Publications by authors named "Jeffrey Okewunmi"
Social and demographic health disparities in shoulder and elbow surgery.
J Shoulder Elbow Surg
January 2025
Article Synopsis
- Racial and ethnic health disparities significantly affect outcomes in orthopedic shoulder surgeries, influenced by socioeconomic factors like insurance status, ethnicity, and race.* -
- A literature review identified 22 studies revealing disparities in access to care and outcomes in shoulder and elbow surgeries related to race, ethnicity, and social determinants of health.* -
- To address these disparities, recommendations include enhancing access to high-quality care by focusing on high-volume outpatient centers and improving geographical reach for surgical and rehab services.*
Article Synopsis
- Girdlestone resection arthroplasty (GRA) is an option for patients unable to have prosthesis reimplantation due to infection, and this study investigates factors influencing reimplantation using a large database from 2012-2015.
- Out of 2,772 GRA cases, 73.1% were successfully reimplanted, with a median reimplantation time of 3 months, and factors like age, race, obesity, and comorbidities negatively impacted the likelihood of reimplantation.
- The study highlights that male patients had higher odds for reimplantation, suggesting a need for further research into the reasons behind the variability in patient outcomes after GRA.
Background: Disparities in orthopedic trauma care have been reported for racial-ethnic minority and socially disadvantaged patients. We examined differences in perioperative metrics by patient race and ethnicity and insurance after pelvic fracture in a national sample in the United States.
Materials And Methods: The 2016-2019 National Inpatient Sample was queried for White, Black, and Hispanic patients 18 to 64 years old with private, Medicaid, or self-pay insurance who underwent non-elective pelvic fracture surgery.
Article Synopsis
- - The 'kickstand screw-rod' technique is introduced for correcting coronal malalignment in patients, using a new 'iliac kickstand screw' that interacts with a unique bone pathway in the ilium.
- - A study of 50 pelvic CT scans aimed to define this osseous corridor, measuring structures to ensure safe placement of the screws with the help of 3D visualization software.
- - Results indicate that the iliac kickstand screw can fit into a significant bone corridor with an average length of around 119.7 mm and a maximum potential diameter of 17.8 mm, along with identified starting points for insertion.
Background: Sex disparities have been noted across various aspects of total hip/knee arthroplasty (THA/TKA). Given incentives to standardize care, bundled payment initiatives including the Comprehensive Care for Joint Replacement (CJR) program may reduce disparities. This study aimed to assess the CJR program's impact on sex disparities in THA/TKA care and outcomes.
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- The study explores the impact of COVID-19 on the rates of venous thromboembolism (VTE) after total hip and knee surgeries from 2016 to 2021.
- It found that while overall VTE rates decreased during this period, prior COVID-19 infections increased the risk of VTE specifically in total knee arthroplasty patients, but not in total hip arthroplasty patients.
- The authors emphasize the need for continued monitoring of VTE trends and the effects of COVID-19 variants and vaccination rates on surgical outcomes.
Article Synopsis
- The study evaluates the statistical reliability of randomized controlled trials (RCTs) comparing hamstring tendon and bone-patellar tendon-bone autografts for ACL reconstruction published since 2010.
- Researchers identified 19 RCTs and found that many outcomes showed statistical fragility, meaning that only a small number of outcome changes could flip the findings from significant to nonsignificant or vice versa.
- Over half of the outcomes had patient losses that could influence results, indicating that these studies may not provide robust evidence for the best graft choice in ACL surgery.
Background: Osteonecrosis of the femoral head is a common indication for total hip arthroplasty (THA). It is unclear to what extent the COVID-19 pandemic has impacted its incidence. Theoretically, the combination of microvascular thromboses and corticosteroid use in patients who have COVID-19 may increase the risk of osteonecrosis.
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- Orthopaedic surgery has one of the lowest proportions of female representation, but efforts are underway to increase gender diversity in this field.
- A study analyzed female authorship trends in several high-impact orthopaedic journals from 2011 to 2020, focusing specifically on the roles of first and last authors.
- Although there has been an increase in female first authors, overall female authorship has remained stagnant, highlighting the need for further research into factors influencing these trends and ways to enhance female representation across the field.
Background: Closed wound drainage has been extensively studied in the hip and knee arthroplasty literature with equivocal results on its clinical benefits. Although also used in orthopaedic surgeries like ankle arthrodesis and ankle arthroplasty, large-scale data are currently lacking on utilization patterns and real-world effectiveness. We, therefore, aimed to address this research gap in this distinct surgical cohort using national claims data.
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- Open hindfoot surgeries have a high complication rate, prompting a study to evaluate outcomes from less invasive percutaneous techniques for calcaneal osteotomies.
- The study involved 118 patients with various osteotomy types, revealing an overall postoperative complication rate of just 3.4%, with no significant differences across the techniques.
- Findings suggest that percutaneous calcaneal osteotomies are a safe alternative, potentially offering fewer complications compared to traditional open surgeries, particularly for high-risk patients.
Background: There is a paucity of literature on racial differences across a full total joint arthroplasty (TJA) "episode of care" and beyond. Given various incentives, the Comprehensive Care for Joint Replacement (CJR) program in the U.S.
View Article and Find Full Text PDFHand and Upper Extremity Trauma in the Undocumented Immigrant Population in the United States.
Plast Reconstr Surg Glob Open
February 2022
Unlabelled: Undocumented immigrants in the United States are at risk for upper extremity trauma due to occupational exposure, and decreased access to healthcare can worsen outcomes. The purpose of this study was to compare documented versus undocumented patients in a large cohort of patients in New York City's most diverse neighborhood in order to characterize upper extremity trauma in this population.
Methods: The Elmhurst Hospital trauma database was examined for patients admitted with upper extremity trauma from April 2016 to December 2019.
Trends in Private Equity Acquisition of Orthopaedic Surgery Practices in the United States.
J Am Acad Orthop Surg Glob Res Rev
December 2021
Background: Independent orthopaedic practices in the United States have become attractive targets for acquisition by hospital systems and private equity (PE) firms because of the increasing demand for outpatient surgery. Consolidation in this market will have notable effects on the delivery and cost of orthopaedic services. In this study, we identified major trends in orthopaedic practice acquisitions over the past decade.
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- Rats are commonly used in research to study intervertebral disc (IVD) degeneration, and a standardized histology grading system is needed to improve comparisons of IVD conditions across different labs.
- This study created and validated a new grading system based on eight key degenerative features, ensuring it was easy for both seasoned and novice graders to use.
- The research also established a standard protocol for preparing rat IVD samples that enhances consistency and comparability in future studies.
Article Synopsis
- * Achilles tendinosis can be classified into two types: insertional (occurring where the tendon inserts into the bone) and noninsertional (located in the tendon itself).
- * The review will discuss different treatment options for Achilles tendinopathy and tendon rupture, noting the effectiveness of both conservative (non-surgical) and surgical methods, while highlighting the ongoing debate about the best approaches.