Caring for the surgically anxious patient: a review of the interventions and a guide to optimizing surgical outcomes.

Background: Preoperative surgical anxiety is an unpleasant and common reaction exhibited by patients who are scheduled for surgical procedures. Beyond emotional effects on the patient, it can also have negative repercussions on the surgery including longer hospital stays and poorer outcomes. Given the widespread impacts of preoperative anxiety, it is critical for surgeons to gain a better understanding of how to identify and reduce surgical anxiety in their patients.

Biomaterial hypersensitivity: is it real? Supportive evidence and approach considerations for metal allergic patients following total knee arthroplasty.

The prospect of biomaterial hypersensitivity developing in response to joint implant materials was first presented more than 30 years ago. Many studies have established probable causation between first-generation metal-on-metal hip implants and hypersensitivity reactions. In a limited patient population, implant failure may ultimately be related to metal hypersensitivity.

Treating periprosthetic joint infections as biofilms: key diagnosis and management strategies.

Considerable evidence suggests that microbial biofilms play an important role in periprosthetic joint infection (PJI) pathogenesis. Compared to free-floating planktonic bacteria, biofilm bacteria are more difficult to culture and possess additional immune-evasive and antibiotic resistance mechanisms, making infections harder to detect and eradicate. This article reviews cutting-edge advances in biofilm-associated infection diagnosis and treatment in the context of current PJI guidelines and highlights emerging technologies that may improve the efficacy and reduce costs associated with PJI.

Impact of diabetes on early postoperative outcomes after total elbow arthroplasty.

Background: Diabetes is known to be associated with poorer perioperative outcomes after hip, knee, and shoulder arthroplasty. This study is the first, to our knowledge, to examine the association between diabetes and in-hospital complications, length of stay, non-homebound discharge, transfusion risk, and total charges after total elbow arthroplasty (TEA).

Methods: By use of International Classification of Diseases, Ninth Revision codes, epidemiologic as well as patient and hospital demographic data for all patients undergoing TEA were extracted from the Nationwide Inpatient Sample from 2007 through 2011.