Publications by authors named "Sambandam S"

Introduction: Manipulation under anesthesia (MUA) is a standard and effective treatment to correct stiffness and improve range of motion (ROM) following total knee arthroplasty (TKA). Delayed MUA has been associated with increased rates of revision surgeries and infections. Early MUA has been shown to double the mean gain in flexion compared to delayed interventions.

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Exposure to household air pollution has been linked to adverse health outcomes among women aged 40-79. Little is known about how shifting from biomass cooking to a cleaner fuel like liquefied petroleum gas (LPG) could impact exposures for this population. We report 24-h exposures to particulate matter (PM), black carbon (BC), and carbon monoxide (CO) among women aged 40 to <80 years participating in the Household Air Pollution Intervention Network trial.

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This study investigated the impact of recent syphilis infection on postoperative outcomes following total knee arthroplasty (TKA). We hypothesized that patients with a documented history of syphilis infection would experience a higher rate of postoperative complications compared to those without such a history. We conducted a retrospective cohort analysis using a national insurance claims database.

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Introduction: While it is generally accepted that most patients undergoing joint replacement do not require a cardiac stress test, individuals with existing or potential cardiac conditions may be at an increased risk of perioperative complications following primary total knee arthroplasty (TKA). This study aims to analyze the immediate postoperative outcomes of patients who underwent primary TKA, comparing those who had a cardiac stress test with no abnormal results and subsequent cardiac interventions to those who did not undergo a stress test.

Materials And Methods: This retrospective cohort study utilized the TriNetX Research Network.

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Article Synopsis
  • Total knee arthroplasty (TKA) can alleviate knee pain, but patients with peripheral artery disease (PAD) face increased risks during and after the procedure.
  • The study analyzed data from nearly 246,000 TKA patients, comparing those with PAD to those without, revealing that patients with PAD had higher rates of major complications, including infections and even death.
  • These results highlight the need for improved management strategies for patients with PAD undergoing TKA to enhance their surgical outcomes and reduce risks.
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  • Total hip arthroplasty (THA) is effective for hip arthritis, but its outcomes for patients with Down's syndrome (DS) have been under-researched; this study analyzed data from over 367,000 patients to assess THA outcomes in DS patients compared to a control group.
  • The findings showed that DS patients were younger, had different health profiles (lower smoking/diabetes rates), and experienced higher morbidity rates, including a significantly increased mortality rate (17-fold) post-surgery.
  • Postoperative complications were notably higher in DS patients, with increased occurrences of anemia, pneumonia, pulmonary embolism, and periprosthetic issues, indicating a need for comprehensive risk assessment in surgical discussions for this group. *
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Background: The knee joint remains the most affected joint in extra-intestinal manifestations of Crohn's disease (CD). Given the increasing prevalence of CD and overall demand for total knee arthroplasty (TKA), it is likely that an increasing number of patients with CD will require TKA. The purpose of this study was to assess the inpatient postoperative complication in patients with CD undergoing TKA.

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Purpose: Limited literature exists substantiating benefits of robotic arm-assisted total knee arthroplasty (raTKA) over conventional total knee arthroplasty (cTKA). This study compared postoperative pain, complications, and costs between patients undergoing raTKA and cTKA using large, propensity score-matched cohorts. We hypothesize that the raTKA cohort will be associated with lower pain, lower anemia, and similar cost and other complications.

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The literature is inconclusive regarding the potential complications of tranexamic acid (TXA), an antifibrinolytic drug, for total hip arthroplasty (THA). The purpose of this study is to compare complication rates and patient outcomes between THA patients administered TXA vs. THA patients not administered TXA.

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Introduction: The number of reverse shoulder arthroplasties (RSA) performed each year is growing rapidly, especially in elderly patients and with expanded indications including geriatric proximal humerus fractures. As the elderly population grows and the number of RSA's annually continues to rise, there will be a proportionate number of adverse events and mortality. However, the rate of early mortality has consistently shown to be less than 1%, so a large-scale analysis of possible risk factors for post-operative mortality is warranted.

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Introduction The inpatient postoperative outcomes of patients with colostomies following primary total knee arthroplasty (TKA) have not been well studied in the literature. The purpose of this study was to analyze how colostomy impacts the immediate postoperative outcomes of TKA. Our null hypothesis is that after correcting for common variables, a colostomy does not predispose patients undergoing TKA to surgical site infections (SSIs) and periprosthetic infections.

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Objectives: Reverse total shoulder arthroplasty (RTSA) continues to increase in popularity as a surgical operation in the United States. As indications for this procedure expand, more attention is needed to evaluate perioperative risk factors and patient characteristics. Postoperative anemia requiring blood transfusion (BT) is a well-documented risk factor for increased in-house mortality although little has been studied on the relationship between RTSA and postoperative BT.

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Objectives: The rising popularity of reverse total shoulder arthroplasties (RTSA) demands attention to its growing costs on the healthcare system, especially with the implementation of bundled payments. Charges associated with patients' inpatient stays can be mitigated with a better understanding of the drivers of cost following RTSA. In this study, we evaluate potential pre-operative and post-operative factors associated with higher inpatient costs following RTSA.

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Introduction: The annual utilization of reverse total shoulder arthroplasty (RTSA) and anatomic total shoulder arthroplasty (ATSA) has grown exponentially, in part due to the expanded indications of RTSA. This evolution in shoulder arthroplasty prompts the need to evaluate outcomes between ATSA and RTSA. However, many other studies comparing outcomes between ATSA and RTSA lacked a large nationally-represented sample, a matched cohort analysis, or both.

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Introduction: Studies investigating the link between mental health disorders and complications following total knee arthroplasty (TKA) have found worse outcomes in individuals with such disorders. Therefore, risk factors and outcomes following TKA in patients with schizophrenia should be better understood. This study aims to investigate cost and duration of hospital stay, inpatient complications, and mortality associated with TKA in patients with schizophrenia.

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Article Synopsis
  • - Early dislocation after total hip arthroplasty (THA) is uncommon but can lead to significant complications and increased healthcare costs; the study aimed to identify patient traits linked to higher dislocation rates.
  • - Researchers examined data from over 367,000 THA patients between 2016 and 2019, finding that those who dislocated were typically older, more likely to be female, and had specific conditions like SLE and Parkinson's disease.
  • - Patients with early dislocations experienced longer hospital stays (4.7 days) and higher costs (about $101,517) compared to those without dislocations, who stayed 2.3 days and incurred costs of about $66,388.
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Introduction: Discrepant data exists regarding the outcomes following total knee arthroplasty (TKA) with a prior anterior cruciate reconstruction (ACLR). The purpose of our study was to compare surgical and medical outcomes in the patients with prior ACLR undergoing TKAs compared to a matched control group of the patients who had undergone TKAs without prior ACLR. We hypothesized that the patients with prior ACLR would have inferior clinical outcomes.

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Introduction: Hip hemiarthroplasty (HHA) is one of the most common types of orthopedic surgery. With the prevalence and utilization of the surgery increasing year after year, this procedure is found to be associated with severe postoperative complications and eventually mortality. Thus, it is crucial to understand the factors that increase the risk of mortality following HHA.

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Article Synopsis
  • Residential biomass burning significantly contributes to black carbon (BC) exposure in rural communities, especially among pregnant women in low- and middle-income countries.
  • In a study involving 3103 pregnant women, those who received liquefied petroleum gas stoves showed much lower BC exposure (2.8 μg/m) compared to those using traditional biomass stoves (9.6 μg/m).
  • The study identified primary stove type as the strongest predictor of BC exposure, and highlights the need to consider various factors, such as kitchen location and adherence to stove use, to improve the efficacy of cookstove intervention trials.
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Purpose: Although a trend of an improved alignment with robotic total hip arthroplasty (THA) over conventional methods has surfaced from recent series, it is unknown whether these results translate into meaningful enhancements in postoperative outcomes. To address this lack in the literature, we compared the perioperative morbidity and mortality with robotic and conventional THA in a large national cohort of 367,894 patients. We hypothesized that no significant differences would exist in the outcomes between the two groups.

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Introduction: With a progressive rise in the number of total hip arthroplasties (THA) over the past decades, the proportion of patients sustaining peri-prosthetic fractures (PPF) has been substantially increasing. In this context, the need for clearly understanding the factors predisposing patients to PPF following THA and the impact of these adverse complications on the overall healthcare burden cannot be understated.

Materials And Methods: Based upon the Nationwide Inpatient Sample (NIS) database, the patients who underwent THA in the United States between 2016 and2019 (with ICD-10 CMP code) were identified.

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Introduction: With innovations in transplant medicine and longer life expectancies in solid organ transplant (SOT) recipients, the incidence of shoulder arthroplasty is predictably rising in this population. Reverse shoulder arthroplasty (RSA) has become increasingly popular due to advances in prosthetic design with expanded indications. While previous studies have examined shoulder arthroplasty in SOT patients, information specifically related to RSA patients is largely unexplored.

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Background: Periprosthetic fractures after total knee arthroplasty (TKA) are a challenging problem due to complex fracture patterns, poor bone quality, and a high-risk patient population. Treatment of both periprosthetic fractures and aseptic complications can include revision TKA. In this study, we compared systemic and orthopaedic complications following periprosthetic fracture associated revision TKA to aseptic revision TKA.

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Background: Comorbid cardiovascular diseases have been associated with poor outcomes in total knee arthroplasty (TKA); however, our understanding of TKA with prior cardiac treatment procedures has largely been undocumented. In this study, we examined TKA patients who had undergone different cardiac interventions that addressed their condition. The purpose was to characterize and compare outcomes for a growing patient population not yet analyzed.

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Introduction: This study elaborates on previous research to compare length of stay, complication rates, and total cost between patients undergoing robotic assisted total knee arthroplasty (rTKA) and conventional total knee arthroplasty (cTKA). We hypothesized that patients undergoing rTKA would have reduced length of stay, lower complication rates, improved perioperative outcomes, and higher total healthcare costs than those undergoing cTKA.

Methods: Data were collected from the National Inpatient Sample Database Healthcare Cost and Utilization Project between the years 2016-2019.

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