THOMAS L. BERNASEK, MD

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This study looked at how frailty affects recovery after total knee surgery in patients. Researchers used a scoring system called the Hospital Frailty Risk Score (HFRS) to assess frailty in patients who had the surgery between 2015 and 2023. They found that frail patients (HFRS score of 5 or higher) were much more likely to be readmitted to the hospital within 90 days (79 out of 100 vs. 14 out of 100 for non-frail patients) and had longer hospital stays (about 3.5 days compared to 2.8 days for non-frail patients). This matters because it shows that identifying frailty can help medical teams focus on improving care for at-risk patients, potentially reducing complications after surgery. Who this helps: Patients undergoing total knee surgery and their healthcare providers.

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This study looked at a surgical procedure called knee resection arthroplasty (KRA) for patients suffering from repeated joint infections after knee replacement surgery. Out of 28 surgeries performed, 79% successfully eliminated the infection, and if we include those who eventually got better after additional procedures, the success rate rises to 93%. Most patients were able to walk with help, although many still needed devices for support, and there was a 29% chance of needing more surgery afterward. Who this helps: This research benefits patients with persistent knee infections and their doctors, providing a treatment option when infections recur.

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The study examined the rise in surgeries to replace hips after failed treatment of hip fractures, particularly those treated with a specific type of device called cephalomedullary nails. With around 280,000 hip fractures occurring annually in the U.S., many of which are extracapsular, the study found that conversion to total hip arthroplasty is often recommended for younger patients without serious joint damage. This matters because understanding the best treatment options and surgical strategies can improve outcomes for these patients, who face complicated surgical challenges. Who this helps: This helps patients recovering from hip fractures and orthopedic surgeons involved in their care.

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This study looked at how hyperbaric oxygen therapy (HBOT) affects patients with serious bone damage in the hip, known as avascular necrosis of the femoral head. The researchers found that after treatment, pain decreased for all patients, and the size of the damaged area shrank significantly in patients with earlier stages of the condition. Specifically, the lesion size was reduced in all patients with stage I and II, and in two out of eleven patients with stage III, while a protein related to bone health (OPG) increased in the blood. Who this helps: This helps patients with avascular necrosis of the hip.

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The study looked at a 56-year-old patient who had serious knee issues after a bad leg injury from a car crash when he was 16. When the patient needed knee replacements, doctors used a new type of surgery, called a free flap, to help cover his knee before the replacements were done. This is important because it's the first time this specific combination of surgeries was documented, showing how techniques in reconstructive surgery have improved over the years. Who this helps: This benefits patients with complex knee injuries and their doctors by providing new treatment options.

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This study looked at the risk of nerve injury in patients undergoing total knee replacement surgery when using a special type of heating device called bipolar electrocautery compared to a standard version. Out of 241 patients using the bipolar device, 7 (2.9%) experienced nerve injuries, while only 1 (0.52%) out of 192 patients using the standard device had the same problem. This is important because it highlights a potential risk for certain groups, especially women and those with rheumatoid arthritis, indicating that doctors may need to be more careful when using this tool on these patients. Who this helps: This helps patients undergoing knee surgery and their doctors by informing them about potential risks.

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This study looked at using a special device called an intra-arterial occlusive balloon to limit blood loss during hip surgery in patients who could not receive blood transfusions, specifically Jehovah's Witnesses. The findings showed that patients using the balloon lost significantly less blood—about 145 mL compared to 402 mL for those who didn’t use it during primary surgery, and 333 mL compared to 767 mL during revision surgery. This is important because it offers a safer surgical option for patients who refuse blood transfusions, reducing the risk of complications related to blood loss. Who this helps: Patients who cannot receive blood transfusions, particularly Jehovah's Witnesses.

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This study looked at how well a custom three-part device, called a triflange acetabular component, works for patients with pelvic problems after hip replacement surgery. They followed 57 patients for an average of over five years and found that 98% did not need more surgery due to loosening of the implant, and 81% had a stable implant with healed pelvic issues. This is important because it shows that the triflange component is a reliable option for treating these complicated cases at a similar cost to other methods. Who this helps: This benefits patients facing complex hip replacement issues.

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This study looked at the problem of squeaking sounds in hip implants made of metal, particularly focusing on how the angle at which the implant is placed, known as the acetabular inclination angle, affects this issue. Out of 542 hips analyzed, squeaking was noticed in only 1.5% (or 8 hips), mainly in women with a higher angle—specifically, 3.2% of those with angles greater than 45 degrees squeaked, while none with angles of 45 degrees or lower did. These findings help understand which patients might be more prone to this squeaking issue, potentially guiding doctors in surgical decisions and post-operative care. Who this helps: This helps patients with metal hip implants and their doctors.

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This study looked at how to treat a specific type of hip fracture in a patient who refuses blood transfusions due to their faith. Researchers used a temporary balloon inside a blood vessel to help reduce blood loss during surgery, which worked effectively, letting the patient lose much less blood than usual. This method is important because it provides a safe option for patients who cannot receive blood transfusions, allowing them to get necessary treatments without compromising their beliefs. Who this helps: This helps Jehovah's Witness patients with severe fractures needing surgery.

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This study compared two walking aids: the Easy Strutter Functional Orthosis System (ESFOS) and standard crutches, focusing on how they help people walk after knee or hip replacements. Researchers found that using the ESFOS significantly reduced the effort needed to walk—people exerted 45% less force on their hands and experienced a 25% drop in energy use compared to crutches. Participants also felt the ESFOS was more comfortable and stable, especially on flat surfaces and stairs. Who this helps: This benefits patients recovering from knee or hip replacement surgeries.