Live MediSum Demo

This review examines targeting coagulation factor XI/FXIa for venous thromboembolism prophylaxis after total knee arthroplasty (TKA), summarizing biologic rationale and clinical trial data. Phase II programs using FXI antisense oligonucleotides, monoclonal antibodies, and small-molecule FXIa inhibitors demonstrated large reductions in venographic VTE with low bleeding profiles comparable to enoxaparin, and two pivotal Phase III programs are ongoing to define their role in contemporary post-TKA practice.

This systematic review and meta-analysis of 16 randomized trials including 3,776 elderly patients with displaced femoral neck fractures compared cemented versus uncemented femoral stem fixation. Cemented fixation was associated with a modest reduction in overall mortality (OR 0.83, 95% CI 0.70–0.97) and a substantially lower risk of periprosthetic fracture (OR 0.22, 95% CI 0.12–0.41), with no significant differences in dislocation or wound infection.

In a retrospective series of 47 patients (mean age 66 years, mean follow-up 3.1 years) undergoing conversion hip arthroplasty after failed ORIF for hip fracture, Kaplan-Meier survivorship was 88.2% at one, three, and five years with an overall complication rate of 21.3% and a reoperation rate of 10.6% (most commonly infection). Harris Hip Scores improved significantly from a mean of 47.5 preoperatively to 83.3 at final follow-up, and all patients were ambulatory at follow-up with variable gait patterns.