The purpose of this study was to compare the radiological outcomes of manual versus robotic-assisted medial unicompartmental knee arthroplasty (UKA). Postoperative radiological outcomes from 86 consecutive robotic-assisted UKAs (RAUKA group) from a single academic centre were retrospectively reviewed and compared to 253 manual UKAs (MUKA group) drawn from a prior study at our institution. Femoral coronal and sagittal angles (FCA, FSA), tibial coronal and sagittal angles (TCA, TSA), and implant overhang were radiologically measured to identify outliers.Aims
Methods
The purpose of this study was to compare the radiographic outcomes of manual versus robotic-assisted medial unicompartmental knee arthroplasty (UKA). Postoperative radiographic outcomes from 86 consecutive robotic-assisted UKAs (RAUKA group) from a single academic center were retrospectively reviewed and compared to 253 manual UKAs (MUKA group) drawn from a prior study at our institution. Femoral coronal and sagittal angles (FCA, FSA), tibial coronal and sagittal angles (TCA, TSA), and implant overhang were radiographically measured to identify outliers. Clinical results at 4–6 weeks postoperative were compared to a control cohort of total knee arthroplasty (TKA) patients from our institution.Introduction
Materials & Methods
The aims of this study were to determine the change in the sagittal alignment of the pelvis and the associated impact on acetabular component position at one-year follow-up after total hip arthroplasty (THA). This study represents the one-year follow-up of a previous short-term study at our institution. Using the patient population from our prior study, the radiological pelvic ratio was assessed in 91 patients undergoing THA, of whom 50 were available for follow-up of at least one year (median 1.5; interquartile range (IQR) 1.1 to 2.0). Anteroposterior radiographs of the pelvis were obtained in the standing position preoperatively and at one year postoperatively. Pelvic ratio was defined as the ratio between the vertical distance from the inferior sacroiliac (SI) joints to the superior pubic symphysis and the horizontal distance between the inferior SI joints. Apparent acetabular component position changes were determined from the change in pelvic ratio. A change of at least 5° was considered clinically meaningful.Aims
Methods
Routine surveillance of primary hip and knee arthroplasties has traditionally been performed with office follow-up visits at one year postoperatively. The value of these visits is unclear. The present study aims to determine the utility and burden of routine clinical follow-up at one year after primary arthroplasty to patients and providers. All patients (473) who underwent primary total hip (280), hip resurfacing (eight), total knee (179), and unicompartmental knee arthroplasty (six) over a nine-month period at a single institution were identified from an institutional registry. Patients were prompted to attend their routine one-year postoperative visit by a single telephone reminder. Patients and surgeons were given questionnaires at the one-year postoperative visit, defined as a clinical encounter occurring at nine to 15 months from the date of surgery, regarding value of the visit.Aims
Methods
The purpose of this study was to assess the overall clinical and radiographic outcomes of unicompartmental knee arthroplasty (UKA) in the 2–10 year postoperative period. The secondary goal was to compare outcomes between fixed- (FB) and mobile-bearing (MB) implant designs. We performed a retrospective analysis of 237 consecutive primary medial UKAs from a single academic center. All cases were performed by high-volume fellowship-trained arthroplasty surgeons, though UKA comprised <10% of their overall knee arthroplasty practice (<20 medial UKAs per surgeon per year). Clinical outcomes included the Oxford Knee Scores (OKS) and revision rates. Femoral and tibial coronal and sagittal angles (FCA, FSA, TCA, TSA) were radiographically measured. FCA (>±10º deviation from the neutral axis), FSA (>15º flexion), TCA (>±5º deviation from the neutral axis), and TSA (>±5º deviation from 7º) outliers were defined. Far outliers were defined as measurements that fell an additional >±2º outside of these ranges. Outcomes were compared between the FB and MB groups.Background
Methods
Periprosthetic infection (PJI) after primary total knee arthroplasty (TKA) remains a challenging issue affecting 1–2% of cases. Locally delivered prophylactic antibiotics, including tobramycin or gentamicin mixed in polymethylmethacrylate (PMMA) bone cement and vancomycin powder, are increasingly used despite a lack of high quality evidence for either practice. In this study, we report the antibiotic susceptibility of organisms recovered in culture from patients with acute prosthetic joint infection after primary TKA to gentamicin, tobramycin and vancomycin. Using a retrospective database of all primary TKA performed at a single institution between January, 1 2014 and July 1, 2018, we identified 18 cases of acute PJI after primary TKA, as defined by the Musculoskeletal Infection Society 2011 guidelines as less than 3 months from symptoms or index surgery to presentation. The use of antibiotic bone cement during the index procedure and time to surgical management of the infection were recorded. Fluid cultures and tissue cultures were obtained intraoperatively at the time of revision. The organisms from positive cultures underwent MIC testing to gentamicin, tobramycin and vancomycin using a gradient diffusion method (ETEST). MIC breakpoints for susceptibility were based on Clinical and Laboratory Standards Institute definitions.Introduction
Methods
The aim of this study was to determine the change in standing pelvic sagittal alignment and associated impact on functional acetabular component position at follow-up after total hip arthroplasty (THA). A retrospective review was performed on 91 consecutive patients who had undergone primary THA by a single surgeon via a posterior approach in the lateral decubitus position. Of these, 41 patients had high quality standing AP pelvis radiographs preoperatively, at six weeks postoperatively, and at one year postoperatively available for analysis. Pelvic ratio was defined as the ratio between the vertical distance from the inferior sacroiliac (SI) joints to the superior pubic symphysis and the horizontal distance between the inferior SI joints. Apparent changes in the functional acetabular component position were determined from the change in pelvic ratio between the preoperative and one year postoperative standing AP pelvic radiograph. A change of at least five degrees was considered clinically meaningful.Background
Patients and Methods
Implant malalignment is an important predictor of prosthetic failure following total knee arthroplasty (TKA). The purpose of this study was to determine the incidence of outliers for common alignment targets and the impact of surgeon volume and experience on the accuracy of implant alignment with current generation manual instrumentation. This study was a retrospective, multi-center, radiographic analysis of 1675 consecutive primary uncomplicated TKAs from seven surgeons at three academic and state-funded centers in the US and UK. Surgeons were categorized as “high-volume” (≥50 TKAs/year) and “high-experience” (≥5 years post-fellowship). Femorotibial, tibial varus/valgus, and posterior tibial slope angles were digitally measured using postoperative radiographs. Femorotibial (<2° or >8° valgus), tibial (> ±3° deviation from the neutral axis), and tibial slope (<0° or >7° of flexion for cruciate retaining, <0° or >5° of flexion for posterior stabilized) angle outliers were identified. The proportion of outliers among surgeons in each subgroup was compared.Introduction
Methods
