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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_9 | Pages 48 - 48
1 Oct 2020
Alamanda VK Sapountzis N Joseph A Chiu Y Cross M Windsor RE Rodriguez JA
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Introduction

Instability following total knee arthroplasty is a leading cause of failure and is often treated with component revision. The goal of this study was to determine if isolated tibial polyethylene insert exchange (ITPIE) to a higher-level constraint would afford similar outcomes to component revision in the properly selected patient.

Methods

We retrospectively evaluated 176 consecutive patients between 2016–2017 who were revised for symptomatic instability at a single institution. Demographic information and level of constraint preoperatively and postoperatively were documented. Radiographic parameters were also recorded for patients undergoing ITPIE. Outcome measures included all cause re-revision rates as well as patient reported outcome measures (PROMs) obtained preoperatively and at minimum 1-yr follow up. Descriptive analysis including sample t-test and chi square test were performed with statistical significance set at p <0.05.


The Bone & Joint Journal
Vol. 101-B, Issue 1_Supple_A | Pages 3 - 9
1 Jan 2019
Alamanda VK Springer BD

Aims

Prosthetic joint infection (PJI) remains a serious complication that is associated with high morbidity and costs. The aim of this study was to prepare a systematic review to examine patient-related and perioperative risk factors that can be modified in an attempt to reduce the rate of PJI.

Materials and Methods

A search of PubMed and MEDLINE was conducted for articles published between January 1990 and February 2018 with a combination of search terms to identify studies that dealt with modifiable risk factors for reducing the rate of PJI. An evidence-based review was performed on 12 specific risk factors: glycaemic control, obesity, malnutrition, smoking, vitamin D levels, preoperative Staphylococcus aureus screening, the management of anti-rheumatic medication, perioperative antibiotic prophylaxis, presurgical skin preparation, the operating room environment, irrigant options, and anticoagulation.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_13 | Pages 57 - 57
1 Oct 2018
Alamanda VK Wally MK Seymour RB Springer BD Hsu JR
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Introduction

Despite evidence-based recommendations opioids and benzodiazepines are commonly prescribed to treat osteoarthritis. This study aims to quantify the prevalence of opioid and benzodiazepine prescriptions given for the primary diagnosis of osteoarthritis across a large healthcare system. Additionally, we aim to characterize risk factors for drug misuse, abuse, and diversion.

Methods

We conducted a descriptive analysis of adult patient encounters with a primary diagnosis of osteoarthritis during a one-year time period from Jan –Dec 2016 at a large, healthcare system. Demographic data, prescription data, patient-specific prescription drug use risk criteria were collected. Descriptive analysis was conducted to characterize the population of arthritis patients who received prescription opioids. The rate of controlled substance prescribing was calculated for the population as a whole and among subgroups (age, facility type, and patient risk profile).