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Table of Contents
doi : 10.1016/S0883-5403(21)00798-1
Volume 36, Issue 12, December 2021, Pages A5-A7
Our Efforts Towards a Diversity Pledge
doi : 10.1016/j.arth.2021.10.007
Volume 36, Issue 12, December 2021, Pages 3823-3824
Reporting and Analyzing Demographics in the Journal of Arthroplasty: Are We Making Progress?
Sean A.GriffinBSabJustin A.MagnusonBAaRyan M.SuttonMDaChad A.KruegerMDa
doi : 10.1016/j.arth.2021.09.017
Volume 36, Issue 12, December 2021, Pages 3825-3830
Demographic factors, including age, sex, body mass index (BMI), race, and ethnicity have great effects on the outcomes of patients undergoing total joint arthroplasty. A portion of this data is included in nearly every study, but the completeness with which it is reported is variable. The purpose of this study is to investigate the frequency at which demographic information is reported and analyzed through formal statistical methods in randomized controlled trials (RCTs) published in the Journal of Arthroplasty (JOA).
Procedures With Longer Intraoperative Times Undervalue Surgeon Work in Total Joint Arthroplasty: A Large, Nationwide Database Study
Christopher A.RothfuszBSDanielGritsBSAhmed K.EmaraMDRobert M.MolloyMDViktor E.KrebsMDNicolas S.PiuzziMD
doi : 10.1016/j.arth.2021.08.023
Volume 36, Issue 12, December 2021, Pages 3831-3838
Work relative value units (wRVUs) measure a surgeon’s time and intensity required to perform the pre-service, intra-service, and post-service work of a surgical procedure and are commonly used to compare a physician’s work between different procedures. Previous literature across multiple specialties report that longer, often revision, operations are undervalued when compared to primary procedures. Our study aims to analyze the differences in intra-operative time, and its corresponding wRVU/h between the Medicare benchmarks and real-world time-stamped data for total joint arthroplasty procedures.
Collapse Progression or Cessation Affects the Natural History of Contralateral Osteonecrosis of the Femoral Head
YusukeOsawaMD, PhDTaisukeSekiMD, PhDYasuhikoTakegamiMD, PhDKazuyaMakidaMDSatoshiOchiaiMDShiroImagamaMD, PhD
doi : 10.1016/j.arth.2021.08.005
Volume 36, Issue 12, December 2021, Pages 3839-3844
It is unclear how the condition of one side of the hip joint affects the natural history of contralateral osteonecrosis of the femoral head (ONFH). This study aimed to investigate the natural progression of bilateral ONFH on the asymptomatic side between patients with collapse progression and cessation on the symptomatic side.
Regional Implicit Bias Does Not Account for Racial Disparity in Total Joint Arthroplasty Utilization
Wayne B.Cohen-LevyMD, MScaMatthewSloanMD, MSbJamie M.ShoagMDcAntonia F.ChenMD, MBAbHany S.BedairMDd
doi : 10.1016/j.arth.2021.08.011
Volume 36, Issue 12, December 2021, Pages 3845-3849
Racial disparities surrounding the utilization of total hip and total knee arthroplasty (THA, TKA) are well documented. The Implicit Association Test (IAT) is a validated tool used to measure implicit and explicit bias. The purpose of this study is to evaluate if variations in IAT scores by geographical region in the United States (US) correspond with regional variations in THA and TKA utilization by blacks compared to whites.
Do Patient Engagement Platforms in Total Joint Arthroplasty Improve Patient-Reported Outcomes?
Andrew J.HolteMDIlda B.MolloyMD, MSPaul M.WerthMS, PhDDavid S.JevsevarMD, MBA
doi : 10.1016/j.arth.2021.08.003
Volume 36, Issue 12, December 2021, Pages 3850-3858
Web-based patient engagement portals are increasing in popularity after total hip and knee arthroplasty (THA and TKA). The literature is mixed regarding patient utilization of these modalities and potential clinical benefit. We sought to determine which demographic factors are associated with increased platform participation and to quantify the impact of a web-based patient portal on patient-reported outcome measures (PROMs).
Sodium Abnormalities Are an Independent Predictor of Complications in Total Joint Arthroplasty: A Cautionary Tale!
ChristopherWesterMDTheodore S.ZhangBSMelvyn A.HarringtonMDMohamad J.HalawiMD
doi : 10.1016/j.arth.2021.08.006
Volume 36, Issue 12, December 2021, Pages 3859-3863
Electrolyte levels are commonly obtained as part of the preoperative workup for total joint arthroplasty, but limited information exists on the interplay between electrolyte abnormalities and outcomes.
Tranexamic Acid is Associated With Decreasing the Risk of Complications in Patients Undergoing Arthroplasty With Preoperative Coagulopathy
Graham S.GohMDTaylorD’AmoreMDJess H.LonnerMDYale A.FillinghamMD
doi : 10.1016/j.arth.2021.08.009
Volume 36, Issue 12, December 2021, Pages 3864-3869.e1
Preoperative coagulopathy is a risk factor for perioperative blood loss. The antifibrinolytic effects of tranexamic acid (TXA) could negate the association between preoperative coagulopathy and adverse outcomes in patients undergoing total joint arthroplasty (TJA). However, no studies have evaluated this relationship. This study compared the perioperative outcomes of coagulopathic patients undergoing TJA who did and did not receive TXA.
Alcohol Withdrawal Is Associated With Worse Outcomes in Patients Undergoing Primary Total Knee or Total Hip Arthroplasty
ZhantaoDengMD, PhDa1JiewenJinMD, PhDb1MengyuanLiMD, PhDaShuaiWangMDaYuanchenMaMD, PhDaQiujianZhengMDa
doi : 10.1016/j.arth.2021.07.015
Volume 36, Issue 12, December 2021, Pages 3870-3877.e5
Alcohol withdrawal (AW) syndrome is an independent risk factor for postoperative complications. This study aims to evaluate the influence of AW on perioperative outcomes in patients who underwent primary total knee (TKA) or total hip arthroplasty (THA).
Unicompartmental Knee Arthroplasty: More Conversions, Fewer Complications Than Proximal Tibial Osteotomy in a Young Population
Daniel L.RodkeyMDaLogan J.McMillanbSean E.SlavenMDaDmitriy A.TreysterMDbJonathan F.DickensMDaJohn P.CodyMDa
doi : 10.1016/j.arth.2021.08.001
Volume 36, Issue 12, December 2021, Pages 3878-3882
Patients with isolated medial compartment osteoarthritis requiring surgical intervention generally have two surgical options: unicompartmental knee arthroplasty (UKA) and proximal tibial osteotomy (PTO). Outcomes of reoperation rates and survivorship are important for counseling patients on treatment options.
Alignment in Medial Fixed-Bearing Unicompartmental Knee Arthroplasty: The Limb Has a Leg Up on the Component
Sean E.SlavenMDaJohn P.CodyMDaRobert A.SershonMDbcHenryHoMScRobert H.HopperJr.PhDcKevin B.FrickaMDbc
doi : 10.1016/j.arth.2021.08.015
Volume 36, Issue 12, December 2021, Pages 3883-3887
To assess how implant alignment affects unicompartmental knee arthroplasty (UKA) outcome, we compared tibial component alignment of well-functioning UKAs against 2 groups of failed UKAs, revised for progression of lateral compartment arthritis (“Progression”) and aseptic loosening (“Loosening”).
A Smartwatch Paired With A Mobile Application Provides Postoperative Self-Directed Rehabilitation Without Compromising Total Knee Arthroplasty Outcomes: A Randomized Controlled Trial
Krishna R.TripuraneniMDaJared R.H.ForanMDbNatalie R.MunsonMPH, MBAaNatalie E.RaccaBAaJoshua T.CarothersMDa
doi : 10.1016/j.arth.2021.08.007
Volume 36, Issue 12, December 2021, Pages 3888-3893
Self-directed rehabilitation (SDR) after total knee arthroplasty (TKA) has not been traditionally recommended. The purpose of this study was to determine if there was an impact on postoperative outcomes with the use of an SDR program after primary TKA.
A Weighted Scoring System Based on Preoperative and Long-Term Patient-Reported Outcome Measures to Guide Timing of Knee Arthroplasty
Yong ZhiKhowMBBSMing Han LincolnLiowMBBS, DWD (CAW), MRCSEd, MMED (Ortho), FRCSEd (Orth), FAMSZhi Guang FelixYeohMBBS, DWD (CAW)Jerry YongqiangChenMBBS, MRCS, MMed (Ortho), FRCS, FAMSNgai NungLoMBBS, MMed (Surg), FRCS (Edin), FAMSSeng JinYeoMBBS, FRCS (Edin), FAMS
doi : 10.1016/j.arth.2021.08.008
Volume 36, Issue 12, December 2021, Pages 3894-3900
There is currently no existing consensus regarding timing of knee arthroplasty. This study aimed to develop a weighted scoring system from patient-reported outcome measures (PROMs) to guide timing of knee arthroplasty based on preoperative severity and long-term effectiveness.
Short Interval Staged Bilateral Total Knee Arthroplasty: Safety Compared to Simultaneous and Later Staged Bilateral Total Knee Arthroplasty
Mohammad S.AbdelaalMDDanielCalemMDMatthew B.ShermanBSPeter F.SharkeyMD
doi : 10.1016/j.arth.2021.08.030
Volume 36, Issue 12, December 2021, Pages 3901-3908
Simultaneous bilateral total knee arthroplasty (sim-BTKA) is reported to be safe in a select group of patients. Patients with symptomatic bilateral knee arthritis who are not candidates for sim-BTKA require staged surgery (stag-BTKA). This study aimed to compare the safety and complications associated with sim-BTKA with stag-BTKA performed at 2 time intervals.
Effects of Intravenous Dexamethasone on Glycemic Control in Patients With Type 2 Diabetes Mellitus After Total Knee Arthroplasty
Hyung JunParkMDa1Moon JongChangMD, PhDa1Tae WooKimMD, PhDaKee SooKangMDbChong BumChangMD, PhDcSeung-BaikKangMD, PhDa
doi : 10.1016/j.arth.2021.07.021
Volume 36, Issue 12, December 2021, Pages 3909-3914
We sought to determine whether administrations of intravenous (IV) dexamethasone jeopardize blood glycemic control, increase rates of postoperative complications, and diabetic medication change after TKA.
Liposomal Bupivacaine vs Ropivacaine for Adductor Canal Blocks in Total Knee Arthroplasty: A Prospective Randomized Trial
MarcHungerfordMDPhilipNeubauerMDJosephCiotolaMDKamalaLittletonMDAshlieBonerLisaChangMS, RN, CMSRN
doi : 10.1016/j.arth.2021.08.017
Volume 36, Issue 12, December 2021, Pages 3915-3921
The purpose of this study is to determine the benefit of the analgesic liposomal bupivacaine compared to ropivacaine, by assessing pain and joint stiffness, and total oral opioid consumption by milligram morphine equivalent (MME) after total knee arthroplasty.
Total Hip Arthroplasty After Hip Arthroscopy Has Increased Complications and Revision Risk
Nicholas J.LemmeMDAshwinVeeramaniBADaniel S.YangBARamin R.TabaddorMDAlan H.DanielsMDEric M.CohenMD
doi : 10.1016/j.arth.2021.07.020
Volume 36, Issue 12, December 2021, Pages 3922-3927.e2
There has been an increase in hip arthroscopy (HA) over the last decade. After HA, some patients may ultimately require a total hip arthroplasty (THA). However, there is a scarcity of research investigating the outcomes in patients undergoing THA with a history of ipsilateral HA.
Use of Total Hip Arthroplasty in Patients Under 21 Years Old: A US Population Analysis
Cynthia A.KahlenbergMD, MPHaJ. Alex B.GibbonsBAbDeanna P.Jannat-KhahDrPH, MSPHbcSusan M.GoodmanMDbcLisa A.MandlMD, MPHbcPeter K.SculcoMDaStuart B.GoodmanMD, PhDdMark P.FiggieMDaBella Y.MehtaMBBS, MSbc
doi : 10.1016/j.arth.2021.08.004
Volume 36, Issue 12, December 2021, Pages 3928-3933.e1
The purpose of this study is to evaluate trends in the use of total hip arthroplasty (THA) in the United States in patients under 21 years of age. Specifically, we examined the frequency of THA in this patient population over the past 2 decades, the epidemiologic characteristics of patients under 21 who underwent THA, and the characteristics of the hospitals where these procedures were performed.
ICD-10 Coding Mismatch in Computer and Robotic Assisted Primary Total Hip Arthroplasty
Eric A.ChenMDMackenzie A.RoofMDKatherine A.LygrisseMDMarkKurapattiBSMatthew S.HepinstallMDRanSchwarzkopfMD
doi : 10.1016/j.arth.2021.08.002
Volume 36, Issue 12, December 2021, Pages 3934-3937
The International Statistical Classification of Disease, 10th Revision Procedural Coding System (ICD-10-PCS) is a granular procedural classification system with the ability to precisely classify types of technology utilized in total hip arthroplasty (THA). However, coding nuances and the rapidly evolving nature of technology may lead to coding inaccuracies. The purpose of this study is to determine the accuracy of ICD-10-PCS coding in computer-navigated and robotic THA and discuss its implications on clinical data.
A Repeat Dose of Perioperative Dexamethasone Can Effectively Reduce Pain, Opioid Requirement, Time to Ambulation, and In-Hospital Stay After Total Hip Arthroplasty: A Prospective Randomized Controlled Trial
Carlos M.LuceroMDAgustínGarcía-MansillaMDGerardoZanottiMDFernandoCombaMDPablo A.SlullitelMDMartin A.ButtaroMD
doi : 10.1016/j.arth.2021.08.020
Volume 36, Issue 12, December 2021, Pages 3938-3944
The ideal dose of intravenous glucocorticoids to control pain in total hip arthroplasty (THA) remains unclear. This randomized controlled trial compared postoperative pain and tramadol requirement in patients undergoing unilateral primary THA who received one versus two perioperative doses of dexamethasone.
Stainless Steel Femoral Heads Reduce Rate of Revision When Compared to Ion-Implanted Chromium-Cobalt Heads With a Single Cemented Femoral Design: An Analysis of 40,468 Total Hip Replacements From the Australian Orthopedic Association National Joint Replacement Registry
SinaBabazadehPhDabcRichard N.de SteigerPhDdeYiPengMBiostatfDirkvan BavelMBBSae
doi : 10.1016/j.arth.2021.08.024
Volume 36, Issue 12, December 2021, Pages 3945-3949
In order to reduce the incidence of total hip joint replacement revision for wear, multiple advanced materials and alloys targeting hip replacement tribology have been introduced. Ion implantation of chromium-cobalt heads is thought to reduce wear due to increased surface hardness and lower friction. These advances in technology result in additional manufacturing costs. However, it is unclear whether these attributes result in a decreased rate of revision for wear and when used with modern highly crosslinked polyethylene (XLPE). The aim of this study is to compare the survivorship of stainless steel and ion-implanted chromium-cobalt femoral heads in order to determine whether ion implantation has a lower risk of revision.
How Accurate Is ICD-10 Coding for Revision Total Knee Arthroplasty?
Mackenzie A.RoofMD, MBAaKatherineLygrisseMDaLaurenKeitelBSbAhmedSiddiqiDO, MBAcAhmedEmaraMDdNicolas S.PiuzziMDdAntonia F.ChenMD, MBAeJohnCallaghanMDbRanSchwarzkopfMD, MScaNicholas A.BedardMDb
doi : 10.1016/j.arth.2021.08.021
Volume 36, Issue 12, December 2021, Pages 3950-3958
The International Classification of Diseases-10 (ICD-10) came into effect in October 2015. The new procedural codes (ICD-10-PCS) were designed to specify granular aspects of the procedure, including laterality and revised components. This specificity could improve data collection in institutional databases, large registries, and administrative claims data. Given these possible applications, this study’s purpose was to assess the accuracy of ICD-10-PCS coding for revision total knee arthroplasty (rTKA).
Distal Femoral Replacement and Periprosthetic Joint Infection After Non-Oncological Reconstruction: A Retrospective Analysis
KamolsakSukhonthamarnMDabJohn T.StronyBSaUrvi J.PatelMD, MSaScot A.BrownMDaDavid G.NazarianMDaJavadParviziMD, FRCSaGregg R.KleinMDa
doi : 10.1016/j.arth.2021.08.013
Volume 36, Issue 12, December 2021, Pages 3959-3965
Distal femoral replacement (DFR) is commonly used to manage massive bone loss around the knee arising from aseptic loosening, periprosthetic joint infection (PJI), and distal femoral fractures. A number of studies report the outcome of DFR with considerable variation in long-term survivorship. This study investigated the outcome of DFR for patients with aseptic failures, fractures, and PJI.
Outcomes Following Revision for Mechanically Assisted Crevice Corrosion in a Single Femoral Design
Jacob M.WilsonMDMattew S.BroggiMDPhilipOladejiMDRahul K.GoelMDJames R.RobersonMD
doi : 10.1016/j.arth.2021.08.010
Volume 36, Issue 12, December 2021, Pages 3966-3972
Mechanically assisted crevice corrosion (MACC) is a described complication following metal-on-polyethylene (MoP) total hip arthroplasty (THA). The literature regarding outcomes following revision for MACC suggests that complication rates are high. The purpose of this investigation is to add to this literature with the largest reported series to date.
Cement Loaded With High-Dose Gentamicin and Clindamycin Reduces the Risk of Subsequent Infection After One-Stage Hip or Knee Arthroplasty Exchange for Periprosthetic Infection: A Preliminary Study
Jean-YvesJennyMDMarieHamonPhDStéphaneKleinMDAurélieReiter-SchatzPhDCécileRondé-OustauMDCyrilBoériMDSandraWisniewskiPhDJeannotGaudiasMD
doi : 10.1016/j.arth.2021.08.014
Volume 36, Issue 12, December 2021, Pages 3973-3978
The use of antibiotic-loaded acrylic cement for treating periprosthetic joint infections remains controversial. We hypothesized that the raw rate of surgical site infection (SSI) is lower after using cement loaded with high-dose gentamicin and clindamycin than after using cement loaded with standard-dose gentamicin for implant fixation during 1-stage hip and knee revision arthroplasty for infection.
Complications and Outcomes Associated With a Novel, Prefabricated, Articulating Spacer for Two-Stage Periprosthetic Joint Infection Treatment
Leonard T.BullerMDabMaryZiemba-DavisBAbR. MichaelMeneghiniMDab
doi : 10.1016/j.arth.2021.08.012
Volume 36, Issue 12, December 2021, Pages 3979-3985
Various prefabricated articulating spacer options have been described for 2-stage treatment of chronic periprosthetic joint infection, but their results are poorly generalizable between designs due to differing antibiotic and material properties. This study reports outcomes for a novel, prefabricated, commercially available cement-on-cement articulating spacer.
Weight-Based Aspirin Dosing May Further Reduce the Incidence of Venous Thromboembolism Following Primary Total Joint Arthroplasty
Christopher R.HalburBSaTrevor R.GulbrandsenMDaChristopher R.WestMDbTimothy S.BrownMDaNicolas O.NoiseuxMD, MSa
doi : 10.1016/j.arth.2021.06.008
Volume 36, Issue 12, December 2021, Pages 3986-3992.e1
Obesity poses a challenge to thromboembolic prophylaxis following total joint arthroplasty (TJA). The purpose of this study is to evaluate a weight-based aspirin dosing regimen for prevention of venous thromboembolism (VTE) following TJA.
Clinical Course of Pain and Function Following Total Knee Arthroplasty: A Systematic Review and Meta-Regression
Said MohamadSayahMDabSaschaKarunaratnePhD CandidateabPaula R.BeckenkampPhDcMarkHorsleyMBBSdMark J.HancockPhDeDavid J.HunterPhDfgRobert D.HerbertPhDhTarcisio F.de CamposPhDeDanielSteffensPhDab
doi : 10.1016/j.arth.2021.06.019
Volume 36, Issue 12, December 2021, Pages 3993-4002.e37
Total knee arthroplasty (TKA) is widely considered a successful intervention for osteoarthritis and other degenerative knee diseases. This study addresses the need for a high-quality meta-analysis that outlines the clinical course of pain and function post-TKA.
Diagnostic Performance of Single-Photon Emission Computed Tomography/Computed Tomography in Aseptic Loosening: A Systematic Review and Meta-Analysis
ZhanPengMDabYukunJiaMDabJinLiMDabGuangyeWangMDab
doi : 10.1016/j.arth.2021.06.018
Volume 36, Issue 12, December 2021, Pages 4003-4012.e3
The aim of this study is to evaluate the diagnostic value and clinical applicability of single-photon emission computed tomography/computed tomography (SPECT/CT) in aseptic loosening (AL) of prostheses by meta-analysis.
Conflict of Interest Statement
doi : 10.1016/S0883-5403(21)00799-3
Volume 36, Issue 12, December 2021, Page A9
