Establishing a Per-Hour Rate for Early-Career Adult Reconstruction Surgeons Performing Medicare Primary Total Joint Arthroplasty.

Background: There is a paucity of data regarding compensation for early-career adult reconstruction surgeons. This study aims to quantify the time throughout the full episode of care for a Medicare primary total hip/knee arthroplasty and convert to per-hour pay for early-career arthroplasty surgeons at various geographic locations and practice settings. Using Center for Medicare and Medicaid Services data, this study also compares the compensation of early-career vs established total joint arthroplasty (TJA) surgeons.

The Trend of Medicare Reimbursement for Total Joint Arthroplasty: Using Mathematical Models to Predict Possible Per-Hour Rate Out to 2030.

Background: While multiple studies have assessed the trends of Medicare reimbursement for orthopedic total joint arthroplasty (TJA) surgeries, none have forecasted reimbursement in relatable per-hour figures. The purposes of this study are to examine trends of reimbursement for primary and revision TJA and translate forecasted primary TJA reimbursement to relatable per-hour compensation.

Methods: The Center for Medicare and Medicaid Services reimbursement data from 1992 to 2024 were used to create a historical view of reimbursement for primary and revision TJA.

Hip-spine parameters change with increasing age.

Aims: Spinopelvic pathology increases the risk for instability following total hip arthroplasty (THA), yet few studies have evaluated how pathology varies with age or sex. The aims of this study were: 1) to report differences in spinopelvic parameters with advancing age and between the sexes; and 2) to determine variation in the prevalence of THA instability risk factors with advancing age.

Methods: A multicentre database with preoperative imaging for 15,830 THA patients was reviewed.

Incidence and Risk Factors of Orthostasis After Primary Hip and Knee Arthroplasty.

Background: Postoperative orthostatic intolerance can limit mobilization after hip and knee arthroplasty. The literature is lacking on the incidence and risk factors associated with orthostatic intolerance after elective arthroplasty.

Methods: A retrospective case-control study of primary total hip, total knee, and unicompartmental knee arthroplasty patients was conducted.

Total Hip Revision with a Custom Acetabular Component and Femoral Allograft-Prosthetic Composite as Salvage for Failed Unstable Megaprosthesis in an Adolescent Patient: A Case Report at 19-Year Follow-up Duration.

Case: A 13-year-old girl presented after a right proximal femur replacement after proximal femoral resection for treatment of an Ewing sarcoma. She presented after multiple episodes of recurrent instability with her hip endoprosthesis chronically dislocated. Her hip was revised to a custom, constrained metal-on-metal acetabular component with a small iliac flange.

Preoperative Diagnosis of Depression Leads to Increased Opioid Tablets Taken After Total Hip Arthroplasty: A Prospective Study.

Balancing postoperative analgesia with minimizing opioid consumption remains a challenge. We aim to document trends in opioid consumption for patients undergoing total hip arthroplasty (THA) and hypothesize that preoperative patient education will decrease postoperative opioid consumption. This is a prospective study of patients undergoing elective primary THA.

Anterior Revision Hip Arthroplasty is Associated With Higher Wound Complications but Fewer Dislocations Compared to Posterior Revision Hip Surgery.

Background: Wound complication after primary direct anterior (DAA) hip arthroplasty has been reported in the literature but there has been no comparison regarding revision anterior vs revision posterior (PA) hip arthroplasty. The authors hypothesize that anterior approach revision surgery may have increased wound complications compared with posterior hip revisions and also report on secondary outcome metrics.

Methods: Ninety-nine DAA and 191 PA revisions were included for analysis.

Mobility Limitation After Surgery for Degenerative Pathology of the Ankle, Hindfoot, and Midfoot vs Total Hip Arthroplasty.

Background: Surgery for degenerative foot and ankle conditions often results in a lengthy recovery. Current outcome measures do not accurately assess postoperative mobility, especially in older patients. The Life-Space Assessment (LSA), a questionnaire quantifying patients' mobility after a medical event, was used in this study to assess perioperative mobility in total hip arthroplasty (THA) and foot and ankle surgery patients.

Ultrasound-Guided Aspiration Does Not Reduce the Recurrence Rate of Ganglion Cysts of the Wrist.

 Ganglion cysts are the most frequent soft tissue tumor encountered in the upper extremity and are commonly treated by aspiration or by surgical excision. Ultrasound is a promising addition to traditional aspiration, as it allows for visualization of the needle within the ganglion before aspiration.  Are ganglion cysts of the wrist less likely to reoccur if they are aspirated under ultrasound guidance versus "blind" aspiration without the use of ultrasound guidance? Does patient functionality change based on whether or not the cyst recurred?  In total, 52 patients were successfully contacted and recurrence rates were compared between those whose cyst was treated with ultrasound-guided (13 patients) with those whose cyst was treated with blind aspiration (39 patients).

Patient Perceptions and Current Trends in Internet Use by Orthopedic Outpatients.

Background: Many studies have highlighted concerns about the completeness and quality of information found online and how this may affect patients' education about their medical problems. One aspect of internet usage that has received less attention in the literature, however, is patient perception of the information that is gathered online, and how patients use it related to their musculoskeletal care.

Questions/purposes: The objective of the study is to utilize a cross-sectional study design to describe internet usage and patient perceptions of orthopedic online information and to identify differences in usage patterns.

Bariatric Surgery Prior to Total Knee Arthroplasty is Associated With Fewer Postoperative Complications.

This study used a national database to compare 90-day postoperative complication rates between three groups of patients who underwent total knee arthroplasty (TKA): (1) non-obese patients (n=66,523), (2) morbidly obese patients who did not have bariatric surgery (n=11,294) and (3) morbidly obese patients who underwent bariatric surgery prior to TKA (n=219). Morbidly obese patients who underwent bariatric surgery prior to TKA had reduced rates of major (OR 0.45, P=0.