Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013

Gwam, Chukwuweike U.; Mistry, Jaydev B.; Mohamed, Nequesha S.; Thomas, Melbin; Bigart, Kevin C.; Mont, Michael A.; Delanois, Ronald E.

doi:10.1016/j.arth.2017.02.046

Cited by 425 publications

(278 citation statements)

References 39 publications

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“…Periprosthetic joint infection (PJI) is the most common cause of knee arthroplasty failure which accounts for 16% to 25% of all failed knee replacements [1][2][3][4] and is the third most common indication for revision hip arthroplasty [5][6][7][8][9]. Our previous findings indicated that the expression level of synovial fluid (SF) interleukin-16 (IL-16) in patients with PJI was higher than that in patients with aseptic loosening [10].…”

Section: Introductionmentioning

confidence: 99%

Synovial Fluid Interleukin-16 Contributes to Osteoclast Activation and Bone Loss through the JNK/NFATc1 Signaling Cascade in Patients with Periprosthetic Joint Infection

Chang

Hsiao

et al. 2020

IJMS

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Because of lipopolysaccharide (LPS)-mediated effects on osteoclast differentiation and bone loss, periprosthetic joint infection (PJI) caused by Gram-negative bacteria increases the risk of aseptic loosening after reimplantation. Synovial fluid interleukin-16 (IL-16) expression was higher in patients with PJI than in patients without joint infection. Thus, we explored the effects of IL-16 on bone. We investigated whether IL-16 modulates osteoclast or osteoblast differentiation in vitro. An LPS-induced bone loss mice model was used to explore the possible advantages of IL-16 inhibition for the prevention of bone loss. IL-16 directly activated p38 and c-Jun N-terminal kinase (JNK)/mitogen-activated protein kinase (MAPK) signaling and increased osteoclast activation markers, including tartrate-resistant acid phosphatase (TRAP), cathepsin K, and nuclear factor of activated T cells 1 (NFATc1). IL-16 directly caused monocytes to differentiate into TRAP-positive osteoclast-like cells through NFATc1 activation dependent on JNK/MAPK signaling. Moreover, IL-16 did not alter alkaline phosphatase activity or calcium deposition during osteoblastic differentiation. Finally, IL-16 inhibition prevented LPS-induced trabecular bone loss and osteoclast activation in vivo. IL-16 directly increased osteoclast activation through the JNK/NFATc1 pathway. IL-16 inhibition could represent a new strategy for treating infection-associated bone loss.Int. J. Mol. Sci. 2020, 21, 2904 2 of 15 of differentiation 4 (CD4 + ) lymphocytes, monocytes, and eosinophils [11,12]. IL-16 is synthesized as a precursor protein (pro-IL-16) of approximately 68 kDa. Pro-IL-16 is cleaved by activated caspase-3 and then IL-16 generation [13]. CD4 serves as a signaling transducing receptor for IL-16 signaling. Increased intracytoplasmic calcium and inositol trisphosphate can be initiated when IL-16 interacts with CD4 receptors, and this subsequently activates stress-activated protein kinases (SAPKs) p46 and p54. Stimulation with IL-16 also activates members of the mitogen-activated protein kinase (MAPK) family, namely c-Jun N-terminal kinase (JNK) and p38 but does not activate extracellular signal-regulated kinase (ERK)-1 or ERK-2 [14]. IL-16 can activate monocytes and stimulate the secretion of inflammatory cytokines, chiefly tumor necrosis factor (TNF)-α, IL-1β, 15,16]. Currently, these cytokines are believed to promote the development of septic arthritis [17][18][19].PJI can result from Gram-positive (GP) or Gram-negative (GN) bacterial infections. Our previous retrospective study revealed that GN infections were associated with an increased risk of aseptic loosening as compared with GP infections [20]. The cell walls of GP bacteria contain lipoteichoic acid (LTA) components, whereas those of GN bacteria contain components of lipopolysaccharide (LPS). In studies of mice receiving intrafemoral injections of LPS or LTA, LPS reduced both the number of trabeculae and bone mineral density, whereas LTA did not have this effect [20]. In addition, disruption of the bal...

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Section: Introductionmentioning

confidence: 99%

Synovial Fluid Interleukin-16 Contributes to Osteoclast Activation and Bone Loss through the JNK/NFATc1 Signaling Cascade in Patients with Periprosthetic Joint Infection

Chang

Hsiao

et al. 2020

IJMS

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“…However, when major medical or surgical complications occur, such as periprosthetic joint infections, pneumoniae or pulmonary emboli, they may amount to a large morbidity, financial, and time burden to patients and healthcare providers and may result in poor patient outcomes (3)(4)(5)(6)(7)(8)(9). Therefore, it is important to understand the risk factors associated with each of these complications, in order to attempt to mitigate them appropriately during peri-operative period.…”

Section: Introductionmentioning

confidence: 99%

Associations between seasonal variation and post-operative complications after total hip arthroplasty

Ng¹,

Song²,

George³

et al. 2017

Ann. Transl. Med.

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Background: Total hip arthroplasty (THA) complication rates are low, but pose marked challenges during the post-operative care period. Therefore, it is important to determine which risk factors are associated with an increased rate of these complications. The purpose of this paper was to investigate the association between seasonal variations and the 30-day post-operative complication rates following THA. Specifically, we evaluated a large prospectively collected national database for: (I) overall complication rates; (II) seasonal variations in incidence; and (III) specific quarter (Q), if any, associations. Results: The overall complication rate in this cohort was 1.09%. Upon tabulation of the different post-operative THA complication incidence rates sorted by quarters, 16 out of 20 outcomes had <1% incidence rate, 3 had between a 1% and 5% incidence rate, and 1 outcome had a complication rate greater than 5% (bleeding transfusion). There were no statistical differences in 19 of the 20 complication rates when compared between the different quarters. Transfusion was the only complication with a statistically significant difference (P value <0.001) between the different quarters, which demonstrated a marked increase in Q3/Q4 (July to December), when compared to Q1 (January to March) (P<0.001).Conclusions: Overall, our results indicate a low complication rate in this cohort of patients who underwent a THA (1.09%). There was no correlation between seasonal variation and 30-day complication rates following THA, except for bleeding risk, which remains unexplained. These findings suggest that elective THA does not have to be scheduled around specific times of the year in order to avoid 30-day postoperative complications.

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“…Ортопедическая литература насыщена публикациями, в которых активно декларируется высочайшая эффективность тотального эндопротезирования (ТЭП) тазобедренного сустава (ТБС) и объясняется широкое распространение этого метода в развитых странах [1,2,3,4,5,6,7]. В то же время существует немало работ, в которых обсуждаются экономические и социальные затраты, связанные с осложнениями и ревизионными вмешательствами, и прогнозируется прогрессирующее увеличение этой нагрузки на систему здравоохранения, а также рост числа все более тяжелых ревизий [6,8,9,10,11]. Отчеты национальных регистров показывают только частичную картину и освещают только часть вопросов в соответствии со структурой вносимых данных [12].…”

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What Has Changed in the Structure of Revision Hip Arthroplasty?

Shubnyakov

Шубняков²,

Тихилов³

et al. 2019

Traumatology and Orthopedics of Russia

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The key aspects of the study: 1) what has changed in the structure of revisions in recent years? 2) what is the spectrum of reasons for revision after primary hip arthroplasty and re-revision? 3) what are the demographic features of patients’ population undergoing the revision? Materials and methods. The authors conducted a retrospective evaluation of 2415 hip revision cases during the period of time from 2014 until 2018. Separately the authors assessed revisions after primary surgeries and re-revisions as well as the group of early revisions. Results. In the period from 2014 until 2018 the overall share of revisions was 16,6% from all total hip arthroplasties, at the same time the authors reported the absolute 1.7 times increase in number of revisions as well as increased share of revisions in the total structure of hip arthroplasty from 12,5% to 18,9% without significant variances in the number of primary procedures. The share of early revisions increased from 32.9% in 2013 to 56.7% while the number of early revisions amounted to 37.4% of all primary revisions. Gender composition in primary and revision hip arthroplasty varied insignificantly. Mean age at the moment of hip revision was 59.2% (95% CI from 58.7 to 59.7; Me 60 years) which is slightly less than in primary replacement — 60.2 years (95% CI from 58.9 to 61.1; Me 62 years), but such variances had a high statistical significance, р0.001. The main reasons for primary revisions were aseptic loosening of prosthesis components (50.3%), infection (27.6%), polyethylene wear and osteolysis (9.0%) as well as dislocations (6,2%). Re-revisions structure featured prevalence of infection (69.0%), aseptic loosening (20.8%) and dislocations (7,8%). Mean period of time after primary hip arthroplasty to revision was 7.9 years (95% CI from 7.7 to 8.2; Me 7.3), to first re-revision — 2.9 (95% CI from 2.6 to 3.2; Me 1.2), to second re-revision — 2.2 (95% CI from 1.8 to 2.7; Me 1.1), to third — 2,2 (95% CI from 1.7 to 2.8; Me 1.1), to fourth — 1.0 (95% CI from 0.6 to 1.3; Me 0.6), remaining cases demonstrated rather high heterogeneity. Conclusion. In the result of the present study the authors observed increased number of all revision hip arthroplasties, especially the share of early revisions within first five years from the moment of previous surgery. The most often reason for revision after primary hip arthroplasty was aseptic loosening of one or both components of prosthesis. Infection was the absolute leader in the group of re-revisions constituting over half of all reasons for secondary intervention.

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Current Epidemiology of Revision Total Hip Arthroplasty in the United States: National Inpatient Sample 2009 to 2013

Cited by 425 publications

References 39 publications

Synovial Fluid Interleukin-16 Contributes to Osteoclast Activation and Bone Loss through the JNK/NFATc1 Signaling Cascade in Patients with Periprosthetic Joint Infection

Synovial Fluid Interleukin-16 Contributes to Osteoclast Activation and Bone Loss through the JNK/NFATc1 Signaling Cascade in Patients with Periprosthetic Joint Infection

Associations between seasonal variation and post-operative complications after total hip arthroplasty

What Has Changed in the Structure of Revision Hip Arthroplasty?

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