Arthroplasty最新文献

{"title":"Outcomes of novel 3D-printed fully porous titanium cup and a cemented highly cross-linked polyethylene liner in complex and revision total hip arthroplasty.","authors":"Ittai Shichman,&nbsp;Lyndsay Somerville,&nbsp;William B Lutes,&nbsp;Stephen A Jones,&nbsp;Richard McCalden,&nbsp;Ran Schwarzkopf","doi":"10.1186/s42836-022-00152-5","DOIUrl":"https://doi.org/10.1186/s42836-022-00152-5","url":null,"abstract":"<p><strong>Introduction: </strong>A novel fully porous acetabular titanium shell has been designed to reduce stiffness mismatch between bone and implant and promote osseointegration in complex (cTHA) and revision total hip arthroplasty (rTHA). A highly cross-linked polyethylene (XLPE) liner is cemented within the cup to reduce wear rates and increase survivorship. This study reported the outcomes of an XLPE liner cemented into a novel 3D-printed fully porous cup in cTHA and rTHA.</p><p><strong>Methods: </strong>Presented was a multicenter retrospective review of 40 patients (6 cTHA and 34 rTHA) who underwent THA with a fully porous titanium acetabular cup and cemented XLPE liner. Data were collected on demographics, surgical information, outcomes, including osseointegration and migration and implant survivorship.</p><p><strong>Results: </strong>On average, patients were 71.42 ± 9.97 years old and obese (BMI: 30.36 ± 6.88 kg/m²) and were followed up for a mean time of 2.21 ± 0.77 years. Six patients underwent cTHA and 34 patients underwent rTHA. The mean hospital length of stay was 5.34 ± 3.34 days. Three (7.5%) 90-day readmissions were noted. Harris Hip Scores improved, on average, from 53.87 ± 12.58 preoperatively to 83.53 ± 12.15 postoperatively (P<0.001). One case of acetabular shell aspetic loosening with migration was noted. Thirty-nine of the 40 acetabular components were fully osseointegrated without migration. Two patients underwent re-revision surgery for PJI and one patient received acetabular shell+liner re-revision due to aseptic loosening. Kaplan-Meier analysis showed an all-cause revision-free survival rate of 95.0% at 6 months and 1 year, and 92.0% at 4-years. Aseptic acetabular cup, liner dislocation/loosening, and fracture-free survival was 100% at 6 months and 1-year, and 97.1% at 2 years.</p><p><strong>Conclusion: </strong>The combined use of a novel 3D-printed fully porous titanium acetabular shell and cemented XLPE acetabular liner yielded excellent rates of osseointegration, and all-cause and acetabular aseptic loosening survivorship at a minimum 1-year follow-up. Further long-term studies are needed to assess the longevity of this construct.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40456991","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":"A bone-conserving revision stem for unstable intertrochanteric fractures of the geriatric osteoporotic population.","authors":"Mengcun Chen,&nbsp;Jinlong Wang,&nbsp;Adnan N Cheema,&nbsp;Shuhua Yang,&nbsp;Xianzhe Liu","doi":"10.1186/s42836-022-00151-6","DOIUrl":"https://doi.org/10.1186/s42836-022-00151-6","url":null,"abstract":"<p><strong>Purpose: </strong>Primary hemiarthroplasty is gaining popularity for the treatment of unstable intertrochanteric fractures in geriatric patients with severe osteoporosis. This study evaluated early clinical and radiographic outcomes by using a bone-conserving revision stem for unstable intertrochanteric fractures in the geriatric osteoporotic population.</p><p><strong>Methods: </strong>A retrospective study involving 31 patients with unstable intertrochanteric fractures was conducted. The patients were aged 82.1 years on average. All patients underwent primary hemiarthroplasty using bone-conserving, fully porous-coated revision stem. The operative time, intraoperative blood loss, length of hospitalization, and need for blood transfusion were noted during the hospital stay. Postoperative complications, including dislocations, deep venous thrombosis, infections, peri-prosthetic fractures, and frontal thigh pain were also recorded. Koval's category was used to quantify activity level, and Harris hip score (HHS) was used for functional assessment. Radiographic outcomes, including osteolysis, bone ingrowth, subsidence of the femoral component, lower limb length discrepancy, and heterotopic ossification, were collected at each follow-up.</p><p><strong>Results: </strong>The 31 patients were followed for an average time of 23 months postoperatively. The average operative time lasted for 74.2 min, while the mean intraoperative blood loss was 200.1 ml, with an average hemoglobin decrease of 11.1 g/L after the procedure. The mean visual analog scale (VAS) score for pain dropped from 7.4 preoperatively to 2.4 at the 4-week follow-up. At the latest follow-up, the mean Harris hip score was 82.1, and the VAS was 1.7. No intraoperative or postoperative peri-prosthetic fractures were noted. Postoperative complications included one case of thrombosis formation in the posterior tibial vein and one case of congestive heart failure. Both patients were discharged uneventfully after treatment. Radiographically, none of the hips had evidence of stem loosening or osteolysis. Within the follow-up period of 23 months, the mortality rate was 3.2% (1/31), and no revision surgeries were required.</p><p><strong>Conclusion: </strong>Primary hemiarthroplasty using a bone-conserving, cementless revision stem could serve as a reliable alternative for the treatment of unstable intertrochanteric fractures in the geriatric population with osteoporosis.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40447662","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":"Obesity and total joint arthroplasty: Does weight loss in the preoperative period improve perioperative outcomes?","authors":"Jacob Laperche,&nbsp;Richard Feinn,&nbsp;Karen Myrick,&nbsp;Mohamad J Halawi","doi":"10.1186/s42836-022-00149-0","DOIUrl":"https://doi.org/10.1186/s42836-022-00149-0","url":null,"abstract":"<p><strong>Background: </strong>The obese population is more likely to develop degenerative joint disease requiring total joint arthroplasty (TJA) and also experience increased rates of adverse post-surgical outcomes. This study assessed whether a quantifiable weight loss prior to TJA had any impact on perioperative and 30-day outcomes in obese patients.</p><p><strong>Method: </strong>Using the American College of Surgeons-National Surgical Quality Improvement Program database, obese patients who underwent total hip or total knee arthroplasty and lost at least 10% of their total body weight prior to surgery were identified and matched to other obese individuals undergoing the same procedures without weight loss. Perioperative outcomes, including operative time, length of stay, discharge destination, or 30-day adverse events, including complications, re-admissions, re-operations, and mortality, were then compared using conditional Logistic regression analysis.</p><p><strong>Results: </strong>Analysis showed no difference between the two groups in terms of operative time, length of stay, discharge destination, or 30-day adverse events, including complications, re-admissions, re-operations, and mortality.</p><p><strong>Conclusion: </strong>The results of this study suggest that weight loss alone in the preoperative period may not be sufficient to mitigate the effects of obesity on immediate post-TJA outcomes.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40679348","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":"Are immediate postoperative X-Rays valuable in evaluating complications of primary total hip arthroplasty?","authors":"Matthew L Brown,&nbsp;David Michel,&nbsp;Arvind Narayanan,&nbsp;Julie C McCauley,&nbsp;William D Bugbee","doi":"10.1186/s42836-022-00148-1","DOIUrl":"https://doi.org/10.1186/s42836-022-00148-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the complications of primary total hip arthroplasty based on immediate postoperative X-rays. The overall quality and cost of X-rays were assessed.</p><p><strong>Methods: </strong>The institutional database was queried to identify all patients who underwent total hip arthroplasty in a single institution between January 1, 2018, and December 31, 2018. Immediate postoperative X-rays were reviewed to identify the complications such as periprosthetic fractures, dislocation, and fixation failure. The quality and cost of X-ray were assessed. The complications were categorized as \"known\" and \"unknown\" according to the intraoperative fluoroscopic results.</p><p><strong>Results: </strong>A total of 518 total hip arthroplasties were included in this study. Based on intraoperative fluoroscopy, periprosthetic fractures were found in 10 (2%) THAs. Compared to the X-rays taken immediately after surgery, 9 periprosthetic fractures (recorded as \"known\") were found and 1 was not (recorded as \"unknown\"). There was no significant difference between intraoperative fluoroscopy and X-rays (P > 0.05). Of the 518 X-rays, 225 (43%) were of suboptimal quality. The cost of a single portable pelvic X-ray was $647.</p><p><strong>Conclusion: </strong>In total hip arthroplasty, X-rays taken immediately after surgery rarely reveal unknown complications. The X-rays are often of suboptimal quality, have minimal clinical utility, and are less cost-effective.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9628056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40448253","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":"Funding has no effect on clinical outcomes of total joint arthroplasty emerging technologies: a systematic review of bibliometrics and conflicts of interest.","authors":"Garrhett G Via,&nbsp;David A Brueggeman,&nbsp;Joseph G Lyons,&nbsp;Isabelle C Ely,&nbsp;Andrew W Froehle,&nbsp;Anil B Krishnamurthy","doi":"10.1186/s42836-022-00146-3","DOIUrl":"https://doi.org/10.1186/s42836-022-00146-3","url":null,"abstract":"<p><strong>Background: </strong>The use of new total joint arthroplasty technologies, including patient-specific implants/instrumentation (PSI), computer-assisted (CA), and robotic-assisted (RA) techniques, is increasing. There is an ongoing debate regarding the value provided and potential concerns about conflicts of interest (COI).</p><p><strong>Methods: </strong>PRISMA guidelines were followed. PubMed, MEDLINE, and Web of Science databases were searched for total hip and knee arthroplasties, unicompartmental knee arthroplasties (UKA), PSI, CA, and RA. Bibliometric data, financial COI, clinical/functional scores, and patient-reported outcomes were assessed.</p><p><strong>Results: </strong>Eighty-seven studies were evaluated, with 35 (40.2%) including at least one author reporting COI, and 13 (14.9%) disclosing industry funding. COI and industry funding had no significant effects on outcomes (P = 0.682, P = 0.447), and there were no significant effects of conflicts or funding on level of evidence (P = 0.508, P = 0.826). Studies in which author(s) disclosed COI had significantly higher relative citation ratio (RCR) and impact factor (IF) than those without (P < 0.001, P = 0.032). Subanalysis demonstrated RA and PSI studies were more likely to report COI or industry funding (P = 0.045). RA (OR = 6.31, 95% CI: 1.61-24.68) and UKA (OR = 9.14, 95% CI: 1.43-58.53) had higher odds of reporting favorable outcomes than PSI.</p><p><strong>Conclusions: </strong>Author COIs (about 40%) may be lower than previously reported in orthopedic technologies/techniques reviews. Studies utilizing RA and PSI were more likely to report COI, while RA and UKA studies were more likely to report favorable outcomes than PSI. No statistically significant association between the presence of COIs and/or industry funding and the frequency of favorable outcomes or study level of evidence was found.</p><p><strong>Level of evidence: </strong>Level V Systematic Review.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659964","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":"Could surgical transepicondylar axis be identified accurately in preoperative 3D planning for total knee arthroplasty? A reproducibility study based on 3D-CT.","authors":"Kai Lei,&nbsp;Li Ming Liu,&nbsp;Jiang Ming Luo,&nbsp;Chao Ma,&nbsp;Qing Feng,&nbsp;Liu Yang,&nbsp;Lin Guo","doi":"10.1186/s42836-022-00147-2","DOIUrl":"https://doi.org/10.1186/s42836-022-00147-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical transepicondylar axis (sTEA) is frequently used for positioning of femoral component rotation in total knee arthroplasty (TKA). Previous studies showed that intraoperative identification of sTEA was not reliable. While surgeons or engineers need to identify sTEA with three-dimensional (3D) computer-aid techniques pre- or intraoperatively, the reproducibility of sTEA identification on preoperative 3D images has not been explored yet. This study aimed to investigate the reproducibility of identifying sTEA in preoperative planning based on computed tomography (CT).</p><p><strong>Methods: </strong>Fifty-nine consecutive patients (60 knees involved) who received TKA in our center from April 2019 to June 2019 were included in this study. Six experienced TKA surgeons identified sTEA three times on 3D model established on the basis of knee CT data. The projection angle of each sTEA and the posterior condyle axis on the transverse plane were measured and analyzed.</p><p><strong>Results: </strong>The overall intra-observer reproducibility was moderate. The median intra-observer variation was 1.27°, with a maximum being up to 14.07°. The median inter-observer variation was 1.24°, and the maximum was 11.47°. The overall intra-class correlation coefficient (ICC) for inter-observer was 0.528 (95% CI 0.417, 0.643).</p><p><strong>Conclusion: </strong>The identification of sTEA on a 3D model established on the basis of knee CT data may not be reliable. Combined with the previous cadaveric and surgical studies, caution should be exercised in determining femoral component rotation by referencing sTEA both preoperatively and intraoperatively.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33541461","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":"A preliminary study on the application of deep learning methods based on convolutional network to the pathological diagnosis of PJI.","authors":"Ye Tao, Hanwen Hu, Jie Li, Mengting Li, Qingyuan Zheng, Guoqiang Zhang, Ming Ni","doi":"10.1186/s42836-022-00145-4","DOIUrl":"10.1186/s42836-022-00145-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to establish a deep learning method based on convolutional networks for the preliminary study of the pathological diagnosis of prosthetic joint infections (PJI).</p><p><strong>Methods: </strong>We enrolled 20 revision patients after joint replacement from the Department of Orthopedics, the First Medical Center, General Hospital of the People's Liberation Army, from January 2021 to January 2022 (10 of whom were confirmed to be infected against 2018 ICM criteria, and the remaining 10 were verified to be non-infected), and classified high-power field images according to 2018 ICM criteria. Then, we inputted 576 positive images and 576 negative images into a neural network by employing a resNET model, used to select 461 positive images and 461 negative images as training sets, 57 positive images and 31 negative images as internal verification sets, 115 positive images and 115 negative images as external test sets.</p><p><strong>Results: </strong>The resNET model classification was used to analyze the pathological sections of PJI patients under high magnification fields. The results of internal validation set showed a positive accuracy of 96.49%, a negative accuracy of 87.09%, an average accuracy of 93.22%, an average recall rate 96.49%, and an F1 of 0.9482. The accuracy of external test results was 97.39% positive, 93.04% negative, the average accuracy of external test set was 93.33%, the average recall rate was 97.39%, with an F1 of 0.9482. The AUC area of the intelligent image-reading diagnosis system was 0.8136.</p><p><strong>Conclusions: </strong>This study used the convolutional neural network deep learning to identify high-magnification images from pathological sections of soft tissues around joints, against the diagnostic criteria for acute infection, and a high precision and a high recall rate were accomplished. The results of this technique confirmed that better results could be achieved by comparing the new method with the standard strategies in terms of diagnostic accuracy. Continuous upgrading of extended training sets is needed to improve the diagnostic accuracy of the convolutional network deep learning before it is applied to clinical practice.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9563129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33505800","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":"Socioeconomic factors affecting outcomes in total knee and hip arthroplasty: a systematic review on healthcare disparities.","authors":"Paul M Alvarez,&nbsp;John F McKeon,&nbsp;Andrew I Spitzer,&nbsp;Chad A Krueger,&nbsp;Matthew Pigott,&nbsp;Mengnai Li,&nbsp;Sravya P Vajapey","doi":"10.1186/s42836-022-00137-4","DOIUrl":"https://doi.org/10.1186/s42836-022-00137-4","url":null,"abstract":"<p><strong>Background: </strong>Recent studies showed that healthcare disparities exist in use of and outcomes after total joint arthroplasty (TJA). This systematic review was designed to evaluate the currently available evidence regarding the effect socioeconomic factors, like income, insurance type, hospital volume, and geographic location, have on utilization of and outcomes after lower extremity arthroplasty.</p><p><strong>Methods: </strong>A comprehensive search of the literature was performed by querying the MEDLINE database using keywords such as, but not limited to, \"disparities\", \"arthroplasty\", \"income\", \"insurance\", \"outcomes\", and \"hospital volume\" in all possible combinations. Any study written in English and consisting of level of evidence I-IV published over the last 20 years was considered for inclusion. Quantitative and qualitative analyses were performed on the data.</p><p><strong>Results: </strong>A total of 44 studies that met inclusion and quality criteria were included for analysis. Hospital volume is inversely correlated with complication rate after TJA. Insurance type may not be a surrogate for socioeconomic status and, instead, represent an independent prognosticator for outcomes after TJA. Patients in the lower-income brackets may have poorer access to TJA and higher readmission risk but have equivalent outcomes after TJA compared to patients in higher income brackets. Rural patients have higher utilization of TJA compared to urban patients.</p><p><strong>Conclusion: </strong>This systematic review shows that insurance type, socioeconomic status, hospital volume, and geographic location can have significant impact on patients' access to, utilization of, and outcomes after TJA.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9528115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40387880","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":"Does functional planning, 3D templating and patient-specific instrumentation improve accuracy in total hip replacement?- a randomized controlled trial.","authors":"Christopher Thomas,&nbsp;Vatsal Gupta,&nbsp;Helen Parsons,&nbsp;Andrew Metcalfe,&nbsp;Pedro Foguet,&nbsp;Richard King","doi":"10.1186/s42836-022-00143-6","DOIUrl":"https://doi.org/10.1186/s42836-022-00143-6","url":null,"abstract":"<p><strong>Aims: </strong>Debate continues as to the optimal orientation of the acetabular component in total hip arthroplasty (THA) and how to reliably achieve this. The primary objective of this study was to compare functional CT-based planning and patient-specific instruments with conventional THA using 2D templating.</p><p><strong>Methods: </strong>A pragmatic single-center, patient-assessor blinded, randomized control trial of patients undergoing THA was performed. 54 patients (aged 18-70) were recruited to either Corin Optimized Positioning System (OPS) or conventional THA. All patients received a cementless acetabular component. All patients underwent pre- and postoperative CT scans, and four functional X-rays. Patients in the OPS group had a 3D surgical plan and bespoke guides made. Patients in the conventional group had a surgical plan based on 2D templating X-rays. The primary outcome measure was the mean error in acetabular anteversion as determined by postoperative CT scan.</p><p><strong>Results: </strong>There was no statistically significant difference in the mean error in angle of acetabular anteversion when comparing OPS and conventional THA. In the OPS group, the achieved acetabular anteversion was within 10° of the planned anteversion in 96% of cases, compared with only 76% in the conventional group. The clinical outcomes were comparable between the groups.</p><p><strong>Conclusion: </strong>Large errors in acetabular orientation appear to be reduced when CT-based planning and patient-specific instruments are used compared to the standard technique but no significant differences were seen in the mean error.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385962","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":"Litigation analysis of medical damage after total knee arthroplasty: a case study based on Chinese legal database in the past ten years.","authors":"Shuai Liu, Jilong Zou, Shuai Wang, Guangyu Liu, Yan Zhang, Shuo Geng","doi":"10.1186/s42836-022-00141-8","DOIUrl":"10.1186/s42836-022-00141-8","url":null,"abstract":"<p><strong>Background: </strong>The medical damage litigations after knee arthroplasty are on the rise year by year. However, few studies examined the litigation after knee arthroplasty. This study analyzed the litigation of medical damage after knee replacement in the past ten years based on a Chinese database. It synthesized the focus of the dispute in these cases to provide a reference for doctors to reduce the risk of litigation.</p><p><strong>Methods: </strong>Retrospectively analyzed were medical damage litigations after total knee arthroplasty in the past ten years (June 2011-June 2021) from the \"Wolters Kluwer Legal Information Database\". The data collected included the characteristics of patients, causes of litigation, the results of litigation and the amount of compensation.</p><p><strong>Results: </strong>A total of 110 litigation cases were analyzed, including 40 male patients (36.3%) and 70 female patients (63.6%). The top cause of litigation was infection (43.6%). The most common factor leading to the doctor losing the case was \"complications caused by operational error\" (P < 0.05). Complications, such as amputation, postoperative ischemic stroke and infection, were more likely to result in higher compensation.</p><p><strong>Conclusions: </strong>The prevention of infection and the avoidance of operational errors are very important in avoiding medical litigations. Moreover, avoiding disabling complications or a protracted course of disease could significantly reduce the amount of compensation. In addition, full and reasonable communication, paying full attention to the reaction of patients, and timely diagnosis could also effectively minimize the risk of litigation and loss.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40387693","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}