Mini-Navigation Utilization in THA Results in Shorter Length of Stay, Increased Home Discharge, and Higher Physical Therapy Mobilization Scores Compared to THA Without Navigation.

Background: As volume of total hip arthroplasty (THA) continues to increase, the utilization and availability of in-traoperative advanced technologies to arthroplasty surgeons continues to rise as well. Our primary goal was to determine whether the use of a mini navigation technology extended operative times and secondarily if it affected postoperative outcomes following elective THA.

Methods: A single-institution total joint arthroplasty da-tabase was utilized to identify adult patients who underwent elective THA from 2017 to 2019.

Cement Burn of the Skin Following Total Knee Arthroplasty Case Report and Review of the Literature.

Introduction: Cement burns following arthroplasty pro-cedures are a rare but serious complication. To the authors' knowledge, this report is the first of its kind in total knee arthroplasty.

Case: A 61-year-old female underwent an otherwise rou-tine left total knee arthroplasty.

Impact of Admission Source on Shoulder Arthroplasty.

Background: The purpose of this study was to determine the relationship between admission source and postoperative length of stay (LOS), index admission hospital charges, and discharge disposition, in patients undergoing shoulder arthroplasty.

Methods: The New York Statewide Planning and Research Cooperative System (SPARCS) was used to identify all patients that underwent elective shoulder arthroplasty from 1994 through 2015. Patients were grouped into institutionalized (INS) versus non-institutionalized (n-INS) groups based on admission source.

The State of Meniscal Allograft Transplantation in New York Over the Last Decade.

Background: The purpose of this study was to evaluate for changes in the incidence of arthroscopic meniscal procedures, especially meniscal allograft transplantation (MAT) in New York State (NYS) between 2005 to 2014.

Methods: The New York Statewide Planning and Research Cooperative Systems (SPARCS) database was queried from 2005 through 2014 to identify patients undergoing meniscetomies, meniscal repairs, and MAT. Patients were followed longitudinally to determine the incidence of subsequent ipsilateral knee procedures.

The Effects of Patient Point of Entry and Medicaid Status on Postoperative Opioid Consumption and Pain After Primary Total Hip Arthroplasty.

Introduction: Medicaid expansion has allowed more patients to undergo total hip arthroplasty (THA). Given the continued focus on the opioid epidemic, we sought to determine whether patients with Medicaid insurance differed in their postoperative pain and narcotic requirements compared with privately or Medicare-insured patients.

Methods: A single-institution database was used to identify adult patients who underwent elective THA between 2016 and 2019.

Payments, Policy, Patients, and Practice Evolution and Impact of Reimbursements in Total Joint Arthroplasty.

Current trajectories are set to create a large gap between total joint arthroplasty (TJA) supply and demand. Economics dictates that when the demand of consumers (TJA patients) exceeds supply (surgeons performing TJA), a new equilibrium should ideally be established at a higher price point. However, in TJA, the price is set by the government and, therefore, not subject to traditional economic models.

History, indications, and advantages of orthopaedic operating room tables: a review.

Although surgical procedures have been occurring as early at 6500 BC, the modern sense of the operating room (OR) did not exist until more recently. As aseptic techniques and surgical procedures began to evolve, so too did the OR table. The OR table began to transition from a static, wooden table to a dynamic table with the ability to position patients for a variety of procedures.

Discontinuation of the liposomal delivery of bupivacaine has no effect on pain management after primary total knee arthroplasty : no effect on pain scores, opioid consumption, or functional status.

Aims: Liposomal bupivacaine (LB) as part of a periarticular injection protocol continues to be a highly debated topic in total knee arthroplasty (TKA). We evaluated the effect of discontinuing the use of LB in a periarticular protocol on immediate postoperative pain scores, opioid consumption, and objective functional outcomes.

Methods: On 1 July 2019, we discontinued the use of intraoperative LB as part of a periarticular injection protocol.

Total knee arthroplasty is associated with greater immediate post-surgical pain and opioid use than total hip arthroplasty.

Background: As greater emphasis is being placed on opioid reduction strategies and implementation of multimodal analgesia, we sought to determine whether immediate post-surgical opioid consumption was different between THA and TKA.

Methods: A single-institution total joint arthroplasty database was used to identify patients who underwent elective THA and TKA from 2016 to July 2019. Baseline demographic data, operative time (defined by incision time), and American Society of Anesthesiologist (ASA) class were collected.

Learning curve for active robotic total knee arthroplasty.

Purpose: Total Knee Arthroplasty (TKA) procedures incorporate technology in an attempt to improve outcomes. The Active Robot (ARo) performs a TKA with automated resections of the tibia and femur in efforts to optimize bone cuts. Evaluating the Learning Curve (LC) is essential with a novel tool.

Differences in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores for a Single Surgeon Comparing Two Institutions: An Unfair Reimbursement Metric.

Background: Emphasis on value-based purchasing links physician financial remuneration to patient-derived outcome scores. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys aim to provide a uniform comparison tool. Of the 22 different survey questions, only 3 (13.

Revision total hip arthroplasty is associated with significantly higher opioid consumption as compared to primary total hip arthroplasty in the acute postoperative period.

Background: There are currently a lack of investigations that characterised narcotic utilisation following revision total hip arthroplasty (THA). We sought to determine if immediate post-surgical opioid use was different between revision THA and primary THA.

Methods: A single institution total joint arthroplasty database was used to identify adult patients who underwent revision THA or primary THA from 2016 to 2019.

The Impact of Arthroplasty Fellowship Training on Total Joint Arthroplasty: Comparison of Peri-Operative Metrics between Fellowship-Trained Surgeons and Non-Fellowship-Trained Surgeons.

Background: We sought to identify differences between total joint arthroplasties (TJAs) performed by adult reconstruction fellowship-trained surgeons (FT) than non-fellowship-trained surgeons (NFT).

Methods: A single-institution database was utilized to identify patients who underwent elective TJA between 2016 and 2019.

Results: In total, 16,882 TJAs were identified: 9111 total hip arthroplasties (THAs) and 7771 total knee arthroplasties (TKAs).

Differences in Pain, Opioid Use, and Function Following Unicompartmental Knee Arthroplasty compared to Total Knee Arthroplasty.

Background: We sought to determine if immediate postsurgical pain, opioid use, and clinical function differed between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA).

Methods: A single-institution database was utilized to identify patients who underwent elective total joint arthroplasty between 2016 and 2019.

Results: In total, 6616 patients were identified: 98.

Revision Total Knee Arthroplasty Is Associated With Significantly Higher Opioid Consumption as Compared With Primary Total Knee Arthroplasty in the Acute Postoperative Period.

Background: There is a scarcity of studies investigating narcotic use after revision total knee arthroplasty (TKA). We compared immediate postsurgical narcotic consumption after revision TKA and primary TKA.

Methods: A single-institution database was used to identify patients who underwent revision TKA or primary TKA between 2016 and 2019.

Utilization of a Novel Opioid-Sparing Protocol in Primary Total Hip Arthroplasty Results in Reduced Opiate Consumption and Improved Functional Status.

Background: Total hip arthroplasty (THA) candidates have historically received high doses of opioids within the perioperative period; however, the amounts are being continually reduced as awareness of opioid abuse spreads. Here we seek to evaluate the effectiveness of a novel opiate-sparing protocol (OSP) for primary THAs in reducing opiate administrations, while maintaining similar levels of pain control and postoperative function.

Methods: All patients undergoing primary THA between January 1, 2019 and June 30, 2019 were placed under a novel OSP.

Total Joint Arthroplasty Is Associated With a Decreased Risk of Traumatic Falls: An Analysis of 499,094 Cases.

Introduction: The rate of traumatic falls in the aging cohort is estimated to increase across the United States. We sought to determine whether patients with lower extremity osteoarthritis (OA) who underwent total joint arthroplasty (TJA) had a reduced risk of falling compared with those with OA who did not undergo TJA.

Methods: The New York Statewide Planning and Research Cooperative System database was queried from 2000 to 2015 to identify 499,094 cases with primary diagnosis of hip or knee OA.

Young age, female gender, Caucasian race, and workers' compensation claim are risk factors for reoperation following arthroscopic ACL reconstruction.

Purpose: Given the increasing incidence of arthroscopic anterior cruciate ligament reconstruction (ACLR), mid- to long-term rates of reoperations were investigated on the ipsilateral knee following ACLR.

Methods: New York Statewide Planning and Research Cooperative Systems (SPARCS) database was queried from 2003 to 2012 to identify patients with a primary ICD-9 diagnosis for ACL tear and concomitant CPT code for ACLR. Patients were longitudinally followed for at least 2 years to determine incidence and nature of subsequent ipsilateral knee procedures.

Preoperative Bariatric Surgery Utilization Is Associated With Increased 90-day Postoperative Complication Rates After Total Joint Arthroplasty.

Background: This study evaluates the incidence of bariatric surgery (BS) before total joint arthroplasty (TJA) in New York State and compares patient comorbidities and 90-day postoperative complications of patients with and without BS before TJA.

Methods: The NY Statewide Planning and Research Cooperative System database between 2005 and 2014 was reviewed and 343,710 patients with TJA were identified. Patients were stratified into the following three cohorts: group 1 (patients who underwent BS < 2 years before TJA [N = 1,478]); group 2 (obese patients without preoperative BS [N = 60,259]); and group 3 (nonobese patients without preoperative BS [N = 281,973]).

Variations in Hip Fracture Baseline Patient Demographics and Comorbidities Repercussions on Bundled Payment Reimbursement Models.

Background: We sought to investigate how patient demographics and baseline comorbidities varied between hip fracture and total joint arthroplasty patients across New York State and to determine implications of differences within the contexts of the bundled payment system.

Methods: All Medicare hip and knee arthroplasty and hip fracture cases in the New York State SPARCS database between 2004 and 2014 were identified. Hospitals were categorized geographically into Metropolitan Statistical Areas (MSAs) to determine case distribution.

The Association Between Concomitant Ulnar Nerve Compression at the Elbow and Carpal Tunnel Syndrome.

Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014.

Cryopreserved bone allograft for the treatment of shoulder instability with glenoid defect.

The purpose of this study was to examine outcomes after cryopreserved tri-cortical iliac crest allograft reconstruction for glenoid bone loss in patients with shoulder instability. 10 patients completed the required assessments at a mean follow up of 4.5 years.

Treatment for Symptomatic SLAP Tears in Middle-Aged Patients Comparing Repair, Biceps Tenodesis, and Nonoperative Approaches: A Cost-Effectiveness Analysis.

Purpose: To evaluate the cost-effectiveness of nonoperative management, primary SLAP repair, and primary biceps tenodesis for the treatment of symptomatic isolated type II SLAP tear.

Methods: A microsimulation Markov model was constructed to compare 3 strategies for middle-aged patients with symptomatic type II SLAP tears: SLAP repair, biceps tenodesis, or nonoperative management. A failed 6-month trial of nonoperative treatment was assumed.