Patient Frailty is Correlated With Increased Adverse Events and Costs After Revision Total Hip Arthroplasty.

Background: Frailty has been associated with poor outcomes and higher costs after primary total hip arthroplasty. However, frailty has not been studied in relation to outcomes after revision total hip arthroplasty (rTHA). This study examined the relationship between the Hospital Frailty Risk Score (HFRS), postoperative outcomes, and cost profiles following rTHA.

Patient Frailty is Correlated With Increased Adverse Events and Costs After Revision Knee Arthroplasty.

Background: Frailty can predict adverse outcomes after various orthopaedic procedures, but is not well-studied in revision total knee arthroplasty (rTKA). We investigated the correlation between the Hospital Frailty Risk Score (HFRS) and post-rTKA outcomes.

Methods: Using the Nationwide Readmissions Database, we identified rTKA patients discharged from January 2017 to November 2019 for the most common diagnoses (mechanical loosening, infection, and instability).

Radiographic Outcomes of Titanium Augment vs Bone Graft in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity.

Background: Lateral column lengthening (LCL) is a surgical procedure used to manage forefoot abduction and, in theory, also increases the longitudinal arch by plantarflexion of the first ray through tensioning the peroneus longus for patients with stage IIB adult acquired flatfoot deformity (AAFD). This procedure utilizes an opening wedge osteotomy of the calcaneus, which is then filled with autograft, allograft, or a porous metal wedge. The primary aim of this study was to compare the radiographic outcomes of these different bone substitutes following LCL for stage IIB AAFD.

Variation in radial head fracture treatment recommendations in terrible triad injuries is not influenced by viewing two-dimensional computed tomography.

Background: We analyzed association between viewing two-dimensional computed tomography (2D CT) images in addition to radiographs with radial head treatment recommendations after accounting for patient and surgeon factors in a survey-based experiment.

Methods: One hundred and fifty-four surgeons reviewed 15 patient scenarios with terrible triad fracture dislocations of the elbow. Surgeons were randomized to view either radiographs only or radiographs and 2D CT images.

Frailty is Associated With Increased Complication, Readmission, and Hospitalization Costs Following Primary Total Knee Arthroplasty.

Background: Frailty has been associated with poor postoperative outcomes in various medical conditions and surgical procedures. However, the relationship between frailty and outcomes after primary total knee arthroplasty (TKA) has not been well-described. This study investigated the association of the Hospital Frailty Risk Score (HFRS) with postoperative events and hospitalization costs after primary TKA.

Conversion total hip arthroplasty following extracapsular hip fracture fixation with a cephalomedullary device: a comprehensive review.

With the annual incidence of hip fractures and hip fracture fixation rising, the need for conversion total hip arthroplasty has also risen. About half of the 280,000 hip fractures that occur annually in the United States are extracapsular. Commonly extracapsular hip fractures are treated with either cephalomedullary nails (CMNs) or sliding hip screws (SHS).

The impact of total knee arthroplasty on golfing activity.

Background: Total knee arthroplasty (TKA) is frequently performed among individuals who golf. This study examines the effect of TKA on pre- and postoperative pain, frequency of sport participation, handicap, driving distance, use of a cart, and overall game enjoyment.

Methods: This is a survey-based retrospective review of 71 patients after primary TKA at a tertiary medical facility in upstate New York.

Frailty Is Associated With Increased 30-Day Adverse Events and Hospitalization Costs After Primary Total Hip Arthroplasty.

Background: Frailty can predict adverse outcomes for multiple medical conditions and surgeries but is not well studied in total hip arthroplasty (THA). We evaluate the association between Hospital Frailty Risk Score and postoperative events and costs after primary THA.

Methods: Using the National Readmissions Database, we identified primary THA patients for osteoarthritis, osteonecrosis, or hip fracture from January to November 2017.

Perioperative Management of Hepatitis C in Patients Undergoing Total Joint Arthroplasty.

»: A small yet growing subset of total joint arthroplasty (TJA) candidates are diagnosed with the hepatitis C virus (HCV), which is a known risk factor for periprosthetic joint infections. Given the poor outcomes associated with TJA infection, we recommend that candidates with HCV receive treatment prior to elective TJA.

»: Interferon and ribavirin have historically been the standard treatment regimen for the management of HCV; however, adverse events and an inconsistent viral response have limited the efficacy of these therapies.

Patient Positioning for Proximal Femur Fracture Fixation: a Review of Best Practices.

Purpose Of Review: Proximal femur fractures are common traumatic injuries treated by orthopedic surgeons. Preparation and positioning for surgical intervention are critical in the proper management of proximal femur fractures. The purpose of this study was to review the current evidence on the various positioning options for patients and to highlight the principles and emerging techniques to help orthopedic surgeons treat this common injury.

Direct Anterior Approach Total Hip Arthroplasty Is Not Associated with Increased Infection Rates: A Systematic Review and Meta-Analysis.

Background: The direct anterior approach (DAA) for primary total hip arthroplasty (THA) has recently increased in popularity. Recent evidence has raised concerns about whether use of the DAA is associated with increased rates of superficial and deep infection. The aim of this study was to systematically assess the literature and comparatively evaluate the rate of superficial and deep infection following primary THA using the DAA and non-direct anterior (non-DAA) approaches.

Outcomes of a Total Joint Arthroplasty Enhanced Recovery Program in a Community Hospital Setting.

Background: Same-day discharge (SDD) total joint arthroplasty (TJA) is increasingly popular, yet there remain concerns regarding patient safety, complication rates, and unforeseen overnight admission (failure to launch; FTL). The aim of this study is to retrospectively examine the outcomes of a large consecutive SDD-TJA series in the community hospital setting.

Methods: We retrospectively reviewed 1200 consecutive SDD-TJA candidates between March 2017 and December 2019 by 5 surgeons at a community hospital.

Misinformation in Patient Handouts About Upper Extremity Conditions.

This study investigated handouts regarding common upper extremity problems for inaccuracies, distracting information, and concepts that reinforce common unhelpful cognitive biases. We reviewed handouts on upper extremity conditions from 2 electronic medical records and 2 professional associations. We categorized information as inaccurate, distracting, and risk of reinforcing common unhelpful cognitive biases.

Team Approach: Evaluation and Management of Pelvic Ring Injuries.

A multidisciplinary approach to the management of pelvic ring injuries has been shown to decrease mortality rates. The primary goals within the emergency room are to assess, resuscitate, and stabilize the patient. The Advanced Trauma Life Support protocol guides the initial assessment of the patient.

The Use of Dual Mobility Implants in Patients Who Are at High Risk for Dislocation After Primary Total Hip Arthroplasty.

Dislocation after total hip arthroplasty (THA) is the leading cause of revision surgery. Dual mobility (DM) implants have been utilized over the past 40 years as a means of addressing and preventing this morbid and expensive complication. Recently, there has been renewed investigation into the role that DM implants may play in reducing instability in high-risk patients.

Team Approach: Developmental Dysplasia of the Hip.

Developmental dysplasia of the hip (DDH) encompasses a wide spectrum of hip disorders, including neonatal instability, acetabular dysplasia, hip subluxation, and frank dislocation of the hip. It is a common disorder, with a reported incidence of between 0.1% and >10% of live births.

An Analysis of Complications and Bone Defect Length With the Use of Induced Membrane Technique in the Upper Limb: A Systematic Review.

The induced membrane technique was originally described as a technique for the reconstruction of long bone defects. The authors performed a systematic review to determine whether the use of the induced membrane technique is effective in large bony defects in the upper extremity. A qualitative systematic review was conducted using PubMed, EBSCO, and Google Scholar databases to record all studies reporting on complications of the induced membrane technique in the upper extremity.

Perioperative Management of Orthopaedic Patients with Hematologic Disorders: A Critical Analysis Review.

Perioperative management of orthopaedic patients with a hematologic disorder is a complex endeavor that requires a multidisciplinary team-based approach. A team composed of an experienced orthopaedic surgeon, an anesthesiologist, and a hematologist is necessary to achieve optimal outcomes. Patients with hemophilia and other complex hematologic disorders should be managed at, or in consultation with a hematologist at, a comprehensive hemophilia center.

Patient and Surgeon Factors Associated With Prosthetic Replacement Rather Than With Open Reduction and Internal Fixation of a Radial Head Fracture.

The decision between radial head arthroplasty and open reduction internal fixation in the context of a terrible triad elbow fracture-dislocation is debated. This study investigated both surgeon and patient factors associated with surgeons' recommendations to use arthroplasty. One hundred fifty-two surgeon members of the Science of Variation Group participated.

Cannabinoid Use in Musculoskeletal Illness: a Review of the Current Evidence.

Purpose Of Review: The use of cannabinoids has increased since legalization of recreational and medical use in the USA. It is likely that many orthopaedic patients consume cannabinoid products during the traumatic or perioperative period. The purpose of this study was to investigate the pre-clinical data evaluating the mechanism of action of cannabidiol (CBD) and Δ-Tetrahydrocannabinol (Δ-THC) and to evaluate the current clinical data on the use of cannabinoids in musculoskeletal illness.

Economic Recovery After the COVID-19 Pandemic: Resuming Elective Orthopedic Surgery and Total Joint Arthroplasty.

Background: The economic effects of the COVID-19 crisis are not like anything the U.S. health care system has ever experienced.

Risk factors associated with persistent chronic opioid use following THA.

Introduction: An understanding of patient characteristics associated with persistent chronic opioid use after total joint arthroplasty (TJA) will allow surgeons to better manage these patients. Our study aims to identify risk factors among preoperative chronic opioid users who continue to chronically use narcotics after total hip arthroplasty (THA).

Methods: A retrospective analysis was performed on 256 THA recipients using the state's mandated opioid monitoring program to identify preoperative chronic opioid users.

Correlation of Single Assessment Numeric Evaluation (SANE) with other Patient Reported Outcome Measures (PROMs).

Background: The Single Assessment Numeric Evaluation (SANE) is a simple, one-question patient-reported outcome measure (PROM). We systematically reviewed correlations between SANE and more extensive PROMs.

Methods: We identified studies with correlation coefficients between SANE and other shoulder, knee, and ankle-specific PROMs.