Postless Hip Distraction Systems Decrease the Amount of Traction Force Needed to Obtain Adequate Hip Distraction Versus a Conventional Post Hip Distractor.

Purpose: To directly compare hip distraction distance and traction force data for hip arthroscopy performed using a post-basedsystem versus a postless system.

Methods: Adult patients undergoing primary hip arthroscopy for femoroacetabular impingement were prospectively enrolled. Before March 26, 2019, arthroscopy was performed using a post-based system.

Management of the Ulnar Nerve in Throwing Athletes.

Purpose Of Review: During overhead throwing, there are tremendous forces placed on the medial elbow that can result in injury to the ulnar nerve. The purpose of this article is to review the anatomy, biomechanics, and appropriate clinical care of an overhead throwing athlete suffering from injury to their ulnar nerve. The authors preferred clinical work-up; non-operative and operative care are included in this review.

Outcomes of Hip Arthroscopy in the Medicare Patient: A Growing Population.

Background: Although the results of hip arthroscopy in the elderly have been inferior to the results in younger patients, there have recently been some encouraging reports in carefully selected series of older patients. The purpose of this study was to identify the utilization of hip arthroscopy in the Medicare population and to determine the rate and timing of revision arthroscopy and/or total hip arthroplasty (THA) with the goal of identifying risk factors for secondary procedures based on patient demographics, comorbidities and the diagnosis at the time of arthroscopy.

Methods: The Medicare Standard Analytic Files were reviewed from 2005-2014 for all patients undergoing hip arthroscopy allowing for minimum 2 year follow-up (100% sample).

Opioid Prescription Refills After Osteochondral Procedures of the Knee.

Purpose: (1) To assess the incidence of postoperative opioid prescription refills in patients undergoing osteochondral autograft transplant (OAT) and osteochondral allograft transplant (OCA) procedures of the knee; (2) to evaluate the effect of filling preoperative opioid prescriptions on the incidence of postoperative filling; and (3) to assess the impact of age, sex, and diagnosis of low-back pain on postoperative opioid prescription filling.

Methods: The Humana administrative claims database was queried for patients undergoing knee OAT and OCA procedures between 2007 and 2017 by use of Current Procedural Terminology codes. Patients were stratified by age, diagnosis of low-back pain, preoperative opioid use, autograft and allograft procedures, and open and arthroscopic procedures.

Systemic Lupus Erythematosus is a Risk Factor for Complications in Total Joint Arthroplasty.

Introduction: Systemic Lupus Erythematosus (SLE) has been associated with increased complications following hip and knee arthroplasty. The Purpose of this study was to determine the extent to which SLE is a risk factor in outcomes following total joint arthroplasty (TJA).

Methods: The nationwide inpatient sample was used to identify a cohort of 505,841 patients who had a total hip arthroplasty (THA) or total knee arthroplasty (TKA) between 2009-2011.

Preoperative Opioid Use and Its Association With Early Revision of Total Knee Arthroplasty.

Background: Few studies have evaluated the impact of preoperative opioid use on risk of subsequent revision following primary total knee arthroplasty (TKA). The purpose of this study was to determine whether preoperative opioid use is associated with an increased risk of early revision TKA.

Methods: The Humana administrative claims database was queried to identify patients who underwent unilateral TKA during the years 2007-2015.

Complications and Obesity in Arthroplasty-A Hip is Not a Knee.

Background: Obesity has previously been demonstrated to be an independent risk factor for increased complications after total hip and knee arthroplasties (THA and TKA). The purpose of this study was to compare the effects of obesity and body mass index (BMI) to determine whether the magnitude of the effect was similar for both procedures.

Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent primary THA or TKA between 2010 and 2014.

Total Joint Arthroplasty in Patients With Schizophrenia: How Much Does It Increase the Risk of Complications?

Background: Mental illness is an often overlooked comorbidity in the total joint arthroplasty (TJA) population. The purpose of this study was to evaluate the risk of schizophrenia on the outcomes of TJA.

Methods: The nationwide inpatient sample was used to identify a cohort of 505,840 patients having total hip arthroplasty between 2009 and 2012, of which 953 patients (0.

Venous Thromboembolism Following Total Knee Arthroplasty: Does Race Matter?

Background: Venous thromboembolism (VTE) (deep venous thrombosis and pulmonary embolism) is a known complication following total knee arthroplasty (TKA). Recent literature has identified differences in VTE risk based on race with African Americans having higher risk of VTE. This study evaluated the impact of race on VTE following TKA using a large multicenter database.

What is the Impact of Smoking on Revision Total Hip Arthroplasty?

Background: There is a paucity of literature evaluating the impact of smoking on revision total hip arthroplasty (THA) outcomes. The purpose of this study was to identify the effect of smoking on complications after revision THA.

Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program database to identify patients who underwent revision THA between 2006 and 2014.

Does Preoperative Opioid Use Increase the Risk of Early Revision Total Hip Arthroplasty?

Background: The purpose of this study is to evaluate the impact of preoperative opioid use on the risk of subsequent revison after primary total hip arthroplasty (THA).

Methods: The Humana database was queried for unilateral THA between 2007-2015. Patients were tracked for the occurrence of an ipsilateral revision THA for 2 years.

Identifying Risk Factors for the Development of Stiffness After Revision Total Knee Arthroplasty.

Background: Although there are several studies concerning manipulation under anesthesia (MUA) after primary total knee arthroplasty, there is a paucity of literature evaluating MUA after revision total knee arthroplasty (rTKA). The purpose of this study was to determine the incidence, timing, and risk factors associated with MUA after rTKA.

Methods: The Humana database was reviewed from 2007 to 2015 for all patients who underwent rTKA.

Trends and risk factors for prolonged opioid use after unicompartmental knee arthroplasty.

Aims: The purpose of this study was to evaluate trends in opioid use after unicompartmental knee arthroplasty (UKA), to identify predictors of prolonged use and to compare the rates of opioid use after UKA, total knee arthroplasty (TKA) and total hip arthroplasty (THA).

Materials And Methods: We identified 4205 patients who had undergone UKA between 2007 and 2015 from the Humana Inc. administrative claims database.

Use of PROMIS for Patients Undergoing Primary Total Shoulder Arthroplasty.

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) consists of question banks for health domains through computer adaptive testing (CAT).

Hypothesis: For patients with glenohumeral arthritis, (1) there would be high correlation between traditional patient-reported outcome (PRO) measures and the PROMIS upper extremity item bank (PROMIS UE) and PROMIS physical function CAT (PROMIS PF CAT), and (2) PROMIS PF CAT would not demonstrate ceiling effects.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

Opioid Use Following Total Hip Arthroplasty: Trends and Risk Factors for Prolonged Use.

Background: The purpose of this study is to answer the following questions: (1) What is the prevalence of opioid use prior to primary total hip arthroplasty (THA)? (2) What is the typical trend in opioid use following THA over the first post-operative year? (3) What are the risk factors for prolonged opioid use following primary THA?

Methods: Primary THA patients were identified in the Humana database from 2007 to 2015. Pre-operative and post-operative opioid use was measured by monthly prescription refill rates. Rates of opioid use were trended monthly for 1 year post-operatively and compared based on pre-operative opioid user (OU) status as well as other patient demographics and co-morbidities.

Are We Still Prescribing Opioids for Osteoarthritis?

Background: The United States is in the midst of an opioid epidemic. These medications continue to be used to manage pain associated with osteoarthritis, despite mounting evidence questioning the benefits. The rate at which opioids are prescribed for osteoarthritis is largely unknown.

The AAHKS Clinical Research Award: What Are the Costs of Knee Osteoarthritis in the Year Prior to Total Knee Arthroplasty?

Background: Despite American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPGs) related to the non-arthroplasty management of osteoarthritis (OA) of the knee, non-recommended treatments remain in common use. We sought to determine the costs associated with non-arthroplasty management of knee OA in the year prior to total knee arthroplasty (TKA) and stratify them by CPG recommendation status.

Methods: The Humana database was reviewed from 2007 to 2015 for primary TKA patients.

Magnetic resonance imaging (MRI) assessment of ventricular remodeling after myocardial infarction in rabbits.

To understand the structure-function relationship in the postinfarcted myocardium in rabbits, we induced cardiac ischemia by ligating the left circumflex coronary artery. Sham controls underwent thoracotomy only. At 7 and 30 d after ligation, cardiac MRI was conducted by using pulse-oxymetry-gated cine acquisition to provide complete phases of the heartbeat.

The prevalence of subclinical gastroduodenal ulceration in Dachshunds with intervertebral disc prolapse.

Endoscopy was used to determine the prevalence of subclinical gastroduodenal ulceration in 30 Dachshunds undergoing decompressive surgery for acute intervertebral disc prolapse. The endoscopy was performed on the day of admission and on the 3rd or 4th day after surgery. Three regions of the stomach (cardia, corpus and pylorus) and the proximal duodenum were visually inspected and biopsy samples were taken for histopathology.

Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot.

Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels.