DR. ANDREW ALBERT FREIBERG, MD

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This study looked at how well anatomically contoured femoral heads (ACH) work in total hip replacements to reduce pain and complications like iliopsoas tendinitis. Out of 53 patients followed for one year, none experienced iliopsoas tendinitis or needed re-operations, and many showed significant improvement in their pain and physical function scores—like 92.9% improvement in hip function one year post-surgery. This is important because it suggests ACH implants can help reduce anterior hip pain and improve outcomes for patients after hip surgery. Who this helps: Patients undergoing total hip arthroplasty.

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This study looked at how making informed decisions about knee and hip surgery affects patient outcomes. It found that 68% of patients made good, informed choices, and those who did experienced better quality of life gains, more pain relief, and increased satisfaction, especially among knee patients. For knee surgery patients, satisfaction was 1.7 times higher, and they were twice as likely to have no regrets about their decision. In contrast, hip surgery patients did not see these benefits and even reported feeling more regret after making similar decisions. Who this helps: Patients considering knee surgery will benefit from shared decision-making.

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This study looked at how different factors affect the amount of opioids used before and after joint surgery. It found that younger patients, those who smoke, people with more depression symptoms, patients with private insurance, and those undergoing knee surgery tend to use more opioids. Understanding these patterns can help doctors provide better pain management and improve patient satisfaction after surgery. Who this helps: This helps doctors and patients recovering from joint surgery.

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This study focused on creating and testing a computer program that uses patient records to identify why certain orthopedic surgeries are performed, specifically for knee and hip arthritis and certain spinal problems. The research found that the program accurately identified the reasons for surgeries about 70-92% of the time, depending on the condition, with very few incorrect identifications. This matters because it can help doctors and patients make better decisions together about elective surgeries. Who this helps: Patients considering elective orthopedic surgeries.

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This study looked at how certain health conditions, like obesity and chronic lung disease, affect the costs of total knee replacement surgeries. Researchers found that the average cost for this type of surgery was about $23,701, but patients with chronic obstructive pulmonary disease had costs as high as $26,299. Understanding these costs helps hospitals plan better and could improve patient care by encouraging doctors to prepare patients with additional health issues before surgery. Who this helps: This helps patients with chronic health conditions and the doctors treating them.

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This study looked at different ways to help patients with hip and knee osteoarthritis make treatment decisions in partnership with their doctors. It involved over 1,100 patients and 8 surgeons, comparing two types of decision-making tools provided to patients, as well as whether the surgeons received specific reports about their patients' treatment preferences. The results will show which strategies lead to better decision quality, which means more patients being well-informed and getting the treatment they prefer, and this is important for improving patient satisfaction and outcomes. Who this helps: This helps patients with hip and knee osteoarthritis and their doctors.

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This study looked at how much pain medication patients needed after different types of knee surgery: partial knee replacement (either medial unicompartmental or patellofemoral) and total knee replacement. It found that 38% of patients who had patellofemoral replacement and 41% of those with total knee replacement used opioids for pain, compared to only 11% of patients with medial unicompartmental replacement. This is important because it shows that patients undergoing patellofemoral and total knee replacements may share similar pain management needs, highlighting the need for targeted pain relief strategies for these surgeries. Who this helps: This helps patients recovering from knee surgery and their doctors in managing post-operative pain effectively.

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This study looked at two different types of patient decision aids (DAs) to see which one helps people with hip or knee osteoarthritis make better treatment choices. Researchers found that a shorter, interactive decision aid was better at increasing patient knowledge by 9% compared to the longer version, although both types helped patients make informed choices about their treatment. Importantly, around 60% of patients still opted for surgery within six months, regardless of which DA they used, and most surgeons felt satisfied with their interactions with patients. Who this helps: This benefits patients with hip or knee osteoarthritis and the doctors treating them.

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Researchers aimed to improve the use of decision aids (DAs) for patients with hip and knee issues, as well as spinal conditions, to help them make informed choices about their treatment. They introduced various strategies over three phases and found that the percentage of patients receiving a DA increased significantly: starting from 28% for spine patients and 37% for hip/knee patients in phase 1 to 56% and 69%, respectively, in phase 3. This is important because better access to DAs helps patients feel more involved in their care decisions, leading to enhanced patient satisfaction and outcomes. Who this helps: This helps patients undergoing orthopedic care.

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This study looked at how two different designs of dual-mobility hip implants interact with a key tendon (the iliopsoas tendon) during movement to help prevent dislocation. Researchers found that the anatomically shaped implant resulted in lower pressure and stress on the tendon compared to the standard design. Specifically, they measured an average tendon stiffness of 339.4 N/mm and found that the contoured design provided better protection for the tendon as the hip flexed, which is important for preventing pain and ensuring a successful hip replacement. Who this helps: This benefits patients undergoing hip replacement surgery, particularly those at risk of dislocation.

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This study looked at whether checking the femoral head (a part of the hip joint) for cancer during hip replacement surgery is worth the cost. Out of 3,200 samples tested, only one unexpected cancer case was found, costing over $614,000 for the testing. Despite the high cost, the results suggest that this screening could be a worthwhile investment compared to other medical interventions, as it's below the World Health Organization's recommended spending threshold. Who this helps: This helps doctors and surgeons make informed decisions about testing practices during hip replacement surgeries.

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This study looked at the effects of multiple steroid injections in the hip of patients with osteoarthritis before hip replacement surgery. Researchers found that patients who received two or more injections had a 6.6% risk of developing a joint infection after surgery, compared to a 2.0% risk for those who had just one injection, making the risk more than three times higher for those with multiple injections. This is important because it helps doctors inform patients about the risks associated with getting multiple injections before surgery. Who this helps: Patients considering multiple steroid injections before hip replacement surgery.

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This study looked at whether giving acetaminophen through an IV (intravenously) or by mouth (orally) helps reduce pain after knee surgery better than using a placebo. The researchers found that pain levels and the amount of other pain medication needed were similar across all groups, with average pain scores around 0.56 for the IV group, 0.67 for the oral group, and 0.58 for the placebo group. This means that using IV or oral acetaminophen did not significantly improve pain relief in patients after total knee arthroplasty when combined with other pain management methods. Who this helps: This information benefits patients recovering from knee surgery and their doctors by clarifying the effectiveness of acetaminophen in this setting.

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This research focused on creating a stronger and more effective joint implant that releases antibiotics to fight infections. The new implant, made from a special type of plastic, released antibiotics at a higher level and for a longer time than standard treatments, while still being strong enough to handle pressure. In tests on rabbits with infected knees, the new implant completely eliminated bacteria without causing any side effects. Who this helps: This benefits patients needing joint replacements who are at risk of infections.

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This study looked at how the shape of dual mobility hip liners can affect hip pain. The researchers found that changing the liner's shape to be lower (or "contoured") significantly reduced soft tissue problems, like impingement, during hip movement, with a notable reduction in issues at low flexion angles (with a p-value of ≤0.04). Importantly, the new liner shape maintained the same strength and stability as the traditional design, making it a potential improvement for hip replacement patients. Who this helps: This helps patients who have hip replacement surgeries.

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This study looked at how dual mobility liners in hip replacements can get damaged over time, specifically from contact with the femoral neck and soft tissue impingement. Researchers examined 15 used liners, which had been in patients for an average of about two and a half years, and found that all of them showed signs of deformation due to this contact. The investigations found that this deformation can limit the movement of these liners, potentially affecting the overall function of the hip replacement. Who this helps: This helps patients undergoing hip replacement by improving understanding of potential issues with their implants.

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This study looked at whether a new mobility score called the AM-PAC "6-Clicks" could help predict where patients would go after surgery for hip or knee replacements. Researchers found that this score was useful in predicting if patients would be discharged home or need rehabilitation services, with an accuracy improvement of 22% compared to traditional models. However, it didn't perform well in predicting longer hospital stays, emergency room visits, or readmissions. Who this helps: This helps patients by providing better assessments of their discharge plans after joint surgery.

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This study looked at how "asymptomatic" pseudotumours form in patients with metal-on-metal hip replacements over at least four years using specialized MRI techniques. Out of 37 patients, 11% of those with Type II pseudotumours showed signs of progression, while 14% of Type I pseudotumours got smaller, and the rest remained stable. These findings suggest that most non-symptomatic pseudotumours don't worsen over time, which can help doctors decide whether follow-up scans are necessary. Who this helps: This helps patients with metal-on-metal hip replacements by reducing unnecessary imaging tests.

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This study looked at patients with a specific type of hip replacement to see how many had "pseudotumors" (abnormal growths) even if they didn't have any symptoms. Researchers found that 15% of asymptomatic patients had these pseudotumors, compared to 36% in the overall group. The study also noted that those with pseudotumors had significantly higher levels of cobalt in their blood. These findings are important because they show that just because a patient feels fine doesn't mean there aren't serious problems developing inside their body; it highlights the need for regular checks in patients with certain hip implants. Who this helps: This helps patients with hip implants and their doctors monitor potential complications.

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This study examined a tool called the Risk Assessment and Prediction Tool (RAPT) to see how well it can predict where patients will go after they have hip or knee replacement surgery in the U.S. Researchers looked at 3,213 patients and found that the RAPT was 78% accurate overall; scores below 6 indicated a high risk of needing rehab, while scores above 10 indicated a high likelihood of going straight home. This is important because knowing a patient's discharge needs ahead of time helps hospitals plan better and potentially reduces costs. Who this helps: This helps patients, doctors, and healthcare planners by improving discharge planning and care decisions.

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This study looked at a new health survey called the EQ-5D-5L to see if it provides better insights into the quality of life for patients who have hip replacement surgery compared to the older EQ-5D-3L version. Researchers found that the new version improved the way patients could express their health status, reducing problems with extreme scores (known as ceiling and floor effects) by up to 30% and 14% in certain areas. This matters because it allows doctors to get a clearer picture of how well hip replacement surgery is working for patients, leading to better care and treatment decisions. Who this helps: Patients undergoing hip replacement surgery and their healthcare providers.

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This study looked at how the positioning of the hip implant changes when patients go from lying down to standing up. Researchers found that on average, the angle of the implant changed by 4.6 degrees for inclination and 5.9 degrees for version when standing, which was significant (P<0.0001). Notably, 43% of screws that were incorrectly placed while lying down ended up in a better position when the patient stood, highlighting that how a patient stands is important in planning hip surgeries. Who this helps: This benefits doctors in planning hip surgeries and improving patient outcomes.

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This research looked at a special type of plastic called highly cross-linked polyethylene (HXLPE), used in hip and knee surgeries, to see how long it lasts without wearing out. The findings showed that HXLPE is notably more durable, helping to reduce problems like wear and bone damage over time. This is important because it can lead to better long-term outcomes for patients undergoing these surgeries. Who this helps: Patients needing hip or knee replacements.

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This study looked at new tools designed to predict how well patients will do after total hip or knee replacement surgeries. It found that these tools, particularly one from Massachusetts General Hospital, help identify which patients may need extra care after their surgery. This is important because it can lead to better planning for recovery and resource allocation. Who this helps: This helps patients planning to have hip or knee replacement surgeries and their doctors.

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This research studied the relationship between vitamin D levels and physical activity before surgery in patients scheduled for knee or hip replacements. They found that patients with low vitamin D levels (below 20 ng/mL) were nearly three times more likely to have lower activity scores compared to those with higher levels. This matters because promoting better vitamin D status may help increase physical activity in these patients, potentially improving their recovery following surgery. Who this helps: Patients undergoing knee or hip surgery.

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The study looked at 18 patients who had infections in their hip or knee joint replacements and ended up keeping temporary prosthetic spacers. Over an average follow-up of nearly 44 months, 15 of these patients continued to use their spacers effectively, reporting high satisfaction scores, while 3 needed additional surgery due to complications. This matters because it shows that some patients can do well for several years with these spacers without needing more operations. Who this helps: Patients with infected joint replacements.

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This study looked at how transferring patients between hospitals during a two-stage procedure for chronic joint infections (infections around prosthetic joints) affects their outcomes. Researchers found that patients who had their first part of the surgery at one hospital and then were treated at another hospital faced worse results. Specifically, 18 transferred patients had longer treatment times and needed more surgeries compared to 36 patients who stayed at the same hospital for both stages. This matters because it shows that continuity of care is important for better recovery and fewer complications. Who this helps: This helps patients with chronic joint infections who need surgical treatment.

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This study looked at a new, non-invasive device that measures hemoglobin levels in patients after hip and knee replacement surgeries. Out of 100 patients, the device avoided the need for a needle blood draw in 73 of them. This matters because it offers a simpler and less painful way to check hemoglobin levels, which can help identify patients who may need a blood transfusion after their surgery. Who this helps: Patients undergoing hip and knee replacements.

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This study looked at the impact of taking immediate X-rays after knee replacement surgeries and whether they influenced the need for additional procedures within 60 days. Out of 6,603 patients, 136 (or about 2%) had to undergo reoperation, but only 76 had X-rays done, and none needed further surgery based on those images. The study found that only 43% of the X-rays were considered good quality, suggesting that these X-rays are not useful for guiding immediate postoperative care and may not be worth the cost. Who this helps: This helps healthcare providers and hospitals decide whether to use immediate X-rays after knee surgeries.

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This study looked at patients with periprosthetic joint infections where lab tests did not find any bacteria (negative culture results) compared to those where bacteria were found (positive culture results). Researchers found that 40 patients with negative cultures had more cases of previous antibiotic use and past surgeries, but surprisingly, they had a higher success rate in controlling the infection—79% for the culture-negative group versus 66% for the culture-positive group. This matters because it challenges the belief that not finding bacteria always means a worse outcome for patients. Who this helps: These findings benefit patients with joint infections and their doctors by providing better insights into treatment expectations.

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This study compared two different surgical methods to treat infections in patients who had undergone total hip replacements. Researchers looked at 83 patients and found that one-stage revisions successfully controlled infections 82% of the time, compared to 75% for two-stage surgeries where the implant was put back in, and 68% for two-stage surgeries where no implant was reinserted. This matters because it suggests that, in certain cases, one-stage surgery can effectively treat infections with results that are just as good as the more common two-stage surgery. Who this helps: Patients with infected hip replacements.

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Researchers conducted a survey at the 2011 meeting of the American Association of Hip and Knee Surgeons to find out how these doctors manage their practices. The survey looked at various topics like their type of practice, use of assistants, extra income sources, consulting work, and how they use electronic health records. The findings are important because they help understand how these surgeons operate and could identify areas for improvement in patient care. Who this helps: This benefits surgeons and healthcare organizations aiming to improve efficiency and patient outcomes.

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This study looked at 128 hip replacement surgeries from 1993 to 2005 where a part of the hip was replaced with a well-fixed component. It found that swapping the liner had a 25% chance of needing more surgery, while completely revising the hip component showed only a 15% chance of needing further surgery, indicating it’s a more reliable option. This matters because it highlights the best treatment approach for complications, potentially leading to better outcomes for patients. Who this helps: Patients undergoing revision hip surgeries.

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This study looked at how well acetabular cups, which are part of hip replacement surgeries, are positioned and what factors might lead to improper placement. Out of 1,823 hip replacements assessed, only 50% were correctly positioned in both key angles, while 63% and 79% were within acceptable ranges for specific measures. The findings indicate that factors like the surgeon's experience and patient obesity significantly increase the risk of malpositioning—low-volume surgeons had a twofold risk, while obesity led to a 1.3-fold increase. Who this helps: This benefits patients undergoing hip replacements, as well as the surgeons who perform these procedures.

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This study looked at a case involving a 46-year-old man who had hip replacement surgery using a ceramic-on-ceramic joint. Two years after the surgery, he developed swelling and a lump in his thigh that was later found to be caused by wear and metal debris from the implant, leading to a serious reaction in the body. The findings show that issues with the Morse taper (a part of the hip joint) can lead to complications that might mimic infection and complicate recovery. Who this helps: This research helps doctors better understand potential failures in hip replacements, improving patient care and outcomes.

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This study looked at the differences in how the patellar tendon (which connects the kneecap to the shinbone) is positioned and how the kneecap moves in men and women when they bend their knees. The researchers found that, at certain angles of bending, women had a different tendon orientation than men, which relates to how their thigh bone rotates (with a notable difference indicated by a statistical significance of p < 0.05). Understanding these differences is important because they could impact the way knee problems are treated, especially in procedures like knee replacement surgery. Who this helps: This helps doctors and healthcare providers treating knee issues in men and women.

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This study explored how the shape of a specific groove in the knee affects the movement of the kneecap when people bend their knees while standing. Researchers found a strong connection between the groove's shape and the kneecap's movement, with a correlation coefficient of 0.86 showing a significant relationship between the groove's location and patellar shift. These findings are important because they can help improve knee treatments and surgeries, ensuring better outcomes for those with knee issues. Who this helps: Patients with knee problems.

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Researchers studied the differences between male and female knees by examining how they move during a lunge. They found that women have a greater range of tibial rotation and different angles in their knee structure compared to men, with specific measurements like -5.4 degrees of rotation in women versus -1.3 degrees in men at a certain flexion angle. Understanding these differences is important for improving knee surgeries and treatments for injuries that may affect women differently than men. Who this helps: This helps patients, especially women undergoing knee surgeries or treatments.

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This study examined unicompartmental knee arthroplasty (UKA), a surgery for arthritis that targets only one part of the knee. Researchers found that when patients are carefully chosen and the surgery is done well, UKA can lead to better movement and satisfaction compared to total knee replacements, while lasting just as long. This surgery matters because it offers a less invasive option for patients with pain in a specific area of the knee, helping them maintain more mobility and a better quality of life. Who this helps: This helps patients suffering from localized knee arthritis.

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This study looked at how well the performance measures used to evaluate hospitals in a nationwide pay-for-performance program for hip and knee replacement surgeries actually reflect the quality of care provided. The researchers found that these measures did a poor job of showing how well hospitals performed, as higher quality scores did not lead to fewer complications or deaths among patients. This is important because it suggests that the current system for measuring hospital performance may not adequately ensure better outcomes for patients. Who this helps: This helps patients and healthcare providers by highlighting flaws in how hospital quality is assessed.

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This study looked at how often patients with high-flex total knee replacements (TKAs) actually bend their knees deeply in everyday life. Researchers found that out of 21 knees monitored for over 35 hours, patients only bent their knees more than 90 degrees for about 10 minutes, or 0.5% of the time, and only 8 knees bent more than 120 degrees for an average of 2.2 minutes. This matters because it shows that even though these knee designs allow for deep bending, most patients aren't using that capability much in real life. Who this helps: This helps patients with knee replacements understand their knee function better.

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This study looked at how the kneecap (patella) moves in relation to the thigh bone (femur) during weight-bearing activities like standing and bending the knee. Researchers found that the patella shifted only about 3 millimeters and tilted within 6 degrees as people flexed their knees. These findings are important because they help establish what normal kneecap movement looks like, which can aid in diagnosing knee problems. Who this helps: This helps patients with knee issues and doctors diagnosing knee conditions.

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This study looked at which types of hospitals in the U.S. are more likely to earn bonuses in pay-for-performance programs focused on hip and knee replacements. Researchers found that hospitals that do a lot of these surgeries, especially teaching hospitals, are more likely to receive bonuses, with factors like specialization in orthopaedics and location in the Midwest playing a significant role. Specifically, high-volume hospitals and those with a teaching component had strong performance relationships, indicating that they excel in patient outcomes. Who this helps: This benefits patients undergoing hip and knee replacements by encouraging better care at certain hospitals.

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This study looked at how patients kneel after getting a specific type of knee replacement surgery. Researchers found that, on average, the patients bent their knees from 107.3 degrees to 128 degrees while kneeling, and most showed good engagement between the knee components, which is important for stability. This matter because understanding how knees move during this activity can help ensure patients feel comfortable and safe while kneeling after surgery. Who this helps: This helps patients recovering from total knee replacement.

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This study looked at how much two different sizes of metal ball joints (28 mm and 36 mm) pushed into a special type of plastic used in hip replacements over three years. Researchers found that both sizes of joints caused similar amounts of wear in the plastic, with no significant increases in wear after the first year. This is important because it shows that patients can choose between these sizes without worrying about extra wear on their hip replacement over time. Who this helps: This benefits patients receiving hip replacements by providing them with options that are equally effective.

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This study looked at the long-term performance of a special type of plastic used in hip replacement surgeries. Researchers followed 182 patients for an average of about 7 years and found that the wear on this plastic was minimal, with an average wear rate of just 0.002 mm per year for the smaller head size and 0.026 mm for the larger one. This is important because it means that patients can expect their hip replacements to last longer and perform well without needing additional surgeries due to wear. Who this helps: This benefits patients undergoing hip replacement surgeries.