The Journal of arthroplasty
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Multicenter Study
Midterm Survivorship After Revision Total Hip Arthroplasty With a Custom Triflange Acetabular Component.
Custom triflange acetabular components are being increasingly used for the reconstruction of Paprosky type IIIB acetabular defects. However, midterm survivorship data are lacking. ⋯ Custom triflange reconstruction for severe acetabular deficiency is a viable option; however, complications are common and significant challenges remain for those that fail.
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Periprosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) is a devastating complication. The short-term morbidity profile of revision TKA performed for PJI relative to non-PJI revisions is poorly characterized. The purpose of this study is to determine 30-day postoperative outcomes after revision TKA for PJI, relative to primary TKA and aseptic revision TKA. ⋯ Utilizing a large, prospectively collected, national database, we found that revision TKA for PJI has a greater risk of short-term morbidity and mortality and requires a higher utilization of healthcare resources. These results have implications for patient counseling and alternative payment models that may eventually include revision TKA.
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Improvements in surgical techniques, implant design, and adherence to indications have resulted in favorable outcomes after unicompartmental knee arthroplasty (UKA), particularly in an older population. However, no studies have compared the performance of contemporary UKA and total knee arthroplasty (TKA) in a young population. ⋯ Although native knee biomechanics are preserved, younger patients do not seem to perceive this oft-cited benefit of UKA, as this did not translate into greater health-related quality of life or patient satisfaction compared to TKA. The theoretical advantages of UKA were not borne out by our findings, other than greater flexion up to 2 years postoperatively.
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Comparative Study
The Influence of Patient Gender on Morbidity Following Total Hip or Total Knee Arthroplasty.
Little research has focused on the influence of gender on postoperative morbidity following total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study aimed to compare operative time, length of stay, 30-day complications, and readmissions based on patient gender. ⋯ Men had increased risk of multiple individual adverse events including death, surgical site infection, cardiac arrest, return to the operating room, and readmission. Conversely, women had increased risk of urinary tract infection and blood transfusion.
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Prolonged opioid use following total knee arthroplasty (TKA) has not been extensively studied. ⋯ Patients who require opioids beyond 90 days after TKA warrant close follow-up.