Adult Reconstruction Archive

SUMMARY: In this randomized trial of 60 TKA patients, one preemptive 20-mg IV nefopam dose lowered 24-hour dynamic pain, morphine use, and nausea, and shortened discharge by about 8 hours, with transient tachycardia.

SUMMARY: In 40 chronic TKA periprosthetic infections, a Rush Rod-reinforced articulating construct achieved 80% infection-free survival with good knee motion, working as either a first-stage spacer or a definitive 1.5-stage option.

SUMMARY: Using a large database, patients under 40 undergoing primary TKA had roughly 3-fold higher odds of infection and reoperation than those over 65, independent of comorbidities and smoking.

SUMMARY: In 83,011 Medicare TKA patients, congestive heart failure, renal disease, and peripheral vascular disease were among the independent risk factors for both 90-day mortality and periprosthetic joint infection, informing preoperative counseling and risk adjustment.

SUMMARY: Educational overview explaining computer vision fundamentals and applications in arthroplasty, written to make this image-analysis tool accessible to orthopaedic surgeons and musculoskeletal researchers rather than computer scientists.

SUMMARY: In 70 hips, traction MR arthrography had good sensitivity (75-86%) but poor specificity (32-52%) for ligamentum teres, fossa, and fovea lesions versus intraoperative findings, so preoperative detection is limited.

SUMMARY: After automated text messaging was introduced for joint arthroplasty patients, patient-initiated phone calls fell 44%, but portal messages and total communications did not change; the pre-post design shows association only.

SUMMARY: Review of treatment options for Vancouver B3 periprosthetic femoral fractures after hip arthroplasty, noting the supporting evidence is poor, limited to small case series with inconsistent B2/B3 classification.

SUMMARY: In 103 primary hip and knee arthroplasties in solid organ transplant recipients, overall complications were 26%, but periprosthetic joint infection was low (only renal recipients affected) and mortality matched expected post-transplant survival.

SUMMARY: In 2023 Medicare data, hospital reimbursement for revision arthroplasty rose with patient risk, but surgeon payment did not, widening the hospital-to-surgeon ratio and highlighting a mismatch for complex cases.

SUMMARY: In robotic-assisted restricted kinematically aligned CR TKA, a lateral gap smaller than the medial gap from mid-range to deep flexion predicted lower satisfaction and worse pain at one year; gap-guided femoral rotation may help.

SUMMARY: In this 86-patient RCT, adding extended oral tranexamic acid after intravenous dosing in TKA did not improve pain, range of motion, opioid use, or ambulation, so routine use is not supported.

SUMMARY: In a 161-knee cohort with mean 13.8-year follow-up, a modern oxinium patellofemoral arthroplasty had 81% revision-free survival at 10 years and 75% at 20, with OA progression the main reason for revision.

SUMMARY: In 2,234 UKAs, revision-free survival was 85% at 15 years, and technology assistance, fixed-bearing design, and high surgeon volume were each associated with lower revision risk.

SUMMARY: In 180 patients surveyed 2-3 years after THA, 89% were satisfied, with lower satisfaction in those with better preoperative status, expectations of improved nonessential activities, or worse postoperative outcomes.

SUMMARY: This annotation summarizes the NIHR-funded INFORM program's findings on periprosthetic joint infection after hip and knee arthroplasty, covering risk factors, impact, diagnosis, treatment, evidence-based guidelines, and future research directions.

SUMMARY: Narrative review introducing Bayesian statistics to arthroplasty surgeons, contrasting it with P-value thresholds and offering guidance on appraising Bayesian research that yields probabilistic rather than yes/no conclusions.

SUMMARY: In 46,805 registry robotic THAs, high-volume centers reached and sustained sub-90-minute operative times after about 300 cases versus 550 for medium-volume centers, while low-volume centers rarely sustained efficiency.

SUMMARY: Across nine national registries from 2014 to 2024, UKA use is rising but remains low (3.5% in the US to 36.6% in Denmark), well below the roughly 50% of knees considered anatomically eligible.

SUMMARY: In 201 revision hip arthroplasties, synovial fluid WBC count above 3,000/mL combined with elevated ESR and CRP was the best predictor of periprosthetic infection, and no hip with normal ESR and CRP was infected.

SUMMARY: In 74 patients aged 75 or older after total knee arthroplasty, nearly 90% reported improvement and satisfaction, supporting TKA in the elderly; revisions were linked to preoperative deformity over 20 degrees.

SUMMARY: In a propensity-matched series, robotic-assisted direct anterior THA in patients with generalized ligamentous laxity gave outcomes and survivorship comparable to controls, with no dislocations at 2-plus years, though larger studies are needed.

SUMMARY: Fixed-bearing lateral UKA showed 90.6% revision-free survival at 10 and 15 years, with failures mostly early and due to progression of arthritis in other compartments, supporting it as a durable option for isolated lateral disease.

SUMMARY: Athletes with FAI and lateral rim dysplasia treated with hip arthroscopy had high survival, improved outcomes, and sports return (84%) comparable to matched athletes with normal coverage at minimum 4.5-year follow-up.

SUMMARY: In 205 patients with metastatic femoral disease, a long uncemented modular stem had a 1% two-year reintervention risk and no revisions for loosening, supporting its use in selected patients.

SUMMARY: Antibiotic-loaded cement is not indicated for infection prophylaxis in routine primary or revision arthroplasty in low-risk patients; commercial premixed products outperform hand-mixed, and FDA clearance covers only the second stage of two-stage revision.

SUMMARY: Global review of periprosthetic joint infection: rising incidence and 5-year mortality of 15-25%, persistent diagnostic challenges, regionally varied surgical strategies, and a proposed tiered framework to standardize success definitions.

SUMMARY: In 493 adults with unilateral hip pain, horizontal vs interteardrop referencing changed LCEA and acetabular index by about 2\u00b0 and reclassified coverage in 10-14%, tracking pelvic obliquity, which matters near borderline dysplasia thresholds.

SUMMARY: In a bench knee simulator, low-load surgical kinematics generally failed to predict high-load functional motion across four non-cruciate TKA designs, except the replica intercondylar design, regardless of collateral ligament tension.

SUMMARY: In Crowe I and II hip dysplasia, some horizontal medialization of the hip center after THA, with the cup inside the true acetabulum, did not worsen clinical outcomes versus anatomic reconstruction.