Journal of Arthroplasty最新文献

{"title":"Body Mass Index is Not an Appropriate Proxy for the Condition of Peri-Incisional Adiposity in Primary Total Joint Arthroplasty Patients","authors":"John J. Heifner MD ,&nbsp;Tejbir S. Pannu MD ,&nbsp;Osmanny Gomez MD ,&nbsp;Philip A. Sakalian DO ,&nbsp;Arturo Corces MD","doi":"10.1016/j.arth.2024.08.020","DOIUrl":"10.1016/j.arth.2024.08.020","url":null,"abstract":"<div><h3>Background</h3><div>The American Academy of Orthopaedic Surgeons defined the acceptable threshold for elective safe surgery as a body mass index (BMI) under 40 due to the increased risk of complications. A consequence of this recommendation has been a hard cutoff based on BMI, which restricts access to care for an increasingly large and diverse population. There is an improved understanding that excess adipose tissue confers additional risk for postoperative complications, including infection, through mechanical and physiologic mechanisms. But, it is unclear if BMI is an accurate indicator of adiposity in total joint arthroplasty (TJA) patients and, thus, whether BMI is capturing clinically relevant information in obese patients. Our objective was to determine the relationship between peri-incisional adiposity (PIA) and BMI in a consecutive series of diverse primary TJA patients.</div></div><div><h3>Methods</h3><div>A consecutive series of patients indicated for primary TJA were preoperatively evaluated. For each patient, the following variables were collected: BMI and measures of PIA on radiographs and ultrasounds.</div></div><div><h3>Results</h3><div>In THA patients (N = 99), Pearson’s correlation coefficient (<em>r</em>) = 0.436, which indicates a moderate correlation between BMI and adiposity. In total knee arthroplasty patients (N = 271), <em>r</em> = 0.395 for femoral PIA (FPIA) and <em>r</em> = 0.249 for tibial PIA, which indicates a weak correlation between BMI and adiposity measured on radiography. In total knee arthroplasty patients, <em>r</em> = 0.560 for femoral PIA and <em>r</em> = 0.544 for tibial PIA, which indicates a moderate correlation between BMI and adiposity measured on ultrasound.</div></div><div><h3>Conclusions</h3><div>Quantification of obesity has become a common practice in the preoperative evaluation of primary TJA patients. The intent is to determine the magnitude of adipose tissue, which is one of the main drivers of postoperative complications in obesity. The BMI is ubiquitously used as a proxy for obesity due to its simplicity of attainment and calculation. We report that BMI has a weak-to-moderate association with PIA in this population. These findings indicate that BMI may not accurately represent the condition of peri-incisional adipose tissue and, thus, is not capturing the relevant obesity data for preoperative risk stratification in primary TJA patients.</div></div><div><h3>Level of evidence</h3><div>III.</div></div>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages 346-351"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047521","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":"Global Trends in Patellar Resurfacing From 2004 to 2022","authors":"Camryn S. Payne ,&nbsp;David G. Deckey MD ,&nbsp;Jens T. Verhey MD ,&nbsp;Paul R. Van Schuyver MD ,&nbsp;Joshua S. Bingham MD ,&nbsp;Mark J. Spangehl MD","doi":"10.1016/j.arth.2024.08.033","DOIUrl":"10.1016/j.arth.2024.08.033","url":null,"abstract":"<div><h3>Background</h3><div>International rates of patellar resurfacing in primary total knee arthroplasty (TKA) are highly variable. This study sought to determine how trends in patellar resurfacing rates have changed between 2004 and 2022. In addition, we investigated how modern rates of revision have varied between resurfaced and unresurfaced patellae in primary TKA among national joint registries.</div></div><div><h3>Methods</h3><div>Data between 2004 and 2022 was obtained either from the publicly available joint registry annual reports, a literature review, or via direct correspondence with registry personnel in Sweden, New Zealand, Australia, the United States, Norway, the United Kingdom, the Netherlands, Switzerland, Canada, and India. Only English language national joint registries or data via direct correspondence with registry administrators were utilized. Additionally, the 10-year cumulative risk of revision TKA with and without patellar resurfacing was pulled from those registries that had this data available.</div></div><div><h3>Results</h3><div>There were persistent differences in the rates of patellar resurfacing among countries. Australia documented a 40% increase in patellar resurfacing rates, while other countries demonstrated modest or little change in resurfacing rates. This may indicate that surgeons are making the decision to resurface based on national TKA revision rates. The average rates of patellar resurfacing in primary TKA ranged from 4% in Sweden to 94% in the United States. Canada, the United States, Australia, and Switzerland documented a lower risk of revision when the patella was resurfaced, while Sweden, conversely, showed a higher risk of revision with resurfacing.</div></div><div><h3>Conclusions</h3><div>Rates of patellar resurfacing in primary TKA were highly variable among countries, as were rates of change over time. It appears that the optimal patellar resurfacing strategy may depend mostly on unique patient factors and surgeon expertise. Future studies should attempt to elucidate the individual patient characteristics that contribute to increased risks of revision or anterior knee pain to determine who will most benefit from patellar resurfacing in primary TKA.</div></div>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages 367-372"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057181","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":"Mid- to Long-Term Outcomes and Complications of Total Hip Arthroplasty in Patients Who Have Crowe IV Developmental Dysplasia of the Hip: A Systematic Review and Meta-Analysis","authors":"Mohammad Poursalehian MD ,&nbsp;Ali Hassanzadeh MD ,&nbsp;Seyyed Hossein Shafiei MD ,&nbsp;S.M. Javad Mortazavi MD","doi":"10.1016/j.arth.2024.08.026","DOIUrl":"10.1016/j.arth.2024.08.026","url":null,"abstract":"<div><h3>Background</h3><div>Severe forms of developmental dysplasia of the hip (DDH) in adulthood often lead to total hip arthroplasty (THA). This study aimed to evaluate the mid-term to long-term outcomes of THA in Crowe type IV DDH cases, which represent a technically challenging and complex patient group.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, Web of Science, and Scopus were searched for observational studies and case series with over 100 months of mean follow-up on adult patients who had Crowe type IV DDH treated with THA. A total of 3,710 records were initially identified, leading to the inclusion of 24 studies in the final analysis. These studies were subjected to quality assessment using the National Institutes of Health Quality Assessment tool. Various outcomes including revision rates, leg-length discrepancy, Harris Hip Score, and complications like periprosthetic joint infections, dislocations, and nerve injuries were analyzed. A random effects model was employed for statistical analysis, with sensitivity analysis and metaregression applied in cases of high heterogeneity.</div></div><div><h3>Results</h3><div>The included studies assessed 1,024 hips with a mean follow-up of 11 years, revealing improvements in Harris Hip Score and reductions in leg length discrepancy post-THA. However, notable challenges were noted, including a 10.7% rate of intraoperative fractures, a 1.8% periprosthetic joint infection rate, and a 5.8% dislocation rate. Osteolysis and aseptic loosening revisions were observed in 9.1 and 8% of cases, respectively. Heterotopic ossification occurred in 11.1% of patients. Nerve injury was reported in 4.2% of cases. With the use of metaregression, some factors for observed heterogeneity were identified.</div></div><div><h3>Conclusions</h3><div>Total hip arthroplasty (THA) in Crowe type IV DDH patients presents notable challenges, but can lead to substantial long-term improvements in patient-reported outcomes.</div></div><div><h3>Level of Evidence</h3><div>IV.</div></div>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages 530-539"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057182","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":"Staying Ahead of the Curve: The Case for Recovery Curves in Total Knee Arthroplasty","authors":"Fred D. Cushner MD ,&nbsp;Jeffrey D. Yergler MD ,&nbsp;Barbara Elashoff MS ,&nbsp;Patrick M. Aubin PhD ,&nbsp;Patrick Verta MD ,&nbsp;Giles R. Scuderi MD","doi":"10.1016/j.arth.2024.07.039","DOIUrl":"10.1016/j.arth.2024.07.039","url":null,"abstract":"<div><h3>Background</h3><div>Sensor technology embedded within the total knee arthroplasty (TKA) implant has the potential to record data that can track recovery and provide diagnostic information. In this study, we introduce the concept of physical function recovery curve analytics, which are created from daily spatial-temporal gait metrics and step counts from a large cohort of TKA patients.</div></div><div><h3>Methods</h3><div>In our study population, 258 patients underwent a primary TKA with a smart implanted tibial extension between October 4, 2021, and July 15, 2022, by 33 surgeons. The average age was 63 years, with 138 (54%) women. All kinematic data were collected on a Health Insurance Portability and Accountability Act–compliant cloud data management platform.</div></div><div><h3>Results</h3><div>Summaries of the gait parameters at 6 weeks are suggestive of differences between people over and under 65 years, with the older patients walking more slowly and having shorter stride lengths. The 6-week percentiles demonstrated a strong linear correlation to the 12-week percentiles for each gait parameter, with correlation coefficients ranging from 0.87 to 0.92.</div></div><div><h3>Conclusions</h3><div>A novel screening gait test at 6 weeks shows promising results for predicting patients who will likely have poor recovery based on at least one gait parameter recovery curve at 12 weeks with high sensitivity and specificity. A future study is needed to validate the screening tool with an independent set of patients.</div></div>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages 373-379"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300288","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":"How Should Vancouver B1-Periprosthetic Fractures at the Tip of a Cemented or Uncemented Femoral Stem Be Treated?","authors":"Pablo A. Slullitel MD ,&nbsp;Jakob Van Oldenrijk MD, MSc, PhD ,&nbsp;Shang-Wen Tsai MD ,&nbsp;Stanislav Bondarenko MD, DMSc ,&nbsp;David Rodriguez-Quintana MD ,&nbsp;Eric L. Smith MD ,&nbsp;Scot A. Brown MD ,&nbsp;Eric B. Smith MD ,&nbsp;Manuj Wadhwa MS, MCh ,&nbsp;Khalid Merghani MBBS, MCh ,&nbsp;Karan Goswami MD","doi":"10.1016/j.arth.2024.10.093","DOIUrl":"10.1016/j.arth.2024.10.093","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages S173-S175"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512502","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":"Is There a Limit to Lengthening in Patients Who Have Crowe IV Developmental Dysplasia of the Hip Undergoing Total Hip Arthroplasty?","authors":"Ibrahim El-Ganzoury MD ,&nbsp;Mohammad T. Ghazavi MD, FRCSC ,&nbsp;Vahit Emre Özden MD ,&nbsp;Jesus Moreta MD ,&nbsp;Oussama Chaar MD ,&nbsp;Vorawit Atipiboosin MD ,&nbsp;Ömer F. Bilgen MD ,&nbsp;Daisuke Inoue MD, PhD ,&nbsp;Peilai Liu MD ,&nbsp;Yanguo Qin MD ,&nbsp;Ahmed S. Younis MD","doi":"10.1016/j.arth.2024.10.079","DOIUrl":"10.1016/j.arth.2024.10.079","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages S132-S135"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512508","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":"What Are the Indications for Using Sleeves and/or Cones During Revision Total Knee Arthroplasty?","authors":"Andrew Fraval MBBS ,&nbsp;Jose Baeza-Oliete MD ,&nbsp;Pawel Bartosz MD ,&nbsp;Job Diego Velázquez Moreno MD ,&nbsp;Robert Hube MD ,&nbsp;Michael Huo MD ,&nbsp;Pablo Sanz-Ruiz MD ,&nbsp;Ashok Rajgopal MBBS","doi":"10.1016/j.arth.2024.10.077","DOIUrl":"10.1016/j.arth.2024.10.077","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages S162-S163"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512512","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":"What Are the Indications for Reconstructive Pelvic Periacetabular Osteotomy in Patients Who Have Hip Pain?","authors":"Vahit Emre Özden MD ,&nbsp;Tahir Khan MD, FRCS ,&nbsp;Yutaka Inaba MD, PhD ,&nbsp;Katsufumi Uchiyama MD, PhD ,&nbsp;Ali Parsa MD ,&nbsp;James N. Powell MD, FRCS ,&nbsp;Marco Teloken MD ,&nbsp;Javad Parvizi MD, FRCS","doi":"10.1016/j.arth.2024.10.075","DOIUrl":"10.1016/j.arth.2024.10.075","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages S151-S153"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512521","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":"Is There a Role for Reinforcing Soft-Tissue Repairs or Flaps for Patients Who Have Abductor Deficiency?","authors":"Şahin Karalar MD ,&nbsp;İbrahim Azboy MD ,&nbsp;Kerem Basarir MD ,&nbsp;Aasis Unnanuntana MD ,&nbsp;Zhi Yang MD ,&nbsp;Javad Parvizi MD","doi":"10.1016/j.arth.2024.10.108","DOIUrl":"10.1016/j.arth.2024.10.108","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages S180-S181"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548822","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":"What Are the Indications for Hinged Implants in Revision Total Knee Arthroplasty?","authors":"Ashraf T. Hantouly MD, MSc ,&nbsp;Sathish Muthu MSc, PhD ,&nbsp;Mahmood Shahab MD ,&nbsp;Maritin Sarungi MD, PhD ,&nbsp;Aasis Unnanuntana MD, MSc ,&nbsp;Brian de Beaubien MD ,&nbsp;Jacobus D. Jordaan MD ,&nbsp;Thorsten Gehrke MD ,&nbsp;Javad Parvizi MD ,&nbsp;Mustafa Citak MD, MBA","doi":"10.1016/j.arth.2024.10.126","DOIUrl":"10.1016/j.arth.2024.10.126","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":"40 2","pages":"Pages S164-S167"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}