Whole Blood Metal Levels in the Setting of an Oncologic Endoprosthesis: Is There Cause for Concern?

Background: Massive modular endoprostheses have become a primary means of reconstruction after oncologic resection of a lower extremity tumor. These implants are commonly made with cobalt-chromium alloys that can undergo wear and corrosion, releasing cobalt and chromium ions into the surrounding tissue and blood. However, there are few studies about the blood metal levels in these patients.

The use of deep learning in medical imaging to improve spine care: A scoping review of current literature and clinical applications.

Background: Artificial intelligence is a revolutionary technology that promises to assist clinicians in improving patient care. In radiology, deep learning (DL) is widely used in clinical decision aids due to its ability to analyze complex patterns and images. It allows for rapid, enhanced data, and imaging analysis, from diagnosis to outcome prediction.

Can the American Joint Replacement Registry Utilize Administrative Claims Data to Accurately Classify Revision Total Hip Arthroplasty (THA) Surgical Diagnoses?

Background: The American Joint Replacement Registry (AJRR) is a valuable tool for studying revision total hip arthroplasty (rTHA). Currently, International Classification of Diseases-10 (ICD-10) codes are utilized by the AJRR for classifying surgical diagnoses. However, the validity of this methodology is unknown.

Longitudinal factors associated with increased alcohol consumption in adults during the COVID-19 pandemic.

Alcohol is the most abused substance among adults in the United States. The COVID-19 pandemic impacted patterns of alcohol use, but data are conflicting, and previous studies are largely limited to cross-sectional analyses. This study aimed to longitudinally assess sociodemographic and psychological correlates of changes in three patterns of alcohol use (number of alcoholic drinks, drinking regularity, and binge drinking) during COVID-19.

Prediction Models for Knee Osteoarthritis: Review of Current Models and Future Directions.

Background: Knee osteoarthritis (OA) is a prevalent joint disease. Clinical prediction models consider a wide range of risk factors for knee OA. This review aimed to evaluate published prediction models for knee OA and identify opportunities for future model development.

Diagnostic Performance of Clinical Examination Versus Ultrasonography in the Detection of Developmental Dysplasia of Hip: A Systematic Review and Meta-Analysis.

Background: Developmental dysplasia of the hip (DDH) is a spectrum of diseases involving the femoroacetabular joint. Due to the controversies over the value of different strategies used for DDH screening, this systematic review and meta-analysis aimed to assess the diagnostic performance of standard physical examination maneuvers on the diagnosis of DDH, compared to the Graf ultrasonography (US) method.

Methods: PubMed, Web of Science, and SCOPUS databases were searched until the end of October 2020.

Longitudinal Correlates of Increased Alcohol Use Among Adolescents and Young Adults During the COVID-19 Pandemic.

Aims: The objective of this study is to longitudinally assess sociodemographic and psychological correlates of increased alcohol use during the coronavirus disease of 2019 (COVID-19) period among adolescents and young adults.

Methods: Pre-COVID period is defined as the 1-year period on or before 31 March 2020, and during-COVID period is defined as the period from 1st April 2020 to 30 March 2021. Univariable logistic regression models are used to evaluate the association of demographic characteristics, Area Deprivation Index (ADI), rurality, changes in Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scale severity, and the risk of increased alcohol consumption (binge drinking, number of drinks and drinking regularity) from pre-COVID to during-COVID period.

Trends in Incidence of Adolescent Idiopathic Scoliosis: A Modern US Population-based Study.

Background: A successful disease screening strategy requires a high incidence of the condition, efficacy of early treatment, and efficient detection. There is limited population-based data describing trends in incidence of adolescent idiopathic scoliosis (AIS) in the United States and potential role of school screening programs on the incidence of AIS. Thus, we sought to evaluate the incidence of AIS over a 20-year period between 1994 and 2013 using a population-based cohort.

Tranexamic acid is associated with decreased transfusion, hospital length of stay, and hospital cost in simultaneous bilateral total knee arthroplasty.

Tranexamic acid (TXA) reduces blood loss and transfusion rates in unilateral total knee arthroplasty (TKA), but there is limited data regarding its efficacy in bilateral TKA. This study reports the impact TXA has on clinical outcomes and hospital cost of care in simultaneous, primary bilateral TKA. The 449 patients were retrospectively reviewed.

Automated Detection of Periprosthetic Joint Infections and Data Elements Using Natural Language Processing.

Background: Periprosthetic joint infection (PJI) data elements are contained in both structured and unstructured documents in electronic health records and require manual data collection. The goal of this study is to develop a natural language processing (NLP) algorithm to replicate manual chart review for PJI data elements.

Methods: PJI was identified among all total joint arthroplasty (TJA) procedures performed at a single academic institution between 2000 and 2017.

Conversion of Failed Hemiarthroplasty to Total Hip Arthroplasty Remains High Risk for Subsequent Complications.

Background: Few studies have described the outcomes following conversion of failed hemiarthroplasties to total hip arthroplasty (THA) and the impact of mortality when estimating implant survivorship. The aims of this study were to evaluate the following: (1) the risks and predictors of complications, dislocations, reoperations, and revisions and (2) the extent of competing risk of death when evaluating outcomes in patients converted from hemiarthroplasty to THA.

Methods: The study comprised 389 patients treated with conversion THA following hemiarthroplasty for femoral neck fractures between 1985 and 2014.

Conversion of Hemiarthroplasty to THA Carries an Increased Risk of Reoperation Compared With Primary and Revision THA.

Background: There is limited information on the complications and costs of conversion THA after hemiarthroplasty for femoral neck fractures. Previous studies have found that patients undergoing conversion THA experience higher risk complications, but it has been difficult to quantify the risk because of small sample sizes and a lack of comparison groups. Therefore, we compared the complications of patients undergoing conversion THA with strictly matched patients undergoing primary and revision THA.

Low Back Pain in Adults With Transfemoral Amputation: A Retrospective Population-Based Study.

Background: Low back pain (LBP) is common among individuals with transfemoral amputation (TFA) and has a negative impact on quality of life. Little is known about health care utilization for LBP in this population and whether utilization varies by amputation etiology.

Objective: To determine if individuals with TFA have an increased likelihood of seeking care or reporting symptoms of acute or chronic LBP during physician visits after amputation compared with matched individuals without amputation.

The risk of major cardiovascular events for adults with transfemoral amputation.

Background: It is well-known that the risk of cardiac disease is increased for those with lower-limb amputations, likely as a result of the etiology of the amputation. Using a longitudinal population-based dataset, we examined the association between transfemoral amputation (TFA) status and the risk of experiencing a major cardiac event for those undergoing either dysvascular or traumatic amputations. The association of receiving a prosthesis with the risk of experiencing a major cardiac event was also examined.

Does School Screening Affect Scoliosis Curve Magnitude at Presentation to a Pediatric Orthopedic Clinic?

Background: With new data supporting the efficacy of bracing, the role of school screening for early detection of moderate scoliosis curves has been revisited. Because of a high rate of false-positive screening and cost concerns, a comprehensive county-wide school screening program was discontinued in 2004. We aim to determine the impact of a comprehensive school screening program on curve magnitude at presentation and initial scoliosis treatment for all local county patients presenting to a pediatric orthopedic clinic from all referral sources.

Comparison of the hospital costs for two-stage reimplantation for deep infection, single-stage revision and primary total elbow arthroplasty.

Background: The purpose of the present study was to determine the cost of two-stage reimplantation for the treatment of deep infection after total elbow arthroplasty (TEA) and compare this with primary and aseptic revision TEA.

Methods: Three hundred and seventy-one primary TEA and 286 revision TEAs (including 47 elbows requiring two-stage reimplantation) were performed. Total direct medical costs during each hospitalization were obtained from our institutional research database and compared for three groups: primary TEA, revision for nonseptic reasons and two-stage reimplantation for deep infection.

Intra-articular injection of a substance P inhibitor affects gene expression in a joint contracture model.

Substance P (SP), a neurotransmitter released after injury, has been linked to deregulated tissue repair and fibrosis in musculoskeletal tissues and other organs. Although SP inhibition is an effective treatment for nausea, it has not been previously considered as an anti-fibrotic therapy. Although there are extensive medical records of individuals who have used SP antagonists, our analysis of human registry data revealed that patients receiving these antagonists and arthroplasty are exceedingly rare, thus precluding a clinical evaluation of their potential effects in the context of arthrofibrosis.

Clinical Factors, Disease Parameters, and Molecular Therapies Affecting Osseointegration of Orthopedic Implants.

Total hip and knee arthroplasty are effective interventions for management of end-stage arthritis. Indeed, about 7 million Americans are currently living with artificial hip and knee joints. The majority of these individuals, however, will outlive their implants and require revision surgeries, mostly due to poor implant osseointegration and aseptic loosening.

Fatigue in systemic lupus erythematosus : Association with disease activity, quality of life and psychosocial factors.

Objective: The aim of the study was to determine which disease-related factors and non-disease features can explain the presence of systemic lupus erythematosus (SLE)-related fatigue in Turkish patients.

Methods: This cross-sectional study was carried out with 99 SLE patients and 71 healthy controls. To assess fatigue and health-related quality of life (HRQoL) the participants were asked to complete two questionnaires: the short form-36 health survey (SF-36) and the multidimensional assessment of fatigue (MAF) scale.

Long-term follow-up of isolated ACL tears treated without ligament reconstruction.

Purpose: The incidence of subsequent meniscal tears and arthritis among patients with isolated ACL tears treated without ligament reconstruction has not been clearly established. The purpose of this study was to (1) compare the risk of subsequent meniscal tears and osteoarthritis (OA) between patients with isolated ACL tears treated without ligament reconstruction and a matched cohort of individuals without ACL tears and (2) examine factors predictive of long-term sequelae after non-operative treatment of isolated ACL tears.

Methods: This study compared a population-based incidence cohort of 364 patients with new-onset, isolated ACL tears between 1990 and 2000, to an age and sex-matched cohort of 364 individuals without ACL tears.

Is Anterior Cruciate Ligament Reconstruction Effective in Preventing Secondary Meniscal Tears and Osteoarthritis?

Background: Reconstruction of anterior cruciate ligament (ACL) tears may potentially prevent the development of secondary meniscal injuries and arthritis.

Purpose/hypothesis: The purpose of this study was to (1) evaluate the protective benefit of ACL reconstruction (ACLR) in preventing subsequent meniscal tears or arthritis, (2) determine if earlier ACLR (<1 year after injury) offers greater protective benefits than delayed reconstruction (≥1 year after injury), and (3) evaluate factors predictive of long-term sequelae after ACLR. The hypothesis was that the incidence of secondary meniscal tears, arthritis, and total knee arthroplasty (TKA) would be higher in patients treated nonoperatively after ACL tears than patients treated with surgical reconstruction.

Incidence and long-term follow-up of isolated posterior cruciate ligament tears.

Purpose: Isolated posterior cruciate ligament (PCL) tears are an uncommon injury. The goals of this study are to (1) determine the population-based incidence of isolated PCL tears, (2) compare the occurrence of secondary meniscal tears or arthritis in patients with PCL deficiency to patients without PCL tears, and (3) evaluate factors associated with long-term sequelae among patients with PCL deficiency.

Methods: This retrospective study included a population-based incidence cohort of 48 patients with new-onset, isolated PCL tears between 1990 and 2010, as well as an age and sex-matched cohort of individuals without PCL tears.

Osteogenic potential of human adipose-tissue-derived mesenchymal stromal cells cultured on 3D-printed porous structured titanium.

Integration of porous metal prosthetics, which restore form and function of irreversibly damaged joints, into remaining healthy bone is critical for implant success. We investigated the biological properties of adipose-tissue-derived mesenchymal stromal/stem cells (AMSCs) and addressed their potential to alter the in vitro microenvironment of implants. We employed human AMSCs as a practical source for musculoskeletal applications because these cells can be obtained in large quantities, are multipotent, and have trophic paracrine functions.