Distal femoral osteotomies improves recurrent patellar instability in patients with genu valgum: A systematic review.

Importance: Coronal plane malalignment can contribute to recurrent patellar instability, a common knee pathology, particularly in adolescents that can negatively impact knee function and stability.

Objective: To systematically review the literature in order to summarize the clinical and radiologic outcomes of the surgical treatment of recurrent lateral patellar instability in patients with genu valgum using varus-producing distal femoral osteotomies (DFOs).

Evidence Review: A systematic review was conducted using PubMed, Cochrane Library, and OVID Medline databases from 1990 to present.

Postoperative Rehabilitation After Superior Labrum Anterior Posterior Repair.

The 4-phase rehabilitation protocol outlined in this article provides a comprehensive 26-week program to return patients with superior labrum anterior posterior repairs to their preinjury states. It is guided by the principle of gradual return to preinjury function while preserving the integrity of the surgical repair. Objective criteria are present at the conclusion of each phase to ensure patients are progressing appropriately.

Evaluation of Achilles Tendon Stiffness as Measured by Shear Wave Elastography in Female College Athletes Compared With Nonathletes.

Background: We sought to utilize a noninvasive technology to assess the effects of activity on Achilles tendon stiffness and define baseline Achilles tendon stiffness in female college athletes compared with nonathletes using tendon shear wave velocity as a marker for tendon stiffness.

Hypothesis: Training status and exercise may affect Achilles tendon stiffness.

Level Of Evidence: Level 4.

Surgical Site Infection After Primary Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis: An Analysis of Risk Factors From a Nationwide Insurance Database.

Study Design: Retrospective review.

Objective: The purpose of this study was to quantify the incidence and factors associated with surgical site infection (SSI) in pediatric patients undergoing spinal fusion for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Infection is a morbid complication after spinal fusion.

Preoperative Risk Factors for Primary Metatarsophalangeal Arthroplasty Revision to MTP Arthrodesis for Hallux Rigidus.

Background: Revision or conversion to arthrodesis following metatarsophalangeal (MTP) joint arthroplasty are salvage procedures to manage complications of MTP joint arthroplasty. The purpose of this study is to use a national administrative database to characterize nationwide trends of patients undergoing hallux MTP arthrodesis vs arthroplasty for hallux rigidus. Additionally, the authors sought to evaluate demographic trends and evaluate influence of patient-related risk factors in those undergoing MTP arthroplasty revision to arthrodesis.

Osteoporosis is associated with increased minor complications following single level ALIF and PSIF: an analysis of 7,004 patients.

Background: Osteoporosis is a prevalent disease that predisposes patients to fracture and additional post-operative complications, potentially contributing to decreased quality of life. The objective of the current study is to (I) characterize the demographic trends of individuals with osteoporosis undergoing single level posterior spine instrumentation and fusion (PSIF) and anterior lumbar interbody fusion (ALIF); (II) determine the association between osteoporosis and postoperative complications; (III) identify whether the use of bone strengthening medications is associated with improved outcomes.

Methods: A retrospective review of the Mariner Claims Database was conducted on patients undergoing single level ALIF (CPT 22558) and PSIF (CPT 22840) between 2011 and 2017.

Resident Level Involvement Affects Operative Time and Surgical Complications in Lower Extremity Fracture Care.

Objective: The purpose of this study is to evaluate the effect of resident participation on operative time and surgical complications in isolated lower extremity fracture care.

Setting: Patients who were treated at teaching hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database.

Participants: A total of 2,488 patients who underwent surgical fixation of isolated hip fractures, femoral or tibial shaft fractures, and ankle fractures.

The Impact of Mental Illness on Postoperative Adverse Outcomes After Outpatient Joint Surgery.

Background: The effect of pre-existing mental illness on outpatient surgical outcomes is not well characterized. The objective of this study was to evaluate the association between pre-existing mental illness diagnosis and postoperative complications after outpatient total knee (TKA) and total hip arthroplasty (THA) and 2) compare with inpatient total joint arthroplasty (TJA).

Methods: The Mariner Claims Database was used to capture patients undergoing outpatient TJA from 2010 to 2017.

Trends in Hospital and Surgeon Charges and Reimbursements for Revision Total Knee Arthroplasty.

Background: The relationship between surgeon and hospital charges and reimbursements for revision total knee arthroplasty (TKA) has not been well examined. The objective of this study is to report trends and variations in hospital charges and payments compared to surgeons for stage 1 (S1) vs stage 2 (S2) septic revision TKA and aseptic revision (AR) TKA.

Methods: The 5% Medicare sample was used to capture hospital and surgeon data for revision TKA from 2005 to 2014.

Pre-operative Hypoalbuminemia Is Associated with Complications Following Proximal Humerus Fracture Surgery: An Analysis of 919 Patients.

Background: Proximal humerus fractures are among the most common presenting fractures to orthopedic surgeons in the USA. Hypoalbuminemia is accepted as a nutrition marker associated with post-operative complications following common orthopedic interventions.

Questions/purposes: Thus, the authors sought to (1) describe the national demographic trends of patients undergoing surgical fixation for proximal humerus fracture and (2) investigate the association between pre-operative hypoalbuminemia, a malnutrition marker, and post-operative complications within 1 year of surgical intervention.

Iron Deficiency Anemia is Associated with Increased Early Postoperative Surgical and Medical Complications Following Total Hip Arthroplasty.

Background: Iron deficiency anemia (IDA) is a medical comorbidity commonly diagnosed in those undergoing primary total hip arthroplasty (THA). The authors sought to evaluate IDA as a risk factor for early postoperative complications following discharge and describe the hospital resource utilization of this patient population.

Methods: Patients with a diagnosis of IDA who underwent THA from 2005 to 2014 were identified in a national insurance database.

Urinary Self-Catheterization is Not Associated with Increased Risk of Major Complications Following Total Hip and Knee Arthroplasty.

Background: The objective of this study is to evaluate urinary self-catheterization as a potential risk factor for postoperative complications following total hip (THA) and knee (TKA) arthroplasty procedures.

Methods: Self-catheterization patients who underwent total joint arthroplasty from 2005 to 2014 were identified in a national insurance database. Rates of death, hospital readmission, emergency room visit, infection, revision, and dislocation for THA or arthrofibrosis for TKA were calculated, as well as cost and length of stay.

Risk Factors for Infection Following Total Wrist Arthroplasty and Arthrodesis: An Analysis of 6641 Patients.

Infection following wrist arthroplasty (WA) or wrist fusion (WF) is an uncommon but difficult complication often resulting in explantation and prolonged courses of antibiotics. The purposes of this study are to: (1) characterize the demographic trends of individuals undergoing WA and WF; (2) determine the incidence of postoperative infection; and (3) identify risk factors for postoperative infection. The PearlDiver database was used to query 100% Medicare Standard Analytic files from 2005 to 2014.

Smoking is associated with increased surgical complications following total shoulder arthroplasty: an analysis of 14,465 patients.

Hypothesis: The purpose of this study was to evaluate the association between smoking and postoperative complications following total shoulder arthroplasty. We hypothesized that active smokers would have significantly greater postoperative medical and surgical complications.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent total shoulder arthroplasties from 2005 through 2016.

New Five-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures.

Introduction: Although the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures.

Methods: The NSQIP database was queried for patients 60 years of age and older who underwent surgical management for hip fractures between 2005 and 2016.

Smoking is associated with increased complications and readmission following extensor mechanism repair.

Purpose: Extensor mechanism injuries are disabling injuries that require prompt evaluation and treatment and complications are often devastating. While smoking has been shown to increase complications following total joint arthroplasty, this relationship has not yet been established in those undergoing extensor mechanism repair. The purpose of this study was to evaluate the risk of smoking on postoperative complications following extensor mechanism repair.