Publications by authors named "Mayfield C"
regional gene therapy is a promising tissue-engineering strategy for bone regeneration: osteogenic mesenchymal stem cells (MSCs) can be genetically modified to express an osteoinductive stimulus (e.g., bone morphogenetic protein-2), seeded onto an osteoconductive scaffold, and then implanted into a bone defect to exert a therapeutic effect.
View Article and Find Full Text PDFUnlabelled: Widespread recognition of food as medicine interventions' role in reducing food insecurity and improving health outcomes has recently emerged. Several states have released In Lieu of Services, state-approved alternative services that may be offered by managed care organizations in place of covered benefits, or 1,115 Medicaid waivers, which may allow for expanded nutrition services to reduce food insecurity and improve health outcomes. However, there are significant gaps in understanding how to create a statewide system for delivering "healthcare by food" interventions.
View Article and Find Full Text PDFBackground: Complete blood cell count-based ratios (CBRs), including the neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), are inflammatory markers associated with postoperative morbidity. Given the link between the surgical stress response and complications after total joint arthroplasty (TJA), this study aimed to evaluate whether higher preoperative CBR values predict greater postoperative benefits associated with dexamethasone utilization.
Methods: The Premier Healthcare Database was queried for adult patients who underwent primary, elective total hip or knee arthroplasty (THA or TKA).
Background: To present rates of reporting bias in systematic reviews and meta-analyses investigating meniscal root repair.
Methods: In this systematic review, PubMed, Scopus and Web of Science databases were queried for studies that investigated meniscal root tears treated with root repair. Included studies were systematic reviews and/or meta-analyses published in peer-reviewed journals in the English language with available full-texts.
Purpose: To investigate the characteristics and rate of sociodemographic variables reported in randomized controlled trials (RCTs) studying platelet-rich plasma (PRP) injections in the treatment of knee osteoarthritis (OA).
Methods: In January 2024, PubMed, Scopus, and Web of Science databases were queried for the phrase "Platelet-Rich Plasma Knee Osteoarthritis." Included studies were RCTs investigating PRP use in knee OA published in English between 2012 and 2023.
Introduction: Higher perioperative opioid use has been associated with an increase in periprosthetic joint infection, thromboembolic complications, respiratory events, gastrointestinal complications, cost, and length of stay following hip and knee arthroplasty. Limited data exists regarding the relationship between the postoperative opioid dose and complication rates following primary total shoulder arthroplasty (TSA). The purpose of this study is to investigate the relationship between perioperative opioid consumption and postoperative complications following TSA.
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- Artri King was an over-the-counter supplement aimed at treating joint pain, but the FDA warned it contained hidden ingredients like dexamethasone, which can pose health risks like adrenal insufficiency.
- A study was conducted on patients who used the supplement and found significant health issues, including low cortisol levels and one case of new diabetes, prompting referrals to endocrinology.
- The findings highlight the potential severe effects of such supplements, leading to recommendations for regular screening and careful monitoring of patients who use them.
Article Synopsis
- There is currently no universal guideline on how much activity patients should restrict themselves to after total hip arthroplasty (THA), which is the surgery to replace a hip joint.
- A systematic review analyzed various studies to see if allowing more activity post-surgery affects outcomes like implant survivorship, patient satisfaction, and ability to return to sports.
- Results indicated that patients who were more active post-THA generally had similar or better results regarding implant longevity, and there was a positive relationship between higher activity levels and improved mental health and satisfaction, although more detailed studies are needed for concrete guidelines.
Background: The American Academy of Orthopaedic Surgeons (AAOS) publishes clinical practice guidelines (CPGs) for various pathologies. An extension to the Consolidated Standards for Reporting (CONSORT) checklist provides authors with a framework for reporting harms in randomized controlled trials (RCTs).
Objectives: The purpose of this study was to measure harms reporting among RCTs cited as supporting evidence for the AAOS CPG on the treatment of clavicle fractures.
Article Synopsis
- This study investigates the safety and effectiveness of aspirin compared to enoxaparin for preventing blood clots in high-risk patients undergoing total joint surgeries, specifically total knee and hip arthroplasties.
- Analyzing data from surgeries performed between 2015 and 2021, the researchers compared patients with a history of venous thromboembolism (VTE) who were given either aspirin or enoxaparin after their surgeries.
- The findings suggest that patients on aspirin had similar rates of serious complications like pulmonary embolism and deep vein thrombosis as those on enoxaparin but experienced fewer bleeding-related issues and complications overall.
Purpose: To identify the return-to-sport (RTS) rate in athletes undergoing a Latarjet procedure while outlining the specific reasons for failure to RTS.
Methods: An electronic literature search was conducted (PubMed/MEDLINE, Scopus, Web of Science). Studies in peer-reviewed journals with Latarjet procedures performed on athletes that reported rates and reasons for failure to RTS were included.
Background: Tranexamic acid (TXA) is increasingly utilized in total shoulder arthroplasty (TSA) to minimize blood loss. Despite its benefits, concerns persist regarding its use in patients at elevated risk of postoperative venous thromboembolism (VTE). This study evaluates trends in TXA use and assesses its safety in both general and high-risk patient populations.
View Article and Find Full Text PDFBackground: Total shoulder arthroplasty (TSA), which includes anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA), is a technically demanding procedure and limited data exist on the relationship between case volume and complications. We sought to identify volume thresholds for TSA, aTSA, and rTSA at which risk of a major surgical complication decreased and to compare complications of patients treated by high-volume surgeons with those of patients treated by low-volume surgeons.
Materials And Methods: Primary, elective TSAs (aTSA and rTSA) from January 1, 2016, to December 31, 2019, were identified in the Premier Healthcare Database.
Background: Limited evidence exists regarding the influence of mental health disorders (MHDs) on opioid use and complications after total shoulder arthroplasty (TSA). We aimed to identify the prevalence of common MHDs among patients undergoing anatomic TSA (aTSA) and reverse TSA (rTSA).
Materials And Methods: The Premier Healthcare Database was queried for patients undergoing primary aTSA and rTSA from 2016 to 2020.
Article Synopsis
- Osteonecrosis of the femoral head (ONFH) affects over 20,000 individuals in the U.S. annually, yet the mechanisms behind its progression are not well understood, prompting research into various contributing factors.
- A study was conducted on 105 ONFH patients to evaluate risk factors, femoral head anatomy, and necrotic lesion size, utilizing multivariable regression to identify predictors of femoral head collapse.
- Findings revealed that alcohol exposure, a larger necrotic lesion, and higher alpha angles increased the risk of collapse, while greater femoral head offset appeared to protect against it; the study emphasizes the need for larger future studies to further investigate these relationships.
Article Synopsis
- The study aimed to evaluate the diagnostic capabilities of AI models ChatGPT, Bard, and Bing Chat by comparing their performance on the Orthopaedic In-Training Examination (OITE) to that of human orthopaedic trainees.
- A dataset of 420 OITE questions from 2021 and 2022 was used, revealing that the AI's overall accuracy ranged from 46.3% to 56.8%, while orthopaedic residents performed better as they advanced in their training years.
- The findings suggest that these AI models are on par with first-year orthopaedic residents in answering board-style questions, indicating a potential baseline for future AI advancements in clinical settings.
Patients with morbid obesity and concomitant hip or knee osteoarthritis represent a challenging patient demographic to treat as these patients often present earlier in life, have more severe symptoms, and have worse surgical outcomes following total hip and total knee arthroplasty. Previously, bariatric and metabolic surgeries represented one of the few weight loss interventions that morbidly obese patients could undergo prior to total joint arthroplasty. However, data regarding the reduction in complications with preoperative bariatric surgery remain mixed.
View Article and Find Full Text PDFBackground: Morbidly obese patients are an ever-growing high-risk population undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) for end-stage osteoarthritis. This study sought to identify preoperative laboratory values that may serve as predictors of periprosthetic joint infection (PJI) in morbidly obese patients undergoing THA or TKA.
Methods: All morbidly obese patients with preoperative laboratory data before undergoing primary elective TKA or THA were identified using the Premier Healthcare Database.
Introduction: The relationship between surgeon volume and risk of dislocation after total hip arthroplasty (THA) is debated. This study sought to characterize this association and assess patient outcomes using a nationwide patient and surgeon registry.
Methods: The Premier Healthcare Database was queried for adult primary elective THA patients from January 1, 2016, to December 31, 2019.
Complete Blood Count Ratios Predict Adverse Events After Total Joint Arthroplasty.
J Am Acad Orthop Surg
December 2024
Article Synopsis
- The study evaluates the relationship between complete blood count-based ratios (CBRs) like NLR, MLR, PLR, and SII with postoperative complications, hospital length of stay (LOS), and mortality in patients undergoing total joint arthroplasty.
- Using a large database, the research identified specific threshold values for these CBRs that are linked to increased risk of complications and prolonged LOS after surgery.
- The findings highlight the significance of CBRs in predicting surgical outcomes, which can potentially guide preoperative assessments and improve patient management.
Background: This research aims to determine the influence of industry on the outcomes of randomized controlled trials (RCTs) for Mesenchymal Stem Cell (MSC) treatments in knee osteoarthritis (OA).
Methods: PubMed, Scopus, and Web of Science were searched from 2010 onwards using the terms "knee osteoarthritis" and "mesenchymal stem cells". After identifying relevant RCTs, studies were categorized as industry-affiliated or non-industry-affiliated.
Background: Evidence regarding the effect of body mass index (BMI) on complications following anatomic shoulder arthroplasty (aTSA) and reverse shoulder arthroplasty (rTSA) remains controversial. This high-powered study examines the effect of BMI on surgical and medical complications following aTSA and rTSA.
Methods: This retrospective cohort study was conducted using the Premier Healthcare Database to query all adult patients who underwent primary, elective TSA (aTSA, rTSA) from 2016 to 2020.
Purpose: To determine whether industry affiliation influences the results of randomized controlled trials (RCTs) studying the use of platelet-rich plasma (PRP) for the treatment of patellar or Achilles tendinopathy.
Methods: The PubMed, Scopus, Cochrane, and MEDLINE databases were searched in July 2023 for RCTs investigating PRP for the treatment of patellar or Achilles tendinopathy published between 2009 and July 2023. Industry affiliation was determined by analyzing each study's funding or conflict-of-interest section.
Background: Perioperative intravenous (IV) dexamethasone is commonly used in lower extremity total joint arthroplasty to manage postoperative pain and nausea/vomiting, and recent studies have demonstrated that its use may lower rates of acute postoperative medical complications. However, there is limited information regarding the safety and efficacy of IV dexamethasone in patients undergoing total shoulder arthroplasty (TSA). Additionally, there is concern surrounding corticosteroid use prior to surgery as preoperative corticosteroid injections have been associated with adverse outcomes after TSA, including periprosthetic joint infection (PJI) and revision surgery.
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