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  • EOS receives FDA approval for THA planning software

    EOS Imaging recently announced the FDA has approved hipEOS, the company's new 3-D planning software for total hip arthroplasty procedures. Designed with the intent to improve preoperative planning, hipEOS allows surgeons to test everything from hip implant selection to positioning in functional, weight-bearing 3-D based on the anatomical data specific to each patient. These data stem from the company's stereo-radiographic 2-D/3-D imaging and represent the first instance of a software portfolio offered with the EOS imaging system, according to a company press release. This improvement in planning via hipEOS is believed to aid surgeons in the accuracy of the restoration they anticipate following THA.

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  • Most dislocated hips placed within ‘safe zone’ during THA, study finds

    DALLAS — During their minimum 2-year follow-up, researchers here reported a 1.9% rate of subsequent dislocation after total hip arthroplasty in a contemporary practice and noted 58% of these cases had an acetabular socket position within the Lewinnek safe zone.

    “Most contemporary total hip arthroplasties that dislocate are within the Lewinnek safe zone,” Matthew P. Abdel, MD, said during his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “Cup position for some patients certainly lies outside this safe zone. Most importantly, new technologies will need better targets to hit prior to them being clinically relevant or economically feasible.”

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  • Researchers found better cup, stem survival after early THA

    Patients who underwent early total hip arthroplasty experienced better 10-year cup and stem survival compared with patients who underwent late total hip arthroplasty, according to study results.

    Researchers searched the Medline databases from January 1990 to January 2014 and retrieved 19 articles reporting on the management of posttraumatic arthritis of the hip following acetabular fractures with the use of late total hip arthroplasty (THA), as well as articles where acetabular fractures were treated with early THA. In all, the researchers assessed THA outcomes following acetabular fracture in 654 patients.

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  • Prehabilitation Could Help Knee and Hip Replacement Patients Recover

    With the number of total knee and hip replacements on the rise, doctors are looking for ways to reduce the amount of care needed after surgery. Prehabilitation (physical therapy before surgery) could help patients recover faster and save money.

    Rehabilitation following knee or hip replacement is the standard of care. The physical therapy is designed to help patients adjust to new joints and strengthen muscles.

    A new study found that physical therapy before the joint replacement surgeries reduced the need for rehab after the surgery.

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  • Intra-articular tranexamic acid benefitted TKA patients without increased risk of DVT, PE

    Among patients who underwent total knee arthroplasty, intra-articular tranexamic acid significantly reduced total blood loss, drainage, reduction of hemoglobin and the need for transfusion without increasing the incidence of deep venous thrombosis and pulmonary embolism, making it safe and efficacious, according to study results.

    Through a search of various databases for relevant randomized, controlled trials, researchers included seven studies comprising 622 patients. The researchers calculated mean difference in total blood loss, risk ratio for transfusion and complication rate in the tranexamic acid-treated group vs. the placebo group.

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  • Acoustic technique developed to detect knee osteoarthritis

    A revolutionary medical technique using sound waves to identify osteoarthritis in the knee has been developed by researchers.

    The UK is leading this new field of health research based on listening to the sounds emitted by the body.

    Microphones are attached to the knees of patients, and the high frequency sound waves emanating from their knees are measured as they stand up. These acoustic emissions are interpreted by computer software to give information about the health of the patient's knee.

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  • Pacira Pharmaceuticals Inc. announces new data on the use of EXPAREL to treat postsurgical pain following total knee arthroplasty

    Pacira Pharmaceuticals, Inc. has announced results of an independent, physician-initiated study designed to evaluate the difference in postsurgical pain and opioid consumption between patients who received EXPAREL versus a multi-drug analgesic cocktail for pain management following total knee arthroplasty (TKA). The data, presented at the annual meeting of the American Association of Hip and Knee Surgeons (AAHKS), found that patients treated with EXPAREL reported significantly lower patient-perceived pain scores and morphine sulfate equivalence consumption, and reported higher satisfaction with pain control and overall experience, compared with patients who received the multi-drug analgesic cocktail.

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  • No functional differences found between short-, straight-stem THA implants

    Recently published study data indicated short-stem and straight-stem implants for total hip arthroplasty exhibited no significant differences in functional outcome measures.

    Researchers conducted a randomized, double-blinded study of 80 patients who underwent total hip arthroplasty (THA). Patients were grouped by whether their THA utilized a short-stem or conventional straight-stem implant. Radiological and functional outcomes were evaluated at 6 weeks postoperatively, and quality of life was quantified via Harris Hip Score, SF-36 and WOMAC scores.

    No significant changes in offset differences were observed in either group from before surgery to after surgery. At final follow-up, no significant differences between groups were found in Harris Hip Score, SF-36 or WOMAC values, according to the researchers.

    Comparison of long-term survival rates among both cohorts will help determine whether short stems are a viable alternative THA solution, the researchers concluded.

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  • Chronic kidney disease increases prosthetic joint infection rates after TJA

    Patients with stage 1, 2 or 3 chronic kidney disease may have a higher rate of prosthetic joint injection after total joint arthroplasty, according to study results.

    Researchers retrospectively reviewed electronic medical records for 377 patients with stage 1 to 2 kidney disease with 402 patients who had stage 3 chronic kidney disease. All patients underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2004 and 2011.

    Patients with stage 3 chronic kidney disease had a greater rate of overall mortality compared with patients with stage 1 to 2 chronic kidney disease, according to the researchers.

    When adjusted for comorbid disease, the researchers found no significant increases in joint infection, readmission or early revision between patients with stage 1 to 2 chronic kidney disease compared with patients with stage 3 chronic kidney disease.

    Compared with patients with end-stage renal disease, dialysis and kidney transplant, overall incidence of infection was high but much less in chronic kidney disease patients.

    In a subgroup analysis, the significant difference in mortality rate persisted between the stage 1 to 2 group vs. the stage 3 group in patients who had undergone THA, but not in patients who had undergone TKA, according to the researchers. 
    Study results showed a slightly lower rate of 90-day readmission in patients with stage 1 to 2 chronic kidney disease who underwent TKA than in patients with stage 3 chronic kidney disease, whereas 90-day readmission was slightly higher in the THA subgroup.

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  • Higher baseline expectations for TJR improved health-related quality of life, satisfaction

    Health-related quality of life and satisfaction improved among patients who had higher expectations for total joint replacement at baseline compared with patients who had lower expectations, according to study results.

    Researchers recruited 892 patients preparing for total joint replacement (TJR) of the knee or hip due to primary osteoarthritis. Before surgery and for 12 months afterward, patients completed questionnaires with five questions about expectations before surgery; an item to measure satisfaction; WOMAC and SF-12; and questions about sociodemographic information. The researchers performed general linear models and logistic regression analysis to determine the association of patients’ expectations at baseline with satisfaction and changes in health-related quality of life (HRQoL) 12 months after surgery.

    Study results showed larger improvements in HRQoL at 12 months among patients who had higher pain relief or ability to walk expectations. WOMAC and SF-12 physical component summary domains also improved more among patients with high expectations regarding the ability to walk, interact with other and psychological wellbeing expectations, according to the researchers.
    Patients with very high expectations on the SF-12 physical component summary regarding their ability to walk and with high or very high pain relief expectations on SF-12 mental component summary experienced better improvement compared with patients with low expectations, the researchers found.

    The researchers also found patients who had high or very high daily activities expectations were more likely to be satisfied.

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