Arthroplasty today 

About: Arthroplasty today is an academic journal published by Elsevier BV. The journal publishes majorly in the area(s): Medicine & Arthroplasty. It has an ISSN identifier of 2352-3441. It is also open access. Over the lifetime, 1100 publications have been published receiving 5996 citations.

Infection burden in total hip and knee arthroplasties: an international registry-based perspective

Abstract: Background Infection remains a leading cause of failure of hip and knee replacements. Infection burden is the ratio of implants revised for infection to the total number of arthroplasties in a specific period, measuring the steady state of infection in a registry. We hypothesized infection burden would be similar among arthroplasty registries.

The American Joint Replacement Registry-the first 5 years.

Abstract: Total joint arthroplasty (TJA) is one of the most cost-effective and successful interventions in medicine. There are more than 1 million TJAs performed in the United States annually [1,2]. This number is expected to increase to nearly 4 million by 2030 [3]. Prospective monitoring of these procedures is critical and can serve as an early warning system for faulty implant designs or procedures with higher than expected failure rates. Results presented based on a nationwide perspective, rather than from a single institution or multicenter trials allow for a larger sample size and national representation of procedures being performed [4]. The ideal way to conduct this national assessment is via an arthroplasty registry. The 2 main purposes of an arthroplasty registry, “are to define the epidemiology of TJR and to monitor its clinical outcomes” [5]. Generally, data from registries are provided back to hospitals, clinics and clinicians which then facilitate comparisons with local, regional, or even national benchmarks. Registries also enable follow-up of large volumes of patients and are a critical element in the area of implant safety surveillance.

Trends in computer navigation and robotic assistance for total knee arthroplasty in the United States: an analysis of patient and hospital factors

Abstract: Background Computer navigation and robotic assistance technologies are used to improve the accuracy of component positioning in total knee arthroplasty (TKA), with the goal of improving function and optimizing implant longevity. The purpose of this study was to analyze trends in the use of technology-assisted TKA, identify factors associated with the use of these technologies, and describe potential drivers of cost. Methods The Nationwide Inpatient Sample database was used to identify patients who underwent TKA using conventional instrumentation, computer navigation, and robot-assisted techniques between 2005 and 2014. Variables analyzed include patient demographics, hospital and payer types, and hospital charges. Descriptive statistics were used to describe trends. Univariate and multivariate analyses were performed to identify differences between conventional and technology-assisted groups. Results Our analysis identified 6,060,901 patients who underwent TKA from 2005 to 2014, of which 273,922 (4.5%) used computer navigation and 24,084 (0.4%) used robotic assistance. The proportion of technology-assisted TKAs steadily increased over the study period, from 1.2% in 2005 to 7.0% in 2014. Computer navigation increased in use from 1.2% in 2005 to 6.3% in 2014. Computer navigation was more likely to be used in the Western United States, whereas robot-assisted TKAs were more likely to be performed in the Northeast. Increased hospital charges were associated with the use of technology assistance ($53,740.1 vs $47,639.2). Conclusions The use of computer navigation and robot-assisted TKA steadily increased over the study period, accounting for 7.0% of TKAs performed in the United States in 2014. Marked regional differences in the use of these technologies were identified. The use of these technologies was associated with increased hospital charges.

Early intraprosthetic dislocation in dual-mobility implants: a systematic review.

Abstract: Background Dual mobility implants are subject to a specific implant-related complication, intraprosthetic dislocation (IPD), in which the polyethylene liner dissociates from the femoral head. For older generation designs, IPD was attributable to late polyethylene wear and subsequent failure of the head capture mechanism. However, early IPDs have been reportedly affecting contemporary designs. Methods A systematic review of the literature according to the preferred reporting items for systematic reviews and meta-analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, Embase, and Google Scholar was conducted for English articles between January 1974 and August 2016 using various combinations of the keywords "intraprosthetic dislocation," "dual mobility," "dual-mobility," "tripolar," "double mobility," "double-mobility," "hip," "cup," "socket," and "dislocation." Results In all, 16 articles met our inclusion criteria. Fourteen were case reports and 2 were retrospective case series. These included a total of 19 total hip arthroplasties, which were divided into 2 groups: studies dealing with early IPD after attempted closed reduction and those dealing with early IPD with no history of previous attempted closed reduction. Early IPD was reported in 15 patients after a mean follow-up of 3.2 months (2.9 SD) in the first group and in 4 patients after a mean follow-up of 15.1 months (9.9 SD) in the second group. Conclusions Based on the current data, most cases have been preceded by an attempted closed reduction in the setting of outer, large articulation dislocation, perhaps indicating an iatrogenic etiology for early IPD. Recognition of this possible failure mode is essential to its prevention and treatment.

Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty

Abstract: Background Surgical site irrigation during total hip (THA) and total knee (TKA) arthroplasty is a routine practice among orthopaedic surgeons to prevent periprosthetic joint infection. The purpose of this study was to evaluate the effect of chlorhexidine gluconate (CHG) irrigation on infection rates following THA and TKA.