Journal of orthopaedics最新文献

{"title":"The low bone mass density in adults with hypertension: A meta-analysis","authors":"Yao Gao ,&nbsp;Xiaomei Tian ,&nbsp;Guofu Zhang ,&nbsp;Jianli Yu ,&nbsp;Liwen Zhang","doi":"10.1016/j.jor.2024.10.041","DOIUrl":"10.1016/j.jor.2024.10.041","url":null,"abstract":"<div><h3>Objectives</h3><div>Osteoporosis and hypertension are frequently co-occurring disorders which cause significant challenges to the public health. According to some researches, adult persons with hypertension often have low bone mass density (BMD). However, there are discrepancies in the reported results. Thus, the primary objective of our meta-analysis is to explore the potential link between low BMD and hypertension in adults.</div></div><div><h3>Methods</h3><div>Two authors systematically carried out a comprehensive review of the available literature on the connection of BMD and hypertension by retrieving PubMed, Web of Science, Cochrane and Embase up to March 2024. The confidence intervals (CIs) and odds ratios (ORs) and were estimated utilising the random effect model. Heterogeneity, subgroup analysis, sensibility analyses and publication bias were performed.</div></div><div><h3>Results</h3><div>13 studies from the 6080 unique records were analyzed. Pooled analysis revealed that the danger of low BMD was significantly elevated in hypertensive patients than in non-hypertension (OR 1.33, 95 % CI 1.17–1.53, <em>I</em>² = 79.9 %<em>, p</em> &lt; 0.01). Subgroup analysis revealed a more pronounced link between low BMD and hypertension in the untreated hypertension group (OR 1.64, 95 % CI 0.45–6.02) as opposed to the cohort receiving antihypertensive medication (OR 1.32, 95 % CI 1.16–1.51). The studies carried out in Europe were consistent with those of studies conducted in Asia and North America.</div></div><div><h3>Conclusions</h3><div>Low BMD is associated with hypertension in adults. Nevertheless, it remains uncertain whether this finding is influenced by shared risk factors, given the considerable heterogeneity between study types and methodologies. Further extensive epidemiological documents are necessary.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncemented versus cemented humeral fixation during reverse total shoulder arthroplasty for proximal humerus fracture","authors":"John S. Barnett,&nbsp;R. Mychael Dopirak,&nbsp;Benjamin L. Brej,&nbsp;Erryk S. Katayama,&nbsp;Akshar V. Patel,&nbsp;Gregory L. Cvetanovich,&nbsp;Julie Y. Bishop,&nbsp;Ryan C. Rauck","doi":"10.1016/j.jor.2024.10.042","DOIUrl":"10.1016/j.jor.2024.10.042","url":null,"abstract":"<div><h3>Introduction</h3><div>Over time, the use of reverse total shoulder arthroplasty (RTSA) treating proximal humerus fractures (PHFs) and fracture sequelae has grown significantly due to its demonstrated effectiveness over open reduction internal fixation (ORIF) and hemiarthroplasty (HA). Cemented humeral stems have been widely utilized in RTSA for PHF, however cementless alternatives have become increasingly popular. This study seeks to analyze outcomes and complications in patients undergoing RTSA for fracture with uncemented and cemented stems at mid-term follow-up.</div></div><div><h3>Methods</h3><div>Patient records were queried for all patients who underwent reverse total shoulder arthroplasty for fracture with between January 7, 2009 and January 10, 2019 and completed a minimum follow-up of 2 years. Demographics characteristics, post-operative functional measurements, complications, and radiographs were assessed. A 5-year Kaplan-Meier survival analysis was performed.</div></div><div><h3>Results</h3><div>A total of 23 patients encompassing 11 cemented and 12 uncemented stems met the inclusion criteria. The mean age of the uncemented cohort was 70.0 ± 9.8 years with a mean follow-up of 2.6 ± 1.3 years while the mean age of the cemented cohort was 68.9 ± 9.2 years with a mean follow-up of 2.9 ± 1.1 years. No differences in strength, range of motion, or survival between groups were observed. Two patients in the cemented cohort demonstrated humeral component loosening on follow-up radiographs.</div></div><div><h3>Discussion</h3><div>Uncemented and cemented humeral fixation during RTSA for proximal humerus fracture leads to similar outcomes, and thus both are safe and effective methods of achieving humeral fixation in fracture patients.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding: Increased blood 1,25 dihydroxyvitamin D levels in infants with metabolic bone disease of infancy in contested cases of child abuse","authors":"Austin Schatzman,&nbsp;Bradley S. Miller","doi":"10.1016/j.jor.2024.10.043","DOIUrl":"10.1016/j.jor.2024.10.043","url":null,"abstract":"","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reverse shoulder arthroplasty with isolated latissimus-dorsi transfer/additional teres-major transfer for combined loss of elevation and external rotation: A systematic review and meta-analysis","authors":"Patrick P. Nian ,&nbsp;Amit Pujari ,&nbsp;Akiro H. Duey ,&nbsp;Andrew A. Palosaari ,&nbsp;Kenneth H. Levy ,&nbsp;Jordan Bernstein ,&nbsp;Paul J. Cagle Jr.","doi":"10.1016/j.jor.2024.10.035","DOIUrl":"10.1016/j.jor.2024.10.035","url":null,"abstract":"<div><h3>Background</h3><div>The relative clinical advantages of reverse shoulder arthroplasty (RSA) with latissimus dorsi transfer (LDT) in direct comparison to RSA with latissimus dorsi and teres major (LD and TM) transfer for the treatment of combined loss of elevation and external rotation (CLEER) are not well understood. The objective of this study was to conduct a systematic review and meta-analysis to compare the two surgeries with regards to (1) preoperative severity/indications, (2) range of motion (ROM) outcomes, (3) functional and patient-reported outcomes (PROs), and (4) complications.</div></div><div><h3>Methods</h3><div>Following screening of three databases in accordance with PRISMA guidelines, 13 studies were included, consisting of 91 and 115 shoulders having received RSA with LDT and with LD and TM, respectively. The primary outcome was the change in external rotation. Secondary outcomes included preoperative Hamada grade and Goutallier score, abduction, forward elevation, and internal rotation, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley Score (CMS), Simple Shoulder Test (SST), Simple Shoulder Value (SSV), Visual Analog Score (VAS) for pain, and major/minor complications, where available. Meta-analysis was performed using a random-effects model. P-values less than 0.05 were considered statistically significant.</div></div><div><h3>Results</h3><div>RSA with LD and TM was utilized more often than RSA with LDT for patients with higher preoperative Hamada grade (p = 0.010) and lower subscapularis Goutallier score (p = 0.015). RSA with LDT was associated with a greater improvement in abduction compared to RSA with LD and TM (75.3 versus 55.6°, p &lt; 0.010), but had comparable changes in external rotation, forward elevation, or internal rotation. RSA with LDT was associated with a greater improvement in CMS compared to RSA with LD and TM (44.1 versus 36.4 points, p &lt; 0.010). RSA with LDT was associated with a lower rate of major complications compared to RSA with LD and TM (7.1 versus 20.2 %, p = 0.032).</div></div><div><h3>Conclusions</h3><div>While improvements of external rotation were comparable, RSA with LDT may offer superior improvement in abduction and CMS, and lower rates of major complications compared to RSA with LD and TM in patients with CLEER. Orthopaedic surgeons may consider these findings in their surgical plan according to a patient's unique anatomy and clinical indications.</div></div><div><h3>Level of evidence</h3><div>IV, Systematic Review and Meta-analysis of Level I-IV Studies.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Periarticular Subcutaneous Fat on CT Images and Adverse Outcomes Following Total Knee Arthroplasty","authors":"Young M. Jee MD ,&nbsp;Mazen Zamzam BS ,&nbsp;Sazid Hasan BS ,&nbsp;Muhammad A. Waheed MD ,&nbsp;Ehab S. Saleh MD ,&nbsp;Abdullah M. Omari MD","doi":"10.1016/j.jor.2024.10.027","DOIUrl":"10.1016/j.jor.2024.10.027","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is associated with a higher rate of wound complications following primary total knee arthroplasty (TKA). With readily available computer tomography (CT) images from robotic-assisted TKA, we analyzed measurement of fat content on preoperative CT images as a possible predictor of wound complications following primary TKA.</div></div><div><h3>Methods</h3><div>Patients who underwent robotic-assisted TKA at one institution in 2018 were included in this retrospective cohort study. Two independent reviewers measured three SCF areas at different axial CT cuts and normalized them by dividing the area of the distal femur. These areas were distributed into 4 groups. Any wound complication that required clinical or surgical intervention was reviewed and analyzed. For further comparison, prepatellar SCF thickness ratio measured on CT scan and BMI were grouped and analyzed similarly for wound complications. We also analyzed any association of SCF measurement with secondary outcomes such as operative time, length of stay, readmission, and reoperation.</div></div><div><h3>Results</h3><div>One hundred fifty patients with diagnosis of osteoarthritis, mean age of 64 years and BMI of 34.3 kg/m² were included in this study. Ninety-one patients (61%) were female. Normalized SCF measurements at 2 cm above the patella, mid-patella, and tibial tubercle had excellent intraclass correlation coefficient at 0.987, 0.989, and 0.989, respectively. When SCF at 2 cm above patella was analyzed, Group 1 (smallest amount of SCF) had a significantly higher wound complication rate compared with Groups 2 and 3 combined (18.9 vs 5.3%, p=0.036). Group 4 (largest amount of SCF) also had a significantly higher wound complication rate compared with Groups 2 and 3 combined (18.9 vs 5.3%, p=0.036).</div></div><div><h3>Conclusions</h3><div>Accurate and consistent measurement of periarticular fat around the knee based on axial CT images demonstrated that moderate amount of fat is associated with better clinical outcomes following primary TKA. Our study did not find any clinical significance of gender difference in fat distribution. Therefore, more studies should be undertaken to evaluate for any clinical association of gender-specific fat distribution and to confirm our finding that a certain amount of fatty tissue is necessary for improved outcomes following TKA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between the course of postoperative pelvic axis rotation and shoulder balance in patients with Lenke types 1 and 2 adolescent idiopathic scoliosis","authors":"Noriaki Sako,&nbsp;Masashi Miyazaki,&nbsp;Tetsutaro Abe,&nbsp;Nobuhiro Kaku","doi":"10.1016/j.jor.2024.10.037","DOIUrl":"10.1016/j.jor.2024.10.037","url":null,"abstract":"<div><h3>Background</h3><div>Posteroanterior radiographs of patients with adolescent idiopathic scoliosis (AIS) show bilateral differences in the iliac wings. This is due to pelvic axis rotation (PAR) associated with scoliosis. We often encounter cases wherein the PAR changes with surgery and postoperatively. We investigated the course of preoperative PAR and the relationship between PAR and shoulder balance in patients with Lenke 1,2 AIS.</div></div><div><h3>Methods</h3><div>In total, 28 patients with Lenke 1,2 AIS undergoing scoliosis correction were included. The PAR and shoulder parameters were measured on posteroanterior radiographs. The correlation between the measured parameters and the extent of changes in each parameter was also examined.</div></div><div><h3>Results</h3><div>Eleven patients (39.3 %) underwent preoperative PAR. Six patients (21.4 %) showed a greater change in PAR from 1 week to 2 years postoperatively. The rotation did not change significantly from preoperatively to immediately postoperatively but changed during the first three months postoperatively. The rotation group had significantly more balanced shoulders at 2 years (P = 0.025). The rotation group had a greater change in shoulder balance in the postoperative course significantly (P &lt; 0.05). The extent of change in pelvic rotation from 1 week to 2 years postoperatively correlated with the extent of change in shoulder balance.</div></div><div><h3>Conclusion</h3><div>The PAR in patients with Lenke 1,2 AIS significantly changed during 3 months postoperatively. Patients with Lenke 1,2 AIS with preoperative PAR can be expected to have postoperative shoulder rebalancing.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of unfixable comminuted posterior wall acetabular fractures with autologous bone graft: A systematic review","authors":"Riccardo Giai Via ,&nbsp;Matteo Giachino ,&nbsp;Ahmed Elzeiny ,&nbsp;Alessandra Cipolla ,&nbsp;Andrea Marino ,&nbsp;Andrea D'Amelio ,&nbsp;Francesco Bosco ,&nbsp;Kristijan Zoccola ,&nbsp;Alessandro Aprato ,&nbsp;Alessandro Massè","doi":"10.1016/j.jor.2024.10.034","DOIUrl":"10.1016/j.jor.2024.10.034","url":null,"abstract":"<div><h3>Background</h3><div>Posterior wall acetabular fractures, often caused by high-energy trauma, are complex injuries that pose significant surgical challenges, especially when comminuted. Traditional fixation techniques have shown variable outcomes, with severe comminution sometimes rendering fragment fixation impossible. The aim of this study was to evaluate the clinical and radiological outcomes of autologous bone grafting for reconstructing severely comminuted unfixable posterior wall acetabular fractures.</div></div><div><h3>Materials and methods</h3><div>A systematic review was conducted in accordance with the PRISMA guidelines. The search for clinical studies was carried out across four databases: Embase, PubMed, Medline, and Scopus. The included studies were evaluated using the Coleman Methodology Score. The present study protocol was registered in PROSPERO.</div></div><div><h3>Results</h3><div>The study involved 71 patients, with an average age of 37.12 years. Autologous iliac crest grafts were predominantly used, with the Kocher-Langenbeck approach in all cases. Clinical outcomes, assessed by Merle d'Aubigne and Harris Hip Scores, showed 78.9 % of patients reporting excellent to good results. Radiological outcomes indicated 66 % with excellent results per Matta's score. The overall success rate ranged from 57 % to 100 %, with a 5 % conversion to total hip arthroplasty. Complications were reported in 7 % of cases, including nonunion and avascular necrosis.</div></div><div><h3>Conclusion</h3><div>Autologous bone grafts for comminuted, non-fixable posterior wall acetabular fractures may be considered as a potential salvage option in young patients, potentially delaying the need for THA.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plate, short nail, or long nail? Revision rates and complications of three different treatments for peritrochanteric femur fractures","authors":"Mason Poffenbarger,&nbsp;Neil Werthmann,&nbsp;Kisan Parikh,&nbsp;John Riehl","doi":"10.1016/j.jor.2024.10.022","DOIUrl":"10.1016/j.jor.2024.10.022","url":null,"abstract":"<div><h3>Background</h3><div>We sought to investigate the relationship between peritrochanteric femur fracture (OTA 31A fractures) fixation and rates of peri-implant fracture, rates of transfusion, and the rates of increased dependence after secondary surgery for fracture for short cephalomedullary nails (SCMN), long cephalomedullary nails (LCMN), and plate and screw devices (PSD).</div></div><div><h3>Methods</h3><div>Multi center retrospective study involving data collected from 151 Level I-IV trauma centers using ICD9/10 and CPT codes for identification. 13,197 patients with peritrochanteric femur fractures between 2016 and 2021 were included in analysis.</div></div><div><h3>Results</h3><div>We report no significant difference in peri-implant fractures in extramedullary and intramedullary devices (LCMN 50, 0.84 %; SCMN 57, 0.88 %; PSD 6, 0.74 %; p = 0.91) as well as no significant difference in the rates of discharge to home after surgical fixation of a peri-implant fracture.</div></div><div><h3>Conclusions</h3><div>There is no difference in peri-implant fracture rates between SCMN, LCMN, and PSD methods of fixation for peritrochanteric femur fractures. Therefore, longer implants do not seem to protect the femur from future peri-implant fracture when compared to shorter implants. Further analysis is needed to more fully elucidate the morbidity associated with readmission and revision of peri-implant fractures following fixation of peritrochanteric femur fractures.</div></div><div><h3>Level of evidence</h3><div>Therapeutic Level III.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term functional outcomes of BIFOLD osteosynthesis in distal femoral fractures with metaphyseal comminution: A retrospective analysis","authors":"Clevio Desouza ,&nbsp;Nicholas Antao ,&nbsp;Sanjay Londhe ,&nbsp;Paras Banka","doi":"10.1016/j.jor.2024.10.033","DOIUrl":"10.1016/j.jor.2024.10.033","url":null,"abstract":"<div><h3>Background</h3><div>This retrospective study aimed to evaluate the long-term functional outcomes of BIFOLD osteosynthesis, employing retrograde nailing and distal femoral locked plating, in patients with distal femoral fractures and metaphyseal comminution.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients treated for distal femur fractures with metaphyseal comminution between 2012 and 2022, with a minimum follow-up of 2 years. Inclusion criteria encompassed distal femur fractures with metaphyseal comminution, excluding specific conditions. BIFOLD osteosynthesis was employed in all 33 cases, utilizing retrograde SIGN (Surgical Implant Generation Network Nail) and distal femoral locking plates. Primary outcome measures included radiographic and functional outcomes assessed through the Sanders functional evaluation score, with secondary outcomes focusing on perioperative or postoperative complications.</div></div><div><h3>Results</h3><div>A total of 33 patients (21 male, 12 female) were included, with an average age of 51.4 years. BIFOLD osteosynthesis exhibited an average radiographic fracture healing time of 6.2 ± 2.5 months. The procedure's average operative time was 100 ± 15 min, and blood loss averaged 420 ± 50 ml. According to Sanders criteria, 28 patients (84.84 %) demonstrated well-to-excellent functional outcomes, while 3 patients (9.09 %) reported fair outcomes, and 2 patients (6.06 %) reported poor outcomes. No significant shortening or implant failure occurred, and all patients achieved over 90 degrees of knee range of motion within 8 weeks. One patient experienced superficial infection, and two patients exhibited insignificant coronal plane deformity.</div></div><div><h3>Conclusion</h3><div>BIFOLD osteosynthesis, combining intra and extra medullary fixation principles, offers a stable construct for distal femoral fractures with metaphyseal comminution. This approach facilitates faster ambulation, pain relief, early knee joint mobilization, and significant early union, resulting in improved functional outcomes. Additionally, BIFOLD osteosynthesis helps prevent collapse, translational and rotational deformities, as well as shortening.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk assessment model used to predict discharge care after total hip and total knee arthroplasty: A population-based study","authors":"Henrique Alves ,&nbsp;Sebastien Di Tommaso ,&nbsp;Julien Wegrzyn ,&nbsp;Cedric Mabire","doi":"10.1016/j.jor.2024.10.031","DOIUrl":"10.1016/j.jor.2024.10.031","url":null,"abstract":"<div><h3>Background</h3><div>Transfer to a post-acute care facility or hospital readmission after total joint arthroplasty represent additional costs and increased surgical and health care resource utilization. Accurate prediction of post-acute care factors could help providers to plan the patient's discharge destination and have a positive impact on postoperative outcomes and readmission rates.</div></div><div><h3>Objective</h3><div>To develop a risk assessment model to predict discharge care after total hip arthroplasty (THA) and total knee arthroplasty (TKA).</div></div><div><h3>Design</h3><div>A retrospective longitudinal observational study.</div></div><div><h3>Settings</h3><div>and participants: This study included 209 patients who underwent primary unilateral THA or TKA at a major academic medical center in Switzerland from January 2018 to December 2019.</div></div><div><h3>Methods</h3><div>A collection of computerized- and paper-recorded data identified the discharge destination, socio-demographic factors, comorbidities, and other factors related to the patient. Univariate and multivariate analyses were performed to describe the predictors of post-surgical discharge destinations.</div></div><div><h3>Results</h3><div>The characteristics associated with post-acute care after primary unilateral THA or TKA were the absence of a caregiver, advanced age, female gender, presence of walking aids, high ASA score, and comorbidity severity. A prediction model demonstrated that these six characteristics were associated 52 % with discharge to a post-acute care destination.</div></div><div><h3>Conclusions</h3><div>This study allowed us to identify predictors of discharge to a post-surgical destination. Predictive models can be efficiently used to better predict which patients are predisposed to post-acute care after hospital discharge. Further studies are needed to determine the optimal criteria for different destinations.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}