The incidence of periprosthetic fractures is increasing as the population ages. Wound complications and surgical site infections following surgery to treat periprosthetic fractures are a major source of patient morbidity and health care burden. This study evaluates the efficacy of closed-incision negative-pressure wound therapy (ciNPT) in decreasing wound complications and surgical site infections (SSIs) after periprosthetic fracture surgery about the hip and knee. An IRB-approved retrospective quality improvement analysis of sixty-five consecutive periprosthetic fracture surgeries performed by four surgeons at a single institution in a fifteen-year period was performed. ciNPT was selectively used on patients in the last 20 months of the study period. Rates of wound complications, surgical site infections, and reoperation were compared with those of a sterile antimicrobial dressing (AMD).Introduction
Methods
Iliopsoas impingement is a well described cause of groin pain after direct anterior total hip arthroplasty (THA). We proposed to evaluate the incidence, natural history and response to treatment of iliopsoas impingement after direct anterior total hip arthroplasty. A retrospective chart review of 725 consecutive patients who underwent anterior approach total hip arthroplasty between 2009 and 2014 was conducted. All surgeries were performed by one of two surgeons. Patients were included if they underwent primary anterior approach THA and had a minimum of 2 years of follow up. Patients who had a posterior approach, revision surgery or had less than 2 years of follow up were excluded. Iliopsoas impingement was identified if patients reported groin pain at greater than 6 weeks of postoperative follow up and in association with pain with resisted seated hip flexion. The natural history and response to treatment was recorded for patients identified as having iliopsoas impingement.Introduction
Methods
