Publications by authors named "Emilie N Miley"

Hip Disability and Osteoarthritis Outcome Survey (HOOS) was developed as a region- and disease-specific outcome to assess hip disability. Despite the use of the HOOS in clinical practice and research, psychometric analyses of the scale in a large dataset of patients have not been performed. As such, the purposes of this study were to assess the structural validity of the HOOS in patients who underwent a total hip arthroplasty.

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Article Synopsis
  • Multimodal analgesia for total hip arthroplasty (THA) improves pain management and mobility while minimizing side effects compared to single-drug therapies.
  • The study compared local infiltration analgesia (LIA) and regional nerve blocks (RNBs) in a review of 1100 THA patients to evaluate their effectiveness within a multimodal pain management approach.
  • Results showed that while overall pain ratings were similar, the LIA group had significantly lower opioid usage, greater ambulation distances, higher same-day discharge rates, and fewer falls, indicating LIA might offer better functional outcomes.
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Periprosthetic joint infections (PJI) are among the most morbid complications in total hip arthroplasty (THA). The ideal incubation time, however, for intraoperative cultures for PJI diagnosis remains unclear. As such, the aim of this study was to determine if any differences existed in culture-positive rates and organism detection between five-day and fourteen-day cultures.

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Background: The downstream regional effect of the Comprehensive Care for Joint Replacement (CJR) program on care pathway-adjacent patients, including revision arthroplasty patients, is poorly understood. Prior studies have demonstrated that care pathways targeting primary total joint arthroplasty may produce a halo effect, impacting more complex patients with parallel care pathways. However, neither the effect of regional referral changes from CJR nor the durability of these positive changes with prolonged bundle participation has been assessed.

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The Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) was developed as a short-form survey to measure progress after total hip arthroplasty (THA). However, the longitudinal validity of the scale structure pertaining to the modified five-item HOOS-JR has not been assessed. Therefore, the purpose of this study was to evaluate the structural validity, longitudinal invariance properties, and latent growth curve (LGC) modeling of the modified five-item HOOS-JR in a large multi-site sample of patients who underwent a THA.

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Aims & Objectives: With modern advancements in surgical techniques and rapid recovery protocols, incidence of outpatient total joint arthroplasty (TJA) is increasing. Previous literature has historically focused on cost, safety, and clinical outcomes, with few studies investigating patient expectations and experiences. The aim of this study was to survey preoperative patient expectations related to outpatient TJA surgery compared with perioperative perceptions and experience.

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Objective: Centers for Medicare and Medicaid Services (CMS) has requested hospitals collect and report patient-reported outcomes (PROs) beginning in 2024 including the Hip Disability and Osteoarthritis Outcome Score Joint Replacement (HOOS-JR). However, scale structural validity of the HOOS-JR has minimally been assessed. The purpose of this study was to assess internal consistency, structural validity, and multi-group invariance properties of the HOOS-JR in a large sample of patients who underwent a total hip arthroplasty (THA).

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Background: The Centers for Medicare & Medicaid Services currently incentivizes hospitals to reduce postdischarge adverse events such as unplanned hospital readmissions for patients who underwent total joint arthroplasty (TJA). This study aimed to predict 90-day TJA readmissions from our comprehensive electronic health record data and routinely collected patient-reported outcome measures.

Methods: We retrospectively queried all TJA-related readmissions in our tertiary care center between 2016 and 2019.

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Article Synopsis
  • Following total hip and knee surgeries, increased opioid use can lead to poor recovery outcomes; this study looks at how Florida's laws affected opioid prescriptions.* -
  • Researchers analyzed data from 651 patients over three time periods: before any laws, after a seven-day prescription limit, and after mandatory electronic prescribing, observing significant decreases in prescribed opioid amounts.* -
  • The study found that new legislative mandates successfully lowered opioid prescriptions without negatively impacting patient recovery, highlighting the importance of regulations in shaping medical practices.*
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Background: The aim of this study was to improve understanding of hospital length of stay (LOS) in patients undergoing total joint arthroplasty (TJA) in a high-efficiency, hospital-based pathway.

Methods: We retrospectively reviewed 1401 consecutive primary and revision TJA patients across 67 patient and preoperative care characteristics from 2016 to 2019 from the institutional electronic health records. A machine learning approach, testing multiple models, was used to assess predictors of LOS.

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Background: Hip Disability and Osteoarthritis Outcome Score (HOOS), HOOS-Joint Replacement (JR), HOOS Physical Function (PS), and HOOS-12 item scale have been suggested as reliable and valid instruments for assessing hip disability. However, factorial validity, invariance across subgroups, and repeated measures of the scale across different populations have not been well supported in the literature.

Purpose: The primary study objectives were to: (1) assess model fit and psychometric properties of the original 40-item HOOS scale, (2) assess model fit of the HOOS-JR, (3) assess model fit of the HOOS-PS, and (4) assess model fit of the HOOS-12.

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Background: Our institution participated in the Comprehensive Care for Joint Replacement (CJR) model from 2016 to 2020. Here we review lessons learned from a total joint arthroplasty (TJA) care redesign at a tertiary academic center amid changing: (1) CJR rules; (2) inpatient only rules; and (3) outpatient trends.

Methods: Quality, financial, and patient demographic data from the years prior to and during participation in CJR were obtained from institutional and Medicare reconciled CJR performance data.

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Context: Sleep has long been understood as an essential component for overall well-being, substantially affecting physical health, cognitive functioning, mental health, and quality of life. Currently, the Athlete Sleep Behavior Questionnaire (ASBQ) is the only known instrument designed to measure sleep behaviors in the athletic population. However, the psychometric properties of the scale in a collegiate student-athlete and dance population have not been established.

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Context: Total Motion Release® (TMR®) is a novel treatment paradigm used to restore asymmetries in the body (eg, pain, tightness, limited range of motion). Six primary movements, known as the Fab 6, are performed by the patient and scored using a 0 to 100 scale. Clinicians currently utilize the TMR® scale to modify treatment, assess patient progress, and measure treatment effectiveness; however, the reliability of the TMR® scale has not been determined.

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Hip osteoarthritis currently affects up to 28% of the population, and the number of affected Americans is expected to rise as the American population increases and ages. Limited hip range of motion (ROM) has been identified as a predisposing factor to hip osteoarthritis and limited patient function. Clinicians often apply therapy techniques, such as stretching and strengthening exercises, to improve hip ROM.

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