E. Vasarhelyi

Knee manipulation under anaesthetic following total knee arthroplasty

The purpose of this study was to compare clinical outcomes of total knee arthroplasty (TKA) after manipulation under anaesthesia (MUA) for post-operative stiffness with a matched cohort of TKA patients who did not requre MUA. In total 72 patients (mean age 59.8 years, 42 to 83) who underwent MUA following TKA were identified from our prospective database and compared with a matched cohort of patients who had undergone TKA without subsequent MUA. Patients were evaluated for range of movement (ROM) and clinical outcome scores (Western Ontario and McMaster Universities Arthritis Index, Short-Form Health Survey, and Knee Society Clinical Rating System) at a mean follow-up of 36.4 months (12 to 120). MUA took place at a mean of nine weeks (5 to 18) after TKA. In patients who required MUA, mean flexion deformity improved from 10° (0° to 25°) to 4.4° (0° to 15°) (p < 0.001), and mean range of flexion improved from 79.8° (65° to 95°) to 116° (80° to 130°) (p < 0.001). There were no statistically significant differences in ROM or functional outcome scores at three months, one year, or two years between those who required MUA and those who did not. There were no complications associated with manipulation. At most recent follow-up, patients requiring MUA achieved equivalent ROM and clinical outcome scores when compared with a matched control group. While other studies have focused on ROM after manipulation, the current study adds to current literature by supplementing this with functional outcome scores.

A cost analysis of single-stage bilateral versus two-stage direct anterior total hip arthroplasty

Purpose The potential cost savings of single-stage bilateral total hip arthroplasty (THA) are unclear, and the risks associated with it are not well defined. We sought to compare the costs and perioperative complications of single-stage bilateral THA via the direct anterior approach (DAA) to a two-stage bilateral protocol. Methods We retrospectively reviewed patients who underwent a single- stage bilateral DAA THA and compared them to a two-stage THA group. We conducted a cost analysis from both the hospital perspective and the Ministry of Health (MOH) perspective. Results 24 patients were included in this study. The 2 groups were similar in age (58.9 vs 63.9 yrs), height (169.2 vs 170.9 cm), weight (80.2 vs 78.6 kg), BMI (27.9 vs 26.3 kg/m2), ASA score (2.2 vs 2.2), and CCI score (2.3 vs 2.9). The mean cost per patient from the hospital perspective for the single-stage group was

Ninety-Day Costs, Reoperations, and Readmissions for Primary Total Knee Arthroplasty Patients With Varying Body Mass Index Levels

10,728.13 (SD = 621.46) compared to

Wear performance of cobalt chromium, ceramic, and oxidized zirconium on highly crosslinked polyethylene at mid-term follow-up

12,670.63 (SD = 519.72) for the two-stage group (Mean Difference =

Cost-Effectiveness of Total Knee Arthroplasty versus Nonoperative Management in Normal, Overweight, Obese, Severely-Obese, Morbidly-Obese, and Super-Obese Patients: A Markov Model

1,942.50, 95% CI =

Patellar Resurfacing in Total Knee Arthroplasty: A Cost-Effectiveness Analysis

1,457.49 to

Innovations in Total Hip Replacement for Young Adult Hip Disease

2,427.51, p<0.001). Similarly, from the MOH perspective, the cost for the single-stage group was

Contribution of Surface Polishing and Sterilization Method to Backside Wear in Total Knee Arthroplasty

12,552.34 (SD = 644.93) compared to

ULTRASOUND-GUIDED MOTOR-SPARING KNEE BLOCKS FOR POST-OPERATIVE ANALGESIA FOLLOWING TOTAL KNEE ARTHROPLASTY: A RANDOMISED BLINDED STUDY

14,740.58 (SD = 598.07) for the two-stage group (Mean Difference =

COST-EFFECTIVENESS OF PATELLAR RESURFACING COMPARED WITH NON-RESURFACING IN PRIMARY TOTAL KNEE ARTHROPLASTY

2,188.24, 95% CI =