Adult Reconstruction & Joint Replacement
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The Adult Reconstruction and Joint Replacement Service (ARJR) at HSS has led the field since pioneering the first artificial human knee replacement more than four decades ago. Through a dedicated program of basic science and clinical research, the clinician-scientists in ARJR are continually making discoveries relevant to improving outcomes for all joint replacement patients. Continued research focus has been directed to our priority thematic areas: periprosthetic joint infection (PJI), perioperative outcomes and implant longevity and outcomes.
In November, Alejandro Gonzalez Della Valle, MD, was named Chief of the Hip Service within ARJR. In July, Michael Cross, MD, was named the new ARJR Research Chair, following Geoffrey Westrich, MD, who dedicated more than 10 years in the same capacity. David Mayman, MD, was also named Vice Chair of Operating Room and Office Efficiency.
A group of researchers on the ARJR service was awarded the prestigious 2020 Otto Aufranc Award for their paper, “Malseating of Modular Dual Mobility Liners: Incidence and Implication.” Physician authors included Jose Romero, MD; Geoffrey H. Westrich, MD; Timothy M. Wright, PhD; and Douglas E Padgett, MD.
K. Keely Boyle, MD, received both the HSS Fellows Research Award and the 2020 James A. Rand, MD, Young Investigator’s Award from the American Association of Hip and Knee Surgeons (AAHKS) for the study, “Are Intraoperative Cultures Necessary if the Aspiration Culture is Positive? A Periprosthetic Joint Infection Concordance Study.” Co-authors included Michael Henry, MD; Andy O. Miller, MD; Alberto V. Carli, MD; and others.
It has been a priority for the service to increase our presence at national conferences, highlighting our interdisciplinary approach to answering research questions. In 2020, the service saw representation at all major orthopaedic conferences, including the American Academy of Orthopaedic Surgeons (AAOS), the AAHKS, Musculoskeletal Infection Society, Orthopaedic Research Society, Eastern Orthopaedic Association, the Hip Society and the Knee Society.
Evaluation of the Spine Is Critical in the Workup of Recurrent Instability after Total Hip Arthroplasty. Vigdorchik J, Eftekhary N, Elbuluk A, Abdel MP, Buckland AJ, Schwarzkopf RS, Jerabek SA, Mayman DJ. Bone Joint J. 2019 Jul;101-B(7):817-823. PMID: 31256675
The Short Form KOOS, JR is Valid for Revision Knee Arthroplasty. Buller LT, McLawhorn AS, Lee YY, Cross M, Haas S, Lyman S. J Arthroplasty. 2020 Sep;35(9):2543-2549. PMID: 32376166
Multimodal Prophylaxis in Patients with a History of Venous Thromboembolism Undergoing Primary Elective Hip Arthroplasty. Gonzalez Della Valle A, Shanaghan KA, Nguyen J, Liu J, Memtsoudis S, Sharrock NE, Salvati EA. Bone Joint J. 2020 Jul;102-B(7_Supple_B):71-77. PMID: 32600195
Research within ARJR is focused on several thematic areas. These include implant longevity and developing patient-centered treatment plans, with the goal to reduce revision rates. The Perioperative group aims include developing an opioid-free pathway for total joint arthroplasty patients, optimizing patients before surgery, decreasing perioperative complications and evaluating surgical approaches to improve outcomes.
In the area of prosthetic joint infection, we have three goals: optimizing patients presurgically to prevent infections; improving diagnostic capabilities; and improving treatment regimens and outcomes for patients who have become infected. We are also seeking to develop a better understanding of patients’ emotional and functional outcomes, to increase patient satisfaction following total joint arthroplasty and to design outcome tools to better assess joint replacement patients.