AAOS Meeting Roundup

ARTHROPLASTY

In the arthroplasty realm, patient-specific implants in total knee arthroplasty (TKA) remained a hot topic this year. A randomised control trial comparing kinematic versus mechanically aligned TKA revealed that all measured outcomes were better in the kinematic group.¹ A popular topic in hip arthroplasty (THA) was primary THA and conversion to THA in the setting of proximal femoral fractures and in failed hardware, respectively.^2,3 Intra-operative and post-operative fractures were suggested to be the most common complications in conversion of failed intertrochanteric, intracapsular and proximal femoral fixation, followed then by dislocation and infection.⁴

Additionally, several papers defined the utility of THA in the setting of either acute or previous acetabular fractures. Morison et al⁵ reported overall poorer outcomes in patients who undergo THA in the setting of a previous acetabular fracture, while Lin and Schmidt⁶ reported similarly excellent results with primary THA in acetabular fractures that involve the posterior wall, compared with open reduction and internal fixation (ORIF) alone, and suggested that in the setting of femoral head involvement, articular comminution or marginal impaction primary THA is preferable in patients under 65 years of age.

One topic becoming increasingly prevalent was in the foot and ankle realm regarding total ankle arthroplasty (TAA), specifically in comparison with ankle fusion (AF). Younger et al^7,8 presented a prospective comparison between these cohorts with the conclusion that TAA still carries a significantly higher re-operation rate and that there is still plenty of room for improvement for design and techniques. Jastifer et al⁹ presented a comparison which suggested that TAA patients performed better on upstairs, downstairs and uphill activities, with no difference between downhill, flat surfaces and uneven surfaces.