Accuracy of Time to Treatment Initiation Data in Musculoskeletal Soft Tissue Sarcoma.

Background: Time to treatment initiation (TTI) is a quality metric in cancer care. The purpose of this study is to determine the accuracy of TTI data from a single cancer center registry that reports to the National Cancer Database (NCDB) for sarcoma diagnoses.

Methods: A retrospective analysis of a single Commission on Cancer (CoC)-accredited cancer center's tumor registry between 2006 and 2016 identified 402 patients who underwent treatment of a musculoskeletal soft tissue sarcoma and had TTI data available.

Association of Surgical Delay and Overall Survival in Patients With T2 Renal Masses: Implications for Critical Clinical Decision-making During the COVID-19 Pandemic.

Objective: To test for an association between surgical delay and overall survival (OS) for patients with T2 renal masses. Many health care systems are balancing resources to manage the current COVID-19 pandemic, which may result in surgical delay for patients with large renal masses.

Methods: Using Cox proportional hazard models, we analyzed data from the National Cancer Database for patients undergoing extirpative surgery for clinical T2N0M0 renal masses between 2004 and 2015.

Delayed Radical Prostatectomy is Not Associated with Adverse Oncologic Outcomes: Implications for Men Experiencing Surgical Delay Due to the COVID-19 Pandemic.

Purpose: The 2019 novel Coronavirus (COVID-19) pandemic has forced many health care organizations to divert efforts and resources to emergent patient care, delaying many elective oncologic surgeries. We investigated an association between delay in radical prostatectomy and oncologic outcomes.

Materials And Methods: This is a retrospective review of men with intermediate and high risk prostate cancer in the National Cancer Database undergoing radical prostatectomy from 2010 to 2016.

Time to treatment initiation and survival in adult localized, high-grade soft tissue sarcoma.

Background: Although shorter delays in soft tissue sarcoma (STS) diagnosis may improve overall survival (OS), the influence of time to treatment initiation (TTI) on OS in STS has not been determined.

Objective: To determine if TTI influences OS in localized, high-grade STS.

Methods: An analysis of the National Cancer Database identified 8648 patients meeting criteria with localized, high-grade STS diagnosed between 2004 and 2012.

In-Room Ultraviolet Air Filtration Units Reduce Airborne Particles During Total Joint Arthroplasty.

Reducing airborne bioburden in total joint arthroplasty (TJA) is of critical importance. The efficacy of crystalline ultraviolet-C (C-UVC) filtration in reducing bioburden in a dynamic operating room (OR) environment has not been evaluated. We assessed whether C-UVC filtration reduced (i) total particle counts (TPC); (ii) viable particle counts (VPC); and (iii) colony-forming units (CFUs).

Clostridium difficile Colitis Following Revision Total Knee Arthroplasty: Incidence and Risk Factors.

Background: Clostridium difficile-associated diarrhea (CDAD) is associated with adverse events and financial liability. As institutions continue to adopt CDAD rates as a quality control metric, it is important to identify patients at risk before surgery, including revision total knee arthroplasty (rTKA). This study was conducted to (1) determine the incidence of CDAD within 30 days of rTKA and (2) identify perioperative risk factors for CDAD following rTKA.

Incidence, Causes, and Timing of 30-Day Readmission Following Total Knee Arthroplasty.

Background: It is important to study the incidence and causes of readmissions in order to understand why they occur and how to reduce them. This study looks at a national sample of patients following total knee arthroplasty (TKA) to identify incidences, trends, causes, and timing of 30-day readmissions.

Methods: Patients undergoing primary TKA from 2012 to 2016 in the American College of Surgeons National Surgical Quality Improvement Program database were identified (n = 197,192).

Etiology of Above-knee Amputations in the United States: Is Periprosthetic Joint Infection an Emerging Cause?

Background: Above-knee amputation (AKA) is a morbid procedure and is performed for a number of conditions. Although AKA is usually performed for dysvascular disease, trauma, and malignancy, AKA is also considered in patients who have failed multiple salvage attempts at treating periprosthetic joint infection (PJI) of TKA. Although aggressive measures are being taken to treat PJI, the huge volume of TKAs might result in a large number of AKAs being performed for PJI in the United States.

Dependent Functional Status is a Risk Factor for Perioperative and Postoperative Complications After Total Hip Arthroplasty.

Background: As the population ages, the need for total hip arthroplasty (THA) will increase. However, this will be associated with an increase in comorbidities and a decrease in the ability to independently perform activities of daily living (ADLs). This study was designed to evaluate the impact preoperative functional status has on short-term outcomes after THA.

Arthroscopic irrigation and debridement is associated with favourable short-term outcomes vs. open management: an ACS-NSQIP database analysis.

Purpose: Septic arthritis of the knee is an orthopaedic emergency that is associated with marked morbidity and can potentially be life threatening. Surgical debridement can be performed either arthroscopically or via an arthrotomy. The aim of this study was to compare the 30-day complications and adverse outcomes between the two procedures.

Adult Primary Bone Sarcoma and Time to Treatment Initiation: An Analysis of the National Cancer Database.

Objective: The time to treatment interval (TTI), defined as the period from diagnosis to first definitive treatment, has very limited descriptions toward understanding delays in primary bone sarcoma (PBS) care. Our primary goal was to determine the national standard for time to treatment initiation (TTI) in PBS in adults and to identify characteristics associated with TTI variability.

Methods: An analysis of the National Cancer Database identified 15,083 adult patients with PBS diagnosed from 2004 to 2013.

Validation of a Novel Surgical Data Capturing System Following Total Hip Arthroplasty.

Background: The OrthoMiDaS (Orthopedic Minimal Data Set) Episode of Care (OME) database was developed in an effort to advance orthopedic outcome measurements on a national scale. This study was designed to evaluate if the OME data capture system would increase the quality of data collected in the context of primary and revision total hip arthroplasty (THA) compared to conventional operative notes.

Methods: This study includes data from the first 100 primary THAs and 100 revision THAs performed by 15 surgeons at a single institution from January through April 2016.

Adult soft tissue sarcoma and time to treatment initiation: An analysis of the National Cancer Database.

Background: The primary goal of this investigation is to determine the current national standards for time to treatment initiation (TTI) in soft tissue sarcoma (STS). Additionally, we aim to identify the variables affecting TTI variability in STS.

Methods: An analysis of the National Cancer Database identified 41 529 patients diagnosed with STS between 2004 and 2013.

Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Knee Arthroplasty.

Background: Chronic obstructive pulmonary disease (COPD) is a major global health issue and a leading cause of morbidity and mortality. Patients with COPD are at increased risk of complications following surgery. The purpose of this study is to evaluate the postoperative total knee arthroplasty (TKA) outcomes in these patients in comparison to a non-COPD matching cohort.

Success of Two-Stage Reimplantation in Patients Requiring an Interim Spacer Exchange.

Background: Some patients undergoing a 2-stage revision for a periprosthetic joint infection require a repeat spacer in the interim (removal of existing spacer with insertion of a new spacer or spacer exchange) due to persistent infection. The objectives of this study are to (1) determine the factors associated with patients who receive a repeat spacer and (2) compare the infection-free survival (overall and stratified by joint type) of reimplantation in patients who did or did not receive a repeat spacer.

Methods: From 2001 to 2014, 347 hip or knee 2-stage revisions that finally underwent reimplantation and had a minimum 2-year follow-up were identified.

Perioperative Outcomes and Short-Term Complications Following Total Knee Arthroplasty in Chronically, Immunosuppressed Patients.

Background: Although there are studies regarding immunosuppressed patients undergoing total knee arthroplasty (TKA) for inflammatory arthritis or osteonecrosis, there is a paucity of studies evaluating immunosuppressed patients undergoing TKA for diagnoses other than these.

Materials And Methods: We identified all patients undergoing primary TKA for osteoarthritis from 2008-2014 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Overall, 111,624 patients were included.

High Efficiency Particulate Air Filters Do Not Affect Acute Infection Rates During Primary Total Joint Arthroplasty Using Forced Air Warmers.

Background: Studies have suggested that forced-air warmers (FAWs) increase contamination of the surgical site. In response, FAWs with high efficiency particulate air filters (FAW-HEPA) were introduced. This study compared infection rates following primary total joint arthroplasty (TJA) using FAW and FAW-HEPA.

Chronic Obstructive Pulmonary Disease Is Associated With Short-Term Complications Following Total Hip Arthroplasty.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients.

Utility of Serological Markers for Detecting Persistent Infection in Two-Stage Revision Arthroplasty in Patients With Inflammatory Arthritis.

Background: Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used for the diagnosis of persistence of infection after the first stage of 2-stage revision arthroplasty for periprosthetic joint infection (PJI). As both ESR and CRP are markers of systemic inflammation, the utility of these tests to monitor infection clearance in patients with inflammatory arthritis is unclear.

Methods: From 2001 to 2016, 44 two-stage revision total hip or knee arthroplasties in patients with an inflammatory arthritis diagnosed by a rheumatologist were identified.

Does a simple syringe applicator enhance bone cement set up time in knee arthroplasty?

Background: The time required for polymethylmethacrylate (PMMA) cement curing or hardening can be modified by a number of variables including the mixing technique, and the temperature and pressure at which the process is taking place. Therefore, the purpose of this study was to evaluate two different methods of PMMA application in terms of set up time. Specifically, we (I) compared the PMMA set up time of cement that remained in the mixing bowl to cement that was placed in a syringe and (II) extrapolated the associated annual cost difference on the national and individual surgeon levels.

Reduction of Particles in the Operating Room Using Ultraviolet Air Disinfection and Recirculation Units.

Background: Airborne bacteria are a major source for wound contamination during total joint arthroplasty. Crystalline ultraviolet C (C-UVC) filter units were designed to disinfect and recirculate air in the operating room (OR). This preliminary study assessed the particle reducing capacity of C-UVC units in a highly controlled OR setting.

Perioperative Outcomes and Complications in Patients With Heart Failure Following Total Knee Arthroplasty.

Background: Heart failure (HF) is a common comorbidity in the aging population and they will require major elective surgery. The purpose of this study is to determine if HF is a risk factor for adverse perioperative outcomes and short-term complications following total knee arthroplasty.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was utilized to identify all patients who underwent total knee arthroplasty for osteoarthritis from 2008 to 2014.

What is the Impact of Body Mass Index on Cardiovascular and Musculoskeletal Health?

Obesity has become a major public health concern over the past several decades and has been shown to be associated with type 2 diabetes, cardiovascular diseases, dyslipidemia, hypertension, osteoarthritis (OA), and certain types of cancer. The impact of excess weight on cardiovascular and musculoskeletal health is not well-summarized in the literature, and there are some contradictory reports. Therefore, the purpose of this study was to assess the impact of body mass index (BMI) on: 1) cardiovascular outcomes; 2) osteoarthritis risk and progression; and 3) total knee arthroplasty outcomes (TKA).

The Incidence of Postoperative Pneumonia in Various Surgical Subspecialties: A Dual Database Analysis.

Introduction: Pneumonia is the third most common postoperative complication. However, its epidemiology varies widely and is often difficult to assess. For a better understanding, we utilized two national databases to determine the incidence of postoperative pneumonia after various surgical procedures.