Submit to Special Issue Submit Abstract to Special Issue Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

New Advances in Hip and Knee Reconstructive Surgery

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 6249

Share This Special Issue

Special Issue Editor

Dr. Senthil Sambandam

E-Mail Website
Guest Editor

1. Department of Orthopedics, VA North Texas Health Care System, Dallas, TX 75216, USA
2. Department of Orthopedics, University of Texas Southwestern, Dallas, TX 75390, USA
Interests: orthopaedic surgery; arthroplasty; knee; hip; ankle; trauma
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Today, knee and hip surgery are among the most successful surgical procedures. Nonetheless, the number and severity of associated complications are still of clinical concern, with periprosthetic joint infection (PJI) being a disastrous complication after hip and knee replacement surgery.

The design and implementation of surgery, as well as the overall diagnosis and treatment of postoperative infectious complications, material failure, prosthetic loosening, and joint instability, etc., have been the subject of intensive research to understand, prevent and treat the diseases associated therewith. Rehabilitation training also has very important clinical significance for the postoperative functional recovery of patients.

This Special Issue aims to invite authors to submit original papers or review articles on specific and novel approaches to knee and hip problems, providing readers with the latest research results.

Dr. Senthil Sambandam
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

knee
hip
joint function
revision arthroplasty
periprosthetic joint infection
muscle damage
alignment
surgical advances
osteotomies
fracture
robotic surgery

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (7 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Other

11 pages, 226 KiB

Open AccessArticle

Usage of Tranexamic Acid for Total Hip Arthroplasty: A Matched Cohort Analysis of 144,344 Patients

by Anubhav Thapaliya, Mehul M. Mittal, Terrul L. Ratcliff, Varatharaj Mounasamy, Dane K. Wukich and Senthil N. Sambandam

J. Clin. Med. 2024, 13(16), 4920; https://doi.org/10.3390/jcm13164920 - 20 Aug 2024

Viewed by 686

Abstract

Background: The literature is inconclusive regarding the potential complications of tranexamic acid (TXA), an antifibrinolytic drug, for total hip arthroplasty (THA). The purpose of this study is to compare complication rates and patient outcomes between THA patients administered TXA vs. THA patients not administered TXA. Methods: The TriNetX Research network was utilized to generate a cohort of adult patients who underwent THA between 2003 and 2024. These patients were categorized into two subgroups for the retrospective analysis: (1) patients who received TXA 24 h prior to THA (TXA), and (2) patients who did not receive TXA 24 h prior to total hip arthroplasty (no-TXA). The follow-up period was 30 and 90 days. Results: At 30 days following THA, the TXA patients had a reduced risk of transfusion (risk ratio (RR): 0.412; 95% confidence intervals (CI): 0.374, 0.453), reduced risk of DVT (RR: 0.856; CI: 0.768, 0.953), reduced risk of joint infection (RR: 0.808; CI: 0.710, 0.920), but a higher rate of periprosthetic fracture (RR: 1.234; CI: 1.065, 1.429) compared to patients who did not receive TXA. At 90 days following THA, TXA patients had a reduced risk of transfusion (RR: 0.446; CI: 0.408, 0.487), DVT (RR: 0.847; CI: 0.776, 0.924), and periprosthetic joint infection (RR: 0.894; CI: 0.815, 0.982) compared to patients who did not receive TXA. Patients who received TXA had higher rates of periprosthetic fracture (RR: 1.219; CI: 1.088, 1.365), acute postoperative anemia (RR: 1.222; CI: 1.171, 1.276), deep surgical site infection (SSI) (RR: 1.706; CI: 1.117, 2.605), and superficial SSI (RR: 1.950; CI: 1.567, 2.428) compared to patients who did not receive TXA. Conclusions: Patients receiving TXA prior to THA exhibited significantly reduced the prevalence of blood transfusions, DVT, and periprosthetic joint infection following THA. However, superficial SSI and periprosthetic fracture were seen with higher rates in the TXA cohort than in the no-TXA cohort. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

► Show Figures

Graphical abstract

12 pages, 867 KiB

Open AccessArticle

Local Infiltration Analgesia Is Superior to Regional Nerve Blocks for Total Hip Arthroplasty: Less Falls, Better Mobility, and Same-Day Discharge

by Catalina Baez, Hernan A. Prieto, Abtahi Tishad, Terrie Vasilopoulos, Emilie N. Miley, Justin T. Deen, Chancellor F. Gray, Hari K. Parvataneni and Luis Pulido

J. Clin. Med. 2024, 13(16), 4645; https://doi.org/10.3390/jcm13164645 - 8 Aug 2024

Viewed by 856

Abstract

Background: Multimodal analgesia in total hip arthroplasty (THA) provides better pain control, mobility, and reduced side effects compared to monotherapies. Local infiltration analgesia (LIA) and regional nerve blocks (RNBs) are commonly used throughout these protocols. This study aimed to compare these procedures as part of a multimodal analgesia protocol for patients undergoing THA. Materials and Methods: A retrospective review of 1100 consecutive elective primary THAs was performed in 996 patients between June 2018 and December 2021. The RNB consisted of a preoperative continuous femoral nerve catheter and single-shot obturator nerve block, and LIA consisted of the intraoperative infiltration of weight-based bupivacaine. Results: A total of 579 (52.6%) patients received RNB, and 521 (47.4%) received LIA. Mean oral morphine equivalents (OMEs) during the first four hours postoperatively were significantly lower for LIA group (p < 0.001). However, the numeric pain rating scale in the post-anesthesia care unit (PACU) was similar between groups. Patients with LIA had significantly greater first ambulation distance in the PACU (p < 0.001), higher successful same-day discharge rate (p = 0.029), fewer falls (p = 0.041), and less refill OMEs post-discharge (p < 0.001) than RNB. Conclusions: In the setting of similar pain management between groups and better functional outcomes for LIA, the use of minimally invasive procedures like LIA for pain control following THA is favorable. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

► Show Figures

Figure 1

12 pages, 2696 KiB

Open AccessArticle

Functional Outcome after Direct Anterior Approach Total Hip Arthroplasty (DAA-THA) for Coxa Profunda and Protrusio Acetabuli—A Retrospective Study

by Tizian Heinz, Hristo Vasilev, Philip Mark Anderson, Ioannis Stratos, Axel Jakuscheit, Konstantin Horas, Boris Michael Holzapfel, Maximilian Rudert and Manuel Weißenberger

J. Clin. Med. 2024, 13(16), 4596; https://doi.org/10.3390/jcm13164596 - 6 Aug 2024

Viewed by 733

Abstract

Objective: The direct anterior approach (DAA) is a recognized technique for total hip arthroplasty (THA) that spares soft tissue. Functional and clinical outcomes following THA via the DAA in patients with complex acetabular deformities, specifically coxa profunda (CP) and protrusio acetabuli (PA), have yet to be determined. Methods: A retrospective analysis was conducted on 188 primary THA cases, including 100 CP hips and 88 PA hips, performed via the DAA. Functional and clinical outcomes were evaluated by means of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Harris Hip Score (HHS) preoperatively and at a mean follow-up of 46 ± 14 months. Furthermore, potential complications were assessed. Results: From the preoperative to the latest postoperative visit, a significant improvement in the WOMAC total score was observed (CP: −34.89 ± 20.66; PA: −40.38 ± 21.11). The length of stay (LOS) was the only parameter predictive of the postoperative WOMAC total score, with each day of LOS increasing the postoperative WOMAC by a mean of 1.77 points (p < 0.01). The HHS improved by 38.37 ± 14.23 (PA-group) and 32.79 ± 14.89 points (CP-group). No significant difference in the patient-reported outcome measures (PROMs) between the CP- and PA-group was found. The survival rate for any revision was 97.70% (PA-group) and 92.80% (CP-group). Conclusion: The results of this study indicate that the minimally invasive DAA was not predictive of the functional and clinical outcome following DAA-THA in patients with CP and PA. Improvements in the mean WOMAC and HHS scores were above or within the reported MCID. Additionally, revision rates were well below those reported in the literature for short and intermediate follow-up periods. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

► Show Figures

Figure 1

11 pages, 524 KiB

Open AccessArticle

Comparison of Five-Day vs. Fourteen-Day Incubation of Cultures for Diagnosis of Periprosthetic Joint Infection in Hip Arthroplasty

by Catalina Baez, Robert MacDonell, Abtahi Tishad, Hernan A. Prieto, Emilie N. Miley, Justin T. Deen, Chancellor F. Gray, Hari K. Parvataneni and Luis Pulido

J. Clin. Med. 2024, 13(15), 4467; https://doi.org/10.3390/jcm13154467 - 30 Jul 2024

Viewed by 927

Abstract

Background: Periprosthetic joint infections (PJI) are among the most morbid complications in total hip arthroplasty (THA). The ideal incubation time, however, for intraoperative cultures for PJI diagnosis remains unclear. As such, the aim of this study was to determine if any differences existed in culture-positive rates and organism detection between five-day and fourteen-day cultures. Methods: This retrospective cohort study consisted of THA cases diagnosed with PJI performed between May 2014 and May 2020 at a single tertiary-care institution. Analyses compared five-day and fourteen-day cultures and carried out a pre-specified subgroup analysis by organism and PJI type. Results: A total of 147 surgeries were performed in 101 patients (57.1% females), of which 65% (n = 98) obtained five-day cultures and 34% (n = 49) obtained fourteen-day cultures. The positive culture rate was 67.3% (n = 99) with Staphylococcus aureus being the most common pathogen identified (n = 41 specimens, 41.4%). The positive culture rate was not significantly different between groups (66.3% five-day, 69.4% fourteen-day, p = 0.852). Fourteen-day cultures had a significantly longer time-to-positive culture (5.0 days) than five-day cultures (3.0 days, p < 0.001), a higher rate of fungi (5.6% vs. 0%), and a lower rate of Gram-negatives (4.5% vs. 18.7%, p = 0.016). Conclusions: Fourteen-day cultures did not increase the positivity rate, had higher rates of slow-growth pathogens, and had a longer time-to-positivization than five-day cultures. Prolonged culture holds may provide more thorough organism detection for PJI without increasing the diagnostic culture yield. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

► Show Figures

Figure 1

8 pages, 178 KiB

Open AccessArticle

Multivariate Analysis of Risk Factors for In-Hospital Dislocation Following Primary Total Hip Arthroplasty

by Hunter B. Jones, Andrew J. Hinkle, Yida Liu and Senthil N. Sambandam

J. Clin. Med. 2024, 13(12), 3456; https://doi.org/10.3390/jcm13123456 - 13 Jun 2024

Viewed by 726

Abstract

Background: Early dislocation following primary total hip arthroplasty (THA) is a rare but devastating complication and represents a source of patient morbidity and financial burden to the healthcare system. The objective of this study was to identify patient characteristics and comorbidities that are associated with increased early in-hospital dislocation rates following primary THA. Methods: A retrospective cohort study was conducted using patient data from the Nationwide Inpatient Sample (NIS) database; we identified patients who had undergone THA from 2016 to 2019 and compared those with an early periprosthetic dislocation prior to discharge to those without. The patient characteristics and comorbidities were compared using univariate analysis with a subsequent investigation of statistically significant variables using multivariate analysis. The variables were compared using chi square, Fisher’s exact test, and independent sample t-tests with data assessed using odds ratio with 95% confidence intervals. Results: A total of 5151 patients sustained an early dislocation compared to 362,743 who did not. Those who sustained an in-hospital dislocation were more likely to share the following characteristics: female sex (OR 1.21, p < 0.01), age > 70 (OR 1.45, p < 0.01), Caucasian ethnicity (OR 1.22, p < 0.01), SLE (OR 1.87, p < 0.01), and Parkinson’s disease (OR 1.93, p < 0.01). Certain characteristics were also associated with decreased odds of having an in-hospital dislocation including elective surgery (OR 0.14, p < 0.01), tobacco use (OR 0.8, p < 0.01), diabetes without complications (OR 0.87, p < 0.01), and a history of heart valve replacement (OR 0.81, p < 0.01). The length of stay was significantly longer (4.7 days vs. 2.3 days) as was the total hospital charges (USD $101,517 vs. USD $66,388) for the early in-hospital dislocation group. Conclusions: Several patient characteristics and comorbidities are associated with early in-hospital dislocation episodes following total hip arthroplasty including female sex, age > 70, non-elective surgery, SLE, and Parkinson’s. This information may be useful to help guide intraoperative implant selection and/or postoperative protocol in select patient populations to limit early instability as well as decrease the financial burden associated with this postoperative complication. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

12 pages, 3415 KiB

Open AccessArticle

Simultaneous Evaluation of Bone Cut and Implant Placement Accuracy in Robotic-Assisted Total Knee Arthroplasty

by Killian Cosendey, Julien Stanovici, Hugues Cadas, Patrick Omoumi, Brigitte M. Jolles and Julien Favre

J. Clin. Med. 2024, 13(5), 1293; https://doi.org/10.3390/jcm13051293 - 25 Feb 2024

Viewed by 967

Abstract

Background: This study aimed to evaluate the accuracy of bone cuts and implant placements, simultaneously, for total knee arthroplasty (TKA) performed using a system with an active robotic arm. Methods: Two experienced orthopaedic surgeons performed TKA on ten cadaveric legs. Computed tomography scans were performed to compare the bone cuts and implant placements with the preoperative planning. The differences between the planned and actual bone cuts and implant placements were assessed using positional and angular errors in the three anatomical planes. Additionally, the cut–implant deviations were calculated. Statistical analysis was performed to detect systematic errors in the bone cuts and implant placements and to quantify the correlations between these errors. Results: The root-mean-square (RMS) errors of the bone cuts (with respect to the planning) were between 0.7–1.5 mm and 0.6–1.7°. The RMS implant placement errors (with respect to the planning) varied between 0.6–1.6 mm and 0.4–1.5°, except for the femur and tibia in the sagittal plane (2.9°). Systematic errors in the bone cuts and implant placements were observed, respectively, in three and two degrees of freedom. For cut–implant deviations, the RMS values ranged between 0.3–2.0 mm and 0.6–1.9°. The bone cut and implant placement errors were significantly correlated in eight degrees-of-freedom (ρ ≥ 0.67, p < 0.05). Conclusions: With most of the errors below 2 mm or 2°, this study supported the value of active robotic TKA in achieving accurate bone cuts and implant placements. The findings also highlighted the need for both accurate bone cuts and proper implantation technique to achieve accurate implant placements. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

► Show Figures

Figure 1

Other

Jump to: Research

13 pages, 1402 KiB

Open AccessSystematic Review

Greater Risk of Periprosthetic Joint Infection Associated with Prolonged Operative Time in Primary Total Knee Arthroplasty: Meta-Analysis of 427,361 Patients

by Kyun-Ho Shin, Jin-Ho Kim and Seung-Beom Han

J. Clin. Med. 2024, 13(11), 3046; https://doi.org/10.3390/jcm13113046 - 22 May 2024

Cited by 1 | Viewed by 765

Abstract

Background/Objectives: Periprosthetic joint infection (PJI) is a severe complication in total knee arthroplasty (TKA) with catastrophic outcomes. The relationship between prolonged operative times and PJI remains debated. This meta-analysis investigated the link between prolonged operative times and the risk of PJI in primary TKA. Methods: A comprehensive search of the MEDLINE/PubMed, Cochrane Library, and EMBASE databases was conducted to identify studies comparing the incidence of PJI in TKAs with prolonged versus short operative times, as well as those comparing operative times in TKAs with and without PJI. Pooled standardized mean differences (SMD) in operative times between groups with and without PJI or surgical site infections (SSI), including superficial SSIs and PJIs, were analyzed. Additionally, the pooled odds ratios (OR) for PJI in TKAs with operative times exceeding 90 or 120 min were examined. Results: Seventeen studies involving 427,361 patients were included. Significant differences in pooled mean operative times between the infected and non-infected TKA groups were observed (PJI, pooled SMD = 0.38, p < 0.01; SSI, pooled SMD = 0.72, p < 0.01). A higher risk of PJI was noted in surgeries lasting over 90 or 120 min compared to those of shorter duration (90 min, pooled OR = 1.50, p < 0.01; 120 min, pooled OR = 1.56, p < 0.01). Conclusions: An association between prolonged operative time and increased risk of PJI in primary TKA has been established. Strategies for infection prevention should encompass thorough preoperative planning aimed at minimizing factors that contribute to prolonged operative times. Full article

(This article belongs to the Special Issue New Advances in Hip and Knee Reconstructive Surgery)

► Show Figures

Journal Menu

Journal Browser

New Advances in Hip and Knee Reconstructive Surgery

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (7 papers)

Research

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI