Associations of Sleep and Shift Work with Osteoarthritis Risk.

Update This article was updated on February 6, 2019, because of a previous error. On page 105, in the subsection titled “Outcomes and Design” the sentence that had read “Furthermore, in a retrospective review, Houdek et al. 48 , at a mean follow-up of 8 years, demonstrated improved survivorship of 9,999 metal-backed compared with 1,645 all-polyethylene tibial components, over all age groups and most BMI categories” now reads “Furthermore, in a retrospective review, Houdek et al. 48 , at a mean follow-up of 8 years, demonstrated inferior survivorship of 9,999 metal-backed compared with 1,645 all-polyethylene tibial components, over all age groups and most BMI categories.” An erratum has been published: J Bone Joint Surg Am. 2019 Mar 20;101(6):e26.

Introduction: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are effective surgical interventions for end-stage osteoarthritis and other degenerative joint diseases. While pain relief is well established, assessment of functional outcomes and quality of life postoperatively remains critical for evaluating overall success. This study aimed to assess functional outcomes in patients undergoing primary or revision total knee or hip arthroplasty. Methods: This prospective observational study was conducted in the Department of Orthopaedics, Burdwan Medical College & Hospital, from June 2023 to June 2024, including 40 adult patients undergoing primary or revision total knee arthroplasty (TKA) or total hip arthroplasty (THA). Patients were evaluated for demographic variables such as age, gender, and BMI, along with comorbidities. Clinical outcomes were assessed using validated functional scores (WOMAC, KSS for TKA; HOOS for THA), pain scores (VAS), range of motion (ROM), and objective performance tests (6-minute walk test and Timed Up & Go test). Postoperative complications were recorded and analyzed. Data were collected systematically and subjected to appropriate statistical analysis to evaluate functional outcomes, pain relief, and complication rates following arthroplasty. Results: This study of 40 patients (20 TKA, 20 THA) demonstrated significant postoperative improvements in pain, function, and mobility with both procedures. TKA patients showed reductions in WOMAC (58.6 to 23.4) and gains in KSS (45.7 to 85.2), while THA patients improved in HOOS (55.3 to 20.7) (all p < 0.001). ROM, VAS, 6-minute walk distance, and TUG time improved significantly in both groups, with no significant difference in complication rates (3 cases each). Pearson’s correlation confirmed a strong negative association between pain reduction and functional improvement (TKA: r = –0.65, p = 0.002; THA: r = –0.58, p = 0.006). Conclusion: Total knee and hip arthroplasty provide significant improvement in pain relief and functional outcomes. Early postoperative rehabilitation and careful patient selection contribute to favorable results. These procedures demonstrate high efficacy and safety, significantly enhancing the quality of life in patients with degenerative joint disease.

European Guidelines on perioperative venous thromboembolism prophylaxis: Executive summary.

What's New in Hip Replacement.

Fast-track hip and knee arthroplasty...how fast?

Background:Loneliness is a risk factor of morbidity and mortality. Although the association of loneliness with osteoarthritis (OA) has been reported among young adults, the causal effect of loneliness on OA...

Effects of the Obesity Epidemic on Total Hip and Knee Arthroplasty Demographics

Shift work-induced circadian rhythm disruption has been identified as a risk factor for specific diseases. Additionally, physically demanding work has been linked to osteoarthritis. This study investigated the independent associations of shift work and physical work with risk of osteoarthritis. UK Biobank participants completed questionnaires detailing their employment status, including shift work, night shifts, heavy manual work and prolonged non-sedentary work. Responses were categorised into binary and categorical variables. Knee and hip osteoarthritis diagnoses were extracted from hospital records and osteoarthritis (any site) was self-reported. Logistic regression models, adjusted for age, sex, BMI, Townsend Deprivation Index and other work factors, were used to investigate the relationships between work characteristics and osteoarthritis outcomes. This study included 285,947 participants (mean age 52.7 years; males 48.0​%). Shift work and night shifts were associated with knee osteoarthritis (fully adjusted OR: 1.12 [95​% CI:1.07-1.17] and 1.12 [1.04-1.20], respectively), and self-reported osteoarthritis but there was little evidence of an association with hip osteoarthritis (1.01 [0.95-1.08] and 1.03 [0.93-1.14]). Heavy manual work and prolonged non-sedentary work were associated with increased risk of all osteoarthritis outcomes. Shift work showed independent associations with knee osteoarthritis and self-reported osteoarthritis but not hip osteoarthritis, suggesting circadian rhythm dysfunction may play a role in knee osteoarthritis pathogenesis. Heavy manual work and prolonged non-sedentary work were associated with all outcomes, with stronger associations in knee osteoarthritis, possibly reflecting the knee's higher susceptibility to biomechanical stress. Further research is needed to explore workplace interventions for reducing these risks.

Comparison of periprosthetic tissues in knee and hip joints: differential expression of CCL3 and DC-STAMP in total knee and hip arthroplasty and similar cytokine profiles in primary knee and hip osteoarthritis

Multicenter Randomized Controlled Trial Comparing Early Versus Late Aquatic Therapy After Total Hip or Knee Arthroplasty

Long-Term Mortality Trends After Total Hip and Knee Arthroplasties: A Population-Based Study

Circadian molecular clock disruption in chronic pulmonary diseases.

Objective To investigate the relationship between discharge C-reactive protein (CRP) level of osteoarthritis (OA) patients and periprosthetic joint infection (PJI) after primary unilateral total hip arthroplasty (THA) or total knee arthroplasty (TKA). Methods From January 2013 to December 2015, 480 OA patients receiving primary unilateral THA or TKA were admitted in department of Orthopedics of Zhongda Hospital Southeast University. The inclusion criteria were normal CRP level before operation, and exclusion criteria were preoperative history of infection, diabetes mellitus, malignant tumors, ect. The patients were divided into the high CRP group (273 cases) and the normal CRP group (207 cases) based on serum CRP level at discharging. Both groups were matched for known confounding factors such as sex, age and discharge time. The hemogram, temperature and wounds of all the patients were normal at discharge, and no antibiotic or NSAIDs were used after discharge. Cases and occurrence time of PJI were recorded during the follow-up. The measurement date were tested by t test, and the incidence of PJI was compared by chi-square test or Fisher’s exact probability method. Results Both groups were matched for known confounding factors such as sex, age and discharge time. A total of 415 cases were followed-up after discharge, ranging from 13 to 26 months (18±3) months on average. Although there were three and two PJI cases in both groups respectively at the last follow-up, the results indicated no significant difference in incidence rate of PJI (χ2=0.023, P>0.05). The occurrence time of PJI in the high CRP group was shorter than that in the normal CRP group obviously, and the higher CRP level at discharge, the shorter occurrence time of PJI. Conclusion There may be no relationship between discharge CRP level of OA patients and incidence rate of PJI after primary unilateral THA or TKA, however, the patients with high discharge C-reactive protein level should be closely followed up. Key words: C-reactive protein; Arthroplasty, replacement; Hip; Knee; Osteoarthritis; Joint prosthesis; Infection

The purpose of this study was to evaluate changes in perioperative tranexamic acid (TXA) utilization among patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA), based on patient demographics and comorbidities, including those at higher and lower risk of venous thromboembolism (VTE). Patients who underwent THA or TKA between 2012 and 2021 were identified using the TriNetX electronic health record database. Perioperative TXA use was evaluated among patients stratified according to risk of VTE. Utilization rates were analyzed using compound annual growth rates (CAGRs) and linear regression analysis. From 2012 to 2021, TXA use increased by 406% (CAGR: +17.66%; P < 0.001) for THA and 459% for TKA (CAGR: +18.86%; P < 0.001). Among patients with at least 1 factor placing them at high risk of VTE, TXA use increased by 1277% for THA (CAGR: +30.0%; P < 0.001) and by 966% for TKA (CAGR: +26.7%; P < 0.001). During the final study year (2021), surgeons overall used TXA in 67.8% of THA cases and 62.5% of TKA cases. In the high-risk group, TXA use was lowest among patients with a history of myocardial infarction (THA, 48.7%; TKA, 51.4%), cerebrovascular accident (THA, 51.0% and TKA, 50.6%), bleeding or clotting disorder (THA, 57.4% and TKA, 57.1%), or previous VTE (THA, 57.3%; TKA, 53.6%). Despite the rapid growth in TXA utilization over the past decade in THA and TKA, patients at high risk of VTE and ischemia are still less likely to receive perioperative TXA.

What's New in Adult Reconstructive Knee Surgery.