The Journal of arthroplasty
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Preoperative planning for total knee arthroplasty (TKA) is essential for streamlining operating room efficiency and reducing costs. Digital templating and patient-specific instrumentation have shown some value in TKA but require additional costs and resources. The purpose of this study was to validate a previously published algorithm that uses only demographic variables to accurately predict TKA tibial and femoral component sizes. ⋯ This prospective series of patients validates a simple algorithm to predict component sizing for TKA with high accuracy based on demographic variables alone. Surgeons can use this algorithm to simplify the preoperative planning process by reducing unnecessary trays, trials, and implant storage, particularly in the community or outpatient setting where resources are limited. Further assessment of components with less than 2.5-mm differences between femoral sizes is required in the future to make this algorithm more applicable worldwide.
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Osteoporosis is common in total joint arthroplasty (TJA) patients and likely contributes to the increasing incidence of periprosthetic fracture. Despite this, the prevalence of osteoporosis in patients undergoing elective TJA is inadequately studied. We hypothesize that preoperative osteoporosis is underrecognized and undertreated in the TJA population. The purpose of this study is to report preoperative osteoporosis screening rates and prevalence prior to TJA and rates of pharmacologic osteoporosis treatment in the TJA population. ⋯ One quarter of TJA patients meet criteria to receive osteoporosis medications, but only 5% receive therapy preoperatively or postoperatively. This lack of preoperative osteoporosis screening and treatment may contribute to periprosthetic fracture risk.
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The purpose of this study is to evaluate the 5-factor modified frailty index (mFI-5) as a predictor of postoperative complications, readmission, and mortality in patients undergoing revision hip and knee arthroplasty. ⋯ III.
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Comparative Study Observational Study
Revision Versus Primary Hospital Consumer Assessment of Healthcare Providers and Systems Scores in Total Joint Arthroplasty.
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's inpatient experience. This study aims to assess whether HCAHPS scores differ between patients undergoing primary total joint arthroplasty (TJA) and patients undergoing revision TJA. ⋯ Patients undergoing primary THA report higher HCAHPS scores than those undergoing revision THA, while revision TKA demonstrated a general trend toward higher scores when compared to primary TKA patients. This publicly reported quality measurement metric which factors into physician reimbursement may be biased by the patient's health status, the complexity of the surgical procedure, and length of stay in hospital rather than a true reflection of the quality of their hospital experience.
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Perioperative periprosthetic femur fractures (PPFx) after total hip arthroplasty (THA) remain a leading cause of early stem failure and revision and are associated with high rates of morbidity and mortality. American Joint Replacement Registry (AJRR) data have been analyzed to determine the relationship of femoral stem fixation to PPFx revision. ⋯ Mirroring other studies and national registries, there was an association between cementless fixation and PPFx in AJRR. Nevertheless, AJRR data demonstrate a trend of increasing utilization of cementless femoral fixation for THA and hemiarthroplasty, with cementless fixation accounting for 93% of THA stems with early periprosthetic fracture. Additional analysis is needed to better understand this phenomenon, especially in the elderly.