Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 450 articles


The Mark Coventry Award: Higher Tissue Concentrations of Vancomycin With Low-dose Intraosseous Regional Versus Systemic Prophylaxis in TKA

Simon W. Young FRACS, Mei Zhang PhD, Joshua T. Freeman FRCPA, John Mutu-Grigg FRACS, Paul Pavlou FRCS, Grant A. Moore BSc (Hons)

In response to increasing antibiotic resistance, vancomycin has been proposed as an alternative prophylactic agent in TKA. However, vancomycin requires a prolonged administration time, risks promoting further antibiotic resistance, and can cause systemic toxicity. Intraosseous regional administration (IORA) is known to achieve markedly higher antibiotic concentrations than systemic administration and may allow the use of a lower vancomycin dose.

Intraarticular Fibrinogen Does Not Reduce Blood Loss in TKA: A Randomized Clinical Trial

Thomas Jan Heyse MD, Steven B. Haas MD, Denise Drinkwater BA, Stephen Lyman PhD, Han Jo Kim MD, Barbara A. Kahn BS, Mark P. Figgie MD

Bleeding remains an ongoing concern after total knee arthroplasty (TKA). Intraarticular application of human fibrinogen with a topical thrombin has been described to stop diffuse bleeding in knee arthroplasty.

Bundled Payments in Total Joint Arthroplasty: Targeting Opportunities for Quality Improvement and Cost Reduction

Kevin J. Bozic MD, MBA, Lorrayne Ward MBA, MPP, Thomas P. Vail MD, Mervyn Maze MB, ChB

Understanding the type and magnitude of services that patients receive postdischarge and the financial impact of readmissions is crucial to assessing the feasibility of accepting bundled payments.

Preemptive Low-dose Dexamethasone Reduces Postoperative Emesis and Pain After TKA: A Randomized Controlled Study

In Jun Koh MD, Chong Bum Chang MD, Jung Ha Lee MD, Young-Tae Jeon MD, Tae Kyun Kim MD

Dexamethasone is a potent analgesic and antiemetic. However, the benefit of dexamethasone after TKA is unclear, as is the efficacy in a current multimodal regime.

What Are the Rates and Causes of Hospital Readmission After Total Knee Arthroplasty?

William W. Schairer BA, Thomas P. Vail MD, Kevin J. Bozic MD, MBA

Total knee arthroplasty (TKA) and related interventions such as revision TKA and the treatment of infected TKAs are commonly performed procedures. Hospital readmission rates are used to measure hospital performance, but risk factors (both medical and surgical) for readmission after TKA, revision TKA, and treatment for the infected TKA have not been well characterized.

Targeted Use of Vancomycin as Perioperative Prophylaxis Reduces Periprosthetic Joint Infection in Revision TKA

Catherine Liu MD, Anthony Kakis DPM, CIC, Amy Nichols RN, MBA, CIC, Michael D. Ries MD, Thomas P. Vail MD, Kevin J. Bozic MD, MBA

The role of vancomycin in surgical antimicrobial prophylaxis and high-risk patients who are most likely to benefit remains unclear.

Statistical Considerations in the Psychometric Validation of Outcome Measures

Alla Sikorskii PhD, Philip C. Noble PhD

The evaluation of the outcomes of total knee arthroplasty requires measurement tools that are valid, reliable, and responsive to change. However, the accuracy of any outcome measurement is determined by the validity and reliability of the instrument used. To ensure this accuracy, it is imperative that each instrument used in orthopaedics is free of biases leading to inaccurate estimates of treatment effects.

Veterans With Diabetes Receive Arthroplasty More Frequently and at a Younger Age

Karen B. King PhD, Thomas W. Findley MD, PhD, Allison E. Williams RN, ND, PhD, Allan L. Bucknell MD

A future increase in total joint arthroplasties in patients with diabetes seems likely considering the prevalence of osteoarthritis and diabetes mellitus are increasing. However, the rates of arthroplasty in the population of patients with diabetes are unclear.

The Chitranjan Ranawat Award: Should Prophylactic Antibiotics Be Withheld Before Revision Surgery to Obtain Appropriate Cultures?

Matthew W. Tetreault BA, Nathan G. Wetters MD, Vinay Aggarwal BS, Michael Mont MD, Javad Parvizi MD, FRCS, Craig J. Della Valle MD

Preoperative antibiotics are known to be critical for decreasing the risk of periprosthetic joint infection (PJI) in primary THA and TKA. However, antibiotics often are withheld before revision surgery, as there is concern that even a single dose of prophylactic antibiotics may affect intraoperative cultures.

Impact of Socioeconomic Factors on Outcome of Total Knee Arthroplasty

Robert L. Barrack MD, Erin L. Ruh MS, Jiajing Chen MPH, Adolph V. Lombardi MD, Keith R. Berend MD, Javad Parvizi MD, FRCS, Craig J. Della Valle MD, William G. Hamilton MD, Ryan M. Nunley MD

Few data exist regarding the impact of socioeconomic factors on results of current TKA in young patients. Predictors of TKA outcomes have focused primarily on surgical technique, implant details, and individual patient clinical factors. The relative importance of these factors compared to patient socioeconomic status is not known.