Background:The purpose of the current study was to evaluate the usage of prehabilitation on a telehealth platform prior to total knee arthroplasty (TKA) and its impact on short-term outcomes. Specifically, the study examined whether patients participating in a prehabilitation program impacted length of stay (LOS) and discharge disposition.Methods: A total of 476 consecutive patients who underwent TKA at three institutions were included. The average age of the 476 patients was 65.1 years (range, 35 and 93 years). There was a total of 114 patients who utilized the novel prehabilitation program that provided exercises, nutritional advice, education regarding home safety and reducing medical risks, and pain management skills prior to surgery. A group of 362 patients who did not utilize the program formed the control cohort. The outcomes evaluated were LOS and discharge disposition to home, home with health aide (HHA), or skilled nursing facility (SNF). Results:The average LOS in the prehabilitation group was significantly shorter than in the control group (2.0 vs. 2.7 days, P<0.001). Additionally, prehabilitation patients had more favorable discharge disposition status in comparison to the control group. In the prehabilitation patients, 77.2% went home without assistance, compared to 42.8% in the control group (P<0.001). Also, significantly fewer patients in the prehabilitation group were discharged to a SNF when compared to the control group (1.8% vs. 21.8%, P<0.0001).Conclusions: Prehabilitation preceding TKA in the current study showed early benefits in LOS and discharge disposition. This study will help expand the current literature and educate orthopaedic surgeons on a novel technology. To truly appreciate the role of telerehabilitation in the setting of TKA, further investigation is needed to investigate long-term outcomes, cost analysis, and patient and clinician satisfaction.

In the current era of total hip arthroplasty (THA), orthopedic surgeons have several fixation options at their disposal. The modern monoblock prosthesis, introduced by Dr. Sir John Charnley, has seen many modifications since its inception in the 1970s and continues to be the most commonly used prosthesis style for primary and revision THA. Proximal modular sleeve technology was introduced in 1967 by Konstantin Sivash, modifying his original 1956 Sivash Stem design. The design is now known as the S-ROM, and although design modifications continue to date, the fundamental structure of the S-ROM remains essentially unchanged. Several other proximal modular prostheses are now currently available for use in THA. Although this similarity in design enables considerable surgical flexibility, it also links their potential for catastrophic failure. This aim of this article was to present a brief history of proximal modularity in THA and to add to the small body of literature regarding catastrophic failure in modular hip implants, including its proposed etiologies including micromotion, fretting and corrosion.

No abstract

No abstract

This article aims to give a brief outline of the pathogenesis and transmission of SARS-CoV-2 and how to safely navigate an arthroplasty practice during and after the pandemic.