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Arthroplasty: Advances in Surgical Techniques and Patient Outcomes—2nd Edition

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Dear Colleagues,

We are pleased to announce the 2nd Edition of the Special Issue titled “Arthroplasty: Advances in Surgical Techniques and Patient Outcomes” after the success of the first edition, in which we published five papers.

Total hip replacement is one of the most successful orthopedic procedures offered to patients with various hip joint pathologies. Researchers, clinical scientists, surgeons, device manufacturers, and hospital policy makers are constantly striving to advance the science and practice of total hip replacement based on the availability of new evidence. The availability of large databases has made it possible to analyze outcomes in rare pathologies and situations that are often not possible from single-center studies. In this Special Issue, we invite authors to submit manuscripts relating to various technical aspects of hip replacement, including, but not limited to, robotic hip replacement, direct anterior approaches, artificial intelligence, virtual reality, and outcomes related to newer advances in total hip replacement.

Dr. Senthil Sambandam
Guest Editor

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13 pages, 1055 KB

Open AccessArticle

Is There Agreement Between Clinical Outcomes as Perceived by the Surgeon and the Patient in Revision Total Hip Arthroplasty?

by Víctor Casas-Gallego, Miguel A. Ortega and Basilio J. de la Torre-Escuredo

J. Clin. Med. 2025, 14(21), 7488; https://doi.org/10.3390/jcm14217488 - 22 Oct 2025

Viewed by 236

Abstract

Objectives: Revision total hip arthroplasty (rTHA) is a complex surgery with variable functional outcomes that often differ between the surgeon’s perception and the patient’s experience. Therefore, the aim of this study is, first, to evaluate functional outcomes based on the reason for revision, type of revision, acetabular defect, and number of prior revision surgeries; and second, to compare outcomes from both the surgeon’s and the patient’s perspectives to determine whether or not there is agreement between them. Materials and Methods: An observational study was conducted on patients who underwent rTHA at a tertiary-level center from January 2013 to December 2018, with a median follow-up of 41 months. A total of 149 procedures were performed during this period. The variables analyzed included the indication for revision surgery, type of revision, presence of acetabular defect, and number of previous revision surgeries. The surgeon’s perspective was assessed using the Harris Hip Score (HHS), while the patient’s perspective was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Short Form-12 Health Survey (SF-12). Results: Analysis of the variables from both surgeon’s and patient’s perspectives showed statistically significant differences regarding the indication for revision and the SF-12 component, with patients undergoing revision for infection or dislocation reporting worse functional outcomes. Although the remaining variables did not reach statistical significance, the surgeon perceived worse outcomes in patients revised for infection and in those who underwent revision of both components (acetabular and femoral). Conversely, patients reported poorer functional outcomes when operated on for infection or dislocation, when both components were revised, and when they had undergone more than one revision surgery. Additionally, a statistically significant trend was observed showing worse outcomes with increasing anesthetic risk. Linear regression analysis between the surgeon’s evaluation and the patient-reported outcome measures showed a statistically significant association, indicating that higher surgeon scores correlated with fewer symptoms and better hip function as reported by patients. Conclusion: There was concordance between the surgeon’s evaluation, measured by the Harris Hip Score (HHS), and the patient’s perception of health status through PROMs, specifically the SF-12 and WOMAC questionnaires. Although overall results were satisfactory regardless of the reason for the revision, type of revision, defect grade, or number of revisions; outcomes were slightly worse in patients revised for dislocation or infection, those undergoing revisions of both components, and in cases involving multiple revision surgeries. Full article

(This article belongs to the Special Issue Arthroplasty: Advances in Surgical Techniques and Patient Outcomes—2nd Edition)

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10 pages, 2177 KB

Open AccessArticle

Arthroscopic Arthrolysis of the Knee Joint Following Total Knee Arthroplasty

by Yersin Zhunussov, Yermek Danenov and Galymzhan Alimbek

J. Clin. Med. 2025, 14(14), 4917; https://doi.org/10.3390/jcm14144917 - 11 Jul 2025

Cited by 1 | Viewed by 1461

Abstract

Background: Arthrofibrosis, mixed contracture, and patellofemoral impingement are frequent complications following total knee arthroplasty (TKA), potentially leading to chronic pain and poor recovery of range of motion (ROM). The comprehensive management of these complications remains challenging and controversial. Methods: This study analyzed the outcomes of arthroscopic arthrolysis performed in 27 patients diagnosed with arthrofibrosis, mixed contracture, and patellofemoral impingement post-TKA to evaluate the efficacy of this technique in improving knee function, enhancing ROM, and reducing pain, as assessed by the Knee Society Score (KSS). A total of 27 patients underwent arthroscopic arthrolysis following unsuccessful conservative rehabilitation. The arthroscopic procedure included removal of fibrous adhesions within the suprapatellar pouch, restoration of medial and lateral gutters, and lateral retinacular release of the patella. Intensive physiotherapy and continuous passive motion commenced immediately postoperatively. The mean follow-up period ranged from 24 to 60 months. Pain and functional outcomes were evaluated using KSSs. Results: Clinical improvements were evident in 26 cases, with the Knee Society Score rising from a preoperative average of 48 to 86, and pain scores improving from 30 to 41. Only one patient did not experience positive outcomes following the procedure. Arthroscopic arthrolysis appears beneficial for patients suffering from arthrofibrosis, patellofemoral impingement, and mixed contracture post-TKA, significantly improving clinical pain scores and KSS outcomes. Conclusions: Further research is recommended to refine specialized surgical instruments and enhance arthroscopic arthrolysis techniques. Full article

(This article belongs to the Special Issue Arthroplasty: Advances in Surgical Techniques and Patient Outcomes—2nd Edition)

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