Journal of Arthroplasty最新文献

{"title":"What Is the Most Optimal Bearing Surface for Minimizing Instability After Revision Total Hip Arthroplasty?","authors":"Saad Tarabichi, Jens T Verhey, Marije C Vink, Rinne M Peters, Mohamed Elkabbani, Ahmed H Abdelazeem, Timothy Petheram, Pieralberto Valpiana, J D Jordaan, Sulaiman Alazzawi, Liu Xian-Zhe, Mark J Spangehl, Wierd P Zijlstra, Joshua S Bingham","doi":"10.1016/j.arth.2024.10.033","DOIUrl":"10.1016/j.arth.2024.10.033","url":null,"abstract":"<p><p>Based on the results of our meta-analysis, dual mobility implants appear to have the most efficacy in preventing instability following revision total hip arthroplasty. Notwithstanding, given the relatively small sample sizes of the included studies, in conjunction with heterogeneity in study design, it is important to recognize that further large randomized controlled trials are necessary to determine the optimal bearing surface to reduce the risk of instability after revision total hip arthroplasty.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480169","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 Surgical Drains Be Used After Routine Primary Total Knee or Total Hip Arthroplasty?","authors":"Pawel Bartosz, Burak Akan, Vladislav Bartak, Jerzy Bialecki, Laszlo Bucsi, Wei Chai, Rafal Kaminski, Nandor J Nemes, Javad Parvizi, Toshiyuki Tateiwa, Akos Zahar","doi":"10.1016/j.arth.2024.10.038","DOIUrl":"10.1016/j.arth.2024.10.038","url":null,"abstract":"<p><strong>Response/recommendation: </strong>The use of surgical drains in routine primary total knee and total hip arthroplasty is not recommended.</p><p><strong>Level of evidence: </strong>High.</p><p><strong>Expert voting: </strong>Agree 83.52%, Disagree 12.91%, Abstain 3.59%.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480157","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 the outcome of primary total knee arthroplasty performed using kinematic versus mechanical alignment?","authors":"George A Komnos, Tom Meade, Mohammadmahdi Sarzaeem, Mark Spangehl, Goksel Dikmen, Nifon K Gkekas, İbrahim Azboy, Roshan P Shah","doi":"10.1016/j.arth.2024.10.039","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.039","url":null,"abstract":"<p><strong>Response/recommendation: </strong>Kinematic alignment (KA) shows improved patient-reported outcome measurements (PROMs) in early recovery but equivalence past mid-term follow-up. KA targets a native joint line obliquity and reapproximates pre-arthritic alignment, thus less soft-tissue adjustment may account for early differences. Several randomized controlled trials (RCTs) and systematic reviews fail to identify a durable clinically meaningful difference; Future non-commercial, non-biased, level-one studies are needed to elucidate long-term clinical outcomes and cost-effectiveness.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480127","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":"Ultrasound-Guided Erector Spinae Plane Block in Elderly Patients Undergoing Total Hip Arthroplasty (THA): A Triple-blind, Randomized, Controlled Trial.","authors":"Qi Li, Liang Zhang, Hong-Mei Zhou, Xin-Wei Wu","doi":"10.1016/j.arth.2024.10.052","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.052","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) induces postoperative pain in elderly individuals. The erector spinae plane block (ESPB) is a novel analgesic approach for postoperative pain control. This randomized controlled trial evaluated the effectiveness of ultrasound-guided ESPB with ropivacaine in reducing pain in elderly patients undergoing THA METHODS: Patients aged 60 to 80 years who had an American society of Aneshesiologists (ASA) physical status I to III were eligible for this study. There were 50 patients who were randomized into two groups: the ESPB group receiving ultrasound-guided ESPB with ropivacaine, and the control group receiving ESPB with normal saline. All patients underwent general anesthesia, and the mean arterial pressure (MAP), heart rate (HR), intraoperative opioid consumption, numerical rating scale (NRS) scores, and postoperative adverse reactions were recorded throughout the perioperative period.</p><p><strong>Results: </strong>A significant reduction in NRS scores was observed in the ESPB group compared to the control group at various time points, including in the recovery room and at 12 and 24 hours postoperatively (P < 0.05). When the observation period was extended to 48 hours, no significant difference in NRS scores was noted between the two groups (P > 0.05). No significant differences in MAP and HR were found between the two groups, but the ESPB group showed lower coefficients of variation (CV) for both MAP and HR. Moreover, the ESPB group demonstrated a significantly lower total remifentanil consumption than the control group. There was no significant difference in complications between these two groups (P < 0.05).</p><p><strong>Conclusions: </strong>Ultrasound-guided ESPB enhances the perioperative stability of mean arterial pressure and heart rate, providing effective analgesia within the initial 24 hours post-surgery, thereby reducing opioid requirements and improving overall postoperative recovery quality for elderly THA patients.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480164","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 urinary catheters be used during routine primary knee or hip arthroplasty?","authors":"Atthakorn Jarusriwanna, Kerem Başarır, Daniele De Meo, William A Jiranek, Jacobus D Jordaan, Deiary F Kader, Gökhan Kaynak, Gabriele Tucci","doi":"10.1016/j.arth.2024.10.044","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.044","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480159","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":"Do Intraarticular Metal Ion Levels Predict Adverse Local Tissue Reaction in Revision Total Hip Arthroplasty for Mechanically Assisted Crevice Corrosion?","authors":"Henry M Gass, Rahul Goel, Kevin Heo, Jason Shah, Jacob Wilson, Ajay Premkumar","doi":"10.1016/j.arth.2024.10.053","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.053","url":null,"abstract":"<p><strong>Background: </strong>Mechanically assisted crevice corrosion (MACC) is a complication that may occur in vivo at modular metal interfaces following metal-on-polyethylene (MoP) total hip arthroplasty (THA). Metal ions released in vivo may be associated with adverse local tissue reactions (ALTR). While there is no definitive value, high serum ion levels are implicated as contributors to ALTR, and various screening levels have been recommended. The purpose of this investigation was to evaluate the relationship between synovial fluid (SF) cobalt and chromium ion levels and the risk of developing ALTR.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 552 patients who underwent 621 MoP primary THAs. A total of 69 patients underwent revision THA due to symptomatic primary failure with elevated serum metal ions levels. There were 28 who had preoperative serum and intraoperative SF chromium and cobalt samples. Patient demographics, surgical, and laboratory data were collected. Descriptive statistics, Mann-Whitney U, Analysis of Variance (ANOVA) tests, and linear regression analyses were performed.</p><p><strong>Results: </strong>There were 40.6% of revisions that had preoperative serum and intraoperative SF samples. The mean time to revision was 5.7 (range, 3.8 to 7.6) years. Mean SF cobalt and chromium levels were 870.9mcg/L (range, 1.1 to 8,300.0) and 573.5mcg/L (range, 1.3 to 10,000.0). Mean serum and SF cobalt-chromium ratios were 4.0 (range, 0.9 to 7.1) and 6.4 (range, 0 to 15.1), respectively. Elevated serum cobalt levels were predictive of ALTR (P = 0.002), SF levels were not. Analysis of preoperative serum to SF cobalt-chromium ratios showed poor correlation (R² = 0.05).</p><p><strong>Conclusion: </strong>There was no correlation between SF ion levels and ALTR. Also, serum and intraarticular ion levels did not correlate, and SF levels did not provide additional value over serum levels for diagnosis or prognosis of MACC. Further studies are needed to better understand the relationship between serum and SF ion levels and its relationship to ALTR.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480105","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":"Do Overall Weight, Body Mass Index, or Clinically Significant Weight Changes Occur After Total Joint Arthroplasty? A Meta-Analysis of 60,837 Patients.","authors":"Michael S Ramos, Martina E Hale, Pedro J Rullán, Kyle N Kunze, Nikhil Nair, Nicolas S Piuzzi","doi":"10.1016/j.arth.2024.10.024","DOIUrl":"10.1016/j.arth.2024.10.024","url":null,"abstract":"<p><strong>Background: </strong>Total joint arthroplasty (TJA) is well-recognized for improving quality of life and functional outcomes of patients with osteoarthritis; however, TJA's impact on body weight remains unclear. Recent trends have demonstrated a shift among TJA patients, such that patients who have higher body mass indices (BMIs) are undergoing this common surgery. Given this trend, it is critical to characterize the impact TJA has on body weight or BMI. This meta-analysis aimed to quantitatively assess whether patients lose, gain, or maintain body weight or BMI after TJA.</p><p><strong>Methods: </strong>This study followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials databases were queried from inception through July 2022. The included studies: (1) reported on weight or BMI after elective, primary total hip arthroplasty (THA) or total knee arthroplasty (TKA); and (2) weight or BMI change was deemed to be associated with THA or TKA. The excluded studies: (1) included weight or BMI interventions; and (2) reported on unicompartmental, partial, or revision arthroplasty or joint arthroscopy. Meta-analyses for weight change, BMI change, and proportion of patients achieving clinically significant change were performed using random-effects models. Factors associated with clinically significant change were systematically reported. A total of 60,837 patients from 39 studies were included.</p><p><strong>Results: </strong>No significant differences existed between preoperative and postoperative weights (P = 1.0; P = 0.28) or BMIs (P = 1.0; P = 1.0) after THA or TKA, respectively. Overall, 66% of THA patients (P < 0.01) and 65% of TKA patients (P < 0.01) did not experience clinically significant weight change.</p><p><strong>Conclusions: </strong>Among a TJA cohort, two-thirds of the patients maintained their preoperative body weight or BMI after surgery. With these results, orthopaedic surgeons can better manage patient expectations of TJA.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480106","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 27: What factors determine the necessity of tibial and/or femoral stem use in primary total knee arthroplasty?","authors":"Andrew Fraval, Mahmoud Abdel Karim, Vaibhav Bagaria, Songcen Lyu, Mojieb Manzary, Cheng-Fong Chen, Weijun Wang, Akram Hammad","doi":"10.1016/j.arth.2024.10.049","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.049","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480150","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: What are the contraindications, if any, for the use of tranexamic acid (TXA) during knee or hip arthroplasty?","authors":"Mohammadali Enayatollahi, Ibrahim Azboy, Matthew J Dietz, Alvaro Aunon, Ramin Heshmat, Serban Dragosloveanu, Ahmadali Ehsani, Cristian Scheau, Gita Shafiee, Arezoo Ghamgosar, Hikmet Çetin, Baran Demir, Antony Palmer","doi":"10.1016/j.arth.2024.10.050","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.050","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480151","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 Surgical Approach Impact Outcomes in Primary Total Hip Arthroplasty?","authors":"Saad Tarabichi, Jens T Verhey, Pietro S Randelli, Ernesto Guerra-Farfan, Ernesto Muñoz-Mahamud, Khalid Merghani, Michele D'Apuzzo, Wadih Y Matar, Ruwais Binlaksar, Mohammad Ayati Firoozabadi, Francesco Falez, Mark J Spangehl, Joshua S Bingham","doi":"10.1016/j.arth.2024.10.036","DOIUrl":"https://doi.org/10.1016/j.arth.2024.10.036","url":null,"abstract":"","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480009","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}