Effect of Surgical Start Time on Length of Stay, Morbidity Rate, and Surgical Risk in Elective Total Hip Arthroplasty.

There is conflicting literature regarding the effect of surgical start time for total hip arthroplasty (THA) on morbidity. This study examined outcomes between start time groups in elective THA. A retrospective review identified patients undergoing elective cementless primary THA between 2009 and 2019.

Robots on the Stage: A Snapshot of the American Robotic Total Knee Arthroplasty Market.

» Computer-assisted robots aid orthopaedic surgeons in implant positioning and bony resection. Surgeons selecting a robot for their practice are faced with numerous options. This study aims to make the choice less daunting by reviewing the most commonly used Food and Drug Administration-approved robotic total knee arthroplasty platforms in the American arthroplasty market.

Precision soft tissue balancing: grid-assisted pie-crusting in total knee arthroplasty.

Introduction: The varus and valgus knee deformities result from imbalance in tension between medial and lateral soft tissue compartments. These conditions need to be addressed during total knee arthroplasty (TKA). However, there is no consensus on optimal soft-tissue release techniques for correcting varus and valgus deformities during TKA.

Outpatient Total Joint Arthroplasty: Are We Closing the Racial Disparities Gap?

Introduction: As ne arly half of all total joint arthroplasty (TJA) procedures are projected to be performed in the outpatient setting by 2026, the impact of this trend on health disparities remains to be explored. This study investigated the racial/ethnic differences in the proportion of TJA performed as outpatient as well as the impact of outpatient surgery on 30-day complication and readmission rates.

Methods: The ACS National Surgical Quality Improvement Program was retrospectively reviewed for all patients who underwent primary, elective total hip and knee arthroplasty (THA, TKA) between 2011 and 2018.

Urinary Tract Infection after Total Hip Arthroplasty: A Retrospective Cohort Study.

Perioperative urinary tract infections (UTI) are a relatively common occurrence after total hip arthroplasty (THA). The purpose of this study was to assess demographics, outcomes and trends in the development of UTI's after THA using the National Hospital Discharge Survey (NHDS). All patients undergoing THA were divided based on whether or not they developed a UTI, and data regarding demographics, outcome and complications were gathered and analyzed.

Multiple ipsilateral femoral stress fractures in a patient taking denosumab for osteoporosis-a case report.

Unlabelled: This is the first report describing three ipsilateral femoral stress fractures in a patient taking denosumab.

Introduction: Multiple reports of atypical femur fractures (AFF) in patients receiving denosumab have emerged recently. Denosumab is an anti-resorptive agent approved for treatment of osteoporosis.

A novel method for predicting superior gluteal nerve safe zones in the lateral approach to the hip.

Introduction: The superior gluteal nerve (SGN) is at risk for laceration during lateral approach total hip arthroplasty (THA). The purpose of this study is to assess the accuracy of the trochanter-to-iliac crest distance (TCD) and the nerve-to-trochanter distance (NTD) ratio in determining a reproducible safe zone around the SGN independent of height.

Materials And Methods: Eighteen hemipelvises were dissected and the SGNs were exposed.

Mechanical Properties of the Human Tibial and Peroneal Nerves Following Stretch With Histological Correlations.

Despite the extensive literature regarding peripheral nerve stretch injuries, there are few studies that compare the nerve histology with the mechanical properties in humans. There is clinical evidence suggesting that the peroneal nerve is at greater risk for injury compared to the tibial nerve following total hip arthroplasty and hip trauma. We examined the two nerves from fresh human cadavers with or without controlled stretch.

Mutant SOD1 prevents normal functional recovery through enhanced glial activation and loss of motor neuron innervation after peripheral nerve injury.

Background: Amyotrophic lateral sclerosis (ALS) is poorly understood with no effective therapeutics. One long entertained observation is that ALS may be precipitated focally by nerve injury. Many patients with ALS are athletes or veterans, and some have suffered nerve injuries at the site where ALS first presents.

Knee Arthrodesis Outcomes After Infected Total Knee Arthroplasty and Failure of Two-stage Revision With an Antibiotic Cement Spacer.

Background: Reinfected total knee arthroplasty can be managed with a second two-stage exchange or a knee arthrodesis procedure.

Methods: Twenty-three patients with knee arthrodesis after failed exchange arthroplasty for infection were reviewed. Patients were managed with a staged protocol of implant extraction, débridement, and implantation of an antibiotic spacer, with subsequent arthrodesis.

Hand Infections in the Immunocompromised Patient: An Update.

Physicians are increasingly caring for immunocompromised individuals owing, in part, to the improved treatments and the increased life expectancy in these patients. Presentation of a patient with hand infection can vary greatly depending on the patient's underlying immune status. It is important to recognize and treat the infections quickly and effectively owing to the higher morbidity and mortality that may result from ineffective or delayed treatment in this patient population.

Blood Transfusion After Primary Total Hip Arthroplasty: National Trends and Perioperative Outcomes.

The purpose of this study was to quantify the changes in transfusion rates, both allogeneic blood transfusion (ALBT) and autogenic blood transfusion (ATBT) on a national scale, and determine patient factors associated with transfusions. The National Hospital Discharge Survey was evaluated between 2001 and 2010 for primary total hip arthroplasty (THA) patients and categorized on the basis of transfusion necessity, type, and comorbidity burden. A logistic regression comparison of ALBT, ATBT, and nontransfused patients was performed with respect to patient demographics and in-hospital complications.

Biomechanical evaluation of distal biceps tendon repair using tension slide technique and knotless fixation technique.

Background: Acute distal biceps tendon ruptures are uncommon injuries that often affect young active males, typically resulting from an eccentric load on their dominant extremity. The purpose of this study was to compare pullout strength and tendon gapping in the tension slide technique (TST) versus a knotless fixation technique (KFT).

Methods: Two sets of experiments were performed using cadaveric elbow specimens.

Septic Arthritis of the Shoulder: A Comparison of Treatment Methods.

Introduction: In-hospital outcomes were compared among patients with shoulder septic arthritis treated with arthrocentesis, open irrigation and débridement, or arthroscopic irrigation and débridement.

Methods: The Nationwide Inpatient Sample database was queried for all cases of native shoulder septic arthritis between 2002 and 2011. Patient demographics, comorbidities, and hospitalization complications were compared for the shoulder arthrocentesis (nonsurgical) and open or arthroscopic irrigation and débridement (surgical) groups.

Humeral head sizing using extra-articular landmarks on conventional radiographs.

Purpose: Proper humeral head (HH) sizing is critical to success in anatomic shoulder replacement for management of glenohumeral arthritis. In this study, we evaluate the accuracy and reliability of using non-articular landmarks on conventional radiographs for HH templating.

Methods: Anatomic HH replacement was performed on five non-arthritic shoulders, from fresh adult cadavers.

Glenoid version and size: does gender, ethnicity, or body size play a role?

Introduction: Variations in glenoid morphology among patients of different gender, body habitus, and ethnicity have been of interest for surgeons. Understanding these anatomical variations is a critical step in restoring normal glenohumeral structure during shoulder reconstruction surgery.

Methods: Retrospective review of 108 patient shoulder CT scans was performed and glenoid version, AP diameter and height were measured.

Total Knee Arthroplasty in Obesity: In-Hospital Outcomes and National Trends.

Background: Both the prevalence of obesity and the utilization rate of total knee arthroplasty are increasing. The rate and proportion of total knee arthroplasty (TKA) performed in the setting of obesity/morbid obesity is increasing significantly over time.

Methods: Using International Classification of Diseases-Ninth Revision codes, we searched the National Hospitals Discharge Survey national database for patients admitted for primary TKA between 2001 and 2010.

Gender Role in Total Knee Arthroplasty: A Retrospective Analysis of Perioperative Outcomes in US Patients.

Background: Women present later than men for total knee arthroplasty (TKA) with more severe osteoarthritic disease but achieve comparable functional improvement and implant survival and also lower rates of revision. Despite these findings, there is significant underutilization of the procedure for women compared to men.

Methods: We conducted a retrospective study to address the lack of information in the literature concerning the immediate and short-term perioperative outcomes between genders.

Revision total hip arthroplasty in the United States: national trends and in-hospital outcomes.

Purpose: With the increasing number of primary total hip arthroplasties (THA) being performed, the frequency of revision surgery is also expected to increase. We analysed the immediate in-hospital complications and epidemiologic data of 3,469 revision and 18,186 primary THA cases.

Methods: The National Hospital Discharge Survey (NHDS) was evaluated between 2001 and 2010 for patients who underwent revision and primary THA.