A Readmission Risk Assessment Tool Is Not Predictive of 90-Day Readmission After Total Joint Arthroplasty at an Urban Tertiary Referral Hospital.

Introduction: Readmission within 90 days of total joint arthroplasty (TJA) via an emergency department (ED) encounter represents a significant economic burden to the healthcare system. We aimed to determine the utility of a previously described readmission risk assessment tool (RRAT) in predicting readmission after presentation to the ED within 90 days of primary TJA.

Methods: At a single academic tertiary referral medical center, a retrospective chart review was used to collect demographic data, surgery type, medical history, reason for presentation in the ED, and ED disposition for the 1,576 patients who underwent TJA between April 1, 2016, and December 31, 2018.

Trust and vaccine hesitancy during the COVID-19 pandemic: A cross-national analysis.

Previous studies of vaccine hesitancy in the context of COVID-19 have reported mixed results in terms of the role played by political and institutional trust. This study addresses this ambiguity with a global analysis of the relationship between trust and vaccine hesitancy, disentangling the effects of generalized trust orientations, trust in specific institutions and conspiracy mentality. It first draws upon a cross-national survey of 113 countries to demonstrate that trust in government is a predictor of vaccine hesitancy across global regions.

Trust and the Coronavirus Pandemic: What are the Consequences of and for Trust? An Early Review of the Literature.

Trust between governors and the governed is seen as essential to facilitating good governance. This claim has become a prominent contention during the coronavirus pandemic. The crisis also presents a unique test of key hypotheses in the trust literature.

Lack of Trust, Conspiracy Beliefs, and Social Media Use Predict COVID-19 Vaccine Hesitancy.

As COVID-19 vaccines are rolled out across the world, there are growing concerns about the roles that trust, belief in conspiracy theories, and spread of misinformation through social media play in impacting vaccine hesitancy. We use a nationally representative survey of 1476 adults in the UK between 12 and 18 December 2020, along with 5 focus groups conducted during the same period. Trust is a core predictor, with distrust in vaccines in general and mistrust in government raising vaccine hesitancy.

Gross Trunnion Failure of a Type 1 Taper After Metal-on-Polyethylene Total Hip Arthroplasty: A Report of 2 Cases.

Case: We describe 2 cases of gross trunnion failure (GTF) in males with Centers for Disease Control and Prevention Class 3 obesity 10 years after metal-on-polyethylene total hip arthroplasty (THA) with a titanium-alloy femoral stem and Type 1 taper. One patient received a large diameter cobalt-chromium femoral head, whereas the other received a smaller diameter head, both with high-offset femoral stems.

Conclusion: This is the first report of GTF involving the Echo Bi-Metric femoral stem after metal-on-polyethylene THA, and surgeons should consider the potential complication of GTF when using this specific femoral stem with metal heads in obese male patients.

Reference Pricing Reduces Total Knee Implant Costs.

Background: Reference pricing establishes a set price a hospital is willing to pay for total knee arthroplasty (TKA) components regardless of vendor. The hospital contracts with vendors that sell implants to the hospital at the hospital-dictated prices. Orthopedic surgeons are free to utilize any implant system that has met the reference price using their best clinical judgment.

The Role of High School Football Coverage in Resident Education.

Athletic team coverage experience varies widely across orthopedic surgery residency programs in the United States. There is a paucity of literature regarding whether serving as a team physician contributes to resident education and whether it can be performed within the bounds of current work-hour restrictions. Residents consider coverage of high school football games a valuable educational experience that does not adversely affect their 80-hour work week.

Covid-19 and the Blunders of our Governments: Long-run System Failings Aggravated by Political Choices.

More urgently than ever we need an answer to the question posed by the late Mick Moran in nearly two decades ago: 'if government now invests huge resources in trying to be smart why does it often act so dumb?'. We reflect on this question in the context of governmental responses to Covid-19 in four steps. First, we argue that blunders occur because of systemic weaknesses that stimulate poor policy choices.

The Obesity Paradox: Body Mass Index Complication Rates Vary by Gender and Age Among Primary Total Hip Arthroplasty Patients.

Background: High body mass index (BMI) has long been recognized as a risk factor for postoperative complication among total hip arthroplasty (THA) patients. However, recent studies showed mixed results in the effect of high BMI on surgical outcomes. Our study is to examine the association of preoperative BMI with complication incidence, stratified by age and gender.

Human Papilloma Virus Vaccination Compliance in a Military Aviation Training Community.

Introduction: Human Papilloma Virus (HPV) vaccination compliance as reported by the CDC in 2011 falls short of a national goal to have 80% of adolescents vaccine-complete by 2020. The Naval Aviation Schools Command, Pensacola, Florida offers a single point of contact for military aviation trainees offering near-complete capture of an HPV vaccine target population. The purpose of this study is to identify baseline HPV vaccination rates among military aviation trainees and whether or not the provision of educational materials at the start of aviation training would increase future HPV vaccination compliance.

Increasing the incidence of drain-free day-case mastectomies with the use of a fibrin tissue sealant; data from a single surgical center in the United Kingdom.

Day-case mastectomy surgery provides benefits to both patients and hospitals. Key barriers are the use of a drain and the risk of postoperative seroma formation. We introduced the use of a tissue sealant (Artiss) into the surgical site (post-mastectomy without immediate reconstruction and postaxillary clearance) and evaluated its effect on our practice, particularly day-case rates.

The Decline in Diffuse Support for National Politics: The Long View on Political Discontent in Britain.

This research note considers how to track long-term trajectories of political discontent in Britain. Many accounts are confined to using either survey data drawn from recent decades or imperfect behavioral measures such as voting or party membership as indicators of political disengagement. We instead develop an approach that provides the long view on political disaffection.

Posterior Cervical Fusion With Recombinant Human Bone Morphogenetic Protein-2: Complications and Fusion Rate at Minimum 2-Year Follow-Up.

Study Design: Retrospective case series.

Objective: The purpose of this study was to determine the fusion rate and evaluate the complications associated with the application of recombinant human bone morphogenetic protein-2 (rhBMP-2) in posterior cervical fusion.

Summary Of Background Data: The rates of fusion and complications associated with the use of rhBMP-2 in posterior cervical fusion is unclear, though recent work has shown up to a 100% fusion rate.

Epidemiology and Severity of Sports and Recreation Injuries Presenting to a Tertiary Adult Emergency Department.

Objective: This study aims to evaluate all sports and recreation injuries that present to an emergency department, identify the activity and injury patterns associated with hospital admission, and determine injuries that could be better treated in alternative care settings.

Methods: This is a retrospective review of all sports injuries that presented to the emergency department of a high volume, urban, tertiary referral center from 1/1/2010 to 12/31/2011. These were identified by a sports term search algorithm applied to all emergency department records.

Multilevel Posterior Vertebral Column Resection for the Revision of Congenital Dislocation of the Spine Following In Situ Fusion: A Case Report.

Background Context: Congenital dislocation of the spine (CDS) is a rare condition. Invariably, sagittal or coronal vertebral translation and an angulated neural canal exist. Mechanical instability, encroachment on the canal by the involved vertebrae, and coexistent spinal cord malformations have all been implicated in CDS-related neurologic deficit.

Radiographical and Clinical Outcomes of Posterior Column Osteotomies in Spinal Deformity Correction.

Study Design: Prospectively enrolled, retrospectively analyzed case series.

Objective: To evaluate a large series of pediatric patients/patients with adult spinal deformity undergoing surgery with posterior column osteotomies (PCOs).

Summary Of Background Data: Osteotomies of the posterior column (Smith-Petersen or Ponté) are used to reduce kyphosis, increase lordosis, or increase spinal flexibility.

Neurologic recovery after anterior cervical discectomy and fusion.

Study Design Retrospective review. Objective The objective of this study is to describe the natural history of neurologic recovery after anterior cervical discectomy and fusion (ACDF). Methods Patients between 18 and 80 years of age, diagnosed with cervical radiculopathy, who underwent single-level ACDF and were followed for a minimum of 2 years were identified from a single-center database.

Differentiating c8-t1 radiculopathy from ulnar neuropathy: a survey of 24 spine surgeons.

Study Design Questionnaire. Objective To evaluate the ability of spine surgeons to distinguish C8-T1 radiculopathies from ulnar neuropathy. Methods Twenty-four self-rated "experienced" cervical spine surgeons completed a questionnaire with the following items.

Hypovitaminosis D and Cervical Disk Herniation among Adults Undergoing Spine Surgery.

Study Design Single-center, retrospective study. Objective Suboptimal concentrations of vitamin D have been linked to hip and knee osteoarthritis in large, population-based cohort studies. We sought to examine the association of vitamin D levels with intervertebral disk disease.

Sagittal range of motion after extensive cervical fusion.

Background Context: Complicated cervical spine revision and deformity correction surgeries are becoming increasingly common. These challenging operations often necessitate fusion of the entire cervical spine. Patients frequently express concern over the likely loss of range of motion (ROM) of the neck postoperatively.

Epilepsy, behavior, and art (Epilepsy, Brain, and Mind, part 1).

Epilepsy is both a disease of the brain and the mind. Brain diseases, structural and/or functional, underlie the appearance of epilepsy, but the notion of epilepsy is larger and cannot be reduced exclusively to the brain. We can therefore look at epilepsy from two angles.

Transforaminal versus anterior lumbar interbody fusion in long deformity constructs: a matched cohort analysis.

Study Design: Prospectively enrolled, retrospectively analyzed matched cohort analysis.

Objective: Evaluate the relative merits of transforaminal lumbar interbody fusion (TLIF) and anterior lumbar interbody fusion (ALIF) when performed in long deformity constructs.

Summary Of Background Data: Interbody fusion is frequently used at the caudal levels of long-segment spinal deformity instrumentation constructs to protect the sacral implants and enhance fusion rates.

Video-assisted thoracoscopic surgery with posterior spinal reconstruction for the resection of upper lobe lung tumors involving the spine.

Background Context: Video-assisted thoracoscopic surgery (VATS) is associated with less morbidity and recovery time compared with traditional open thoracotomy (OT) for the resection of early stage non-small cell lung cancer (NSCLC). Local invasion of NSCLC into adjacent vertebrae confers a TNM T status of T4. Anatomical lobectomy by VATS with simultaneous posterior spinal reconstruction (PSR), as a single procedure, offers advantages to selected patients judged as suitable candidates for resection.

Posterior vertebral column resection for the treatment of dystrophic kyphosis associated with type-1 neurofibromatosis: a case report and review of the literature.

Study Design: Case report.

Objective: To describe the use of posterior-only vertebral column resection and postoperative traction for spinal deformity associated with type-1 neurofibromatosis (NF1).

Summary Of Background Data: Vertebral deformity, namely, thoracic scoliosis, is the predominant orthopedic manifestation of NF1.

Preoperative vitamin D status of adults undergoing surgical spinal fusion.

Study Design: Retrospective investigation of cross-sectional data.

Objective: To define the prevalence and determinants of preoperative vitamin D deficiency among adults undergoing spinal fusion.

Summary Of Background Data: Vitamin D plays a critical role in establishing optimal bone health, which, in turn, is vital to the success of spinal arthrodesis.