Use of technology-assisted elective total knee arthroplasties (TKAs) increased from 2010-2018 and is associated with reduced odds of short-term complications, according to a study published in Arthroplasty Today. Ilya Bendich, MD, and colleagues retrospectively identified patients who underwent primary, elective TKA and classified procedures as conventional, computer-assisted navigation (CAN), or robotic assistance (RA). Of the 1.3 million elective TKAs, 92.8%, and 7.7% were conventional and technology-assisted, respectively (95.2% and 4.9% CAN and RA, respectively). e greatest increase in utilization was for RA-TKAs. Ninety-day postoperative complications requiring readmission were highest and lowest for conventional TKA and RA-TKA, respectively. Significantly lower odds of all-cause 90-day complications requiring readmission were seen for RA-TKA and CAN-TKA compared with conventional TKA (ORs, 0.68 and 0.93, respectively).
Smartphone Intervention Is Beneficial to Those With Severe Mental Illness
For patients with severe mental illness (SMI), a smartphone intervention is highly usable and acceptable and improves outcomes, according to a study published in the Journal of Medical Internet Research. Dror Ben-Zeev, Ph.D., and colleagues conducted a trial of CORE, a smartphone intervention that includes daily exercises designed to promote reassessment of dysfunctional beliefs. The study team randomly assigned 315 individuals from 45 states to either active intervention or wait-list control groups. Participants were assessed at baseline, 30 days, and 60 days with the Beck Depression Inventory-Second Edition (BDI-II), Generalized Anxiety Disorder-7 (GAD-7), Hamilton Program for Schizophrenia Voices, Green Paranoid thought to Scale, Recovery Assessment Scale (RAS), Rosenberg Self-Esteem Scale (RSES), Friendship Scale, and Sheehan Disability Scale (SDS). Participants had self-reported bipolar disorder, major depressive disorder, and schizophrenia or schizoaffective disorder (35.2%, 43.2%, and 21.6%, respectively) and displayed moderate-to-severe symptoms and disability levels at baseline. CORE was rated as acceptable and highly usable. Significant treatment by-time interactions were seen for the BDI-II, GAD7, RAS, RSES, and SDS in intent-to-treat analyses. Large effect sizes were seen for the BDI-II, RAS, and RSES, while the SDS had a moderate effect size and A small effect size was seen for GAD-7.
