Dr. Carli said more research needs to be done on the use of robotics and computer navigation in longer and more technically challenging procedures to see if the technologies contribute to an increase in complications. In addition, he said more work needs to be done to see if robotics and computer navigation lead to meaningful reductions in hip dislocations, dissatisfaction, and residual pain after TKA. 

Read the full article at healio.com. 

“All of these things are useful to know subsequently for cost analyses and patient benefits, but we can at least say with some confidence that computer navigation and robotic assistance do not put the patient at risk of having a higher risk for surgical site infections,” Alberto V. Carli, MD, hip and knee surgeon at HSS. 

Dr. Carli and colleagues retrospectively reviewed data for patients who underwent either primary total hip (n = 12,726) or knee (n = 11,727) arthroplasty between 2018 and 2021 at HSS. Patients were grouped based on whether they had conventional, computer-navigated, or robotic-assisted surgery.

Results showed computer-navigated and robotic-assisted THAs had longer operative times by 3 and 11 minutes, respectively, compared with conventional THA. Researchers found this difference to be significant. Although robotic-assisted TKA had a significantly longer operative time by 14 minutes compared with conventional TKA, researchers found surgical times were similar between the computer navigation and conventional TKA groups.

Read the full article at healio.com. 

According to Dr. Carli, “The study findings confirm the vital importance of finding and sampling synovial fluid to establish or exclude the diagnosis of periprosthetic joint infection. Ultrasonography provides its operator with the ability to visualize intraarticular effusions, a key advantage over fluoroscopy. However, it is also critical to note that ultrasound is more of a technically demanding procedure which can depend on operator experience, as well as patient factors, including BMI, body habitus and if revision surgery has been previously performed.”

He added, “The study highlights the evident need in the periprosthetic joint infection clinical literature for a standardized method by which aspiration results and the technique utilized to be reported. The study also raises the question of whether an effusion by itself is suggestive of periprosthetic joint infection, a question which will hopefully be addressed through prospective investigations, improvement in imaging techniques and more standardized outcome reporting.”

Read the full article at Healio.com.

Pictured above from L to R: Dr. Alberto Carli; Dr. Angela Hewlett, MSIS President; Dr. Barry Brause.

The Musculoskeletal Infection Society (MSIS) selects HSS as the 2021 recipient of the George C. Cierney, III Award. HSS physicians Alberto Carli, MD, hip and knee surgeon and Barry D. Brause, MD, infectious disease specialist, accepted the award at the 31^st MSIS Annual Open Scientific Meeting in Ft. Lauderdale, Florida on Friday, August 6.

The prestigious award recognizes institutions for their outstanding contribution to musculoskeletal infection research, while exhibiting excellence in orthopedics, patient care and treatment of infectious disease.

Read more about the George C. Cierney Award at Msis-na.org.

Dr. Carli explains how robust preoperative guidelines are utilized to ensure optimal patient health prior to surgery, including screenings for malnutrition, anemia, ulcers and infections, as well as weight management dependent on BMI.

According to Dr. Levack, treating PJI can vary based on symptom duration and time since surgery. If PJI develops within the first 6 weeks, it’s considered acute and is treated differently than if it develops after that time and is considered chronic.

Read the full article at RheumatologyAdvisor.com.