Arthroplasty Today最新文献

{"title":"Time to Achieve a Minimal Clinically Important Difference After Total Hip Arthroplasty: A Retrospective Cohort Comparison of Robotic-Assisted, Navigation-Assisted, and Conventional Techniques","authors":"Kareem Omran MD, MPhil (Cantab) ,&nbsp;Colleen Wixted MD, MBA ,&nbsp;Daniel Waren MSPH, CCRP ,&nbsp;Joshua C. Rozell MD ,&nbsp;Ran Schwarzkopf MD, MSc","doi":"10.1016/j.artd.2025.101902","DOIUrl":"10.1016/j.artd.2025.101902","url":null,"abstract":"<div><h3>Background</h3><div>Technological advancements in total hip arthroplasty (THA), including robotic-assisted (RA-THA) and navigation-assisted (NA-THA) techniques, aim to improve outcomes. However, impact on recovery timing remains unclear. This study examined whether these technologies reduce the time to reach the minimal clinically important difference (MCID) on the Hip Disability and Osteoarthritis Outcome Score for Joint Replacement compared with conventional THA.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed osteoarthritic THA patients (01/2020-04/2023) who completed preoperative and postoperative Hip Disability and Osteoarthritis Outcome Score for Joint Replacement questionnaires. The exclusion criteria included bilateral procedures or revision within 1 year. MCID was defined using anchor-based (23 points) and distribution-based thresholds (7.6 points). Multivariable interval-censored accelerated failure time models assessed time to MCID.</div></div><div><h3>Results</h3><div>Among the 1395 patients, 181 (12.9%) underwent RA-THA, 754 (54.1%) underwent NA-THA, and 460 (33.0%) underwent conventional THA. Anchor-based MCID rates were 65.2%, 63.4%, and 66.5%, respectively (<em>P</em> &gt; .05), with median times of 38.9, 48.4, and 45.1 days. Neither RA-THA (time ratio [TR] = 0.86, 95% confidence interval [CI]: 0.63-1.18, <em>P</em> = .347) nor NA-THA (TR = 1.07, 95% CI: 0.87-1.32, <em>P</em> = .502) significantly affected time to MCID vs conventional distribution-based thresholds yielded higher MCID rates (93.9%, 88.9%, 89.8%; <em>P</em> &gt; .05) with median times of 8.6, 11.4, and 12.9 days, respectively. RA-THA reached MCID 33.5% faster than conventional THA (TR = 0.66, 95% 26 CI: 0.52-0.86, <em>P</em> = .002) and 24.3% faster than NA-THA (TR = 0.76, 95% CI: 0.60-0.95, <em>P</em> = .019), while NA-THA showed no significant difference vs conventional THA (TR = 0.88, 95% CI: 0.74-1.04, <em>P</em> = .140).</div></div><div><h3>Conclusions</h3><div>Anchor-based MCID demonstrated comparable recovery times across RA, NA, and conventional THA, suggesting no patient-perceived advantage with technology. Distribution-based thresholds indicated RA-THA achieved faster statistically significant improvement, though the relevance remains uncertain.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101902"},"PeriodicalIF":2.1,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Research Productivity Trends Among Orthopaedic Adult Reconstruction Fellowship Applicants: A Bibliometric Study","authors":"Emily Tufford BS ,&nbsp;Andrew H. Kim BS ,&nbsp;Peter F. Monahan BS ,&nbsp;Peter Tortora BS ,&nbsp;Luke B. Elias BA ,&nbsp;Andrew B. Harris MD ,&nbsp;Gregory J. Kirchner MD, MPH ,&nbsp;Mark W. Mason MD","doi":"10.1016/j.artd.2025.101903","DOIUrl":"10.1016/j.artd.2025.101903","url":null,"abstract":"<div><h3>Background</h3><div>The research benchmarks necessary for a successful adult reconstruction fellowship match remain unclear. This study aimed to characterize and identify trends in the academic profiles of adult reconstruction fellows in the United States.</div></div><div><h3>Methods</h3><div>The American Association of Hip and Knee Surgeons fellowship directory was used to identify U.S. adult reconstruction fellowships programs that listed fellows graduating from 2019 to 2023. For each fellow, total number of publications, authorship position, number of publications with an adult reconstruction focus, and number of citations were collected using Scopus. Only publications accepted or published before the fellow’s match year were compiled. Research productivity was compared across medical degree, sex, fellowship year, and residency program geographic region.</div></div><div><h3>Results</h3><div>A total of 247 fellows from 46 programs were identified. Fellows published an average of 5.5 ± 9.7 publications during residency, with 66.6 ± 190.4 citations. There was no significant change in research productivity from 2019 to 2023. Average number of publications per fellow was significantly greater for fellows with an MD degree compared with a DO degree (5.8 ± 10.0 vs 2.1 ± 4.2; <em>P</em> &lt; .05). Fellows who completed residency in the northeast had the highest average number of publications per fellow (9.9 ± 16.3) and average number of first author publications per fellow (2.6 ± 4.0) among all regions.</div></div><div><h3>Conclusions</h3><div>There was no change in research output among adult reconstruction fellows graduating from 2019 to 2023, suggesting that research may not be driving the increased competitiveness of adult reconstruction fellowships.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101903"},"PeriodicalIF":2.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airplane Test: An Intraoperative Assessment for Flexion Contracture in Total Knee Arthroplasty","authors":"Hamidreza Yazdi MD ,&nbsp;Mahmoud Jabalameli MD ,&nbsp;Seyed Arman Moein MD ,&nbsp;Seyyed Hamidreza Ayatizadeh MD ,&nbsp;Mohammad Amin Ahmadi MD ,&nbsp;Amir Mohsen Khorrami MD","doi":"10.1016/j.artd.2025.101901","DOIUrl":"10.1016/j.artd.2025.101901","url":null,"abstract":"<div><h3>Background</h3><div>Total knee arthroplasty (TKA) effectively relieves pain and restores function in patients with degenerative knee diseases. Complications like postoperative flexion contracture (FC) can impair functional outcomes. Assessing FC intraoperatively remains challenging due to the limitations imposed by surgical drapes. The \"Airplane Test\" offers a novel intraoperative assessment method for FC, addressing the limitations of traditional evaluation techniques. This study evaluates its utility in FC correction and predicting postoperative resolution.</div></div><div><h3>Methods</h3><div>A prospective cohort study evaluated 126 knees in 122 patients undergoing primary TKA. Our data included demographics, comorbidities, and clinical findings such as FC severity. Intraoperative FC assessments using the Airplane Test guided surgical adjustments, including additional femoral cuts or posterior capsular release. Statistical analyses compared outcomes between groups with and without initial FC.</div></div><div><h3>Results</h3><div>Demographics revealed a predominantly female cohort (88.52%) with a median age of 68 years. Preoperative FC averaged 8.5°, with a higher prevalence of severe FC (&gt;15°) in males. In a comparison between patients with or without preoperative FC, despite significant difference in early postoperative FC, by 6 months, both groups achieved a comparable FC resolution (≤5°) and ROM. With negative Airplane Test, more than 99% of patients with or without preoperative FC experienced spontaneous resolution (≤5°) of postoperative FC after 6 months.</div></div><div><h3>Conclusions</h3><div>The Airplane Test is a simple intraoperative tool for assessing and addressing FC during TKA. Patients with negative Airplane Test results achieved near-complete FC resolution (≤5°), supporting its role in intraoperative decision-making. Ethical constraints precluded a control group with uncorrected FC.</div></div><div><h3>Level of Evidence</h3><div>II.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101901"},"PeriodicalIF":2.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Collateral Ligament Repair With Internal Suture Brace Augmentation in Total Knee Arthroplasty","authors":"Sergio F. Guarin Perez MD ,&nbsp;Diego Alarcon Perico MD ,&nbsp;Katherine E. Mallet MD ,&nbsp;Rafael J. Sierra MD ,&nbsp;Robert A. Cates DO","doi":"10.1016/j.artd.2025.101836","DOIUrl":"10.1016/j.artd.2025.101836","url":null,"abstract":"<div><div>Medial collateral ligament (MCL) insufficiency during or after total knee arthroplasty (TKA) is a challenging scenario that often necessitates constrained implants or allograft reconstruction. This series describes 3 patients who underwent MCL repair with internal suture brace augmentation (ISBA). Two patients (ages 54 and 51) had chronic valgus instability after primary TKA and were treated with revision surgery using a more constrained implant or liner plus ISBA. A third patient (age 77) sustained an intraoperative MCL disruption during primary TKA and was managed acutely with ISBA. At 12–34.5 months of follow-up, all patients achieved full motion and medial stability. ISBA provided soft-tissue reinforcement and may represent a useful adjunct for medial instability, though its long-term effectiveness remains uncertain.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101836"},"PeriodicalIF":2.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Quality of YouTube Videos Related to Perioperative Nutrition for Patients Undergoing Total Joint Arthroplasty","authors":"Jillian H. Neuner BA ,&nbsp;Meagan K. Mitchell BS ,&nbsp;Lindsay Orbeta MS, RD ,&nbsp;Mary K. Mulcahey MD ,&nbsp;Stephanie E. Wong MD","doi":"10.1016/j.artd.2025.101891","DOIUrl":"10.1016/j.artd.2025.101891","url":null,"abstract":"<div><h3>Background</h3><div>Optimal perioperative nutrition affects outcomes in total joint arthroplasty (TJA), with malnutrition linked to increased complications. While YouTube is a popular platform for patient education, the quality of videos on perioperative nutrition is unknown. This study evaluated the quality and educational value of videos using established and TJA-specific scoring systems.</div></div><div><h3>Methods</h3><div>A systematic YouTube search with 11 arthroplasty and nutrition-related keywords was performed, excluding sponsored and non-English content. Two reviewers recorded view count, duration, upload age, health-system affiliation, and presenter credentials, then graded quality with <em>Journal of the American Medical Association</em> criteria, Global Quality Score, modified DISCERN, and a novel Joint Replacement Nutrition Score (JRNS). Interrater reliability was evaluated using intraclass correlation coefficients.</div></div><div><h3>Results</h3><div>Of 98 videos identified, 43 met inclusion criteria. Mean view count was 34,751 (range, 2-470,475). Mean duration was 11.2 minutes (range, 0.5-51.4). Health system affiliation was present in 41.9% (18/43), and 32.6% (14/43) were authored by physicians. Quality scores were: <em>Journal of the American Medical Association</em> 2.77 (range, 1-4), Global Quality Score 3.07 (range, 1-5), modified DISCERN 2.83 (range, 1-4), and JRNS 4.64 (range, 0-11), with high interrater reliability (intraclass correlation coefficient range, 0.717-0.922). Quality did not differ by health system affiliation nor presenter credentials.</div></div><div><h3>Conclusions</h3><div>YouTube videos on TJA perioperative nutrition were generally low to moderate quality, omitting key topics like individualized nutrition, increased caloric needs, and evidence-based supplementation. The novel JRNS demonstrated interrater reliability and highlighted content gaps across available videos. Nonphysician professionals produced some of the most informative videos. The lack of correlation between view count and quality emphasizes the need for higher-quality content to reach patients. Interdisciplinary collaboration is needed to develop comprehensive educational resources on perioperative nutrition for TJA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101891"},"PeriodicalIF":2.1,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Patellofemoral Outcomes in Medially Stabilized Total Knee Arthroplasty: The Role of Implant Design and Rotational Strategy in Kinematic Alignment","authors":"Chia-Hao Hsu MD","doi":"10.1016/j.artd.2025.101895","DOIUrl":"10.1016/j.artd.2025.101895","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101895"},"PeriodicalIF":2.1,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor Regarding “Utility of Frailty Index in Predicting Discharge Disposition and Prolonged Length of Stay Following Enhanced Recovery After Surgery Protocol Total Hip and Knee Arthroplasty”","authors":"Parth Aphale PhD,&nbsp;Himanshu Shekhar BHMS,&nbsp;Shashank Dokania BHMS","doi":"10.1016/j.artd.2025.101893","DOIUrl":"10.1016/j.artd.2025.101893","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101893"},"PeriodicalIF":2.1,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Anatomic Joint-Line Obliquity Prostheses on Coronal Plane Alignment of the Knee Alignment in a Chinese Population","authors":"Poon Jerome Chi Wang MBBS, HKU,&nbsp;Qunn-jid Lee MB-ChB, CUHK,&nbsp;Kenneth Wing-kin Law MB-ChB, CUHK,&nbsp;Daniel Wai-yip Wong MBBS, HKU,&nbsp;Cho Pong Lo MB-ChB, CUHK","doi":"10.1016/j.artd.2025.101888","DOIUrl":"10.1016/j.artd.2025.101888","url":null,"abstract":"<div><h3>Background</h3><div>The Coronal Plane Alignment of the Knee (CPAK) classification describes knee phenotypes based on limb alignment and joint-line obliquity (JLO). This study evaluates CPAK distribution in the Hong Kong population and assesses how prosthesis design affects CPAK reproducibility and clinical outcomes.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who underwent navigated total knee arthroplasty (TKA) with adjusted mechanical alignment in a single institution in 2021. First, we analyzed the epidemiology of CPAK phenotypes in our population. Second, patients were divided into 2 propensity score-matched groups based on implant design: Journey II BCS TKA (JLO prothesis) vs Persona PS TKA (joint line neutral prothesis). Radiological outcomes (mechanical hip–knee–ankle angle, lateral distal femoral angle, medial proximal tibial angle) and clinical outcomes (range of motion, Knee Society Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index score, Forgotten Joint Score) assessed preoperatively and at 6 and 12 months postoperatively.</div></div><div><h3>Results</h3><div>Our CPAK distribution was comparable to that of other East Asian populations. The Journey II BCS TKA more effectively restored JLO and CPAK phenotypes compared to the Persona PS TKA. However, there was no statistically significant clinical correlation between the restoration of JLO, arithmetic HKA, and CPAK.</div></div><div><h3>Conclusions</h3><div>Although radiological restoration improves with JLO prostheses, short-term clinical outcomes remain unaffected.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101888"},"PeriodicalIF":2.1,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral Nerve Palsy After Anterior Total Hip Arthroplasty: A Systematic Review","authors":"Mallery Zeiman BS,&nbsp;Athena Makrides,&nbsp;Jason Lee DO,&nbsp;Richard S. Yoon MD","doi":"10.1016/j.artd.2025.101889","DOIUrl":"10.1016/j.artd.2025.101889","url":null,"abstract":"<div><h3>Background</h3><div>Femoral nerve palsy (FNP) is a rare but debilitating complication of total hip arthroplasty (THA). The direct anterior approach (DAA) has been gaining popularity in recent years. Concerns regarding the risk of FNP after DAA THA have been rising due to the anatomical proximity of the femoral nerve. This systematic review evaluates the risk and incidence of FNP after DAA THA.</div></div><div><h3>Methods</h3><div>A search was conducted using PubMed, Cochrane, Ovid Medline, and Scopus databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Data were extracted pertaining to incidence, comparison to other approaches and recovery. A qualitative analysis was done.</div></div><div><h3>Results</h3><div>Our study included 9 studies—1 randomized control trial, 3 retrospective reviews, 4 case series, and 1 case report. The total sample size of DAA THA patients was 16,258 with an incidence of 0.36% (95% confidence interval (CI), 0.28-0.47%). The 3 studies that compared DAA to other approaches reported a higher incidence of FNP with the DAA. Of the studies that included recovery, most cases of FNP demonstrated full motor recovery in 3-15 months.</div></div><div><h3>Conclusions</h3><div>FNP is a rare complication of THA that occurs more frequently in the DAA. Retractor placement, patient positioning, and patient related risk factors play a key role in increasing risk. Further high quality studies are needed to assess the risk and preventative measures.</div></div><div><h3>Level of Evidence</h3><div>V.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101889"},"PeriodicalIF":2.1,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Routine Use of Femoral Heads Sized 40 mm or Greater in Primary Total Hip Arthroplasty: A Review of Current Practice","authors":"Martin S. Davey MCh, MRCS, MD ,&nbsp;Peter K. Sculco MD","doi":"10.1016/j.artd.2025.101887","DOIUrl":"10.1016/j.artd.2025.101887","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"36 ","pages":"Article 101887"},"PeriodicalIF":2.1,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}