Timing of Readmissions After Elective Total Hip and Knee Arthroplasty: Does a 30-Day All-Cause Rate Capture Surgically Relevant Readmissions?

Background: The 30-day all-cause readmission rate is a widely used metric of hospital performance. However, there is lack of clarity as to whether 30 days is an appropriate time frame following surgical procedures. Our aim is to determine whether a 90-day time window is superior to a 30-day time window in capturing surgically relevant readmissions after total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Testing Densities and Refractive Indices of Extraterrestrial Ice Components Using Molecular Structures - Organic Compounds and Molar Refractions.

The use of infrared spectra to determine molecular abundances of icy astronomical objects and to study their chemistry requires laboratory measurements of reference spectra and related quantities, such as the index of refraction () and density () of candidate ices. Here we present new and measurements on ices involving C-, H-, and O-containing compounds, both acyclic and cyclic, representing seven chemical families. We examine the results in a way that is rare in the astrochemical literature, namely one in which data from an ice formed from molecules of a particular chemical family are compared to measurements on another member of the same family, such as of a homologous series or a pair of isomers.

Venous thromboembolism rates after hip and knee arthroplasty and hip fractures.

Background: The ideal thromboprophylaxis regime following lower limb arthroplasty and proximal femur fractures remains controversial. Guidelines disagree on the type of chemical prophylaxis, its dose or duration. This article describes a method of monitoring venous thromboembolism (VTE) rates following Total Hip (THA), Total Knee Arthroplasty (TKA) and surgery for hip fractures (NOF#).

Risk factors for early revision after total hip and knee arthroplasty: National observational study from a surgeon and population perspective.

Aims: To identify predictors of early revision (within 3 years of the index operation) for hip and knee replacement (HR, KR) from both surgeon and population perspectives.

Patients And Methods: Hierarchical logistic regression on national administrative data for England for index procedures between April 2009 and March 2014.

Results: There were 315,273 index HR procedures and 374,530 index KR procedures for analysis.

Predictors of 30-Day Readmission After Total Knee Arthroplasty: Analysis of 566,323 Procedures in the United Kingdom.

Background: All-cause 30-day readmission after total knee arthroplasty (TKA) is currently used as a measure of hospital performance in the United States and elsewhere. Readmissions from surgical causes may more accurately reflect preventability and costs. However, little is known about whether predictors of each type of readmission differ.

Comparison of 3 Types of Readmission Rates for Measuring Hospital and Surgeon Performance After Primary Total Hip and Knee Arthroplasty.

Background: All-cause 30-day hospital readmission is in widespread use for monitoring and incentivizing hospital performance for patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, little is known on the extent to which all-cause readmission is influenced by hospital or surgeon performance and whether alternative measures may be more valid.

Methods: This is an observational study using multilevel modeling on English administrative data to determine the interhospital and intersurgeon variation for 3 readmission metrics: all-cause, surgical, and return-to-theater.

Factors Associated With 30-Day Readmission After Primary Total Hip Arthroplasty: Analysis of 514 455 Procedures in the UK National Health Service.

Importance: Thirty-day readmission to hospital after total hip arthroplasty (THA) has significant direct costs and is used as a marker of hospital performance. All-cause readmission is the only metric in current use, and risk factors for surgical readmission and those resulting in return to theater (RTT) are poorly understood.

Objective: To determine whether patient-related predictors of all-cause, surgical, and RTT readmission after THA differ and which predictors are most significant.

Does early return to theatre add value to rates of revision at 3 years in assessing surgeon performance for elective hip and knee arthroplasty? National observational study.

Background: Joint replacement revision is the most widely used long-term outcome measure in elective hip and knee surgery. Return to theatre (RTT) has been proposed as an additional outcome measure, but how it compares with revision in its statistical performance is unknown.

Methods: National hospital administrative data for England were used to compare RTT at 90 days (RTT90) with revision rates within 3 years by surgeon.

Pre-operative digital templating in cemented hip hemiarthroplasty for neck of femur fractures.

Pre-operative digital templating allows the surgeon to foresee any anatomical anomalies which may lead to intra-operative problems, and anticipate appropriate instruments and implants required during surgery. Although its role is well-established in successful elective total hip arthroplasty, little work has been done on its use in hip hemiarthroplasty in neck of femur fractures. We describe our initial experience of digital templating in 40 consecutive patients who have undergone cemented hip hemiarthroplasty, assessing templating accuracy between templated implant sizes to actual implant sizes.

Descent without Modification? The Thermal Chemistry of H2O2 on Europa and Other Icy Worlds.

The strong oxidant H2O2 is known to exist in solid form on Europa and is suspected to exist on several other Solar System worlds at temperatures below 200 K. However, little is known of the thermal chemistry that H2O2 might induce under these conditions. Here, we report new laboratory results on the reactivity of solid H2O2 with eight different compounds in H2O-rich ices.

The effect of new oral anticoagulants and extended thromboprophylaxis policy on hip and knee arthroplasty outcomes: observational study.

The efficacy and safety of the new oral anticoagulants (NOAC) and the benefits of extended duration thromboprophylaxis following hip and knee replacements remain uncertain. This observational study describes the relations between thromboprophylaxis policies following hip and knee replacements across England's NHS and patient outcomes between January 2008 and December 2011. From the national administrative database, we analyzed mortality, thromboembolic complications, emergency readmission, and bleeding rates for 201,418 hip and 230,282 knee replacements.

Patient Satisfaction: Receiving a copy of the GP letter following fracture or elective orthopaedic clinic.

Following orthopaedic/fracture clinics at our hospital, patients now receive a copy of the letter summarizing an outpatient consultation that is sent to their General Practitioner. We undertook a patient satisfaction questionnaire to determine if patients found this change in practice beneficial. Of the 83 patients who had received this letter, most patients had read the letter (96%) and understood the content (90%).

Mortality and morbidity following hip fractures related to hospital thromboprophylaxis policy.

Chemical thromboprophylaxis has been shown to reduce the incidence of venous thromboembolism (VTE) for patients with fractures of the hip, but it is not known with certainty whether it use also reduces mortality. Using postal and telephone questionnaires we collected data from English National Health Service (NHS) hospitals about their thromboprophylaxis policy for hip fractures patients from April 2003 to April 2007. Using Hospital Episode Statistics (HES) we ascertained in-hospital mortality rates at 30 days and at one year following admission to hospital.

Osteochondral fracture of the lateral femoral condyle involving the entire weight bearing articular surface fixed with biodegradable screws.

Osteochondral fracture of lateral femoral condyle can result from support and other twisting injuries of the knee. Arthroscopy is a better diagnostic and therapeutic tool as standard radiographs can mislead regarding the size and location of the fragment. If fragment is large and displaced, arthrotomy may become necessary.

Making strong cords from surgical sutures.

The authors present a simple and cost effective technique of preparing strong cords from surgical sutures. The technique requires suture material, a drill, a clip and it takes less than a minute to prepare. The mechanical strength of the cord obtained by this method was compared to the mechanical strength of a single suture.

Decomposition of solid amorphous hydrogen peroxide by ion irradiation.

We present laboratory studies of the radiolysis of pure (97%) solid H2O2 films by 50 keV H+ at 17 K. Using UV-visible and infrared reflectance spectroscopies, a quartz-crystal microbalance, and a mass spectrometer, we measured the absolute concentrations of the H2O, O2, H2O2, and O3 products as a function of irradiation fluence. Ozone was identified by both UV and infrared spectroscopies and O2 from its forbidden transition in the infrared at 1550 cm(-1).