Pub Date : 2024-10-14DOI: 10.1016/j.artd.2024.101479
Marius Ludwig MD, Martin Faschingbauer MD, Heiko Reichel MD, Tobias Freitag MD
Since the early 2000s, oxidized zirconium implants have emerged as a valuable option in total hip and knee arthroplasty due to their wear resistance and suitability for patients with metal hypersensitivity. The surface of these components is created through a heating and oxidation process of a zirconium alloy, resulting in a thin layer with favorable wear properties. However, there have been few reports of severe metallosis resulting from inadvertent wear of oxidized zirconium components through various mechanisms, including dissociation of the polyethylene liner and joint instability. We present a case involving a dramatic failure of an oxidized zirconium total knee arthroplasty, necessitating a staged revision arthroplasty.
{"title":"Dramatic Failure of an OXINIUM Total Knee Arthroplasty With a Massive Pseudotumor Formation","authors":"Marius Ludwig MD, Martin Faschingbauer MD, Heiko Reichel MD, Tobias Freitag MD","doi":"10.1016/j.artd.2024.101479","DOIUrl":"10.1016/j.artd.2024.101479","url":null,"abstract":"<div><div>Since the early 2000s, oxidized zirconium implants have emerged as a valuable option in total hip and knee arthroplasty due to their wear resistance and suitability for patients with metal hypersensitivity. The surface of these components is created through a heating and oxidation process of a zirconium alloy, resulting in a thin layer with favorable wear properties. However, there have been few reports of severe metallosis resulting from inadvertent wear of oxidized zirconium components through various mechanisms, including dissociation of the polyethylene liner and joint instability. We present a case involving a dramatic failure of an oxidized zirconium total knee arthroplasty, necessitating a staged revision arthroplasty.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101479"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1016/j.artd.2024.101446
Haley Prough DO , Daniel Mesko DO
Osteolysis due to polyethylene wear is a well-known complication associated with total knee arthroplasty (TKA). Here, we present the case of one failure that has been rarely reported. We report the case of a 51-year-old male who fractured through a large osteolytic lesion in his femur after a previous TKA. The patient presented 4 years after revision TKA after a fall and was found to have fractured through the large lesion. After a diagnostic workup, he was treated with open reduction and internal fixation (ORIF) of the distal femur fracture, and the fixation was augmented with a morselized femoral head allograft and ViviGen (LifeNet Health, Virginia Beach, VA). Osteolysis secondary to polyethylene wear and reactions to arthroplasty components continues to be an ever-present complication of TKAs.
{"title":"Periprosthetic Femur Fracture Through a Large Osteolytic Lesion After Total Knee Arthroplasty","authors":"Haley Prough DO , Daniel Mesko DO","doi":"10.1016/j.artd.2024.101446","DOIUrl":"10.1016/j.artd.2024.101446","url":null,"abstract":"<div><div>Osteolysis due to polyethylene wear is a well-known complication associated with total knee arthroplasty (TKA). Here, we present the case of one failure that has been rarely reported. We report the case of a 51-year-old male who fractured through a large osteolytic lesion in his femur after a previous TKA. The patient presented 4 years after revision TKA after a fall and was found to have fractured through the large lesion. After a diagnostic workup, he was treated with open reduction and internal fixation (ORIF) of the distal femur fracture, and the fixation was augmented with a morselized femoral head allograft and ViviGen (LifeNet Health, Virginia Beach, VA). Osteolysis secondary to polyethylene wear and reactions to arthroplasty components continues to be an ever-present complication of TKAs.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101446"},"PeriodicalIF":1.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101507
Richard D. Murray MD, Charles W. Powell MD, Joseph R. Duff MD, Dillon L. Morrow MD, Kristopher C. Sanders MD
The use of dual-mobility systems in both primary and revision total hip arthroplasty for patients with concern for instability has become increasingly popular. While these systems are an effective means for combating instability, they are not without unique complications, such as liner malseating. We describe an intraoperative technique to evaluate for malseating via fluoroscopy, allowing a surgeon to identify and correct malseating intraoperatively. Reducing the incidence of liner malseating in dual-mobility total hip replacement systems could reduce overall complication rates postoperatively and presumably improve their efficacy.
{"title":"Modified Iliac Oblique for Intraoperative Evaluation of Dual-Mobility Liner Malseating","authors":"Richard D. Murray MD, Charles W. Powell MD, Joseph R. Duff MD, Dillon L. Morrow MD, Kristopher C. Sanders MD","doi":"10.1016/j.artd.2024.101507","DOIUrl":"10.1016/j.artd.2024.101507","url":null,"abstract":"<div><div>The use of dual-mobility systems in both primary and revision total hip arthroplasty for patients with concern for instability has become increasingly popular. While these systems are an effective means for combating instability, they are not without unique complications, such as liner malseating. We describe an intraoperative technique to evaluate for malseating via fluoroscopy, allowing a surgeon to identify and correct malseating intraoperatively. Reducing the incidence of liner malseating in dual-mobility total hip replacement systems could reduce overall complication rates postoperatively and presumably improve their efficacy.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101507"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101493
Robert T. Tisherman MD , Richard A. Wawrose MD , Aditya M. Mittal BS , Stephen R. Chen MD , Joseph Chen BS , Christopher J. Como MD , Malcolm Dombrowski MD , Jeremy D. Shaw MD
Background
Relationships between industry and physicians are critical for innovation in the field of arthroplasty surgery. However, these relationships can present a conflict of interest (COI) for medical research and are required to be disclosed by most journals. The rate of accurate disclosures by physicians has not been studied in arthroplasty surgery.
Methods
The names of all authors publishing in The Journal of Arthroplasty and Arthroplasty Today between 2014 and 2018 were obtained from MEDLINE. Financial disclosure statements were obtained from the journal websites and manually compared against Open Payments. Statistical comparisons were made using chi-square testing with significance defined as P < .05.
Results
From 2014-2018, 3147 articles were published with 4038 authors meeting inclusion criteria. Of authors with financial disclosures, 2298 (57%) authors correctly disclosed. The total value of disclosed COI equaled $1.71 billion. The total value of undisclosed conflicts of interest equaled $334 million. For payments >$1,000,000 physicians disclosed accurately 86% of the time. For payments between $100 and $9999 physicians accurately disclosed 26% of the time. Senior authors disclosed correctly 72% of the time, which was significantly higher compared to middle and first authors.
Conclusions
There is a high prevalence of inaccurate disclosures in the field of arthroplasty surgery. This suggests a need to further educate early-career physicians on what constitutes a COI. Standardization of disclosure forms and verifications with the Open Payments Database can help increase the rate of accurate disclosures.
{"title":"Conflict of Interest Disclosure in American Arthroplasty Surgical Literature","authors":"Robert T. Tisherman MD , Richard A. Wawrose MD , Aditya M. Mittal BS , Stephen R. Chen MD , Joseph Chen BS , Christopher J. Como MD , Malcolm Dombrowski MD , Jeremy D. Shaw MD","doi":"10.1016/j.artd.2024.101493","DOIUrl":"10.1016/j.artd.2024.101493","url":null,"abstract":"<div><h3>Background</h3><div>Relationships between industry and physicians are critical for innovation in the field of arthroplasty surgery. However, these relationships can present a conflict of interest (COI) for medical research and are required to be disclosed by most journals. The rate of accurate disclosures by physicians has not been studied in arthroplasty surgery.</div></div><div><h3>Methods</h3><div>The names of all authors publishing in <em>The Journal of Arthroplasty</em> and <em>Arthroplasty Today</em> between 2014 and 2018 were obtained from MEDLINE. Financial disclosure statements were obtained from the journal websites and manually compared against Open Payments. Statistical comparisons were made using chi-square testing with significance defined as <em>P</em> < .05.</div></div><div><h3>Results</h3><div>From 2014-2018, 3147 articles were published with 4038 authors meeting inclusion criteria. Of authors with financial disclosures, 2298 (57%) authors correctly disclosed. The total value of disclosed COI equaled $1.71 billion. The total value of undisclosed conflicts of interest equaled $334 million. For payments >$1,000,000 physicians disclosed accurately 86% of the time. For payments between $100 and $9999 physicians accurately disclosed 26% of the time. Senior authors disclosed correctly 72% of the time, which was significantly higher compared to middle and first authors.</div></div><div><h3>Conclusions</h3><div>There is a high prevalence of inaccurate disclosures in the field of arthroplasty surgery. This suggests a need to further educate early-career physicians on what constitutes a COI. Standardization of disclosure forms and verifications with the Open Payments Database can help increase the rate of accurate disclosures.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101493"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101504
Kevin Ilo BSc, FRCS , Prith Hallikeri FRCS , Habillan Naathan BMBS , Bernard Van Duren D Phil, FRCS , Mark Higgins FRCS , Iain McNamara MD, FRCS , Toby Smith BSc, MSc, PhD
Background
This systematic review aims to evaluate the effectiveness and safety of custom femoral stems in primary total hip arthroplasty (THA) for patients with secondary osteoarthritis with abnormal hip anatomy.
Methods
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases were systematically searched for studies published on primary THA utilizing custom femoral stems. Inclusion criteria were studies on patients with secondary osteoarthritis receiving custom stems, with outcomes including implant survival, revision rates, and functional scores. Data were extracted from eligible studies, with a focus on overall and cause-specific revision rates.
Results
A total of 689 studies were screened, 13 met the inclusion criteria, encompassing 806 patients and 951 custom THA procedures. The collective follow-up period averaged 11.6 years, with a mean age of 44.6 years. The mean reoperation and revision rates were 6.9% (95% confidence interval [CI]: 3.24-10.13) and 8.25% (95% CI: 4.02-12.47), respectively. The mean intraoperative fracture rate was 3.23% (95% CI: 1.35-5.11), and the mean postoperative leg length discrepancy was 4.25 mm (95% CI: 1.57-6.93). The mean improvement of postoperative Harris Hip Score was 40.32 (range 30-56).
Conclusions
Custom femoral stems in primary THA demonstrate promising results in terms of implant survival and functional outcomes for patients with complex hip anatomy due to secondary osteoarthritis. These findings support the consideration of custom implants as a viable option for this patient demographic, although further research is warranted for long-term outcomes and direct comparisons with standard prostheses.
{"title":"Outcomes of Primary Total Hip Arthroplasty Using Custom Femoral Stems in Patients With Secondary Hip Osteoarthritis: A Systematic Review","authors":"Kevin Ilo BSc, FRCS , Prith Hallikeri FRCS , Habillan Naathan BMBS , Bernard Van Duren D Phil, FRCS , Mark Higgins FRCS , Iain McNamara MD, FRCS , Toby Smith BSc, MSc, PhD","doi":"10.1016/j.artd.2024.101504","DOIUrl":"10.1016/j.artd.2024.101504","url":null,"abstract":"<div><h3>Background</h3><div>This systematic review aims to evaluate the effectiveness and safety of custom femoral stems in primary total hip arthroplasty (THA) for patients with secondary osteoarthritis with abnormal hip anatomy.</div></div><div><h3>Methods</h3><div>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases were systematically searched for studies published on primary THA utilizing custom femoral stems. Inclusion criteria were studies on patients with secondary osteoarthritis receiving custom stems, with outcomes including implant survival, revision rates, and functional scores. Data were extracted from eligible studies, with a focus on overall and cause-specific revision rates.</div></div><div><h3>Results</h3><div>A total of 689 studies were screened, 13 met the inclusion criteria, encompassing 806 patients and 951 custom THA procedures. The collective follow-up period averaged 11.6 years, with a mean age of 44.6 years. The mean reoperation and revision rates were 6.9% (95% confidence interval [CI]: 3.24-10.13) and 8.25% (95% CI: 4.02-12.47), respectively. The mean intraoperative fracture rate was 3.23% (95% CI: 1.35-5.11), and the mean postoperative leg length discrepancy was 4.25 mm (95% CI: 1.57-6.93). The mean improvement of postoperative Harris Hip Score was 40.32 (range 30-56).</div></div><div><h3>Conclusions</h3><div>Custom femoral stems in primary THA demonstrate promising results in terms of implant survival and functional outcomes for patients with complex hip anatomy due to secondary osteoarthritis. These findings support the consideration of custom implants as a viable option for this patient demographic, although further research is warranted for long-term outcomes and direct comparisons with standard prostheses.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101504"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101520
Reece Vesperman MD , J. Ryan Martin MD , Logan Locascio BS , Christina T. Fiske MD, MPH , Jessica Rice MSN, FNP-C , Stephen Engstrom MD, MBA
Prosthetic joint infections (PJIs) following total joint arthroplasties are relatively rare but devastating complications. To date, no cases of Mycobacterium fortuitum PJIs associated with contaminated water supplies have been reported in the literature. Our report details 5 patients with Mycobacterium fortuitum PJIs related to a contaminated water supply at an ambulatory surgical center. These patients were identified by referral to our academic center. All underwent at least 1 revision surgery prior to referral and required prolonged broad-spectrum antibiotics. All had extensive wound complications, and 4 of 5 patients have received at least stage 1 of a 2-stage revision. All will require further surgery, but long-term outcomes remain relatively uncertain.
{"title":"Water Contamination at an Ambulatory Surgical Center Leads to Severe Mycobacterium Fortuitum Prosthetic Joint Infections: A Case Series","authors":"Reece Vesperman MD , J. Ryan Martin MD , Logan Locascio BS , Christina T. Fiske MD, MPH , Jessica Rice MSN, FNP-C , Stephen Engstrom MD, MBA","doi":"10.1016/j.artd.2024.101520","DOIUrl":"10.1016/j.artd.2024.101520","url":null,"abstract":"<div><div>Prosthetic joint infections (PJIs) following total joint arthroplasties are relatively rare but devastating complications. To date, no cases of <em>Mycobacterium fortuitum</em> PJIs associated with contaminated water supplies have been reported in the literature. Our report details 5 patients with <em>Mycobacterium fortuitum</em> PJIs related to a contaminated water supply at an ambulatory surgical center. These patients were identified by referral to our academic center. All underwent at least 1 revision surgery prior to referral and required prolonged broad-spectrum antibiotics. All had extensive wound complications, and 4 of 5 patients have received at least stage 1 of a 2-stage revision. All will require further surgery, but long-term outcomes remain relatively uncertain.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101520"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Synovial fistula of the knee occurs when a defect in the joint capsule creates a connection between skin, bursa, and a near tissue, manifesting as an opening with continuous draining fluid or a cyst. This is a case of an 80-year-old male who developed a synovial fistula with cystic presentation 6 years after the primary total knee arthroplasty. Management included a total knee arthroplasty revision surgery with intraoperative identification of the fistula with methylene blue, and using a gelatin-thrombin matrix for closure. This case shows a possible complication of catastrophic polyethylene insert wear and management.
{"title":"Synovial Fistula Associated With Total Knee Replacement Aseptic Loosening and Polyethylene Wear","authors":"Saul Hernandez-Rodriguez MD, FAAOS, Liannette Padilla-Martinez MLS, MD","doi":"10.1016/j.artd.2024.101447","DOIUrl":"10.1016/j.artd.2024.101447","url":null,"abstract":"<div><div>Synovial fistula of the knee occurs when a defect in the joint capsule creates a connection between skin, bursa, and a near tissue, manifesting as an opening with continuous draining fluid or a cyst. This is a case of an 80-year-old male who developed a synovial fistula with cystic presentation 6 years after the primary total knee arthroplasty. Management included a total knee arthroplasty revision surgery with intraoperative identification of the fistula with methylene blue, and using a gelatin-thrombin matrix for closure. This case shows a possible complication of catastrophic polyethylene insert wear and management.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101447"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101482
Siddhartha Dandamudi BBA , Joyee Tseng BS , John Ratz BS , Lisa Boggio MD, MS , Brett R. Levine MD, MS
Avascular necrosis (AVN) of the femoral head accounts for up to 10% of all total hip arthroplasties performed annually. Typically associated with intravascular coagulation, AVN is extremely rare in patients with bleeding disorders such as hemophilia B. In this report, we describe the therapeutic management of a 46-year-old male with hemophilia B, presenting with chronic left hip pain and AVN of the femoral head. He presented with progressive groin pain for 6 months and was unable to ambulate without the assistance of crutches. Radiographs showed evidence of degenerative joint disease secondary to AVN of the femoral head. After exhausting treatment options, the patient elected to proceed with an elective total hip arthroplasty. Intricate preoperative planning and hemophilia management were required by a multidisciplinary team to mitigate bleeding risks and promote success of the surgery. Postoperatively, the patient experienced a short-term rise in creatinine, but experienced no bleeding complications. The long-term follow-up revealed significant functional improvement without any complications of hemophilia B. There are no reports outlining AVN in hemophilia B (factor IX deficiency) or step-by-step treatment strategies for successful hip replacement in these patients.
在每年进行的全髋关节置换术中，股骨头血管性坏死（AVN）的发生率高达 10%。AVN 通常与血管内凝血有关，但在 B 型血友病等出血性疾病患者中却极为罕见。在本报告中，我们介绍了一名 46 岁 B 型血友病男性患者的治疗方法，该患者出现慢性左髋关节疼痛和股骨头无血管坏死。他的腹股沟疼痛持续了 6 个月，没有拐杖的帮助无法行走。X光片显示，股骨头坏死继发关节退行性病变。在用尽各种治疗方案后，患者选择进行选择性全髋关节置换术。多学科团队需要进行复杂的术前规划和血友病管理，以降低出血风险并促进手术成功。术后，患者肌酐短期内有所升高，但未出现出血并发症。长期随访显示，患者功能明显改善，未出现任何 B 型血友病并发症。目前还没有报告概述 B 型血友病（IX 因子缺乏症）患者的房室缺损情况，也没有为这些患者制定成功实施髋关节置换术的逐步治疗策略。
{"title":"Total Hip Arthroplasty for Avascular Necrosis in a Patient With Hemophilia B","authors":"Siddhartha Dandamudi BBA , Joyee Tseng BS , John Ratz BS , Lisa Boggio MD, MS , Brett R. Levine MD, MS","doi":"10.1016/j.artd.2024.101482","DOIUrl":"10.1016/j.artd.2024.101482","url":null,"abstract":"<div><div>Avascular necrosis (AVN) of the femoral head accounts for up to 10% of all total hip arthroplasties performed annually. Typically associated with intravascular coagulation, AVN is extremely rare in patients with bleeding disorders such as hemophilia B. In this report, we describe the therapeutic management of a 46-year-old male with hemophilia B, presenting with chronic left hip pain and AVN of the femoral head. He presented with progressive groin pain for 6 months and was unable to ambulate without the assistance of crutches. Radiographs showed evidence of degenerative joint disease secondary to AVN of the femoral head. After exhausting treatment options, the patient elected to proceed with an elective total hip arthroplasty. Intricate preoperative planning and hemophilia management were required by a multidisciplinary team to mitigate bleeding risks and promote success of the surgery. Postoperatively, the patient experienced a short-term rise in creatinine, but experienced no bleeding complications. The long-term follow-up revealed significant functional improvement without any complications of hemophilia B. There are no reports outlining AVN in hemophilia B (factor IX deficiency) or step-by-step treatment strategies for successful hip replacement in these patients.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101482"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101512
Christian DeMaio BS , Conner Patrick MD , Grayson Domingue MD , Jake Fox MD , Justin Dvorak PhD , Rishi Thakral MD
Background
Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article seeks to better characterize the complication risks in patients undergoing THA with SCD when compared to osteoarthritis (OA) using a large database from the National Inpatient Sample.
Methods
National Inpatient Sample data from 2006 through the third quarter of 2015 were analyzed using International Classification of Diseases, Ninth Revision codes. A weighted frequency of 4,350,961 THAs were recorded for OA and 4279 for SCD. These were compared using a Rao-Scott chi-squared test, and the prespecified complications were given sampling weights to approximate national estimates.
Results
The following complications were found to occur at a significantly increased frequency in patients with OA with SCD vs OA only: wound infection (0.69% vs 0.36%), dislocation (1.68% vs 0.80%), and urinary complications (3.61% vs 2.35%). SCD, when evaluated independent of avascular necrosis, was reported with higher frequency wound infection (0.86% vs 0.36%), and overall complications (7.25% vs 5.06%). Additionally, multiple comorbidities were significantly more prevalent in the SCD population compared to OA patients.
Conclusions
This study illustrates that patients with SCD have increased complication rates when compared to OA patients. This information benefits orthopaedic surgeons in preoperative and postoperative planning and counseling patients for realistic expectations. Furthermore, this study provides data that could benefit decision-making on bundled reimbursement for this specific patient population.
背景全髋关节置换术（THA）是美国最常见的骨科手术之一，但也存在一些罕见的并发症，这些并发症可能具有毁灭性。镰状细胞病（SCD）可导致股骨头血管性坏死，通常需要进行全髋关节置换术。本文试图利用全国住院病人抽样调查的大型数据库，更好地描述与骨关节炎（OA）相比，接受 THA 手术的 SCD 患者的并发症风险。方法利用国际疾病分类第九版代码分析了 2006 年至 2015 年第三季度的全国住院病人抽样调查数据。根据加权频率记录，OA 的 THAs 数量为 4,350,961 例，SCD 的 THAs 数量为 4279 例。结果发现以下并发症在伴有 SCD 的 OA 患者和仅伴有 OA 的患者中发生的频率显著增加：伤口感染（0.69% vs 0.36%）、脱位（1.68% vs 0.80%）和泌尿系统并发症（3.61% vs 2.35%）。在独立于血管性坏死进行评估时，SCD的伤口感染（0.86% vs 0.36%）和整体并发症（7.25% vs 5.06%）发生率较高。结论这项研究表明，与 OA 患者相比，SCD 患者的并发症发生率更高。这一信息有利于矫形外科医生制定术前和术后计划，并向患者提供切合实际期望的咨询服务。此外，本研究提供的数据还有利于针对这一特殊患者群体的捆绑报销决策。
{"title":"Total Hip Arthroplasty Complications in Patients With Sickle Cell Disease: A Comparison Study","authors":"Christian DeMaio BS , Conner Patrick MD , Grayson Domingue MD , Jake Fox MD , Justin Dvorak PhD , Rishi Thakral MD","doi":"10.1016/j.artd.2024.101512","DOIUrl":"10.1016/j.artd.2024.101512","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed in the United States, but there are rare complications which can be devastating. Sickle cell disease (SCD) can lead to avascular necrosis of the femoral head, often necessitating THA. This article seeks to better characterize the complication risks in patients undergoing THA with SCD when compared to osteoarthritis (OA) using a large database from the National Inpatient Sample.</div></div><div><h3>Methods</h3><div>National Inpatient Sample data from 2006 through the third quarter of 2015 were analyzed using International Classification of Diseases, Ninth Revision codes. A weighted frequency of 4,350,961 THAs were recorded for OA and 4279 for SCD. These were compared using a Rao-Scott chi-squared test, and the prespecified complications were given sampling weights to approximate national estimates.</div></div><div><h3>Results</h3><div>The following complications were found to occur at a significantly increased frequency in patients with OA with SCD vs OA only: wound infection (0.69% vs 0.36%), dislocation (1.68% vs 0.80%), and urinary complications (3.61% vs 2.35%). SCD, when evaluated independent of avascular necrosis, was reported with higher frequency wound infection (0.86% vs 0.36%), and overall complications (7.25% vs 5.06%). Additionally, multiple comorbidities were significantly more prevalent in the SCD population compared to OA patients.</div></div><div><h3>Conclusions</h3><div>This study illustrates that patients with SCD have increased complication rates when compared to OA patients. This information benefits orthopaedic surgeons in preoperative and postoperative planning and counseling patients for realistic expectations. Furthermore, this study provides data that could benefit decision-making on bundled reimbursement for this specific patient population.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101512"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-12DOI: 10.1016/j.artd.2024.101486
Sarah Welch BS , Kian Bagheri DO , Mikhail Bethell MS , Albert T. Anastasio MD , Troy Q. Tabarestani MD , Michael Bolognesi MD
Background
The utilization of social media for health-related purposes has surged, especially during the COVID-19 pandemic. TikTok, a short-form video platform, has seen substantial growth, becoming a prominent medium for health information dissemination. However, the lack of regulation poses challenges in evaluating the validity of TikTok content.
Methods
This cross-sectional study assesses TikTok videos related to total knee arthroplasty rehabilitation exercises. Search terms identified 84 videos, with 64 meeting the inclusion criteria. Engagement metrics and quality scores were analyzed, utilizing the DISCERN tool and the Total Knee Replacement Exercises Education Score.
Results
The analyzed videos accumulated nearly 6 million views, with a median of 10,293.5 (interquartile range = 4139.3-26,100.0). Health-care professionals contributed 48% of the content. Despite higher engagement metrics for health-care professional videos, the overall quality, as indicated by DISCERN and Total Knee Replacement Exercises Education scores, remained poor. No videos achieved an “excellent” rating, with the majority categorized as “poor.”
Conclusions
This study underscores TikTok’s substantial role in total knee arthroplasty rehabilitation information dissemination but reveals a critical deficit in content quality and reliability. Health-care professionals marginally outperformed general users but displayed overall inadequacy. The study emphasizes the necessity for improving the quality of health-related content on emerging social media platforms, especially within the realm of orthopaedic surgery.
{"title":"Evaluating the Quality and Reliability of Total Knee Arthroplasty Rehabilitation Exercises on the Social Media Platform TikTok","authors":"Sarah Welch BS , Kian Bagheri DO , Mikhail Bethell MS , Albert T. Anastasio MD , Troy Q. Tabarestani MD , Michael Bolognesi MD","doi":"10.1016/j.artd.2024.101486","DOIUrl":"10.1016/j.artd.2024.101486","url":null,"abstract":"<div><h3>Background</h3><div>The utilization of social media for health-related purposes has surged, especially during the COVID-19 pandemic. TikTok, a short-form video platform, has seen substantial growth, becoming a prominent medium for health information dissemination. However, the lack of regulation poses challenges in evaluating the validity of TikTok content.</div></div><div><h3>Methods</h3><div>This cross-sectional study assesses TikTok videos related to total knee arthroplasty rehabilitation exercises. Search terms identified 84 videos, with 64 meeting the inclusion criteria. Engagement metrics and quality scores were analyzed, utilizing the DISCERN tool and the Total Knee Replacement Exercises Education Score.</div></div><div><h3>Results</h3><div>The analyzed videos accumulated nearly 6 million views, with a median of 10,293.5 (interquartile range = 4139.3-26,100.0). Health-care professionals contributed 48% of the content. Despite higher engagement metrics for health-care professional videos, the overall quality, as indicated by DISCERN and Total Knee Replacement Exercises Education scores, remained poor. No videos achieved an “excellent” rating, with the majority categorized as “poor.”</div></div><div><h3>Conclusions</h3><div>This study underscores TikTok’s substantial role in total knee arthroplasty rehabilitation information dissemination but reveals a critical deficit in content quality and reliability. Health-care professionals marginally outperformed general users but displayed overall inadequacy. The study emphasizes the necessity for improving the quality of health-related content on emerging social media platforms, especially within the realm of orthopaedic surgery.</div></div><div><h3>Level of Evidence</h3><div>Level III, Cross-sectional study.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101486"},"PeriodicalIF":1.5,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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