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Recent Advances and Clinical Outcomes of Hip and Knee Arthroplasty
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Recent Advances and Clinical Outcomes of Hip and Knee Arthroplasty

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

Deadline for manuscript submissions: 28 April 2026 | Viewed by 7785

Special Issue Editor

Dr. Andrea Volpin

E-Mail Website
Guest Editor
Department of Trauma and Orthopaedics, NHS Grampian, University of Aberdeen, Aberdeen, UK
Interests: arthroscopic surgery; hip and knee arthroplasty; sport medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Recent advancements in medical technology and surgical techniques have transformed the landscape of hip and knee arthroplasty, enhancing patient outcomes and expanding the scope of treatment options. This Special Issue focuses on the latest innovations, clinical approaches, and long-term results associated with these critical procedures.

Topics of interest include, but are not limited to, the following:

  • Emerging technologies in arthroplasty, such as robotics and AI-driven systems.
  • Optimizing perioperative care to improve patient recovery.
  • New materials and implant designs to enhance joint longevity.
  • Comparative studies on minimally invasive versus traditional surgical techniques.
  • Addressing challenges such as prosthetic infections and revision surgeries.
  • Insights into patient-specific care strategies and their impact on clinical outcomes.

We warmly invite submissions from researchers, clinicians, and industry experts, aiming at fostering a multidisciplinary exchange of ideas and knowledge that will shape the future of hip and knee arthroplasty.

Dr. Andrea Volpin
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 250 words) can be sent to the Editorial Office for assessment.

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

  • hip arthroplasty
  • knee arthroplasty
  • joint replacement
  • clinical outcomes
  • surgical innovation
  • patient recovery
  • prosthetics
  • perioperative care

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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14 pages, 1775 KB  
Article
Development of a Deep Learning Model for Hip Arthroplasty Templating Using Anteroposterior Hip Radiograph
by Siwadol Wongsak, Tanapol Janyawongchot, Nithid Sri-Utenchai, Dhammathat Owasirikul, Suphaneewan Jaovisidha, Patarawan Woratanarat and Paphon Sa-Ngasoongsong
J. Clin. Med. 2025, 14(24), 8689; https://doi.org/10.3390/jcm14248689 - 8 Dec 2025
Cited by 1 | Viewed by 696
Abstract
Background: Preoperative templating is an essential step in hip arthroplasty (HA), guiding implant selection and reducing surgical complications. It is typically performed using acetate templates or digital software. These methods, however, depend on the surgeon’s experience and may be limited by cost and [...] Read more.
Background: Preoperative templating is an essential step in hip arthroplasty (HA), guiding implant selection and reducing surgical complications. It is typically performed using acetate templates or digital software. These methods, however, depend on the surgeon’s experience and may be limited by cost and availability. This study aimed to develop and validate a deep learning (DL) model using plain radiographs to predict implant sizes in HA. Methods: This retrospective study included patients who underwent primary HA using a cementless CORAIL® femoral stem and PINNACLE® acetabular cup. The DL model was trained on 688 preoperative anteroposterior (AP) hip radiographs and validated temporally on 98 additional cases. Implant sizes predicted by the DL model were compared with on-screen templating (acetate templates overlaid on digital images). The actual implanted size was used as the reference standard. Accuracy, mean absolute error (MAE), and root mean square error (RMSE) were calculated. Logistic regression was performed to identify factors influencing prediction accuracy. Results: The DL model showed higher accuracy than the on-screen templating for the acetabular cup (88.9% [77.4% to 95.8%] vs. 83.3% [70.7% to 90.2%]) and femoral stem components (85.7% [77.2% to 92.0%] vs. 81.6% [72.5% to 88.7%]), while the on-screen method performed better for the bipolar head (93.2% [81.3% to 98.6%] vs. 72.7% [57.2% to 85.0%]). MAE and RMSE were comparable between the methods for acetabular and femoral stem components (all p > 0.05), with statistically significant differences observed only in the bipolar head (p < 0.01 and 0.02, respectively). Although logistic regression analysis showed trends toward higher accuracy in acetabular size prediction among women and those with shorter height, no demographic factors were statistically significant predictors of accuracy. Conclusions: A DL model using only plain radiographs can accurately predict implant sizes in HA, particularly for the acetabulum and femoral stem. These findings suggest that the DL-based model could be a useful tool in preoperative planning. With further refinement to improve generalizability, this approach could be useful in a routine clinical setting in the future. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Hip and Knee Arthroplasty)
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13 pages, 961 KB  
Article
Efficacy of NSAID Transdermal Patch for Postoperative Management in Total Knee Arthroplasty
by Khanawan Tubsrinuan, Paphon Sa-ngasoongsong, Chavarat Jarungvittayakon, Kulapat Chulsomlee and Siwadol Wongsak
J. Clin. Med. 2025, 14(22), 8098; https://doi.org/10.3390/jcm14228098 - 15 Nov 2025
Viewed by 2084
Abstract
Background: While topical NSAID patches are effective in non-surgical knee conditions, their efficacy following total knee arthroplasty (TKA) remains understudied. The intention behind this study was the comparison of pain and functional score between esflurbiprofen and placebo patches for postoperative pain control after [...] Read more.
Background: While topical NSAID patches are effective in non-surgical knee conditions, their efficacy following total knee arthroplasty (TKA) remains understudied. The intention behind this study was the comparison of pain and functional score between esflurbiprofen and placebo patches for postoperative pain control after TKA. Methods: A triple-blinded randomized controlled trial was conducted among patients aged 55–80 years with primary knee osteoarthritis. Patients who had an allergy to study medications, had chronic kidney disease, had diabetes, used steroids, were unsuitable for spinal and subsartorial block, or were unwilling to participate were excluded. All eligible participants were randomized and assigned to either esflurbiprofen 40 mg transdermal patch or placebo patch starting from postoperative day 3 to 16 blindly and followed up for 3 months. Outcome assessment was a visual analog scale (VAS), morphine use, minimum daily VAS, time to minimum VAS, knee osteoarthritis outcome score, joint replacement (KOOS, JR), knee circumference, flexion angle, and adverse events. Results: Seventy patients underwent primary TKA (n = 35 each group). The average age and body mass index were 67.5 ± 13.7 years and 26.8 ± 4.5 kg/m2. There was no statistically significant difference in baseline characteristics between the two groups. When compared with the placebo group, the esflurbiprofen group presented statistically significantly diminished VAS scores after day 7 and morphine use at day 3 (p < 0.001), as well as subsequently enhanced KOOS scores at 6 weeks and 3 months (p < 0.001). No statistically significant difference between groups was found in terms of knee circumference, flexion angle, or time to minimum VAS (p > 0.05 for all). One patient in the esflurbiprofen group (2.86%) reported a mild skin reaction. Conclusions: Esflurbiprofen patches significantly reduce postoperative pain and improve short-term function after TKA without major complications. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Hip and Knee Arthroplasty)
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Other

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20 pages, 439 KB  
Systematic Review
Outcomes of Iso-Elastic Acetabular Cup in Primary Total Hip Arthroplasty with 5-Year Minimum Follow-Up: A Systematic Review
by Vincenzo Longobardi, Marco Minelli, Giacomo Pietrogrande, Giuseppe Anzillotti, Federico Della Rocca and Mattia Loppini
J. Clin. Med. 2025, 14(18), 6621; https://doi.org/10.3390/jcm14186621 - 19 Sep 2025
Cited by 1 | Viewed by 1251
Abstract
Background: Long-term survivorship in total hip arthroplasty (THA) is influenced by implant stability and stress distribution to surrounding bone. Isoelastic acetabular components are monoblock polyethylene cups with a low elastic modulus, which were developed to reduce stress shielding and enhance periacetabular bone preservation. [...] Read more.
Background: Long-term survivorship in total hip arthroplasty (THA) is influenced by implant stability and stress distribution to surrounding bone. Isoelastic acetabular components are monoblock polyethylene cups with a low elastic modulus, which were developed to reduce stress shielding and enhance periacetabular bone preservation. This systematic review aimed to evaluate the mid- to long-term clinical outcomes, wear rate, and survivorship of isoelastic cups in primary THA with a minimum follow-up of five years. Materials and methods: A systematic literature search was performed in April 2025 across PubMed, Embase, Cochrane Library, and Google Scholar following PRISMA 2020 guidelines. Inclusion criteria comprised clinical studies on isoelastic acetabular cups in primary THA with a minimum of five years of follow-up. Data on survivorship, complications, clinical outcomes, wear, and radiological performance were extracted and analyzed. Risk of bias in each study was assessed through the Newcastle–Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias 2 (RoB 2) tool for randomized controlled trials. Results: Twelve studies, encompassing 1491 hips, met the inclusion criteria. Mean follow-up was 8.1 years. Overall implant survival rate ranged from 82.7% to 100%. Mean Harris Hip Score was 92.6, with low reported pain and high satisfaction. Mean annual wear was 0.05 mm/year. Vitamin E-infused highly cross-linked polyethylene (VEHXLPE) cups demonstrated lower femoral head penetration compared to UHMWPE. A randomized trial showed reduced bone loss in the polar region with isoelastic cups versus modular titanium cups (4.9% versus 15.9%, p = 0.005). Complication and revision rates were low, though heterogeneity in cup positioning reporting and variable follow-up durations were noted. Conclusions: Isoelastic acetabular components demonstrate excellent survivorship, low wear rates, and favorable clinical outcomes at mid- to long-term follow-up. High-quality, long-term comparative studies are needed to confirm these findings across broader patient populations. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Hip and Knee Arthroplasty)
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19 pages, 406 KB  
Systematic Review
Risk Factors for Iliopsoas Impingement Following Total Hip Arthroplasty: A Systematic Review
by Marco Minelli, Vincenzo Longobardi, Alessandro Del Monaco, Alessio D’Addona, Pierangelo Za, Federico Della Rocca and Mattia Loppini
J. Clin. Med. 2025, 14(18), 6376; https://doi.org/10.3390/jcm14186376 - 10 Sep 2025
Cited by 1 | Viewed by 3318
Abstract
Background: Iliopsoas impingement (IPI) is an increasingly recognized cause of persistent groin pain following total hip arthroplasty (THA), often resulting from mechanical conflict between the iliopsoas tendon and the anterior rim of the acetabular component. Despite its clinical relevance, risk factors contributing to [...] Read more.
Background: Iliopsoas impingement (IPI) is an increasingly recognized cause of persistent groin pain following total hip arthroplasty (THA), often resulting from mechanical conflict between the iliopsoas tendon and the anterior rim of the acetabular component. Despite its clinical relevance, risk factors contributing to IPI remain poorly defined. Methods: A systematic search of PubMed, Embase, Scopus, and the Cochrane Library was conducted according to PRISMA guidelines. Studies were eligible if they evaluated adult patients undergoing primary THA and reported at least one risk factor associated with IPI. Only studies with a clearly defined clinical diagnosis of IPI were included. Data extraction and risk of bias assessments were performed independently by two reviewers. Risk of bias in each study was assessed through the Newcastle-Ottawa Scale. Results: Twelve observational studies met the inclusion criteria. Diagnosis of IPI was based on clinical symptoms of anterior groin pain exacerbated by hip flexion; 9 studies confirmed diagnosis with anesthetic injections. Key surgical risk factors included anterior cup prominence (ORs 1.16–35.20), oversized cups (cup-to-head ratio > 1.2, OR = 5.39, or ≥6 mm difference, OR = 26.00), decreased cup inclination, collared stem protrusion (OR = 13.89), and acetabular screw protrusion > 6.4 mm. Patient-specific risk factors included female sex (ORs 2.56, 2.79), higher BMI (OR = 1.07), younger age, previous hip arthroscopy (OR = 9.60) and spinal fusion (OR = 4.60). The anterolateral approach was also associated with higher IPI risk when compared to the posterior approach (OR = 4.20). Conclusions: IPI after THA is a multifactorial complication influenced by modifiable surgical variables and patient-specific anatomy. Careful preoperative planning, precise implant positioning, and attention to individual risk factors are essential to reduce IPI incidence and improve outcomes. Full article
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Hip and Knee Arthroplasty)
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