based planning software, femoral and acetabular version were systematically adjusted from 0° to 37°, simulating bony and implant impingement in flexion and internal rotation and extension and external rotation. Simulations were performed with 28-, 32-, 36-, and 40-mm heads, totaling 57,750 tests. Functional range of motion (ROM) was defined as ≥40° internal rotation at 90° flexion and ≥10° external rotation at 20° extension. For each head size, maximum IFROM and acceptable CA configurations meeting functional ROM criteria were recorded. A mathematical formula was developed to describe optimal CA per head size.</div></div><div><h3>Results</h3><div>For all patients and head sizes, the optimal CA was described by (acetabular anteversion+(0.7×femoral anteversion) = 36 and was independent of native version. Larger femoral heads were associated with broader functional ROM. Acceptable CA angles increased by 158% from 28 to 32 mm, 86% from 32 to 36 mm, and 31% from 36 to 40 mm.</div></div><div><h3>Conclusions</h3><div>Larger femoral head sizes increase IFROM and expand the range of CA positions achieving functional ROM. These findings highlight the importance of head size selection in optimizing IFROM and surgical planning for THA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101925"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791573","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":"Interlaboratory Reliability of Synovial Fluid Analysis in Prosthetic Knee Aspiration","authors":"Richard D. Murray MD ,&nbsp;Charles W. Powell MD ,&nbsp;Mitchell S. Scull MD ,&nbsp;Andrew W. Wilson MS ,&nbsp;Mark G. Freeman MD","doi":"10.1016/j.artd.2025.101920","DOIUrl":"10.1016/j.artd.2025.101920","url":null,"abstract":"<div><h3>Background</h3><div>Synovial fluid analysis is a critical step in the diagnosis of periprosthetic knee joint infection. We hypothesized that clinically meaningful differences between white blood cell (WBC) count, polymorphonuclear leukocyte (PMN) cell percentage, and culture results would exist between 2 independent laboratories when the same synovial fluid aspirate is analyzed.</div></div><div><h3>Methods</h3><div>A retrospective chart review was completed on total knee arthroplasty patients who underwent knee arthrocentesis between 2017 and 2025. The synovial fluid aspirate from a single knee arthrocentesis was divided into identical samples and analyzed by 2 independent laboratories. WBC count, PMN percentage, and culture results were recorded.</div></div><div><h3>Results</h3><div>In total, 202 consecutive prosthetic knee aspirates were analyzed. Agreement was found in 14 of 20 samples (70%) that tested ≥3000 WBC/μl (<em>k</em> = 0.81; 95% confidence inverval [CI], 0.66-0.96), 9 of 13 samples (69%) that tested ≥80% PMNs (<em>k</em> = 0.81; 95% CI, 0.62-0.99), 7 of 12 cases (58%) reported both ≥80% PMNs and ≥3000 WBC/μl, 8 of 9 cases (89%) that tested ≥90% PMNs (<em>k</em> = 0.94; 95% CI, 0.82-1.00), 3 of 23 cases (13%) with positive culture results (<em>k</em> = 0.18; 95% CI, −0.05-0.40).</div></div><div><h3>Conclusions</h3><div>Two independent laboratories displayed clinically meaningful variability in WBC count, PMN percentage, and culture results. The difficulty in diagnosing periprosthetic joint infection may at least in part be due to poor interlaboratory reliability concerning synovial fluid analysis. Refinement of interlaboratory agreement, further research into advanced diagnostic methods, and measures to improve the accuracy of synovial fluid analysis are all critical steps toward refining the diagnosis of periprosthetic joint infection.</div></div><div><h3>Level III</h3><div>Retrospective Cohort study, Diagnostic.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101920"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791640","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":"Social and Demographic Health Disparities in Knee Osteoarthritis and Total Knee Arthroplasty","authors":"Alexander S. Dash MD, MSCR ,&nbsp;Omneya A. Ghanem MPH ,&nbsp;Wakenda K. Tyler MD, MPH ,&nbsp;Clark T. Hung PhD ,&nbsp;Nadeen O. Chahine PhD ,&nbsp;Nana O. Sarpong MD, MBA","doi":"10.1016/j.artd.2025.101948","DOIUrl":"10.1016/j.artd.2025.101948","url":null,"abstract":"<div><div>There has been increased awareness around the interplay between patients’ social and demographic background and health outcomes. The influence of social determinants of health on patients outcomes has recently been recognized in orthopaedic literature. As knee osteoarthritis (OA) is one of the leading causes of disability in the world and the procedural volume of total knee arthroplasty (TKA) is rising with increased access and an aging population, better appreciation for these factors is imperative. This review seeks to examine the effect of sociodemographic factors on OA care and disease burden; and TKA outcomes. Our goal is to provide the arthroplasty surgeon community with a better understanding of how inequities in care and research impact our patients’ OA and TKA outcomes. Previously published research has focused mainly on race and ethnicity, but the literature is limited, with what is available showing that there are disparate presentations and outcomes in both OA and TKA based on different social determinants of health. There is substantial work that will be required to better understand and address nonmodifiable risk factors and optimize surgery outcomes across all demographics.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101948"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554558","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":"Association Between Regional Social Vulnerability and Race-Based Differences in Total Knee Arthroplasty Use Among Medicare Beneficiaries","authors":"Jordan J. Cruse BS ,&nbsp;Derek T. Schloemann MD, MPHS ,&nbsp;Elizabeth C. Danielson PhD ,&nbsp;Benjamin F. Ricciardi MD ,&nbsp;Rishi Balkissoon MD, MPH ,&nbsp;Patricia D. Franklin MD, MPH, MBA ,&nbsp;Caroline P. Thirukumaran MBBS, MHA, PhD","doi":"10.1016/j.artd.2025.101801","DOIUrl":"10.1016/j.artd.2025.101801","url":null,"abstract":"<div><h3>Background</h3><div>There is inequity in total knee arthroplasty (TKA) use between racial groups. The social vulnerability index (SVI) may characterize mechanisms underlying disparity, which is essential for identifying targeted interventions. We examined the relationship of the overall SVI and its themes with TKA use rates for Black and White Medicare beneficiaries and the difference in TKA utilization between these groups.</div></div><div><h3>Methods</h3><div>We used 2013-2017 Medicare data to calculate annual TKA use rates per 1000 beneficiaries in each hospital referral region (HRR). Multivariable mixed-effects linear regressions estimated the relationship between social vulnerability and TKA use.</div></div><div><h3>Results</h3><div>The mean (standard deviation) TKA rates were 9.4 (1.7) and 5.9 (2.2) per 1000 White and Black beneficiaries, respectively. HRRs with highest social vulnerability (quartile 4) had lower TKA rates for White (estimate for quartile 4: −1.7, 95% confidence interval [CI]: −2.2 to −1.1, <em>P</em> &lt; .001) and Black beneficiaries (quartile 4: −1.7, 95% CI: −2.3 to −1.0, <em>P</em> &lt; .001) compared to HRRs with the least vulnerability. The SVI’s minority status and language theme was linked with wider rate differences between White and Black beneficiaries (quartile 4: 0.6, 95% CI: 0.0-1.2, <em>P</em> = .046).</div></div><div><h3>Conclusions</h3><div>Worse overall SVI was related to lower TKA use rates for both White and Black Medicare beneficiaries. Areas with the highest minority status and language vulnerability had disproportionately lower TKA rates for Black compared to White beneficiaries. Our findings suggest regional mechanisms that health-care professionals and policymakers will need to address to ensure equitable TKA access.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101801"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554559","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":"Barriers to Care for Total Joint Arthroplasty Patients With Medicaid Insurance: A Survey Study of the Surgeon Perspective","authors":"Christopher Bloise MD ,&nbsp;LaMiah Hall MPH ,&nbsp;Leslie Sisco-Wise MD ,&nbsp;Timmothy Randell MD ,&nbsp;Claudia Leonardi PhD ,&nbsp;Anna Cohen-Rosenblum MD, MSc","doi":"10.1016/j.artd.2025.101780","DOIUrl":"10.1016/j.artd.2025.101780","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to assess the demographic characteristics of orthopaedic surgeons in Louisiana taking care of patients with Medicaid insurance and to assess any perceived barriers to care, with a focus on total joint arthroplasty (TJA).</div></div><div><h3>Methods</h3><div>An electronic survey was distributed to all practicing surgeon members of the Louisiana Orthopaedic Association with questions about practice type, subspecialty, demographics, estimated percentage of Medicaid patient volume, and perceived barriers to care. Responses were collected using a secure database, and statistical analysis was performed.</div></div><div><h3>Results</h3><div>The 114 respondents were mostly male (95.6%), white (87.7%), and in private practice (61.4%). Most respondents (73.8%) did not accept Medicaid insurance (22.8%) or took care of &lt;25% patients with Medicaid (50.9%). Fifty-eight respondents (50.9%) reported performing TJA. The majority of surgeons performing TJA (76.6% total hip arthroplasty [THA], 93.7% total knee arthroplasty [TKA]) either did not accept Medicaid insurance (36.2% THA, 47.3% TKA) or performed less than 25% of their TJA volume on patients with Medicaid insurance (40.4% THA, 36.4% TKA). The most commonly reported perceived barriers to care were lower physician and facility reimbursement, and difficulty referring to ancillary services. Surgeons in academic practice were significantly more likely to take care of a higher percentage of patients with Medicaid insurance (<em>P</em> = .0001).</div></div><div><h3>Conclusions</h3><div>Most orthopaedic surgeons performing TJA in Louisiana either do not accept or perform a relatively small percentage of their practice volume on patients with Medicaid insurance. Low physician and facility reimbursement rates and difficulty referring to ancillary services were perceived as the greatest barriers to caring for these patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101780"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Social Needs Associated With Worse Patient-Reported Outcomes and Increased Adverse Events Following Total Joint Arthroplasty","authors":"Camila L. Hayashi BS ,&nbsp;Adam D. Winter MS ,&nbsp;Luis A. Túa-Vargas MS ,&nbsp;Nicholas Chau ,&nbsp;Aarush Kalia ,&nbsp;David H. Gibson MD ,&nbsp;Lee E. Rubin MD ,&nbsp;Ilda B. Molloy MD, MS ,&nbsp;Daniel H. Wiznia MD","doi":"10.1016/j.artd.2025.101739","DOIUrl":"10.1016/j.artd.2025.101739","url":null,"abstract":"<div><h3>Background</h3><div>Health-related social needs (HRSNs) are the individual-level adverse social conditions that negatively impact a person’s health. This study characterizes the association of HRSNs with patient-reported outcomes and adverse events following total hip (THA) and knee arthroplasty (TKA).</div></div><div><h3>Methods</h3><div>This single-institution cross-sectional study utilized the Centers for Medicare &amp; Medicaid Services HRSN Screening Tool. In-person interviews captured HRSNs, patient-reported outcome measures, and demographic data from postoperative THA and TKA patients in an academic arthroplasty practice. Charlson Comorbidity Index, American Society of Anesthesiologists scores, discharge data, and 90-day complications were collected via chart review. Regression analysis was used to determine associations between HRSNs and outcomes.</div></div><div><h3>Results</h3><div>Among 190 patients, food insecurity had a significant association with reoperation (odds ratio (OR) = 5.78, 95% confidence interval 1.44-23.2, <em>P</em> = .013). Patients with food and transportation HRSNs had significantly worse postoperative physical function, pain, and mobility (all <em>P</em> &lt; .05). Black patients had significantly higher odds of visiting the emergency department (OR = 2.15, 95% CI 1.10-4.20, <em>P</em> = .025) or being readmitted (OR = 2.70, 95% confidence interval 1.11-6.58, <em>P</em> = .029) within 90 days postoperation compared to White patients.</div></div><div><h3>Conclusions</h3><div>Food insecurity was associated with increased odds of reoperation, and food insecurity and transportation were associated with worse patient-reported outcomes following THA and TKA. Black patients had increased risks of readmission and emergency department visits. These findings highlight the critical impacts of HRSNs on THA and TKA outcomes and underscore the need for targeted interventions addressing HRSNs to improve postoperative recovery and health-care equity.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"37 ","pages":"Article 101739"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554450","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}