Frailty and Pre-Frailty in the Setting of Total Joint Arthroplasty: A Narrative Review.

Background: Total joint arthroplasties are among the most common surgical procedures performed in the United States. Although numerous safeguards are in place to optimize patient health and safety pre-, intra-, and postoperatively, patient frailty is often incompletely assessed or not assessed at all. Frailty has been shown to increase rates of adverse events and length of stay.

Ultrasonography for the Busy Orthopaedic Surgeon: The Lower Extremity.

Ultrasonography has the potential to become a fundamental component of the diagnosis and management of musculoskeletal conditions and injuries. Moreover, in the context of modern healthcare systems that are focused on optimizing value, ultrasonography has the advantage of minimizing costs when compared with other advanced imaging modalities. Because of its low cost, lack of radiation exposure, speed, and capability to diagnose dynamic conditions, more orthopaedic surgeons are routinely integrating musculoskeletal ultrasonography into their daily practice.

Ultrasonography for the Busy Orthopaedic Surgeon: The Upper Extremity.

Ultrasonography is increasingly used in the diagnosis and treatment of musculoskeletal conditions and injuries. Ultrasonography possesses multiple advantages compared with other methods of imaging, including low cost, lack of radiation exposure, speed, and means for dynamic examination. Because of these advantages, many orthopaedic surgeons are routinely using ultrasonography to diagnose musculoskeletal conditions of the upper extremity.

Underweight Body Mass Index Is Associated With Increased In-Hospital Complications and Length of Stay After Revision Total Joint Arthroplasty.

Introduction: The purpose of this study was to assess the impact of underweight status on in-hospital postoperative outcomes and complications after revision total joint arthroplasty (rTJA) of the hip and knee.

Methods: Data from the National Inpatient Sample were used to identify all patients undergoing rTJA in the United States between 2006 and 2015. Patients were divided into two groups based on a concomitant diagnosis of underweight body mass index and a control normal weight group.

The Impact of Morbid Obesity on In-hospital Outcomes after Revision Total Hip Arthroplasty: An Analysis of the National Inpatient Sample.

Introduction: There remain limited data on the effect of obesity on in-hospital outcomes after revision total hip arthroplasty (rTHA).

Methods: Discharge data from the National Inpatient Sample were used to identify patients undergoing rTHA from 2006 to 2015. Propensity score analysis was done to analyze the effects of obesity and morbid obesity on in-hospital economic and complication outcomes after rTHA.

Current Guidelines and Practice Recommendations to Prevent Hospital-Acquired Conditions After Major Orthopaedic Surgeries.

»: In 2016, a total of 48,771 hospital-acquired conditions (HACs) were reported in U.S. hospitals.

Epidemiology of Obese Patients Undergoing Revision Total Knee Arthroplasty: Understanding Demographics, Comorbidities, and Propensity Weighted Analysis of Inpatient Outcomes.

Introduction: Obesity is a public health epidemic that is projected to grow in coming years. Observational data on the epidemiologic profile and immediate postoperative outcomes of obesity and morbid obesity after revision total knee arthroplasty (rTKA) are limited.

Methods: Discharge data from the National Inpatient Sample was used to identify patients who underwent rTKA from 2006 to 2015.

The Implementation of Lean Six Sigma Principles to Improve the Value of Care Delivery for Total Joint Arthroplasty Patients: The Perioperative Institute of Surgical Excellence Experience.

Background: With the projected increase in the volume of total joint arthroplasty (TJA), minimizing variations in surgery times, hospital length of stay (LOS), discharge dispositions, and inhospital complication rates would help reduce costs and improve the quality of care. As the move toward bundle payment models gains further traction, providers will be reimbursed based on the quality and cost associated with the surgical episode. As such, it remains critical to design and implement high-quality cost-effective perioperative delivery care models.

Hospital-Acquired Conditions: A Review of Classical and Novel Risk Factors Following Total Hip and Knee Arthroplasties.

»: In 2016, a total of 48,771 hospital-acquired conditions (HACs) were reported in U.S. hospitals.

Enterocutaneous Fistula: A Simplified Clinical Approach.

A "fistula" is an abnormal connection between two epithelial surfaces. Fistulae are named based on the two surfaces or lumens they connect to. Fistulae form due to loss of wall integrity from an underlying insult, leading to the penetrance of an adjacent organ or epithelized surface.