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Current and Emerging Treatment Options in Shoulder, Hip and Knee Arthroplasty

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 4108

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Special Issue Editor

Dr. Nahum Rosenberg

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Guest Editor

Department of Orthopedic Surgery, Rambam Health Care Campus, P.O. Box 9602, Haifa, Israel
Interests: joint biomechanics; outcomes of orthopaedic surgery; arthroplasty; tissue regeneration
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to explore the current and emerging treatment options for shoulder, hip, and knee arthroplasty. With the increasing prevalence of musculoskeletal disorders and the growing demand for joint replacement surgeries, it is crucial to stay updated on the latest advancements in this field. This Special Issue provides a platform for researchers, clinicians, and experts to share their insights, experiences, and research findings related to innovative treatment approaches in arthroplasty. We invite original research articles, systematic reviews, and meta-analyses that focus on various aspects of shoulder, hip, and knee arthroplasty. The scope of this Special Issue includes, but is not limited to:

Surgical techniques and approaches in joint replacement;
Implant design and materials;
Rehabilitation and post-operative care;
Patient outcomes and satisfaction;
Complications and their management.

We encourage submissions that present novel ideas, evidence-based practices, and clinical studies that contribute to the advancement of arthroplasty. However, please note that we will not be accepting mini reviews or case reports for this Special Issue.

By bringing together diverse perspectives and cutting-edge research, this Special Issue aims to enhance our understanding of the current and emerging treatment options in shoulder, hip, and knee arthroplasty. We hope that this collection of articles will serve as a valuable resource for healthcare professionals, researchers, and policymakers involved in the field of orthopedics. Thank you for considering submitting your work to this Special Issue.

Dr. Nahum Rosenberg
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

joint replacement surgery
arthroplasty techniques
implant selection
prosthetic materials
revision arthroplasty
pain management strategies

Published Papers (4 papers)

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Research

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11 pages, 291 KiB

Open AccessArticle

Evaluation of Neuropathic Pain after Total Knee Arthroplasty: Do Yellow Flags Matter?

by Danijel Colovic, Alexander Draschl, Patrick Reinbacher, Andrzej Hecker, Gregor Schittek, Stefan Franz Fischerauer, Andreas Leithner, Sebastian Martin Klim, Amir Koutp, Ulrike Wittig, Kevin Brunnader, Andreas Sandner-Kiesling and Patrick Sadoghi

J. Clin. Med. 2023, 12(24), 7708; https://doi.org/10.3390/jcm12247708 - 15 Dec 2023

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Abstract

Up to 20% of total knee arthroplasty (TKA) patients continue to experience chronic postsurgical pain. Various factors have been identified as potential contributors, including so-called “yellow flags”, encompassing symptoms of depression, anxiety, and catastrophizing, which were examined in this study to assess their predictive value concerning functional outcomes after TKA. Methods: Fifty TKA patients were categorized into high-risk and low-risk groups based on clinical assessment, demographic data, medication, and patient-reported outcome measures (DN4, SF-36, WOMAC, NRS, Fibromyalgia Survey Questionnaire, Pain Catastrophizing Scale, and Hospital Anxiety and Depression Scale). Postoperative outcomes within six months after TKA were then compared. Results: Both groups exhibited significant (p < 0.001) improvements in all WOMAC and NRS subscales, as well as in the physical function, role physical, pain, and energy/fatigue subdomains of the SF-36 after six months, while the high-risk group showed lower WOMAC scores regarding stiffness (19.0 ± 18.3 vs. 27.2 ± 20.7, p < 0.001) and pain (13.5 ± 13.3 vs. 15.1 ± 16.3, p = 0.029). The high-risk group showed significantly worse preoperative DN4 scores (1.8 ± 1.3 vs. 3.0 ± 1.1, p = 0.002) than the low-risk group, which persisted for one day (2.3 ± 1.2 vs. 3.5 ± 1.5, p = 0.005) and six weeks (2.2 ± 1.9 vs. 3.6 ± 2.3, p = 0.041) postoperatively. Conclusions: Our results indicate that pre-existing yellow flags contribute to a more challenging early postoperative phase, underscoring the importance of considering individual patient characteristics and psychological factors to optimize TKA outcomes. Full article

(This article belongs to the Special Issue Current and Emerging Treatment Options in Shoulder, Hip and Knee Arthroplasty)

14 pages, 2640 KiB

Open AccessArticle

Pain Management, Functional Recovery, and Stress Response Expressed by NLR and PLR after the iPACK Block Combined with Adductor Canal Block for Total Knee Arthroplasty—A Prospective, Randomised, Double-Blinded Clinical Trial

by Malgorzata Domagalska, Tomasz Reysner, Grzegorz Kowalski, Przemysław Daroszewski, Aleksander Mularski and Katarzyna Wieczorowska-Tobis

J. Clin. Med. 2023, 12(22), 7088; https://doi.org/10.3390/jcm12227088 - 14 Nov 2023

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Abstract

Introduction: This study aimed to investigate pain management, functional recovery, and stress response expressed by the neutrophile-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) after the popliteal artery and posterior knee capsule infiltration (iPACK) block combined with adductor canal block (ACB) in total knee arthroplasty (TKA). Patients and Methods: This was a prospective, double-blinded, randomised, controlled trial in a tertiary referral hospital. Three hundred and sixty-six patients were randomly allocated into the sham block group and iPACK combined with the ACB group. The primary outcome was postoperative pain scores. The secondary outcomes were opioid consumption, functional recovery expressed by a range of motion, and quadriceps strength. Also, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. Results: There were significant differences between the sham block and iPACK + ACB group in pain scores p < 0.0001 at all time points. Therefore, there was a significant difference in opioid consumption (p < 0.0001) and functional recovery (p < 0.0001). Also, NLR and PLR levels 12 h (p < 0.0001) and 24 h (24 h) after surgery (p < 0.0001) were much lower in the iPACK + ACB group. Conclusion: After total knee arthroplasty, the iPACK combined with ACB block group improved pain management, functional recovery, and stress response. Therefore, we strongly recommend this technique as a part of a multimodal analgesia protocol in knee surgery. Full article

(This article belongs to the Special Issue Current and Emerging Treatment Options in Shoulder, Hip and Knee Arthroplasty)

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11 pages, 1158 KiB

Open AccessArticle

Postoperative Hemodynamics of Total Knee Arthroplasty Unaffected by Cementless Approach under Contemporary Patient Blood Management Protocol: A Propensity Score-Matched Study

by Keun Young Choi, Yong Deok Kim, Nicole Cho, Man Soo Kim, Yong In, Hwang Yong You and In Jun Koh

J. Clin. Med. 2023, 12(22), 6980; https://doi.org/10.3390/jcm12226980 - 8 Nov 2023

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Abstract

(1) Background: A cementless total knee arthroplasty (TKA) is a recent and an increasingly popular innovation that enhances porous fixation surfaces. However, the lack of cemented sealing of an exposed resected bone has raised concerns about the potential for greater blood loss. The goals of this study were to determine if a cementless approach impacts post-TKA hemodynamics and to identify risk factors for blood loss in instances of cementless (vs. cemented) TKAs under a contemporary patient blood management (PBM) protocol. (2) Methods: We recruited 153 consecutive patients undergoing unilateral TKAs between 2019 and 2023. All enrollees received cementless or cemented prostheses of the same design (cementless, 87; cemented, 66). After propensity score matching for demographics, there were 46 patients in each group. We then compared blood loss metrics (total [TBL] and estimated [EBL]), drainage volumes, hemoglobin (Hb) levels, and transfusion rates by group. (3) Results: Post-TKA hemodynamics (i.e., TBL, EBL, drainage, Hb level, and transfusion rate) of cementless (n = 46) and cemented (n = 46) TKA groups did not differ significantly. In addition, the proportions of patients with Hb drops > 3.0 g/dL were similar for the two groups. A logistic regression analysis revealed that only preoperative Hb and EBL during the early postoperative period were predictive of a substantial fall in Hb levels. The fixation method was not associated with Hb decline > 3.0 g/dL by postoperative Day 3. (4) Conclusion: The cementless TKA has no impact on customary post-TKA hemodynamics and is not associated with greater TKA-related blood loss when implementing a contemporary PBM protocol. Full article

(This article belongs to the Special Issue Current and Emerging Treatment Options in Shoulder, Hip and Knee Arthroplasty)

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Other

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11 pages, 4643 KiB

Open AccessSystematic Review

Anterior Referencing versus Posterior Referencing in Primary Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

by Filippo Familiari, Michele Mercurio, Francesco Napoleone, Olimpio Galasso, Ermes Giuzio, Roberto Simonetta, Michelangelo Palco, Nicholas N. DePhillipo and Giorgio Gasparini

J. Clin. Med. 2023, 12(23), 7453; https://doi.org/10.3390/jcm12237453 - 1 Dec 2023

Viewed by 1481

Abstract

(1) Background: The purpose of this study was to perform a systematic review and meta-analysis of studies comparing clinical and radiographic outcomes between anterior referencing (AR) and posterior referencing (PR) systems in total knee arthroplasty (TKA). (2) Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, MEDLINE, Scopus, and Cochrane Central databases were searched in August 2022. Data extracted for quantitative analysis included the Knee Society Score (KSS), the Western Ontario and McMaster University (WOMAC) index, knee ROM, posterior condylar offset (PCO), and the posterior condylar offset ratio (PCOR). The methodological quality of the included studies was assessed using the Modified Newcastle–Ottawa Quality Assessment. Randomized controlled trials were assessed with version 2 of the risk of bias tool (RoB2), recommended by the Cochrane Collaboration. (3) Results: For the meta-analysis, five comparative studies met the eligibility criteria. There were 584 patients in all, 294 of whom had AR TKA and 290 of whom had PR TKA. Three studies with 181 and 179 cases in the AR and PR groups, respectively, had reported preoperative KSS. A statistically significant difference was found favoring the PR group. (p = 0.01). The same cases’ postoperative range of motion was documented, and a statistically significant difference was discovered in favor of the AR group. Postoperative PCO was described in four studies in 243 and 241 cases in the AR and PR TKA groups, respectively, and a statistically significant difference was found with a higher postoperative PCO in the PR group (p = 0.003). Postoperative PCOR was calculated in two studies in the same cases in the AR and PR TKA groups and a statistically significant difference was found with a higher postoperative PCOR in the PR group (p = 0.002). (4) Conclusion: Anterior referencing for TKA may result in improved knee ROM postoperatively, while posterior referencing may produce larger PCO and PCOR on postoperative imaging. However, no significant differences were noted in clinical outcomes between the AR and PR groups at final follow-up. Full article

(This article belongs to the Special Issue Current and Emerging Treatment Options in Shoulder, Hip and Knee Arthroplasty)

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