The Journal of arthroplasty
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The traditional goal of the gap-balancing method in total knee arthroplasty is to create equal and symmetric knee laxity throughout the arc of flexion. The purpose of this study was to (1) quantify the laxity in the native and the replaced knee throughout the range of flexion in gap-balancing total knee arthroplasty (TKA) and (2) quantify the precision in achieving a targeted gap profile throughout flexion using a robotic-assisted technique with active ligament tensioning. ⋯ Aiming for equal gaps at 0° and 90° of flexion produced equal gaps in extension and flexion with larger gaps in midflexion. Consistent soft-tissue balance to a planned gap profile could be achieved by using controlled ligament tensioning in robotic-assisted TKA.
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One potential benefit of the direct anterior approach (DAA) for total hip arthroplasty is the ability to use intraoperative fluoroscopy for acetabular cup positioning and limb-length evaluation. Previous studies comparing the use of fluoroscopy with an anterior approach to a posterior approach have reported conflicting results. To our knowledge, no prior study has compared acetabular cup position and limb-length discrepancy (LLD) using a DAA with and without fluoroscopy. ⋯ This study found no clinically or statistically significant difference in acetabular inclination, anteversion, or LLD between the fluoroscopy and nonfluoroscopy groups. Both surgeons achieved a similar mean acetabular cup position and an equivalent mean LLD.
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The incidence of and risk factors for kinesiophobia after total knee arthroplasty (TKA) have not been well characterized in the literature. Thus, the aim of this study was to investigate the incidence of postoperative kinesiophobia among patients undergoing TKA and to identify the associated risk factors. ⋯ A 24.4% incidence rate of postoperative kinesiophobia was noted in patients following TKA. Older age (most notably ≥76 years old), lower education levels, negative coping styles, greater pain intensity, lower self-efficacy, and less social support were associated with odds of developing postoperative kinesiophobia.
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The objective of this study was to review Vancouver B2 and B3 periprosthetic hip fractures treated with uncemented modular fluted tapered stems to analyze survivorship, risk factors for stem subsidence, and clinical outcomes. ⋯ Level III, retrospective cohort.
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The use of narcotics has been found to be a modifiable risk factor for success of arthroplasty. We sought to determine the risk factors leading to increased narcotic use after total hip arthroplasty and total knee arthroplasty. ⋯ This study suggests that a patient's preoperative narcotic, tramadol, benzodiazepine, and tobacco use are correlated to the amount of postoperative narcotic prescriptions filled in the 3 months following surgery. Predisposition to substance abuse may be a characteristic which leads to increased postoperative narcotic use.