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Background and Objective: Metastatic cancer of the acetabulum can produce marked pain and disability for patients. Several reconstruction techniques for such lesions have been described, with variable outcomes. The purpose of this study was to determine functional outcomes and complication rate for patients undergoing cement rebar reconstruction using posterior column screws with total hip arthroplasty for large, uncontained lesions of the acetabulum., Methods: Twenty-two consecutive patients who underwent cement rebar reconstruction with posterior column screws and total hip arthroplasty for metastatic tumors of the acetabulum between 2014 and 2017 were identified. All cases were reviewed for patient demographics, surgical parameters, implant survival, complications, and functional status following these procedures., Results: There was a significant increase in the proportion of patients able to ambulate post-surgery (95.5%) compared with presurgery (22.7%) (p < 0.001). Mean musculoskeletal tumor society score postoperatively was 17.9 (60%). Average operative time was 174 min and average estimated blood loss was 689 mL. Seven patients required an intraoperative or postoperative blood transfusion. Three patients had postoperative complications (14%), two of whom required revision (9%)., Conclusion: Reconstruction using cement rebar with posterior column screws and total hip arthroplasty is a safe, reproducible approach that may greatly improve functional outcomes with a low rate of intraoperative or postoperative complications., (© 2023 Wiley Periodicals LLC.)

Background: NSAIDs have been shown to be highly effective analgesic agents in the postoperative period. NSAIDs do have several potential adverse effects, including kidney injury (AKI). Little is known about AKI in the outpatient total joint arthroplasty (TJA) setting, where patient labs are not closely monitored. The objective of this study was to evaluate the renal safety of combined use of ibuprofen for pain control and aspirin for deep vein thrombosis chemoprophylaxis after outpatient primary TJA., Methods: Patients undergoing primary total hip or total knee arthroplasty between January 2020 and July 2020 at a single center were included for analysis. All included patients were discharged on a standard regimen including aspirin 81 mg twice a day and ibuprofen 600 mg three times a day. Patients were ordered a serum creatinine test at 2 and 4 weeks postoperatively. Patients with postoperative acute kidney injury were identified per Acute Kidney Injury Network criteria., Results: Between January 23, 2020, and August 30, 2020, 113 patients were included in this study, of whom creatinine levels were measured in 103 patients (90.3%) at the 2-week postoperative time point, 58 patients (50.9%) at the 4-week time point, and 48 (42.1%) at combined 2- and 4-week time points. Three patients (2.9%) were found to have an AKI., Conclusion: This study found a rate of AKI of 2.9% with the use of dual NSAID therapy postoperatively after primary TJA. All cases occurred at 2 weeks postoperatively and saw spontaneous resolution., (Copyright © 2022 by the American Academy of Orthopaedic Surgeons.)

Introduction: Total hip arthroplasty (THA) is a viable option to restore mobility and relieve pain in patients with severe post-tuberculous arthritis, but has been controversial due to concerns of disease reactivation. Over the past several decades, a number of authors have reported outcomes of THA for tuberculosis (TB) infections. However, there is marked heterogeneity in regard to disease activity, surgical approaches, and the use of chemoprophylaxis in these studies., Areas Covered: The purpose of this review was to critically assess: 1) patient characteristics; 2) perioperative planning; 3) clinical outcomes; 4) radiographic outcomes; and 5) complications of THA in the setting of tuberculosis of the hip., Expert Opinion: THA is an effective treatment for post-TB hip arthritis. There has been controversy regarding its safety during the past several decades, as it has been thought to increase the risk of disease reactivation. While studies thus far have shown generally favorable results, they have been limited by small sample sizes and their design as retrospective case series. Comparison of these studies reveals marked heterogeneity in the clinical management of this complex disease. However, synthesis of their findings demonstrates favorable outcomes and low rates of complication, including disease reactivation particularly when perioperative anti-tuberculosis therapy is instituted.