Publications by authors named "Simcox T"

Article Synopsis
  • A study compared the clinical outcomes of lateralized reverse shoulder arthroplasty (RSA) and RSA with latissimus dorsi transfer (LDT) in patients with poor preoperative external rotation (ER).
  • The analysis showed that lateralized RSA alone led to better postoperative ER and Constant scores while having fewer complications compared to RSA with LDT.
  • Both procedures are effective for restoring ER, but lateralized RSA is preferred due to its lower risk of nerve injuries and dislocations, although LDT may still be suitable for select patients with severe ER loss.
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Article Synopsis
  • The study compared functional outcomes and survival rates in non-smokers, former smokers, and current smokers who underwent anatomical total shoulder arthroplasty (aTSA).
  • It analyzed data from 428 patients, noting that non-smokers had significantly better functional scores, strength, and range of motion compared to both former and current smokers.
  • The results indicate that smoking negatively impacts recovery and revision-free survival after shoulder surgery, with non-smokers experiencing the best outcomes.
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  • The study analyzed how smoking status (current, former, non-smokers) affects pain, function, and complications in patients undergoing reverse total shoulder arthroplasty (rTSA).
  • A total of 676 patients were included, and results showed that current smokers had worse functional outcomes compared to former smokers and non-smokers after 2-4 years.
  • However, there were no significant differences in complication rates or the need for revision surgery between the different smoking cohorts.
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Article Synopsis
  • * Researchers reviewed data on 1,148 shoulder surgeries, correlating Area Deprivation Index (ADI) scores from zip codes with patients' functional outcomes before and after surgery.
  • * Results indicated a weak negative correlation between higher ADI (representing greater area deprivation) and poorer preoperative and postoperative function; however, there was no significant difference in outcome achievement among socioeconomic groups for anatomic TSA.
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Background: Stilting is a novel technique used in reverse shoulder arthroplasty (RSA) in patients with significant glenoid bone loss. This technique utilizes peripheral locking screws placed behind an unseated portion of the baseplate to transmit forces from the baseplate to the cortical surface of the glenoid, without the need for bone grafting. The stilted screw, once locked, provides a fixed angle point of support for this unseated aspect of a baseplate.

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Article Synopsis
  • Elbow medial ulnar collateral ligament (mUCL) injuries are rising, leading to more reconstruction surgeries (UCLR), with a focus on graft types, surgical techniques, and complications from those methods.
  • The research reviewed 47 articles on 6,671 patients, mostly male (98%), averaging 21 years old, with a majority (92%) receiving autografts, primarily from the palmaris longus.
  • The figure-of-8 technique was the most common (68%), with modified Jobe being the leading method (37%), while 14% of patients reported complications.
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Background: This study examined trends in inpatient charges for primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA), hemiarthroplasty (HA), and revision total shoulder arthroplasty (revTSA) over the past decade.

Methods: The New York Statewide Planning and Research Cooperative System was queried for patients undergoing primary aTSA, rTSA, HA, and revTSA from 2010 to 2020 using International Classification of Diseases procedure codes. The primary outcome measured was total charges per encounter.

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Background: The purpose of this study was to investigate the impact of high body mass index on the 1-year minimal outcome following arthroscopic shoulder stabilization.

Methods: Patients who underwent arthroscopic Bankart repair (ABR) between 2017 and 2021 were identified and assigned to 1 of 3 cohorts based on their preoperative body mass index: normal (18-25), overweight (25-30), and obese (>30). The primary outcomes assessed were postoperative shoulder instability and revision rates.

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Background: The incidence of proximal humerus fractures (PHF) is continuing to rise due to shifts towards a more aged population as well as advancements in surgical treatment options. The purpose of this study is to examine and compare trends in the treatment of PHFs (nonoperative vs. operative; different surgical treatments) across different age groups over the last decade (2010-2020).

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Background: Parkinson disease (PD) is an established risk factor for higher rates of complications and revision surgery following shoulder arthroplasty, yet the economic burden of PD remains to be elucidated. The purpose of this study is to compare rates of complication and revisions as well as inpatient charges for shoulder arthroplasty procedures between PD and non-PD patients using an all-payer statewide database.

Methods: Patients undergoing primary shoulder arthroplasty from 2010 to 2020 were identified from the New York (NY) Statewide Planning and Research Cooperative System (SPARCS) database.

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Article Synopsis
  • Selective dual mobility (DM) implants in total hip arthroplasty (THA) show no significant difference in 90-day readmission or reoperation rates compared to fixed-bearing (FB) implants.
  • A review of 14,818 THA procedures from 2011 to 2021 indicated that surgeon-specific rates of DM usage varied widely but did not correlate with improved outcomes.
  • Other dislocation prevention methods may have overshadowed any advantages that selective DM use might offer in reducing complications.
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Hypothesis And Background: Although on-field performance metrics are useful in measuring overall success of ulnar collateral ligament (UCL) reconstruction (UCLR) in professional baseball pitchers, they may not comprehensively quantify athletic performance after returning to playing in the league. To utilize fantasy baseball score (FBS) as a novel and objective outcome to assess the quality of return to play in major league baseball (MLB) pitchers who went back to professional pitching after UCLR.

Methods: This is a retrospective observational cohort study of 216 established MLB pitchers who underwent UCLR while in the MLB between the years 1974 and 2018.

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Background: Different approaches for total hip arthroplasty (THA) may offer advantages in regard to achieving same-day-discharge (SDD) success.

Methods: We retrospectively identified patients aged ≥ 18 years who underwent elective primary THA from 2015 to 2020 who were formally enrolled in a single institution's SDD program. A total of 1,127 and 207 patients underwent THA via direct anterior approach and posterior approach, respectively, were included.

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Article Synopsis
  • The study assesses the use and outcomes of technology-assisted total knee arthroplasty (TA-TKA) compared to traditional unassisted total knee arthroplasty (U-TKA) using data from 402,284 patients between 2010 and 2018.* -
  • TA-TKA was performed in only 2.6% of cases and was linked to shorter hospital stays, lower rates of major complications and transfusions, and higher discharge rates to home, but did not significantly impact operative times or rates of reoperation and readmission.* -
  • Overall, while TA-TKA shows some clinical advantages, its adoption in orthopedic practice remains limited.*
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Background: Same-day discharge (SDD) total joint arthroplasty (TJA) programs often have stringent selection criteria. Some patients deemed ineligible may nonetheless be discharged on the day of surgery. This study compares the outcomes between patients enrolled in our SDD TJA program who were SDD to those who did not participate in the program but were also SDD.

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Introduction: Although technology-assisted total hip arthroplasty (TA-THA) may improve implant positioning, it remains unknown whether TA-THA confers improved clinical outcomes. We sought to examine national TA-THA utilization trends and compare clinical outcomes between TA-THA and unassisted THA (U-THA).

Methods: Patients who underwent primary, elective THA from 2010 to 2018 were identified using the American College of Surgeons National Surgical Quality Improvement Program database.

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Background: This study aims to investigate whether compensation is equitable among the most commonly performed orthopedic hand surgeries and when compared with general orthopedic procedures.

Methods: The National Surgical Quality Improvement Program database was queried for all orthopedic procedures, from 2016 to 2018, performed more than 150 times using Current Procedural Terminology (CPT) codes. Physician work relative value unit (wRVU) data were obtained from the 2020 US Centers for Medicare and Medicaid Services fee schedule.

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Purpose: To assess whether reimbursement for orthopaedic sports procedures adequately compensates for operative time and surgical complexity.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for all orthopedic sports medicine procedures performed greater than 150 times from 2016 to 2018 with regard to operative time, preoperative risk factors, morbidity, and mortality data. Physician work relative value units (wRVU) data were obtained from the 2020 Centers for Medicare & Medicaid Services (CMS) fee schedule.

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Background: The physician work relative value unit (wRVU) scale is the primary determinant of compensation. Operative time, technical skill, effort, and surgical complexity contribute to wRVU allocation. The aim of this study was to identify the relationship between these factors and reimbursement for trauma procedures.

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Background: Tip-apex distance (TAD) of greater than 25 mm increases the risk of cephalomedullary nail (CMN) cutout for trochanteric hip fractures. The Stryker ADAPT navigation system provides intraoperative feedback to guide implant positioning. This study compares lag screw positioning using the ADAPT to conventional methods and investigates if the use of ADAPT impacts operating room efficiency.

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 The etiology of carpal tunnel syndrome (CTS) is multifactorial. Static mechanical characteristics of CTS have been described, but dynamic (muscular) parameters remain obscure. We believe that musculature overlying the transverse carpal ligament may have an effect on carpal tunnel pressure and may explain the prevalence of CTS in manual workers.

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Background: The use of technology such as navigation and robotic systems may improve the accuracy of component positioning in total hip arthroplasty (THA), but its impact on patient-reported outcome measures (PROMs) remains unclear. This study aims to elucidate the association between the use of intraoperative technology and PROMs in patients who underwent primary THA.

Methods: We retrospectively reviewed a consecutive series of patients who underwent primary THA between 2016 and 2020 and answered PROM questionnaires.

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Background: An adult reconstruction (AR) fellowship is designed to provide advanced training for a broad range of primary reconstructive and complex knee revision surgeries. This study aims to identify outcome differences between primary total knee arthroplasty (TKA) performed by AR fellowship-trained surgeons and non-AR (NAR) fellowship-trained surgeons.

Material And Methods: We retrospectively reviewed 7415 patients who underwent primary TKA from 2016 to 2020.

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Introduction: Obesity has been associated with poorer outcomes following total knee arthroplasty (TKA); however, data remain sparse on its impact on patients' joint awareness following surgery. This study aims to investigate the impact of body mass index (BMI) on improvement in outcomes following TKA as assessed by the Forgotten Joint Score-12 (FJS-12).

Materials And Methods: We retrospectively reviewed 1075 patients who underwent primary TKA from 2017 to 2020 with available postoperative FJS-12 scores.

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