The Journal of arthroplasty
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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.
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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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There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). ⋯ A failed prior DAIR results in higher failure rates, lower functional outcome, and increased risk of wound-related complications.
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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.