Head and Neck Cutaneous Soft-Tissue Sarcoma Demonstrate Sex and Racial/Ethnic Disparities in Incidence and Socioeconomic Disparities in Survival.

Background: Cutaneous soft-tissue sarcoma (CSTS) of the head and neck are rare and are known to have aggressive clinical course. The current study utilizes a population-based registry in the U.S.

The Use of Carbon Fiber Implants for Impending or Existing Pathologic Fractures.

Objectives: To evaluate the utility and complications of using carbon fiber implants (CFIs) compared with standard titanium alloy (TI) intramedullary implants for stabilization of impending or existing pathologic fractures.

Design: Retrospective comparison.

Patients/participants: Ninety-four patients undergoing intramedullary fixation of 100 impending or existing pathologic fractures between 2014-2019 were identified for inclusion.

Impact of local treatment modality on overall- and disease-specific survival for nonmetastatic pelvic and sacral Ewing sarcoma.

Purpose: The ideal local treatment modality for pelvic and sacral Ewing sarcoma (EWS) is controversial.

Methods: We present the data from the American College of Surgeon's National Cancer Database (NCDB) and the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) database to investigate the impact of local treatment modalities on survival for nonmetastatic pelvic and sacral Ewing sarcoma. Local treatment includes "surgery," "radiation," and a combination of "surgery and radiation.

Outcomes and complications after different surgical techniques for the treatment of chronic distal biceps tendon ruptures: a systematic review and quantitative synthesis.

Hypothesis: The purpose of this study was to perform a systematic review of the available literature evaluating surgical outcomes after chronic distal biceps tendon rupture. Surgical techniques, including primary repair, autograft reconstruction, and allograft reconstruction, were compared, as well as subjective and objective clinical outcomes and complication rates.

Methods: A systematic literature search of Level I-IV studies reporting outcomes of surgically treated chronic distal biceps tendon ruptures were performed via PubMed, Cochrane Collaboration, Science Direct, and Google Scholar databases.

COVID-19 modifications of offseason and preseason training for NFL athletes are associated with increased risk of regular season injuries.

Objectives: COVID-19 altered National Football League (NFL) player and team training during the 2020 offseason. All preseason games were cancelled resulting in absence of game play before the first week of the regular season. Thus, concerns exist regarding injury susceptibility of players during regular season games.

Quadriceps tendon autograft is an effective alternative graft for posterior cruciate ligament reconstruction in isolated or multiligament injuries: a systematic review.

Importance: High-grade posterior cruciate ligament (PCL) tears can be a significant cause of patient morbidity and knee instability. The graft of choice for operative repair remains controversial, although recently there has been increased interest in quadriceps tendon (QT) as an autologous graft option.

Objective: The purpose of this study was to perform a systematic review to assess reported clinical outcomes of PCL reconstructions using QT autografts.

Resident Level Involvement Affects Operative Time and Surgical Complications in Lower Extremity Fracture Care.

Objective: The purpose of this study is to evaluate the effect of resident participation on operative time and surgical complications in isolated lower extremity fracture care.

Setting: Patients who were treated at teaching hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program database.

Participants: A total of 2,488 patients who underwent surgical fixation of isolated hip fractures, femoral or tibial shaft fractures, and ankle fractures.

Elevated BMI increases concurrent pathology and operative time in adolescent ACL reconstruction.

Purpose: The purpose of this study was to (1) report on the incidence of concurrent surgical pathology at the time of adolescent ACL reconstruction, (2) evaluate patient risk factors for concurrent pathology, and (3) measure the effect of BMI on operating room (OR) time.

Methods: A retrospective analysis of the NSQIP database for the years 2005-2017 was conducted. Nine-hundred and seventeen patients 18 years of age and younger who underwent ACL reconstruction (ACLR) were identified using CPT code 29888 and patients undergoing surgery for multi-ligamentous knee injuries were excluded.

Combined Oral Contraceptive Use Increases the Risk of Venous Thromboembolism After Knee Arthroscopy and Anterior Cruciate Ligament Reconstruction: An Analysis of 64,165 Patients in the Truven Database.

Purpose: To use the Truven MarketScan database to (1) report the incidence of venous thromboembolism (VTE), including deep vein thromboses (DVTs) and pulmonary embolism (PE), in patients undergoing simple knee arthroscopy and anterior cruciate ligament (ACL) reconstruction, and (2) evaluate combined oral contraceptive (COCP) use as a potential risk factor for VTE in patients undergoing knee arthroscopy.

Methods: All female patients between the ages of 16 and 40 years undergoing knee arthroscopy and ACL reconstruction between 2010 and 2015 were identified in the MarketScan database. Patients were stratified by whether they had a documented pharmaceutical claim for COCP therapy, and the primary outcome was the risk of DVT and or PE within 90 postoperative days.

Obesity and risk for open reduction and internal fixation of syndesmotic injuries in the setting of concomitant ankle fractures.

Introduction: The association between obesity and the need for open reduction and surgical fixation of the syndesmosis in the setting of malleolar ankle fractures remains to be elucidated. Therefore, the primary objective of this study was to assess the relationship between obesity, ankle fracture complexity, and the need for open reduction and fixation of the syndesmosis.

Methods: A retrospective analysis of the NSQIP database was performed for patients undergoing surgical fixation of isolated, closed ankle fractures.

Fungal Periprosthetic Joint Infection: A Review of Demographics and Management.

Background: Periprosthetic joint infection (PJI) is one of the most feared complications of total joint arthroplasty (TJA). Although commonly the result of colonization by Staphylococcal species, a growing number of cases of PJI with fungal pathogens have been reported within the last decade. Although standard treatment with two-stage exchange mirrors that of bacterial PJI, the variability in virulence between fungal species makes for an unpredictable and challenging treatment course.

Increased Risk of Short-Term Complications and Venous Thromboembolism in Latarjet-Bristow Procedures Compared With Bankart Repairs.

Purpose: To (1) determine the rate of surgical complications and venous thromboembolism (VTE) in patients undergoing arthroscopic Bankart repair, open Bankart repair, or Latarjet-Bristow; and (2) assess potential risk factors for surgical complications and VTE in patients undergoing shoulder stabilization procedures.

Methods: The NSQIP database was used to identify patients undergoing isolated surgery for shoulder instability from 2005 to 2017. Demographic data were collected and compared.

Elevated BMI is associated with intra-articular comminution, prolonged operative time, and postoperative complications in distal radius fractures.

Introduction: Obesity continues to be a problem in the United States with greater than 35% of the adult population affected. Obesity influences fracture care as it affects impact forces, alters cellular pathways of healing, and is often associated with higher complication rates. Distal radius fractures are among the most common fracture patterns in the adult population.

Notable Variability in Opioid-prescribing Practices After Common Orthopaedic Procedures.

Introduction: The purpose of this study was to evaluate nationwide trends and regional variability in opioid prescriptions after common orthopaedic procedures.

Methods: A retrospective analysis of privately insured subjects from the MarketScan database between 2015 and 2016 was conducted. Median oral morphine equivalents and interquartile ranges were analyzed by region for the initial post-op prescriptions and 90-day total prescriptions for opioid-naive patients undergoing the following: carpal tunnel release; anterior cruciate ligament reconstruction; arthroscopic meniscectomy; bimalleolar ankle fracture open reduction and internal fixation; distal radius fracture open reduction and internal fixation; arthroscopic rotator cuff repair; single-level anterior cervical discectomy and fusion; and total shoulder, hip, and knee arthroplasties.

Notable Racial and Ethnic Disparities Persist in Lower Extremity Amputations for Critical Limb Ischemia and Infection.

Introduction: The purpose of this study is to investigate the current disparities for major lower extremity amputation in patients with critical limb ischemia (CLI) and infection.

Methods: A retrospective analysis of the National Surgical Quality Improvement Program's database for the years 2011 to 2017 was conducted. Multivariate models were used to isolate the effect of race and ethnicity on the likelihood of a below-knee or above-knee amputation (BKA and AKA, respectively) for CLI secondary to type 2 diabetes mellitus, atherosclerosis, peripheral vascular disease, chronic osteomyelitis, and deep soft-tissue infections.

The 5-Factor Modified Frailty Index Predicts Complications, Hospital Admission, and Mortality Following Arthroscopic Rotator Cuff Repair.

Introduction: The purpose of this study is to evaluate the utility of the modified frailty index-5 (mFI-5) as a predictor for postoperative complications in patients undergoing arthroscopic rotator cuff repair (RCR).

Methods: The National Surgical Quality Improvement Program database was queried for patients undergoing arthroscopic RCR between 2006 and 2016. The mFI-5, a 5-factor score comprising comorbid diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functional status limiting independence, was calculated for each patient.

Insulin-Dependence Predicts Surgical Complications and Hospital Admission following Knee Arthroscopy.

While prior studies have demonstrated that insulin-dependence is an independent risk factor for postoperative complications, morbidity, and mortality following spine and shoulder, hip, and knee arthroplasty, it has not been evaluated in the setting of knee arthroscopy. Therefore, the purpose of this study is to compare the risk of postoperative complications among patients with insulin-dependent diabetes mellitus and noninsulin-dependent diabetes mellitus (IDDM and NIDDM respectively) with the general population following knee arthroscopy. A retrospective analysis of the National Surgical Quality Improvement Program's database for the years 2005 to 2016 was conducted.

Risk Factors for Infection Following Total Wrist Arthroplasty and Arthrodesis: An Analysis of 6641 Patients.

Infection following wrist arthroplasty (WA) or wrist fusion (WF) is an uncommon but difficult complication often resulting in explantation and prolonged courses of antibiotics. The purposes of this study are to: (1) characterize the demographic trends of individuals undergoing WA and WF; (2) determine the incidence of postoperative infection; and (3) identify risk factors for postoperative infection. The PearlDiver database was used to query 100% Medicare Standard Analytic files from 2005 to 2014.

Smoking is associated with increased surgical complications following total shoulder arthroplasty: an analysis of 14,465 patients.

Hypothesis: The purpose of this study was to evaluate the association between smoking and postoperative complications following total shoulder arthroplasty. We hypothesized that active smokers would have significantly greater postoperative medical and surgical complications.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent total shoulder arthroplasties from 2005 through 2016.

A propensity-score matched analysis of limb salvage vs amputation for osteosarcoma.

Background And Objectives: With recent advances in chemotherapy and surgical techniques, the trend in the treatment of osteosarcoma continues to progress towards limb salvage. However, studies comparing limb salvage with amputation continue to be limited by selection bias and small sample sizes. This study utilized propensity-score matching to minimize potential confounders and selection bias to compare the survival rates in patients with osteosarcoma that were treated with amputation vs limb salvage surgery.

Modified frailty index predicts medical complications, length of stay, readmission, and mortality following total shoulder arthroplasty.

Hypothesis: The purpose of this study was to evaluate the 5-factor modified frailty index (mFI-5) as a predictor of postoperative complications in patients undergoing total shoulder arthroplasty (TSA).

Methods: We conducted a retrospective analysis of the National Surgical Quality Improvement Program database for patients undergoing TSA between the years 2005 and 2017. The mFI-5 score, which includes the presence of comorbid diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functional status, was calculated for each patient.

Insulin Dependence Is Associated With Increased Medical Complications and Mortality After Shoulder Arthroscopy.

Purpose: To compare complications after shoulder arthroscopy in patients with insulin-dependent diabetes mellitus (IDDM), patients with non-insulin-dependent diabetes mellitus (NIDDM), and nondiabetic patients.

Methods: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database for the years 2005 to 2016 was conducted. Logistic regression analyses were used to assess the relation between diabetic status (nondiabetic patients, n = 50,626; NIDDM patients, n = 5,332; and IDDM patients, n = 2,484) and outcomes.

Frailty Predicts Medical Complications, Length of Stay, Readmission, and Mortality in Revision Hip and Knee Arthroplasty.

Background: The purpose of this study is to evaluate the 5-factor modified frailty index (mFI-5) as a predictor of postoperative complications, readmission, and mortality in patients undergoing revision hip and knee arthroplasty.

Methods: A retrospective analysis of the American College of Surgeon's National Surgical Quality Improvement Program's database for patients undergoing revision total hip arthroplasty (rTHA) and revision total knee arthroplasty (rTKA) between the years 2005 and 2016 was conducted. The 5-factor score, which includes presence of comorbid diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functional status, was calculated for each patient.

Preoperative Shoulder Injections Are Associated With Increased Risk of Revision Rotator Cuff Repair.

Purpose: The goal of this study was to determine whether the timing of preoperative shoulder injections is associated with an increased risk of revision rotator cuff repair following primary rotator cuff repair (RCR).

Methods: A retrospective analysis of claims data of privately insured subjects from the MarketScan database for the years 2010 to 2014 was conducted. Multivariable logistic regression models were used to compare the odds of reoperation between groups.

New Five-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures.

Introduction: Although the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures.

Methods: The NSQIP database was queried for patients 60 years of age and older who underwent surgical management for hip fractures between 2005 and 2016.