Number Of Arthroplasty Procedures Research Articles

Understanding Health Economics in Joint Replacement Surgery.

The number of arthroplasty procedures has been rising at a significant rate, contributing to a notable portion of the nation's health care spending. This growth has contributed to an increase in the number of health care economic studies in the field of adult reconstruction surgery. Although these articles are filled with important information, they can be difficult to understand without a background in business or economics. The goal of this review is to define the common terminology used in health care economic studies, assess their value and benefit in the context of total joint arthroplasty, and highlight shortcomings in the current literature. [Orthopedics. 2022;45(4):e174-e182.].

Targeting repeatability of a less obtrusive surgical navigation procedure for total shoulder arthroplasty.

Surgical navigation systems have demonstrated improvements in alignment accuracy in a number of arthroplasty procedures, but they have not yet been widely adopted for use in total shoulder arthroplasty (TSA). We believe this is due in part to the obtrusiveness of conventional optical tracking systems, as well as the need for additional intraoperative steps such as calibration and registration. The purpose of this study is to evaluate the feasibility of adapting a less-intrusive dental navigation system for use in TSA. We developed a proof-of-concept system based on validated laser-engraved surgical tools recently introduced for use in dental surgery that are calibrated once when manufactured and not recalibrated at time of use. The design also features a notably smaller bone-mounted tracker that can be tracked from a wide range of viewing angles. To assess our system's performance, we modified the dental surgical software to support guidance of a TSA procedure. We then conducted a user study in which three participants with varying surgical experience used the system to drill 30 holes in a glenoid model. Using a coordinate measuring machine, we determined the resulting drilled trajectory and compared this to the pre-planned trajectory. Since we used a model glenoid rather than anatomical specimens, we report on targeting precision rather than overall procedure precision or accuracy. We found targeting precision < 1mm (standard deviation) for locating the entry hole and < ~ 1° (SD) for both version and inclination. The latter value was markedly lower than the end-to-end angular precision achieved by previously reported TSA navigation systems (approximately 3°-5° SD). We conclude that variability during the targeting phase represents a small fraction of the overall variability exhibited by existing systems, so a less obtrusive navigation system for TSA based on laser-engraved tooling is likely feasible, which could improve the uptake rates of surgical navigation for TSA, thereby potentially leading to improved overall surgical outcomes.

Aspirin as venous thromboembolism prophylaxis in total joint arthroplasty: a narrative review of the current evidence

The utilization of aspirin (acetylsalicylic acid [ASA]) as primary prophylaxis for venous thromboembolism (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the United States has increased in concordance with the number of arthroplasty procedures being completed. The available literature regarding dosage, duration, efficacy, and safety varies considerably. This review assessed the recent published literature for both the efficacy and safety of aspirin as VTE prophylaxis. Overall, the rates of symptomatic VTE found in the literature ranged from 0.1% to 4.1%, of deep vein thrombosis (DVT) 0.1% to 3.0%, and of pulmonary embolism (PE) 0.1% to 1.5%. As for secondary outcome measures, the rate of major bleeding from either a gastrointestinal source or at the surgical site ranged from 0% to 3.2%, and the rate of transfusion between 7.0% to 20.0%. Among the studies that reported the infection rates, it ranged from 0.1% to 6.1%. The 90-day mortality rate was 0% to 0.23%. The available data and evidence remain inconclusive with regard to ASA dosage or the duration for patients after TKAs and THAs. However, ASA appears to be an effective option for VTE prevention when utilized as part of a multimodal approach to prophylaxis that includes early mobilization and mechanical compression devices.

Arthroplasty of the hip joint

Total hip arthroplasty has completely revolutionized the nature in which the arthritic hip is treated, and it is considered to be one of the most successful orthopedic interventions of its generation. It has been practiced at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad since 1970, and several thousand interventions like this have been performed. A continuous increase in the number of such interventions is noticed, this particularly applies to revision hip arthroplasty procedures by implanting cementless, hybrid and cemented prostheses. In routine clinical practice fresh frozen allotransplants from bone bank are used to fill the bone defect, and 671 revision hip interventions were performed in the last 15 years. A large number of arthroplasty procedures and good postoperative outcome result from long tradition in performing these interventions, and they are achieved by well educated orthopedic surgeons, excellent anesthesiology care and very professional staff assisting in treatment of these patients.