The mobile seniors' clinic - an innovative transition of care for frail older adults.

Background: This study aims to evaluate the impact of Quebec's first hospital-at-home-inspired mobile Seniors' Clinic, the "Clinique des Ainés (CDA)", on frail older adults' returns to the Emergency Department (ED), mortality, and hospital Length Of Stay (LOS) and rehospitalizations.

Methods: Design: Quasi-experimental pre-post implementation cohort study.

Population: Patients aged ≥ 75 years admitted to the short-term geriatric unit after an ED consultation (control) or included by the CDA (intervention).

Cobalt ions induce a cellular senescence secretory phenotype in human synovial fibroblast-like cells that may be an early event in the development of adverse local tissue reactions to hip implants.

Objectives: Total hip arthroplasty is a successful procedure for treating advanced osteoarthritis (OA). Metal bearing surfaces remain one of the most widely implanted prosthesis, however approximately 10% of patients develop adverse local tissue reactions (ALTRs), namely lymphocytic predominant soft tissue reaction with or without necrosis and osteolysis resulting in high revision rates. The mechanism(s) for these reactions remains unclear although T lymphocyte mediated type IV hypersensitivity to cobalt (Co) and chromium (Cr) ions have been described.

Comparing a Portable Motion Analysis System against the Gold Standard for Potential Anterior Cruciate Ligament Injury Prevention and Screening.

Knee kinematics during a drop vertical jump, measured by the Kinect V2 (Microsoft, Redmond, WA, USA), have been shown to be associated with an increased risk of non-contact anterior cruciate ligament injury. The accuracy and reliability of the Microsoft Kinect V2 has yet to be assessed specifically for tracking the coronal and sagittal knee angles of the drop vertical jump. Eleven participants performed three drop vertical jumps that were recorded using both the Kinect V2 and a gold standard motion analysis system (Vicon, Los Angeles, CA, USA).

Indication for total knee arthroplasty based on preoperative functional score: Are we operating earlier?

Background: The number of total knee arthroplasty (TKA) procedures performed annually is increasing for reasons not fully explained by population growth and increasing rates of obesity. The purpose of this study was to determine the role of patient functional status as an indication for surgery and to determine if patients are undergoing surgery with a higher level of preoperative function than in the past.

Methods: A systematic review and meta-analysis of the MEDLINE, Embase and Cochrane databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Using an Affordable Motion Capture System to Evaluate the Prognostic Value of Drop Vertical Jump Parameters for Noncontact ACL Injury.

Background: Knee kinematic parameters during a drop vertical jump (DVJ) have been demonstrated to be associated with increased risk of noncontact anterior cruciate ligament (ACL) injury. However, standard motion analysis systems are not practical for routine screening. Affordable and practical motion sensor alternatives exist but require further validation in the context of ACL injury risk assessment.

Do Consumers Value Welfare and Environmental Attributes in Egg Production Similarly in Fresh Eggs and Prepared Meals?

Food items are increasingly chosen based on sustainability attributes as the public is becoming increasingly aware of the environmental and animal welfare impacts of production systems, in addition to the traditional consideration for nutrition. Although surveys have been used to investigate the demand for these attributes in unprocessed products, little information exists on how these attributes impact consumer preferences in the case of processed products or prepared meals. This study uses a stated preference survey to examine Quebec (Canada) consumers' preferences for eggs from four production systems with different impacts on animal welfare and on the environment.

Long-Term Survivorship of Cemented and Uncemented Polyethylene Liner Exchange.

Background: Revision surgery is usually required for complications associated with total hip arthroplasty (THA). Significant morbidity can be associated with revision THA and thus some may only revise the liner of the original metal back component if it is found to be well fixed. We compare the long-term survivorship of cemented and uncemented head-liner THA exchange surgeries and possible causes.

Patient Functional Status as an Indication for Primary Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Background: The number of total hip arthroplasties performed per year is increasing for reasons not fully explained by a growing and aging population. The purpose of this study was to determine the role of patient functional status as an indication for surgery and determine if patients are undergoing surgery at a better functional status than in the past.

Methods: A systematic review and meta-analysis of the MEDLINE, EMBASE, and Cochrane databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Long-Term Outcome of Small Head Metal-On-Metal Total Hip Arthroplasty: A 15-to-22 Year Follow-Up.

Background: The Metasul articular interface was a second-generation metal-on-metal (MoM) total hip arthroplasty (THA) that was introduced as a promising interface with improved manufacturing technology, better clearances, and enhanced metal hardness. In December 2001, the manufacturer recalled these implants due to the failure of cup osseointegration.

Methods: Between 1997 and 2004, 168 consecutive primary Metasul THAs were performed in 144 patients.

Commercial Poultry Production Stocking Density Influence on Bird Health and Performance Indicators.

This study examines poultry production stocking density (SD) effect on bird welfare and economic performance. It is based on a large dataset from commercial production including observations for 2.2 million male broilers and 2.

No Difference in Major Complication and Readmission Rates Following Simultaneous Bilateral vs Unilateral Total Hip Arthroplasty.

Background: Simultaneous bilateral total hip arthroplasty (THA) is an attractive option for patients with osteoarthritis as it requires a single anesthetic and hospitalization. Nonetheless, serious concerns remain over the perioperative safety and rate of hospital readmission. The purpose of the present study was to compare the rate of 30-day major complications and hospital readmissions between patients undergoing simultaneous bilateral vs unilateral THA using the National Surgical Quality Improvement Program database.

Hospital Discharge within 2 Days Following Total Hip or Knee Arthroplasty Does Not Increase Major-Complication and Readmission Rates.

Background: The rising costs of total knee arthroplasty (TKA) and total hip arthroplasty (THA) have resulted in a substantial economic burden on the U.S. health-care system.

Navigated vs Conventional Total Knee Arthroplasty: Is There a Difference in the Rate of Respiratory Complications and Transfusions?

Background: Proponents of navigation in total knee arthroplasty (TKA) report lower rates of systemic embolization and perioperative bleeding compared to conventional TKA given that breeching the intramedullary canal is not required.

Methods: We queried the National Surgical Quality Improvement Program to compare perioperative respiratory complications and transfusions between navigated and conventional TKA. We identified 2008 patients who underwent navigated TKA.

Major Complications and Transfusion Rates After Hemiarthroplasty and Total Hip Arthroplasty for Femoral Neck Fractures.

Background: Postoperative complications and perioperative transfusions are common after hemiarthroplasty or total hip arthroplasty (THA) and can lead to increased morbidity and mortality.

Methods: The National Surgical Quality Improvement Program Database was queried to compare 30-day major complications and perioperative transfusions after femoral neck fractures.

Results: A total of 4058 patients were included in the study: 3192 were treated with hemiarthroplasty and 866 with THA.

A Meta-Analysis of the Association Between Radiation Therapy and Survival for Surgically Resected Soft-Tissue Sarcoma.

Objectives: Radiotherapy for soft-tissue sarcoma (STS) has been shown to reduce local recurrence, but without clear improvement in survival. We conducted a meta-analysis to study the association between radiotherapy and survival in patients undergoing surgery for STS.

Methods: A systematic review was conducted from PubMed, EMBASE, Web of Science, and Cochrane databases.

Shorter Hospital Stay and Lower 30-Day Readmission After Unicondylar Knee Arthroplasty Compared to Total Knee Arthroplasty.

Background: Reducing hospital stay and unplanned hospital readmission of arthroplasty patients has been a topic of recent interest. The aim of the present study was to query the National Surgical Quality Improvement Program database to compare the length of hospital stay (LOS) and the subsequent 30-day hospital readmission rates in patients undergoing primary unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA).

Methods: We identified 1340 UKAs and 36,274 TKAs over a 2-year period (2011-2012).

A Validated Orthopaedic Surgical Simulation Model for Training and Evaluation of Basic Arthroscopic Skills.

Background: To our knowledge, there is currently no validated educational model to evaluate and teach basic arthroscopic skills that is widely accessible to orthopaedic residency training programs. The primary objective was to design and to validate a surgical simulation model by demonstrating that subjects with increasing level of training perform better on basic arthroscopic simulation tasks. The secondary objective was to evaluate inter-rater and intra-rater reliability of the model.

Simultaneous Bilateral Versus Unilateral Total Knee Arthroplasty: A Comparison of 30-Day Readmission Rates and Major Complications.

We queried the National Surgical Quality Improvement Program to compare the rate of 30-day readmissions and major complications between simultaneous bilateral and unilateral total knee arthroplasty (TKA). We identified 1771 patients who underwent simultaneous (same-day) bilateral TKA and matched them to a control group of 6790 patients who underwent unilateral TKA. The simultaneous bilateral TKA patients had longer surgery, were more commonly performed under general anesthesia, had a higher rate of postoperative transfusion, and a greater proportion of patients discharged to rehabilitation facilities.

Comparison of US and Canadian Perioperative Outcomes and Hospital Efficiency After Total Hip and Knee Arthroplasty.

Importance: The combination of an aging population, growing number of medical interventions, and surging economic burden of health care has renewed interest in reevaluating and exploring new health care models.

Objectives: To compare the performance of the US and Canadian health care systems by assessing major complications following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) and to measure the efficiency of both health care models by comparing the postoperative length of stay.

Design, Setting, And Participants: With patients grouped according to the country where they underwent surgery, we queried the National Surgical Quality Improvement Program database to identify 55,335 Canadian and US patients who underwent primary elective THA or TKA between January 1, 2011, and December 31, 2012.

Perioperative Complications and Length of Stay After Revision Total Hip and Knee Arthroplasties: An Analysis of the NSQIP Database.

Goals of this study were (1) to determine the 30-day complications after aseptic revision hip arthroplasty (RHA) and aseptic revision knee arthroplasty (RKA) and (2) to identify patient-related risk factors predicting major complications and prolonged hospital stay beyond 7 days. The National Surgical Quality Improvement Program (NSQIP) database was used to identify patients with RHA (n=2643) or RKA (n=2425) from 2011 to 2012. The 30-day mortality rates for RHA and RKA were 1.

The effect of the Massachusetts healthcare reform on the uninsured rate of the orthopaedic trauma population.

Background: The 2006 Massachusetts Healthcare Reform (MHR) has resulted in health coverage for 98.1% of residents in Massachusetts. The purpose of this study was to evaluate the effect of MHR on the actual rate of uninsured individuals in the orthopaedic trauma population in the largest metropolitan area of Massachusetts.

Management of posttraumatic radioulnar synostosis.

Posttraumatic radioulnar synostosis is a rare complication following fracture of the forearm and elbow. Risk factors for synostosis are related to the initial injury and surgical management of the fracture. Typically, patients present with complete loss of active and passive forearm pronation and supination.

Total knee replacement and chemical thromboprophylaxis: current evidence.

Thromboembolic disease remains one of the most devastating and potentially lethal complications after elective total knee replacement (TKR) surgery. Studies have shown that 40-85% of patients undergoing TKR will develop venographically confirmed deep vein thrombosis (DVT) if they are not given any type of post-operative thromboprophylaxis and approximately 0.1 to 1.