Editor's Note Thomas King, MD, an orthopedic surgeon at the Knee, Hip & Shoulder Center, Portsmouth, New Hampshire, has developed a process for total knee and hip replacements that allows many patients to leave the same day after surgery. He uses a combination of a minimally invasive technique, regional anesthesia,…

Read More

Editor's Note The Food and Drug Administration on October 2 categorized the recall of PROFEMUR Neck Varus/Valgus CoCr 8 degree, Part number PHAC 1254, by MicroPort Orthopedics as Class I, the most serious. The company has received reports of unexpected fractures after surgery related to this modular neck. If the…

Read More

Editor's Note Postoperative hip fracture patients are more likely to be successfully discharged home if they are rehabilitated in centers that care for at least 25 hip fracture patients per year, this study finds. Successful discharge was 43.7% for high-volume facilities (> 24 admissions/year) vs 18.8% for low-volume facilities (1-6…

Read More

Editor's Note Hip fracture surgery was associated with a higher risk of mortality and morbidity than elective total hip replacement (THR) even after adjustment for age, gender, and comorbidities, in this French study. Hip fracture patients had a 1.8% chance of dying before hospital discharge compared to 0.3% for THR…

Read More

Editor's Note Between 2000 and 2010, more than 5.2 million total knee replacements were performed in the US, and the rate at which adults had their knees replaced more than doubled (from 24 per 10,000 adults to 45 per 10,000), according to the Centers for Disease Control and Prevention’s National…

Read More

Editor's Note Total knee and total hip arthroplasties are associated with a substantially increased risk of myocardial infarction during the first postoperative month, finds this study. The MI risk gradually declined overtime, but the risk for venous thromboembolism remained years after the procedure. The study included 40,000 patients, half of…

Read More

Editor's Note The rate of major complications was significantly higher in Canada than the US after total knees, but there was no significant difference after total hips, this study finds. US patients also had substantially shorter lengths of stay, which perhaps reflects more efficient postoperative care and discharge planning, the…

Read More

Editor's Note Characteristics of total hip replacements (THRs) were found to be related to early prosthetic revision in this French study.  Antibiotic-free cemented and antibiotic-impregnated cemented THRs were compared with uncemented. Ceramic-on-ceramic, ceramic-on-polyethylene, and metal-on-metal THRs were compared with metal-on-polyethylene.  The antibiotic-impregnated cemented THRs had a better prognosis than uncemented,…

Read More

Editor's Note In this study, patients having hip fracture surgery under regional anesthesia had significantly more complications than patients who received general anesthesia. Spinal anesthesia had the highest complication rate (19.6%), followed by general anesthesia (17.9%), and regional nerve blocks (12.6%). After combining regional nerve block and spinal anesthesia patients,…

Read More

Editor's Note The Centers for Medicare & Medicaid Services is planning to require more than 800 hospitals in 75 geographic areas to participate in a bundled payments initiative for hip and knee replacements. These procedures are among the most common that Medicare beneficiaries receive, and prices vary significantly across geographic…

Read More