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Hip preservation and peri-trochanteric procedures are becoming more commonplace for the arthroplasty surgeon. Understanding the reimbursement for these procedures remains a challenge for those looking to expand this portion of their practice. In order to financially maximize the surgeon's efforts, we present recommendations for hip preservation procedural coding.Oxinium implants are composed of a zirconium alloy with a hard ceramic surface formed by oxidization of the outer layer. This material has been shown to be an effective bearing surface for total joint arthroplasty and an alternative material for use in patients with metal hypersensitivity. Reports exist of metallosis due to unintended wear of Oxinium components from multiple mechanisms including polyethylene liner dissociation and joint instability. This metallosis creates a distinct appearance on radiographic imaging similar to that of an arthrogram. We report 2 cases of metallosis and describe the characteristic radiographic appearance of failed oxidized zirconium implants.

The enhanced frictional resistance of modern ultraporous acetabular components can impede complete seating; however, surgeons expect the enhanced ingrowth surface to resolve polar (zone 2) gaps over time via osseointegration. This study characterized zone 2 radiographic osseointegration in 3 acetabular component designs 2 highly porous ingrowth and one traditional ongrowth.

A consecutive cohort of primary total hip arthroplasties was reviewed which utilized 3 different acetabular cup designs ongrowth titanium with hydroxyapatite (HA), highly porous titanium with machined radial grooves (MRG), and dual-porous titanium substrate with micropore (MP). Radiographic analysis was performed using accepted measurement criteria with particular attention to radiolucent lines.

Seven hundred ninety cases were available for analysis. Initial 1-month radiographs revealed 43.2% of HA, 78.2% of MRG, and 81.0% of MP cups exhibited zone 2 radiolucencies, consistent with incomplete seating. At 1 year, all HA radiolucencies resolved, whereas 46.2% and 34.7% of radiolucencies remained in MRG and MP cups, respectively (

≤ .005). At minimum 2 years, a significant proportion of zone 2 radiolucencies remained in 46.0% of MRG compared with 23.9% of MP cups and 3.0% of HA cups (

≤ .007).

The resolution of zone 2 radiolucencies at 1-year and minimum 2-year follow-up signified osseointegration for nearly all HA and most MP cups. Highly porous titanium cups with machined radial grooves demonstrated persistent zone 2 radiolucencies at 1 year and beyond. Given reports of early loosening with this particular acetabular implant, further follow-up is warranted as this study highlights that not all contemporary highly porous metal acetabular components perform equally.

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Total hip arthroplasty (THA) performed for displaced femoral neck fractures (FNF) is becoming a more frequent treatment in the active elderly population. The complication profiles associated with THA surgical approaches in the fracture setting are unclear. The purpose of this study was to compare a series of THA for FNF performed via the direct anterior (DA) approach vs alternative approaches (anterolateral and posterolateral).

A retrospective review identified 52 patients who underwent primary THA for FNF between 2009 and 2018, including 20 via the DA approach and 32 by alternative approaches. All procedures were exclusively performed by high-volume arthroplasty surgeons. Perioperative results, complications, and clinical outcomes were compared with those of routine statistical methods. Mean follow-up duration was 3 years (range, 1-8).

The average age was 74 years (range, 57-92) with similar baseline characteristics between the 2 groups (

= .09). The DA cohort demonstrated significantly shorter length of stay (3 days vs 5 days,

< .01) and discharge to home vs skilled nursing facility (40.0% vs 9.4%

= .014). There was a trend toward decreased complications (0% vs 16%,

= .08). There were no dislocations or fractures in either cohort. Final Harris Hip Scores (94 vs 81,

= .07) and return to community ambulation (96%) were similar between DA and alternative approach groups.

The DA approach to THA performed for FNF appears safe with improved outcomes compared with alternative approaches. Larger studies are needed to verify these results.

The DA approach to THA performed for FNF appears safe with improved outcomes compared with alternative approaches. Larger studies are needed to verify these results.Failure to achieve postoperative stability is disappointing for both surgeons and patients after revision total hip arthroplasty. In particular, when available revision options have been exhausted. We describe our modification of previously reported surgical techniques without revising any component in a high-risk female patient with persistent hip dislocation despite multiple cup revisions using different implants. To stabilize the hip through the posterolateral approach, a synthetic polyethylene tube was used. This relatively simple, modified technique may be a solution in disappointing cases with failure to achieve hip stability in revision total hip arthroplasty.In recent years, there has been increased interest in transitioning total joint arthroplasty procedures from inpatient settings to ambulatory surgical centers to decrease costs and eliminate the need for hospital stays. In addition, simultaneous bilateral total hip arthroplasty (THA) has been found to be favorable in certain patient populations when compared with staged bilateral THA. In this study, we report the results of a series of three patients who underwent single-stage bilateral THA in a free-standing ambulatory surgical center with excellent short-term outcomes and no 90-day complications.One of the biggest challenges for wireless communication network operators is how to minimize or mitigate radio frequency interference (RFI) for efficient network services at the desired quality of service (QoS). Microwave radio links are highly susceptible to interference from narrow and wideband sources. Interference ultimately affects network quality and contributes to the colossal loss of usable mobile data, leading to substantial operational costs for network operators. Tebipenem Pivoxil Additionally, the implementation of high capacity microwave links could potentially force the channels to point towards the same direction, posing a significant interference source. Radio frequency interference issues on the microwave links should be prioritized for prompt resolution or mitigation to achieve the minimum QoS requirement for the growing network subscribers. Toward this end, frequency scans are required to accurately picture the available frequency plan and channels based on the allocated spectrum. This article presents experimental data on radio frequency interference of active microwave links at 6 GHz, 7 GHz, and 8 GHz.