The Journal of arthroplasty
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The argument on the clinical effects between gap balancing (GB) and measured resection (MR) in total knee arthroplasty remains to be resolved. A systematic review and meta-analysis was performed to investigate which technique in total knee arthroplasty has better clinical effect. ⋯ We conclude that both techniques can result in equivalent results when done properly, and each surgeon must understand the strengths and weaknesses of each technique.
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Pain persists in a moderate proportion of patients after total knee arthroplasty (TKA). Identifying patient factors that are associated with persistent pain may lead to improved care. ⋯ Several preoperative factors were associated with prolonged opioid use after TKA, and their identification can assist providers guide pain management. Avoidance or weaning of preoperative opioids should be considered.
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As the number of total hip and knee arthroplasty cases increases, it is important to understand the burden of factors that impact patient outcomes of these procedures. This article examined the time trends in key demographics, clinical characteristics, comorbidity burden (Deyo-Charlson Comorbidity Index [CCI]), and presence of depression in patients undergoing primary total hip arthroplasty and total knee arthroplasty using population-based, all-payer inpatient database, California Healthcare Cost and Utilization Project, from 2007 to 2010. ⋯ Despite the younger age of the joint arthroplasty population over time, we found increased prevalence of depression and comorbidity scores but shorter LOS. Further study is needed to determine the impact of the changing demographics of the total joint population and the best strategies to optimize their outcome with these procedures.
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Elevated metal ion levels have been associated with the presence of adverse local tissue reactions in patients with metal-on-polyethylene (MoP) total hip arthroplasty (THA) secondary to corrosion at head-neck taper junction. Patients are frequently concerned with their elevated systemic metal ion levels. This study investigated the rate of decline of serum cobalt and chromium ion levels after revision surgery. ⋯ At 3 months after revision surgery, cobalt and chromium ion levels declined by 34% and 8% of prerevision level, respectively. This study provides evidence-based practical information for surgeons to provide MoP THA patients when considering revision surgery for head-neck taper corrosion.
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This article was presented at the 2017 annual meeting of the American Association of Hip and Knee Surgeons to introduce the members gathered as the audience to the concepts behind artificial intelligence (AI) and the applications that AI can have in the world of health care today. We discuss the origin of AI, progress to machine learning, and then discuss how the limits of machine learning lead data scientists to develop artificial neural networks and deep learning algorithms through biomimicry. ⋯ The aim of this article is to provide the reader with a basic understanding of the fundamentals of AI. Its purpose is to demystify this technology for practicing surgeons so they can better understand how and where to apply it.