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Total hip arthroplasty (THA) is a widely performed surgical procedure that has evolved significantly due to advancements in artificial intelligence (AI) and robotics. As demand for THA grows, reliable tools are essential to enhance diagnosis, preoperative planning, surgical precision, and postoperative rehabilitation. AI applications in orthopedic surgery offer innovative solutions, including automated hip osteoarthritis (OA) diagnosis, precise implant positioning, and personalized risk stratification, thereby improving patient outcomes. Deep learning models have transformed OA severity grading and implant identification by automating traditionally manual processes with high accuracy. Additionally, AI-powered systems optimize preoperative planning by predicting the hip joint center and identifying complications using multimodal data. Robotic-assisted THA enhances surgical precision with real-time feedback, reducing complications such as dislocations and leg length discrepancies while accelerating recovery. Despite these advancements, barriers such as cost, accessibility, and the steep learning curve for surgeons hinder widespread adoption. Postoperative rehabilitation benefits from technologies like virtual and augmented reality and telemedicine, which enhance patient engagement and adherence. However, limitations, particularly among elderly populations with lower adaptability to technology, underscore the need for user-friendly platforms. To ensure comprehensiveness, a structured literature search was conducted using PubMed, Scopus, and Web of Science. Keywords included "artificial intelligence", "machine learning", "robotics", and "total hip arthroplasty". Inclusion criteria emphasized peer-reviewed studies published in English within the last decade focusing on technological advancements and clinical outcomes. This review evaluates AI and robotics' role in THA, highlighting opportunities and challenges and emphasizing further research and real-world validation to integrate these technologies into clinical practice effectively. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome (PRO) measures are essential for evaluating disease-related quality of life. The International Hip Outcome Tool 12 (iHOT12) assesses various aspects of hip-related symptoms, function, sports participation, and social limitations. This study aimed to adapt and validate an Italian version of the iHOT12 according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Materials and methods: A multicenter observational cohort study was conducted to translate and validate the iHOT-12 into Italian (iHOT-12-ita) and assess its psychometric properties. Following international guidelines, we translated and culturally adapted the iHOT-12-ita. Patients with hip pain included in the study completed the iHOT-12-ita and mHHS-ita questionnaires at three timepoints: initial consultation (T0), 10–20 days later (T1), and at least 2 months after treatment (T2): hip injection, hip arthroscopy or total hip replacement. The evaluation of the iHOT-12-ita psychometric properties was conducted following the COSMIN checklist, assessing its reliability, responsiveness, interpretability, and acceptability. Results: Between May 2019 to September 2022, 104 patients were included, from two tertiary hip surgery referral center clinics, they completed both questionnaires and were available for data analysis. The psychometric evaluations revealed robust test–retest reliability on 27 patients at T1, with a Lin coefficient of 0.709 [95% confidence interval (CI) 0.553–0.888] and a high Pearson correlation coefficient of 0.745. At T2 after treatment, there was significant responsiveness (p < 0.001, n = 72), with excellent correlation observed between the iHOT-12-Ita and mHHS-Ita questionnaires (pwcorr = 0.7971). All predefined hypotheses were confirmed. Conclusions: The Italian iHOT-12-ita proved reliable, valid, and responsive in assessing hip disease-related quality of life. Its implementation in routine clinical practice and research can enhance patient care and research quality in hip preservation surgery for the Italian orthopedic community. Level of evidence: II. [ABSTRACT FROM AUTHOR]

Copyright of Rostrum of Asclepius / Vima tou Asklipiou is the property of Technological Educational Institute of Athens and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Robotic-assisted hip and knee arthroplasty represents significant advancements in orthopedic surgery. Artificial intelligence (AI)-driven chatbots, such as ChatGPT, could play a significant role in healthcare education. This study aims to evaluate the quality of responses provided by ChatGPT to the top 20 questions concerning robotic-assisted hip and knee arthroplasty. We have asked ChatGPT to select the top 20 questions on Google concerning robotic hip and knee arthroplasty and to provide a detailed answer to each of them. The accuracy and completeness of the information provided were examined by three orthopedic surgeons with scientific and clinical experience in hip- and knee-replacement surgery. The accuracy was assessed through a 5-point Likert scale (from 1—completely incorrect to 5—correct); the completeness through a 4-point Likert scale (from 0—comprehensiveness not assessable for completely incorrect answers to 3—exhaustive information) on two different occasions to ensure the consistency of the assessment. Our analysis reveals that ChatGPT provides a relatively high degree of accuracy; moreover, the explanations can be considered satisfying, especially for factual questions. The findings suggest that ChatGPT can serve as a valuable initial resource for general information on robotic hip and knee arthroplasty but the integration with human expertise remains essential. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to formulate evidence‐based recommendations for optimising wound management in hip and knee arthroplasty by exploring alternative methods such as barbed sutures and skin adhesives. Methods: A Delphi panel, comprising seven orthopaedic surgeons, one musculoskeletal infectious disease specialist, and one health economics expert, was convened to evaluate the use of barbed sutures and skin adhesives for wound closure in hip and knee arthroplasty. Two systematic reviews informed the development of questionnaires, with panelists ranking their agreement on statements using a 5‐point Likert scale. Consensus was achieved if ≥75% agreement. Unresolved statements were revisited in a second round. Results: Consensus was reached on 11 statements, providing evidence‐based recommendations. The expert panel advocates for a multilayer watertight technique using barbed sutures to prevent surgical site infections (SSI), reduce complications, shorten surgical times, optimise resources and improve cosmetic appearance. For skin closure, the panel recommends topical adhesives to decrease wound dehiscence, enhance cosmetic appearance, promote patient compliance, prevent SSIs, and optimise resources. Conclusion: The Delphi consensus by Italian total joint arthroplasty experts underscores the pivotal role of barbed sutures and skin adhesives in optimising outcomes. While guiding clinical decision‐making, these recommendations are not prescriptive and should be adapted to local practices. The study encourages further research to enhance current evidence. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Since the end of the 19th and the beginning of the 20th centuries, technological equipment, implant designs (endoprosthesis) and the surgical technique of total hip replacement (THR) have been constantly improved and reached a high level of functionality and quality. Therefore, at present, THR is one of the most high-tech, reliable and popular surgical operations that allow a large number of people suffering from osteoarthritis and other serious diseases of the hip joint to return to an active lifestyle. At the same time, it is known that even operations at this level do not always guarantee the achievement of the desired result and can lead to various complications. The question arises: are there potential opportunities for creating an "ideal endoprosthesis" that allows one to perform an "ideal THR"? In this paper, based on a critical analysis of modern endoprosthesis designs for THR, technologies for their implantation and systemic postoperative complications, the most probable, according to the authors, ways of their development are formulated, which allow asymptotically approaching the "ideal". [ABSTRACT FROM AUTHOR]

The goal of the trial was to examine the effects of adding electromyographic biofeedback (EMG-BF) to the conventional program of physiotherapy after total hip arthroplasty (THA) on functional recovery and quality of life. The trial was designed as a prospective, interventional, single-blinded randomized controlled study. Ninety patients were randomized into an experimental group (EG) (n = 45; mean age 63.9 ± 8.8) and control group (CG) (n = 45; mean age 63.9 ± 9). All patients received 21 days of physiotherapy which consisted of therapeutic exercise (land-based and aquatic), electrotherapy, and education. Electromyographic biofeedback was added to a portion of the land-based exercise in EG. The Hip Disability and Osteoarthritis Outcome Score (HOOS), Numeric Rating Scale (NRS), Short Form Health Survey-36 (SF-36), use of a walking aid, 30 s chair stand test (CST) as well as the Timed Up and Go (TUG) test were used for outcome measurement. A higher proportion of the participants in both groups did not need a walking aid after the intervention (p < 0.05). All participants improved their 30 s CST and TUG results (p < 0.001), as well as their NRS and HOOS scores (p < 0.05). No significant differences between the groups were found. There were no additional benefits from adding EMG-BF to the conventional physiotherapy protocol. [ABSTRACT FROM AUTHOR]

Background: Identifying patients at high risk of acute postoperative pain after total knee or hip arthroplasty (TKA/THA) will facilitate individualized pain management and research on the efficacy of treatment options. Numerous studies have reported that psychological patient factors may influence acute postoperative pain, but most reviews have focused on chronic pain and functional outcomes. This systematic review aims to evaluate which psychological metrics are associated with acute postoperative pain after TKA and THA. Methods: A systematic search was conducted using the databases PubMed, EMBASE, Web of Science, and Cochrane Library until June 2022. Full‐text articles reporting associations of preoperative psychological factors with acute pain within 48 h of TKA or THA surgery were identified. Quality was assessed using the Quality in Prognostic Studies tool. Results: Eighteen studies containing 16 unique study populations were included. TKA was the most common procedure, and anxiety and depression were the most evaluated psychological metrics. Several different anesthetic techniques and analgesic regimens were used. The studies were generally rated as having a low to moderate risk of bias. Catastrophizing was associated with acute pain in six studies (of nine), mainly after TKA. In contrast, three studies (of 13) and two studies (of 13) found anxiety and depression, respectively, to be associated with acute postoperative pain. Conclusion: Pain catastrophizing seemed to be the most consistent psychological predictor of acute postoperative pain after TKA. The results for other psychological factors and THA were inconsistent. However, the interpretation of results was limited by considerable methodological heterogeneity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Different interventions are used during rehabilitation after hip replacement surgery, but it is unclear if task-oriented exercise is more effective than conventional physiotherapy. OBJECTIVE: This study compared the effectiveness of conventional physiotherapy (CPT) programme with task-oriented exercise (TOE) on hip pain, function, static and dynamic balance during the early rehabilitation stage after total hip replacement. METHODS: This randomized controlled parallel-group trial was executed in an inpatient physical medicine and rehabilitation centre. The study included 40 patients who were randomly classified into CPT and TOE groups (n = 20 in each). Hip pain (assessed by visual analogue scale), function in the operated leg (assessed by modified Harris Hip Score, mHHS), static balance (assessed by Abili Balance analyser system) and dynamic balance (assessed by Berg Balance Scale) were evaluated at baseline and after 18 days of rehabilitation. Cohen's effect size (d) was calculated. RESULTS: Greater pain reduction (p < 0.05; d = 0.08) was observed after TOE (1.6 ± 0.68 scores) compared with the CPT programme (2.2 ± 0.83 scores). Hip function assessed by the modified mHHS improved more (p < 0.05; d = 0.30) in the TOE group (73.45 ± 6.23 scores) than in the CPT group (54.90 ± 6.28 scores). Static balance improved significantly in both groups after the interventions but did not differ significantly between the groups. The improvement in dynamic balance was significantly greater (p < 0.05; d = 0.45) after TOE (50.55 ± 1.57 scores) than after CPT (38.55 ± 3.43 scores). CONCLUSION: Both interventions reduced pain and improved function of the operated leg and static and dynamic balance. The effect on hip function was superior for TOE compared with CPT. [ABSTRACT FROM AUTHOR]

Copyright of Timisoara Physical Education & Rehabilitation Journal is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Total knee (TKA) and hip arthroplasty (THA) are successful procedures in treating end-stage osteoarthritis when nonoperative treatments fail. However, a growing body of literature has been reporting suboptimal outcomes following TKA and THA. While pre- and post-operative rehabilitation is imperative to recovery, little is known about their effectiveness for patients at risk of poor outcomes. In the 2 systematic reviews with identical methodology, we aim to evaluate the effectiveness of (a) pre-operative and (b) post-operative rehabilitation interventions for patients at risk of poor outcomes following TKA and THA. Methods: The 2 systematic reviews will follow the principles and recommendations outlined in the Cochrane Handbook. Only randomized controlled trials (RCTs) and pilot RCTs will be searched in 6 databases: CINAHL, MEDLINE, Embase, Web of Science, Pedro, and OTseeker. Eligible studies including patients at risk of poor outcomes and evaluating rehabilitation interventions following and preceding arthroplasty will be considered for inclusion. Primary outcomes will include performance-based tests and functional patient-reported outcome measures, and secondary outcomes will include health-related quality of life and pain. The quality of eligible RCTs will be evaluated using the Cochrane's risk of bias tool, and the strength of evidence will be assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). Discussion: These reviews will synthesize the evidence regarding the effectiveness of pre-and post-operative rehabilitation interventions for patients at risk of poor outcomes, which in turn may inform practitioners and patients in planning and implementing the most optimal rehabilitation programs to achieve the best outcomes after arthroplasty. Systematic Review Registration: PROSPERO CRD42022355574 [ABSTRACT FROM AUTHOR]

Background: One million Total Hip Replacements (THA) are thought to be performed annually. To measure prosthesis awareness throughout daily activities, the FJS-12 patient-reported outcome scale was developed. This article's goal is to undertake a psychometric validation of the Italian FJS-12 among a sample of related THA patients. Methods: Between January and July 2019, data from 44 patients were retrieved. The participants were required to complete the Italian version of FJS-12 and of the WOMAC at preoperative follow-up, after two weeks, 1, 3, and 6 months postoperatively. Results: The Pearson correlation coefficient between the FJS-12 and WOMAC was 0.287 (p = 0.002) at preoperative follow-up, r = 0.702 (p < 0.001) at 1 month, r = 0.516 (p < 0.001) at 3 months and r = 0.585 (p < 0.001) at 6 months. The ceiling effect surpassed the acceptable range (15%) for FJS-12 in 1 month (25.5%) and WOMAC in 6 months follow-up (27.3%). Conclusions: The psychometric validation of the Italian version of this score for THA was executed with acceptable results. FJS-12 and WOMAC reported no ceiling and floor effects. Therefore, to distinguish between patients who had good or exceptional results following UKA, the FJS-12 could be a reliable score. Under the first four months, FJS-12 had a smaller ceiling effect than WOMAC. It is recommended to use this score in clinical research concerning the outcomes of THA. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Total knee (TKA) and hip arthroplasty (THA) are successful procedures in treating end-stage osteoarthritis when nonoperative treatments fail. However, a growing body of literature has been reporting suboptimal outcomes following TKA and THA. While pre- and post-operative rehabilitation is imperative to recovery, little is known about their effectiveness for patients at risk of poor outcomes. In the 2 systematic reviews with identical methodology, we aim to evaluate the effectiveness of (a) pre-operative and (b) post-operative rehabilitation interventions for patients at risk of poor outcomes following TKA and THA. METHODS: The 2 systematic reviews will follow the principles and recommendations outlined in the Cochrane Handbook. Only randomized controlled trials (RCTs) and pilot RCTs will be searched in 6 databases: CINAHL, MEDLINE, Embase, Web of Science, Pedro, and OTseeker. Eligible studies including patients at risk of poor outcomes and evaluating rehabilitation interventions following and preceding arthroplasty will be considered for inclusion. Primary outcomes will include performance-based tests and functional patient-reported outcome measures, and secondary outcomes will include health-related quality of life and pain. The quality of eligible RCTs will be evaluated using the Cochrane's risk of bias tool, and the strength of evidence will be assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). DISCUSSION: These reviews will synthesize the evidence regarding the effectiveness of pre-and post-operative rehabilitation interventions for patients at risk of poor outcomes, which in turn may inform practitioners and patients in planning and implementing the most optimal rehabilitation programs to achieve the best outcomes after arthroplasty. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022355574 [ABSTRACT FROM AUTHOR]

Short femoral stems, with preservation of the femoral bone stock, are commonly used in recent years for hip replacement in younger and more active patients. Obesity is increasingly spreading even in the younger population. The aim of this case-series study is to evaluate short stems compared to traditional hip prostheses in the obese population. A total of 77 consecutive patients with a BMI greater than or equal to 30 Kg/m2 were enrolled in this prospective study and were divided into two groups: 49 patients have been implanted with short stems while 28 patients were implanted with traditional stems. All the patients were treated for primary osteoarthritis or avascular necrosis and all the stems were implanted by the same surgeon using a posterior approach. Clinical (Harris Hip Score—HHS, Western Ontario and McMaster Universities Osteoarthritis Index—WOMAC, visual analogue scale—VAS, 12-item Short Form Health Survey—SF-12) and radiographic outcomes were recorded. Radiological evaluations were carried out by three different blinded surgeons. A statistical analysis was performed (chi-square, t-test, Wilcoxon Rank Sum Test, 2-factor ANOVA). At a mean follow-up of 42.6 months both groups showed a marked improvement in pain and in the clinical scores between pre- and post-surgical procedures (p < 0.05) with no significant differences between the two groups at last follow-up (p > 0.05). The radiological evaluations, with high concordance correlation between the three blinded surgeons (ICC consistently >0.80), showed good positioning and osseointegration in all cases, with no significant differences in the restoration of the joint geometry and complications. No revisions were recorded during the follow-up period. In conclusion, short stems appear to be a good option for bone preservation even in obese patients, showing comparable results to traditional implants. [ABSTRACT FROM AUTHOR]