This study aims to assess the relationship between history of pseudotumour formation secondary to metal-on-metal (MoM) implants and periprosthetic joint infection (PJI) rate, as well as establish ESR and CRP thresholds that are suggestive of infection in these patients. We hypothesized that patients with a pseudotumour were at increased risk of infection. A total of 1,171 total hip arthroplasty (THA) patients with MoM articulations from August 2000 to March 2014 were retrospectively identified. Of those, 328 patients underwent metal artefact reduction sequence MRI and had minimum two years’ clinical follow-up, and met our inclusion criteria. Data collected included demographic details, surgical indication, laterality, implants used, history of pseudotumour, and their corresponding preoperative ESR (mm/hr) and CRP (mg/dl) levels. Multivariate logistic regression modelling was used to evaluate PJI and history of pseudotumour, and receiver operating characteristic curves were created to assess the diagnostic capabilities of ESR and CRP to determine the presence of infection in patients undergoing revision surgery.Aims
Methods
Modular dual mobility (MDM) acetabular components are often used with the aim of reducing the risk of dislocation in revision total hip arthroplasty (THA). There is, however, little information in the literature about its use in this context. The aim of this study, therefore, was to evaluate the outcomes in a cohort of patients in whom MDM components were used at revision THA, with a mean follow-up of more than five years. Using the database of
a single academic centre, 126 revision THAs in 117 patients using a single
design of an MDM acetabular component were retrospectively reviewed. A total of 94 revision THAs in 88 patients with a mean follow-up of 5.5 years were included in the study. Survivorship was analyzed with the endpoints of dislocation, reoperation for dislocation, acetabular revision for aseptic loosening, and acetabular revision for any reason. The secondary endpoints were surgical complications and the radiological outcome.Aims
Methods
Survival after contemporary solid organ transplant (SOT) is increasing, and demand for total hip arthroplasty (THA) among SOT recipients is rising accordingly. The purpose of this study is to compare the perioperative outcomes and short-term implant- and patient-survivorship of contemporary THA following the most common types of SOT. Among SOT recipients, 119 primary THAs (92 patients, 39% female) were performed at a single institution from 2000–2020 and were retrospectively reviewed at a mean follow-up of 3.6yrs. Revisions, conversion to THA and multiple organs transplanted were excluded. The most common SOT was renal (39%), followed by lung (34%), liver (18%) and heart (8%). Demographics, peri-operative outcomes, 90-day re-admissions, re-operations and mortality were compared between SOT groups using chi-squared, Fisher's exact, Wilcoxon tests and Cox proportional hazard ratios.Introduction
Methods
Modular dual mobility (MDM) acetabular components are often used to prevent dislocation in revision total hip arthroplasty (THA). As there is insufficient data on these components, the outcomes were evaluated in a cohort with a mean follow-up time of greater than five years. Using the database of a single academic center, 126 revision THAs (117 patients) with one MDM were retrospectively reviewed. There were 94 hips in 88 patients with a mean follow-up time of 5.5 years. Survivorship analysis was performed with the endpoints of dislocation, reoperation for dislocation, cup revision for aseptic loosening, and cup revision for any reason. The secondary endpoints were perioperative complications and radiographic review.Background
Methods
Alternative payment models for total hip arthroplasty (THA) were initiated by the Center for Medicare and Medicaid Services (CMS) to decrease overall healthcare cost by optimizing healthcare delivery. The associated shift of financial risk to participating institutions has been criticized to introduce patient selection in order to avoid potentially high cost of care. This study aimed to evaluate the impact of the Comprehensive Care for Joint Replacement (CJR) model on patient selection, care delivery and hospital costs at a single care center. This is a retrospective review of THA patient from July 2015-December 2017 was performed. Patient were stratified by insurance type (Medicare and commercial insurance) and whether care was provided before or after implementation of the CJR bundle. Patient age, gender, and BMI, as well as Elixhauser comorbidities and ASA scores were analyzed. Delivery of care variables including surgery duration, discharge disposition, length of stay, and direct hospital costs were compared before and after CJR implementation.Introduction
Methods
