Journal of Arthroplasty最新文献

{"title":"Cemented Hemiarthroplasty Results in Substantial Cost Savings Over Uncemented Hemiarthroplasty for the Treatment of Femoral Neck Fractures in Patients Over 60 Years Old: A Markov Analysis.","authors":"Nathan H Varady, Jacob F Oeding, Elizabeth B Gausden, William M Ricci, Antonia F Chen","doi":"10.1016/j.arth.2024.10.098","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.098","url":null,"abstract":"<p><strong>Background: </strong>While there is growing scientific evidence supporting superior outcomes following cemented versus uncemented hip hemiarthroplasty (HHA) in elderly femoral neck fractures (FNFs), the relative cost-effectiveness of this in the United States is unknown. Thus, the purpose of this study was to compare the cost-effectiveness of cemented versus uncemented HHA for the treatment of FNFs in patients > 60 years old in the United States, accounting for postoperative outcomes including periprosthetic fractures.</p><p><strong>Methods: </strong>A Markov model utilizing Monte Carlo microsimulation was developed to evaluate the outcomes and costs of patients at least 60 years of age (mean ± standard deviation, 84 ± 8 years) undergoing cemented versus uncemented HHA for the treatment of FNFs. Health utility values, transition probabilities, and upfront costs were derived from the published literature. Outcome measures included average total costs associated with each treatment (including those from patients who sustained a periprosthetic fracture), quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>Mean total costs resulting from cemented and uncemented HHA were $19,462 ± 3,581 and $21,997 ± 3,574, respectively (upfront costs from the published literature were $18,267 for cemented HHA and $16,803 for uncemented HHA). Average QALYs resulting from cemented and uncemented HHA were 4.0 ± 0.7 and 3.1 ± 0.6. The resulting ICER was -$2,688.9/QALY. Cemented HHA was found to be the most cost-effective treatment strategy in 89% of the patients in the Monte Carlo microsimulation model.</p><p><strong>Conclusion: </strong>Despite documented higher upfront costs for cemented HHA, the averaged total costs over a 10-year time horizon were $2,534 less for cemented HHA than for uncemented HHA. In addition, cemented HHA resulted in an additional 0.9 QALYs relative to uncemented HHA. The findings of this United States-based study replicate the financial and quality-of-life benefits of cemented HHA for elderly FNFs seen in other health systems.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512496","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 resurfacing hip arthroplasty for patients who have arthritis of the hip?","authors":"Hakan Kocaoğlu, Ross Crawford, Javad Parvizi, James N Powell, Alfredas Smailys, Saheed Yakub","doi":"10.1016/j.arth.2024.10.092","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.092","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512509","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":"Question 54: What are the indications for using sleeves and/or cones during revision total knee arthroplasty?","authors":"Andrew Fraval, Jose Baeza-Oliete, Pawel Bartosz, Job Diego Velázquez Moreno, Robert Hube, Michael Huo, Pablo Sanz Ruiz, Ashok Rajgopal","doi":"10.1016/j.arth.2024.10.077","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.077","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","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":"Does Metal Allergy to Total Knee Arthroplasty Components Exist?","authors":"Seyed Mohammad Javad Mortazavi, Valentin Antoci, Pooya Hosseini-Monfared, Mohammadreza Razzaghof, Eleftherios Tsiridis, Samih Tarabichi, Shang-Wen Tsai, Alfredas Smailys, Nelson Enrique Medina Socorro, Ismet Gavrankapetanovic","doi":"10.1016/j.arth.2024.10.068","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.068","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512498","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 difference in outcomes between collared and non-collared uncemented femoral stems in primary total hip arthroplasty?","authors":"L Bayam, K Karaytug, O Marin-Pena, A Rana, E Romanini, E Feng, A Murcia, R Tozun","doi":"10.1016/j.arth.2024.10.094","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.094","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512506","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 the integration of robotic technology improve outcomes in unicompartmental knee arthroplasty?","authors":"K Karaytug, E Caliskan, M K Abdelnasser, R Sorial, A F Kamath","doi":"10.1016/j.arth.2024.10.095","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.095","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512499","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 The Use of Ceramic Femoral Head Versus Metal Femoral Head Improve the Outcome of Primary Total Hip Arthroplasty?","authors":"Terry A Clyburn, Elizabeth A Abe, Koos Jordaan, Eoin C Sheehan, Dragan Radoičić, Yihe Hu, Paul M Courtney, Javad Parvizi","doi":"10.1016/j.arth.2024.10.071","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.071","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512500","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":"Should intravenous heparin be administered during total knee or total hip arthroplasty?","authors":"Armita Armina Abedi, Ibrahim Tuncay, Mohamed Muath Adi, Samih Tarabichi, Stavros Memtsoudis, Martin Buttaro, Javad Parvizi","doi":"10.1016/j.arth.2024.10.072","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.072","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512517","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, Mohammad T Ghazavi, Vahit Emre Özden, Jesus Moreta, Oussama Chaar, Vorawit Atipiboosin, Ömer F Bilgen, Daisuke Inoue, Peilai Liu, Yanguo Qin, Ahmed S Younis","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":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","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":"The Addition of a Non-Steroidal Anti-Inflammatory Drug (NSAID) in Local Infiltration Analgesia During Total Knee Arthroplasty Increases the Risk of Acute Kidney Injury in Patients Who Have Renal Impairment: A Propensity-Matched Retrospective Cohort Study.","authors":"Brian Rui Kye Chee, Emrick Sen Hui Quah, Carol Xiaoshu Zhao, Kelvin Guoping Tan, Lynn Thwin","doi":"10.1016/j.arth.2024.10.020","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.020","url":null,"abstract":"<p><strong>Background: </strong>Local infiltration analgesia (LIA) is a crucial component of pain management during total knee arthroplasty (TKA). Various formulations of the LIA drug cocktail have been described, with non-steroidal anti-inflammatory drugs (NSAIDs) commonly included. Although NSAIDs are highly effective in improving postoperative pain, they are associated with adverse renal, gastrointestinal, and cardiovascular effects. This study aimed to investigate whether the addition of an NSAID in LIA affects the incidence of acute kidney injury (AKI) in TKA patients, especially those who have pre-existing renal impairment. The secondary aim was to determine overall AKI incidence.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on elective, primary TKA patients in a single tertiary institution between January 2020 and April 2024. Data was obtained from a prospectively collected institutional knee arthroplasty registry. Patients were administered LIA intraoperatively, with or without an NSAID (30 mg of ketorolac). The study population was divided into two subpopulations, patients who did or did not have chronic kidney disease (CKD), and analyzed separately. Propensity matching was performed on the CKD group, correcting for age, sex, BMI, ASA score, and presence of diabetes mellitus/hypertension. The outcome of interest was the incidence of AKI. A t-test or Chi-square test was used, where appropriate, to determine the statistical significance of the results.</p><p><strong>Results: </strong>In patients who had CKD (n = 114), the presence of ketorolac in LIA was associated with a higher AKI incidence (12.7 versus 2.0%, P = 0.041). In patients who did not have CKD (n = 870), the presence of ketorolac in LIA was not associated with a higher AKI incidence (2.0 versus 1.9%, P = 1.0). Overall AKI incidence was 2.6%.</p><p><strong>Conclusion: </strong>In patients who have CKD, orthopaedic surgeons should be highly cautious of administering ketorolac in LIA during TKA, as it is associated with a higher risk of AKI. Patients who have normal renal function can be safely given ketorolac in LIA without an elevated risk of AKI. Further studies are needed to examine AKI incidence when other NSAIDs are used in LIA.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512520","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}