A contact binary satellite of the asteroid (152830) Dinkinesh.

Asteroids with diameters less than about 5 km have complex histories because they are small enough for radiative torques (that is, YORP, short for the Yarkovsky-O'Keefe-Radzievskii-Paddack effect) to be a notable factor in their evolution. (152830) Dinkinesh is a small asteroid orbiting the Sun near the inner edge of the main asteroid belt with a heliocentric semimajor axis of 2.19 AU; its S-type spectrum is typical of bodies in this part of the main belt.

The Impact of Preoperative Medical Evaluation in an Orthopaedic Perioperative Medical Clinic on Total Joint Arthroplasty Outcomes: An Observational Study.

Background: A preoperative medical evaluation (PME) in total joint arthroplasty (TJA) is routine despite considerable variation and uncertainty regarding its benefits. The orthopaedic department in our academic health system established a perioperative medical clinic (PMC) to standardize perioperative management and to study the effect of this intervention on total hip arthroplasty (THA) and total knee arthroplasty (TKA) outcomes. This observational study compared the impact of a PME within 30 days prior to surgery at the PMC (Periop30) versus elsewhere ("Usual Care") on postoperative length of stay (LOS), extended LOS (i.

Do Patients With Higher Preoperative Functional Outcome Scores Preferentially Seek Direct Anterior Approach Total Hip Arthroplasty?

Background: There is focus on the direct anterior approach (DAA) for total hip arthroplasty because of perceived postoperative functional improvement. We compared baseline, short-term, and long-term outcomes between the DAA and the posterior approach focusing on baseline function.

Material And Methods: Multivariate linear and logistic regression models were used to analyze prospective data on 1457 total hip arthroplasties comparing baseline characteristics, operative time, 90-day reoperation, length of stay (LOS), extended LOS (>3 days), and facility discharge.

Nonmechanical Revision Indications Portend Repeat Limb-Salvage Failure Following Total Femoral Replacement.

Background: There is scant evidence to guide decision-making for patients considering total femoral replacement (TFR). We aimed to identify the indication, patient, disease, and surgical technique-related factors associated with failure. We hypothesized that failure occurs more frequently in the setting of revision surgical procedures, with infection as the predominant failure mode.

Do Medicare's Patient-Reported Outcome Measures Collection Windows Accurately Reflect Academic Clinical Practice?

Background: The Comprehensive Care for Joint Replacement (CJR) mandates collection of patient-reported outcome measures (PROMs) for eligible total hip and total knee arthroplasty (THA and TKA) procedures during specific time periods that may not be attainable within routine academic practice.

Methods: We performed a retrospective analysis of prospectively collected PROM data from a 2017 cohort of primary THA and TKA patients who completed the Patient-Reported Outcomes Measurement Information System-10 global health survey in preoperative or postoperative time periods. The primary outcome was completion rates of Patient-Reported Outcomes Measurement Information System-10 per the CJR collection periods (90-0 days preoperative and 270-365 days postoperative) compared to an extended postoperative collection period of 270-396 days.

Patient-reported outcomes after above-knee amputation for prosthetic joint infection.

Background: Prosthetic joint infection (PJI) is a challenging complication after total knee arthroplasty (TKA). Above-knee amputation (AKA) is a salvage procedure that may be performed after revision TKAs fail to eradicate PJI. Few studies have investigated patient-reported outcomes.

Long-Term Implant Survivorship and Modes of Failure in Simultaneous Concurrent Bilateral Total Knee Arthroplasty.

Background: There is limited evidence describing long-term implant survivorship and modes of failure in simultaneous concurrent bilateral total knee arthroplasty (TKA).

Methods: We performed a retrospective review of 266 consecutive patients (532 knees) who underwent simultaneous concurrent bilateral TKA. We reviewed medical records for preoperative characteristics, perioperative complications, and revision surgeries.

Does the thigh circumference affect the positioning of the acetabular component when using the direct anterior approach in total hip arthroplasty?

Aims: The hypothesis of this study was that thigh circumference, distinct from body mass index (BMI), may be associated with the positioning of components when undertaking total hip arthroplasty (THA) using the direct anterior approach (DAA), and that an increased circumference might increase the technical difficulty.

Patients And Methods: We performed a retrospective review of prospectively collected data involving 155 consecutive THAs among 148 patients undertaken using the DAA at an academic medical centre by a single fellowship-trained surgeon. Preoperatively, thigh circumference was measured at 10 cm, 20 cm, and 30 cm distal to the anterior superior iliac spine, in quartiles.

Patient outcomes after total hip arthroplasty in extreme elderly patients older than 80 years.

Background: While extreme elderly patients (age 80 and above) benefit from joint replacement, there is controversy about whether their physical function improves as much as younger individuals following total hip arthroplasty.

Methods: We completed a retrospective cohort study comparing extreme elderly total hip arthroplasty (THA) patients to younger patients. We obtained data from a large institutional repository of 2327 consecutive THAs performed from April 2011 through July 2016 at an American academic medical centre.

Short term patient outcomes after total knee arthroplasty: Does the implant matter?

Background: Newer implants for total knee arthroplasty (TKA) often gain market share at higher cost with little patient-reported and long-term clinical data. We compared outcomes after TKA using two different implants: DePuy PFC Sigma and Attune.

Methods: Using a prospective data repository from an academic tertiary medical center, we analyzed 2116 TKAs (1603 Sigma and 513 Attune) from April 2011 through July 2016.

Patient Outcomes After Total Knee Arthroplasty in Patients Older Than 80 Years.

Background: Patients aged 80 and above who suffer from end-stage osteoarthritis may benefit from total knee arthroplasty (TKA), but at high potential risk. Additionally, there is controversy about whether functional improvement in patients above age 80 is similar to younger patients. We compared functional improvement, length of stay (LOS), and facility discharge rates after TKA between this cohort and patients less than 80 years of age.

Military Service and Decision Quality in the Management of Knee Osteoarthritis.

Background: Decision quality measures the degree to which care decisions are knowledge-based and value-aligned. Because military service emphasizes hierarchy, command, and mandates some healthcare decisions, military service may attenuate patient autonomy in healthcare decisions and lower decision quality. VA is the nation's largest provider of orthopedic care.

Prognostic Factors for Success After Irrigation and Debridement With Modular Component Exchange for Infected Total Knee Arthroplasty.

Background: Irrigation and debridement with modular component exchange (IDMCE) can treat prosthetic joint infection (PJI) after total knee arthroplasty (TKA). Compared to 2-stage revision, IDMCE is associated with lower morbidity but may carry higher infection recurrence rates. We aimed to identify prognostic factors associated with successful IDMCE in patients with PJI.

Resident Participation is Not Associated With Worse Outcomes After TKA.

Background: Approximately one-half of all US surgical procedures, and one-third of orthopaedic procedures, are performed at teaching hospitals. However, the effect of resident participation and their level of training on patient care for TKA postoperative physical function, operative time, length of stay, and facility discharge are unclear.

Questions/purposes: (1) Are resident participation, postgraduate year (PGY) training level, and number of residents associated with absolute postoperative Patient-Reported Outcomes Measurement Information System (PROMIS®-10) global physical function score (PCS), and achieving minimum clinically important difference (MCID) PCS improvement, after TKA? (2) Are resident participation, PGY, and number of residents associated with increased TKA operative time? (3) Are resident participation, PGY, and number of residents associated with increased length of stay after TKA? (4) Are resident participation, PGY, and number of residents associated with higher odds of patients being discharged to another inpatient facility, rather than to their home (facility discharge)?

Methods: We performed a retrospective study using a longitudinally maintained institutional registry of TKAs that included 1626 patients at a single tertiary academic institution from April 2011 through July 2016.

Excess Opioid Medication and Variation in Prescribing Patterns Following Common Orthopaedic Procedures.

Background: Postoperative pain management in orthopaedic surgery accounts for a substantial portion of opioid medications prescribed in the United States. Understanding prescribing habits and patient utilization of these medications following a surgical procedure is critical to establishing appropriate prescribing protocols that effectively control pain while minimizing unused opioid distribution. We evaluated prescribing habits and patient utilization following elective orthopaedic surgical procedures to identify ways of improving postoperative opioid-prescribing practices.

Do Aggregate Socioeconomic Status Factors Predict Outcomes for Total Knee Arthroplasty in a Rural Population?

Background: We sought to determine whether several preoperative socioeconomic status (SES) variables meaningfully improve predictive models for primary total knee arthroplasty (TKA) length of stay (LOS), facility discharge, and clinically significant Veterans RAND-12 physical component score (PCS) improvement.

Methods: We prospectively collected clinical data on 2198 TKAs at a high-volume rural tertiary academic hospital from April 2011 through March 2016. SES variables included race and/or ethnicity, living alone, education, employment, and household income, along with numerous adjusting variables.

The Effect of Absorbable Calcium Sulfate on Wear Rates in Ultra-high-Molecular-weight Polyethylene: Potential Implications for Its Use in Treating Arthroplasty Infections.

Introduction: Patients, hospitals, and healthcare systems incur substantial burdens when infections result in total joint revisions. One potential solution to mitigate some of these burdens may be to transition from a two-stage infection treatment to a single-stage procedure. Off-label use of an absorbable calcium sulfate antibiotic carrier has been implemented in single-stage and two-stage procedures globally, with the goal of moving toward more single-stage revisions in the United States.

The stability of the hip after the use of a proximal femoral endoprosthesis for oncological indications: analysis of variables relating to the patient and the surgical technique.

Aims: Instability of the hip is the most common mode of failure after reconstruction with a proximal femoral arthroplasty (PFA) using an endoprosthesis after excision of a tumour. Small studies report improved stability with capsular repair of the hip and other techniques, but these have not been investigated in a large series of patients. The aim of this study was to evaluate variables associated with the patient and the operation that affect post-operative stability.

Preoperative body mass index and physical function are associated with length of stay and facility discharge after total knee arthroplasty.

Background: Hospital length of stay (LOS) and facility discharge are primary drivers of the cost of total knee arthroplasty (TKA). We sought to identify modifiable patient factors that were associated with increased LOS and facility discharge after TKA.

Methods: Prospective data were reviewed from 716 consecutive, primary TKA procedures performed by two arthroplasty surgeons between 2006 and 2012 at a single institution.

Patient-Reported Outcomes After Revision of Metal-on-Metal Total Bearings in Total Hip Arthroplasty.

Background: Failure of metal-on-metal (MOM) total hip arthroplasty (THA) bearings is often accompanied by an aggressive local reaction associated with destruction of bone, muscle, and other soft tissues around the hip. Little is known about whether patient-reported physical and mental function following revision THA in MOM patients is compromised by this soft tissue damage, and whether revision of MOM THA is comparable with revision of hard-on-soft bearings such as metal-on-polyethylene (MOP).

Methods: We identified 75 first-time MOM THA revisions and compared them with 104 first-time MOP revisions.

A Comparison of Radiographic Outcomes After Total Hip Arthroplasty Between the Posterior Approach and Direct Anterior Approach With Intraoperative Fluoroscopy.

Background: Radiographic outcomes after total hip arthroplasty (THA) have been linked to clinical outcomes. The direct anterior approach (DAA) for THA has been criticized by some for providing limited exposure and compromised implant position but allows for routine use of intraoperative fluoroscopy. We sought to determine whether radiographic measurements differed by THA approach using prospective cohorts.

Does Surgical Approach Affect Patient-reported Function After Primary THA?

Background: Total hip arthroplasty (THA) relieves pain and improves physical function in patients with hip osteoarthritis, but requires a year or more for full postoperative recovery. Proponents of intermuscular surgical approaches believe that the direct-anterior approach may restore physical function more quickly than transgluteal approaches, perhaps because of diminished muscle trauma. To evaluate this, we compared patient-reported physical function and other outcome metrics during the first year after surgery between groups of patients who underwent primary THA either through the direct-anterior approach or posterior approach.

Predictors of Facility Discharge, Range of Motion, and Patient-Reported Physical Function Improvement After Primary Total Knee Arthroplasty: A Prospective Cohort Analysis.

Background: Patients are discharged to home or inpatient settings after primary unilateral total knee arthroplasty (TKA). Few studies have compared patient outcomes following these 2 rehabilitation models for TKA patients. We identified predictors of inpatient discharge, 3-month postoperative range of motion (ROM), and 3-month postoperative patient-reported physical function improvement (Veterans RAND 12-Item Physical Component Score [PCS]) between these discharge settings.