Orthopedics Commons^™

Cemented Femoral Fixation In A High-Risk Periprosthetic Fracture Cohort – A Case Series, John Spak, Philip C. Aurigemma, Yaser C. Rahim

The Lahey Journal

Introduction:
Periprosthetic femur fractures (PPFx) are a major cause of early revision after total hip arthroplasty (THA), accounting for nearly 20% of early failures. Cementless fixation, though widely used, has been associated with an increased risk of early PPFx, particularly in elderly or osteoporotic patients. Cemented femoral fixation may reduce this risk in high-risk populations.

Case Presentation:
We performed a retrospective review of 430 consecutive primary THAs conducted between July 2022 and July 2025 at a single institution. Cementless fixation was used in 390 patients and cemented fixation in 40 high-risk patients (mean age 81.7 vs. 65.9 years; BMI 24.5 …

Elixhauser Comorbidity Index To Predict Perioperative Bleeding And Adverse Spine Surgery Outcomes, Mitchell K. Ng, Michael A. Mont, Mosadoluwa Afolabi, Prathiksha N V, Amitha Kumar, Stephen S. Johnston

Rothman Institute Papers

Introduction: As spine surgery volume continues to grow, ensuring patient safety and minimizing complications are increasingly critical. Disruptive bleeding—defined as hemorrhagic events requiring clinical intervention—is a significant perioperative challenge. This study aimed to: (1) quantify disruptive bleeding incidence; (2) evaluate associations between patient demographics, Elixhauser Comorbidity Index (ECI), and bleeding risk; and (3) assess the impact of disruptive bleeding on mortality, ventilator use, length of inpatient stay, 90-day readmissions, and inpatient costs. Methods: A nationwide healthcare database was used to identify patients who underwent spine surgery in 2019. Patients were subdivided by the Elixhauser Comorbidity Index (ECI) from 0 to …

Partial Versus Full Revision In Cementless Single-Stage Exchange For Hip Periprosthetic Joint Infection: A Multicenter Comparative Study With 10-Year Survivorship Analysis, Wenbo Mu, Atthakorn Jarusriwanna, Boyong Xu, Scot A. Brown, Xiaogang Zhang, Alexander Dawes, Javad Parvizi Md, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty (THA). Traditional management typically involves full revision to ensure comprehensive infection eradication. However, for patients with well-fixed implants, partial revision in a single-stage cementless approach may provide a viable alternative, potentially preserving bone stock and reducing operative time. The relative efficacy of this approach compared with full revision remains to be fully explored. This multicenter study aims to determine whether partial revision in cementless single-stage exchange surgery offers comparable infection control outcomes to full revision for select patients with well-fixed implants.

METHODS: We conducted …

Effects Of Glucagon-Like-Peptide-1 Receptor Agonists (Glp-1a) Medications In Patients Undergoing Total Hip Arthroplasty (Tha): A Systematic Review And Meta-Analysis, Tanner Haechten, Troy B. Puga, Vincent Dieu, Mckenna W. Box, Kyle O'Connor, John T. Riehl

North Texas GME Research Forum 2026

Background Glucagon-Like-Peptide-1 Receptor Agonists (GLP-1a) medications have rapidly grown in popularity, however, their effects on the outcomes of Total Hip Arthroplasty (THA) remain largely unclear. The objective of this systematic review and meta-analysis is to evaluate the outcomes of patients undergoing THA and using a GLP-1a medication. Methods A search was conducted across six databases. The search used a combination of keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and included if they met eligibility criteria. Demographics and results of the studies were extracted from included articles. …

Efficacy And Outcomes Of Oxidized Regenerated Cellulose (Orc) In Total Joint Arthroplasty (Tja): A Systematic Review And Meta-Analysis, Jenna Chrabolowski, Troy B. Puga, Abanoub Attalah, Kyle P. O'Connor, Mckenna W. Box, Ashley Stovall, Michael Muncy, John T. Riehl

North Texas GME Research Forum 2026

Introduction Intraoperative and postoperative blood loss is a major concern and challenge for surgeons in total joint arthroplasty (TJA). Patients with large blood loss can develop postoperative anemia and associated complications. Novel hemostatic agents, such as oxidized regenerated cellulose (ORC) have grown in popularity as intraoperative hemostatic adjuncts. The aim of this systematic review and meta-analysis is to evaluate the efficacy of ORC for intraoperative and postoperative blood loss.

Methods A search was conducted across MEDLINE/Pubmed, Cochrane, Google Scholar, Web of Science, and Embase databases. Titles and abstracts were screened for eligibility for inclusion criteria. Full texts were screened and …

Identifying Critical Evidence Gaps In Wound Closure And Incision Management After Total Hip Arthroplasty: Delphi Panel Insights, Margaret Ainslie-Garcia, Lucas Anderson, Benjamin Bloch, Tim N Board, Antonia Chen, Samantha Craigie, Walter Danker, Najmuddin Gunja, James Harty, Victor Hernandez, Kate Lebedeva, Mitchell Ng, Daniel Hameed, Michael Mont, Ryan Nunley, Javad Parvizi, Sean Sequeira, Carsten Perka, Nicolas Piuzzi, Ola Rolfson, Joshua Rychlik, Emilio Romanini, Pablo Sanz-Ruiz, Rafael Sierra, Linda Suleiman, Eleftherios Tsiridis, Pascal-André Vendittoli, Helge Wangen, Luigi Zagra

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: In total hip arthroplasty (THA), proper management of surgical incisions is essential for optimal wound healing and patient outcomes. Despite advances in surgical techniques, significant challenges remain in preventing complications and infections. This study aimed to identify evidence gaps in THA wound care, including presurgical preparation, intraoperative practices, and postsurgical complications.

METHODS: Using a modified Delphi method, 20 expert orthopedic surgeons from Europe and North America participated in a 3-phase consensus process from April 1 to September 30, 2023. This included a preliminary questionnaire, a remote conference, and a final online survey. The panel reviewed literature and achieved agreement …

Increasing Patient Age And General Anesthesia Are Risk Factors For Failure Of Same-Day Discharge Total Hip Arthroplasty, Kevin Xavier Farley, Robert Dean, Mark S. Karadsheh, Drew Douglas Moore

Conference Presentation Abstracts

INTRODUCTION: As cost containment efforts in orthopedic surgery increase, there has been a rise in same-day discharge total hip arthroplasty (THA). Same-day discharge THA has been further accelerated by the COVID-19 pandemic and the removal of THA from the Medicare inpatient only list. This study sought to evaluate risk factors for readmission following same-day discharge THA. METHODS: From 2012-2021, the National Surgical Quality Improvement Project database was used to identify all patients undergoing elective THA discharged the day of surgery to their home. Demographic, comorbid, and operative variables were collected, as displayed in Table 1. Readmission within 30-days of surgery …

Two-Dimensional Preoperative Digital Templating Is Less Accurate When Using A Collared Triple Taper Stem Versus A Single Taper Design, Claudio Diaz-Ledezma, Angel X. Xiao, Juan David Lizcano, Erik N. Hansen, Camilo Restrepo, William J. Hozack

Rothman Institute Papers

Background

Collared triple taper stems (CTTS) and single taper stems (STS) have an excellent performance in primary total hip arthroplasty (THA). While 2-dimensional radiographic templating is accurate for STS, data are lacking for CTTS. We hypothesize that CTTS’ more anatomical design in the anteroposterior dimension may lead to inaccurate templating sizing. This study compared templating accuracy of CTTS to a predecessor STS in THA patients.

Methods

106 THA performed with CTTS were compared to 106 THA performed with STS by 2 high-volume surgeons. The stems chosen for comparison were manufactured by the same company, use the same templating software, shared …

Outcomes After Total Hip Arthroplasty: Comparison Between Posterior And Anterior Approaches, Phillip Vartanyan, James Feng, Alex Miller, Ali Omari, Elijah Christian Auch, Hasson Alosh, Drew Douglas Moore, Mark S. Karadsheh

Conference Presentation Abstracts

INTRODUCTION: The effects of surgical approach in total hip arthroplasty (THA) are often debated. Here we compare patients who underwent THA through a posterior versus anterior approach and compared clinical outcomes and patient reported outcome measures (PROMs). METHODS: All primary THAs between January 2016 and December 2022 were obtained retrospectively from a prospective institutional database utilized for contribution to a state-wide joint arthroplasty database. Prospective data was abstracted including baseline demographics, select medical comorbidities, intraoperative variables, postoperative course/complications and patient reported outcomes. Two cohorts were developed based on approach: anterior (aTHA) and posterior (pTHA) THA. Cohort groups were compared utilizing …

Heterotopic Ossification (Ho) Prophylaxis In Total Hip Arthroplasty (Tha): A Systematic Review Of Level I And Level Ii Evidence Since 2000, Troy Puga, Mckenna Box, Vincent Dieu, Charles Marchese, John T. Riehl

North Texas Research Forum 2025

Introduction: Heterotopic ossification (HO) is a somewhat common occurrence after total hip arthroplasty (THA), particularly with certain approaches. This complication can be detrimental to the success of the surgical outcome. Indomethacin and radiotherapy remain common treatment modalities; however, no true gold-standard treatment is universally agreed upon. This study aims to evaluate Level I and Level II evidence for treatment practices of HO prophylaxis since 2000. Methods: To evaluate HO prophylaxis in total hip arthroplasty, a search was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases using keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for …

Evaluasi Ekonomi Total Hip Arthroplasty Protokol Enhance Recovery After Surgery Dibandingkan Konvensional Di Rsup Fatmawati Jakarta, Hanna Elisabet Lumbangaol, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Total hip arthroplasty (THA) is a common orthopedic procedure performed to replace damaged hip joints with prostheses. The demand for this procedure is expected to rise in the future. Enhanced Recovery After Surgery (ERAS) has been introduced as an evidence-based, multidisciplinary approach aimed at optimizing postoperative recovery and reducing hospital length of stay. This study aims to evaluate the costs and effectiveness, including hospital stay duration and surgical success rates, of THA using the ERAS protocol compared to conventional approaches. This cross-sectional study involved data collection from healthcare providers between January 2020 and May 2023. The analysis showed that both …

Total Hip Arthroplasty With Subtrochanteric Osteotomy For Crowe Iv Dysplasia Using An Extensile Direct Anterior Approach: A Surgical Technique, Brian T Muffly, Erik M Hegeman, Braden E Hartline, Keerat Singh, Ajay Premkumar, George N Guild

Faculty, Staff and Student Publications

The direct anterior approach (DAA) has been increasing in popularity for primary total hip arthroplasty (THA). Despite previously documented anatomic limitations to its direct distal extension, alternative exposure methods have been described to safely access the femoral diaphysis and facilitate increasingly complex primary and revision THA scenarios. The DAA has several purported advantages compared to alternative approaches (eg, posterior and lateral-based), including its muscle-sparing nature, use of an internervous plane, and preservation of posterior stabilizing structures. Proponents of the DAA cite decreased postoperative pain, quicker recovery times, potentially lower dislocation rates, ease of intraoperative fluoroscopy, and improved implant placement/restoration of …

Neuraxial Vs. General Anesthesia In Total Hip Arthroplasty For Femoral Neck Fracture: A Comparison Of Postoperative Complications, Kevin X. Farley, Hassan Mouzailhem, Robert S. Dean, Mark Karadsheh, Leonardo Cavinatto, Jacob Wilson, Drew Moore

Conference Presentation Abstracts

OBJECTIVE: Rates of complications with differing anesthetic choices has not been directly compared for patients undergoing total hip arthroplasty (THA) for femoral neck fractures. This study sought to directly compare neuraxial vs. general anesthetic use and compare postoperative outcomes for patients undergoing THA for a femoral neck fracture. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing THA for a femoral neck fracture. Anesthetic type was identified and categorized as neuraxial (spinal, epidural) or general. Demographic and comorbid variables were collected. Days from admission to surgery was also identified. Postoperative complications …

Patients Achieving 90°/45°/0° Intraoperative Stability Do Not Require Hip Precautions Following Posterior Approach Total Hip Arthroplasty: A Prospective Randomized Study, Rachael A. Turner, Marlie R. Mounts, Nimesh B. Patel, Erin N. Snelling, Raquel E. Phillips, Dean A. Levesque, Jared R.H. Foran

Research Symposium

Background: Hip precautions are traditionally employed after posterior total hip arthroplasty (THA). The primary purpose was to investigate the necessity of hip precautions after posterior approach THA. We hypothesized that eliminating precautions in patients that achieved appropriate intraoperative stability would not increase the dislocation rate.

Methods: Randomized controlled trial of 346 consecutive eligible patients undergoing primary THA with a mean follow-up of 2.3 years (range 11 months to 3.7 years). Exclusion criteria: lumbar fusion, scoliosis, abductor insufficiency, inability to achieve intraoperative stability with combined 90° flexion and 45° internal rotation in 0° adduction. Fisher's exact test was used to compare …

Surveillance Of Dual-Mobility Hip Systems: Damage Mode And Clinical Data Analysis, Camilla Cascardo, Conner D. Ahlgren, Michael J. Maxwell, Tyler Vovos, Mark Karadsheh, Drew Moore

Posters

Hip instability following total hip arthroplasty (THA) is a prominent indication for revision surgery. Dual mobility (DM) implants are designed to increase stability, and trending use makes characterizing in vivo damage and clinical failure modes important. This study expounds upon micro- and macroscopic damage mode findings of Lombardo et al., including novel screw ring damage using an updated retrieval registry.

Public Perception Of Robotic-Assisted Total Hip Replacement Surgery, James E. Feng, Marvee Espiritu, Phillip Vartanyan, Drew Moore, Robert Runner, Mark Karadsheh

Conference Presentation Abstracts

PURPOSE: Computer-assisted and robotic (CA/R) total hip arthroplasty (THA) has gained considerable attention due to its superior accuracy and precision. However, few studies have evaluated the public’s understanding and appraisal of this technology. Here, we evaluate the public’s initial perception of technology-assisted compared to traditional THA, and if interactive education may alter an individual’s preferences. MATERIALS & METHODS: A prospective cohort study was developed utilizing a 48-question, paid survey distributed via a clinically validated, public, online marketplace in April 2022. After collecting baseline demographics and knowledge regarding THA, participants were queried whether they would prefer a CA/R THA or traditional …

Surgeon Estimations Of Acetabular Cup Orientation Using Intraoperative Fluoroscopic Imagining Are Unreliable., Parker L Brush, Adrian Santana, Gregory R Toci, Eric Slotkin, Michael Solomon, Tristan Jones, Arjun Saxena

Rothman Institute Papers

BACKGROUND: Accurate acetabular cup orientation is associated with decreased revision rates and improved outcomes of primary total hip arthroplasty. This study assesses surgeon's ability to estimate both the acetabular component inclination and anteversion angles via intraoperative fluoroscopy (IF) images.

METHODS: We surveyed orthopedic surgeons to estimate acetabular component inclination and anteversion based on 20 IF images of total hip arthroplasty through a direct anterior approach. Postoperative computed-tomography scans were used to calculate the true inclination and anteversion component angles. The absolute difference between the true and estimated values was calculated to determine the mean and standard deviation of the survey …

Hemoglobinopathy Is Associated With Total Hip Arthroplasty Indication Even Beyond Sickle Cell Anemia, Maxwell J. Rakutt, Daniel N. Bracey, Anna Cohen-Rosenblum, Peter K. Sculco, Franco M. Sabatini, Cale A. Jacobs, Stephen T. Duncan, David C. Landy

School of Medicine Faculty Publications

Background: The extent to which hemoglobinopathies other than sickle anemia (HbSS) are associated with hip osteonecrosis is unknown. Sickle cell trait (HbS), hemoglobin SC (HbSC), and sickle/β-thalassemia (HbSβTh) may also predispose to osteonecrosis of the femoral head (ONFH). We sought to compare the distributions of indications for a total hip arthroplasty (THA) in patients with and without specific hemoglobinopathies. Methods: PearlDiver, an administrative claims database, was used to identify 384,401 patients aged 18 years or older undergoing a THA not for fracture from 2010 to 2020, with patients grouped by diagnosis code (HbSS N = 210, HbSC N = 196, …

Total Hip Arthroplasty In The Setting Of Post-Traumatic Arthritis Following Acetabular Fracture: A Systematic Review, Conor S O'Driscoll, Martin S Davey, Andrew J Hughes, John M O'Byrne, Michael Leonard, Brendan J O'Daly

Rothman Institute Papers

Background: Acetabular fractures are frequently associated with post-traumatic arthritis (PTA), for which total hip arthroplasty (THA) has emerged as the established procedure. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival of delayed THA for patients with PTA following acetabular fracture.

Methods: A systematic review was performed in December 2021 as per Preferred Reporting Items for Systematic Review and Meta-Analysis Guidelines to identify all studies reporting outcomes of delayed THA performed for PTA with a history of acetabular fracture. From an initial screen of 893 studies, 29 studies which met defined inclusion criteria …

Total Hip Arthroplasty In Patients With Neurological Conditions: A Systematic Review, Conor S O'Driscoll, Andrew J Hughes, Martin S Davey, Joseph M Queally, Brendan J O'Daly

Rothman Institute Papers

Background: As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, instability, and altered muscular tone. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival following THA for patients with neurological conditions affecting the hip. Thus, we aim to support orthopaedic surgeon decision-making when considering and planning THA for these patients.

Methods: A systematic review was performed as per Preferred Reporting Items for Systematic …

Optimisation Of Imaging Parameters During Ct Guided Interventional Procedures In Patients With Total Hip Arthroplasty, Anish Patel, Christine Azzopardi, Scott Evans, A Mark Davies, Steven James, Rajesh Botchu

Faculty, Staff and Student Publications

OBJECTIVE: To determine the optimal KV and mAs settings during CT guided injections in the presence of a total hip arthroplasty so that image quality is maintained whist keeping the dose as low as reasonably achievable.

METHODS: A total hip arthroplasty phantom with needles with differing gauges was scanned using different CT parameters (from low dose to high dose) and evaluating if this had any effect on needle conspicuity. Conspicuity was graded from 1 to 3 by 2 independent blinded reviewers.

RESULTS: Irrespective of the CT settings used (high dose or low dose parameters) needle conspicuity was not adversely affected …

Short-Term Pain Outcomes In Robotic Versus Manual Total Hip Arthroplasty, Brienne Paradis Oms3, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background: Four-hundred-fifty-thousand patients annually undergo total hip arthroplasty (THA) in the United States. THA has been shown to alleviate pain, restore function, and improve quality of life. Manual implant postoperative complications have led to a need for more advanced technology. Robotic assisted THA has the potential for greater accuracy in component positioning compared to manual. Comparing robotic and manual THA, significant differences have been shown in hip-specific functional outcomes, component positioning, complications, and patient-centered outcomes. The effects of these techniques on differences from baseline pain have yet to be investigated.

Methods: A retrospective review of the Berkshire Medical Center electronic …

Is Prior Hip Arthroscopy Associated With Higher Complication Rates Or Prolonged Opioid Claims After Total Hip Arthroplasty? A Matched Cohort Study, Bailey J Ross, Ryan J Wortman, Olivia C Lee, Alfred A Mansour, Wendell W Cole, William F Sherman

Faculty, Staff and Student Publications

BACKGROUND: Hip arthroscopy (HA) procedures have increased exponentially in recent years. Their effect on outcomes after subsequent total hip arthroplasty (THA) remains unclear.

PURPOSE: To compare rates of complications and opioid claims after elective THA among patients with prior HA versus controls.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent THA were identified in the PearlDiver database. Arthroplasty performed for hip fractures and hip avascular necrosis were excluded. Within this population, patients with HA before arthroplasty (n = 3156) were propensity score matched 1:1 with controls on age, sex, US region, and several comorbidities. Rates of …

Is Prior Hip Arthroscopy Associated With Higher Complication Rates Or Prolonged Opioid Claims After Total Hip Arthroplasty? A Matched Cohort Study, Bailey J Ross, Ryan J Wortman, Olivia C Lee, Alfred A Mansour, Wendell W Cole, William F Sherman

Faculty, Staff and Student Publications

BACKGROUND: Hip arthroscopy (HA) procedures have increased exponentially in recent years. Their effect on outcomes after subsequent total hip arthroplasty (THA) remains unclear.

PURPOSE: To compare rates of complications and opioid claims after elective THA among patients with prior HA versus controls.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent THA were identified in the PearlDiver database. Arthroplasty performed for hip fractures and hip avascular necrosis were excluded. Within this population, patients with HA before arthroplasty (n = 3156) were propensity score matched 1:1 with controls on age, sex, US region, and several comorbidities. Rates of …

Resolution Of Deep Peroneal Nerve Palsy After Seroma Evacuation In A Primary Total Hip Arthroplasty: A Case Report., Brian W Skura, Craig Goubeaux, William C Burgette

Surgery Articles

INTRODUCTION: In this manuscript, we present a late presentation of deep peroneal nerve symptoms after total hip arthroplasty (THA) which subsequently completely resolved after seroma evacuation and sciatic nerve decompression. While hematoma formation causing deep peroneal nerve symptoms after THA has been reported in the literature, we are unaware of any reports of seroma formation causing similar symptoms.

CASE PRESENTATION: A 38-year-old female underwent an uncomplicated primary THA and developed paresthesia's over the lateral leg and foot drop on post-operative day 7. Ultrasound diagnosed a fluid collection compressing the sciatic nerve. The patient underwent seroma evacuation and sciatic nerve decompression. …

Consistency Of Acetabular Height In Sequential Bilateral Total Hip Arthroplasty, Qingwu Kong, Walaa Abdelfadeel, Rock Hwang, Arjun Saxena, Andrew Star

Rothman Institute Papers

Background: Achieving appropriate leg length after surgery remains a concern for surgeons performing total hip arthroplasty (THA). The focus of surgeons trying to equalize leg length has been primarily on positioning of the femoral implant. This study evaluates the impact of acetabular height on leg length and its impact on femoral component choices during THA.

Methods: We reviewed standing pelvic radiographs of 100 patients who underwent staged bilateral THA by a single surgeon from 2016 to 2019. Leg length discrepancies and acetabular heights were determined from preoperative and postoperative radiographs. The difference between the first and second operative hips was …

Dual-Mobility Implants And Constrained Liners In Revision Total Hip Arthroplasty, Emanuele Chisari, Blair Ashley, Ryan Sutton, Garrett Largoza, Marco Dispagna, Nitin Goyal, P. Maxwell Courtney, Javad Parvizi

Rothman Institute Papers

Background

Instability remains the most common complication after revision total hip arthroplasty (THA). The purpose of this study was to determine whether there was a difference in aseptic revision rates and survivorship between dual-mobility (DM) and constrained liners (CL) in revision THA.

Methods

We reviewed a consecutive series of 2432 revision THA patients from 2008 to 2019 at our institution and identified all patients who received either a CL or DM bearing. We compared demographics, comorbidities, indications, dislocations, and aseptic failure rates between the two groups. Bivariate and multivariate regression analyses were used to determine risk factors for failure, and …

Increased Use Of Opioids Perioperatively Leads To Unmanaged Postoperative Pain, Halida Sehic

Nursing | Senior Theses

Background: Total knee and total hip joint arthroplasty are two frequently preformed surgeries, with 5.2 million total knee arthroplasties performed the United States between the year 2000 and 2010 (Williams et al., 2015). Opioids are widely used to manage pain for patients undergoing total joint arthroplasty. However, use of opioids is associated with undesirable adverse effects, such as nausea and respiratory depression, (Johnson et al., 2011). In postoperative patients following total joint replacement, 75 % of the patients complain of inadequately controlled moderate to severe pain (De Luca et al., 2018). Increased use and overprescribing increase tolerance to opioids …

Surgeon Decision-Making For Individuals With Obesity When Indicating Total Joint Arthroplasty, William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee

School of Medicine Faculty Publications

Background: Obesity is a risk factor for complications after total joint arthroplasty (TJA). This study analyzed the impact of individual surgeon demographics, financial concerns, and other factors in determining patient candidacy for TJA based on body mass index (BMI). Methods: A 21-question survey was approved by the American Association of Hip and Knee Surgeons Research Committee for distribution to its membership. Objective questions asked about surgeon or hospital BMI thresholds for offering TJA. Subjective questions asked about physician comfort discussing topics including obesity, bariatric surgery, and weight loss before TJA, as well as insurance and age considerations. Results: For TJA …

A Surgeon's Handedness In Direct Anterior Approach-Hip Replacement., Xiangpeng Kong, Minzhi Yang, Alvin Ong, Renwen Guo, Jiying Chen, Yan Wang, Wei Chai

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: The impact of handedness on clinical outcomes was easily overlooked in hip replacement. This study aimed to find whether the component positioning and hip function were affected by the handedness in total hip arthroplasty (THA) through direct anterior approach (DAA).

METHODS: Total 102 patients who underwent bilateral DAA-THAs simultaneously between May 2016 and November 2018 in our institute were reviewed. All surgeries were operated by one right-handed surgeon. Their demographic, cup positioning, stem alignment, femoral stem fit, Harris hip score (HHS), intraoperative and postoperative complications were used to evaluate the role of handedness in DAA.

RESULTS: The inclination of …