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Journal J Arthroplasty

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Postoperative Opioid Consumption After Total Hip Arthroplasty: A Comparison of Three Surgical Approaches.

Sebastian Seah, Mark Quinn, Oren Tirosh, Phong Tran,

BACKGROUND:The surgical approach for total hip arthroplasty (THA) has the potential to affect the immediate postoperative recovery; however, there is limited published data comparing the 3 most common surgical approaches. The purpose of the study was to investigate postoperative pain and subsequent opioid consumption between surgical approaches (anterior-AA, lateral-LA, and ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Accuracy of a New Robotically Assisted Technique for Total Knee Arthroplasty: A Cadaveric Study.

Sébastien Parratte, Andrew J Price, Lee M Jeys, William F Jackson, Henry D Clarke,

BACKGROUND:Although the utility of robotic surgery has already been proven in cadaveric studies, it is our hypothesis that this newly designed robotically assisted system will achieve a high level of accuracy for bone resection. Therefore, we aimed to analyze in a cadaveric study the accuracy to achieve targeted angles and ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Reevaluating Current Cutoffs for Acute Periprosthetic Joint Infection: Current Thresholds Are Insensitive.

Chi Xu, Timothy L Tan, Feng-Chih Kuo, Karan Goswami, Qiaojie Wang, Javad Parvizi,

BACKGROUND:Diagnosing acute periprosthetic joint infection remains a challenge. Several studies have proposed different acute cutoffs resulting in the International Consensus Meeting recommending a cutoff of 100 mg/L, 10,000 cell/μL and 90% for serum C-reactive protein (CRP), synovial white blood cell count (WBC), and polymorphonuclear percentage (PMN%), respectively. However, establishing cutoffs ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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A Novel Opioid-Sparing Pain Management Protocol Following Total Hip Arthroplasty: Effects on Opioid Consumption, Pain Severity, and Patient-Reported Outcomes.

Jorge A Padilla, Jonathan A Gabor, Ran Schwarzkopf, Roy I Davidovitch,

BACKGROUND:Opioid prescriptions and subsequent opioid-related deaths have increased substantially in the past several decades. Orthopedic surgery ranks among the highest of all specialties with respect to the amount of opioids prescribed. We present here the outcomes of our opioid-sparing pain management pilot protocol for total hip arthroplasty (THA). METHODS:A retrospective ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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The Combination of Inlay Patellofemoral Arthroplasty and Medial Unicompartmental Knee Arthroplasty Versus Total Knee Arthroplasty for Mediopatellofemoral Osteoarthritis: A Comparison of Mid-Term Outcomes.

Enes Uluyardimci, Cetin Isik, Mesut Tahta, Fahri Emre, Sahin Cepni, Ismail Oltulu,

BACKGROUND:To the best of our knowledge, there have been no studies in the literature related to the use of second-generation inlay patellofemoral arthroplasty and unicompartmental knee arthroplasty combination (inlay PFA/UKA) in the treatment of mediopatellofemoral osteoarthritis (MPFOA). The aim of this study is to evaluate the efficacy of inlay PFA/UKA ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Clostridium difficile Colitis Following Revision Total Knee Arthroplasty: Incidence and Risk Factors.

Gannon L Curtis, Sanar S Yokhana, Linsen T Samuel, Jaiben George, Carlos A Higuera-Rueda, Bryan E Little, Hussein F Darwiche,

BACKGROUND:Clostridium difficile-associated diarrhea (CDAD) is associated with adverse events and financial liability. As institutions continue to adopt CDAD rates as a quality control metric, it is important to identify patients at risk before surgery, including revision total knee arthroplasty (rTKA). This study was conducted to (1) determine the incidence of ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates.

Aaron J Buckland, Laviel Fernandez, Andrew J Shimmin, Jonathan V Bare, Stephen J McMahon, Jonathan M Vigdorchik,

BACKGROUND:Recent research has demonstrated that patients with reduced pelvic mobility from standing to sitting have higher rates of dislocation after total hip arthroplasty (THA). This study evaluates the effect of sagittal spinal deformity, defined by pelvic incidence-lumbar lordosis mismatch (PI-LL), on postural changes in pelvic tilt (PT). METHODS:A multicenter database ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Comparison of the Efficacy Between Closed Incisional Negative-Pressure Wound Therapy and Conventional Wound Management After Total Hip and Knee Arthroplasties: A Systematic Review and Meta-Analysis.

Jun-Ho Kim, Hyun-Jung Kim, Dae-Hee Lee,

BACKGROUND:Wound-related problems after total hip arthroplasty (THA) and total knee arthroplasty (TKA) can cause periprosthetic joint infections. We sought to evaluate the effect of closed incisional negative-pressure wound therapy (ciNPWT) on wound complications, skin blisters, surgical site infections (SSIs), reoperations, and length of hospitalization (LOH). METHODS:Studies comparing ciNPWT with conventional ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Partial Component-Retained 2-Stage Reconstruction in the Treatment of Infected Hip Arthroplasty.

Jian Zhou, Shuo Jie, Xiadong Du, Yihan Li, Wanchun Wang, Tang Liu,

BACKGROUND:It is considered the gold standard treatment for infected hip arthroplasty to remove and reimplant the corresponding whole set of implant components before and after infection control, but it usually causes substantial bone loss to remove the well-fixed cup or stem, which may increase the difficulty in reconstruction. We would ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Hybrid Fixation for Total Hip Arthroplasty Showed Improved Survival Over Cemented and Uncemented Fixation: A Single-Center Survival Analysis of 2156 Hips at 12-18 Years.

Anna-Kate Fowler, Andrew R Gray, David P Gwynne-Jones,

BACKGROUND:Despite increased use of uncemented and hybrid fixation, there is little evidence of their superiority over cemented implants. The aim of this study is to compare the long-term survivorship of cemented, hybrid and uncemented total hip arthroplasty (THA) at varying ages. METHODS:A total of 2156 hips (1315 cemented, 324 uncemented, ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Does It Matter: Total Hip Arthroplasty or Lumbar Spinal Fusion First? Preoperative Sagittal Spinopelvic Measurements Guide Patient-Specific Surgical Strategies in Patients Requiring Both.

Frank W Parilla, Ritesh R Shah, Alexander C Gordon, Steven M Mardjetko, Nancy E Cipparrone, Wayne M Goldstein, Jeffrey M Goldstein,

BACKGROUND:In patients requiring both total hip arthroplasty (THA) and lumbar spinal fusion (LSF), consideration of preoperative sagittal spinopelvic measurements can aid in the prediction of postfusion compensatory changes in pelvic tilt (PT) and inform adjustments to traditional THA cup anteversion. This study aims to identify relationships between spinopelvic measurements and ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Indwelling Urinary Catheter for Total Joint Arthroplasty Using Epidural Anesthesia.

Oliver J Scotting, Wayne T North, Chaoyang Chen, Michael A Charters,

BACKGROUND:The objective of this study was to evaluate if not placing an indwelling urinary catheter leads to a higher potential for adverse genitourinary (GU) issues after total joint arthroplasty (TJA) under epidural anesthesia. METHODS:Three hundred thirty-five consecutive patients who underwent primary TJA using epidural anesthesia were retrospectively reviewed. The initial ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Quantifying the Perioperative Work Associated With Total Hip and Knee Arthroplasty: The Burden Has Increased With Contemporary Care Pathways.

Amy S Wasterlain, P Maxwell Courtney, Michael F Yayac, David G Nazarian, Matthew S Austin,

BACKGROUND:Recently, the Centers for Medicare and Medicaid Services (CMS) has labeled the procedural codes for total hip arthroplasty (THA) and total knee arthroplasty (TKA) as potentially misvalued and has asked the American Medical Association (AMA) and its Relative Value Scale Update Committee (RUC) to review this. To assess the validity ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Use of Observation Status Versus Readmission in Elective Total Knee and Hip Arthroplasty Returns to Hospital: A Single-Institution Perspective.

Adam E Goode, Trevor M Owen, Joseph T Moskal, Thomas K Miller,

BACKGROUND:The Affordable Care Act's Readmission Reduction Program (RRP) and ongoing transparency efforts to promote consumer-driven competition place significant institutional focus on improving 30-day readmission rates. It remains unclear whether the reduction in readmission rates subsequent to the RRP occurred due to improved quality and/or partly due to increased use of ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Letter to the Editor on "Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes".

Eustathios Kenanidis,

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Deep Learning Preoperatively Predicts Value Metrics for Primary Total Knee Arthroplasty: Development and Validation of an Artificial Neural Network Model.

Prem N Ramkumar, Jaret M Karnuta, Sergio M Navarro, Heather S Haeberle, Giles R Scuderi, Michael A Mont, Viktor E Krebs, Brendan M Patterson,

BACKGROUND:The objective is to develop and validate an artificial neural network (ANN) that learns and predicts length of stay (LOS), inpatient charges, and discharge disposition before primary total knee arthroplasty (TKA). The secondary objective applied the ANN to propose a risk-based, patient-specific payment model (PSPM) commensurate with case complexity. METHODS:Using ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Short-Term Morbidity and Mortality After Hemiarthroplasty and Total Hip Arthroplasty for Pathologic Proximal Femur Fractures.

Nathan H Varady, Bishoy T Ameen, Brett L Hayden, Caleb M Yeung, Pierre-Emmanuel Schwab, Antonia F Chen,

BACKGROUND:As oncology patients have increasing life expectancies, total hip arthroplasty (THA) may become an important treatment option for pathologic proximal femur fractures (PPFFs). Although THA and hemiarthroplasty (HA) have been compared for native hip fracture treatment, no data on short-term morbidity and mortality are available in the pathologic setting. The ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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No Evidence to Support Lowering Surgeon Reimbursement for Total Joint Arthroplasty Based on Operative Time: An Institutional Review of 12,567 Cases.

Morad Chughtai, Atul F Kamath, ,

BACKGROUND:The Centers for Medicare and Medicaid Services has recently added primary total joint arthroplasty (TJA) codes to the 2019 Potentially Misvalued Codes List. the American Association of Hip and Knee Surgeons and the American Medical Association have called for contemporary data that would assess operative time to inform the decision ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Two-Stage Exchange Arthroplasty for Periprosthetic Joint Infection: The Rate and Reason for the Attrition After the First Stage.

Qiaojie Wang, Karan Goswami, Feng-Chih Kuo, Chi Xu, Timothy L Tan, Javad Parvizi,

BACKGROUND:Two-stage exchange arthroplasty remains a popular surgical treatment for patients with chronic periprosthetic joint infection (PJI). Patients who do not receive reimplantation were largely overlooked in the current literature. We aimed at investigating the clinical outcomes of these patients. METHODS:Our institutional PJI database was retrospectively reviewed to identify 616 patients ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Total Knee Arthroplasty in Patients With Knee Osteoarthritis: Effects on Proprioception. A Systematic Review and Best Evidence Synthesis.

Giorgio di Laura Frattura, Stefano Zaffagnini, Giuseppe Filardo, Iacopo Romandini, Augusto Fusco, Christian Candrian,

BACKGROUND:Impact of total knee arthroplasty (TKA) on proprioception remains to be determined. The aim of this systematic review is to analyze factors influencing proprioception in patients with knee osteoarthritis (OA) undergoing TKA. METHODS:A systematic literature search was conducted on 3 medical electronic databases: PubMed, PeDRO, and Cochrane Collaboration. The Preferred ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Surgeon Mean Operative Times in Total Knee Arthroplasty in a Variety of Settings in a Health System.

Harpal S Khanuja, Mitchell A Solano, Robert S Sterling, Julius K Oni, Yash P Chaudhry, Lynne C Jones,

BACKGROUND:High-quality care is essential in total joint arthroplasty. Multiple initiatives such as centers of excellence, patient optimization, and alternative payment models have demonstrated improved outcomes and decreased cost. Many studies have shown that longer operative times (OTs) are associated with increased frequency of postoperative complications. These findings often come from ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Reply to the Letter to the Editor on "Continuous Antibiotic Therapy Can Reduce Recurrence of Prosthetic Joint Infection in Patients Undergoing 2-Stage Exchange" by Castaño et al.

Tiziana Ascione, Giovanni Balato, Pasquale Pagliano,

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Gastrointestinal Complications Warranting Invasive Interventions Following Total Joint Arthroplasty.

Abidemi S Adenikinju, James E Feng, Clementine A Namba, Tyler A Luthringer, Claudette M Lajam,

BACKGROUND:Gastrointestinal (GI) complications following total joint arthroplasty (TJA) are uncommon but can be associated with substantial morbidity and mortality. The current literature on GI complications that warrant invasive procedures after TJA is lacking. This study reviews the incidence and outcomes of GI complications after TJA that went on to require ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Artificial Intelligence and Arthroplasty at a Single Institution: Real-World Applications of Machine Learning to Big Data, Value-Based Care, Mobile Health, and Remote Patient Monitoring.

Prem N Ramkumar, Heather S Haeberle, Michael R Bloomfield, Jonathan L Schaffer, Atul F Kamath, Brendan M Patterson, Viktor E Krebs,

BACKGROUND:Driven by the recent ubiquity of big data and computing power, we established the Machine Learning Arthroplasty Laboratory (MLAL) to examine and apply artificial intelligence (AI) to musculoskeletal medicine. METHODS:In this review, we discuss the 2 core objectives of the MLAL as they relate to the practice and progress of ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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Response to Letter to the Editor on "Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes".

Kang-Il Kim, Sang Jun Song, Sang-Woo Jeon,

J Arthroplasty (The Journal of arthroplasty)
[2019, :]

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