Impact of anterior cruciate ligament tears on player efficiency ratings and salary in National Basketball Association over the past 20 years: a retrospective case control study.

Objectives: Players in the National Basketball Association (NBA) are at high risk for ACL tears which are detrimental to their career due to the months of rehabilitation. The authors hypothesize that after anterior crucial ligament (ACL) injury, older players will be less likely to return to the NBA, players that do return will have a lower performance efficiency rating (PER), and the decrease in PER will be associated with a lower salary.

Methods: This case-control study utilized the publicly available database maintained by the NBA, professional basketball players from 2002 to 2022 who suffered an ACL tear were identified.

Shoulder Arthroplasty Patients Are Underscreened for Osteoporosis.

Introduction: Osteoporosis screening and subsequent treatment has been shown to be efficacious in decreasing the rates of fragility fractures and periprosthetic fractures (PPF). However, current screening and treatment rates are low. This study aims to determine (1) the prevalence of total shoulder arthroplasty (TSA) patients who meet criteria for osteoporosis screening, (2) the prevalence of those screened, and (3) the 5-year cumulative incidence of fragility fracture (FF) and periprosthetic fractures (PPF).

Medicare and Medicaid patients undergoing total joint arthroplasty have more complications and healthcare utilization than privately insured patients.

Aims & Objectives: This study characterized the independent association between insurance type and healthcare outcomes in patients undergoing total joint arthroplasty (TJA).

Materials &methods: National data identified patients who underwent total hip, knee, shoulder, elbow, ankle or wrist joint arthroplasty surgery from 2012 to 2020 for osteoarthritis. Medicaid, Medicare≥65 years old, Medicare<65 years old, and uninsured patients were matched to privately insured patients based on age, sex, and comorbidities.

Racial disparities in early postoperative proximal humerus fracture outcomes: Do minorities face longer operative times, extended hospital stays, and higher risks?

Background: Racial disparities in orthopedic surgery outcomes have been extensively documented, highlighting systemic biases in care. Proximal humerus fractures (PHFs), about 6% of all fractures, are rising, especially among the elderly. Despite the prevalence of PHFs, a research gap exists regarding racial disparities in postoperative complications and outcomes.

Higher Modified Frailty Index Score is Associated with Increased 30-Day Postoperative Complications Following Surgical Treatment of Tibial Shaft Fractures.

Objectives: This study was conducted to determine if factors comprising the mFI were correlated with adverse outcomes following surgical intervention of tibial shaft fractures.

Methods: We identified patients 50 years or older with tibial shaft fractures that were managed surgically from a national database from 2007-2019. The 5-item mFI score, which comprised of diabetes, hypertension, congestive heart failure, dependent functional status, and chronic obstructive pulmonary disease, was calculated for each patient.

Increased revision rates in shoulder arthroplasty following shoulder arthroscopy.

Introduction: Total shoulder arthroplasty (TSA) and reverse TSA (rTSA) are successful treatments for end-stage shoulder arthritis. However, it is unknown whether prior arthroscopy is associated with an increased risk for revision surgery. This study investigates if undergoing a shoulder arthroscopy in the year prior to primary arthroplasty increases risk of revision surgery within 2 years.

Revision shoulder arthroplasty: predictors of subsequent revision surgery and economic burden amongst Medicare beneficiaries.

Background: Revision shoulder arthroplasty continues to add an increasing burden on patients and the healthcare system. This study aimed to delineate long-term shoulder arthroplasty revision incidence, quantify associated Medicare spending, and identify relevant predictors of both revision and spending.

Methods: The complete 2016-2022 (Q3) Medicare fee-for-service inpatient and outpatient claims data was analyzed.

Decreasing Incidence of Anterior Cruciate Ligament Tears and Increasing Utilization of Anterior Cruciate Ligament Reconstruction in the United States From 2010 to 2020.

Purpose: To characterize the incidence of anterior cruciate ligament (ACL) tears, anterior cruciate ligament reconstruction (ACLR), and ACL nonoperative management from 2010 to 2020, stratifying by age, biological sex, and Charlson Comorbidity Index (CCI) score.

Methods: A retrospective cohort analysis was performed using the PearlDiver national insurance claims database. Cohorts of patients with ACL tears, ACLR, and nonoperative management were identified using International Classification of Diseases, Ninth and Tenth Revision and Current Procedural Terminology codes between 2010 and 2020.

Utility of Machine Learning, Natural Language Processing, and Artificial Intelligence in Predicting Hospital Readmissions After Orthopaedic Surgery: A Systematic Review and Meta-Analysis.

Background: Numerous applications and strategies have been utilized to help assess the trends and patterns of readmissions after orthopaedic surgery in an attempt to extrapolate possible risk factors and causative agents. The aim of this work is to systematically summarize the available literature on the extent to which natural language processing, machine learning, and artificial intelligence (AI) can help improve the predictability of hospital readmissions after orthopaedic and spine surgeries.

Methods: This is a systematic review and meta-analysis.

Decreasing Incidence of Partial Meniscectomy and Increasing Incidence of Meniscus Preservation Surgery From 2010 to 2020 in the United States.

Purpose: To characterize the incidence of meniscus surgery from 2010 to 2020 in the United States, using the metrics of age, sex, type of meniscus surgery, and Charlson Comorbidity Index (CCI).

Methods: A retrospective analysis was performed using the PearlDiver national insurance claims database from 2010 to 2020. Meniscus surgeries were identified using Current Procedural Terminology codes.

Higher modified frailty index score is associated with 30-day postoperative complications following simultaneous bilateral total knee arthroplasty.

Background: There is no clear consensus regarding patient populations at highest risk for complications from simultaneous bilateral total knee arthroplasty (TKA). The purpose of this study was to determine whether the comorbidities comprising the modified Frailty Index (mFI) were correlated with poor outcomes following simultaneous bilateral TKA.

Methods: From 2006 to 2019, patients undergoing bilateral TKA aged 50 years or older were identified in a national database.

Evaluating the Effect of Rotator Cuff Repair With Concomitant Distal Claviculectomy on 2 and 4 Year Reoperation Rates.

Background: The current literature has differing views on the efficacy of concomitant distal claviculectomy (DC) during rotator cuff repair (RCR) in preventing revision surgery. Our aim was to investigate the revision surgery rate between RCR with DC and RCR without DC.

Methods: A retrospective cohort analysis was conducted using a national claims database.

Payer Status and Racial Disparities in Time to Surgery for Emergent Orthopaedic Procedures.

Introduction: Delay in surgical management for orthopaedic emergencies and severe fracture types can result in notable morbidity and even mortality for patients. Disparities in various facets of orthopaedic care have been identified based on race/ethnicity, socioeconomic status, and payer status, but disparities in time to surgery have been poorly explored. The purpose of this study was, therefore, to investigate whether disparities exist in time to emergent orthopaedic surgery.

Prior fragility fractures are associated with a higher risk of 8-year complications following total shoulder arthroplasty.

Unlabelled: Patients who sustain fragility fractures prior to total shoulder arthroplasty have significantly higher risk for bone health-related complications within 8 years of procedure. Identification of these high-risk patients with an emphasis on preoperative, intraoperative, and postoperative bone health optimization may help minimize these preventable complications.

Purpose: As the population ages, more patients with osteoporosis are undergoing total shoulder arthroplasty (TSA), including those who have sustained a prior fragility fracture.

Does Reusable Instrumentation for Four-Anchor Rotator Cuff Repair Offer Decreased Waste Disposal Costs and Lower Waste-Related Carbon Emissions?

Introduction: Orthopaedic surgery is culpable, in part, for the excessive carbon emissions in health care partly due to the utilization of disposable instrumentation in most procedures, such as rotator cuff repair (RCR). To address growing concerns about hospital waste, some have considered replacing disposable instrumentation with reusable instrumentation. The purpose of this study was to estimate the cost and carbon footprint of waste disposal of RCR kits that use disposable instrumentation compared with reusable instrumentation.

Racial and gender disparities in utilization of outpatient total shoulder arthroplasties.

Background: Utilization in outpatient total shoulder arthroplasties (TSAs) has increased significantly in recent years. It remains largely unknown whether utilization of outpatient TSA differs across gender and racial groups. This study aimed to quantify racial and gender disparities both nationally and by geographic regions.

A preoperative risk assessment tool for predicting adverse outcomes among total shoulder arthroplasty patients.

Background: With the increased utilization of Total Shoulder Arthroplasty (TSA) in the outpatient setting, understanding the risk factors associated with complications and hospital readmissions becomes a more significant consideration. Prior developed assessment metrics in the literature either consisted of hard-to-implement tools or relied on postoperative data to guide decision-making. This study aimed to develop a preoperative risk assessment tool to help predict the risk of hospital readmission and other postoperative adverse outcomes.

The association of alcohol use disorder with revision rates and post-operative complications in total shoulder arthroplasty.

Background: Alcohol use disorder (AUD) is the most prevalent substance use disorder in the United States. However, the current literature on AUD as a preoperative risk factor for Total Shoulder Arthroplasty (TSA) outcomes is limited. The purpose of this study was to identify the association of AUD with revision rates and 90-day postoperative complications in TSA.

Variation in the Cost of Hip Arthroscopy for Labral Pathological Conditions: A Time-Driven Activity-Based Costing Analysis.

Background: Despite growing interest in delivering high-value orthopaedic care, the costs associated with hip arthroscopy remain poorly understood. By employing time-driven activity-based costing (TDABC), we aimed to characterize the cost composition of hip arthroscopy for labral pathological conditions and to identify factors that drive variation in cost.

Methods: Using TDABC, we measured the costs of 890 outpatient hip arthroscopy procedures for labral pathological conditions across 5 surgeons at 4 surgery centers from 2015 to 2022.

No difference in 10-year survivorship of total shoulder arthroplasty vs. hemiarthroplasty for avascular necrosis of the humeral head.

Background: Avascular necrosis (AVN) of the humeral head is characterized by osteonecrosis secondary to disrupted blood flow to the glenohumeral joint. Following collapse of the humeral head, arthroplasty, namely, total shoulder arthroplasty (TSA) or humeral head arthroplasty (hemiarthroplasty), is recommended standard of care. The literature is limited to underpowered and small sample sizes in comparing arthroplasty modalities.

Five-Year Mortality Rates Following Elective Shoulder Arthroplasty and Shoulder Arthroplasty for Fracture in Patients Over Age 65.

Background: To effectively counsel patients prior to shoulder arthroplasty, surgeons should understand the overall life trajectory and life expectancy of patients in the context of the patient's shoulder pathology and medical comorbidities. Such an understanding can influence both operative and nonoperative decision-making and implant choices. This study evaluated 5-year mortality following shoulder arthroplasty in patients ≥65 years old and identified associated risk factors.

Massive rotator cuff tears: algorithmic approach to surgical treatment.

The management of massive rotator cuff tears (MRCT) presents a unique challenge to many orthopedic specialists. Unlike tears that are predicted to do well with primary, complete repair, MRCT are affected by tissue retraction, in-elasticity, bursal scarring, muscle atrophy, and fatty degeneration; operative repair thus portends worse healing rates than smaller tears and is associated with recurrent tear rates of up to 91% based on ultrasonography and magnetic resonance imaging (MRI). Rotator cuff tears are a common condition in patients over the age of 50.