Projected Volume of Primary Total Joint Arthroplasty in the U.S., 2014 to 2030

Sloan, Matthew; Premkumar, Ajay; Sheth, Neil P.

doi:10.2106/jbjs.17.01617

Cited by 1,463 publications

(917 citation statements)

References 17 publications

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“…Total hip arthroplasty is one of the most commonly performed elective surgical procedures . The procedure is effective for treatment of disabling hip osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Denosumab on Femoral Periprosthetic BMD and Early Femoral Stem Subsidence in Postmenopausal Women Undergoing Cementless Total Hip Arthroplasty

et al. 2019

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Antiresorptive denosumab is known to improve the quality and strength of cortical bone in the proximal femurs of osteoporotic women, but its efficacy in preventing periprosthetic bone loss and reducing femoral stem migration has not been studied in women undergoing cementless total hip arthroplasty. We conducted a single‐center, randomized, double‐blinded, placebo‐controlled trial of 65 postmenopausal women with primary hip osteoarthritis and Dorr type A or B proximal femur anatomy. The patients randomly received subcutaneous injections of denosumab 60 mg or placebo once every 6 months for 12 months, starting 1 month before surgery. The primary endpoint was the change in bone mineral density (BMD) of the proximal femur (Gruen zone 7) at week 48, and the secondary endpoint was stem subsidence measured by radiostereometric analysis (RSA) at week 48. Exploratory endpoints included changes in BMDs of the contralateral hip, lumbar spine and distal radius, serum levels of bone turnover markers, walking speed, walking activity, patient‐reported outcome measures, and radiographic assessment of stem osseointegration. The participants underwent vertebral‐fracture assessment in an extension safety study at 3 years. Denosumab significantly decreased bone loss in the medial femoral neck (zone 7) and increased periprosthetic BMD in the greater trochanteric region (zone 1) and lesser trochanteric region (zone 6). Denosumab did not reduce temporary femoral stem migration. The migration occurred mainly during the settling period (0 to 12 weeks) after implantation of the prosthesis. All of the stems osseointegrated, as evaluated by RSA and radiographs. There were no intergroup differences in functional recovery. Discontinuation of denosumab did not lead to any adverse events. In conclusion, denosumab increased periprosthetic BMD in the clinically relevant regions of the proximal femur, but the treatment response was not associated with any reduction of initial stem migration. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.

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“…Total hip arthroplasty is one of the most commonly performed elective surgical procedures . The procedure is effective for treatment of disabling hip osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

“…T otal hip arthroplasty is one of the most commonly performed elective surgical procedures. (1) The procedure is effective for treatment of disabling hip osteoarthritis. The majority of patients receive cementless implant components in the Unites States and Australia (2,3) but not in all countries.…”

Section: Introductionmentioning

confidence: 99%

Effect of Denosumab on Femoral Periprosthetic BMD and Early Femoral Stem Subsidence in Postmenopausal Women Undergoing Cementless Total Hip Arthroplasty

et al. 2019

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“…Batches were randomly scaled and horizontally flipped during training for the purpose of data augmentation. Our TensorFlow implementation is publicly available 1 .…”

Section: A Implementation Detailsmentioning

confidence: 99%

Extending pretrained segmentation networks with additional anatomical structures

Özdemir

Göksel

2019

Int J CARS

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For comprehensive surgical planning with sophisticated patient-specific models, all relevant anatomical structures need to be segmented. This could be achieved using deep neural networks given sufficiently many annotated samples, however datasets of multiple annotated structures are often unavailable in practice and costly to procure. Therefore, being able to build segmentation models with datasets from different studies and centers in an incremental fashion is highly desirable. We propose a class-incremental framework for extending a deep segmentation network to new anatomical structures using a minimal incremental annotation set. Through distilling knowledge from the current network state, we overcome the need for a full retraining. We evaluate our methods on 100 MR volumes from SKI10 challenge with varying incremental annotation ratios. For 50% incremental annotations, our proposed method suffers less than 1% Dice score loss in retaining old-class performance, as opposed to 25% loss of conventional finetuning. Our framework inherently exploits transferable knowledge from previously trained structures to incremental tasks, demonstrated by results superior even to non-incremental training: In a single volume one-shot incremental learning setting, our method outperforms vanilla network performance by >11% in Dice. With the presented method, new anatomical structures can be learned while retaining performance for older structures, without a major increase in complexity and memory footprint; hence suitable for lifelong class-incremental learning. By leveraging information from older examples, a fraction of annotations can be sufficient for incrementally building comprehensive segmentation models. With our meta-method, a deep segmentation network is extended with only a minor addition per structure, thus can be applicable also for future network architectures.

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“…In 2014, there were 680,150 primary total knee arthroplasty and 370,770 total hip arthroplasty procedures, according to the National Inpatient Sample (NIS), prepared via the Healthcare Cost and Utilization Project (HCUP) by the Agency for Healthcare Research and Quality; these data are generated by numerous state‐based databases. (Sloan, Premkumar, & Sheth, ; AHRQ, HCUP, NIS overview, , ). Solid biologic fixation at the bone‐implant interface provides long‐term stability of arthroplasty and other orthopedic implant components.…”

Section: Introductionmentioning

confidence: 99%

Titania nanotube morphologies for osseointegration via models of in vitro osseointegrative potential and in vivo intramedullary fixation

et al. 2019

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As total joint replacements increase annually, new strategies to attain solid bone‐implant fixation are needed to increase implant survivorship. This study evaluated two morphologies of titania nanotubes (TiNT) in in vitro experiments and an in vivo rodent model of intramedullary fixation, to simulate joint arthroplasty conditions. TiNT surfaces were prepared via an electrochemical etching process, resulting in two different TiNT morphologies, an aligned structure with nanotubes in parallel and a trabecular bone‐like structure. in vitro data showed bone marrow cell differentiation into osteoblasts as well as osteoblastic phenotypic behavior through 21 days. In vivo, both TiNT morphologies generated greater bone formation and bone‐implant contact than control at 12 weeks, as indicated by μCT analyses and histology, respectively. TiNT groups also exhibited greater strength of fixation compared to controls, when subjected to wire pull‐out testing. TiNT may be a promising surface modification for promoting osseointegration.

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Projected Volume of Primary Total Joint Arthroplasty in the U.S., 2014 to 2030

Cited by 1,463 publications

References 17 publications

Effect of Denosumab on Femoral Periprosthetic BMD and Early Femoral Stem Subsidence in Postmenopausal Women Undergoing Cementless Total Hip Arthroplasty

Effect of Denosumab on Femoral Periprosthetic BMD and Early Femoral Stem Subsidence in Postmenopausal Women Undergoing Cementless Total Hip Arthroplasty

Extending pretrained segmentation networks with additional anatomical structures

Titania nanotube morphologies for osseointegration via models of in vitro osseointegrative potential and in vivo intramedullary fixation

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