Wagner Cone Midterm Survivorship and Outcomes.

Background: Total hip arthroplasty (THA) in patients with abnormal proximal femoral anatomy requires an individualized treatment approach to prevent complications. Metaphyseal engaging stems in this population risk fracture, size/offset mismatch, and aseptic loosening. The Wagner conical femoral implant is a short diaphyseal engaging femoral stem that could improve treatment success in this difficult patient population.

Long-Term Clinical and Radiographic Follow-Up of Preaxial Polydactyly Reconstruction.

Purpose: The purpose of the study was to determine the long-term results of preaxial polydactyly reconstruction through evaluating strength, range of motion, pain, arthritis, and functional outcomes.

Methods: Patients having preaxial polydactyly reconstruction 15 to 60 years ago completed the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Computer Adaptive Test (CAT). Aggregate scores were compared with those of the general population.

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.

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.

Patient Factors Systematically Influence Hospital Length of Stay in Common Orthopaedic Procedures.

Introduction: As the United States healthcare system evolves towards improved value delivery, patient outcomes and healthcare costs are increasingly used to evaluate physicians and provider organizations. One such metric is hospital length of stay, which has the potential to be influenced by a variety of patient characteristics and comorbidities. Determining factors influencing length of stay represents an opportunity to increase value in healthcare delivery.

Management of Painful Patellar Clunk and Crepitance: Results at a Mean Follow-Up of Five Years.

Introduction: Painful patellar clunk and crepitance (PCC) is a known complication of total knee arthroplasty (TKA) with posterior-stabilized designs. Arthroscopic management of PCC has been proposed as a treatment option for PCC.

Methods: We reviewed all cases of PCC from a consecutive single-surgeon series using a specific posterior stabilized (PS) design treated with arthroscopy for PCC.

Hip Fractures: Appropriate Timing to Operative Intervention.

Background: The purpose of this study is to (1) identify the incidence of surgical delay in hip fractures, (2) evaluate the time point surgical delay puts patients at increased risk for complications, and (3) identify risk factors for surgical delay in the setting of surgical management of hip fractures.

Methods: A multi-center database was queried for patients of 60 years of age or older undergoing surgical treatment of a hip fracture. Surgical delay was defined by days from admission until surgical intervention.

Computer Navigated Total Knee Arthroplasty: Rates of Adoption and Early Complications.

Background: When new technologies are introduced, it is important to evaluate the rate of adoption and outcomes compared with preexisting technology. The purpose of this study was to determine the adoption rate of computer-assisted navigation in total knee arthroplasty (TKA), to determine if the short-term complication rate changed over time with navigation, and to compare short-term complication rates of navigated and traditional TKA.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 108,277 patients undergoing primary TKA between 2010 and 2014, of which 3573 cases (3.

Can We Predict Discharge Status After Total Joint Arthroplasty? A Calculator to Predict Home Discharge.

Background: Postoperative discharge to a skilled nursing facility after total joint arthroplasty (TJA) is associated with increased costs, complications, and readmission. The purpose of this study was to identify the risk factors for discharge to a location other than home to build a calculator to predict discharge disposition after TJA.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2011 to 2013 to identify patients who underwent primary total hip or total knee arthroplasty.

Length of Hospitalization After Joint Arthroplasty: Does Early Discharge Affect Complications and Readmission Rates?

Background: Length of hospital stay is a quality metric in joint arthroplasty. Rapid recovery protocols have safely reduced the average length of hospitalization, but it is unclear whether there is a difference in complication and readmission rates between patients discharged the day of surgery or on postoperative day 1 (POD 1). We calculated 30-day complication and readmission after total knee arthroplasty (TKA), total hip arthroplasty (THA), and unicompartmental knee arthroplasty (UKA) based on day of discharge.

Morbid Obesity and Congestive Heart Failure Increase Operative Time and Room Time in Total Hip Arthroplasty.

Background: Obesity is increasingly common in patients having total hip arthroplasty, and previous studies have shown a correlation with increased operative time in total hip arthroplasty. Decreasing operative time and room time is essential to meeting the increased demand for total hip arthroplasty, and factors that influence these metrics should be quantified to allow for targeted reduction in time and adjusted reimbursement models. This is the first study to use a multivariate approach to identify which factors increase operative time and room time in total hip arthroplasty.

Return to driving after arthroscopic rotator cuff repair: patient-reported safety and maneuverability.

This survey investigated patients' return to driving after rotator cuff surgery, to determine whether pain, weakness, sling use, and narcotics correlate with self-assessed safety and maneuvering. Fifty-four patients (80.6% of those eligible) were surveyed 4 months after surgery.

Functional Outcomes After Treatment of Scaphoid Fractures in Children and Adolescents.

Background: Little is known about longer-term functional outcomes of children treated for scaphoid fractures. We hypothesized that with appropriate treatment, functional outcomes would be consistent with population norms and would not vary between patients treated with cast-immobilization versus surgery. We further hypothesized that osteonecrosis and chronic nonunion would each be independent predictors of worse functional outcomes.

Scaphoid fractures in children and adolescents: contemporary injury patterns and factors influencing time to union.

Background: Historically, scaphoid fractures in children and adolescents have predominantly involved the distal pole, requiring neither surgical care nor extended follow-up. Changing patient characteristics, however, appear to be altering fracture epidemiology and treatment. The purpose of this investigation was to characterize contemporary fracture patterns in children and adolescents and to identify factors influencing time to healing following both nonoperative and operative treatment.

Project CHAT: a brief motivational substance abuse intervention for teens in primary care.

Many adolescents use alcohol and drugs (AODs); however, most do not seek help because of stigma or confidentiality concerns. Providing services in settings that teens frequent may decrease barriers. We examined the feasibility of adapting a brief motivational intervention (MI) for high-risk adolescents (age 12-18 years) in a primary care (PC) setting by conducting small feedback sessions with adolescents, parents, and clinic staff, and pilot testing the MI with adolescents.