Journal of Arthroplasty最新文献

{"title":"Does Surgical Approach in Total Hip Arthroplasty Affect Postoperative Corticosteroid Injection Requirements?","authors":"Braden V Saba, Casey Cardillo, Muhammad A Haider, Ran Schwarzkopf, Roy I Davidovitch","doi":"10.1016/j.arth.2025.03.045","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.045","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroid injections following total hip arthroplasty (THA) are commonly utilized to address soft-tissue pathology such as bursitis and tendinitis. The THA surgical approaches differ in the extent of muscle and soft-tissue dissection. The aim of this study was to compare the impact of surgical approach on postoperative corticosteroid injection requirements when controlling for multiple covariates. A secondary aim was to identify risk factors associated with the various injection types.</p><p><strong>Methods: </strong>This was a propensity-matched retrospective study of 10,907 THA patients from June 2016 to December 2022 at a single, urban, academic health center. Patients were stratified into cohorts based on surgical approach: anterior (n = 4,287) and posterior (n = 6,620), then propensity-matched 1:1 with nearest-neighbor matching to form two cohorts of 4,287 patients. Baseline characteristics and corticosteroid injection data for soft-tissue pathology were obtained and analyzed. Chi-square and multivariate logistic regression analyses were used to assess the impact of patient and surgical factors on receiving postoperative steroid injections.</p><p><strong>Results: </strong>A posterior approach conferred increased risk of postoperative injections (aOR [adjusted odds ratio] 1.242, P = 0.001) after controlling for multiple covariates. The posterior approach also had higher total rates of greater trochanter (GT) bursitis injections postoperatively compared to the anterior group (11.5 versus 7.3%, P < 0.001). Both surgical approaches demonstrated comparable rates of iliopsoas bursitis injections (P = 0.39), gluteus medius tendinosis injections (P = 0.09), and lateral femoral cutaneous nerve injections (P = 0.27). The strongest predictor of postoperative injections was a history of preoperative injection (aOR 3.772, P < 0.001).</p><p><strong>Conclusion: </strong>Posterior approach, women, and history of preoperative corticosteroid injection were identified as the strongest risk factors for postoperative GT bursitis injection or postoperative soft-tissue injection. These factors should be considered when counseling patients on expected postoperative outcomes and the likelihood of corticosteroid injections following THA.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732828","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}

{"title":"Cost Analysis of Direct Anterior versus Direct Lateral Approach for Outpatient Total Hip Arthroplasty: Does Surgical Approach Impact Cost?","authors":"Jacquelyn D Marsh, Bryn Zomar, Anthony Tannous, James Howard, Steven MacDonald, Brent Lanting","doi":"10.1016/j.arth.2025.03.052","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.052","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is an effective surgery for advanced osteoarthritis. The rising demand for THA and increasing wait times are having a substantial impact on healthcare resources, resulting in increased pressure to move to outpatient care. This has most commonly been enabled through a minimally invasive, direct anterior (DA) surgical approach; however, recently, the direct lateral (DL) approach has also been used in outpatient THA. The purpose of this study was to compare costs between outpatient THA using a DA compared to a DL approach.</p><p><strong>Methods: </strong>The present study is a secondary analysis of a randomized controlled trial and a prospective cohort study. Participants undergoing primary THA using the DA approach were randomly assigned to be discharged on the same day as surgery (outpatient) or on day one post-surgery (inpatient). The cohort study included patients undergoing outpatient THA using the DL approach. We compared patients in the outpatient arm of the randomized trial to the prospective cohort of outpatient DL THAs. We recorded all costs associated with each surgical approach. Following discharge, participants also completed a self-reported cost diary regarding any resource utilization such as emergency department visits or subsequent hospitalizations, tests and procedures, consultations or follow-up, healthcare professional services, rehabilitation, medications, informal care, productivity losses, and out-of-pocket expenditures up to three months postoperative. There were 127 patients in the DA group and 51 patients in the DL group. The mean age of patients in the DA group was 66 years compared to 59 years in the DL group (P < 0.01).</p><p><strong>Results: </strong>There were no statistically significant differences in costs between groups from either the healthcare payer (DA = 7,910.19, DL = 7,847.17, P = 0.80) or societal perspectives (DA = 14,657.21, DL = 14,581.21, P = 0.96).</p><p><strong>Conclusion: </strong>Our results suggest similar overall mean costs over 90 days postoperative between outpatient THA using a DL or DA surgical approach.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732820","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}

{"title":"Higher Pulmonary Embolism Risk in Morbidly Obese Patients on Aspirin Monotherapy After Total Knee Arthroplasty: A Claims Database Analysis.","authors":"Aymen Alqazzaz, Thompson Zhuang, Weston E Smith, Emannuel Gibon, Charles L Nelson","doi":"10.1016/j.arth.2025.03.046","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.046","url":null,"abstract":"<p><strong>Background: </strong>Aspirin is the most common drug used for venous thromboembolism (VTE) prophylaxis after total knee arthroplasty (TKA). Morbid obesity is a potential risk factor for VTE, prompting some to use stronger anticoagulants. However, there are no established guidelines for VTE prevention in obese or morbidly obese patients undergoing primary TKA.</p><p><strong>Methods: </strong>Using a national administrative claims database, patients who underwent primary TKA were divided into three cohorts based on body mass index (BMI): < 30, 30 to 39.9, or ≥ 40. Each patient had a prescription claim for aspirin, but no other prophylaxis agents within three days after the index procedure. We assessed deep vein thrombosis (DVT) and pulmonary embolism (PE) incidence at 90 and 180 days postoperatively. Secondary outcomes included wound dehiscence, hematoma, periprosthetic joint infection (PJI), and debridement, antibiotics, and implant retention (DAIR) or explantation procedures. We included 20,097 patients, of whom 4,277 (21%), 10,663 (53%), and 5,157 (26%) had a BMI < 30, 30 to 39.9, and ≥ 40, respectively.</p><p><strong>Results: </strong>In the multivariable analysis, there was no difference in the incidence of DVT or PE within 90 or 180 days after surgery for the BMI 30 to 39.9 compared to the BMI < 30 cohort. However, the incidence of PE within 90 days after surgery was higher in the BMI ≥ 40 cohort (OR [odds ratio]: 2.74), an effect that disappeared by 180 days. There was a higher adjusted odds of DAIR procedures in the BMI ≥ 40 compared to the BMI < 30 cohort; otherwise, the incidence of secondary outcomes did not differ by BMI.</p><p><strong>Conclusion: </strong>When aspirin was utilized as a standardized monotherapy for VTE prophylaxis following primary TKA, there was an increased 90-day incidence of PE in morbidly obese patients but no difference in DVT or PE incidence in obese patients.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712051","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}

{"title":"Debridement, Antibiotics, and Implant Retention for Acute Periprosthetic Joint Infection: Results of 126 Primary Hip Arthroplasties at Extended Follow-Up of Seven Years.","authors":"E Bailey Terhune, Khaled A Elmenawi, Jessica A Grimm, Charles P Hannon, Nicholas A Bedard, Elie F Berbari, Daniel J Berry, Matthew P Abdel","doi":"10.1016/j.arth.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.arth.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>There is renewed interest in debridement, antibiotics, and implant retention (DAIR) for acute periprosthetic joint infections (PJIs). The purpose of this study was to assess the results of single DAIRs for acute PJI after primary hip arthroplasty in a large series with extended follow-up.</p><p><strong>Methods: </strong>We identified 126 hips (108 total hip arthroplasties, 18 hemiarthroplasties) with acute PJIs treated with DAIR followed by chronic antibiotic suppression between 2000 and 2021 at a single institution. Acute postoperative PJI was defined as infection within four weeks of primary hip arthroplasty, and acute hematogenous PJI was defined as infection occurring more than four weeks after primary hip arthroplasty with symptoms for less than 21 days. The mean age was 67 years, 44% were women, and the mean body mass index was 34. Kaplan-Meier survivorship analyses were performed. The mean follow-up was seven years.</p><p><strong>Results: </strong>Survivorship free of reinfection was 80% at one year, 79% at two years, and 77% at five years. There was no difference in survivorship free of reinfection between early postoperative and acute hematogenous PJIs (P = 0.1). McPherson Host Grade C was predictive of reinfection (hazard ratio 5, P = 0.03). Reinfection was caused by the original organism in 33% of hips. The median time to reinfection was 13 days. Survivorship free of any revision was 82% at five years. Indications for revision included recurrent PJI (91%), dislocation (5%), and aseptic failures (5%).</p><p><strong>Conclusions: </strong>In this large series of acute PJIs after primary hip arthroplasties treated with a single DAIR, infection-free survival was 77% at five years. Poor host status predicted reinfection. With a rigorous definition of acute PJI, success was markedly improved at extended follow-up compared to many historical series.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702047","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}

{"title":"Does Orthopaedic Subspecialty Training Affect Treatment Decision-Making and Outcomes for Displaced Femoral Neck Fractures.","authors":"Joshua Giordano, Anthony Modica, Jorge A Padilla, Randy M Cohn, James Germano","doi":"10.1016/j.arth.2025.03.058","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.058","url":null,"abstract":"<p><strong>Background: </strong>Approximately 1.3 to 2.2 million femoral neck fractures occur annually globally, with up to 80% being displaced, requiring hemiarthroplasty or total hip arthroplasty (THA). As the population ages, femoral neck fractures may surpass six million by 2050. Optimal treatment for displaced femoral neck fractures is debated with literature supporting both hemiarthroplasty and THA. Our objective was to determine if subspecialty training plays a role in the decision-making and outcomes of displaced femoral neck fractures.</p><p><strong>Methods: </strong>A retrospective analysis was performed of 386 patients who underwent hemiarthroplasty or THA for displaced femoral neck fracture at an academic health system from 2017 to 2023. To assess subspecialty training impact, patients were stratified based on training: adult reconstruction (AR) fellowship or other orthopaedic training (non-AR). Procedure duration, 90-day postoperative complications, length of stay, and discharge disposition were compared between cohorts. A sub-analysis was performed comparing procedures.</p><p><strong>Results: </strong>The AR surgeons performed THA 31.8% for femoral neck fractures compared to 10.5% for non-AR-trained surgeons (P< 0.001). Patients treated by AR-trained surgeons were on average younger (79 versus 82 years; P = 0.01). Procedure duration was shorter for hemiarthroplasty (80.4 versus 90.1 minutes; P = 0.01) and THA (94.9 versus 132.6 minutes; P = 0.01) when performed by AR surgeons (overall P = 0.01). The THA patients were more likely discharged home when treated by AR surgeons (55.3 versus 28%; P = 0.03). The AR-trained surgeons used cemented prostheses less compared to non-AR surgeons (16.9 versus 33.2%; P < 0.001).</p><p><strong>Conclusion: </strong>Subspecialty training plays a role in decision-making, procedure duration, and discharge disposition for femoral neck fractures. The AR-trained surgeons more often perform THA for femoral neck fractures compared to non-AR-trained surgeons. The AR-trained surgeons completed hemiarthroplasty and THA in significantly shorter time compared with non-AR-trained surgeons and more frequently discharged patients home.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712049","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}

{"title":"Low-Dose Aspirin is Safe and Effective for Prevention of Venous Thromboembolism after Femoral Neck Fracture.","authors":"Amy Y Zhao, Alex Gu, Aribah Shah, Avilash Das, Philip M Parel, James N Debritz, Robert S Sterling","doi":"10.1016/j.arth.2025.03.059","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.059","url":null,"abstract":"<p><strong>Introduction: </strong>Although patients who undergo arthroplasty for hip fractures are at high risk of venous thromboembolism (VTE), current guidelines do not specify the optimal VTE prophylactic agent. Recent evidence demonstrates that aspirin (ASA) may be safe and effective for VTE prevention in these patients. The purpose of this study was to determine the safety and efficacy of low-dose ASA (81 mg) compared to non-ASA agents after arthroplasty for femoral neck fracture.</p><p><strong>Methods: </strong>A total of 36,576 patients who underwent arthroplasty for femoral neck fracture from January 2012 through December 2023 were identified in a national database. Patients were stratified by baseline VTE risk into high-risk and standard-risk groups and further categorized based on the type of VTE prophylaxis received - low-dose ASA only or non-ASA prophylaxis only. Rates and odds of deep vein thrombosis (DVT), pulmonary embolism (PE), and adverse events, including bleeding, blood transfusion requirements, and emergency department visits, were assessed in the 90-day postoperative period for propensity-matched cohorts.</p><p><strong>Results: </strong>Compared to non-ASA prophylaxis, use of low-dose ASA only was associated with significantly lower odds of DVT in both high-risk (odds ratio [OR]: 0.46; 95% confidence interval [CI]: 0.30 to 0.69) and standard-risk (OR: 0.37; 95% CI: 0.18 to 0.76) groups, and lower odds of PE in high-risk patients (OR: 0.27; 95% CI: 0.14 to 0.55). There were no significant differences in odds of PE in standard-risk patients (OR: 0.71; 95% CI: 0.32 to 1.61). Low-dose ASA was associated with lower odds of bleeding events, blood transfusion requirements, and emergency department visits.</p><p><strong>Conclusions: </strong>Use of low-dose ASA is safe and effective in preventing VTE in patients undergoing arthroplasty for femoral neck fracture. As this population is at higher risk of mortality, prospective studies comparing VTE prophylaxis regimens are necessary to further improve clinical outcomes.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712053","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}

{"title":"Diagnosis and Treatment Influence Hospital Costs of Revision Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Aaron S Hammat, Emmanuel S Gnanamanickam, Chan Hee Cho, Boopalan Ramasamy, Renjy Nelson, David Campbell, Lucian B Solomon, Stuart A Callary","doi":"10.1016/j.arth.2025.03.057","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.057","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to synthesize the hospital costs of revision total hip arthroplasty (rTHA) by periprosthetic joint infection (PJI), periprosthetic fracture (PPF), aseptic loosening, and recurrent dislocation diagnoses. Additionally, as several surgical options are available within some diagnoses, this study aimed to synthesize the evidence on hospital costs for septic rTHA between debridement and implant retention (DAIR), one-stage and two-stage rTHA, and for PPF the cost between rTHA and open reduction internal fixation (ORIF) treatment.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Scopus identified all studies reporting the hospital costs of rTHA. Screening, data extraction, and risk of bias assessment were conducted. Hospital costs of each study cohort by main diagnosis and treatment were adjusted to 2024 USD and pooled using a random effects model.</p><p><strong>Results: </strong>Of 866 publications identified, 24 studies were included in the meta-analysis. Mean pooled costs of rTHA for dislocation, aseptic loosening, PPF, and septic rTHA were $25,256, $34,533, $35,904, and $55,707, respectively. The mean cost of septic rTHA (16 study cohorts) at $57,264 was 87% higher than aseptic rTHA (22 cohorts) at $30,224. A two-stage septic rTHA ($70,311) cost 77% more than one-stage septic rTHAs ($39,676). The cost of rTHA for PPF ($35,904) was 26% more than ORIF for PPF ($28,410).</p><p><strong>Conclusion: </strong>The cost of rTHA is progressively higher by diagnosis in the order of dislocation, aseptic loosening, PPF, and infection. Future studies should separately report rTHA costs by diagnosis and treatment type and longitudinally examine the hospital costs of this patient cohort, particularly for septic cases, beyond initial treatment to better understand the burden of rTHA.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712047","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}

{"title":"Characterizing the Cost Trends of Readmissions after Aseptic Revision Total Knee Arthroplasty.","authors":"Bryce T Hrudka, Andrew Fuqua, Jenny Nguyen, Janice Bonsu, Bridger Rodoni, Ayomide M Ayeni, Jacob Wilson, Ajay Premkumar","doi":"10.1016/j.arth.2025.03.051","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.051","url":null,"abstract":"<p><strong>Introduction: </strong>A rise in total knee arthroplasty (TKA) volume has led to an increased incidence of aseptic revision TKA (rTKA), resulting in significant associated healthcare costs. This study evaluated the economic impact and clinical factors associated with readmission following aseptic rTKA, aiming to identify key drivers of cost and risk factors for readmission.</p><p><strong>Methods: </strong>This retrospective analysis used data from a large national database from January 1, 2009, to June 30, 2022. Patients undergoing aseptic rTKA were identified via CPT (Current Procedural Terminology) codes. Readmissions within 90 days postoperatively were analyzed. Baseline characteristics, comorbidities, and readmission costs were compared, and significant risk factors for readmission were identified. Of 34,144 aseptic rTKA patients, 1,953 (5.7%) were readmitted within 90 days (56.1% medical, 29.2% surgical, 14.8% unknown).</p><p><strong>Results: </strong>The median cost of all readmissions was $25,181. Readmissions requiring reoperation had a higher cost (median $40,524 versus $20,907, P < 0.001). Among readmissions for surgical complications, periprosthetic joint infection was the most common cause (36.3%) and was associated with the greatest cost (median $38,104). The most common medical causes of readmission were rehabilitative care, ischemic cardiac events, and acute kidney injury. Significant risk factors for all-cause readmission included men, index revision for periprosthetic fracture, and comorbidities, including diabetes, coronary artery disease, renal disease, and congestive heart failure.</p><p><strong>Conclusion: </strong>Readmission after aseptic rTKA results in a major economic burden to the healthcare system, particularly in readmission pertaining to surgical complications and requiring reoperation. This study highlights the need for targeted strategies aimed at effectively reducing the rate of and costs associated with readmission post-rTKA with a goal of cost containment and improved patient outcomes.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694455","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}

{"title":"Why Do Total Joint Arthroplasties Get Canceled on the Day of Surgery?","authors":"Carlos G Sandoval, Jonathan L Katzman, Patrick Connolly, Eric L Grossman, Armin Arshi, Ran Schwarzkopf","doi":"10.1016/j.arth.2025.03.048","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.048","url":null,"abstract":"<p><strong>Background: </strong>Same-day cancellations of elective surgeries present challenges to patients, providers, and healthcare institutions. This study aimed to investigate the frequency and predictors of same-day cancellations for elective total joint arthroplasty (TJA).</p><p><strong>Methods: </strong>A retrospective review was conducted on 13,744 scheduled primary, elective TJAs at an urban academic center from September 2017 to August 2023. Cases that experienced same-day cancellations were grouped based on the reasoning for cancellation into one of two categories - operative concern (e.g., acute health issues, medication non-compliance) or a nonoperative concern (e.g., financial clearance, transportation issues). Patient demographics were compared between the cancellation and surgery cohorts and between the categorical reasons for cancellation.</p><p><strong>Results: </strong>Out of the 38,849 scheduled TJAs, 362 cases (0.9%) were canceled on the day of surgery. Higher patient body mass index (BMI) was the singular patient factor predictive of same-day cancellation across all TJAs. Non-white race, men, and higher Charlson Comorbidity Index (CCI) were additional significant predictors for THA, but not TKA cancellation. Operative concerns accounted for 74.9% of the cancellations, and nonoperative concerns accounted for 25.1%. Increased patient BMI was predictive of TJAs canceled due to operative concerns, whereas younger patient age was predictive of TJAs canceled due to nonoperative concerns. Of all same-day cancellations, 81.8% were ultimately rescheduled, and rescheduled cases occurred at a median of 25 days (range, one to 425) after cancellation. There were no significant differences in rescheduling rates and time to reschedule cases between the reasons for cancellation.</p><p><strong>Conclusion: </strong>Approximately 1% of patients experienced a same-day cancellation of their elective TJA, most of which occurred due to operative concerns. These findings may guide the development of preoperative optimization strategies aimed at reducing the occurrence of same-day cancellations for high-risk patients, thereby maximizing the utilization of operative resources and enhancing care for TJA patients.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694466","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}

{"title":"Hip Resurfacing Arthroplasty in Men: A Minimum 15-Year Follow-Up Study.","authors":"Anand Saluja, Zachary Wong, Louis Andrew Jordan, Jonathan Spaan, Edwin Su","doi":"10.1016/j.arth.2025.03.038","DOIUrl":"https://doi.org/10.1016/j.arth.2025.03.038","url":null,"abstract":"<p><strong>Background: </strong>Hip resurfacing arthroplasty (HRA) has emerged as an alternative to total hip arthroplasty (THA) for managing osteoarthritis, particularly in younger, active men. However, long-term data on HRA outcomes in the United States remains limited.</p><p><strong>Methods: </strong>We retrospectively examined 472 consecutive HRA cases in 407 men performed between January 2006 and December 2008 with a minimum 15-year follow-up outcomes. Patient-reported outcome measures (PROMs), including the modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR), Visual Analog Scale (VAS) for pain, and University of California-Los Angeles (UCLA) Activity Scale, were collected. Serum metal ion levels, survivorship, and radiographic outcomes were also assessed. Kaplan-Meier survival analysis was performed to evaluate implant survivorship. The mean follow-up was 16.0 years (range, 15.0 to 18.4).</p><p><strong>Results: </strong>The overall survivorship at 15 years was 95.1%. Implants with femoral head sizes ≥ 48 mm demonstrated 95.8% survivorship, while those < 48 mm showed 91.3% survivorship. For unrevised hips, mean final follow-up scores were HOOS-JR 97.8 ± 5.6, mHHS 97.3 ± 6.4, VAS 0.4 ± 1.1, and UCLA Activity 8.0 ± 1.9. The median serum metal ion levels at the final follow-up were 2.3 μg/L for chromium and 1.7 μg/L for cobalt. There were 26 revisions that occurred, with aseptic loosening being the most common cause (n = 11).</p><p><strong>Conclusion: </strong>This study demonstrates that HRA is a viable long-term solution for appropriately selected men with high survivorship and positive functional outcomes at a minimum 15-year follow-up.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694459","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}