Patient Perception of Allograft Versus Autograft in ACL Reconstruction Using a Validated Online Survey Marketplace.

Background: Little is known regarding the opinions of the general population on anterior cruciate ligament (ACL) graft options.

Purpose: To evaluate the general population's perception of the use of allografts versus autografts in ACL reconstruction using a previously validated online marketplace platform.

Methods: A prospective 34-question survey was distributed via the online marketplace.

Chronic exertional compartment syndrome is frequently diagnosed through static compartment pressure measurements and managed with fasciotomy: A systematic review.

Objectives: Chronic exertional compartment syndrome (CECS) can be diagnosed either clinically or with intra-compartmental pressure monitor measurements and can be treated surgically or conservatively.

Methods: A systematic review was performed on diagnostic and treatment modalities for CECS. Included studies were those that reported both their specific diagnostic modality and treatment regimens.

Tramadol use before total shoulder arthroplasty: patients have lower risk of complications and resource utilization than those using traditional opioids.

Background: Evidence continues to mount for the deleterious effects of preoperative opioid use in the setting of total shoulder arthroplasty (TSA). Tramadol, a synthetic opioid with concomitant neurotransmitter effects, has become a popular alternative to traditional opioids, but it has not been well studied in the preoperative setting of TSA. The purpose of this study is to evaluate postsurgical outcomes in TSA for patients with preoperative tramadol use compared with patients using traditional opioids and those who were opioid naïve.

Medicaid Payer Status Is Associated With Increased 90-Day Resource Utilization, Reoperation, and Infection Following Aseptic Revision Total Hip Arthroplasty.

Background: Prior literature has demonstrated increased resource utilization and perioperative complications in patients with a Medicaid payor status undergoing primary total hip and knee arthroplasty. This relationship has yet to be explored in patients undergoing revision total hip arthroplasty (rTHA).

Methods: The National Readmissions Database was queried from 2010 to 2015 for all patients undergoing aseptic rTHA.

Medicaid payer status is associated with increased 90-day morbidity and resource utilization following primary shoulder arthroplasty: a propensity score-matched analysis.

Background: Medicaid payer status has been shown to affect risk-adjusted patient outcomes and health care utilization across multiple medical specialties and orthopedic procedures. However, there is a paucity of data regarding the impact of Medicaid payer status on 90-day morbidity and resource utilization following primary shoulder arthroplasty (reverse total shoulder arthroplasty [rTSA], anatomic total shoulder arthroplasty [aTSA], and hemiarthroplasty [HA]). The purpose of this study was to examine 90-day readmission and reoperation rates, hospital length of stay (LOS), and direct cost following primary shoulder arthroplasty in the Medicaid population.

Projections and Epidemiology of Total Ankle and Revision Total Ankle Arthroplasty in the United States to 2030.

Total ankle arthroplasty (TAA) utilization is increasing in the United States. As the incidence of this procedure grows, it is important for providers to understand the future projections for ankle arthroplasty and more importantly revision total ankle arthroplasty (rTAA). : The National Inpatient Sample (USA) was queried from 2005 to 2017 for all TAA and rTAA.

Racial Disparities in the Utilization of Shoulder Arthroplasty in the United States: Trends from 2011 to 2017.

Unlabelled: As the incidence of shoulder arthroplasty rises at exponential rates, race is an important consideration, as racial disparities have been reported in lower-extremity arthroplasty in the United States. Our study sought to examine these disparities.

Methods: Using the National Inpatient Sample (NIS) database, all anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (RSA) procedures from 2011 to 2017 were analyzed.

Upper extremity firearm injuries: epidemiology and factors predicting hospital admission.

Introduction: Civilian gun violence is a public health crisis in the USA that will be an economic burden reported to be as high as $17.7 billion with over half coming from US taxpayers dollars through Medicaid-related costs. The purpose of this study is to review the epidemiology of upper extremity firearm injuries in the USA and the associated injury burden.

Fixation vs Arthroplasty for Femoral Neck Fracture in Patients Aged 40-59 Years: A Propensity-Score-Matched Analysis.

Background: Internal fixation (IF) has historically been favored for the treatment of femoral neck fractures (FNFs) in young, nongeriatric patients. However, recent literature reporting high reoperation rates among those receiving IF, taken in conjunction with favorable survivorship of modern bearing surfaces in total hip arthroplasty (THA), has begun to question this paradigm. Our study sought to compare outcomes between IF and THA for FNFs in patients aged 40-59 years.

Association of Preoperative Opioid Use With Complication Rates and Resource Use in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement.

Background: Preoperative opioid use has been shown to be a negative predictor of patient outcomes, complication rates, and resource utilization in a variety of different orthopaedic procedures. To date, there are no studies investigating its effect on outcomes after hip arthroscopy in the setting of femoroacetabular impingement (FAI).

Purpose: To determine the association of preoperative opioid use with postoperative outcomes after hip arthroscopy in patients with FAI.

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.

Prevalence of Shoulder Arthroplasty in the United States and the Increasing Burden of Revision Shoulder Arthroplasty.

Unlabelled: Existing data on the epidemiology of shoulder arthroplasty are limited to future projections of incidence. However, the prevalence of shoulder arthroplasty (the number of individuals with a shoulder arthroplasty alive at a certain time and its implications for the burden of revision procedures) remains undetermined for the United States. Hence, the purpose of this study was to estimate the prevalence of shoulder arthroplasty in the United States.

When Is It Safe to Operate After Therapeutic Carpal Tunnel Injections?

Background: Recent studies suggest increased complications when surgery closely follows corticosteroid injection. The purpose of this study was to understand the occurrence of surgical site infection (SSI), wound complications, and reoperation rates after carpal tunnel release (CTR) when corticosteroid injections were given within 180 days preoperatively.

Methods: Data were collected from the Truven MarketScan database from 2009 to 2018.

The Cost of Getting in: Is It Time for Change in the Adult Reconstruction Fellowship Application Process?

Background: The number of applicants to adult reconstruction fellowships (ARFs) has increased significantly in recent years, making the application process increasingly competitive. With this, applicants are applying to and interviewing at more programs which has inherent cost and time implications. The purpose of this study was to assess these implications as well as investigate applicant attitudes toward proposed changes.

Intraoperative Radiographic Detection of Intrapelvic Acetabular Screw Penetration: Lessons Learned From Our Trauma Colleagues.

Background: Intraoperative vascular injury during total hip arthroplasty represents a catastrophic complication. Acetabular screw placement represents one possible mode of injury. The purpose of this study was to evaluate the utility of various fluoroscopic views in the detection of intrapelvic screw penetration.

New-Onset Depression After Total Knee Arthroplasty: Consideration of the At-Risk Patient.

Background: Postoperative new-onset depression (NOD) has gained recent attention as a previously unrecognized complication which may put patients at risk for poor outcomes after elective total hip arthroplasty. We aimed to investigate risk factors for the development of NOD after total knee arthroplasty (TKA) and assess its association with postoperative complications.

Methods: This is a retrospective, population-level investigation of elective TKA patients.

The Association of Preoperative Opioid Use With Revision Surgery and Complications Following Carpometacarpal Arthroplasty.

Purpose: Preoperative opioid use has been shown to be associated with poor outcomes following different upper-extremity surgeries. We aimed to examine the relationship between preoperative opioid use and outcomes following carpometacarpal (CMC) arthroplasty. We hypothesized that patients prescribed higher daily average numbers of preoperative oral morphine equivalents (OMEs) would show higher rates of complications and revision surgery.

Needle Diagnostic Arthroscopy and Magnetic Resonance Imaging of the Shoulder Have Comparable Accuracy With Surgical Arthroscopy: A Prospective Clinical Trial.

Purpose: To examine the accuracy, sensitivity, and specificity of a minimally invasive needle arthroscopy device and magnetic resonance imaging (MRI) compared with diagnostic arthroscopy, the gold standard in diagnosing intra-articular shoulder pathologies.

Methods: This was a prospective, blinded clinical trial over 6 months on 50 patients with shoulder pathology requiring arthroscopy. Patients were eligible if they had an MRI and consented for surgical arthroscopy.

Metformin Use Is Associated with Fewer Complications in Patients with Type-2 Diabetes Undergoing Total Knee Arthroplasty: A Propensity Score-Matched Analysis.

Background: Diabetes is a well-established risk factor for complications following total knee arthroplasty (TKA), and the incidence of type-2 diabetes is increasing. Metformin is considered first-line therapy for type-2 diabetes and has been shown to reduce all-cause mortality and to possess anti-inflammatory properties. The impact of metformin use as it relates to outcomes following TKA is unknown.

Combined Oral Contraceptive Use Increases the Risk of Venous Thromboembolism After Knee Arthroscopy and Anterior Cruciate Ligament Reconstruction: An Analysis of 64,165 Patients in the Truven Database.

Purpose: To use the Truven MarketScan database to (1) report the incidence of venous thromboembolism (VTE), including deep vein thromboses (DVTs) and pulmonary embolism (PE), in patients undergoing simple knee arthroscopy and anterior cruciate ligament (ACL) reconstruction, and (2) evaluate combined oral contraceptive (COCP) use as a potential risk factor for VTE in patients undergoing knee arthroscopy.

Methods: All female patients between the ages of 16 and 40 years undergoing knee arthroscopy and ACL reconstruction between 2010 and 2015 were identified in the MarketScan database. Patients were stratified by whether they had a documented pharmaceutical claim for COCP therapy, and the primary outcome was the risk of DVT and or PE within 90 postoperative days.

Projected Economic Burden of Periprosthetic Joint Infection of the Hip and Knee in the United States.

Background: In addition to the significant morbidity and mortality associated with periprosthetic joint infection (PJI), the cost of treating PJI is substantial. Prior high-quality national estimates of the economic burden of PJI utilize data up to 2009 to project PJI growth in the United States through 2020. Now in the year 2020, it is appropriate to evaluate these past projections and incorporate the latest available data to better understand the current scale and burden of PJI in the United States.

Preoperative depression is a risk factor for complication and increased health care utilization following total shoulder arthroplasty.

Background: The incidence of total shoulder arthroplasty (TSA) continues to increase. Although researchers expect preoperative depression to influence outcomes following primary hip and knee arthroplasty, there is a paucity of data on this relationship after primary TSA. The purpose of this study was to define the relationship between a preoperative diagnosis of depression and postoperative outcomes following TSA.