Robotic Assistance Is Not Associated With Decreased Early Revisions in Cementless TKA: An Analysis of the American Joint Replacement Registry.

Background: Previously, we conducted a retrospective study of American Joint Replacement Registry (AJRR) data that examined the 2-year odds of revision between robotic-assisted and nonrobotic-assisted TKA, and we found no benefit to robotic assistance. However, proponents of robotic assistance have suggested that robot platforms confer more accurate bone cuts and precise implant sizing that might promote osteointegration of cementless implants by limiting micromotion at the bone-implant interface that could lead to aseptic loosening. Therefore, it seems important specifically to evaluate the odds of revision among patients with cementless implants only within our previous study population.

Adverse events associated with robotic-assistance in total hip arthroplasty: an analysis based on the FDA MAUDE database.

Background: The Food and Drug Administration (FDA) maintains the Manufacturer and User Facility Device Experience (MAUDE) database for reporting adverse events associated with medical devices, including emerging technologies, such as robotic-assisted total hip arthroplasty (THA). Aim of this study was to evaluate the variation of adverse events associated with robotics in THA.

Methods: Medical device reports (MDRs) within the MAUDE database were identified between 2017 and 2021.

Charcot Neuroarthropathy Is Associated With Higher Rates of Phantom Limb After Lower Extremity Amputation.

Background: The incidence of phantom limb pain in patients with Charcot neuroarthropathy who undergo major amputation is not well described. The purpose of this study was to determine whether patients with Charcot neuroarthropathy and diabetes who underwent either a below-knee amputation (BKA) or above-knee amputation (AKA) had an increased rate of phantom limb pain compared with those with a diagnosis of diabetes alone.

Methods: Using international classification of disease (ICD) and common procedural terminology (CPT) codes, the TriNetX research database identified 10 239 patients who underwent BKA and 6122 who underwent AKA between 2012 and 2022.

Robotic-assisted TKA is Not Associated With Decreased Odds of Early Revision: An Analysis of the American Joint Replacement Registry.

Background: Robotic-assisted TKA continues to see wider clinical use, despite limited knowledge of its impact on patient satisfaction and implant survival. Most studies to date have presented small cohorts and came from single-surgeon or single-center experiences. Therefore, a population-level comparison of revision rates between robotic-assisted and conventional TKA in the registry setting may help arthroplasty surgeons better define whether robotic assistance provides a meaningful advantage compared with the conventional technique.

Venous thromboembolism prophylaxis in shoulder surgery: a break-even cost-effectiveness study.

Background: Venous thromboembolism (VTE) is a serious complication following orthopedic shoulder surgery; however, research is limited involving the break-even cost-effectiveness of VTE prophylaxis. The purpose of this study was to determine whether the cost of aspirin and enoxaparin would break even for VTE prevention in patients following shoulder surgery.

Methods: A drug retail database was used to obtain the lowest price for a course of aspirin (81 mg) and enoxaparin (40 mg) to perform a break-even cost analysis.

Vancomycin Powder Is Highly Cost-Effective in Total Ankle Arthroplasty.

Prosthetic joint infection (PJI) is a costly and potentially fatal complication in total ankle arthroplasty (TAA). Some surgeons apply topical vancomycin powder to minimize the risk of infection during TAA procedures. The purpose of our study was to determine the cost-effectiveness of using vancomycin powder to prevent PJI following TAA and to propose an economic model that can be applied by foot and ankle surgeons in their decision to incorporate vancomycin powder in practice.

Why and What Happens to Patients Younger Than 60 Years Who Need Revision Total Knee Arthroplasty?

Background: With the increasing number of young patients undergoing primary total knee arthroplasty (TKA), there will be an increase in the number of patients who require revision. While the results of TKA in younger patients are well known, there is little information regarding to the outcomes of revision TKA in this population. The purpose of this study was to evaluate the clinical outcomes in patients <60 years of age undergoing aseptic revision TKA.

Improving Randomized-Controlled Trials in Foot and Ankle Orthopaedics: The Need to Include Sociodemographic Patient Data.

Background: The representation of sociodemographic data within randomized-controlled trials (RCT) regarding foot and ankle surgery is undefined. The purpose of this study was to determine the incidence of sociodemographic data being reported in contemporary foot and ankle RCTs.

Methods: Randomized-controlled trials within the PubMed database from 2016 to 2021 were searched and the full text of 40 articles was reviewed to identify sociodemographic variables reported in the manuscript.

Can Artificial Intelligence Improve the Readability of Patient Education Materials?

Background: The recommended readability of online health education materials is at or below the sixth- to eighth-grade level. Nevertheless, more than a decade of research has demonstrated that most online education materials pertaining to orthopaedic surgery do not meet these recommendations. The repeated evidence of this limited progress underscores that unaddressed barriers exist to improving readability, such as the added time and cost associated with writing easily readable materials that cover complex topics.

Factors Associated With Amputation Following Ankle Fracture Surgery.

Patients with diabetes mellitus (DM) are at increased risk of complications following ankle fracture surgery. Previous research suggests that patients of low socioeconomic status are at increased risk of amputation following orthopedic complications. The purpose of this research was to determine if low socioeconomic status increases risk of below-knee amputation (BKA) following ankle fractures among patients with DM.

Most patient education materials on shoulder conditions from the American Academy of Orthopaedic Surgeons exceed recommended readability levels.

Background: A growing number of patients use the internet to learn about their conditions and management options, but there may exist a disconnect between the readability of online education materials and a patient's health literacy. This issue is of particular relevance for shoulder conditions, where even with traumatic injuries (eg, clavicle fracture, shoulder dislocation), treatment is discretionary, directed primarily at quality of life, and therefore highly preference-sensitive.The purpose of this study was to utilize multiple readability algorithms to calculate the readability of the American Academy of Orthopaedic Surgeons (AAOS) patient education materials pertaining to diseases and conditions of the shoulder.

Few Randomized Controlled Trials in Spine Surgery in the United States Include Sociodemographic Patient Data: A Systematic Review.

Introduction: The importance of sociodemographic factors such as race, education, and income on spine surgery outcomes has been well established, yet the representation of sociodemographic data within randomized controlled trials (RCTs) in spine literature remains undefined in the United States (U.S).

Methods: Medical literature was reviewed within PubMed for RCTs with "spine" in the title or abstract published within the last 8 years (2014 to 2021) in seven major spine journals.

Venous Thromboembolism Chemoprophylaxis in Knee Arthroscopy: A Break-Even Analysis of Cost.

Background: Symptomatic venous thromboembolism (VTE) is a serious and costly complication after knee arthroscopy. There continues to be debate regarding the use of VTE prophylaxis after knee arthroscopy, and minimal research has explored its cost-effectiveness.

Hypothesis: Both aspirin and enoxaparin would be cost-effective in preventing symptomatic VTE.

Ankle Arthroscopy Procedural Volume Is Low Among Graduating Orthopaedic Surgery Residents.

Purpose: To evaluate graduating orthopaedic resident case volume and variability for ankle arthroscopy from 2016 to 2020.

Methods: The Accreditation Council for Graduate Medical Education surgical case log data from 2016 to 2020 for graduating United States orthopaedic surgery residents was assessed. Arthroscopy procedures of the leg/ankle were categorized.

Reported Events Associated With Spine Robots: An Analysis of the Food and Drug Administration's Manufacturer and User Facility Device Experience Database.

Study Design: Cross-Sectional Analysis.

Objectives: To summarize medical device reports (MDRs) between August 1, 2017 and November 30, 2021 relating to robot-assisted spine systems within the Manufacturer and User Facility Device Experience (MAUDE) database maintained by The Food and Drug Administration (FDA).

Methods: The MAUDE database was abstract for all MDRs relating to each FDA-approved robot-assisted spine system.

Cost-Effective Modeling of Thromboembolic Chemoprophylaxis for Total Ankle Arthroplasty.

Background: Symptomatic venous thromboembolism (VTE) following total ankle arthroplasty (TAA) can cause substantial morbidity and mortality. To prevent this complication, surgeons often prescribe postoperative chemoprophylaxis. However, much controversy exists regarding the efficacy of chemoprophylaxis because of the limited studies exploring its use.

Cannabis Use Does Not Increase Risk of Perioperative Complications Following Primary Total Hip Arthroplasty: A Cohort-Matched Comparison.

Cannabis use among arthroplasty patients has dramatically increased throughout the United States. Despite this trend, knowledge remains particularly limited regarding the effects of cannabis use on perioperative outcomes in total hip arthroplasty (THA). Therefore, the goal of this research was to investigate how cannabis use affects risk of perioperative outcomes, cost and length of stay (LOS) after THA.

Marijuana Use is Not a Contraindication for Tranexamic Acid Utilization in Lumbar Spine Surgery.

Study Design: Retrospective cohort study.

Objective: The purpose of this study was to evaluate safety in lumbar spinal fusion with tranexamic acid (TXA) utilization in patients using marijuana.

Methods: This was a retrospective cohort study involving a single surgeon's cases of 1 to 4 level lumbar fusion procedures.

Intraoperative Imaging in Total Hip Arthroplasty Is Cost-Effective Regardless of Surgical Approach.

Background: Component positioning in total hip arthroplasty (THA) may be improved with utilization of intraoperative imaging. The purpose of this study is to determine if intraoperative imaging during THA is cost-effective.

Methods: A break-even analysis was used as a model for cost-effectiveness, which incorporates cost of imaging (including direct charges and the additional time required for imaging), rate of revision surgery, and cost of revision surgery, yielding a final revision rate that needs to be achieved with use of intraoperative imaging in order for its use to be cost-effective.

Intra-wound vancomycin and tobramycin powder for infection prophylaxis in orthopaedic trauma surgery: Economically justifiable?

Objectives: There is increasing interest regarding the risks and benefits of intrawound antibiotics applied directly to surgical wounds for the prevention of infection following orthopaedic trauma surgery. The purpose of this study was to investigate the economic justifiability of vancomycin and tobramycin powders for infection prophylaxis in orthopaedic trauma surgery.

Methods: The cost of vancomycin and tobramycin powders, infection rates and costs of treating surgical site infections were obtained from our institution's records and existing literature.

Cost-effectiveness of Inpatient Tympanostomy Prophylaxis.

Objective: Tympanostomy is the most common pediatric ambulatory surgery. Post-tympanostomy otorrhea is a prevalent complication leading to high costs to patients for treatment. The cost-effectiveness of intraoperative prophylaxis for both patient and institution has not been examined.

Increasing Reoperations and Failures With Increasing BMI in Patients Undergoing 2-Stage Exchange for Infected Total Hip Arthroplasty.

Background: While morbid obesity is associated with increased infection after total hip arthroplasty, little is known on the outcomes after 2-stage reimplantation for prosthetic joint infection (PJI) in this population. The purpose of this study is to evaluate the impact of morbid obesity (body mass index>40 kg/m2) on reinfection, postoperative complications, readmissions, and reoperations.

Methods: We conducted a retrospective review of 107 patients undergoing first time 2-stage reimplantation for PJI from 2013 to 2019.