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: 15 December 2024 | Viewed by 569

Special Issue Editor


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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
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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

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Keywords

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

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Published Papers (1 paper)

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Research

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 276
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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