Integrated Care for Comprehensive Management of Patients with Osteoarthritis: Program Development and Implementation
The objective of this article is to summarize the process for implementation of an integrated program to manage patients with symptomatic knee OA and the initial outcomes at our institution as an example of the effects of integrated patient management in orthopaedics. At the author's institution, an integrated program was implemented, successfully addressing the unmet need for coordinated care for patients with bone and joint health problems and medical comorbidities. Patients who completed the full program experienced significant improvements in both pain and function. Potential applications for knee surgeons considering ...
Source: Journal of Knee Surgery - May 23, 2023 Category: Orthopaedics Authors: Rucinski, Kylee Crecelius, Cory R. Stucky, Ren ée Stannard, James P. Cook, James L. Tags: Special Focus Section Source Type: research
Are All Patients Going Home after Total Knee Arthroplasty? A Temporal Analysis of Discharge Trends and Predictors of Nonhome Discharge (2011 –2020)
This study aimed to evaluate (1) trends in discharge disposition (home vs nonhome discharge), (2) episode-of-care outcomes for home and nonhome discharge cohorts, and (3) predictors of nonhome discharge among patients undergoing TKA from 2011 to 2020. The National Surgical Quality Improvement Program database was reviewed for all primary TKAs from 2011 to 2020. A total of 462,858 patients were identified and grouped into home discharge (n = 378,771) and nonhome discharge (n = 84,087) cohorts. The primary outcome was the annual rate of home/nonhome discharges. Secondary outcomes included trends in health care utiliz...
Source: Journal of Knee Surgery - April 24, 2023 Category: Orthopaedics Authors: Pan, Xuankang Xu, James Rull án, Pedro J. Pasqualini, Ignacio Krebs, Viktor E. Molloy, Robert M. Piuzzi, Nicolas S. Tags: Original Article Source Type: research
Social Media Influence and Gender Are Correlated with Industry Payments to Orthopaedic Sports Surgeons
This study seeks to understand correlations among social medial influence, academic influence, and gender among academic orthopaedic sport surgeons. A list of all orthopaedic sports surgeons serving as faculty of sports fellowships in the United States was compiled, along with publicly available demographic information. Their Hirsh indices (h-indices) were obtained using the Scopus database. The Physician Payments Sunshine Act Web site was used to determine their industry payments from 2014 through 2020. The number of Twitter followers was used as a measure of social media influence. Multivariable linear regression models ...
Source: Journal of Knee Surgery - April 24, 2023 Category: Orthopaedics Authors: Leong, Natalie L. Morcos, George Jiang, Jie O'Hara, Nathan Tags: Original Article Source Type: research
Optimal Method of Skin Wound Management for Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
J Knee Surg DOI: 10.1055/s-0043-1768248Skin closure for total knee arthroplasty (TKA) typically focuses on promoting optimal healing, while preventing wound complications and infection, allowing for functionality and immediate ambulation, and providing for excellent cosmesis. In this systematic review and meta-analysis of the literature, we will focus on closure of the skin. Specifically, we assessed: (1) wound complication risk of different techniques and (2) closing time of different sutures/techniques. There were 20 reports on infection risk and closing time. Meta-analyses focused on the qualifying studies for closing t...
Source: Journal of Knee Surgery - April 21, 2023 Category: Orthopaedics Authors: Chen, Zhongming Bains, Sandeep S. Sax, Oliver C. Sodhi, Nipun Mont, Michael A. Tags: Original Article Source Type: research
Factors Important to Patients when Making Treatment Decisions for Knee Osteoarthritis
This study was completed to synthesize literature related to patient treatment decisions for nonoperative and surgical management of knee OA, finding that patients consider multiple subjective factors when choosing whether to move forward with treatment. Understanding how patients' beliefs determine their preferences for treatment can improve shared decision-making. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - April 18, 2023 Category: Orthopaedics Authors: Rucinski, Kylee Leary, Emily Royse, Lisa A. Tags: Special Focus Section Source Type: research
Intraoperative Surgeon-Performed versus Conventional Anesthesiologist-Performed Continuous Adductor Canal Block in Total Knee Arthroplasty: A Randomized Controlled Trial
This study was divided into two phases. In Phase 1 study, an experimental dissection of 16 cadaveric knees to expose the saphenous nerve and related muscles around the adductor canal was conducted. The extent of dye after injection via a catheter inserted into the adductor canal at the time of TKA was evaluated. In Phase II, a randomized controlled trial study comparing clinical outcomes between surgeon-performed (Group 1) and anesthesiologist-performed cACB (Group 2) during TKA in 63 patients was evaluated. The visual analogue scale (VAS) at rest and during movement at several time points and functional outcomes during ho...
Source: Journal of Knee Surgery - April 18, 2023 Category: Orthopaedics Authors: Chaiperm, Chayut Tanavalee, Chotetawan Kampitak, Wirinaree Amarase, Chavarin Ngarmukos, Srihatach Tanavalee, Aree Tags: Original Article Source Type: research
Preoperative Corticosteroid Injections Are Not Associated with Deep Infection after Unicompartmental Knee Arthroplasty
This study sought to determine if there is a time- and/or dose-dependent relationship between preoperative CSI and postoperative infection. An administrative claims database was queried for patients undergoing UKA with more than 1 year of pre-enrollment and follow-up. Of 31,676 patients with a UKA who met enrollment criteria, 8,628 patients had a CSI 0 to 3 months prior to surgery, 111 had a CSI 3 to 12 months prior to surgery, and 22,937 never received an injection. Overall, 246 postoperative deep infections were reported (0.8%). Time-dependent and dose-dependent relationships were modeled using multivariable logistic reg...
Source: Journal of Knee Surgery - April 11, 2023 Category: Orthopaedics Authors: McCormick, Johnathon R. Berlinberg, Elyse J. Oladipo, Victoria Forlenza, Enrico M. Forsythe, Brian Gerlinger, Tad L. Tags: Original Article Source Type: research
Results of a Highly Porous Metal-Backed Cementless Patella Implant: A Minimum 5-Year Follow-Up
This study evaluates clinical outcomes and survivorship of total knee arthroplasty (TKA) using a current generation highly porous metal-backed patellar component. One-hundred twenty-five consecutive primary cementless TKAs with a compression molded highly porous metal-backed patella were reviewed. One-hundred three TKAs (82.4%) with 5-year clinical and radiographic follow-up were available for review. These were matched with 103 consecutive TKAs using a cemented patella of the same implant design. The cementless cohort had a mean age of 65.5 years, body mass index (BMI) of 33.0, and follow-up of 64.4 months. Indications fo...
Source: Journal of Knee Surgery - April 11, 2023 Category: Orthopaedics Authors: Baker, James F. Smith, Nolan S. Likine, Elive F. Smith, Langan S. Yakkanti, Madhusudhan R. Malkani, Arthur L. Tags: Original Article Source Type: research
Biomechanical Comparison of Four- versus Six-Strand Transosseous Suture Repair for Patellar Tendon Rupture
Conclusion Utilizing a six-stand transosseous patella tendon repair construct with one additional suture increases overall construct strength by over 50% compared with a four-strand construct. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Journal of Knee Surgery)
Source: Journal of Knee Surgery - April 6, 2023 Category: Orthopaedics Authors: Zhang, Tina Wahl, Alexander Schneider, Matheus Xu, Dali Hahn, Alexander Meredith, Sean J. Packer, Jonathan D. Leong, Natalie L. Zhang, Li-Qun Henn, R. Frank Jauregui, Julio J. Tags: Original Article Source Type: research
Closed Suction Drainage after Total Knee Arthroplasty with Concomitant Intravenous Tranexamic Acid Administration
J Knee Surg DOI: 10.1055/a-2045-8211Drain use in total knee arthroplasty (TKA) remains controversial. Use has been associated with increased complications, particularly postoperative transfusion, infection, increased cost, and longer hospital stays. However, studies examining drain use were performed before widespread adoption of tranexamic acid (TXA), which markedly reduces transfusion without increasing venous thromboembolism events. We aim to investigate incidence of postoperative transfusion and 90-day return to the operating room (ROR) for hemarthrosis in TKA with use of drains and concomitant intravenous (IV) TXA. Pr...
Source: Journal of Knee Surgery - April 6, 2023 Category: Orthopaedics Authors: Case, Slaton Thomas, William C. Edgington, Jonathan Manning, David Hardt, Kevin Tags: Original Article Source Type: research
Adductor Canal Nerve Block versus Intra-articular Anesthetic in Knee Arthroscopy: A Single-Blinded Prospective Randomized Trial
This study directly compares the effect of each of these treatment modalities. Patients undergoing knee arthroscopy were blinded and randomized to receive either an ACB (n = 60) or intra-articular injection of local anesthetic (IAB, n = 64). Outcome measures included patient reported visual analog scale (VAS) scores at 1, 2, 4, 8, 16, 24, 36, 48 hours and 1 week and total narcotic consumption at 12, 24, and 48 hours postoperatively. Student's t-tests were used to compare unadjusted VAS scores at each time point and use of postoperative pain medication between treatment groups. Adjusted VAS scores were estimated...
Source: Journal of Knee Surgery - April 1, 2023 Category: Orthopaedics Authors: Perry, Michael LeDuc, Ryan Stakenas, Steven Wozniak, Amy Francois, Audrice Evans, Douglas Tags: Original Article Source Type: research
National Inpatient Datasets May No Longer Be Appropriate for Overall Total Hip and Knee Arthroplasties Projections after Removal from Inpatient-Only Lists
J Knee Surg DOI: 10.1055/a-2037-6323It is unknown if the National Inpatient Sample (NIS) remains suitable to conduct projections for total knee arthroplasty (TKA) and total hip arthroplasty (THA), after their removal from “inpatient-only lists” in 2018 and 2020, respectively. We aimed to: (1) quantify primary THA and TKA volume from 2008 to 2018; (2) project estimates of future volume of THA and TKA until 2050; and (3) compare projections based on NIS data from 2008 to 2018 and 2008 to 2017, respectively. We identified all primary THA and TKA performed from 2008 to 2018 from the NIS. The projected volumes of THA and TK...
Source: Journal of Knee Surgery - March 29, 2023 Category: Orthopaedics Authors: Rull án, Pedro J. Emara, Ahmed K. Zhou, Guangjin Pasqualini, Ignacio Klika, Alison K. Koroukian, Siran Barsoum, Wael K. Piuzzi, Nicolas S. Tags: Original Article Source Type: research
Complications of Bicruciate-Retaining Total Knee Arthroplasty: The Importance of Alignment and Balance
J Knee Surg DOI: 10.1055/a-2037-6261Bicruciate-retaining total knee arthroplasty (BCR TKA) results in kinematics closer to the native knee and in greater patient satisfaction but information concerning its outcome and complications is lacking.The goal of this study is to report the clinical and radiological outcomes of BCR prosthesis implanted using a spacer-based gap balancing technique and to assess if some preoperative factors are associated with a worse prognosis.A cohort of 207 knees in 194 patients who underwent BCR TKA, with a minimum 1-year follow-up, was retrospectively analyzed.Patients were followed at 6 weeks, ...
Source: Journal of Knee Surgery - March 28, 2023 Category: Orthopaedics Authors: Perreault, Caroline Al-Shakfa, Fidaa Lavoie, Fr édéric Tags: Original Article Source Type: research
Mucoid Degeneration of the Anterior Cruciate Ligament: Characteristics and Conservative Management
J Knee Surg DOI: 10.1055/a-2037-6138Clinical and radiographic characteristics of mucoid degeneration of the anterior cruciate ligament (MD-ACL) were poorly documented in previous literature. And the optimal management strategy for MD-ACL remains unclear. Here, we summarized the characteristics associated with MD-ACL, and evaluated the clinical outcome of conservative management to MD-ACL.A total of 18 knees in 18 patients diagnosed with MD-ACL were collected and reviewed retrospectively. Sixteen patients underwent conservative management and two patients underwent arthroscopic surgery. Baseline demographic, clinical data, ...
Source: Journal of Knee Surgery - March 28, 2023 Category: Orthopaedics Authors: Luo, Jianzhou Zhou, Minmin Luo, Xiaozhen Luo, Peng Yang, Zili Li, Ruifang Duan, Chunguang Feng, Xujiao Wu, Tailin Tags: Original Article Source Type: research
Characterizing Osteochondral Allograft Biomechanics for Optimizing Transplant Success: A Systematic Review
J Knee Surg DOI: 10.1055/s-0043-1764403Osteochondral allograft (OCA) transplantation has been largely successful in treating symptomatic articular cartilage lesions; however, treatment failures persist. While OCA biomechanics have been consistently cited as mechanisms of treatment failure, the relationships among mechanical and biological variables that contribute to success after OCA transplantation have yet to be fully characterized. The purpose of this systematic review was to synthesize the clinically relevant peer-reviewed evidence targeting the biomechanics of OCAs and the impact on graft integration and functional s...
Source: Journal of Knee Surgery - March 20, 2023 Category: Orthopaedics Authors: Luk, Josephine Troyer, Luke Guess, Trent M. Teixeiro, Emma Stannard, James P. Cook, James L. Tags: Original Article Source Type: research
