Arthroplasty Today最新文献_第7页

Patient Perspective on Robotic-Assisted Total Joint Arthroplasty 患者对机器人辅助全关节成形术的看法。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101598

Siddhartha Dandamudi BBA , Kyleen Jan MD , Madelyn Malvitz BS , Anne DeBenedetti MSc , Omar Behery MD, MPH , Brett R. Levine MD, MS

Background

Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear. This study aims to assess patients' expectations on robotic technology in TJA.

Methods

A 9-question survey assessing patient understanding and expectations of the use of robotics in TJA was distributed to preoperative and postoperative hip and knee patients of five surgeons at a high-volume academic center. Responses were descriptively analyzed.

Results

A total of 498 responses were collected. Of all respondents, 69.1% are aware of robotic usage in TJA, 68.5% are interested but unsure of the benefits, and only 19.5% feel it is superior to manual surgery. Most patients did not consider robotic TJA as minimally invasive surgery, with 61.7% stating they are not the same. In addition, 52.3% were not comfortable with extra or longer incisions for robotic procedures. Regarding surgeon choice, 94.9% did not consider if the surgeon is able to perform robotic TJA, 74.4% wanted their surgeon proficient in manual TJA, and 72.4% felt that surgeons who use robotic technology are not more capable than manual surgeons.

Conclusions

Awareness and curiosity of robotic-assisted TJA exists; however, most patients did not appear to acknowledge superiority or benefits over manual surgery. Furthermore, patients appear to prefer surgeon proficiency in manual techniques, which may influence training programs in the future. Surgeons should weigh patient goals, expectations, outcomes, and costs when choosing to perform robotic TJA.

背景：机器人辅助全关节置换术（TJA）近年来越来越受欢迎。尽管患者和外科医生的看法不一，但与手工TJA相比，关于疗效和成本效益的证据相互矛盾。患者对机器人辅助TJA的看法尚不清楚。本研究旨在评估患者对机器人技术在TJA中的期望。方法：对某大容量学术中心的5位外科医生的髋关节和膝关节术前和术后患者进行9个问题的调查，评估患者对机器人技术在TJA中使用的理解和期望。对反馈进行描述性分析。结果：共收集问卷498份。在所有受访者中，69.1%的人知道机器人在TJA中的使用，68.5%的人感兴趣但不确定好处，只有19.5%的人认为它优于人工手术。大多数患者不认为机器人TJA是微创手术，61.7%的患者表示他们不一样。此外，52.3%的人对机器人手术的额外或更长的切口感到不舒服。在选择外科医生时，94.9%的人不考虑外科医生是否会进行机器人TJA， 74.4%的人希望他们的外科医生熟练进行手动TJA， 72.4%的人认为使用机器人技术的外科医生并不比手动外科医生更有能力。结论：存在机器人辅助TJA的意识和好奇心；然而，大多数患者似乎并不承认人工手术的优越性或益处。此外，患者似乎更喜欢外科医生熟练掌握手工技术，这可能会影响未来的培训计划。在选择机器人TJA时，外科医生应该权衡患者的目标、期望、结果和成本。

{"title":"Patient Perspective on Robotic-Assisted Total Joint Arthroplasty","authors":"Siddhartha Dandamudi BBA , Kyleen Jan MD , Madelyn Malvitz BS , Anne DeBenedetti MSc , Omar Behery MD, MPH , Brett R. Levine MD, MS","doi":"10.1016/j.artd.2024.101598","DOIUrl":"10.1016/j.artd.2024.101598","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted total joint arthroplasty (TJA) has gained popularity in recent years. Despite mixed patient and surgeon perceptions, conflicting evidence regarding efficacy and cost-effectiveness in comparison to manual TJA exists. Patients' beliefs surrounding robotic-assisted TJA remain unclear. This study aims to assess patients' expectations on robotic technology in TJA.</div></div><div><h3>Methods</h3><div>A 9-question survey assessing patient understanding and expectations of the use of robotics in TJA was distributed to preoperative and postoperative hip and knee patients of five surgeons at a high-volume academic center. Responses were descriptively analyzed.</div></div><div><h3>Results</h3><div>A total of 498 responses were collected. Of all respondents, 69.1% are aware of robotic usage in TJA, 68.5% are interested but unsure of the benefits, and only 19.5% feel it is superior to manual surgery. Most patients did not consider robotic TJA as minimally invasive surgery, with 61.7% stating they are not the same. In addition, 52.3% were not comfortable with extra or longer incisions for robotic procedures. Regarding surgeon choice, 94.9% did not consider if the surgeon is able to perform robotic TJA, 74.4% wanted their surgeon proficient in manual TJA, and 72.4% felt that surgeons who use robotic technology are not more capable than manual surgeons.</div></div><div><h3>Conclusions</h3><div>Awareness and curiosity of robotic-assisted TJA exists; however, most patients did not appear to acknowledge superiority or benefits over manual surgery. Furthermore, patients appear to prefer surgeon proficiency in manual techniques, which may influence training programs in the future. Surgeons should weigh patient goals, expectations, outcomes, and costs when choosing to perform robotic TJA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101598"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984849","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}

引用次数: 0

Distal Femoral Replacement With a Metaphyseal Sleeve: Outcomes and Risk Factors for Subsidence

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101403

David Alexander George MBChB, BMedSc, FRCS (Tr & Orth), Christopher Lee Buckle MBBS, BSc, MSc (Oxon), FRCS (Tr & Orth), Abtin Alvand BSc (Hons), MBBS, DPhil (PhD), FRCS (Tr & Orth), William Jackson MBBS, BSc, FRCS (Tr & Orth), Adrian Taylor MBBS, FRCS (Orth), Ben Kendrick DPhil (PhD), FRCS (Tr & Orth)

In this study, we report on the outcomes of our experience using a metaphyseal sleeve with a distal femoral replacement (DFR) and review the risk factors for sleeve subsidence over a 3 year period.

引用次数: 0

Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis 无图像机械臂辅助全膝关节置换术的手术时间学习曲线：累积和分析。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101588

Cale A. Pagan MD , Theofilos Karasavvidis MD , Breana Siljander MD , Eytan M. Debbi MD, PhD , Charles A. DeCook MD , Jonathan Vigdorchik MD

Background

Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system.

Methods

The study analyzed the first 80 RA-TKA and the last 80 M-TKA cases performed by a single surgeon using the VELYS robotic system after transitioning from M-TKA. Cases were subdivided into groups of 20 and compared to M-TKA cases. A cumulative summation analysis identified the learning curve phases.

Results

Three phases were identified: Phase 1 (initial learning, cases 1-9), Phase 2 (increased competence, plateau from cases 10-52), and Phase 3 (post-learning, optimized performance from cases 53-80). Mean surgical time for RA-TKA was 42.4 ± 8.7 minutes, compared to 35.3 ± 7.0 minutes for M-TKA (P < .001). Early RA-TKA cases (1-20) had significantly longer times than late RA-TKA cases (61-80) and M-TKA cases (P < .05). Late RA-TKA times were comparable to M-TKA (P = .06).

Conclusions

RA-TKA is an enabling surgical tool that can be integrated efficiently into a surgical workflow with a rapid learning curve of 9 cases.

背景：与人工全膝关节置换术（M-TKA）相比，机械臂辅助全膝关节置换术（RA-TKA）旨在提高骨切除、植入物定位和关节对齐的准确性。然而，RA-TKA的学习曲线可能会破坏手术室效率，增加并发症并提高成本。本研究考察了使用单一机器人系统的RA-TKA的手术时间学习曲线。方法：对由M-TKA过渡到VELYS机器人系统的80例RA-TKA和80例M-TKA患者进行分析。病例被细分为20组，并与M-TKA病例进行比较。累积求和分析确定了学习曲线阶段。结果：确定了三个阶段：阶段1（初始学习，案例1-9），阶段2（能力提升，案例10-52的平台期），阶段3（学习后，案例53-80的绩效优化）。RA-TKA的平均手术时间为42.4±8.7分钟，M-TKA的平均手术时间为35.3±7.0分钟（P < 0.001）。早期RA-TKA病例（1 ~ 20例）比晚期RA-TKA病例（61 ~ 80例）和中期RA-TKA病例（P < 0.05）明显延长。晚期RA-TKA时间与M-TKA时间相当（P = .06）。结论：RA-TKA是一种有利的手术工具，可以有效地整合到手术流程中，具有9例的快速学习曲线。

{"title":"Operative Time Learning Curve for an Image-Free Robotic Arm Assisted Total Knee Arthroplasty: A Cumulative Sum Analysis","authors":"Cale A. Pagan MD , Theofilos Karasavvidis MD , Breana Siljander MD , Eytan M. Debbi MD, PhD , Charles A. DeCook MD , Jonathan Vigdorchik MD","doi":"10.1016/j.artd.2024.101588","DOIUrl":"10.1016/j.artd.2024.101588","url":null,"abstract":"<div><h3>Background</h3><div>Robotic arm assisted total knee arthroplasty (RA-TKA) aims to improve accuracy in bone resection, implant positioning, and joint alignment compared to manual TKA (M-TKA). However, the learning curve of RA-TKA can disrupt operating room efficiency, increase complications, and raise costs. This study examines the operative time learning curve of RA-TKA using a single robotic system.</div></div><div><h3>Methods</h3><div>The study analyzed the first 80 RA-TKA and the last 80 M-TKA cases performed by a single surgeon using the VELYS robotic system after transitioning from M-TKA. Cases were subdivided into groups of 20 and compared to M-TKA cases. A cumulative summation analysis identified the learning curve phases.</div></div><div><h3>Results</h3><div>Three phases were identified: Phase 1 (initial learning, cases 1-9), Phase 2 (increased competence, plateau from cases 10-52), and Phase 3 (post-learning, optimized performance from cases 53-80). Mean surgical time for RA-TKA was 42.4 ± 8.7 minutes, compared to 35.3 ± 7.0 minutes for M-TKA (<em>P</em> < .001). Early RA-TKA cases (1-20) had significantly longer times than late RA-TKA cases (61-80) and M-TKA cases (<em>P</em> < .05). Late RA-TKA times were comparable to M-TKA (<em>P</em> = .06).</div></div><div><h3>Conclusions</h3><div>RA-TKA is an enabling surgical tool that can be integrated efficiently into a surgical workflow with a rapid learning curve of 9 cases.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101588"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984743","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}

引用次数: 0

Postoperative Pain and Opiate Requirement is Increased Following Second-Side Surgery Among Patients Undergoing Staged Total Knee Arthroplasty 在分期全膝关节置换术的患者中，术后疼痛和阿片类药物需求增加。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101591

Vivek P. Chadayammuri MD, Shuvalaxmi D. Haselton MS, Elizabeth Diaz PA-C, Roger H. Emerson MD

Background

Primary total knee arthroplasty (TKA) continues to grow exponentially, with a significant subset of patients requiring staged bilateral procedures. The optimal interval between staged procedures and effective strategies to minimize postoperative pain to enhance rehabilitation and mobility remain poorly understood.

Methods

160 consecutive patients undergoing staged bilateral TKA between August 2017 and January-2021 was retrospectively reviewed. Patients with a history of chronic opioid dependency were excluded. Baseline demographics, primary outcome measures, including visual analog scale (VAS) pain scores, perioperative opioid utilization (MME/day), and surgical satisfaction were evaluated. All patients had a minimum follow-up of 1-year-postoperatively. All univariate and multivariate statistical analyses were performed with significance given by P < .05.

Results

The mean interval between staged TKA was 8-weeks (standard deviation, 4.9-weeks). Preoperative VAS pain scores were significantly higher for the initial TKA, confirming that the more symptomatic knee was addressed first. Despite this, VAS pain scores were significantly increased following second-side TKA at 6-months postoperatively (P = .001). Multivariate analysis identified weekly interval duration between staged procedures as the single-most predictive factor of increased pain following second-side TKA (β = −0.106; P < .01). Female patients were increasingly susceptible to elevated pain levels following second-side TKA (β = 0.372; P = .057).

Conclusions

Postoperative pain increases after second-side TKA in staged-bilateral procedures, despite the more symptomatic side being addressed first. Our study identified weekly interval between staged procedures as the single-most predictive factor of pain, and female patients being predisposed to heightened pain following second-side TKA; implicating nociceptive pathways require weeks to normalize, necessitating gender-specific pain management and extended intervals.

背景：原发性全膝关节置换术（TKA）持续呈指数增长，有相当一部分患者需要分阶段双侧手术。分阶段手术之间的最佳间隔和减少术后疼痛以增强康复和活动能力的有效策略仍然知之甚少。方法：回顾性分析2017年8月至2021年1月期间160例连续接受分阶段双侧TKA的患者。排除有慢性阿片类药物依赖史的患者。评估基线人口统计学、主要结局指标，包括视觉模拟量表（VAS）疼痛评分、围手术期阿片类药物使用（MME/day）和手术满意度。所有患者术后至少随访1年。所有单因素和多因素统计分析均以P < 0.05为显著性。结果：TKA分期的平均间隔时间为8周（标准差为4.9周）。术前VAS疼痛评分明显高于初始TKA，证实首先解决了更有症状的膝关节。尽管如此，术后6个月第二侧TKA后VAS疼痛评分显著升高（P = 0.001）。多变量分析发现，分期手术之间的每周间隔时间是第二侧TKA后疼痛增加的最单一预测因素(β = -0.106；P < 0.01)。女性患者在第二侧TKA后越来越容易出现疼痛水平升高(β = 0.372；P = .057)。结论：在分阶段双侧手术中，尽管首先解决了更有症状的一侧，但第二侧TKA术后疼痛增加。我们的研究确定分期手术之间的每周间隔时间是疼痛的最单一预测因素，女性患者易在第二侧TKA后加剧疼痛；暗示的伤害通路需要数周的时间才能正常化，需要针对性别的疼痛管理和延长的间隔。

{"title":"Postoperative Pain and Opiate Requirement is Increased Following Second-Side Surgery Among Patients Undergoing Staged Total Knee Arthroplasty","authors":"Vivek P. Chadayammuri MD, Shuvalaxmi D. Haselton MS, Elizabeth Diaz PA-C, Roger H. Emerson MD","doi":"10.1016/j.artd.2024.101591","DOIUrl":"10.1016/j.artd.2024.101591","url":null,"abstract":"<div><h3>Background</h3><div>Primary total knee arthroplasty (TKA) continues to grow exponentially, with a significant subset of patients requiring staged bilateral procedures. The optimal interval between staged procedures and effective strategies to minimize postoperative pain to enhance rehabilitation and mobility remain poorly understood.</div></div><div><h3>Methods</h3><div>160 consecutive patients undergoing staged bilateral TKA between August 2017 and January-2021 was retrospectively reviewed. Patients with a history of chronic opioid dependency were excluded. Baseline demographics, primary outcome measures, including visual analog scale (VAS) pain scores, perioperative opioid utilization (MME/day), and surgical satisfaction were evaluated. All patients had a minimum follow-up of 1-year-postoperatively. All univariate and multivariate statistical analyses were performed with significance given by <em>P</em> < .05.</div></div><div><h3>Results</h3><div>The mean interval between staged TKA was 8-weeks (standard deviation, 4.9-weeks). Preoperative VAS pain scores were significantly higher for the initial TKA, confirming that the more symptomatic knee was addressed first. Despite this, VAS pain scores were significantly increased following second-side TKA at 6-months postoperatively (<em>P</em> = .001). Multivariate analysis identified weekly interval duration between staged procedures as the single-most predictive factor of increased pain following second-side TKA (β = −0.106; <em>P</em> < .01). Female patients were increasingly susceptible to elevated pain levels following second-side TKA (β = 0.372; <em>P</em> = .057).</div></div><div><h3>Conclusions</h3><div>Postoperative pain increases after second-side TKA in staged-bilateral procedures, despite the more symptomatic side being addressed first. Our study identified weekly interval between staged procedures as the single-most predictive factor of pain, and female patients being predisposed to heightened pain following second-side TKA; implicating nociceptive pathways require weeks to normalize, necessitating gender-specific pain management and extended intervals.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101591"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972513","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}

引用次数: 0

What Is the Prevalence of Hip Abductor Pathology in Patients Undergoing Total Hip Arthroplasty? 全髋关节置换术患者髋关节内收肌病变的发病率是多少？

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101601

David A. Brethouwer DO , Matthew L. Brown MD , Julie C. McCauley MPH , William D. Bugbee MD , Eric Y. Chang MD , Alecio F. Lombardi MD , Brian J. Rebolledo MD

Background

Total hip arthroplasty (THA) is generally considered a successful operation for patients with advanced hip arthritis. Hip abductor pathology can lead to diminished outcomes. The prevalence of hip abductor pathology in patients undergoing THA is not well described.

Methods

Our institution’s arthroplasty registry was queried to identify patients undergoing THA who had preoperative magnetic resonance imaging (MRI) of the hip or pelvis. MRIs were reviewed for presence of abductor (gluteus medius or gluteus minimus) tendon injury. Dysfunction of the abductor musculotendinous units was assessed by grading fatty infiltration of the muscle bellies using the Goutallier/Fuchs classification.

Results

A total of 1090 primary THAs were performed during the study period, and 118 (10.8%) patients had a preoperative MRI of the hip or pelvis ≤12 months prior to surgery. Among the 118 patients who had an MRI, abductor tendon tears were diagnosed in 33 patients (28.0%), and tendinosis was noted in 106 patients (89.8%).

Conclusions

There is a high prevalence of hip abductor pathology in patients presenting for THA. Clinicians should evaluate patients for signs of abductor tendon pathology when presenting for consideration of THA. Careful examination and MRI may be helpful to further evaluate the status of the gluteus minimus and gluteus medius musculotendinous units.

背景：全髋关节置换术（THA）通常被认为是晚期髋关节关节炎患者的成功手术。髋关节外展肌病理可导致预后降低。髋关节外展肌病理在THA患者中的患病率尚未得到很好的描述。方法：查询本机构的关节置换术登记，以确定术前有髋关节或骨盆磁共振成像（MRI）的THA患者。mri检查是否有外展肌（臀中肌或臀小肌）肌腱损伤。外展肌腱单位的功能障碍是通过使用Goutallier/Fuchs分类对肌肉腹部脂肪浸润进行分级来评估的。结果：在研究期间共进行了1090例原发性tha手术，118例（10.8%）患者在手术前≤12个月进行了髋关节或骨盆MRI检查。在118例接受MRI检查的患者中，33例（28.0%）被诊断为外展肌腱撕裂，106例（89.8%）被诊断为肌腱萎缩。结论：髋关节外展肌病变在THA患者中有很高的患病率。临床医生在考虑THA时应评估患者的外展肌腱病理征象。仔细的检查和MRI可能有助于进一步评估臀小肌和臀中肌腱单位的状态。

{"title":"What Is the Prevalence of Hip Abductor Pathology in Patients Undergoing Total Hip Arthroplasty?","authors":"David A. Brethouwer DO , Matthew L. Brown MD , Julie C. McCauley MPH , William D. Bugbee MD , Eric Y. Chang MD , Alecio F. Lombardi MD , Brian J. Rebolledo MD","doi":"10.1016/j.artd.2024.101601","DOIUrl":"10.1016/j.artd.2024.101601","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is generally considered a successful operation for patients with advanced hip arthritis. Hip abductor pathology can lead to diminished outcomes. The prevalence of hip abductor pathology in patients undergoing THA is not well described.</div></div><div><h3>Methods</h3><div>Our institution’s arthroplasty registry was queried to identify patients undergoing THA who had preoperative magnetic resonance imaging (MRI) of the hip or pelvis. MRIs were reviewed for presence of abductor (gluteus medius or gluteus minimus) tendon injury. Dysfunction of the abductor musculotendinous units was assessed by grading fatty infiltration of the muscle bellies using the Goutallier/Fuchs classification.</div></div><div><h3>Results</h3><div>A total of 1090 primary THAs were performed during the study period, and 118 (10.8%) patients had a preoperative MRI of the hip or pelvis ≤12 months prior to surgery. Among the 118 patients who had an MRI, abductor tendon tears were diagnosed in 33 patients (28.0%), and tendinosis was noted in 106 patients (89.8%).</div></div><div><h3>Conclusions</h3><div>There is a high prevalence of hip abductor pathology in patients presenting for THA. Clinicians should evaluate patients for signs of abductor tendon pathology when presenting for consideration of THA. Careful examination and MRI may be helpful to further evaluate the status of the gluteus minimus and gluteus medius musculotendinous units.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101601"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984783","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}

引用次数: 0

Does a Provider Contact Wristband Reduce Emergency Department Visit Rates Following Hip or Knee Arthroplasty? 医生联系腕带是否能降低髋关节或膝关节置换术后急诊室的就诊率？

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101599

David C. Hein MD , Ajay K. Srivastava MD , Seann E. Willson MD , Paul M. Telehowski MD , Patrick J. Atkinson PhD , Theresa S. Atkinson PhD

Background

Reducing unnecessary emergency department (ED) visits following joint arthroplasty is an important goal. Literature suggests 30-day visit rates range between 4% and 15%, with only 20%-25% of these admitted for care. Low admissions suggest an opportunity to reduce unnecessary postarthroplasty ED visits. This study examined whether a wristband would encourage patients to call the care team with concerns prior to going to the ED.

Methods

A wristband displaying a contact phone number was placed on patients at discharge. ED visit rates (30 and 90 days) and readmissions (90 days) were tabulated for 2 years prior to and up to 3 years after the implementation of the wristband program. Residents who responded to calls and call logs were also reviewed.

Results

At 2 years after implementation, a total of 1023 joint replacements produced 273 calls or 1 call per 3.75 patients. Nearly half (48.1%) of the calls were received during weekday work hours when the patients had been directed to call the office. While ED visits declined after the implementation of the wristband at both 2 and 3 years, these reductions were not statistically significant (30 days: 5.1% before, 4.1% after; 90 days: 8.1% before, 7.1% after). There was a significant reduction in 90-day readmissions (6.4% before, 4.0% after).

Conclusions

Patients utilized the wristband number, but this did not significantly reduce the number of ED visits within 3 years. Future studies should track ED visits and identify decision-making factors behind ED use in order to find ways to improve the intervention.

背景：减少关节置换术后不必要的急诊科（ED）就诊是一个重要目标。文献显示，30天的住院率在4%到15%之间，其中只有20%到25%的人接受了治疗。低入院率表明有机会减少不必要的瓣后成形术急诊。这项研究调查了腕带是否会鼓励患者在去急诊室之前打电话给护理小组。方法：在出院时将显示联系电话号码的腕带放在患者身上。ED就诊率（30天和90天）和再入院率（90天）在腕带计划实施前2年和实施后3年被制成表格。对接听电话的居民和通话记录也进行了审查。结果：在实施后2年，总共1023例关节置换术产生273个电话或每3.75例患者1个电话。近一半（48.1%）的电话是在平日工作时间接到的，当时病人被指示打电话给办公室。虽然在佩戴腕带后的第2年和第3年，急诊科就诊人数都有所下降，但这些减少没有统计学意义(30天：佩戴腕带前5.1%，佩戴腕带后4.1%；90天：前8.1%，后7.1%)。90天再入院率显著降低（入院前6.4%，入院后4.0%）。结论：患者使用腕带数量，但这并没有显著减少3年内急诊科就诊次数。未来的研究应该跟踪ED就诊情况，确定ED使用背后的决策因素，以便找到改善干预措施的方法。

{"title":"Does a Provider Contact Wristband Reduce Emergency Department Visit Rates Following Hip or Knee Arthroplasty?","authors":"David C. Hein MD , Ajay K. Srivastava MD , Seann E. Willson MD , Paul M. Telehowski MD , Patrick J. Atkinson PhD , Theresa S. Atkinson PhD","doi":"10.1016/j.artd.2024.101599","DOIUrl":"10.1016/j.artd.2024.101599","url":null,"abstract":"<div><h3>Background</h3><div>Reducing unnecessary emergency department (ED) visits following joint arthroplasty is an important goal. Literature suggests 30-day visit rates range between 4% and 15%, with only 20%-25% of these admitted for care. Low admissions suggest an opportunity to reduce unnecessary postarthroplasty ED visits. This study examined whether a wristband would encourage patients to call the care team with concerns prior to going to the ED.</div></div><div><h3>Methods</h3><div>A wristband displaying a contact phone number was placed on patients at discharge. ED visit rates (30 and 90 days) and readmissions (90 days) were tabulated for 2 years prior to and up to 3 years after the implementation of the wristband program. Residents who responded to calls and call logs were also reviewed.</div></div><div><h3>Results</h3><div>At 2 years after implementation, a total of 1023 joint replacements produced 273 calls or 1 call per 3.75 patients. Nearly half (48.1%) of the calls were received during weekday work hours when the patients had been directed to call the office. While ED visits declined after the implementation of the wristband at both 2 and 3 years, these reductions were not statistically significant (30 days: 5.1% before, 4.1% after; 90 days: 8.1% before, 7.1% after). There was a significant reduction in 90-day readmissions (6.4% before, 4.0% after).</div></div><div><h3>Conclusions</h3><div>Patients utilized the wristband number, but this did not significantly reduce the number of ED visits within 3 years. Future studies should track ED visits and identify decision-making factors behind ED use in order to find ways to improve the intervention.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101599"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013242","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}

引用次数: 0

Optimal Bone Preparation for Triple-Tapered Stems: Does the Sagittal Taper Affect Optimal Femoral Sizing?

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101605

Jeff Shi MD , Kevin Salomon MD , Victor Shen BS , Andrew Moore MD , John T. Wilson MD , Brian Palumbo MD

Background

Conventional single-tapered, total hip arthroplasty stems achieve fixation namely through coronal, metaphyseal fit. Triple taper stems have a sagittal taper to optimize fixation in the antero-posterior (AP) plane as well; however, limited guidance exists on appropriate bone preparation. Often, similar preparation techniques are used despite geometric differences which may lead to underpreparation. We’ve defined a novel technique in which a small portion of posterior femoral neck and cancellous bone is removed to permit preparation collinear to the diaphyseal sagittal femoral axis. We hypothesize this will optimize stem fit and stability compared to conventional techniques.

Methods

This is a retrospective review of 38 cementless primary total hip arthroplasty cases performed by a single surgeon. In each case, broach preparation was initially performed through the center of the femoral neck as although it was a single-tapered stem. Once tactile sensation of adequate fit was achieved, fluoroscopic images were taken to document AP and mediolateral fit, and stem size was recorded. Then that broach was removed, and a standardized one-third of the posterior femoral neck and posterior cancellous bone was removed, permitting broaches to prepare the femur collinear to the femoral diaphyseal sagittal axis— triple-tapered preparation (TTP). Outcomes included change in stem size from initial broach trial to final stem selection and radiographic stem fill on AP and lateral views.

Results

Median single-tapered preparation broach size was 8 (range, 5-12) and final stem size after TTP was 11 (range, 6-13). The TTP overall mean percent metaphyseal fill was 74 ± 6% in the AP view and 71 ± 5% in the lateral view, both significantly higher than single-tapered preparation which was 67 ± 7% and 65 ± 7%, respectively (P < .001). No fractures or loosening occurred in this series.

Conclusions

Preparation of triple-tapered stems collinear to the diaphyseal sagittal femoral axis improves stem size, fit, and fill.

{"title":"Optimal Bone Preparation for Triple-Tapered Stems: Does the Sagittal Taper Affect Optimal Femoral Sizing?","authors":"Jeff Shi MD , Kevin Salomon MD , Victor Shen BS , Andrew Moore MD , John T. Wilson MD , Brian Palumbo MD","doi":"10.1016/j.artd.2024.101605","DOIUrl":"10.1016/j.artd.2024.101605","url":null,"abstract":"<div><h3>Background</h3><div>Conventional single-tapered, total hip arthroplasty stems achieve fixation namely through coronal, metaphyseal fit. Triple taper stems have a sagittal taper to optimize fixation in the antero-posterior (AP) plane as well; however, limited guidance exists on appropriate bone preparation. Often, similar preparation techniques are used despite geometric differences which may lead to underpreparation. We’ve defined a novel technique in which a small portion of posterior femoral neck and cancellous bone is removed to permit preparation collinear to the diaphyseal sagittal femoral axis. We hypothesize this will optimize stem fit and stability compared to conventional techniques.</div></div><div><h3>Methods</h3><div>This is a retrospective review of 38 cementless primary total hip arthroplasty cases performed by a single surgeon. In each case, broach preparation was initially performed through the center of the femoral neck as although it was a single-tapered stem. Once tactile sensation of adequate fit was achieved, fluoroscopic images were taken to document AP and mediolateral fit, and stem size was recorded. Then that broach was removed, and a standardized one-third of the posterior femoral neck and posterior cancellous bone was removed, permitting broaches to prepare the femur collinear to the femoral diaphyseal sagittal axis— triple-tapered preparation (TTP). Outcomes included change in stem size from initial broach trial to final stem selection and radiographic stem fill on AP and lateral views.</div></div><div><h3>Results</h3><div>Median single-tapered preparation broach size was 8 (range, 5-12) and final stem size after TTP was 11 (range, 6-13). The TTP overall mean percent metaphyseal fill was 74 ± 6% in the AP view and 71 ± 5% in the lateral view, both significantly higher than single-tapered preparation which was 67 ± 7% and 65 ± 7%, respectively (<em>P</em> < .001). No fractures or loosening occurred in this series.</div></div><div><h3>Conclusions</h3><div>Preparation of triple-tapered stems collinear to the diaphyseal sagittal femoral axis improves stem size, fit, and fill.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101605"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123846","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}

引用次数: 0

Peripheral Nerve Blocks Are Associated With Decreased Early Medical Complications, Dislocations, and Opioid Consumption Following Total Hip Arthroplasty 外周神经阻滞可减少全髋关节置换术后的早期医疗并发症、脱位和阿片类药物用量。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101587

Brian P. McCormick MD, Sean B. Sequeira MD, Mark D. Hasenauer MD, Robert P. McKinstry MD, Frank R. Ebert MD, Henry R. Boucher MD

Background

Peripheral nerve blocks (PNBs) may be utilized for postoperative pain control following total hip arthroplasty (THA). The purpose of this study was to evaluate the association between PNBs and postoperative complication rates, healthcare utilization, and opioid consumption following elective THA.

Methods

Opioid-naive patients who received PNBs on the same day as undergoing THA for degenerative etiologies were identified from a large national database and matched 1:5 to a control cohort using propensity scoring. Rates of medical complications, inpatient readmissions, and emergency department presentations occurring within 90 days of THA and surgery-related complications occurring within 1 year of THA were compared using odds ratios. Total cost and perioperative opioid consumption in morphine milligram equivalents (MMEs) per day were also evaluated and compared between groups.

Results

Propensity score matching resulted in 4748 PNB patients matched to 23,740 control patients. THA patients who received PNBs had lower incidences of deep vein thrombosis (odds ratio [OR] 0.67, P = .004), urinary tract infection (OR 0.76, P < .001), and dislocation (OR 0.51, P < .001). PNBs were also associated with decreased perioperative opioid consumption (38.6 MME/day vs 55.3 MME/day, P < .001). Regarding healthcare utilization, there were no differences between cohorts in rates of inpatient readmission, emergency department presentation, or total cost.

Conclusions

PNBs are associated with decreased risk of deep vein thrombosis, urinary tract infection, and dislocation and decreased perioperative opioid consumption following THA.

Level of evidence

III, Retrospective review.

背景：周围神经阻滞（PNBs）可用于全髋关节置换术（THA）术后疼痛控制。本研究的目的是评估选择性全髋关节置换术后pnb与术后并发症发生率、医疗保健利用和阿片类药物消耗之间的关系。方法：从一个大型国家数据库中确定在接受退行性病因THA的同一天接受pnb的阿片类药物新手患者，并使用倾向评分与对照队列进行1:5匹配。采用优势比比较THA术后90天内发生的医疗并发症、住院再入院率和急诊科就诊率以及THA术后1年内发生的手术相关并发症。还评估和比较各组之间每天吗啡毫克当量（MMEs）的总成本和围手术期阿片类药物消耗。结果：倾向评分匹配，4748例PNB患者与23740例对照患者匹配。接受pnb治疗的THA患者深静脉血栓形成（比值比[OR] 0.67, P = 0.004）、尿路感染（比值比[OR] 0.76, P < 0.001）、脱位（比值比[OR] 0.51, P < 0.001）发生率较低。pnb还与围手术期阿片类药物消耗减少相关（38.6 MME/天vs 55.3 MME/天，P < 0.001）。在医疗保健利用方面，各队列在住院再入院率、急诊科就诊率或总费用方面没有差异。结论：PNBs与THA术后深静脉血栓形成、尿路感染和脱位风险降低以及围手术期阿片类药物消耗减少有关。证据等级：III，回顾性评价。

{"title":"Peripheral Nerve Blocks Are Associated With Decreased Early Medical Complications, Dislocations, and Opioid Consumption Following Total Hip Arthroplasty","authors":"Brian P. McCormick MD, Sean B. Sequeira MD, Mark D. Hasenauer MD, Robert P. McKinstry MD, Frank R. Ebert MD, Henry R. Boucher MD","doi":"10.1016/j.artd.2024.101587","DOIUrl":"10.1016/j.artd.2024.101587","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral nerve blocks (PNBs) may be utilized for postoperative pain control following total hip arthroplasty (THA). The purpose of this study was to evaluate the association between PNBs and postoperative complication rates, healthcare utilization, and opioid consumption following elective THA.</div></div><div><h3>Methods</h3><div>Opioid-naive patients who received PNBs on the same day as undergoing THA for degenerative etiologies were identified from a large national database and matched 1:5 to a control cohort using propensity scoring. Rates of medical complications, inpatient readmissions, and emergency department presentations occurring within 90 days of THA and surgery-related complications occurring within 1 year of THA were compared using odds ratios. Total cost and perioperative opioid consumption in morphine milligram equivalents (MMEs) per day were also evaluated and compared between groups.</div></div><div><h3>Results</h3><div>Propensity score matching resulted in 4748 PNB patients matched to 23,740 control patients. THA patients who received PNBs had lower incidences of deep vein thrombosis (odds ratio [OR] 0.67, <em>P</em> = .004), urinary tract infection (OR 0.76, <em>P</em> < .001), and dislocation (OR 0.51, <em>P</em> < .001). PNBs were also associated with decreased perioperative opioid consumption (38.6 MME/day vs 55.3 MME/day, <em>P</em> < .001). Regarding healthcare utilization, there were no differences between cohorts in rates of inpatient readmission, emergency department presentation, or total cost.</div></div><div><h3>Conclusions</h3><div>PNBs are associated with decreased risk of deep vein thrombosis, urinary tract infection, and dislocation and decreased perioperative opioid consumption following THA.</div></div><div><h3>Level of evidence</h3><div>III, Retrospective review.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101587"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984833","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}

引用次数: 0

Single-Institution Experience With Nononcologic Total Femoral Replacement

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101607

Ryan Ouillette MD, Kevin Chen BA, Matthew Dipane BA, Alexander Christ MD, Edward McPherson MD, Alexandra Stavrakis MD

Background

Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcologic TFR in one of the largest single-center modern series.

Methods

A retrospective analysis was conducted on 23 nononcologic TFR procedures performed on 22 patients between 2012 and 2021. Primary outcomes included TFR revision rate and indication for revision, while secondary outcomes included overall reoperation rate, complications, patient ambulatory status, and assistive device requirements.

Results

The average age at time of TFR was 65.7 years, with periprosthetic fracture (65.2%) and periprosthetic joint infection (34.8%) as predominant indications. More than half of patients (52.2%) required TFR revision, primarily due to periprosthetic joint infection (75.0%). Despite a high complication profile, only 1 patient underwent limb amputation and there was only 1 mortality during the study period. Overall, 63.6% of patients were ambulating (assisted or unassisted) at final follow-up.

Conclusions

Nononcologic TFR remains a viable limb-salvage option for patients undergoing revision arthroplasty with extensive bone loss. Despite a notable revision rate and infection risk, the majority of patients maintain or regain ambulatory function, emphasizing the procedure’s role in preserving limb function. Clinicians should weigh potential complications when considering TFR, emphasizing patient counseling and risk mitigation strategies.

{"title":"Single-Institution Experience With Nononcologic Total Femoral Replacement","authors":"Ryan Ouillette MD, Kevin Chen BA, Matthew Dipane BA, Alexander Christ MD, Edward McPherson MD, Alexandra Stavrakis MD","doi":"10.1016/j.artd.2024.101607","DOIUrl":"10.1016/j.artd.2024.101607","url":null,"abstract":"<div><h3>Background</h3><div>Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcologic TFR in one of the largest single-center modern series.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 23 nononcologic TFR procedures performed on 22 patients between 2012 and 2021. Primary outcomes included TFR revision rate and indication for revision, while secondary outcomes included overall reoperation rate, complications, patient ambulatory status, and assistive device requirements.</div></div><div><h3>Results</h3><div>The average age at time of TFR was 65.7 years, with periprosthetic fracture (65.2%) and periprosthetic joint infection (34.8%) as predominant indications. More than half of patients (52.2%) required TFR revision, primarily due to periprosthetic joint infection (75.0%). Despite a high complication profile, only 1 patient underwent limb amputation and there was only 1 mortality during the study period. Overall, 63.6% of patients were ambulating (assisted or unassisted) at final follow-up.</div></div><div><h3>Conclusions</h3><div>Nononcologic TFR remains a viable limb-salvage option for patients undergoing revision arthroplasty with extensive bone loss. Despite a notable revision rate and infection risk, the majority of patients maintain or regain ambulatory function, emphasizing the procedure’s role in preserving limb function. Clinicians should weigh potential complications when considering TFR, emphasizing patient counseling and risk mitigation strategies.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101607"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029776","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}

引用次数: 0

Automated Web Tool Measurement of Total Hip Arthroplasty Acetabular Component Inclination and Anteversion Angles 全髋关节成形术髋臼组件倾角和反转角的自动网络工具测量。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101606

Christine Yoon BS , Anna Eligulashvili BS , Zeynep Seref-Ferlengez PhD , Barlas Goker MD , Eli Kamara MD , Edward Mardakhaev MD

Background

Periprosthetic hip dislocation after total hip arthroplasty is a devastating postoperative complication. It is often associated with suboptimal orientation of the acetabular component, characterized by the acetabular abduction and anteversion angles obtained from anteroposterior pelvic radiographs. We introduce a novel automated web tool to streamline the subjective and lengthy process of this manual measurement and compare it to manual human measurements.

Methods

One board-certified orthopaedic surgeon used the web tool to make automatic measurements of anteroposterior radiographs of 97 patients who underwent unilateral hip arthroplasty. Manual and web tool measurements included abduction angle and calculated anteversion angle by Liaw’s method. Differences between manual and web tool measurements were compared with a paired t-test and Bland-Altman analysis.

Results

There were no statistically significant differences between the average of manual measurements as compared to the web tool measurement in abduction angle (43.29 ± 7.05 vs 43.00 + 6.22, P = .85), anteversion angle (20.43 ± 7.62 vs 20.82 ± 7.37, P = .52), and ratio of the minor axis of the acetabular cup circumference in the AP radiograph to the total length of the acetabular head (0.42 ± 0.15 vs 0.44 ± 0.15, P = .18). The mean difference of average for abduction angle, anteversion angle, and ratio between the short axis of the transverse ellipse to the total length of the acetabular cup were −0.28, 0.39, and 0.02, respectively. Bland-Altman analysis for all 3 measurements displayed negligible systemic bias with random scattering.

Conclusions

Automated measurements obtained with a novel web tool are in strong agreement with the manually obtained ground truth measurements. The web tool helps to eliminate interobserver differences that arise with manual annotation. The web tool has the potential to streamline acetabular measurements with enhanced accuracy.

背景：全髋关节置换术后假体周围脱位是一种严重的术后并发症。它通常与髋臼组件的定向欠佳有关，而髋臼外展和前内翻角度是从骨盆前向X光片上获得的。我们引入了一种新颖的自动化网络工具，以简化这一主观且冗长的人工测量过程，并将其与人工测量进行比较：一名获得认证的骨科外科医生使用该网络工具对97名接受单侧髋关节置换术的患者的前胸X光片进行了自动测量。手动和网络工具的测量结果包括外展角度和用Liaw方法计算的内翻角度。通过配对 t 检验和 Bland-Altman 分析比较了手动测量和网络工具测量之间的差异：结果：在外展角（43.29 ± 7.05 vs 43.00 + 6.22，P = .85）、内翻角（20.43 ± 7.62 vs 20.82 ± 7.37，P = .52）和AP片中髋臼杯周小轴与髋臼头总长度之比（0.42 ± 0.15 vs 0.44 ± 0.15，P = .18）方面，人工测量与网络工具测量的平均值差异无统计学意义。外展角、内翻角和横向椭圆短轴与髋臼杯总长度之比的平均差分别为-0.28、0.39和0.02。对所有 3 项测量结果进行的 Bland-Altman 分析表明，随机散射的系统偏差可以忽略不计：结论：使用新型网络工具获得的自动测量结果与人工获得的地面实况测量结果非常一致。网络工具有助于消除人工标注时出现的观察者之间的差异。该网络工具具有简化髋臼测量、提高测量准确性的潜力。

{"title":"Automated Web Tool Measurement of Total Hip Arthroplasty Acetabular Component Inclination and Anteversion Angles","authors":"Christine Yoon BS , Anna Eligulashvili BS , Zeynep Seref-Ferlengez PhD , Barlas Goker MD , Eli Kamara MD , Edward Mardakhaev MD","doi":"10.1016/j.artd.2024.101606","DOIUrl":"10.1016/j.artd.2024.101606","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic hip dislocation after total hip arthroplasty is a devastating postoperative complication. It is often associated with suboptimal orientation of the acetabular component, characterized by the acetabular abduction and anteversion angles obtained from anteroposterior pelvic radiographs. We introduce a novel automated web tool to streamline the subjective and lengthy process of this manual measurement and compare it to manual human measurements.</div></div><div><h3>Methods</h3><div>One board-certified orthopaedic surgeon used the web tool to make automatic measurements of anteroposterior radiographs of 97 patients who underwent unilateral hip arthroplasty. Manual and web tool measurements included abduction angle and calculated anteversion angle by Liaw’s method. Differences between manual and web tool measurements were compared with a paired <em>t</em>-test and Bland-Altman analysis.</div></div><div><h3>Results</h3><div>There were no statistically significant differences between the average of manual measurements as compared to the web tool measurement in abduction angle (43.29 ± 7.05 vs 43.00 + 6.22, <em>P</em> = .85), anteversion angle (20.43 ± 7.62 vs 20.82 ± 7.37, <em>P</em> = .52), and ratio of the minor axis of the acetabular cup circumference in the AP radiograph to the total length of the acetabular head (0.42 ± 0.15 vs 0.44 ± 0.15, <em>P</em> = .18). The mean difference of average for abduction angle, anteversion angle, and ratio between the short axis of the transverse ellipse to the total length of the acetabular cup were −0.28, 0.39, and 0.02, respectively. Bland-Altman analysis for all 3 measurements displayed negligible systemic bias with random scattering.</div></div><div><h3>Conclusions</h3><div>Automated measurements obtained with a novel web tool are in strong agreement with the manually obtained ground truth measurements. The web tool helps to eliminate interobserver differences that arise with manual annotation. The web tool has the potential to streamline acetabular measurements with enhanced accuracy.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101606"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053678","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}

引用次数: 0