Arthroplasty最新文献

{"title":"Acetabular cup positioning in primary routine total hip arthroplasty-a review of current concepts and technologies.","authors":"Aravind Sai Sathikumar, George Jacob, Appu Benny Thomas, Jacob Varghese, Venugopal Menon","doi":"10.1186/s42836-023-00213-3","DOIUrl":"10.1186/s42836-023-00213-3","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) has revolutionized the treatment of hip joint arthritis. With the increased popularity and success of the procedure, research has focused on improving implant survival and reducing surgical complications. Optimal component orientation has been a constant focus with various philosophies proposed. Regardless of the philosophy, achieving an accurate acetabular position for each clinical scenario is crucial. In this paper, we review the recent developments in improving the accuracy and ideal positioning of the acetabular cup in routine primary THA.</p><p><strong>Methodology: </strong>A review of the recent scientific literature for acetabular cup placement in primary THA was performed, with available evidence for safe zones, spinopelvic relationship, preoperative planning, patient-specific instrumentation, navigation THA and robotic THA.</p><p><strong>Conclusion: </strong>Though the applicability of Lewinnek safe zones has been questioned with an improved understanding of spinopelvic relationships, its role remains in positioning the acetabular cup in a patient with normal spinopelvic alignment and mobility. Evaluation of spinopelvic relationships and accordingly adjusting acetabular anteversion and inclination can significantly reduce the incidence of dislocation in patients with a rigid spine. In using preoperative radiography, the acetabular inclination, anteversion and intraoperative pelvic position should be evaluated. With improving technology and the advent of artificial intelligence, superior and more accurate preoperative planning is possible. Patient-specific instrumentation, navigated and robotic THA have been reported to improve accuracy in acetabular cup positioning as decided preoperatively but any significant clinical advantage over conventional THA is yet to be elucidated.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"59"},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464312","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":"Prediction of gap balancing based on 2-D radiography in total knee arthroplasty for knee osteoarthritis patients.","authors":"Zhuo Zhang, Yang Luo, Chong Zhang, Xin Wang, Tianwei Zhang, Guoqiang Zhang","doi":"10.1186/s42836-023-00218-y","DOIUrl":"10.1186/s42836-023-00218-y","url":null,"abstract":"<p><strong>Background: </strong>To investigate the influence of osteophytes on postoperative gap balancing, and to work out a predictive model of the relationship between osteophyte size and gap gaining in primary total knee replacement.</p><p><strong>Methods: </strong>One hundred and ten patients were enrolled in the study. Pre- and postoperative radiographs were collected and analyzed. They were assigned to the training dataset and test dataset randomly at a ratio of 9:1 by using the statistical package R (version 4.0.5). Size and marginal distances of osteophytes, planned bone cut planes, predicted bone cuts and joint gaps were labeled on the preoperative standing anteroposterior and lateral views, while actual bone cuts and joint gaps were recorded on the postoperative plain films, respectively. Statistical analysis was performed.</p><p><strong>Results: </strong>Actual joint gaps were significantly related to the distances of medial and lateral predictive bone cutting lines, bone cut thickness on tibial side and posterior condylar, as well as size and marginal distances of osteophytes (P < 0.05). A predictive equation was generated, with a root mean square error (RMSE) of 3.4761 in validation. A 2-D planning system with adjustable input parameters and dim predictive outputs on joint gap was developed. The equation is [Formula: see text] CONCLUSION: Postoperative joint gap can be predicted on the basis of preoperative measurements on 2-D plain films. Larger sample size may help improve the effectiveness and accuracy of the predictive equation.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"60"},"PeriodicalIF":0.9,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10652581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134650514","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":"Surgical helmet systems in total joint arthroplasty: assessment of hood sterility and donning technique.","authors":"Timothy McAleese, Tiarnán Ó Doinn, James M Broderick, Ross Farrington, Anna-Rose Prior, John F Quinlan","doi":"10.1186/s42836-023-00212-4","DOIUrl":"10.1186/s42836-023-00212-4","url":null,"abstract":"<p><strong>Background: </strong>The incidence of prosthetic joint infection (PJI) is increasing, coincident with the rising volume of joint arthroplasty being performed. With recent controversy regarding the efficacy of surgical helmet systems (SHS) in preventing infection, the focus has turned to the correct donning techniques and usage of surgical hoods. The aim of this study was to compare the bacterial contamination of the operating surgeon's gloves after two common donning techniques of SHS hoods. We also evaluated the baseline sterility of the SHS hoods at the beginning of the procedure.</p><p><strong>Methods: </strong>The bacterial contamination rate was quantified using colony-forming units (CFUs), with 50 trials performed per donning technique. Samples were cultured on 5% Columbia blood agar in ambient air at 37 °C for 48 h and all subsequent bacterial growth was identified using a MALDI-TOF mass spectrometer. In Group 1, the operating surgeon donned their colleague's hood. In Group 2, the operating surgeon had their hood applied by a non-scrubbed colleague. After each trial, the operating surgeon immediately inoculated their gloves onto an agar plate. The immediate sterility of 50 SHS hoods was assessed at two separate zones-the screen (Zone 1) and the neckline (Zone 2).</p><p><strong>Results: </strong>There was no significant difference in contamination rates between the two techniques (3% vs. 2%, P = 0.99) or between right and left glove contamination rates. Immediately after donning, 6/50 (12%) of SHS hoods cultured an organism. Contamination rates at both the face shield and neckline zones were equivalent. The majority of bacteria cultured were Bacillus species.</p><p><strong>Discussion: </strong>We found no significant difference in the operating surgeon's glove contamination using two common SHS hood-donning techniques when they were performed under laminar airflow with late fan activation. We suggest the SHS hood should not be assumed to be completely sterile and that gloves are changed if it is touched intraoperatively.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"53"},"PeriodicalIF":0.9,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592783","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":"Comparable performance of machine learning algorithms in predicting readmission and complications following total joint arthroplasty with external validation.","authors":"Hashim J F Shaikh, Mina Botros, Gabriel Ramirez, Caroline P Thirukumaran, Benjamin Ricciardi, Thomas G Myers","doi":"10.1186/s42836-023-00208-0","DOIUrl":"10.1186/s42836-023-00208-0","url":null,"abstract":"<p><strong>Background: </strong>The purpose of the study was to use Machine Learning (ML) to construct a risk calculator for patients who undergo Total Joint Arthroplasty (TJA) on the basis of New York State Statewide Planning and Research Cooperative System (SPARCS) data and externally validate the calculator on a single TJA center.</p><p><strong>Methods: </strong>Seven ML algorithms, i.e., logistic regression, adaptive boosting, gradient boosting (Xg Boost), random forest (RF) classifier, support vector machine, and single and a five-layered neural network were trained on the derivation cohort. Models were trained on 68% of data, validated on 15%, tested on 15%, and externally validated on 2% of the data from a single arthroplasty center.</p><p><strong>Results: </strong>Validation of the models showed that the RF classifier performed best in terms of 30-d mortality AUROC (Area Under the Receiver Operating Characteristic) 0.78, 30-d readmission (AUROC 0.61) and 90-d composite complications (AUROC 0.73) amongst the test set. Additionally, Xg Boost was found to be the best predicting model for 90-d readmission and 90-d composite complications (AUC 0.73). External validation demonstrated that models achieved similar AUROCs to the test set although variation occurred in top model performance for 90-d composite complications and readmissions between our test and external validation set.</p><p><strong>Conclusion: </strong>This was the first study to investigate the use of ML to create a predictive risk calculator from state-wide data and then externally validate it with data from a single arthroplasty center. Discrimination between best performing ML models and between the test set and the external validation set are comparable.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"58"},"PeriodicalIF":0.9,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523315","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":"Improved perioperative narcotic usage patterns in patients undergoing robotic-assisted compared to manual total hip arthroplasty.","authors":"Graham B J Buchan, Zachary Bernhard, Christian J Hecht, Graeme A Davis, Trevor Pickering, Atul F Kamath","doi":"10.1186/s42836-023-00211-5","DOIUrl":"10.1186/s42836-023-00211-5","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted total hip arthroplasty (RA-THA) improves accuracy in achieving the planned acetabular cup positioning compared to conventional manual THA (mTHA), but optimal dosage for peri-RA-THA and mTHA pain relief remains unclear. This study aimed to compare pain control with opioids between patients undergoing direct anterior approach THA with the use of a novel, fluoroscopic-assisted RA-THA system compared to opioid consumption associated with fluoroscopic-assisted, manual technique.</p><p><strong>Methods: </strong>Retrospective cohort analysis was performed on a consecutive series of patients who received mTHA and fluoroscopy-based RA-THA. The average amount of postoperative narcotics in morphine milligram equivalents (MME) given to each cohort was compared, including during the in-hospital and post-discharge periods. Analyses were performed on the overall cohort, as well as stratified by opioid-naïve and opioid-tolerant patients.</p><p><strong>Results: </strong>The RA-THA cohort had significantly lower total postoperative narcotic use compared to the mTHA cohort (103.7 vs. 127.8 MME; P < 0.05). This difference was similarly seen amongst opioid-tolerant patients (123.6 vs. 181.3 MME; P < 0.05). The RA-THA cohort had lower total in-hospital narcotics use compared to the mTHA cohort (42.3 vs. 66.4 MME; P < 0.05), consistent across opioid-naïve and opioid-tolerant patients. No differences were seen in post-discharge opioid use between groups.</p><p><strong>Conclusions: </strong>Fluoroscopy-based RA-THA is associated with lower postoperative opioid use, including during the immediate perioperative period, when compared to manual techniques. This may have importance in rapid recovery protocols and mitigating episode burden of care.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"56"},"PeriodicalIF":0.9,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488835","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":"Understanding the use of artificial intelligence for implant analysis in total joint arthroplasty: a systematic review.","authors":"Aakash K Shah, Monish S Lavu, Christian J Hecht, Robert J Burkhart, Atul F Kamath","doi":"10.1186/s42836-023-00209-z","DOIUrl":"10.1186/s42836-023-00209-z","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, there has been a significant increase in the development of artificial intelligence (AI) algorithms aimed at reviewing radiographs after total joint arthroplasty (TJA). This disruptive technology is particularly promising in the context of preoperative planning for revision TJA. Yet, the efficacy of AI algorithms regarding TJA implant analysis has not been examined comprehensively.</p><p><strong>Methods: </strong>PubMed, EBSCO, and Google Scholar electronic databases were utilized to identify all studies evaluating AI algorithms related to TJA implant analysis between 1 January 2000, and 27 February 2023 (PROSPERO study protocol registration: CRD42023403497). The mean methodological index for non-randomized studies score was 20.4 ± 0.6. We reported the accuracy, sensitivity, specificity, positive predictive value, and area under the curve (AUC) for the performance of each outcome measure.</p><p><strong>Results: </strong>Our initial search yielded 374 articles, and a total of 20 studies with three main use cases were included. Sixteen studies analyzed implant identification, two addressed implant failure, and two addressed implant measurements. Each use case had a median AUC and accuracy above 0.90 and 90%, respectively, indicative of a well-performing AI algorithm. Most studies failed to include explainability methods and conduct external validity testing.</p><p><strong>Conclusion: </strong>These findings highlight the promising role of AI in recognizing implants in TJA. Preliminary studies have shown strong performance in implant identification, implant failure, and accurately measuring implant dimensions. Future research should follow a standardized guideline to develop and train models and place a strong emphasis on transparency and clarity in reporting results.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"54"},"PeriodicalIF":0.9,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429079","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":"Robotic arm-assisted unicondylar knee arthroplasty resulted in superior radiological accuracy: a propensity score-matched analysis.","authors":"Matthew H Y Yeung, Henry Fu, Amy Cheung, Vincent Chan Wai Kwan, Man Hong Cheung, Ping Keung Chan, Kwong Yuen Chiu, Chun Hoi Yan","doi":"10.1186/s42836-023-00210-6","DOIUrl":"10.1186/s42836-023-00210-6","url":null,"abstract":"<p><strong>Introduction: </strong>Unicompartmental knee arthroplasty (UKA) is an effective surgical treatment for medial compartment arthritis of the knee, yet surgical outcomes are directly related to surgical execution. Robotic arm-assisted surgery aims to address these difficulties by allowing for detailed preoperative planning, real-time intraoperative assessment and haptic-controlled bone removal. This study aimed to compare the clinical and radiological outcomes between conventional manual mobile bearing and robot arm-assisted fixed bearing medial UKA in our local population.</p><p><strong>Materials and methods: </strong>This is a retrospective case-control study of 148 UKAs performed at an academic institution with a minimum of 1-year follow-up. 74 robotic arm-assisted UKAs were matched to 74 conventional UKAs via propensity score matching. Radiological outcomes included postoperative mechanical axis and individual component alignment. Clinical parameters included a range of motion, Knee Society knee score and functional assessment taken before, 6 and 12 months after the operation.</p><p><strong>Results: </strong>Robot arm-assisted UKA produced a more neutral component coronal alignment in both femoral component (robotic -0.2 ± 2.8, manual 2.6 ± 2.3; P = 0.043) and tibial component (robotic -0.3 ± 4.0, manual 1.7 ± 5.3; P < 0.001). While the postoperative mechanical axis was comparable, robot arm-assisted UKA demonstrated a smaller posterior tibial slope (robotic 5.7 ± 2.7, manual 8.2 ± 3.3; P = 0.02). Clinical outcomes did not show any statistically significant differences.</p><p><strong>Conclusion: </strong>Compared with conventional UKA, robotic arm-assisted UKA demonstrated improved component alignment and comparable clinical outcomes. Improved radiological accuracy with robotic-arm assistance demonstrated promising early results.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"55"},"PeriodicalIF":0.9,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429078","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":"Analysis of in vivo humeral rotation of reverse total shoulder arthroplasty patients during shoulder abduction on the scapular plane with a load.","authors":"Yuji Takahashi, Naoya Nishinaka, Kanji Furuya, Takashi Ikeda, Tetsuya Jinno, Atsushi Okawa, Tomoko Sakai","doi":"10.1186/s42836-023-00207-1","DOIUrl":"10.1186/s42836-023-00207-1","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated the kinematics after reverse total shoulder arthroplasty (RTSA). This study aimed to compare the shoulder kinematics in RTSA patients during shoulder abduction on the scapular plane with and without a load and yield information regarding the function of stabilizing the joints against gravity for the functional assessment of the shoulder after RTSA, which could lead to changes in postoperative rehabilitation treatment.</p><p><strong>Methods: </strong>Twenty RTSA patients (7 men, 13 women; mean age: 78.1 [64-90] years) were examined. First, active shoulder abduction in the scapular plane was captured using single-plane fluoroscopic X-ray images. Imaging was performed by stipulating that one shoulder abduction cycle should be completed in 6 s. Two trials were conducted: one under a load equivalent to 2% of body weight and one without a load. Next, a three-dimensional (3D) model of each humeral and scapular component was matched to the silhouette of the fluoroscopic image to estimate the 3D dynamics. By using the 3D dynamic model obtained, the kinematics of the glenosphere and humeral implant were calculated relative to the shoulder abduction angle on the scapular plane and were compared between groups with and without a load. A one-way analysis of variance and a post hoc paired t-test with a statistical significance level of 0.05 were performed.</p><p><strong>Results: </strong>The humeral internal rotation decreased with a load at shoulder abduction between 40° and 90° on the scapular plane (P < 0.01, effect size: 0.15). No significant differences in scapular upward rotation (P = 0.57, effect size: 0.022), external rotation (P = 0.83, effect size: 0.0083) and posterior tilting (P = 0.74, effect size: 0.013) were observed between groups with and without a load. The main effect was not observed with and without a load (P = 0.86, effect size: 0.0072). However, the scapulohumeral rhythm was significantly greater without a load during shoulder joint abduction between 40° and 60° on the scapular plane.</p><p><strong>Conclusion: </strong>In RTSA patients, the glenohumeral joint was less internally rotated, and the scapulohumeral rhythm decreased under loaded conditions. It was stabilized against the load through the mechanical advantage of the deltoid muscle and other muscles.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"51"},"PeriodicalIF":0.9,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147006","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":"Hospital characteristics and perioperative complications of Hispanic patients following reverse shoulder arthroplasty-a large database study.","authors":"Nikit Venishetty, Garrett Sohn, Ivy Nguyen, Meesha Trivedi, Varatharaj Mounasamy, Senthil Sambandam","doi":"10.1186/s42836-023-00206-2","DOIUrl":"10.1186/s42836-023-00206-2","url":null,"abstract":"<p><strong>Background: </strong>Hispanic patients are the youngest and fastest-growing ethnic group in the USA. Many of these patients are increasingly met with orthopedic issues, often electing to undergo corrective procedures such as reverse shoulder arthroplasty (RSA). This patient population has unique medical needs and has been reported to have higher incidences of perioperative complications following major procedures. Unfortunately, there is a lack of information on the hospitalization data and perioperative complications in Hispanic patients following procedures such as RSA. This project aimed to query the Nationwide Inpatient Sample (NIS) database to assess patient hospitalization information, demographics, and the prevalence of perioperative complications among Hispanic patients who received RSA.</p><p><strong>Methods: </strong>Information from 2016-2019 was queried from the NIS database. Demographic information, incidences of perioperative complications, length of stay, and costs of care among Hispanic patients undergoing RSA were compared to non-Hispanic patients undergoing RSA. A subsequent propensity matching was conducted to consider preoperative comorbidities.</p><p><strong>Results: </strong>The query of NIS identified 59,916 patients who underwent RSA. Of this sample, 2,656 patients (4.4%) were identified to be Hispanic, while the remaining 57,260 patients (95.6%) were found to belong to other races (control). After propensity matching, Hispanic patients had a significantly longer LOS (median = 1.4 days) than the patients in the control group (median = 1.0, P < 0.001). The Hispanic patients (89,168.5 USD) had a significantly higher cost of care than those in the control group (67,396.1 USD, P < 0.001). In looking at postoperative complications, Hispanic patients had increased incidences of acute renal failure (Hispanics: 3.1%, control group: 1.1%, P = 0.03) and blood loss anemia (Hispanics: 12.7%, control group: 10.9%, P = 0.03).</p><p><strong>Conclusions: </strong>Hispanic patients had significantly longer lengths of stay, higher costs of care, and higher rates of perioperative complications compared to the control group. For patients who are Hispanic and undergoing RSA, this information will aid doctors in making comprehensive decisions regarding patient care and resource allocation.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"50"},"PeriodicalIF":0.9,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165295","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":"Management of soft tissues in patients with periprosthetic joint infection.","authors":"Hongyi Shao, Yixin Zhou","doi":"10.1186/s42836-023-00205-3","DOIUrl":"10.1186/s42836-023-00205-3","url":null,"abstract":"<p><strong>Background: </strong>Appropriate soft tissue management represents a critical step in treating periprosthetic joint infection (PJI). This review discusses relevant guidelines that surgeons should follow in the management of soft tissues in PJI treatment. BODY: It is imperative for arthroplasty surgeons to thoroughly debride and rebuild soft tissue with a good blood supply. Relevant guidelines that surgeons should follow rigorously include preoperative evaluation of soft tissue status and plan-making, adequate surgical area exposure, intraoperative removal of all necrotic and infected soft tissues, adequate coverage of soft tissue defects, timely postoperative assessment and management of soft tissues, wound management and proper rehabilitation.</p><p><strong>Conclusion: </strong>Soft tissue management plays a critical role in the treatment of PJI. To improve the infection control rate and postoperative joint function, surgeons should be familiar with these general principles and rigorously practice them in PJI management.</p>","PeriodicalId":52831,"journal":{"name":"Arthroplasty","volume":"5 1","pages":"52"},"PeriodicalIF":0.9,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167894","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}