In the News
Dilute Betadine Lavage Reduces the Risk of Acute Postoperative Periprosthetic Joint Infection in Aseptic Revision Total Knee and Hip Arthroplasty: A Randomized Controlled Trial
The purpose of this randomized, controlled trial is to determine whether dilute betadine lavage compared to normal saline lavage reduces the rate of acute postoperative periprosthetic joint infection (PJI) in aseptic revision total knee (TKA) and hip arthroplasty (THA).
“The data didn’t really support any one of three modalities per se. None of the anticoagulants were favored, our results just said they did pretty well,” Brett Levine, MD, said in an interview with Healio.com/Orthopedics.
If you’ve had a hip or knee replaced, you are probably worried about going through airport security. Here's the one thing to do.
Physical Therapy on Postoperative Day Zero Following Total Knee Arthroplasty: A Randomized, Controlled Trial of 394 Patients
Surgeons have increasingly emphasized early mobilization as a way to facilitate discharge following total knee arthroplasty (TKA). The purpose of this study was to determine whether starting formal physical therapy (PT) the afternoon of postoperative day (POD) 0, instead of starting PT the morning of POD 1, could shorten hospital length of stay (LOS).
Overall the 2019 AAOS Annual Meeting was a great success in Las Vegas, Nevada. As an Arthroplasty Surgeon, I focused my time on the hip and knee reconstruction sections and I still was unable to see many of the available offerings. There were a tremendous number of clinical papers, scientific exhibits, instructional course lectures and posters (double the number this year, as posters rotated after two days of the meeting). The exhibitors were out in full force with their latest products, a large emphasis was placed on computer navigation, targeting devices, robotic surgery and imageless guidance systems. While all forms of presentation were different, there did seem to be a few common themes, including: opioid use/protocols to limit over-prescribing for hip and knee arthroplasty, spine-pelvis interaction and implications with component placement, infection detection, and goals/techniques to optimize patient outcomes, particularly in the short-stay arena.
Hip and knee replacement surgery involve replacing the worn-out bone and cartilage lining your hip or knee joint with new implants that are composed of materials such as ceramic, metal and plastic. The materials used for hip and knee replacements are quite similar.
Hip or knee joint replacement surgery is considered the last line of treatment for joint pain. For some people, it’s the only way to alleviate arthritis-related pain that significantly affects daily activities, such as walking up and down stairs, putting on shoes and socks, and getting in and out of a car. If you find yourself unable to perform simple tasks after trying more conservative treatments, it may be time to consider a joint replacement.
To determine if you’re a candidate, most doctors will consider how much you can gain by undergoing the procedure. Your doctor will review your medical history and x-ray the affected joint. If your symptoms are severe and correspond with what is found on the x-ray, your doctor will likely recommend the surgery.
The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those...
The 11th Congress of Chinese Association of Orthopaedic Surgeons (CAOS) in Hangzhou, China featured a co-branded program with AAHKS with Richard H. Rothman, MD, PhD and Yan Wang, MD serving as Chairs and Quoqiang Zhang serving as Executive Chair. The program included numerous American and Chinese surgeons discussing a wide array of topics in both a lecture and small panel question and answer format. Specific lectures addressed management of dysplastic hips, perioperative optimization of patients, femoral and acetabular revision principles, biomaterial properties of acetabular components and practice management pearls. The program appeared to be a great success with outstanding discussions amongst the moderators, panel members and attendees.
The day was filled with stimulating discussions featuring differing opinions amongst the CAOS and AAHKS members. Significant attention was focused on bearing surfaces for total hip arthroplasty, single vs. two-stage procedures for infection and overall management of bony defects in revision hip and knee arthroplasty. It was a wonderful collaboration between the two organizations that culminated in a high-tech opening ceremony, followed by a night out in Hangzhou to witness the Impression West Lake Show.
Dr. Levine joins members of AAHKS on Capitol Hill to lobby for a clarification of the outpatient designation for total knee replacements.
New research from the Departments of Orthopaedic Surgery and Anesthesiology at Rush University Medical Center in Chicago set out to compare aspirin, rivaroxaban, and warfarin in preventing venous thromboembolism (VTE) after primary total joint arthroplasty (TJA). The work, presented at the recent meeting of The American Academy of Orthopaedic Surgeons, was a retrospective review of 1,361 patients who underwent primary total hip or knee arthroplasty at Rush.
According to the presentation, a total of 500 patients (36.7%) received aspirin, 460 (33.8%) received rivaroxaban, and 401 (29.4%) received warfarin. Patients were excluded if they underwent bilateral TJA, had incomplete data, or received other anticoagulants. Patients receiving rivaroxaban demonstrated higher estimated blood loss intraoperatively and greater transfusion rates (2+ units) during the perioperative period. The patients who received aspirin experienced lower procedural times and shorter postoperative length of stay than those in the rivaroxaban or warfarin groups
A research team including Dr. Brett R Levine, a joint replacement specialist at Midwest Orthopaedics at Rush, recently presented a study to compare patient-reported outcomes and complications in patients with cemented and cementless techniques at the annual meeting of the American Academy of Orthopaedic Surgeons.
The scientists utilized data on 70 cementless knees and cemented controls matched on age, body mass index, medical comorbidities, and implant design. According to their presentation, the authors found a 30% total complication rate in the cementless fixation group and 7% in the cemented fixation group.
According to Dr. Levine, “Cementless knee technology has improved but currently still seems inferior to cemented techniques. We didn’t think there would be such a difference in the number of revisions for cementless knees as we found. In this series the cemented knees had no revisions; in the cementless knees there were seven revisions for loosening and three others for issues not related to cementless knees.”
For the full Orthopedics This Week article and complete list of researchers, click here.
The overall mission for the Generation Next leadership group includes a variety of important goals. Orthopedics Today, in conjunction with the selection committee, will continue to recognize promising young surgeons and their accomplishments.
The Hospital for Special Surgery in New York has been named by U.S. News & World Report as the top-ranked hospital for orthopedic medicine in the country.
DePuy Synthes Joint Reconstruction recognizes next …
Orthopedics, March 21, 2013
Orthopedics Today and DePuy Synthes Joint Reconstruction recognized promising surgeons in the field of total joint replacement yesterday here at the American Academy of Orthopaedic.
Dr. Brett Levine, an orthopedic surgeon at Midwest Orthopaedics at Rush, talks about using Pilates as a rehab tool in this Naperville Sun/Aurora Beacon News story about a young dancer who recently recovered from an ACL injury.
After conducting research on 40 patients who use Pilates as a form of rehabilitation following joint replacement surgery, Dr. Brett Levine, orthopedic surgeon at Midwest Orthopaedics at Rush, has co-authored the book, Pilates for Hip and Knee Syndromes and Arthroplasties. Seventy percent of the patients were extremely satisfied with their outcome after using Pilates. Dr. Levine believes Pilates is an excellent form of exercise post-surgically and pre-surgically because it is low-impact and strengthens the core, improves range of motion of joints and studies show it quickens recuperation time after injury.