Periprosthetic joint infection is one of the most challenging complications arthroplasty. We identified current risk factors periprosthetic after modern arthroplasty, and determined incidence timing infection. reviewed prospectively collected data from our database on 9245 patients undergoing primary hip or knee arthroplasty between January 2001 April 2006. infections developed in 63 (0.7%). Sixty-five percent within first year index The infecting organism was isolated 57 cases (91%). common...

Background: With the recent trend toward minimally invasive total joint arthroplasty and increased emphasis on faster recovery shorter hospital stays, it has become increasingly important to recognize timing severity of various complications associated with elective ensure that early patient discharge is a safe practice. Methods: We evaluated systemic local primary unilateral lower-extremity arthroplasties performed during one year in 1636 patients. A 966 patients had hip arthroplasty, 670...

Abstract We compared the effectiveness, safety, and costs of outpatient (n = 87) inpatient 77) detoxification from alcohol in a randomized, prospective trial involving 164 male veterans low socioeconomic status. The outpatients were evaluated medically psychiatrically then prescribed decreasing doses oxazepam on basis daily clinic visits. program combined comprehensive psychiatric medical evaluation, with oxazepam, initiation rehabilitation treatment. mean duration treatment was...

Background Deep infection remains one of the most devastating and costly complications after total knee arthroplasty (TKA). The risk deep revision TKA is reportedly greater than that for primary TKA; however, we do not know exact incidence TKA. Questions/purposes We determined revision, type microorganisms involved TKA, potential factors this infection. Methods retrospectively reviewed 475 patients (476 knees) with 499 revisions performed between March 1998 December 2005. Of 476 knees, 91...

The association between wound drainage and subsequent periprosthetic infection is well known. However, the most appropriate treatment of not understood. We retrospectively reviewed records 10,325 patients (11,785 procedures), among whom 300 (2.9%) developed persistent (greater than 48 hours postoperatively) drainage. Wound stopped spontaneously 2 4 days in 217 treated with local care oral antibiotics. remaining 83 (28%) underwent further surgery. A single débridement resulted cessation...

Background: A rotating hinged total knee prosthesis may be utilized for the treatment of global instability or severe bone loss around knee. Older generations designs were associated with suboptimal outcomes. We evaluated outcome salvage reconstructions that had been performed use modern-generation modular segmental kinematic prostheses. Methods: The cohort included forty-three patients (twenty-nine women and fourteen men) who underwent forty-four arthroplasties a non-neoplastic condition...

Currently, most hospitals in the United States are obliged to report infections that occur following total joint arthroplasty Centers for Disease Control and Prevention through National Healthcare Safety Network surveillance. The objective of this study was identify risk factors surgical site were reported from a single institution.For study, 6111 primary revision arthroplasties performed April 2010 June 2012 identified. Surgical infection cases captured by surveillance staff on basis...

Background: The value of formal physical therapy after total hip arthroplasty is unknown. With substantial changes that have occurred in surgical and anesthesia techniques, self-directed may be efficacious restoring function to patients undergoing arthroplasty. Methods: We conducted a single-center, randomized trial 120 primary, unilateral who were eligible for direct home discharge. experimental group followed exercise program 10 weeks. control received the standard protocol included...

Clinical outcome measures used under value-based reimbursement models require risk stratification of patient demographics and medical history. Only certain perioperative factors may be influenced by the surgeon. The study evaluated surgeon-influenced modifiable associated with achieving literature-defined KOOS score thresholds to serve as foundation newly established alternative payment for total knee arthroplasties (TKA). We retrospectively reviewed a consecutive cohort 4,324 patients...

Background: It is currently unknown whether functional restrictions following total hip arthroplasty can reduce the prevalence of early postoperative dislocation. Our hypothesis was that dislocation more likely to occur in patients who were not placed on these restrictions. Methods: We performed a prospective, randomized study evaluate role uncemented through an anterolateral approach. Of 630 eligible consecutive patients, 265 (303 hips) consented be into one two groups (the "restricted"...

Our research group developed an implant retrieval program to study in vivo degradation of polyethylene. We now have evidence support our hypothesis that radiation-sterilized polyethylene occurs the body for not only historical gamma air sterilized liners, but also conventional inert (ArCom) and annealed highly crosslinked (Crossfire) liners as well. has led discovery most severe manifestations oxidation typically occur regions liner experiencing minimal wear, such rim component, where fluids...

Recurrent or persistent infection after two-stage exchange arthroplasty for previously infected total knee replacement is a challenging clinical situation. We asked whether second procedure could eradicate the and preserve function. evaluated 18 selected patients with failed implantation treated reimplantation between 1999 2005. Failure of treatment was defined as recurrence persistence infection. The minimum followup 24 months (mean, 40 months; range, 24-83 months). diagnosed in four...

This prospective study explores the incidence of preoperative deep venous thrombosis (DVT) in a group patients with hip and femur fracture who for various reasons experienced delay >24 hours from time injury until surgery. We also evaluated results treatment inferior vena cava (IVC) filter.There were 101 consecutive mean age 75.8 years. The to surgery was 3.5 days. All signs symptoms DVT underwent Doppler ultrasound before received prophylactic anticoagulation. Those IVC filter insertion...