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  1. Article: Flip Autograft Technique for Anterolateral Femoral Deficiency in Total Knee Arthroplasty.

    Dietz, Matthew J / Gilligan, Patrick H / Makani, Ankur / Machi, Anthony S

    Arthroplasty today

    2022  Volume 15, Page(s) 29–33

    Abstract: Anterolateral bone loss of the femur within the trochlear groove presents a unique and rare issue in primary total knee arthroplasty (TKA). Unlike distal and posterior femur bone loss for which most contemporary TKA systems have modular augments, the ... ...

    Abstract Anterolateral bone loss of the femur within the trochlear groove presents a unique and rare issue in primary total knee arthroplasty (TKA). Unlike distal and posterior femur bone loss for which most contemporary TKA systems have modular augments, the same does not exist for anterolateral bone loss. We present a technique in which a patient's host bone from the standard distal femoral cuts was used to augment and provide a stable base for cementing of final femoral implants. Currently, the patient has 3-year follow-up with excellent results in terms of pain control with no evidence of component failure on the most recent radiographs. This technique provides a simple solution to a complex problem within primary TKA.
    Language English
    Publishing date 2022-04-01
    Publishing country United States
    Document type Journal Article
    ISSN 2352-3441
    ISSN 2352-3441
    DOI 10.1016/j.artd.2022.02.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Maintenance of Surgical Optimization in Total Joint Arthroplasty Patients.

    Dietz, Matthew J / Chaharbakhshi, Edwin O / Roberts, Austin J / Gilligan, Patrick H / Kasicky, Kathryn R / Pincavitch, Jami D

    The Journal of arthroplasty

    2024  

    Abstract: Background: There are increased efforts to maximize medical optimization to improve the outcomes of total joint arthroplasty (TJA). However, there is a paucity of literature demonstrating that optimized parameters are maintained throughout the ... ...

    Abstract Background: There are increased efforts to maximize medical optimization to improve the outcomes of total joint arthroplasty (TJA). However, there is a paucity of literature demonstrating that optimized parameters are maintained throughout the perioperative period.
    Methods: A retrospective review of 877 elective TJA patients from 2015 to 2019 was conducted. Patients who underwent medical optimization for body mass index (BMI), hemoglobin A1c (HbA1c), hemoglobin, albumin, and smoking status were reviewed at the initial visit, preoperatively, time of surgery, and one year postoperatively. For each of these variables at each time point, patients were stratified into 3 optimization groups. Analyses were performed to identify mean time to optimization, loss of optimization, and maintenance of optimization.
    Results: Patients considered not optimized due to specific parameters at the initial visit were as follows: BMI (19%), HbA1c (13.5%), hemoglobin (16%), albumin (19%), and smoking status (9.5%). The mean time to optimization was 187.7 days [longest being BMI (220.1 days), and the shortest being HbA1c (60.9 days) (P = .0003)]. Patients who had intermediate optimization of BMI at the preoperative visit were at higher risk [odds ratio: 2.1 (0.97 to 4.6)] of worsening BMI by time of surgery (P < .0001). Between the preoperative and surgery time points, over 93.5% of patients maintained or improved optimization.
    Conclusions: Surgeon led medical optimization efforts alongside a TJA program provide maintenance of, or improvement in optimization in more than half of TJA patients up to one year postoperatively. Patients who had a BMI between 40 and 45 at the preoperative visit are at significant risk of increasing their BMI by the day of surgery.
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2024.01.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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