Evaluating Self-Directed Rehabilitation for Knee and Hip Arthroplasty During the COVID-19 Pandemic: A Multicenter Study.

The COVID-19 pandemic has triggered the adoption of new technologies to reduce the need for in-person physical therapy (PT). This study evaluated the impact of the COVID-19 pandemic on PT utilization and outcomes of patients prescribed a smartphone-based care management platform (sbCMP) for self-directed rehabilitation (SDR). A secondary analysis of data collected in a multicenter, prospective cohort trial investigating a mobile platform to deliver SDR after arthroplasty was performed.

Machine learning model identifies patient gait speed throughout the episode of care, generating notifications for clinician evaluation.

Introduction: The advent of digital and mobile health innovations, especially use of wearables for passive data collection, allows remote monitoring and creates an abundance of data. For this information to be interpretable, machine learning (ML) processes are necessary.

Research Question: Can a machine learning model successfully identify patients expected to have low gait speed in the early recovery period following joint replacement surgery?

Methods: A commercial database from a smartphone-based care management platform passively collecting mobility data pre- and post-lower limb arthroplasty was used.

Comparison of Early Postoperative Step and Stair Counts With the Direct Anterior Approach Versus the Posterior Approach for Total Hip Arthroplasty.

Background: The purpose of this study was to evaluate the impact of direct anterior approach (DAA) or posterior approach (PA) on step and stair counts after total hip arthroplasty using a remotely monitored mobile application with a smartwatch while controlling for baseline characteristics.

Methods: This is a secondary data analysis from a prospective cohort study of patients utilizing a smartphone-based care management platform. The primary outcomes were step and stair counts and changes from baseline through one year.

Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty.

Purpose: Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA.

Methods: 1736 patients within a prospective observational study were categorized into BMI classes.

Impact of Chronic Opioid Use on Postoperative Mobility Recovery and Patient-Reported Outcomes: A Propensity-Matched Study.

Background: Opioid use prior to total joint arthroplasty may be associated with poorer postoperative outcomes. However, few studies have reported the impact on postoperative recovery of mobility. We hypothesized that chronic opioid users would demonstrate impaired objective and subjective mobility recovery compared to nonusers.

A Retrospective Study on the Feasibility of Using Low-burden Patient-reported Pain Scores to Track Recovery and Outcomes After Total Joint Replacement.

Background: Patients undergo total joint arthroplasty to improve function and resolve pain. Patient-reported outcome measures (PROMs) are often sought to determine the success of total joint arthroplasty but are time-consuming and patient response rates are often low. This study sought to determine whether pain numeric rating scores (NRSs) were associated with PROMs and objective mobility outcomes.

Is There a Change in Anxiety and Depression Following Total Knee Arthroplasty?

Background: The primary purpose of this study was to investigate whether anxiety and depression change following total knee arthroplasty (TKA). A secondary objective was to explore the association between preoperative variables and changes in anxiety and depression.

Methods: This was a prospective, multicenter, cohort study.

Despite Greater Improvement in Pain and Function Among Obese Patients Shortly After Total Knee Arthroplasty, There is No Difference in Patient-Reported Outcomes and Satisfaction Between Body Mass Index Classes at 1 Year Postoperatively.

Background: Although obesity may be associated with an increased risk of perioperative and postoperative complications after total knee arthroplasty (TKA), body mass index (BMI) cutoffs for TKA patient selection remain a controversial topic. This study aimed to investigate patient-reported outcomes, satisfaction, and pain among BMI classes at 3 months and 1 year following TKA.

Methods: A total of 2,365 patients were categorized into Centers for Disease Control BMI classes according to preoperative values.

Completion of Patient-Reported Outcome Measures Improved With Use of a Mobile Application in Arthroplasty Patients: Results From a Randomized Controlled Trial.

Background: The collection of patient-reported outcome measures (PROMs) has historically been reported as costly and time-consuming, with low compliance rates that may impact reimbursement. Little research has reported the effects of mobile applications to support PROMs collection following arthroplasty.

Methods: Secondary analysis of data from a multicenter randomized controlled trial was performed.

Delayed Recovery Following Total Knee Arthroplasty Identified by Remote Monitoring With Tibial Extension Sensors.

Remote monitoring of patient activity following total knee arthroplasty has grown in popularity over the past decade. Recent technological advances have allowed for implantation of accelerometry devices within the tibial stem for remote monitoring of mobility postoperatively. Remote monitoring is suggested to allow for intervention in the case of events that may occur outside of regular follow-up appointments or traditional patient questionnaires.

Adjunct fixation in upper extremity long bone fracture plating.

Purpose: A variety of adjunct fixation methods to supplement primary plate and screw constructs are available. There are no large clinical series of these techniques in the upper extremity. The purpose of this study was to review patients with upper extremity fractures that underwent primary plating with adjunct fixation.

Early post-operative walking bouts are associated with improved gait speed and symmetry at 90 days.

Introduction: There is a paucity of literature on optimal patterns of daily walking following joint arthroplasty, which are now evaluated with consumer technologies like smartphones, and can enhance our understanding of post-operative mobility. When smartphone-recorded, daily walking patterns are captured, qualities of gait-recovery such as gait speed or symmetry can be analyzed in real-world environments.

Research Question: Are the daily distribution of walking bouts in the early post-operative period associated with 90-day gait quality measures following hip and knee arthroplasty?

Methods: Gait data was collected passively using a smartphone-based care management platform in patients undergoing hip and knee arthroplasty.

An orthopaedic intelligence application successfully integrates data from a smartphone-based care management platform and a robotic knee system using a commercial database.

Purpose: To evaluate the feasibility of using a smartphone-based care management platform (sbCMP) and robotic-assisted total knee arthroplasty (raTKA) to collect data throughout the episode-of-care and assess if intra-operative measures of soft tissue laxity in raTKA were associated with post-operative outcomes.

Methods: A secondary data analysis of 131 patients in a commercial database who underwent raTKA was performed. Pre-operative through six week post-operative step counts and KOOS JR scores were collected and cross-referenced with intra-operative laxity measures.

The Risk of Esophageal Food Impaction in Eosinophilic Esophagitis Patients: The Role of Clinical and Socioeconomic Factors.

Background: Eosinophilic esophagitis (EoE) patients present with dysphagia and often suffer from esophageal food impaction (EFI). EFI can lead to life-threatening perforation, and requires emergent endoscopic intervention. The aim of this study is to evaluate the risk factors for EFI in EoE patients.

Effects of acute pain medications on posttraumatic stress symptoms in early aftermath of trauma.

Posttraumatic stress symptoms (PTSS) develop as sequelae from traumatic injuries. Limited studies suggest that using opioids to reduce acute pain immediately after trauma may also reduce subsequent PTSS, but other pain medications rarely have been examined for preventing acute PTSS. The current study examined the effects of commonly used pain medications, opioid and nonsteroidal anti-inflammatory drugs (NSAIDs), on PTSS after acute traumatic injuries.

Initial Experience Using Magseed for Breast Lesion Localization Compared With Wire-Guided Localization: Analysis of Volume and Margin Clearance Rates.

Background: Detection of nonpalpable lesions requiring surgical intervention has increased during the past several decades. Techniques have evolved to help surgeons locate lesions in the operating room. Disadvantages of wire localization has led to the use of new approaches for surgical guidance.

Ninety-Day Readmission Rates in a Geriatric Hip Fracture Population, From a Bundled Care Payment Initiative Perspective.

Objective: To determine the incidence of hospital readmission in a geriatric hip fracture population within 90 days.

Methods: Analysis of patients ≥60 years of age presenting with a fragility fracture of the hip from a prospective geriatric hip fracture program registry was performed. Demographics, diagnoses, treatments, complications, hospital events, and readmission for any cause within 30 and 90 days were collected.

Gunshot Fracture of the Femoral Neck: Internal Fixation and Immediate Proximal Femoral Valgus Osteotomy: A Case Report.

Case: We report on a 22-year-old patient with a comminuted femoral neck fracture because of a low-velocity gunshot wound. Treatment consisted of reduction and internal fixation with a fixed angled blade plate and immediate valgus osteotomy. He went on to uneventful healing and an excellent clinical result.

Correction to: Mesenchymal stem cells in the treatment of severe COVID-19.

[This corrects the article DOI: 10.1186/s41231-021-00095-0.].

Does The Use of Ethyl Chloride Improve Patient-Reported Pain Scores With Negative Pressure Wound Therapy Dressing Changes? A Prospective, Randomized Controlled Trial.

Background: Negative pressure wound therapy (NPWT) is commonly used for surgical incisions and large wounds, particularly in the context of trauma. Research has shown that patients report that the most painful aspect of NPWT is related to foam dressing changes. This study aimed to determine whether topical use of the vapocoolant anesthetic ethyl chloride would impact patient-reported pain during these procedures.

Thrombosis, Bleeding, and the Observational Effect of Early Therapeutic Anticoagulation on Survival in Critically Ill Patients With COVID-19.

Background: Hypercoagulability may be a key mechanism of death in patients with coronavirus disease 2019 (COVID-19).

Objective: To evaluate the incidence of venous thromboembolism (VTE) and major bleeding in critically ill patients with COVID-19 and examine the observational effect of early therapeutic anticoagulation on survival.

Design: In a multicenter cohort study of 3239 critically ill adults with COVID-19, the incidence of VTE and major bleeding within 14 days after intensive care unit (ICU) admission was evaluated.