Arthroplasty最新文献

{"title":"Preoperative weight loss interventions before total hip and knee arthroplasty: a systematic review of randomized controlled trials","authors":"L. C. Lau, P. Chan, Tak Wai David Lui, Siu Wai Choi, Elaine Au, T. Leung, M. Luk, A. Cheung, Henry Fu, M. Cheung, KwongYuen Chiu","doi":"10.1186/s42836-024-00252-4","DOIUrl":"https://doi.org/10.1186/s42836-024-00252-4","url":null,"abstract":"","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140965804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative weight loss interventions before total hip and knee arthroplasty: a systematic review of randomized controlled trials.","authors":"Lawrence Chun Man Lau, Ping Keung Chan, Tak Wai David Lui, Siu Wai Choi, Elaine Au, Thomas Leung, Michelle Hilda Luk, Amy Cheung, Henry Fu, Man Hong Cheung, Kwong Yuen Chiu","doi":"10.1186/s42836-024-00252-4","DOIUrl":"https://doi.org/10.1186/s42836-024-00252-4","url":null,"abstract":"<p><strong>Background: </strong>The high co-prevalence of obesity and end-stage osteoarthritis requiring arthroplasty, with the former being a risk factor for complications during arthroplasty, has led to increasing interest in employing preoperative weight loss interventions such as bariatric surgery and diet modification. However, the current evidence is conflicting, and this study aimed to investigate the effect of weight loss intervention before arthroplasty in prospective randomized controlled trials.</p><p><strong>Methods: </strong>Four electronic databases (MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) were searched for prospective randomized controlled trials that compared weight loss interventions with usual care from inception to October 2023 by following the PRISMA guidelines. The Cochrane risk of bias tool and GRADE framework were used to assess the quality of the studies. Meta-analyses were performed when sufficient data were available from 2 or more studies.</p><p><strong>Results: </strong>Three randomized controlled trials involving 198 patients were identified. Two studies employed diet modification, and one study utilized bariatric surgery. All three studies reported significant reductions in body weight and body mass index (BMI), and intervention groups had fewer postoperative complications. There was no difference in the length of stay between the intervention group and the control group. Variable patient-reported outcome measures were used by different research groups.</p><p><strong>Conclusion: </strong>Weight loss intervention can achieve significant reductions in body weight and body mass index before arthroplasty, with fewer postoperative complications reported. Further studies with different populations could confirm the effect of these interventions among populations with different obesity characteristics.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current concept: personalized alignment total knee arthroplasty as a contrast to classical mechanical alignment total knee arthroplasty.","authors":"Takafumi Hiranaka","doi":"10.1186/s42836-024-00246-2","DOIUrl":"10.1186/s42836-024-00246-2","url":null,"abstract":"<p><p>Mechanical alignment (MA) total knee arthroplasty (TKA), with neutral leg alignment, mechanical component alignment, and parallel gaps, has achieved good long-term survival. Patient satisfaction, however, is not always perfect. In contrast to the MA, which aims for an ideal goal for all patients, an alternative has been proposed: kinematic alignment (KA)-TKA. In KA, the articular surface is replicated using components aligning with the three kinematic axes. KA-TKA has been gaining popularity, and in addition to the true or calipered KA, various derivatives, such as restricted KA, soft-tissue respecting KA, and functional alignments, have been introduced. Moreover, the functional approach encompasses several sub-approaches. This somewhat complicated scenario has led to some confusion. Therefore, the terminology needs to be re-organized. The term \"personalized alignment (PA)\" has been used in contrast to the MA approach, including all approaches other than MA. The term \"PA-TKA\" should be used comprehensively instead of KA and it represents the recent trends in distinct and unique consideration of each individual case. In addition to a comparison between MA and KA, we suggest that evaluation should be conducted to decide which approach is the best for an individual patient within the \"personalized alignment\" concept.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11071279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effects of combined anteversion and offset on postoperative dislocation in total hip arthroplasty.","authors":"Ryo Hidaka, Kenta Matsuda, Shigeru Nakamura, Masaki Nakamura, Hirotaka Kawano","doi":"10.1186/s42836-024-00245-3","DOIUrl":"https://doi.org/10.1186/s42836-024-00245-3","url":null,"abstract":"<p><strong>Background: </strong>Implant impingement and soft tissue tension are factors involved in dislocation after total hip arthroplasty (THA). Combined anteversion (CA) has been used as an indicator for implant placement. However, optimal implant placement remains a challenge. Moreover, the effect of changes in offset on dislocation is still unclear. In this study, we aimed to clarify the effects of postoperative CA and pre- and postoperative changes in offset on dislocation.</p><p><strong>Methods: </strong>Included were patients who underwent primary cementless THA between 2013 and 2020. The mean values of CA and offset in the dislocation and non-dislocation groups were compared. The CA values within ± 10% of the recommended values were defined as good CA, and those outside the range were rated as poor CA. The dislocation rates were compared between the good and poor CA groups and between the groups with and without increased offset.</p><p><strong>Results: </strong>A total of 283 hips were included. The mean values of CA in the dislocation and non-dislocation groups were significantly different (P < 0.05). The dislocation rate was significantly lower in the good CA group (P < 0.05). The dislocation rates in the groups with and without increased total offset were 0.5% and 4.3%, respectively (P = 0.004). There were no dislocations in patients with good CA and increased offset.</p><p><strong>Conclusions: </strong>The dislocation rate was significantly lower when implants were placed within ± 10% of the recommended CA value. Our results suggest that dislocation can be avoided by placing the implant in the good CA range and considering the increase in total offset on the operative side.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11070079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of machine learning to predict the outcomes of shoulder arthroplasty: a systematic review.","authors":"Amir H Karimi, Joshua Langberg, Ajith Malige, Omar Rahman, Joseph A Abboud, Michael A Stone","doi":"10.1186/s42836-024-00244-4","DOIUrl":"https://doi.org/10.1186/s42836-024-00244-4","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) uses computer systems to simulate cognitive capacities to accomplish goals like problem-solving and decision-making. Machine learning (ML), a branch of AI, makes algorithms find connections between preset variables, thereby producing prediction models. ML can aid shoulder surgeons in determining which patients may be susceptible to worse outcomes and complications following shoulder arthroplasty (SA) and align patient expectations following SA. However, limited literature is available on ML utilization in total shoulder arthroplasty (TSA) and reverse TSA.</p><p><strong>Methods: </strong>A systematic literature review in accordance with PRISMA guidelines was performed to identify primary research articles evaluating ML's ability to predict SA outcomes. With duplicates removed, the initial query yielded 327 articles, and after applying inclusion and exclusion criteria, 12 articles that had at least 1 month follow-up time were included.</p><p><strong>Results: </strong>ML can predict 30-day postoperative complications with a 90% accuracy, postoperative range of motion with a higher-than-85% accuracy, and clinical improvement in patient-reported outcome measures above minimal clinically important differences with a 93%-99% accuracy. ML can predict length of stay, operative time, discharge disposition, and hospitalization costs.</p><p><strong>Conclusion: </strong>ML can accurately predict outcomes and complications following SA and healthcare utilization. Outcomes are highly dependent on the type of algorithms used, data input, and features selected for the model.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11069283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic study of direct anterior approach hip arthroplasty: a 10-15 year follow-up of Chinese patients.","authors":"Weilin Sang, Peng Lai, Xun Xu, Yu Liu, Jinzhong Ma, Libo Zhu","doi":"10.1186/s42836-024-00249-z","DOIUrl":"https://doi.org/10.1186/s42836-024-00249-z","url":null,"abstract":"<p><strong>Background: </strong>Controversy remains over whether different surgical approaches exert an impact on the component positioning in total hip arthroplasty. We conducted a retrospective study to reveal the long-term position of prostheses in the first group of patients in China who underwent direct anterior hip arthroplasty.</p><p><strong>Methods: </strong>Collected were data from 350 patients who underwent direct anterior hip arthroplasty between 2008 and 2013, including demographic information, imaging data, Harris hip scores, and surgical complications. Variables, measured radiographically or by CT, included hip offset, leg length discrepancy, component position, and stability within one week after surgery and at the last follow-up. The data were subjected to statistical analysis by using paired t-tests and Pearson chi-square tests.</p><p><strong>Results: </strong>Data were harvested by follow-up and self-reported questionnaires. The postoperative follow-up lasted for 13.1 years on average (minimum, 10 years; maximum, 15 years), and the overall survival rate of hip prostheses was 96.3%. The mean Harris score at the final follow-up was 91.8 points. After excluding patients with significant preoperative hip deformities, the incidence of postoperative limb inequality (> 5 mm) was 4.9% at the last follow-up, and the incidence of hip offset discrepancy (> 5 mm) was 14.6%. The overall proportion of the acetabular components located in the Lewinnek safe zone was 77.7%, whereas the proportion of femoral prostheses in the safe zone (< 3° inclination) was 94.0%. Based on the revised data and the last follow-up imaging, the total proportion of acetabular and femoral prostheses with a radiolucence of > 2 mm was 5.1%.</p><p><strong>Conclusion: </strong>Direct anterior approach hip arthroplasty could achieve excellent component positioning and long-term prosthesis survival in patients without severe hip deformities.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unicompartmental knee replacement: controversies and technical considerations.","authors":"Waleed Albishi, Nasser M AbuDujain, Mohammed Aldhahri, Meshari Alzeer","doi":"10.1186/s42836-024-00242-6","DOIUrl":"https://doi.org/10.1186/s42836-024-00242-6","url":null,"abstract":"<p><strong>Background: </strong>Unicompartmental knee replacement (UKR) is one of the effective interventions for the treatment of symptomatic knee osteoarthritis. Moreover, it has multiple advantages over total knee arthroplasty (TKA), including reduced intraoperative blood loss, decreased risk of transfusion, and faster recovery. This study aimed to discuss critical technical considerations regarding UKR and some of the controversies and updates.</p><p><strong>Methods: </strong>We conducted a review to provide an overview of the controversies and technical considerations about UKR in several aspects. Only peer-reviewed articles were included, up to December 2023 using PubMed, Google Scholar, ERIC, and Cochrane database for systematic reviews databases.</p><p><strong>Result: </strong>UKR is associated with superior patient-reported clinical and functional outcomes, as well as shorter hospital stays, fewer postoperative complications, and revealed favorable outcomes in patients' return to sport. The choice between mobile- and fixed-bearing prostheses depends, in part, on the surgeon's preference. The mobile-bearing UKR is a less constrained prosthesis and can potentially result in less wear, but it is more technically demanding. While no significant difference between mobile-bearing versus fixed-bearing prostheses, cementless is superior to cemented design. Furthermore, UKR can be a good alternative for high tibial osteotomy (HTO) and still can be considered after a failed HTO. Lastly, recent reviews have shown a revision rate comparable to that of TKA. This is probably influenced by Improved comprehension of the best indications, patient selection criteria, as well as of the design, materials, and technological advances.</p><p><strong>Conclusion: </strong>UKR treatment for unicompartmental knee osteoarthritis is secure and effective. Based on clinical and functional outcomes, decreased morbidity and mortality, and cost-effectiveness, long-term studies suggest that UKR is superior to TKA. Further investigation in this area is warranted.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11064323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymmetric gap balancing improves knee kinematic following primary total knee arthroplasty","authors":"Pieralberto Valpiana, Andrea Giordano Salvi, S. Ghirardelli, Matteo Bernardi, Giuseppe Petralia, Giuseppe Aloisi, Christian Schaller, P. Indelli","doi":"10.1186/s42836-024-00243-5","DOIUrl":"https://doi.org/10.1186/s42836-024-00243-5","url":null,"abstract":"","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend of using cementless total knee arthroplasty: a nationwide analysis from 2015 to 2021","authors":"A. Agarwal, Emile-Victor Kuyl, A. Gu, G. Golladay, S. Thakkar, Gautam Siram, Anthony Unger, Sandesh Rao","doi":"10.1186/s42836-024-00241-7","DOIUrl":"https://doi.org/10.1186/s42836-024-00241-7","url":null,"abstract":"","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience as a psychiatric factor affecting outcomes after total joint arthroplasty: a systematic review","authors":"Andrew G Kim, Parshva A Sanghvi, Adam A. Rizk, Aaron Ahn, Thomas J. Pumo, A. Kamath","doi":"10.1186/s42836-024-00240-8","DOIUrl":"https://doi.org/10.1186/s42836-024-00240-8","url":null,"abstract":"","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140737866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}