The Journal of arthroplasty
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Randomized Controlled Trial
Vancomycin Powder and Dilute Povidone-Iodine Lavage for Infection Prophylaxis in High-Risk Total Joint Arthroplasty.
Dilute povidone-iodine lavage has been shown to be safe and effective in decreasing acute periprosthetic joint infection (PJI) following total joint arthroplasty (TJA). Vancomycin powder is reported to be effective in preventing infection in spine surgery. We hypothesize that a "vanco-povidone protocol" (VIP) for TJA patients at high risk for infection is safe and will decrease the rate of PJI. ⋯ Retrospective Observational Cohort.
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Adequate interference fit and mechanical stability through optimal surgical technique are essential to prevent subsidence and loosening in cementless total hip arthroplasty. The purpose of this study is to determine the effect of surgical technique on radiographic subsidence and subsequent stability of a modern taper-wedge cementless stem. ⋯ These observations support that maximizing mediolateral canal fill and avoiding under-sizing the femoral implant with meticulous broaching technique minimizes subsidence and optimizes stability of modern cementless taper-wedge stems. Failure to optimize canal fill with appropriate broaching and surgical technique may predispose femoral components to failure from aseptic loosening.
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This study aims to investigate how expectation fulfillment changes up to 10 years following total knee arthroplasty (TKA). ⋯ Expectation fulfillment following TKA changes with time. Expectations of kneeling ability and the ability to perform outside activities demonstrated persistently low levels of fulfillment. This information can be used to manage the longer term expectations of patients undergoing TKA.
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This prospective study aimed to examine whether patients' and physicians' outcome expectations were related to subjective (ie, fulfillment of expectations) and objective outcomes (ie, change in pain and function) in hip and knee arthroplasty patients up to 6 months post-surgery. ⋯ Although patients' high expectations were associated with better objective outcomes, improvement was still less than patients expected. Thus, patients often have too high expectations of outcomes of surgery. In addition, physicians were able to influence patients' expectations and to change experienced knee patients' outcomes.
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As the world grapples with the COVID-19 pandemic, we as health care professionals thrive to continue to help our patients, and as orthopedic surgeons, this goal is ever more challenging. As part of a major academic tertiary medical center in New York City, the orthopedic department at New York University (NYU) Langone Health has evolved and adapted to meet the challenges of the COVID pandemic. ⋯ We have reorganized our residency and fellowship rotations and assignments as well as adapting our educational programs to online learning. While constantly evolving to meet the institution's and our patient demands, our leadership starts planning for the return to a new "normal".