Telemedicine in Orthopedic Oncology: An Opportunity for Cost Savings Without Compromising Clinical Outcomes.

Background: Prior work has demonstrated that telemedicine in orthopedic surgery is cost-effective and can yield good clinical outcomes with high patient satisfaction. However, few studies have investigated the use of telemedicine in orthopedic oncology. In this study, we assessed the effect of telemedicine on (1) potential cost savings for orthopedic oncologic patients and (2) clinical outcomes as measured by unexpected in-person clinic visits and missed complications.

Quantifying Patient Expectations for Total Knee Arthroplasty: Expectations for Improvement Are Greater Than Minimal Clinically Important Difference.

Background: Achieving a minimal clinically important difference (MCID) in patient-reported outcomes following total knee arthroplasty (TKA) is common, yet up to 20% patient dissatisfaction persists. Unmet expectations may explain post-TKA dissatisfaction. No prior studies have quantified patient expectations using the same patient-reported outcome metric as used for MCID to allow direct comparison.

Racial and Ethnic Minorities Underrepresented in Pain Management Guidelines for Total Joint Arthroplasty: A Meta-analysis.

Background: Total joint arthroplasty aims to improve quality of life and functional outcomes for all patients, primarily by reducing their pain. This goal requires clinical practice guidelines (CPGs) that equitably represent and enroll patients from all racial/ethnic groups. To our knowledge, there has been no formal evaluation of the racial/ethnic composition of the patient population in the studies that informed the leading CPGs on the topic of pain management after arthroplasty surgery.

Increased 30-Day Postoperative Readmission and Medical Complication Rates Among Patients 65 Years and Older Following Arthroscopic Rotator Cuff Repair.

Purpose: The purpose of this study is to use a large national database to assess short-term adverse events following arthroscopic rotator cuff repair in patients 65 years and older.

Methods: The ACS NSQIP database was queried to identify patients that underwent arthroscopic rotator cuff repair between December 31, 2015, and January 1, 2017. Patients were split into two groups: 1) between 40-65 years old and 2) 65+ years old.

A Surgeon's Guide to Understanding Artificial Intelligence and Machine Learning Studies in Orthopaedic Surgery.

Purpose Of Review: In recent years, machine learning techniques have been increasingly utilized across medicine, impacting the practice and delivery of healthcare. The data-driven nature of orthopaedic surgery presents many targets for improvement through the use of artificial intelligence, which is reflected in the increasing number of publications in the medical literature. However, the unique methodologies utilized in AI studies can present a barrier to its widespread acceptance and use in orthopaedics.

Determining the incidence and risk factors for short-term complications following distal biceps tendon repair.

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair.

Pregnancy-Associated Perivascular Epithelioid Cell Tumor of the Tarsal Navicular: A Case Report.

Case: A 30-year-old pregnant woman with perivascular epithelioid cell tumor (PEComa) of the tarsal navicular underwent intralesional curettage with allograft at 30 weeks' gestation. She had an uncomplicated delivery at term and is ambulating without tumor recurrence at 1-year follow-up.

Conclusion: PEComas are rare tumors most commonly found in soft tissues but have been reported in bone and are occasionally associated with pregnancy.

The content and accessibility of spine surgery fellowship websites and the North American Spine Surgery (NASS) fellowship directory.

Background Context: The North American Spine Society (NASS) spine fellowship directory is an established resource that provides applicants with access to important information about different fellowship programs. Additionally, some programs have created websites to provide information about their fellowship program. There has been limited research on the amount and breadth of information provided by these different resources.

Unscheduled Clinical Encounters in the Postoperative Period After Adult and Pediatric Urologic Surgery.

Objective: To qualify and quantify unscheduled clinical encounters (UCEs) in postoperative urologic patients and to identify patient and procedural risk factors for UCEs.

Materials And Methods: All UCEs, including phone calls, emails, patient portal messages, clinic visits, ER visits, and hospital readmissions, were analyzed, including the reason for the interaction (eg, pain, infection, etc) were assessed retrospectively for consecutive surgical patients over a 3-month period. Demographic and perioperative data for each patient and surgery was recorded and risk factors for UCE were determined using uni- and multivariate analyses.

Acute Periacetabular Osteotomy for Recurrent Posttraumatic Dislocation of the Hip: A Case Report.

Case: A 23-year-old woman with injury-induced acetabular dysplasia developed subacute recurrent dislocation of the right hip following closed reduction of a traumatic dislocation. The initial dislocation had been associated with small posterior wall and femoral head fractures. The recurrent dislocation was addressed with an acute periacetabular osteotomy (PAO) for hip stabilization and femoral head fragment excision.

How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study.

Introduction: Clinician perceptions of patients with low socioeconomic status (SES) have been shown to affect clinical decision making and health care delivery in this group. However, it is unknown how and if low SES patients perceive clinician bias might affect their health care.

Methods: In-depth interviews with 80 enrollees in a state Medicaid program were analyzed to identify recurrent themes in their perceptions of care.