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Study confirms socioeconomic value of hip protectors, joint arthroplasty

Researchers in a recent issue of Orthopedic Research and Review have concluded that medical devices, such as hip protectors and total joint arthroplasty implants, are cost-effective and significantly improve patients’ lives, confirming their socioeconomic value.

“Orthopedic devices such as knee and hip implants or hip protectors have the potential to improve people’s lives. They allow for greater flexibility, faster return to an active, independent lifestyle and reduced risk of future fractures to name but a few benefits,” Yves Verboven, executive director at the European Health Technology Institute for Socio-Economic Research (EHTI), stated in a press release.

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Study shows direct correlation between linear wear of hip implants and patient activity

German and American researchers have conducted one of the first studies indicating a direct link between patient activity and the rate of linear wear in total hip replacements using alumina heads and conventional polyethylene.

Using univariate regression analysis, Finn and colleagues were able to assess weight, age at surgery, peak activity, medium intensity steps, high intensity steps, inclination angle and acetabular anteversion, according to the abstract. Age, weight, gender and cup position were not associated with the linear wear rate.

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Robot assistance simplifies placing patient-specific UKA prostheses in pilot study

A new robotic device led to placement of unicompartmental knee arthroplasty implants matched to the patient's anatomy that exceeded the accuracy of placements involving traditional procedures and components, according to results of a pilot study presented at the British Orthopaedic Association Congress 2012, here.

Preoperatively surgeons made operative plans for all these cases using input from CT scans that guided component position, orientation and selection of component size. Intraoperatively the surgeon holds the burr used to remove bone, but the robot provides haptic and visual feedback, Andrews said.

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PCL repair surgery did not lead to growth problems in pediatric, adolescent patients

Following failed conservative treatment, PCL repair or reconstruction is a safe and viable treatment option for pediatric and adolescent patients with multiligament or isolated PCL injuries, according to recent study results.

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Patients with high BMI show similar improvements in patient-reported outcomes after TKA

Researchers from the United Kingdom have reported similar improvements in patient-reported outcomes after elective total knee arthroplasty regardless of patient body mass index, according to a recent study published in the Journal of Bone & Joint Surgery.

“Patients achieve equivalent improvements in knee function and general health irrespective of their preoperative BMI,” Baker told ORTHOPEDICS TODAY. “Obese patients gain as much benefit from knee replacement as patients with a ‘normal’ BMI, even if they do not end up at a similar postoperative level. Accordingly, we feel that the obese should not be excluded from the benefit experienced by their fellow patients with lower BMI from undergoing total knee replacement.”

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Meta-analysis finds initial walking speed positively impacted by knee arthroplasty

Knee arthroplasty helped increase patients’ walking speed at 6 months to 60 months postoperatively, according to a study conducted by researchers in The Netherlands.
For the analysis, the authors looked through 16 independent comparisons of pre-operative and postoperative walking speed for patients who underwent knee arthroplasty. In all, they identified 12 studies in their survey of MEDLINE, Web of Science, and PEDro, for a total of 419 patients.

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Primary TKA found effective in patients with BMI greater than 50

Researchers from London, Ontario, found total knee arthroplasty efficacious in patients with body mass indices equal to or greater than 50, but remained cautious about the safety of the procedure in the group due to higher risks of complications and revisions.

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Direct anterior approach to THA yields good results, depends upon surgeon experience

The use of the direct anterior approach in total hip arthroplasty can yield good results backed by numerous studies but depends upon proper education, according to one surgeon’s experience.

J. Bohannon Mason, MD, shared his findings at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today.

“The best approach? They all have advantages and disadvantages,” he said. “When you look at [DA], it does require special instrumentation and I would say it does require special training – however, you have quick recovery, stability and proper cup positioning.”

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Long-term study reveals lower steady state wear with highly crosslinked polyethylene liners

After an initial period of rapid penetration in the first year, investigators of a level 1 study using radiostereometric analysis found a significantly lower steady state wear rate during 10-year follow-up among total hip arthroplasties performed with highly crosslinked polyethylene liners compared to conventional polyethylene.

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Follow-up, revision parameters for metal-on-metal hip implants outlined

In a recent presentation, one surgeon outlined his indications for follow-up and revision of metal-on-metal total hip replacements.

Thomas P. Schmalzried, MD, presented his experience at the International Congress for Joint Reconstruction San Diego 2012 meeting, which was held in collaboration with Orthopedics Today.

According to Schmalzried, revision should be considered in patients who display poor clinical results, such as pain or mechanical symptoms. Pseudotumor or other soft tissue involvement, such as edema and necrosis, are also a sign that revision should be performed within 3 months. Osteolysis and high metal ion levels should also bring revision into consideration.

Schmalzried stressed he still observes asymptomatic patients with “clean” MRIs, regardless of their metal ion levels.

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