Sarc-Global: a new sarcopenia screening tool in older adults.

Background: Sarcopenia is associated with clinical complications that increase mortality in older adults. Current screening tools, such as Sarc-F and Sarc-CalF, focus primarily on muscular performance but have limited sensitivity in identifying elderly individuals at risk of sarcopenia. The present study aims to develop a more comprehensive sarcopenia risk screening tool, Sarc-Global, which integrates additional anthropometric and clinical variables to enhance the sensitivity and accuracy of sarcopenia risk assessment in older adults.

Pain Management in Total Hip and Knee Arthroplasty: Evidence-Based and Controversial Practices in 2024.

Multimodal analgesia and anesthesia have become the gold standard in total joint arthroplasty to reduce postoperative pain and opioid consumption and minimize complications associated with opioid use. There are several elements in an effective multimodal protocol, including oral medications, periarticular injection, regional nerve blocks, and spinal and general anesthesia. Many nonopioid medications are often used, such as acetaminophen and NSAIDs.

Double-Butter: A Cementation Technique That Significantly Reduces Lipid Contamination of the Tibial Baseplate in Total Knee Arthroplasty.

Background: Aseptic loosening is the most common aseptic failure modality following total knee arthroplasty. Recent literature suggests that the implant-cement interface is the "weak-link" in fixation and lipid contamination may drive this debonding pattern. Therefore, the purpose of this study was to determine if the "double-butter" technique would significantly decrease lipid contamination of the tibial tray.

Outcomes Following Direct Anterior Approach Total Hip Arthroplasty: A Contemporary Multicenter Study.

Background: The direct anterior approach (DAA) is a popular approach for primary total hip arthroplasty (THA). However, the contemporary outcomes for DAA THA need further elucidation. Therefore, we aimed to describe implant survivorship, complications, and clinical outcomes after DAA THA.

Outpatient Total Joint Arthroplasty at an Ambulatory Surgical Center: An Analysis of Failure to Launch.

Background: There has been a tremendous increase in same-day discharge (SDD) following primary total joint arthroplasty (TJA). Although the concept of failure to launch (FTL) has been recently investigated in hospital settings, there is a paucity of data in the ambulatory surgical center (ASC) context. This study aimed to examine the incidence and underlying causes of FTL within an ASC at a major academic medical center.

Rates of Extended Oral Antibiotic Prophylaxis After Primary Total Knee Arthroplasty Among High-Risk and Standard-Risk Patients: 2009 to 2022.

Background: Recent evidence suggests extended courses of oral antibiotics (EOA) after total hip arthroplasty and total knee arthroplasty (TKA) may reduce the risk of periprosthetic joint infection in high-risk patients. EOA rates after total hip arthroplasty have risen significantly. However, there is a lack of epidemiologic data on EOA prophylaxis following TKA.

Glucagon-Like Peptide-1 Receptor Agonist Use Is Not Associated With Increased Complications After Total Hip Arthroplasty in Patients Who Have Type 2 Diabetes.

Background: Glucagon-like peptide-1 (GLP-1) agonists have emerged as a powerful diabetic treatment adjunct; however, their effects on outcomes following total hip arthroplasty (THA) are not well known. This study aimed to compare the risk of complications in patients who had type 2 diabetes mellitus (DM) who were on GLP-1 agonists with those who were not on these medications.

Methods: In total, 14,065 patients who had type 2 DM undergoing primary THA between 2016 and 2021 were retrospectively reviewed using a national database.

Socioeconomic Indices Are Associated With Increased Resource Utilizations, but Not 90-Day Complications Following Total Hip and Knee Arthroplasty.

Background: Socioeconomic disadvantage has been associated with negative outcomes following total hip arthroplasty (THA) and total knee arthroplasty (TKA). The area deprivation index (ADI) and distressed communities index (DCI) are composite rankings that score socioeconomic status (SES) using patients' home addresses. The purpose of this study was to examine the association of ADI and DCI with outcomes following THA and TKA while controlling for potential confounding covariates.

Freshwater fish and the Cretaceous/Palaeogene boundary: a critical assessment of survivorship patterns.

Mass extinctions are major influences on both the phylogenetic structure of the modern biota and our ability to reconstruct broad-based patterns of evolutionary history. The most recent mass extinction is also the most famous-that which implicates a bolide impact in defining the Cretaceous/Palaeogene boundary (K/Pg). Although the biotic effects of this event receive intensive scrutiny, certain ecologically important and diverse groups remain woefully understudied.

Neurodevelopmental implications of COVID-19-induced gut microbiome dysbiosis in pregnant women.

The global public health emergency of COVID-19 in January 2020 prompted a surge in research focusing on the pathogenesis and clinical manifestations of the virus. While numerous reports have been published on the acute effects of COVID-19 infection, the review explores the multifaceted long-term implications of COVID-19, with a particular focus on severe maternal COVID-19 infection, gut microbiome dysbiosis, and neurodevelopmental disorders in offspring. Severe COVID-19 infection has been associated with heightened immune system activation and gastrointestinal symptoms.

A novel multi-ingredient supplement significantly improves ocular symptom severity and tear production in patients with dry eye disease: results from a randomized, placebo-controlled clinical trial.

Introduction: Dry eye disease (DED) is multifactorial and characterized by a loss of tear film homeostasis that causes a cycle of tear film instability, tear hyperosmolarity, and inflammation. While artificial tears are the traditional mainstay of treatment, addressing the underlying pathophysiology could relieve symptoms and prevent progression. Increasing evidence indicates a role for oral nutritional supplementation in multiple ophthalmic diseases, including DED.

Not so Fast: Extended Oral Antibiotic Prophylaxis Does Not Reduce 90-Day Infection Rate Following Joint Arthroplasty.

Background: Periprosthetic joint infection (PJI) is a devastating complication following both total hip (THA) and knee (TKA) arthroplasty. Extended oral antibiotic (EOA) prophylaxis has been reported to reduce PJI following TJA in high-risk patients. The purpose of this study was to determine if EOA reduces PJI in all-comers and high-risk THA and TKA populations.

Cemented dual-mobility constructs in uncemented revision acetabular components.

Aims: Dislocation remains a leading cause of failure following revision total hip arthroplasty (THA). While dual-mobility (DM) bearings have been shown to mitigate this risk, options are limited when retaining or implanting an uncemented shell without modular DM options. In these circumstances, a monoblock DM cup, designed for cementing, can be cemented into an uncemented acetabular shell.

Can ChatGPT Answer Patient Questions Regarding Total Knee Arthroplasty?

The internet has introduced many resources frequently accessed by patients prior to orthopaedic visits. Recently, Chat Generative Pre-Trained Transformer, an artificial intelligence-based chat application, has become publicly and freely available. The interface uses deep learning technology to mimic human interaction and provide convincing answers to questions posed by users.

Glucagon-like Peptide-1 Agonists: What the Orthopaedic Surgeon Needs to Know.

» Orthopaedic surgeons are increasingly likely to encounter patients with obesity and/or type 2 diabetes taking glucagon-like peptide-1 (GLP-1) agonists for weight loss.» GLP-1 agonists are an effective treatment for weight loss with semaglutide and tirzepatide being the most effective agents. Randomized controlled trials using these agents have reported weight loss up to 21 kg (46 lb).

Central Sensitization: The Missing Link Between Psychological Distress and Poor Outcome Following Primary Total Knee Arthroplasty.

Background: While preoperative psychological distress is known to predict risk for worse total knee arthroplasty (TKA) outcomes, distress may be too broad and nonspecific a predictor in isolation. We tested whether there are distinct preoperative TKA patient types based jointly on psychological status and measures of altered pain processing that predict adverse clinical outcomes.

Methods: In 112 TKA patients, we preoperatively assessed psychological status (depression, anxiety, and catastrophizing) and altered pain processing via a simple quantitative sensory testing protocol capturing peripheral and central pain sensitization.

Total Hip Arthroplasty Following Operative Fixation of Acetabular Fracture: A Contemporary Series.

Background: Total hip arthroplasty (THA) is the operation of choice for salvage of post-traumatic arthritis following acetabular fracture. While high failure rates have been reported for these procedures, existing literature reports mainly on historical implant designs and techniques. We aimed to describe implant survivorships, complications, radiographic results, and clinical outcomes of contemporary THA following prior open reduction internal fixation (ORIF) of an acetabular fracture.

Removing Cemented Dual Mobility Liners From Acetabular Components: A Technical Tip for a Challenging Surgical Problem.

Dislocation remains the leading cause of failure following revision total hip arthroplasty. Dual mobility (DM) constructs, including monoblock cups designed for cementation, reduce but do not eliminate this risk. Cemented DM constructs offer several unique advantages in revision total hip arthroplasty, and as such, they have gained popularity.

Tramadol use before total shoulder arthroplasty: patients have lower risk of complications and resource utilization than those using traditional opioids.

Background: Evidence continues to mount for the deleterious effects of preoperative opioid use in the setting of total shoulder arthroplasty (TSA). Tramadol, a synthetic opioid with concomitant neurotransmitter effects, has become a popular alternative to traditional opioids, but it has not been well studied in the preoperative setting of TSA. The purpose of this study is to evaluate postsurgical outcomes in TSA for patients with preoperative tramadol use compared with patients using traditional opioids and those who were opioid naïve.

Pancreaticoduodenal Artery Aneurysm Complicated by Median Arcuate Ligament Syndrome.

Purpose: To highlight median arcuate ligament syndrome as a potential cause for celiac artery stenosis and pancreaticoduodenal artery aneurysm, and describe treatment options in this setting.

Case Report: A 63-year-old male presented with a pancreaticoduodenal artery aneurysm and concomitant celiac artery stenosis that was treated with celiac artery stenting and aneurysm coiling. He subsequently developed stent fracture and celiac artery occlusion secondary to previously unrecognized median arcuate ligament syndrome causing reperfusion of the aneurysm.

Standardized Opioid Counseling Is Underperformed Before and After Anterior Cruciate Ligament Reconstruction.

Purpose: To characterize contemporary pain management strategies after anterior cruciate ligament reconstruction (ACLR) within the US and international orthopaedic community.

Methods: This was a cross-sectional survey-based study disseminated to a consortium of expert orthopaedic surgeons in the management of anterior cruciate ligament injuries. The survey was a 27-question, multiple choice-style questionnaire with question topics ranging from demographic characteristics and practice characteristics to surgeon-specific pain management strategies in the postoperative period after ACLR.