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Weekly News, Analysis, and Commentary

Large Joints Features & News

Whiteside, Rosenberg Debate Cementless, Cemented Revision

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“With cemented TKA, if you have the right skill level, instruments, design, fixation, and the correct implant, then you can guarantee your patients a well fixed TKA,” says Leo Whiteside. Aaron Rosenberg isn’t so sure about that guarantee. “The registries show a significantly higher rate of revision amongst uncemented knees. Besides, the data is trending towards cementless TKA.”

Parvizi v. Maloney Over Direct Anterior

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“There isn’t a single randomized prospective study showing that the direct anterior is worse than other approaches,” says Jay Parvizi. “It’s the marketing,” says Bill Maloney. “This approach is being pushed by patients because of that. And it’s harder clinically…in part because you can’t easily visualize the femur.”

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Paprosky, Callaghan Debate Constraint Versus Big Heads

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“Cup position is critical,” says Wayne Paprosky. “And if the abductors are deficient then I’m not sure there is an advantage to constrained liners.” “Really?” says John Callaghan; “There are good results with large heads in revision surgery. And if you need something very large you can go to the dual mobility rather than jumping straight to a constrained liner.”

CMS Takes a Second Look at HA Knee Injections

Knee Injection / Source: Wikimedia Commons and Harry Gouvas
Knee Injection / Source: Wikimedia Commons and Harry Gouvas

CMS has decided to take a second look at HA knee injections. Furthermore, CMS’ sister agency, AHRQ, released a study that says evidence is lacking that intra-articular HA knee injections delay knee replacement surgery; improve function or quality of life. CMS wants public comment. These are ominous signs. Could CMS change HA national coverage policy? Read on.

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