Living in immigrant communities does not impact total knee arthroplasty outcomes: experience from a high-volume center in the United States.

Background: Community characteristics such as poverty affect total knee arthroplasty (TKA) outcomes. However, it is unknown whether other community factors such as immigrant proportion (IP) also affect outcomes. Our objective was to determine the association of neighborhood IP on preoperative (pre-op) and 2-year postoperative (post-op) Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function after elective TKA.

Disparities in Total Hip Arthroplasty Outcomes: Census Tract Data Show Interactions Between Race and Community Deprivation.

Introduction: Socioeconomic factors such as poverty may mediate racial disparities in health outcomes after total hip arthroplasty (THA) and confound analyses of differences between blacks and whites.

Methods: Using a large institutional THA registry, we built models incorporating individual and census tract data and analyzed interactions between race and percent of population with Medicaid coverage and its association with 2-year patient-reported outcomes.

Results: Black patients undergoing THA had worse baseline and 2-year pain and function scores compared with whites.

Does my patient have a pulmonary embolism? The Wells vs. PISA 2 rule in orthopedic patients.

The diagnosis of venous thromboembolism is difficult in the postoperative setting because signs such as hypoxemia, leg pain, and swelling are so common. CTPA can also detect subsegmental PE (SSPE), of which the clinical significance has been widely debated. Clinical decision rules (CDR), such as the Wells and PISA 2, have been developed to identify symptomatic patients at low risk for PE who could forgo imaging.

Does Education Level Mitigate the Effect of Poverty on Total Knee Arthroplasty Outcomes?

Objective: Total knee arthroplasty (TKA) outcomes are worse for patients from poor neighborhoods, but whether education mitigates the effect of poverty is not known. We assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function.

Methods: Patient-level variables from an institutional registry were linked to US Census Bureau data (census tract [CT] level).

Clinical Decision Rules for Pulmonary Embolism in Hospitalized Patients: A Systematic Literature Review and Meta-analysis.

 Clinical decision rules (CDRs) for pulmonary embolism (PE) have been validated in outpatients, but their performance in hospitalized patients is not well characterized.  The goal of this systematic literature review was to assess the performance of CDRs for PE in hospitalized patients.  We performed a structured literature search using Medline, EMBASE and the Cochrane library for articles published on or before January 18, 2017.