Arthroplasty Today最新文献

{"title":"Optimal Bone Preparation for Triple-Tapered Stems: Does the Sagittal Taper Affect Optimal Femoral Sizing?","authors":"Jeff Shi MD ,&nbsp;Kevin Salomon MD ,&nbsp;Victor Shen BS ,&nbsp;Andrew Moore MD ,&nbsp;John T. Wilson MD ,&nbsp;Brian Palumbo MD","doi":"10.1016/j.artd.2024.101605","DOIUrl":"10.1016/j.artd.2024.101605","url":null,"abstract":"<div><h3>Background</h3><div>Conventional single-tapered, total hip arthroplasty stems achieve fixation namely through coronal, metaphyseal fit. Triple taper stems have a sagittal taper to optimize fixation in the antero-posterior (AP) plane as well; however, limited guidance exists on appropriate bone preparation. Often, similar preparation techniques are used despite geometric differences which may lead to underpreparation. We’ve defined a novel technique in which a small portion of posterior femoral neck and cancellous bone is removed to permit preparation collinear to the diaphyseal sagittal femoral axis. We hypothesize this will optimize stem fit and stability compared to conventional techniques.</div></div><div><h3>Methods</h3><div>This is a retrospective review of 38 cementless primary total hip arthroplasty cases performed by a single surgeon. In each case, broach preparation was initially performed through the center of the femoral neck as although it was a single-tapered stem. Once tactile sensation of adequate fit was achieved, fluoroscopic images were taken to document AP and mediolateral fit, and stem size was recorded. Then that broach was removed, and a standardized one-third of the posterior femoral neck and posterior cancellous bone was removed, permitting broaches to prepare the femur collinear to the femoral diaphyseal sagittal axis— triple-tapered preparation (TTP). Outcomes included change in stem size from initial broach trial to final stem selection and radiographic stem fill on AP and lateral views.</div></div><div><h3>Results</h3><div>Median single-tapered preparation broach size was 8 (range, 5-12) and final stem size after TTP was 11 (range, 6-13). The TTP overall mean percent metaphyseal fill was 74 ± 6% in the AP view and 71 ± 5% in the lateral view, both significantly higher than single-tapered preparation which was 67 ± 7% and 65 ± 7%, respectively (<em>P</em> &lt; .001). No fractures or loosening occurred in this series.</div></div><div><h3>Conclusions</h3><div>Preparation of triple-tapered stems collinear to the diaphyseal sagittal femoral axis improves stem size, fit, and fill.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101605"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123846","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":"Peripheral Nerve Blocks Are Associated With Decreased Early Medical Complications, Dislocations, and Opioid Consumption Following Total Hip Arthroplasty","authors":"Brian P. McCormick MD,&nbsp;Sean B. Sequeira MD,&nbsp;Mark D. Hasenauer MD,&nbsp;Robert P. McKinstry MD,&nbsp;Frank R. Ebert MD,&nbsp;Henry R. Boucher MD","doi":"10.1016/j.artd.2024.101587","DOIUrl":"10.1016/j.artd.2024.101587","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral nerve blocks (PNBs) may be utilized for postoperative pain control following total hip arthroplasty (THA). The purpose of this study was to evaluate the association between PNBs and postoperative complication rates, healthcare utilization, and opioid consumption following elective THA.</div></div><div><h3>Methods</h3><div>Opioid-naive patients who received PNBs on the same day as undergoing THA for degenerative etiologies were identified from a large national database and matched 1:5 to a control cohort using propensity scoring. Rates of medical complications, inpatient readmissions, and emergency department presentations occurring within 90 days of THA and surgery-related complications occurring within 1 year of THA were compared using odds ratios. Total cost and perioperative opioid consumption in morphine milligram equivalents (MMEs) per day were also evaluated and compared between groups.</div></div><div><h3>Results</h3><div>Propensity score matching resulted in 4748 PNB patients matched to 23,740 control patients. THA patients who received PNBs had lower incidences of deep vein thrombosis (odds ratio [OR] 0.67, <em>P</em> = .004), urinary tract infection (OR 0.76, <em>P</em> &lt; .001), and dislocation (OR 0.51, <em>P</em> &lt; .001). PNBs were also associated with decreased perioperative opioid consumption (38.6 MME/day vs 55.3 MME/day, <em>P</em> &lt; .001). Regarding healthcare utilization, there were no differences between cohorts in rates of inpatient readmission, emergency department presentation, or total cost.</div></div><div><h3>Conclusions</h3><div>PNBs are associated with decreased risk of deep vein thrombosis, urinary tract infection, and dislocation and decreased perioperative opioid consumption following THA.</div></div><div><h3>Level of evidence</h3><div>III, Retrospective review.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101587"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984833","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":"Single-Institution Experience With Nononcologic Total Femoral Replacement","authors":"Ryan Ouillette MD,&nbsp;Kevin Chen BA,&nbsp;Matthew Dipane BA,&nbsp;Alexander Christ MD,&nbsp;Edward McPherson MD,&nbsp;Alexandra Stavrakis MD","doi":"10.1016/j.artd.2024.101607","DOIUrl":"10.1016/j.artd.2024.101607","url":null,"abstract":"<div><h3>Background</h3><div>Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcologic TFR in one of the largest single-center modern series.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 23 nononcologic TFR procedures performed on 22 patients between 2012 and 2021. Primary outcomes included TFR revision rate and indication for revision, while secondary outcomes included overall reoperation rate, complications, patient ambulatory status, and assistive device requirements.</div></div><div><h3>Results</h3><div>The average age at time of TFR was 65.7 years, with periprosthetic fracture (65.2%) and periprosthetic joint infection (34.8%) as predominant indications. More than half of patients (52.2%) required TFR revision, primarily due to periprosthetic joint infection (75.0%). Despite a high complication profile, only 1 patient underwent limb amputation and there was only 1 mortality during the study period. Overall, 63.6% of patients were ambulating (assisted or unassisted) at final follow-up.</div></div><div><h3>Conclusions</h3><div>Nononcologic TFR remains a viable limb-salvage option for patients undergoing revision arthroplasty with extensive bone loss. Despite a notable revision rate and infection risk, the majority of patients maintain or regain ambulatory function, emphasizing the procedure’s role in preserving limb function. Clinicians should weigh potential complications when considering TFR, emphasizing patient counseling and risk mitigation strategies.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101607"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029776","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":"Automated Web Tool Measurement of Total Hip Arthroplasty Acetabular Component Inclination and Anteversion Angles","authors":"Christine Yoon BS ,&nbsp;Anna Eligulashvili BS ,&nbsp;Zeynep Seref-Ferlengez PhD ,&nbsp;Barlas Goker MD ,&nbsp;Eli Kamara MD ,&nbsp;Edward Mardakhaev MD","doi":"10.1016/j.artd.2024.101606","DOIUrl":"10.1016/j.artd.2024.101606","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic hip dislocation after total hip arthroplasty is a devastating postoperative complication. It is often associated with suboptimal orientation of the acetabular component, characterized by the acetabular abduction and anteversion angles obtained from anteroposterior pelvic radiographs. We introduce a novel automated web tool to streamline the subjective and lengthy process of this manual measurement and compare it to manual human measurements.</div></div><div><h3>Methods</h3><div>One board-certified orthopaedic surgeon used the web tool to make automatic measurements of anteroposterior radiographs of 97 patients who underwent unilateral hip arthroplasty. Manual and web tool measurements included abduction angle and calculated anteversion angle by Liaw’s method. Differences between manual and web tool measurements were compared with a paired <em>t</em>-test and Bland-Altman analysis.</div></div><div><h3>Results</h3><div>There were no statistically significant differences between the average of manual measurements as compared to the web tool measurement in abduction angle (43.29 ± 7.05 vs 43.00 + 6.22, <em>P</em> = .85), anteversion angle (20.43 ± 7.62 vs 20.82 ± 7.37, <em>P</em> = .52), and ratio of the minor axis of the acetabular cup circumference in the AP radiograph to the total length of the acetabular head (0.42 ± 0.15 vs 0.44 ± 0.15, <em>P</em> = .18). The mean difference of average for abduction angle, anteversion angle, and ratio between the short axis of the transverse ellipse to the total length of the acetabular cup were −0.28, 0.39, and 0.02, respectively. Bland-Altman analysis for all 3 measurements displayed negligible systemic bias with random scattering.</div></div><div><h3>Conclusions</h3><div>Automated measurements obtained with a novel web tool are in strong agreement with the manually obtained ground truth measurements. The web tool helps to eliminate interobserver differences that arise with manual annotation. The web tool has the potential to streamline acetabular measurements with enhanced accuracy.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101606"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053678","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 Predictors of Soft Tissue Releases Required for Femoral Exposure in Direct Anterior Total Hip Arthroplasty","authors":"Michael S. Barnum MD ,&nbsp;Bryan M. Grommersch MD ,&nbsp;Samuel Hovland BS ,&nbsp;George J. Haidukewych MD ,&nbsp;Cody C. Green MD","doi":"10.1016/j.artd.2024.101585","DOIUrl":"10.1016/j.artd.2024.101585","url":null,"abstract":"<div><h3>Background</h3><div>Sequential soft tissue releases are utilized in direct anterior approach (DAA) total hip arthroplasty (THA) as incomplete femoral exposure may lead to complications. This study identifies patient-specific parameters associated with soft tissue releases required for femoral exposure.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on 133 patients (150 hips) who underwent primary THA via DAA with a single surgeon. Preoperative radiographic measurements included ilium-ischial ratio (IIR), anterior superior iliac spine to tip of the greater trochanter (AGT), femoral neck-shaft angle (FNA), and articulotrochanteric distance (ATD). Operative reports were reviewed and a multinomial logistic regression model was conducted to identify associations of soft tissue releases.</div></div><div><h3>Results</h3><div>Among patients, 12 (8%) had no release, 94 (62%) had conjoined release, 44 (29%) had conjoined and piriformis releases. Multivariate analysis revealed IIR (OR [odds ratio] 1.68, <em>P</em> = .008), right laterality (OR 7.41, <em>P</em> = .025), and body mass index (BMI) (OR 1.26, <em>P</em> = .041) were associated with conjoined release. BMI (OR 1.51, <em>P</em> = .001), right laterality (OR 7.63, <em>P</em> = .038), and IIR (OR 2.06, <em>P</em> = .001) were also associated with piriformis release. There were no statistically significant differences between AGT, FNA, or ATD between groups.</div></div><div><h3>Conclusions</h3><div>Patients with increased ilium to ischial ratio, right laterality, and larger BMI were associated with greater number of soft tissue releases for adequate femoral exposure. Surgeons may consider these factors to anticipate femoral releases or challenging femoral exposure in direct anterior total hip arthroplasty.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101585"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972514","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":"Investigating Postoperative Urinary Retention: Risk Factors and Postsurgical Outcomes in Total Joint Arthroplasty","authors":"Madeleine J.F. Powers MSIII ,&nbsp;Zachary T. Grace MD ,&nbsp;Barrett B. Torre MD ,&nbsp;Dorothy B. Wakefield MS ,&nbsp;Laura Sanzari MS, BSN, RN ,&nbsp;Matthew J. Grosso MD","doi":"10.1016/j.artd.2024.101600","DOIUrl":"10.1016/j.artd.2024.101600","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative urinary retention (POUR), a known complication following total joint arthroplasty (TJA), remains inconsistent in its diagnostic criteria, prevalence, and risk factors. This study aims to quantify POUR rates, identify risk factors, and assess complications associated with catheterization in TJA.</div></div><div><h3>Methods</h3><div>A single-center cohort undergoing TJA between January 2015 and December 2022 was retrospectively reviewed. POUR rates were quantified using 3 different diagnostic criteria. Variables analyzed included age, sex, alpha-blocker prescription, operative joint, body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index classification, and anesthesia type. Complication rates between POUR and non-POUR patients were compared. Among POUR patients, 90-day postoperative renal and infectious complications were evaluated based on catheterization type and frequency.</div></div><div><h3>Results</h3><div>Among the 17,220 TJA patients identified, POUR incidence rates varied from 20% (catheterization), 25% (postoperative bladder scan &gt; 500 mL), to 29% (catheterization and/or bladder scan). Advanced age, male gender, lower body mass index, moderate Charlson Comorbidity Index scores, total knee arthroplasty, spinal anesthesia, and alpha-blocker use were significantly more prevalent among POUR patients. The development of postoperative complications, including renal/infectious complications, was not significant between POUR and non-POUR patients. Among POUR patients, there was a significant increase in renal/infectious complications among patients who received 4+ catheters (odds ratio = 10.17, 2.75, 37.59).</div></div><div><h3>Conclusions</h3><div>Diagnostic variability in POUR after TJA persists. For POUR management, patients receiving 4+ catheters were at a 10-fold risk for renal/infectious complications compared to those without catheterization. Reducing catheterization frequency and employing risk stratification for susceptible patients may help mitigate these risks effectively.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101600"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984500","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":"Efficacy of Adjunctive Antiseptic Lavage Solution in Managing Acute Hip/Knee Prosthetic Joint Infection: A Comparative Study in a Tertiary Revision Center","authors":"Jonathan Quinn FRACS ,&nbsp;Bernard H. van Duren DPhil, FRCS ,&nbsp;Reshid Berber PhD, FRCS ,&nbsp;Mark Higgins FRCS ,&nbsp;Hosam E. Matar FRCS ,&nbsp;Andrew R. Manktelow FRCS ,&nbsp;Benjamin V. Bloch FRCS","doi":"10.1016/j.artd.2024.101593","DOIUrl":"10.1016/j.artd.2024.101593","url":null,"abstract":"<div><h3>Background</h3><div>Debridement, antibiotics and implant retention (DAIR) procedure is well-established as a management option for acute periprosthetic joint infection (PJI). We investigated the infection eradication rates of DAIR procedures at our center using Bactisure wound lavage.</div></div><div><h3>Methods</h3><div>A retrospective consecutive review of DAIR procedures for hip and knee PJI was conducted between 2018 and 2023 with a minimum 12-month follow-up at our tertiary revision arthroplasty center. Suitability for DAIR was determined at the multi-disciplinary team discussion. Revision procedures and patients with previous PJI were excluded. Patient, surgical, microbiological, and postoperative data (minimum 12 months) was reviewed. The use of Bactisure was in addition to routine surgical management.</div></div><div><h3>Results</h3><div>During the study period, 76 DAIR procedures were performed (55 knees and 21 hips). Bactisure was used in 26 cases (20 knees and 6 hips). Overall, 6 of 26 Bactisure DAIRs failed (23%), while 14 of 50 non-Bactisure DAIRs failed (28%), which did not demonstrate statistical significance (<em>P</em> = .644). Subgroup analysis demonstrated no difference in knee DAIRs (<em>P</em> = .761) but a trend toward significance in hip DAIRs (<em>P</em> = .262). No adverse effects of Bactisure use were noted intraoperatively or postoperatively. DAIR failed in 50% of diabetic patients compared to 20% of nondiabetic patients (<em>P</em> = .015). Age, body mass index, and organism identification did not influence outcome.</div></div><div><h3>Conclusions</h3><div>The addition of Bactisure to DAIR procedures did not demonstrate statistically significant improvement of successful eradication of infection, but a potential trend toward significance was noted in hip DAIRs. Diabetic patients failed DAIR in 50% of cases. The in-vivo outcomes of Bactisure use during DAIR procedures remain inconclusive.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101593"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162544","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":"Massive Periacetabular Osteolysis Treated With Acetabular Cup Retention and Cemented Screw Fixation","authors":"Isabella T. Wu MD, MPH,&nbsp;Cary S. Politzer MD,&nbsp;Frank Chiarappa MD,&nbsp;Scott T. Ball MD","doi":"10.1016/j.artd.2024.101595","DOIUrl":"10.1016/j.artd.2024.101595","url":null,"abstract":"<div><div>Management of periacetabular osteolysis is a challenging dilemma in revision total hip arthroplasty. When the acetabular shell is well-fixed, the surgeon may prefer to retain the cup to minimize further bone loss. However, filling the surrounding defect can be difficult if the area of involvement is massive. In this case, holes were created in the existing acetabular cup for supplemental pelvic screws, which were placed using computed tomography navigation, and then the areas of osteolysis were filled with cement. The patient recovered uneventfully, and he was satisfied with the outcome at 4 years postoperatively. Thus, pelvic screw placement with cement augmentation could be a viable option for a stable cup with surrounding osteolysis. Patient selection should be considered carefully as the long-term outcomes of this procedure are unknown.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101595"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029812","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":"Short- and Mid-term Radiographic Outcomes of Ream-then-broaching Metaphyseal Cones During Revision Total Knee Arthroplasty","authors":"Aria Darbandi MD ,&nbsp;Andrew Schaver MD ,&nbsp;Micah MacAskill MD ,&nbsp;Rex Lutz DO ,&nbsp;Amira Scaramella BS ,&nbsp;Christian Sangio BS ,&nbsp;John Shields MD ,&nbsp;Alvin Ong MD ,&nbsp;Matthew Bullock DO MPT","doi":"10.1016/j.artd.2025.101615","DOIUrl":"10.1016/j.artd.2025.101615","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study is to assess the short- and mid-term radiographic outcomes of a ream-then-broach metaphyseal cone design for revision total knee arthroplasty (rTKA).</div></div><div><h3>Methods</h3><div>A retrospective, multicenter analysis of rTKA patients utilizing femoral and/or tibial metaphyseal cone placement from January 2017 to July 2022 was performed. Assessment of radiolucency was performed utilizing a novel “cones score” for radiolucency for tibial and femoral cones.</div></div><div><h3>Results</h3><div>Sixty-four rTKAs (23 femoral and 59 tibial cones) with short-term follow-up (12-24 months) and 80 rTKA (24 femoral and 76 tibial cones) with mid-term follow-up (&gt;24 months) were assessed. No intraoperative complications were reported. No cases of cone or stem aseptic loosening were observed. The cones scoring system had a significantly strong intraclass correlation between the 3 reviewers (<em>P</em> &lt; .001). Of tibial cones, 96.6% and 96.1% had no change in cones scoring at short- and mid-term follow-ups, respectively. Of femoral cones, 87.0% and 100% had no change in cones scoring at short- and mid-term follow-ups, respectively. All tibial and femoral implants were deemed radiographically stable at last radiographic follow-up.</div></div><div><h3>Conclusions</h3><div>The utilization of a ream-then-broach metaphyseal cones demonstrated excellent radiographic stability at short- and mid-term follow-ups. The use of this method has minimal risk of intraoperative or short-term failures. Surgeons should be familiar with this type of cone implantation system.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101615"},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092427","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":"Farewell","authors":"Gregory J. Golladay MD (Editor-in-Chief)","doi":"10.1016/j.artd.2024.101604","DOIUrl":"10.1016/j.artd.2024.101604","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101604"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972510","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}