Journal of Arthroplasty最新文献

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Streamlining Your Arthroplasty Practice: Establishing Efficiency. 简化您的关节置换术:建立效率。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-09 DOI: 10.1016/j.arth.2025.09.053
Johnathan R Lex, Jesse Wolfstadt, Joshua C Rozell, Jenna A Bernstein, David C Landy
{"title":"Streamlining Your Arthroplasty Practice: Establishing Efficiency.","authors":"Johnathan R Lex, Jesse Wolfstadt, Joshua C Rozell, Jenna A Bernstein, David C Landy","doi":"10.1016/j.arth.2025.09.053","DOIUrl":"https://doi.org/10.1016/j.arth.2025.09.053","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Timing of Debridement, Antibiotics, and Implant Retention within 48 Hours for Acute Knee Periprosthetic Joint Infection May Not Improve Success Rate. 急性膝关节假体周围关节感染48小时内清创术、抗生素和植入物保留的时机可能不能提高成功率。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-09 DOI: 10.1016/j.arth.2025.09.055
Michael F Shannon, Victoria R Wong, Andrew J Frear, Robert E Bilodeau, Eduardo Drummond, Johannes F Plate, Brian Klatt, Kenneth L Urish
{"title":"Timing of Debridement, Antibiotics, and Implant Retention within 48 Hours for Acute Knee Periprosthetic Joint Infection May Not Improve Success Rate.","authors":"Michael F Shannon, Victoria R Wong, Andrew J Frear, Robert E Bilodeau, Eduardo Drummond, Johannes F Plate, Brian Klatt, Kenneth L Urish","doi":"10.1016/j.arth.2025.09.055","DOIUrl":"https://doi.org/10.1016/j.arth.2025.09.055","url":null,"abstract":"<p><strong>Background: </strong>Debridement, antibiotics, and implant retention (DAIR) is a common first-line treatment for acute periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). However, the optimal timing for DAIR remains undefined. This study aimed to evaluate whether the time from initial presentation or diagnosis to surgical intervention impacts treatment outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 166 patients who underwent DAIR for acute PJI after TKA between 2016 and 2022 within a regional academic health system. Patients were stratified by time to DAIR from both the first healthcare contact and formal PJI diagnosis: < 24 hours, 24 to 48 hours, and > 48 hours. The primary outcome was DAIR failure, defined as reoperation for PJI. The secondary outcomes included 90-day readmission, chronic antibiotic suppression, adverse events, and mortality. Outcomes were assessed with analysis of variance tests or Chi-squares, and multivariate logistic regressions.</p><p><strong>Results: </strong>A DAIR failure occurred in 40.4% of cases, with no significant differences by timing from first contact (P = 0.97) or diagnosis (P = 0.84). Similarly, time to debridement was not associated with differences in readmission, chronic suppression, or adverse events. Notably, 90-day mortality was higher in patients who underwent DAIR within 24 hours of diagnosis (12.1%, P = 0.001), potentially reflecting clinical triage of higher-risk patients. Multivariable analysis analyses found that age, diabetes mellitus, and low preoperative hemoglobin were independently associated with worse outcomes. Elevated C-reactive protein was not predictive of failure or complications.</p><p><strong>Conclusion: </strong>Timing of DAIR for acute TKA PJI within early windows did not significantly affect failure or complication rates, suggesting that urgent, rather than emergent, intervention is appropriate. Brief delays to allow clinical optimization may be safely considered, although power may have been limited to form definitive conclusions. Larger and more robust studies are needed.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medicare Reimbursement Trends for Common Knee Arthroplasty Procedures: A Generational Perspective, 2006 to 2024. 普通膝关节置换术的医疗保险报销趋势:2006年至2024年的代际视角。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-09 DOI: 10.1016/j.arth.2025.10.012
Afshin A Anoushiravani, Amir Human Hoveidaei, Roham Borazjani, Reza M Katanbaf, Monica Misch, James E Feng, Casey M O'Connor, James Nace, Michael A Mont, Ronald E Delanois
{"title":"Medicare Reimbursement Trends for Common Knee Arthroplasty Procedures: A Generational Perspective, 2006 to 2024.","authors":"Afshin A Anoushiravani, Amir Human Hoveidaei, Roham Borazjani, Reza M Katanbaf, Monica Misch, James E Feng, Casey M O'Connor, James Nace, Michael A Mont, Ronald E Delanois","doi":"10.1016/j.arth.2025.10.012","DOIUrl":"https://doi.org/10.1016/j.arth.2025.10.012","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of this study was to assess the trends in Medicare reimbursement for knee arthroplasty procedures between 2006 and 2024.</p><p><strong>Methods: </strong>This study examined payment trends for common knee arthroplasty procedures by analyzing data from the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule (1) between 2006 and 2024. Medicare reimbursement was determined by multiplying Relative Value Units (RVUs) by the CMS conversion factor, with adjustments made for inflation to 2024 United States (U.S.) dollars using the Consumer Price Index (CPI) (2) inflation calculator provided by the U.S. Department of Labor. Future trend projections were generated based on average values from 2020 to 2024.</p><p><strong>Results: </strong>Between 2006 and 2024, total reimbursements for all knee procedures dropped by 2.7%, while the CPI increased by 55%, leading to an inflation-adjusted average reimbursement drop of 37.2%. Primary total knee arthroplasty had the most significant drop, with reimbursements decreasing by 45.1%. Unadjusted work reimbursements across all procedures decreased by 8.5%, translating to a 40.9% inflation-adjusted reduction. Considering the current trend, projections for 2029 indicate a further projected reduction in total surgeon reimbursement of 18.5 to 54.7%, while work reimbursements could decrease by 23.2 to 63.6%.</p><p><strong>Conclusion: </strong>From 2006 to 2024, there has been a major decline in Medicare reimbursements for knee arthroplasty procedures after adjusting for inflation, raising concerns about the financial sustainability of orthopaedic practices. This trend may pressure healthcare providers to increase patient volumes, potentially leading to burnout and compromised patient care. Reimbursement rates should be adjusted to the value that orthopaedic surgeons provide to patients.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Are Patients Who Have Pre-Existing Psychiatric Diagnoses Less Likely to Achieve the Centers for Medicare & Medicaid Services Defined Substantial Clinical Benefit following Total Hip and Total Knee Arthroplasty? 在全髋关节和全膝关节置换术后,既往有精神疾病诊断的患者是否更不可能获得医疗保险和医疗补助服务中心定义的实质性临床获益?
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-09 DOI: 10.1016/j.arth.2025.10.004
Phillip C McKegg, Noah Hodson, Mazen Zamzam, Alexander Driessche, Trevor North, Michael Charters
{"title":"Are Patients Who Have Pre-Existing Psychiatric Diagnoses Less Likely to Achieve the Centers for Medicare & Medicaid Services Defined Substantial Clinical Benefit following Total Hip and Total Knee Arthroplasty?","authors":"Phillip C McKegg, Noah Hodson, Mazen Zamzam, Alexander Driessche, Trevor North, Michael Charters","doi":"10.1016/j.arth.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.arth.2025.10.004","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric disorders affect nearly one in four adults and are associated with worse surgical outcomes. However, limited data exist on their impact on patient-reported outcome measures (PROMs) or the achievement of substantial clinical benefit (SCB), as defined by the Centers for Medicare & Medicaid Services (CMS). This study evaluated how psychiatric diagnoses influence outcomes after total joint arthroplasty (TJA), including PROMs, emergency department (ED) visits, discharge dispositions, and lengths of stay (LOS).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients undergoing primary TJA from 2021 to 2023. Psychiatric diagnoses (e.g., schizophrenia, bipolar disorder, major depressive disorder [MDD], anxiety, post traumatic stress disorder, antisocial personality disorder) were identified via International Classification of Diseases (ICD)-10 codes. The primary outcome was achieving CMS-defined SCB. The secondary outcomes included 90-day ED visits, LOS, and discharge dispositions. Univariate and multivariate regression analyses assessed associations between psychiatric comorbidities and outcomes.</p><p><strong>Results: </strong>In THA patients, psychiatric comorbidity was not associated with failure to achieve SCB (odds ratio (OR): 0.67, P = 0.6), but was linked to higher ED visit rates in MDD patients (4.3 versus 2.4%, P = 0.015), more facility-based discharges (19 versus 5.3%, P < 0.001), and longer LOS (OR: 1.96, P < 0.001). In TKA patients, psychiatric diagnoses were associated with lower odds of achieving SCB (OR: 3.06, P = 0.013), increased ED visits (6.4 versus 4.4%, P = 0.011), more facility discharges (17 versus 4.3%, P < 0.001), and prolonged LOS (OR: 2.48, P < 0.001).</p><p><strong>Conclusions: </strong>Psychiatric comorbidities, especially in TKA, adversely affect recovery and functional outcomes after arthroplasty. Preoperative mental health screening and tailored perioperative strategies may help optimize recovery.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of Cutibacterium Avidum versus Acnes in Periprosthetic Hip Infections: A Matched Cohort Analysis. 假体周围髋关节感染中角质杆菌与痤疮的比较:一项匹配队列分析。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-08 DOI: 10.1016/j.arth.2025.09.052
J A Mitterer, R M Kinsky, Bjh Frank, A Aichmair, M Dominkus, J G Hofstaetter
{"title":"Comparison of Cutibacterium Avidum versus Acnes in Periprosthetic Hip Infections: A Matched Cohort Analysis.","authors":"J A Mitterer, R M Kinsky, Bjh Frank, A Aichmair, M Dominkus, J G Hofstaetter","doi":"10.1016/j.arth.2025.09.052","DOIUrl":"https://doi.org/10.1016/j.arth.2025.09.052","url":null,"abstract":"<p><strong>Introduction: </strong>The precise role of Cutibacterium in periprosthetic joint infections (PJIs) and unexpected positive intraoperative cultures (UPIC) in presumed aseptic revision total hip arthroplasty (rTHA) remains unclear. Moreover, little is known about whether there are differences in prevalence, clinical outcomes, and microbiological characteristics between Cutibacterium avidum (C. avidum) and C. acnes. This study aimed to evaluate outcomes and related factors in C. avidum and C. acnes-positive rTHA cases.</p><p><strong>Materials and methods: </strong>We analyzed 636 culture-positive rTHA of 564 patients (men : women = 253:311, mean age: 67 years (range, 37 to 88)) with a minimum follow-up of 40 months (range, 40 to 164) between 2011 and 2021 from a single center. Cases positive for C. avidum or C. acnes were evaluated for clinical presentation, risk factors, mono- and polymicrobial detections, and antibiotic resistance patterns. The PJI cases were classified according to the International Consensus Meeting 2018 criteria. A 1:3 propensity-score matching was used to compare outcomes between pathogens.</p><p><strong>Results: </strong>Cutibacteria were detected in 120 of 636 (18.9%) rTHA, including C. avidum in 24 of 120 and C. acnes in 96 of 120 cases. Polymicrobial infections occurred in 40 of 120 (33.3%) cases, mainly co-occurring with gram-positive pathogens. True-septic PJIs were more frequent in C. avidum (83.3%, P < 0.01), whereas C. acnes was more evenly distributed between PJI (56.4%) and UPIC (43.6%). Cutibacterium avidum was strongly associated with the direct anterior approach (DAA) (58.3 versus 17.7%, P < 0.01), higher body mass index (BMI), and American society of anesthesiologists (ASA) scores (P < 0.01). Early septic failure rates were higher in C. acnes-positive PJIs, whereas increased antibiotic resistances were observed for C. avidum.</p><p><strong>Conclusions: </strong>We found clinically relevant differences between C. avidum and C. acnes positive rTHA. Cutibacterium avidum was more prone to cause PJI in obese patients who underwent primary DAA. The higher early septic failure in C. acnes-positive PJI cases underlines their role as a clinically important pathogen in periprosthetic hip joint infections.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chronic Postsurgical Pain after Primary Total Hip Arthroplasty for Osteoarthritis: A Nationwide Cross-Sectional Survey Study. 骨关节炎原发性全髋关节置换术后慢性术后疼痛:一项全国性的横断面调查研究。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-08 DOI: 10.1016/j.arth.2025.09.057
Jens Laigaard, Saber Muthanna Aljuboori, Lone Nikolajsen, Ole Mathiesen, Troels Haxholt Lunn, Søren Overgaard
{"title":"Chronic Postsurgical Pain after Primary Total Hip Arthroplasty for Osteoarthritis: A Nationwide Cross-Sectional Survey Study.","authors":"Jens Laigaard, Saber Muthanna Aljuboori, Lone Nikolajsen, Ole Mathiesen, Troels Haxholt Lunn, Søren Overgaard","doi":"10.1016/j.arth.2025.09.057","DOIUrl":"https://doi.org/10.1016/j.arth.2025.09.057","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is frequently performed in patients who have osteoarthritis to relieve pain and improve quality of life. However, there is limited contemporary data on satisfaction and risk of persistent postsurgical pain, even though it is essential for informed decision-making. The objective of our study was to investigate the incidence of chronic postsurgical pain, pain characteristics, use of analgesics, patient satisfaction, and willingness to undergo surgery again one year after THA for osteoarthritis.</p><p><strong>Methods: </strong>We conducted a nationwide cross-sectional online survey of unselected patients who underwent primary, unilateral THA for primary osteoarthritis. At one year after surgery, we invited 2,533 patients identified from two national registers to participate in the survey. The primary outcome was moderate to severe chronic postsurgical pain, defined as a numerical rating scale (NRS) score ≥ 4. The secondary outcomes included frequency of pain, pain interference with everyday life, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain domain, the Doleur Neuropatique 4 interview (DN4i), use of analgesics, satisfaction, and willingness to undergo surgery again.</p><p><strong>Results: </strong>Of 1,880 (74.2%) respondents, 244 (13.0%) had moderate or severe chronic postsurgical pain (NRS ≥ 4), 1,715 (91.2%) patients were either satisfied or very satisfied with the result of surgery, and 1,752 (93.2%) would still have undergone surgery if they could go back in time.</p><p><strong>Conclusion: </strong>At one year after primary THA, at least 13% of Danish patients experienced moderate to severe postsurgical pain. However, up to 91% of patients reported being satisfied or very satisfied with the outcome.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Impact of Glucagon-Like Peptide-1 Receptor Agonist Use on Clinical Outcomes After Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of 346,899 Patients. 胰高血糖素样肽-1受体激动剂对全髋关节置换术后临床结果的影响:346,899例患者的系统回顾和荟萃分析
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-08 DOI: 10.1016/j.arth.2025.09.054
Seungjun Lee, Kevin Singh, Sean C Clark, Graham S Goh
{"title":"The Impact of Glucagon-Like Peptide-1 Receptor Agonist Use on Clinical Outcomes After Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of 346,899 Patients.","authors":"Seungjun Lee, Kevin Singh, Sean C Clark, Graham S Goh","doi":"10.1016/j.arth.2025.09.054","DOIUrl":"https://doi.org/10.1016/j.arth.2025.09.054","url":null,"abstract":"<p><strong>Background: </strong>Obesity and diabetes are highly prevalent comorbidities in patients undergoing total hip (THA) and knee arthroplasty (TKA). Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are novel agents that promote weight loss and glycemic control, assisting with perioperative optimization and potentially improving clinical outcomes. However, there have been safety concerns surrounding GLP-1RA use due to delayed gastric emptying and increased aspiration risk. The purpose of this systematic review was to evaluate the impact of GLP-1RA usage on perioperative outcomes following THA and TKA.</p><p><strong>Methods: </strong>PubMed (MEDLINE), Scopus (EMBASE, MEDLINE, COMPENDEX), and Cochrane databases were queried to conduct a systematic review of articles from inception to June 2025. A total of 13 studies were included (119,092 hip, 227,381 knee, 426 hip or knee). Demographics, surgical complications, medical complications, resource utilization, and revision rates were recorded at 90 days and at one and two years. Meta-analysis was performed using a random-effects model.</p><p><strong>Results: </strong>The GLP-1RA use was associated with a lower risk of 90-day PJI following TKA (odds ratio (OR), 0.75; 95% confidence interval (CI), 0.57 to 1.00; P = 0.047) and a lower risk of 90-day revision following THA (OR, 0.76; 95% CI, 0.59 to 0.98; P = 0.034). There was a significant decrease in 90-day readmission rates for TKA and THA with GLP-1RA use. Of note, no significant association was found between GLP-1RA use and aspiration or pneumonia (OR, 1.09; 95% CI, 0.71 to 1.67; P = 0.70), but GLP-1RA usage was associated with an elevated risk of MI in the setting of TKA (OR, 1.39; 95% CI, 1.05 to 1.85; P = 0.02).</p><p><strong>Conclusion: </strong>The GLP-1RA use was associated with improved early surgical outcomes and decreased resource utilization following THA and TKA. These findings suggest a potential benefit of GLP-1RA use for optimizing high-risk patients who have obesity or diabetes undergoing TJA.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effect of Body Mass Index on the Efficacy of Semaglutide Use at the Time of Total Knee Arthroplasty. 体重指数对全膝关节置换术时使用西马鲁肽疗效的影响。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-08 DOI: 10.1016/j.arth.2025.09.056
Jacquelyn J Xu, Matthew C Johnson, Gabriel Lama, Jacob Budin, Ameer Tabbaa, Aaron Z Chen, Matthew L Magruder
{"title":"The Effect of Body Mass Index on the Efficacy of Semaglutide Use at the Time of Total Knee Arthroplasty.","authors":"Jacquelyn J Xu, Matthew C Johnson, Gabriel Lama, Jacob Budin, Ameer Tabbaa, Aaron Z Chen, Matthew L Magruder","doi":"10.1016/j.arth.2025.09.056","DOIUrl":"https://doi.org/10.1016/j.arth.2025.09.056","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the impact of semaglutide on postoperative complications following total knee arthroplasty (TKA) by body mass index (BMI) class.</p><p><strong>Methods: </strong>A retrospective analysis of a national claims database was performed for patients undergoing primary TKA for osteoarthritis who had an active semaglutide prescription from January 2010 to April 2023. Patients were divided into non-obese (BMI < 30), obese (BMI 30.0 to 39.9), and morbidly obese (BMI > 40) groups. Semaglutide users were propensity score matched to non-users, yielding non-obese (7,402 versus 36,884), obese (4,034 versus 20,134), and morbidly obese (2,383 versus 11,853). Outcomes included 90-day medical complications, 90-day readmissions, and 90-day and 2-year implant-related complications. Univariate and multivariate regressions compared outcomes within BMI groups.</p><p><strong>Results: </strong>In the non-obese group, semaglutide users had significantly lower odds of deep vein thrombosis (DVT) (odds ratio (OR) 0.68; 95% confidence interval (CI) 0.57 to 0.81; P < 0.001), pulmonary embolism (PE) (OR 0.49; 95% CI 0.34 to 0.70; P < 0.001), and pneumonia (PNA) (OR 0.69; 95% CI 0.53 to 0.89; P = 0.004). In obese patients, semaglutide users had significantly lower odds of 90-day periprosthetic joint infection (PJI) (OR 0.53; 95% CI 0.38 to 0.76; P < 0.001), 2-year PJI (OR 0.65; 95% CI 0.52 to 0.81; P < 0.001), 90-day revisions (OR 0.54; 95% CI 0.35 to 0.85; P = 0.008), DVT (OR 0.67; 95% CI 0.54 to 0.82; P < 0.001), pulmonary embolism (OR 0.39; 95% CI 0.23 to 0.62; P < 0.001), and PNA (OR 0.69; 95% CI 0.49 to 0.90; P = 0.008). In morbidly obese patients, semaglutide use was associated with significantly lower rates of 90-day aseptic loosening and myocardial infarction (both P < 0.001).</p><p><strong>Conclusion: </strong>Our findings support a BMI-based approach to perioperative semaglutide use, particularly in patients who have a BMI > 30.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Call to Action: National Funding for the American Joint Replacement Registry. 行动呼吁:为美国关节置换登记提供国家资金。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-08 DOI: 10.1016/j.arth.2025.10.008
Robert A Burnett, Omar Shalakti, James I Huddleston, Adam J Rana
{"title":"A Call to Action: National Funding for the American Joint Replacement Registry.","authors":"Robert A Burnett, Omar Shalakti, James I Huddleston, Adam J Rana","doi":"10.1016/j.arth.2025.10.008","DOIUrl":"https://doi.org/10.1016/j.arth.2025.10.008","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis: Survivorship After a Mean Follow-up of 11 Years. 青少年特发性关节炎的翻修全髋关节置换术:平均随访11年后的生存率。
IF 3.8 2区 医学
Journal of Arthroplasty Pub Date : 2025-10-08 DOI: 10.1016/j.arth.2025.10.009
Puthi Tantikosol, Katherine Hwang, Nicole Alexandriadria Segovia, Stuart B Goodman
{"title":"Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis: Survivorship After a Mean Follow-up of 11 Years.","authors":"Puthi Tantikosol, Katherine Hwang, Nicole Alexandriadria Segovia, Stuart B Goodman","doi":"10.1016/j.arth.2025.10.009","DOIUrl":"https://doi.org/10.1016/j.arth.2025.10.009","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition that often affects the hip joints during childhood. Due to the high incidence of failure of initial total hip arthroplasty (THA) performed years earlier for JIA, revision surgeries are frequently necessary and particularly challenging. This study evaluated the outcomes of these complex revision procedures after an average follow-up of 11 years.</p><p><strong>Methods: </strong>A retrospective review of 24 patients (34 hips) who had JIA undergoing revision THA between January 1999 and December 2023 was conducted. The mean age of the cohort was 40 years (range, 17 to 61), with an equal number of men and women patients. All surgeries were performed by a single surgeon. Data sources included clinical records and surgical reports. Univariate analyses were performed using Mann-Whitney tests for continuous variables and Chi-square/Fisher's exact tests for categorical variables. Kaplan-Meier survival curves were generated to estimate reoperation-free survival.</p><p><strong>Results: </strong>The Kaplan-Meier survival analysis showed reoperation-free survival rates of 54% at five years and 36% at 10 years. The 95% CI (confidence intervals) for these estimates were 31 to 93% and 17 to 80%, respectively. Univariate analyses revealed a significant association between complications and length of hospital stay (hazard ratio [HR]: 0.15; 95% CI: 0.03 to 0.72; P = 0.018). A total of 41.2% of patients experienced complications such as infection, nerve palsy, and dislocation.</p><p><strong>Conclusions: </strong>Revision THA in patients who had JIA is associated with a high complication rate and reduced reoperation-free survival. Early identification of risk factors, meticulous surgical planning, and comprehensive postoperative care are critical to improving long-term outcomes.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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