Quantifying Patient Expectations for Total Knee Arthroplasty: Expectations for Improvement Are Greater Than Minimal Clinically Important Difference.

Background: Achieving a minimal clinically important difference (MCID) in patient-reported outcomes following total knee arthroplasty (TKA) is common, yet up to 20% patient dissatisfaction persists. Unmet expectations may explain post-TKA dissatisfaction. No prior studies have quantified patient expectations using the same patient-reported outcome metric as used for MCID to allow direct comparison.

Age-Based Heuristics Bias Treatment of Displaced Femoral Neck Fractures in the Elderly.

Background: Surgeons performing arthroplasty for femoral neck fractures may rely on mental shortcuts (heuristics) when choosing total hip arthroplasty (THA) vs hemiarthroplasty (HA). We sought to quantify the extent to which age-based heuristics drive decision-making.

Methods: We identified all Medicare beneficiaries from 2017-2018 with femoral neck fractures who underwent THA or HA.

Injury Rates at an NCAA Division I Institution After the COVID-19 Lockdown: A Descriptive Epidemiological Study.

Background: The coronavirus 2019 (COVID-19) pandemic led to frequent schedule changes, abbreviated seasons, and disrupted training at all levels of organized sports.

Purpose/hypothesis: The purpose of this study was to investigate the epidemiology of sports-related injuries at a single National Collegiate Athletic Association (NCAA) Division I institution during the 2020 COVID lockdown season when compared with pre-COVID seasons. It was hypothesized that there would be an increase in the overall injury rate and an increase in the number of days missed because of injury during the 2020 season when compared with the previous seasons.

Does Running Increase the Risk of Hip and Knee Arthritis? A Survey of 3804 Marathon Runners.

Background: Long-distance running is a popular form of cardiovascular exercise with many well-described health benefits, from improving heart health to the management of obesity, diabetes, and mental illness. The impact of long-distance running on joint health in recreational runners, however, remains inconclusive.

Hypothesis: The prevalence of osteoarthritis in runners is not associated with an athlete's running-related history, including the number of marathons completed, cumulative years of running, average weekly mileage, and average running pace.

Increase in Deltoid Compartment Pressures Immediately After Arthroscopic Rotator Cuff Repair Does Not Significantly Affect Postoperative Opioid Consumption.

Purpose: To investigate the association between changes in individual (anterior, lateral, and posterior) and overall deltoid compartment pressures and postoperative opioid consumption up to 14 days after primary double-row arthroscopic rotator cuff repair (ARCR).

Methods: In 113 consecutive patients undergoing primary double-row ARCR, anterior, lateral, and posterior deltoid compartment pressures were measured prior to incision and immediately after closure with a manometer. Postoperatively, all patients were provided with an identical rehabilitation protocol, quantity and dose of opioid tablets, and pain journal in which to record daily opioid consumption and visual analog scale pain scores for 14 days after surgery.

Trends in Orthopedic Device Innovation: An Analysis of 510(k) Clearances and Premarket Approvals From 2000 to 2019.

The objective of this study was to characterize recent trends in orthopedic device development across different subspecialty areas. Orthopedic 510(k) clearances, premarket approvals (PMAs; together, "authorizations"), and new market entrants from 2000 to 2019 were analyzed as markers of research and development activity. Data were extracted from the US Food and Drug Administration website and stratified into one of 9 "subspecialty" groups: spine, trauma, hip arthroplasty, knee arthroplasty, shoulder, hand/elbow, foot/ankle, cement/filler/graft, and other.

Risk factors for loss to follow up of pelvis and acetabular fractures.

Introduction: Pelvic and acetabular fracture incidence is increasing worldwide for more than four decades. There is currently no evidence examining risk factors for loss to follow up in patients with these injuries.

Methods: Patients presenting with pelvic and/or acetabular fractures at our institution between 2015 and 2020 were included.

Evaluating the Chase Utley Rule: The Association Between a Rule Change and Collision-Related Injuries in Major League Baseball.

Background: Major League Baseball (MLB) adopted a rule change in 2016 to reduce the number of collisions that occur when a player slides into a base. The effect of rule 6.01(j) has not been quantified, and it remains unknown if this rule change has led to improved player safety.

Epidemiology of Tibial Fractures in Professional American Football Athletes From 2013 to 2019.

Background: Lower extremity injuries occur with high frequency in National Football League (NFL) athletes and cause high burden to players and teams. Tibial fractures are among the most severe lower extremity injuries sustained in athletes and are associated with prolonged time loss from sport.

Purpose: To determine the number of tibial fractures in NFL athletes from the 2013 to 2019 NFL seasons and describe athlete demographics, fracture characteristics, and details of injury onset.

The change in postoperative opioid prescribing after lumbar decompression surgery following state-level opioid prescribing reform.

Objective: On August 31, 2017, the state of Ohio implemented legislation limiting the dosage and duration of opioid prescriptions. Despite the widespread adoption of such restrictions, few studies have investigated the effects of these reforms on opioid prescribing and patient outcomes. In the present study, the authors aimed to evaluate the effect of recent state-level reform on opioid prescribing, patient-reported outcomes (PROs), and postoperative emergency department (ED) visits and hospital readmissions after elective lumbar decompression surgery.

Adoption of Health System Innovations: Evidence of Urban-Rural Disparities from the Ohio Primary Care Marketplace.

Background: Accountable care organizations (ACOs), patient-centered medical homes (PCMHs), and the meaningful use of electronic health records (EHRs) generated particular attention during the last decade. Translating these reforms into meaningful increases in population health depends on improving the quality and clinical integration of primary care providers (PCPs). However, if these innovations spread more quickly among PCPs in urban and wealthier areas, then they could potentially worsen existing geographic disparities in health outcomes.

Unicompartmental Knee Arthroplasty in Octogenarians versus Younger Patients: A Comparison of 30-Day Outcomes.

As the United States' octogenarian population (persons 80-89 years of age) continues to grow, understanding the risk profile of surgical procedures in elderly patients becomes increasingly important. The purpose of this study was to compare 30-day outcomes following unicompartmental knee arthroplasty (UKA) in octogenarians with those in younger patients. The American College of Surgeons National Surgical Quality Improvement Program database was queried.

Epidemiology, Treatment, and Performance-Based Outcomes in American Professional Baseball Players With Symptomatic Spondylolysis and Isthmic Spondylolisthesis.

Background: Repetitive lumbar hyperextension and rotation during athletic activity affect the structural integrity of the lumbar spine. While many sports have been associated with an increased risk of developing a pars defect, few previous studies have systematically investigated spondylolysis and spondylolisthesis in professional baseball players.

Purpose: To characterize the epidemiology and treatment of symptomatic lumbar spondylolysis and isthmic spondylolisthesis in American professional baseball players.

Prediction calculator for nonroutine discharge and length of stay after spine surgery.

Background Context: Following spine surgery, delays in referral to rehabilitation facilities leads to increased length of hospital stay (LOS), increases costs, more risk of hospital acquired complications, and decreased patient satisfaction.

Purpose: We sought to create a prediction calculator to determine the expected LOS after spine surgery and identify patients most likely to need postoperative nonhome discharge. The goal would be to facilitate earlier referral to rehabilitation and thereby ultimately shorten LOS, reduce costs, and improve patient satisfaction.

Identifying a clinical decision tool to predict discharge disposition following operative treatment of hip fractures in the United States.

Background: Post-discharge management following operative treatment of hip fractures continues to be performed on a case-by-case basis, with no uniform guidelines dictating management. Predicting discharge to post-acute care (PAC) facilities (i.e.

Prevalence of Bennett lesions based on sex, ancestry, and age in an osteologic collection of 5,662 scapulae.

Background: Bennett lesions represent an extra-articular ossification on the posteroinferior aspect of the glenoid fossa and a potential source of posterior shoulder pain and limitation. The prevalence of Bennett lesions in the general population is unknown.

Materials And Methods: A total of 5,662 scapulae from 2,831 individual cadaveric specimens greater than 18 years of age at the time of death were examined.

Early Complications Following Articular Calcaneus Fracture Repair: Evaluation of Open Versus Percutaneous Techniques.

Objectives: To assess complications and secondary operations in patients treated with either open reduction and internal fixation (ORIF) versus percutaneous fixation of displaced intra-articular calcaneus fractures.

Design: Retrospective comparative study.

Setting: Level 1 trauma center.

Association of Cost Savings and Surgical Quality With Single-Vendor Procurement for Spinal Implants.

Importance: Significant cost savings can be achieved from consolidating purchases of spinal implants with a single vendor. However, it is currently unknown whether sole-source contracting or vendor rationalization more broadly affects patient care.

Objectives: To describe the single-vendor procurement of spinal implants, characterize the economic benefits of sole-source contracting, and gauge whether vendor rationalization is associated with a diminished quality of care.

The efficacy of intraoperative multimodal monitoring in pedicle subtraction osteotomies of the lumbar spine.

Objective: Iatrogenic spine injury remains one of the most dreaded complications of pedicle subtraction osteotomies (PSOs) and spine deformity surgeries. Thus, intraoperative multimodal monitoring (IOM), which has the potential to provide real-time feedback on spinal cord signal transmission, has become the gold standard in such operations. However, while the benefits of IOM are well established in PSOs of the thoracic spine and scoliosis surgery, its utility in PSOs of the lumbar spine has not been robustly documented.

DRG-based bundled reimbursement for lumbar fusion: implications for patient selection.

Objective: Under the Bundled Payments for Care Improvement (BPCI) initiative, Medicare reimburses for lumbar fusion without adjusting for underlying pathology. However, lumbar fusion is a widely used technique that can treat both degenerative and traumatic pathologies. In other surgical cohorts, significant heterogeneity exists in resource use when comparing procedures for traumatic versus degenerative pathologies.

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review.

Study Design: Systematic review.

Objectives: The objectives of this systematic review were to report the available clinical evidence on patient outcomes associated with perioperative allogeneic red blood cell (RBC) transfusions in adult patients undergoing spinal surgery and to determine whether there is any evidence to support an association between transfusion timing and clinical outcomes.

Methods: A systematic review of the PubMed, EMBASE, and Cochrane Library databases was performed to identify all articles examining outcomes of adult spinal surgery patients who received perioperative allogeneic RBC transfusions.

Utility of Patient-reported Symptoms and Health Conditions for Predicting Surgical Candidacy and Utilization of Surgery via an Outpatient Spine Clinic Nomogram.

Study Design: Retrospective cohort.

Objective: Identify the nonradiographic predictors of a patient's decision to undergo elective spine surgery.

Summary Of Background Data: Up to 132 million people seek elective evaluation by spine surgeons annually, though 55%-82% of specialty referrals may be inappropriate.

Impact of length of stay on HCAHPS scores following lumbar spine surgery.

Objective: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, completed by patients following an inpatient stay, are utilized to assess patient satisfaction and quality of the patient experience. HCAHPS results directly impact hospital and provider reimbursements. While recent work has demonstrated that pre- and postoperative factors can affect HCAHPS results following lumbar spine surgery, little is known about how these results are influenced by hospital length of stay (LOS).

Utility of repeat magnetic resonance imaging in surgical patients with lumbar stenosis without disc herniation.

Background Context: Routine use of magnetic resonance imaging (MRI) as a diagnostic tool in lumbar stenosis is becoming more prevalent due to the aging population. Currently, there is no clinical guideline to clarify the utility of repeat MRI in patients with lumbar stenosis, without instability, neurological deficits, or disc herniation.

Purpose: To evaluate the utility of routine use of MRI as a diagnostic tool in lumbar stenosis, and to help formulate clinical guidelines on the appropriate use of preoperative imaging for lumbar stenosis.