State of Art in Hip, Knee and Shoulder Replacement (Volume 2)

A special issue of Prosthesis (ISSN 2673-1592).

Deadline for manuscript submissions: 30 November 2024 | Viewed by 2699

Special Issue Editors


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Guest Editor
Department of Basic Medical Sciences, Neuroscience and Organs of Sense, School of Medicine, Uo Orthopaedics and Traumatology, Aou Policlinico, Università Di Bari "Aldo Moro", 70124 Bari, Italy
Interests: primary and revision hip and knee replacement; treatment of femoral fractures
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Guest Editor
AO Ordine Mauriziano Hospital, Department of Orthopaedics and Traumatology, University of Torino, Largo Turati 62, 10128 Torino, Italy
Interests: hip and knee arthroplasty; knee surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The great success of the first volume of this Special Issue, “State of Art in Hip and Knee Replacement”, was of huge satisfaction and a great signal for the editors of Prosthesis, encouraging for the second volume.

A joint replacement is considered routine and in some institutions is even performed as an outpatient surgery, but this can be confused with an easy procedure with no implications. This is a great mistake that has to be limited, and knowledge is the only way to do so.

Joint replacement surgery must be considered by young and even experienced surgeons due to the impact on patients’ activity and quality of life. In addition, patient populations are growing in different directions; older people for pain relief and young patients for increasing daily activity.

This aspect represents a great challenge and makes it even more difficult to standardize the treatment due to the high variability in indication and expectations.

In this volume of “State of the Art in Hip, Knee and Shoulder Replacement” we will focus on replacement surgeries of the hip and knee—as in the previous one—but we will also include the shoulder, to address all the bigger joints and give a broad perspective on more up-to-date surgical techniques, indications, and results.

We are living in a new golden era of orthopedic surgery thanks to the great boost of technology (e.g., robotics, artificial intelligence) that is giving new stamina to research and clinical outcomes; particular attention will be given to this aspect, which in our vision is of paramount importance for the future.

It is mandatory for surgeons to have high levels of skill and knowledge to perform a time-saving, tissue-sparing, and highly effective procedure that can give patients a better and faster recovery, reducing the risk of infection or complications.

This Special Issue would like to be a thorough investigation of the actual state of the art in hip, knee, and shoulder replacement, with the contributions of great surgeons, scientists, and clinicians that apply the best practices to their patients every day.

This is a new great opportunity to give a guide to joint replacement surgeons and the correct visibility to useful papers.

Prof. Dr. Giuseppe Solarino
Dr. Umberto Cottino
Guest Editors

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. Prosthesis 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 1600 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 prostheses
  • knee prostheses
  • shoulder prostheses

Related Special Issue

Published Papers (4 papers)

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Research

8 pages, 228 KiB  
Article
Mortality Rate in Periprosthetic Proximal Femoral Fractures: Impact of Time to Surgery
by Jacopo Vittori, Norsaga Hoxha, Federico Dettoni, Carolina Rivoira, Roberto Rossi and Umberto Cottino
Prosthesis 2024, 6(4), 817-824; https://doi.org/10.3390/prosthesis6040058 (registering DOI) - 17 Jul 2024
Abstract
Hip replacement surgery is increasingly being performed on older patients, raising the risk of periprosthetic proximal femur fractures (PPFFs). While the impact of surgery timing on mortality in proximal femoral fractures is established, its effect on PPFFs remains unclear. This study aims to [...] Read more.
Hip replacement surgery is increasingly being performed on older patients, raising the risk of periprosthetic proximal femur fractures (PPFFs). While the impact of surgery timing on mortality in proximal femoral fractures is established, its effect on PPFFs remains unclear. This study aims to examine the correlation between surgery timing and mortality in PPFF patients. In a historical cohort study, we analyzed data from 79 PPFF patients treated from 2012 to 2022. Patients were categorized by surgery timing (≤48 h, 32 patients vs. >48 h, 47 patients). Outcomes and mortality rates were compared. No significant difference in mortality was observed between patients undergoing early (<48 h) and delayed (>48 h) surgery at 30 days and 1 year. Factors such as age (p = 0.154), gender (p = 0.058), ASA score (p = 0.893), Vancouver classification (p = 0.577), and surgery type (implant revision p = 0.691, OR = 0.667) did not affect 30-day mortality. However, 1-year mortality was influenced by gender (male p = 0.045) and age (p = 0.004), but not by other variables (Vancouver classification p = 0.443, implant revision p = 0.196). These findings indicate no association between surgery timing and mortality in PPFF patients, suggesting that other factors may influence outcomes. Further research is needed to optimize PPFF management. Full article
(This article belongs to the Special Issue State of Art in Hip, Knee and Shoulder Replacement (Volume 2))
9 pages, 518 KiB  
Article
Can Machine Learning Algorithms Contribute to the Initial Screening of Hip Prostheses and Early Identification of Outliers?
by Khashayar Ghadirinejad, Stephen Graves, Richard de Steiger, Nicole Pratt, Lucian B. Solomon, Mark Taylor and Reza Hashemi
Prosthesis 2024, 6(4), 744-752; https://doi.org/10.3390/prosthesis6040052 - 26 Jun 2024
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Abstract
Registries have significant roles in assessing the comparative performance of devices. Ideally, early identification of outliers should use a time-to-event outcome while reducing the confounding effects of other components in the device and patient characteristics. Machine learning (ML), which contains self-learning algorithms, is [...] Read more.
Registries have significant roles in assessing the comparative performance of devices. Ideally, early identification of outliers should use a time-to-event outcome while reducing the confounding effects of other components in the device and patient characteristics. Machine learning (ML), which contains self-learning algorithms, is one approach to consider many variables simultaneously to reduce the impact of confounding. The principal objective of this study was to investigate the effectiveness of using either random survival forest (RSF) or regularised/unregularised Cox regression to account for patient and associated device confounding factors in comparison with current standard techniques. This study evaluated RSF and regularised/unregularised Cox regression using data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to detect outlier devices among 213 individual primary total hip components performed in 163,356 primary procedures from 1 January 2015 to the end of 2019. Device components and patient characteristics were the inputs, and time to first revision surgery was the primary outcome treated as a censored case for death. The effectiveness of the ML approaches was assessed based on the ability to detect the outliers identified by the AOANJRR standard approach. In the study cohort, the standardised AOANJRR approach identified three acetabular components and seven femoral stems as outliers. The ML approaches identified some but not all the outliers detected by the AOANJRR. Both the methods identified three of the same femoral stems, and the RSF identified the other five components, including two of the same acetabular cups and three of the same femoral stems. In addition, both the RSF and Cox techniques detected a number of additional device components that were not previously identified by the standard approach. The results showed that ML may be able to offer a supplementary approach to enhance the early identification of outlier devices. Random survival forest was a more comparable technique to the AOANJRR standard than the Cox regression, but further studies are required to better understand the potential of ML to improve the early identification of outliers. Full article
(This article belongs to the Special Issue State of Art in Hip, Knee and Shoulder Replacement (Volume 2))
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11 pages, 797 KiB  
Article
Comparative Analysis of Cemented and Cementless Straight-Stem Prostheses in Hip Replacement Surgery for Elderly Patients: A Mid-Term Follow-up Study
by Marco Sapienza, Danilo Di Via, Marco Simone Vaccalluzzo, Luciano Costarella, Vito Pavone and Gianluca Testa
Prosthesis 2024, 6(3), 540-550; https://doi.org/10.3390/prosthesis6030038 - 20 May 2024
Viewed by 529
Abstract
This retrospective cohort study assesses the effectiveness of straight-stem cementless versus cemented prostheses in hip replacement surgeries for elderly patients with femoral neck fractures. We analyzed 80 patients aged 70 and over who underwent surgery between 2018 and 2021. Clinical outcomes were evaluated [...] Read more.
This retrospective cohort study assesses the effectiveness of straight-stem cementless versus cemented prostheses in hip replacement surgeries for elderly patients with femoral neck fractures. We analyzed 80 patients aged 70 and over who underwent surgery between 2018 and 2021. Clinical outcomes were evaluated using the Harris Hip Score, WOMAC Score, and Visual Analogue Scale, alongside radiological assessments through Brooker’s classification. Preoperative Dorr classification and five postoperative criteria (subsidence, cortical hypertrophy, pedestal sign, radiolucent lines, and stress shielding) were used to assess implant efficacy. The results demonstrated satisfactory mid-term outcomes for both groups, with slightly higher clinical scores observed in the cementless stem group. The Harris Hip Score (HHS) averaged 74.4 ± 6.7 in the cemented group and 79.2 ± 10.4 in the cementless group, with a statistically significant difference (p = 0.0146). The WOMAC Score showed an average of 30.1 ± 4.6 in the cemented group compared to 27.1 ± 6.9 in the cementless group, also indicating a statistically significant improvement (p = 0.0231). However, radiographic findings call for a re-evaluation of long-term stability. Our statistical analysis, which included power calculation and multivariate analysis to adjust for confounding variables, offers a comprehensive assessment of implant effectiveness. The findings contribute to the ongoing debate on the choice between cemented and cementless prostheses, indicating that both are viable options catering to different patient needs. Further research overcoming this study’s limitations is crucial for a deeper understanding of optimal treatment strategies in hip replacement surgery for the elderly. Full article
(This article belongs to the Special Issue State of Art in Hip, Knee and Shoulder Replacement (Volume 2))
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8 pages, 1242 KiB  
Article
Dual Mobility Hip Arthroplasty: Innovative Technological Advances
by Domenico Tigani, Ludovica Solito, Stefano Stallone, Corrado Maria Leonida, Tommaso Dieterich, Francesco Taverniti, Lorenzo Banci and Giuseppe Melucci
Prosthesis 2024, 6(2), 393-400; https://doi.org/10.3390/prosthesis6020029 - 17 Apr 2024
Viewed by 960
Abstract
The use of 3D-printed highly porous titanium acetabular cups in total hip arthroplasty (THA) is increasing. The porosity and mechanical properties of such highly porous titanium structures mimic those of natural cancellous bone, possibly allowing biological implant fixation to be improved. Recently, a [...] Read more.
The use of 3D-printed highly porous titanium acetabular cups in total hip arthroplasty (THA) is increasing. The porosity and mechanical properties of such highly porous titanium structures mimic those of natural cancellous bone, possibly allowing biological implant fixation to be improved. Recently, a 3D-printed highly porous Dual Mobility (DM) monobloc construct fully manufactured using Ti6Al4V alloy, with a titanium–niobium nitride (TiNbN) ceramic coating on the articular side to allow articulation against the mobile liner by improving the titanium vs. polyethylene tribological behavior, was introduced in THA. To the best of our knowledge, this is the first highly porous titanium monobloc DM implant on the market. The reasons for using a Ti alloy highly porous DM are multifarious: to prevent any possible adverse reactions due to the corrosion of Cobalt–Chromium–Molybdenum Alloy (CoCrMo) and Stainless Steel (SS) implants and to improve implant primary and secondary stability, particularly in cases of poor bone quality. Finally, with the introduction of an inner TiNbN ceramic coating surface, it was possible to overcome the poor tribological quality of titanium. Another interesting characteristic is this material’s higher implant radiolucency, which might facilitate the radiographic assessment of cup orientation, which can, in turn, facilitate the detection of any intraprosthetic dislocation (IPD) and the measurement of polyethylene wear, which is very important in the study of the durability of THA. Full article
(This article belongs to the Special Issue State of Art in Hip, Knee and Shoulder Replacement (Volume 2))
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