Pub Date : 2025-10-01Epub Date: 2025-08-15DOI: 10.1016/j.artd.2025.101798
Ugonna N. Ihekweazu MD , Timothy B. Alton MD , Shawn O. Okpara MD , Philip G. Ghobrial MD , Corey F. Hryc PhD
Inverse kinematic alignment (iKA) is an emerging technique in total knee arthroplasty (TKA) that aims to restore the patients' native tibial joint line obliquity with femoral resections adjusted to balance the knee. By emphasizing joint line restoration and patient-specific balancing, iKA has gained interest as a potentially favorable alternative to traditional alignment techniques. This step-by-step surgical technique aims to outline the essential principles of iKA in robotic-assisted TKA. The method prioritizes an anatomic tibia resection and then a tensioner-based gap balancing technique to recreate natural kinematics. Since the technique is applicable to a wide range of patients and can be integrated to a variety of robotic platforms, iKA offers a promising pathway to standardize personalized alignment in TKA.
{"title":"Inverse Kinematic Alignment in Robot-Assisted Total Knee Arthroplasty: A Simplified Surgical Technique","authors":"Ugonna N. Ihekweazu MD , Timothy B. Alton MD , Shawn O. Okpara MD , Philip G. Ghobrial MD , Corey F. Hryc PhD","doi":"10.1016/j.artd.2025.101798","DOIUrl":"10.1016/j.artd.2025.101798","url":null,"abstract":"<div><div>Inverse kinematic alignment (iKA) is an emerging technique in total knee arthroplasty (TKA) that aims to restore the patients' native tibial joint line obliquity with femoral resections adjusted to balance the knee. By emphasizing joint line restoration and patient-specific balancing, iKA has gained interest as a potentially favorable alternative to traditional alignment techniques. This step-by-step surgical technique aims to outline the essential principles of iKA in robotic-assisted TKA. The method prioritizes an anatomic tibia resection and then a tensioner-based gap balancing technique to recreate natural kinematics. Since the technique is applicable to a wide range of patients and can be integrated to a variety of robotic platforms, iKA offers a promising pathway to standardize personalized alignment in TKA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101798"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852127","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}
Restoring a neutral coronal alignment in revision total knee arthroplasty (rTKA) is paramount. Stem length and fixation type influence final limb alignment. This study compared overall limb alignment, measured by hip-knee-ankle (HKA) angle, in revisions using short-cemented (<75 mm), long-cemented (>75 mm), and press-fit stems. Secondary aims included evaluating coronal and sagittal alignment of tibial and femoral components and assessing canal fill ratio (CFR) in the press-fit group.
Methods
A retrospective multicenter review of 124 rTKAs from January 2019 to January 2022 was conducted. Included cases had revision of both femoral and tibial components using stems, with postoperative weight-bearing radiographs. Patients were divided into 3 groups based on stem type. Radiographic assessments included HKA, mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and CFR. analysis of variance and chi-square tests were used for statistical analysis.
Results
Data from 81 rTKAs were analyzed. Mean HKA was similar across all groups (group A: 178.9°, group B: 178.7°, group C: 178.7°; P = .985). No significant differences were found in mLDFA or mMPTA between groups. However, mLDFA showed more variability than mMPTA (P = .021), indicating greater femoral alignment deviation. CFR in press-fit stems averaged 77.3%, with no significant side-to-side differences.
Conclusions
Short-cemented stems achieved alignment comparable to long-cemented and press-fit stems. Femoral alignment was more variable than tibial. Short-cemented stems provide a flexible option with reliable alignment outcomes.
{"title":"Coronal Alignment in Revision Total Knee Arthroplasty: A Comparison of Cemented Vs Press-Fit Stems for Restoring Mechanical Axis","authors":"Niccolò Giabbani MD , Matteo Innocenti MD , Rudy Sangaletti MD , Fabrizio Matassi MD , Francesco Benazzo MD , Roberto Civinini MD , Marco Mugnaini MD , Luigi Zanna MD","doi":"10.1016/j.artd.2025.101863","DOIUrl":"10.1016/j.artd.2025.101863","url":null,"abstract":"<div><h3>Background</h3><div>Restoring a neutral coronal alignment in revision total knee arthroplasty (rTKA) is paramount. Stem length and fixation type influence final limb alignment. This study compared overall limb alignment, measured by hip-knee-ankle (HKA) angle, in revisions using short-cemented (<75 mm), long-cemented (>75 mm), and press-fit stems. Secondary aims included evaluating coronal and sagittal alignment of tibial and femoral components and assessing canal fill ratio (CFR) in the press-fit group.</div></div><div><h3>Methods</h3><div>A retrospective multicenter review of 124 rTKAs from January 2019 to January 2022 was conducted. Included cases had revision of both femoral and tibial components using stems, with postoperative weight-bearing radiographs. Patients were divided into 3 groups based on stem type. Radiographic assessments included HKA, mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and CFR. analysis of variance and chi-square tests were used for statistical analysis.</div></div><div><h3>Results</h3><div>Data from 81 rTKAs were analyzed. Mean HKA was similar across all groups (group A: 178.9°, group B: 178.7°, group C: 178.7°; <em>P</em> = .985). No significant differences were found in mLDFA or mMPTA between groups. However, mLDFA showed more variability than mMPTA (<em>P</em> = .021), indicating greater femoral alignment deviation. CFR in press-fit stems averaged 77.3%, with no significant side-to-side differences.</div></div><div><h3>Conclusions</h3><div>Short-cemented stems achieved alignment comparable to long-cemented and press-fit stems. Femoral alignment was more variable than tibial. Short-cemented stems provide a flexible option with reliable alignment outcomes.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101863"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219986","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}
Pub Date : 2025-10-01Epub Date: 2025-10-30DOI: 10.1016/j.artd.2025.101897
Daniel Schmitt MD, Nicholas Brown MD
{"title":"Outcomes and Penalties: Why Am I being Sent to the Penalty Box?","authors":"Daniel Schmitt MD, Nicholas Brown MD","doi":"10.1016/j.artd.2025.101897","DOIUrl":"10.1016/j.artd.2025.101897","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101897"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415853","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}
Pub Date : 2025-10-01Epub Date: 2025-08-12DOI: 10.1016/j.artd.2025.101794
Hinpetch Daungsupawong PhD, Viroj Wiwanitkit MD
{"title":"Comment on “Comparative Efficacy of ChatGPT and DeepSeek in Addressing Patient Queries on Gonarthrosis and Total Knee Arthroplasty”","authors":"Hinpetch Daungsupawong PhD, Viroj Wiwanitkit MD","doi":"10.1016/j.artd.2025.101794","DOIUrl":"10.1016/j.artd.2025.101794","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101794"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826397","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}
Pub Date : 2025-10-01Epub Date: 2025-09-04DOI: 10.1016/j.artd.2025.101835
Robert Schmidt MD , Winston Scambler BS , Jack A. Will BS , David Shau MD, MBA
Background
Single-component polyethylene revision (SCPR) is a less invasive approach for addressing polyethylene wear in total knee arthroplasty by replacing only the tibial polyethylene component. While traditionally used for aseptic ligamentous mid-flexion instability and limited arc of motion, this study introduces paradoxical instability as a third indication, characterized by ligamentous laxity with knee effusion causing mid-flexion instability and secondary flexion contracture.
Methods
A retrospective study analyzed 58 consecutive SCPR patients treated by a single fellowship-trained surgeon between 2012 and 2024, with a minimum 2-year follow-up. The cohort included 20 men (34%) and 38 women (66%), with a mean age of 70.2 years and average follow-up of 2.83 years. Patients were categorized into 3 groups: mid-flexion instability (n = 43), limited arc of motion (n = 9), and paradoxical instability (n = 6). Outcomes were assessed using clinical examinations and Knee Society Score 2011 and UCLA activity scores.
Results
Clinical success rates defined as good to excellent clinical outcomes were 88.3% (38 of 43) for mid-flexion instability, 88.8% (8 of 9) for limited arc of motion, and 100% (6 of 6) for paradoxical instability patients. No readmissions or reoperations occurred within 90 days postsurgery. The mean hospital stay was 0.87 days.
Conclusions
SCPR demonstrated effectiveness in treating all 3 indications, with particularly promising results for paradoxical instability cases. This study establishes paradoxical instability as a distinct clinical entity characterized by knee imbalance, mid-flexion instability, recurrent effusions, and limited motion arc. This limited motion arc is paradoxically treated with an increase of polyethylene thickness. The findings support SCPR as a viable treatment option for carefully selected patients with these conditions.
{"title":"Defining “Paradoxical Instability” and Other Indications for Aseptic Single-Component Polyethylene Revision: A Cohort Study Including Mid-flexion Instability and Limited Arc of Motion","authors":"Robert Schmidt MD , Winston Scambler BS , Jack A. Will BS , David Shau MD, MBA","doi":"10.1016/j.artd.2025.101835","DOIUrl":"10.1016/j.artd.2025.101835","url":null,"abstract":"<div><h3>Background</h3><div>Single-component polyethylene revision (SCPR) is a less invasive approach for addressing polyethylene wear in total knee arthroplasty by replacing only the tibial polyethylene component. While traditionally used for aseptic ligamentous mid-flexion instability and limited arc of motion, this study introduces paradoxical instability as a third indication, characterized by ligamentous laxity with knee effusion causing mid-flexion instability and secondary flexion contracture.</div></div><div><h3>Methods</h3><div>A retrospective study analyzed 58 consecutive SCPR patients treated by a single fellowship-trained surgeon between 2012 and 2024, with a minimum 2-year follow-up. The cohort included 20 men (34%) and 38 women (66%), with a mean age of 70.2 years and average follow-up of 2.83 years. Patients were categorized into 3 groups: mid-flexion instability (n = 43), limited arc of motion (n = 9), and paradoxical instability (n = 6). Outcomes were assessed using clinical examinations and Knee Society Score 2011 and UCLA activity scores.</div></div><div><h3>Results</h3><div>Clinical success rates defined as good to excellent clinical outcomes were 88.3% (38 of 43) for mid-flexion instability, 88.8% (8 of 9) for limited arc of motion, and 100% (6 of 6) for paradoxical instability patients. No readmissions or reoperations occurred within 90 days postsurgery. The mean hospital stay was 0.87 days.</div></div><div><h3>Conclusions</h3><div>SCPR demonstrated effectiveness in treating all 3 indications, with particularly promising results for paradoxical instability cases. This study establishes paradoxical instability as a distinct clinical entity characterized by knee imbalance, mid-flexion instability, recurrent effusions, and limited motion arc. This limited motion arc is paradoxically treated with an increase of polyethylene thickness. The findings support SCPR as a viable treatment option for carefully selected patients with these conditions.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101835"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988505","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}
Pub Date : 2025-10-01Epub Date: 2025-09-24DOI: 10.1016/j.artd.2025.101838
Mouhanad M. El Othmani MD, Prerana Katiyar MD, Klara I.M. Aastroem BS, Nana O. Sarpong MD, MBA, Alexander L. Neuwirth MD, H. John Cooper MD, Roshan P. Shah MD, JD
Background
Although robotic technology enhanced surgery does not directly address the patella, its associated improvement in knee reconstruction and flexion balance may result in improved patellar function and radiographs. In this retrospective observational analysis, we aimed to 1) compare patellar and femoral radiographic metrics between robotic-assisted and conventional total knee arthroplasty (RA-TKA and C-TKA) and 2) assess the correlation between these radiographic metrics and postoperative patient-reported outcomes in the RA-TKA cohort.
Methods
Fifty RA-TKAs were compared with 50 C-TKAs at an average 2.8 years of follow-up. Age, gender, body mass index, type of arthritis, preoperative range of motion, preoperative pain localization, type of implant, precut patellar thickness at the expected location of the apex, postcut patellar thickness at the same location, patellar button thickness, and length of stay were compared, along with patient reported outcome measures. Descriptive stats, t-tests, chi-squared, and Fisher’s exact tests were applied.
Results
A significantly lower postoperative patellar displacement (1.92 vs 3.16; P = .008) and posterior femoral overstuffing (21.97 vs 23.97; P = .017) were noted among the RA-TKA group. The RA-TKA group had a significantly smaller number of patients with patellar tilt >5 degrees (10% vs 32%; P = .013). The regression analysis of patellar and femoral radiographic metrics revealed no statistically significant correlation between radiographic metrics and majority of patient-reported outcomes within the RA-TKA cohort.
Conclusions
RA-TKA had better patellofemoral metrics than conventional TKA. The RA-TKA group showed a significant improvement in patellar displacement and posterior femoral overstuffing, and lower incidence of patellar tilt >5 degrees compared to the C-TKA cohort.
虽然机器人技术增强手术不能直接治疗髌骨，但其相关的膝关节重建和屈曲平衡的改善可能导致髌骨功能和x线片的改善。在这项回顾性观察分析中，我们的目的是1)比较机器人辅助和传统全膝关节置换术（RA-TKA和C-TKA）的髌骨和股骨放射学指标，2)评估这些放射学指标与RA-TKA队列中术后患者报告的结果之间的相关性。方法50例ra - tka患者与50例c - tka患者在平均2.8年的随访期间进行比较。比较年龄、性别、体重指数、关节炎类型、术前活动范围、术前疼痛定位、植入物类型、预期尖端位置的切开前髌骨厚度、同一位置的切开后髌骨厚度、髌骨钮扣厚度、住院时间以及患者报告的结果测量。应用了描述性统计、t检验、卡方检验和Fisher精确检验。结果RA-TKA组术后髌骨移位（1.92 vs 3.16, P = 0.008）和股骨后路填充（21.97 vs 23.97, P = 0.017）明显降低。RA-TKA组髌骨倾斜5度的患者数量明显较少（10% vs 32%; P = 0.013）。髌骨和股骨放射学指标的回归分析显示，放射学指标与RA-TKA队列中大多数患者报告的结果之间没有统计学上显著的相关性。结论ra -TKA的髌股指标优于传统TKA。与C-TKA组相比，RA-TKA组髌骨移位和股骨后侧过度填充显著改善，髌骨倾斜发生率降低5度。
{"title":"Femoral and Patellar Radiographic Metrics Are Improved With Robotic-Assisted Total Knee Arthroplasty","authors":"Mouhanad M. El Othmani MD, Prerana Katiyar MD, Klara I.M. Aastroem BS, Nana O. Sarpong MD, MBA, Alexander L. Neuwirth MD, H. John Cooper MD, Roshan P. Shah MD, JD","doi":"10.1016/j.artd.2025.101838","DOIUrl":"10.1016/j.artd.2025.101838","url":null,"abstract":"<div><h3>Background</h3><div>Although robotic technology enhanced surgery does not directly address the patella, its associated improvement in knee reconstruction and flexion balance may result in improved patellar function and radiographs. In this retrospective observational analysis, we aimed to 1) compare patellar and femoral radiographic metrics between robotic-assisted and conventional total knee arthroplasty (RA-TKA and C-TKA) and 2) assess the correlation between these radiographic metrics and postoperative patient-reported outcomes in the RA-TKA cohort.</div></div><div><h3>Methods</h3><div>Fifty RA-TKAs were compared with 50 C-TKAs at an average 2.8 years of follow-up. Age, gender, body mass index, type of arthritis, preoperative range of motion, preoperative pain localization, type of implant, precut patellar thickness at the expected location of the apex, postcut patellar thickness at the same location, patellar button thickness, and length of stay were compared, along with patient reported outcome measures. Descriptive stats, <em>t</em>-tests, chi-squared, and Fisher’s exact tests were applied.</div></div><div><h3>Results</h3><div>A significantly lower postoperative patellar displacement (1.92 vs 3.16; <em>P</em> = .008) and posterior femoral overstuffing (21.97 vs 23.97; <em>P</em> = .017) were noted among the RA-TKA group. The RA-TKA group had a significantly smaller number of patients with patellar tilt >5 degrees (10% vs 32%; <em>P</em> = .013). The regression analysis of patellar and femoral radiographic metrics revealed no statistically significant correlation between radiographic metrics and majority of patient-reported outcomes within the RA-TKA cohort.</div></div><div><h3>Conclusions</h3><div>RA-TKA had better patellofemoral metrics than conventional TKA. The RA-TKA group showed a significant improvement in patellar displacement and posterior femoral overstuffing, and lower incidence of patellar tilt >5 degrees compared to the C-TKA cohort.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101838"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157955","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}
Pub Date : 2025-10-01Epub Date: 2025-09-17DOI: 10.1016/j.artd.2025.101833
Joshua C. Rozell MD
{"title":"How to Wow From the Podium: Creating and Delivering a Great Presentation in Orthopedic Surgery","authors":"Joshua C. Rozell MD","doi":"10.1016/j.artd.2025.101833","DOIUrl":"10.1016/j.artd.2025.101833","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101833"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105371","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}
Pub Date : 2025-10-01Epub Date: 2025-09-17DOI: 10.1016/j.artd.2025.101850
Martha Burla MPH , T. Jacob Selph Jr. BS , Finola M. Summerville BS , Rachel Bergman MD , Isaac Sontag-Milobsky BS , Patricia D. Franklin MD, MBA, MPH , Linda I. Suleiman MD
Background
Knee osteoarthritis (OA) is a common chronic condition in the United States, significantly impacting quality of life and health-care costs. Disparities in OA treatment across racial, ethnic, and socioeconomic groups highlight the importance of federally qualified health centers (FQHCs) in managing under-treated populations. This study assessed the feasibility of using a text message-based system to collect patient-reported outcomes (PROs) on knee OA prevalence and symptom severity among FQHC primary care patients.
Methods
A multimethod pilot study invited 223 FQHC patients with knee OA via text to complete a PRO survey on knee pain and function. Nonresponders received text and phone reminders. Researchers evaluated response rates, reasons for noncompletion, and patient perspectives on symptom monitoring.
Results
Overall, 24.7% of patients completed the PRO survey—28% among English speakers and 17% among Spanish speakers. The most common barrier was disconnected phone numbers. Qualitative feedback from both responders and nonresponders showed strong support (92%) for ongoing symptom monitoring. Responders found the survey user-friendly, while nonresponders noted technical and trust-related challenges.
Conclusions
Text message-based PRO collection is a feasible and acceptable method for knee OA symptom tracking in FQHCs. While the approach is scalable and well-received, patient education about the purpose of PROs is essential. Improved communication and accessibility strategies are recommended to increase engagement and fully leverage PROs for managing chronic conditions in low-resource settings.
{"title":"Primary Care Patient Engagement With Patient-Reported Outcomes to Assess Osteoarthritis Symptoms","authors":"Martha Burla MPH , T. Jacob Selph Jr. BS , Finola M. Summerville BS , Rachel Bergman MD , Isaac Sontag-Milobsky BS , Patricia D. Franklin MD, MBA, MPH , Linda I. Suleiman MD","doi":"10.1016/j.artd.2025.101850","DOIUrl":"10.1016/j.artd.2025.101850","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (OA) is a common chronic condition in the United States, significantly impacting quality of life and health-care costs. Disparities in OA treatment across racial, ethnic, and socioeconomic groups highlight the importance of federally qualified health centers (FQHCs) in managing under-treated populations. This study assessed the feasibility of using a text message-based system to collect patient-reported outcomes (PROs) on knee OA prevalence and symptom severity among FQHC primary care patients.</div></div><div><h3>Methods</h3><div>A multimethod pilot study invited 223 FQHC patients with knee OA via text to complete a PRO survey on knee pain and function. Nonresponders received text and phone reminders. Researchers evaluated response rates, reasons for noncompletion, and patient perspectives on symptom monitoring.</div></div><div><h3>Results</h3><div>Overall, 24.7% of patients completed the PRO survey—28% among English speakers and 17% among Spanish speakers. The most common barrier was disconnected phone numbers. Qualitative feedback from both responders and nonresponders showed strong support (92%) for ongoing symptom monitoring. Responders found the survey user-friendly, while nonresponders noted technical and trust-related challenges.</div></div><div><h3>Conclusions</h3><div>Text message-based PRO collection is a feasible and acceptable method for knee OA symptom tracking in FQHCs. While the approach is scalable and well-received, patient education about the purpose of PROs is essential. Improved communication and accessibility strategies are recommended to increase engagement and fully leverage PROs for managing chronic conditions in low-resource settings.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101850"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104758","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}
Pub Date : 2025-10-01Epub Date: 2025-09-08DOI: 10.1016/j.artd.2025.101800
Evan P. Bailey MD , Bryce T. Hrudka BS , Bailey J. Ross MD , Ajay Premkumar MD, MPH , Jacob M. Wilson MD , Galen E. Berdis MD
We present the first documented case of polyethylene liner fracture in a primary dual-mobility cup (DMC) total hip arthroplasty leading to intraprosthetic dislocation. A 50-year-old female with a history of hip dysplasia and leg length discrepancy underwent primary total hip arthroplasty with a DMC. She presented with an anterior intraprosthetic hip dislocation. Revision surgery revealed a fractured highly cross-linked polyethylene liner. The liner and fragments were removed and a new liner was implanted. This case underscores the potential mechanical limitations of highly cross-linked polyethylene in DMC configurations.
{"title":"Fracture of Dual-Mobility Polyethylene Liner in a Primary Total Hip Arthroplasty: A New Complication to a Modern Design: A Case Report","authors":"Evan P. Bailey MD , Bryce T. Hrudka BS , Bailey J. Ross MD , Ajay Premkumar MD, MPH , Jacob M. Wilson MD , Galen E. Berdis MD","doi":"10.1016/j.artd.2025.101800","DOIUrl":"10.1016/j.artd.2025.101800","url":null,"abstract":"<div><div>We present the first documented case of polyethylene liner fracture in a primary dual-mobility cup (DMC) total hip arthroplasty leading to intraprosthetic dislocation. A 50-year-old female with a history of hip dysplasia and leg length discrepancy underwent primary total hip arthroplasty with a DMC. She presented with an anterior intraprosthetic hip dislocation. Revision surgery revealed a fractured highly cross-linked polyethylene liner. The liner and fragments were removed and a new liner was implanted. This case underscores the potential mechanical limitations of highly cross-linked polyethylene in DMC configurations.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"35 ","pages":"Article 101800"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010534","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}
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