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Arthroplasty: Advances in Surgical Techniques and Patient Outcomes
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Arthroplasty: Advances in Surgical Techniques and Patient Outcomes

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

Deadline for manuscript submissions: closed (15 December 2024) | Viewed by 1546

Special Issue Editor

Dr. Senthil Sambandam

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
Interests: hip arthroplasty; knee arthroplasty; hip fractures; arthroplasty; osteoarthritis; knee arthroscopy; joint replacement
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Total hip replacement is one of the most successful orthopedic procedures offered to patients with various hip joint pathologies. Researchers, clinical scientists, surgeons, device manufacturers, and hospital policy makers are constantly striving to advance the science and practice of total hip replacement based on the availability of new evidence. The availability of large databases has made it possible to analyze outcomes in rare pathologies and situations that are often not possible from single-center studies. In this Special Issue, we invite authors to submit manuscripts relating to various technical aspects of hip replacement, including, but not limited to, robotic hip replacement, direct anterior approaches, artificial intelligence, virtual reality, and outcomes related to newer advances in total hip replacement.

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

  • hip arthroplasty
  • knee arthroplasty
  • hip fractures
  • arthroplasty
  • osteoarthritis
  • knee arthroscopy
  • joint replacement

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Published Papers (2 papers)

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Research

10 pages, 226 KiB  
Article
The Effects of Syphilis Infection on Total Knee Arthroplasty Outcomes: A Retrospective Cohort Study
by Paul Gudmundsson, Marc Gadda, Aruni Areti and Senthil Sambandam
J. Clin. Med. 2024, 13(23), 7116; https://doi.org/10.3390/jcm13237116 - 25 Nov 2024
Viewed by 442
Abstract
Objective: This study investigated the impact of recent syphilis infection on postoperative outcomes following total knee arthroplasty (TKA). We hypothesized that patients with a documented history of syphilis infection would experience a higher rate of postoperative complications compared to those without such a [...] Read more.
Objective: This study investigated the impact of recent syphilis infection on postoperative outcomes following total knee arthroplasty (TKA). We hypothesized that patients with a documented history of syphilis infection would experience a higher rate of postoperative complications compared to those without such a history. Methods: We conducted a retrospective cohort analysis using a national insurance claims database. Our study population included 237,360 patients who underwent primary TKA between 2005 and 2024. Patients were classified into two groups based on the presence (+Syph) or absence (−Syph) of a syphilis diagnosis within one year prior to the TKA. We evaluated the rates of several postoperative complications at 30 days postsurgery, including infection, hematologic issues, and cardiac events. Statistical analyses between groups was performed using chi-squared tests and Fisher’s exact tests. Routine demographic data such as age, sex, race, and comorbidities were also analyzed. Results: Among the 237,360 TKA patients, we identified 71 with a history of syphilis within one year of their surgery. The +Syph group exhibited significantly higher rates of periprosthetic infection (4.23% vs. 0.81%, p = 0.001), need for manipulation under anesthesia (MUA) at four months (7.04% vs. 2.82%, p = 0.032), deep venous thrombosis (4.23% vs. 1.27%, p = 0.026), periprosthetic fracture (2.82% vs. 0.23%, p < 0.001), and pneumonia (2.82% vs. 0.62%, p = 0.019) within 30 days postTKA. No significant differences were observed in 30-day mortality, deep or superficial surgical site infections, wound dehiscence, blood loss anemia, or transfusion requirements. Additionally, rates of acute renal failure, pulmonary embolism, and cardiac events did not differ significantly between groups. Demographically, patients in the syphilis cohort had a higher prevalence of smoking and diabetes preoperatively within one year of their surgical date. Conclusions: A documented syphilis diagnosis within one year of TKA significantly affects postoperative outcomes, increasing the rates of prosthetic joint infection, MUA, deep venous thrombosis, periprosthetic fracture, and pneumonia. These findings underscore the need for heightened vigilance in the pre- and postoperative management of patients with a history of syphilis infection undergoing TKA. Further research is warranted to explore the relationship between prior syphilis infection and TKA outcomes, as well as to develop strategies to mitigate this increased risk. Full article
(This article belongs to the Special Issue Arthroplasty: Advances in Surgical Techniques and Patient Outcomes)
12 pages, 505 KiB  
Article
Intraoperative Periprosthetic Fractures in Total Hip Arthroplasty: A 1.6-Million-Patient Analysis of Complications, Costs, and the Challenges in AI-Based Prediction
by David Maman, Yaniv Steinfeld, Yaniv Yonai, Linor Fournier, Ofek Bar, Oleg Safir and Yaron Berkovich
J. Clin. Med. 2024, 13(22), 6862; https://doi.org/10.3390/jcm13226862 - 14 Nov 2024
Viewed by 625
Abstract
Background: Periprosthetic fractures following total hip arthroplasty are serious complications occurring in up to 2.4% of primary cases, contributing to significant morbidity, extended hospital stays, and elevated healthcare costs. Predicting these fractures remains a challenge despite advances in surgical techniques and prosthetic materials. [...] Read more.
Background: Periprosthetic fractures following total hip arthroplasty are serious complications occurring in up to 2.4% of primary cases, contributing to significant morbidity, extended hospital stays, and elevated healthcare costs. Predicting these fractures remains a challenge despite advances in surgical techniques and prosthetic materials. Methods: This study analyzed 1,634,615 cases of primary THA from the NIS database (2016–2019) using propensity score matching to compare outcomes between patients with and without intraoperative periprosthetic fractures. Predictive models, including logistic regression, decision tree, and deep neural network, were evaluated for their ability to predict fracture risk. Results: Patients with periprosthetic fractures exhibited a 14-fold increase in pulmonary embolism risk, a 12-fold increase in infections, and a 5-fold increase in hip dislocations. Fractures extended hospital stays (3.8 vs. 2.5 days) and added approximately USD 32,000 in costs per patient. The predictive models yielded low accuracy (AUC max = 0.605), underscoring the complexity of predicting periprosthetic fractures. Conclusions: Intraoperative periprosthetic fractures in THA significantly elevate complication rates, costs, and length of stay. Despite extensive modeling efforts, accurate prediction remains difficult, highlighting the need to focus on preventive strategies, such as improved surgical techniques and real-time intraoperative monitoring. Full article
(This article belongs to the Special Issue Arthroplasty: Advances in Surgical Techniques and Patient Outcomes)
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