Hss Journal最新文献

{"title":"Prediabetes as an Unrecognized Risk Factor for Inpatient Postoperative Complications after Total Knee Arthroplasty: A Retrospective Cohort Study Using the Nationwide Inpatient Sample.","authors":"David S Constantinescu, Joseph P Costello, Aneesh V Samineni, Michele R D'Apuzzo","doi":"10.1177/15563316261443297","DOIUrl":"https://doi.org/10.1177/15563316261443297","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a well-established risk factor for a multitude of adverse outcomes in total knee arthroplasty (TKA). However, the effects of prediabetes (hemoglobin A1c 5.7%-6.4%) on TKA patient outcomes have yet to be fully elucidated.</p><p><strong>Purpose: </strong>We sought to compare inpatient rates of postoperative complications and resource use in patients with and without prediabetes undergoing primary, elective TKA.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using data from the Nationwide Inpatient Sample to identify patients with and without prediabetes undergoing unilateral, primary, elective TKA from January 1, 2017 to December 31, 2020. Patients with prediabetes were matched 1:1 to patients without prediabetes. There were 65 330 patients identified and included, with half in each cohort.</p><p><strong>Results: </strong>For patients undergoing TKA, having prediabetes was associated with higher rates of respiratory failure (0.4% vs 0.3%), aspiration pneumonitis (0.05% vs 0.02%), postoperative urinary retention (2.4% vs 2.0%), postoperative constipation (3.7% vs 2.8%), postoperative nausea and vomiting (3.3% vs 3.0%), postoperative anemia (15.0% vs 12.9%), hypotension (3.1% vs 2.2%), wound dehiscence (0.03% vs 0.00%), and infection (0.11% vs 0.05%) compared to patients without prediabetes. Having prediabetes was associated with increased total costs ($17 197 vs $15 544).</p><p><strong>Conclusion: </strong>This retrospective cohort study found that in TKA patients, prediabetes was associated with higher rates of postoperative complications and increased costs compared to patients without prediabetes.</p><p><strong>Level of evidence: </strong>Level III: retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261443297"},"PeriodicalIF":1.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Tibial Tubercle Fracture-Associated Compartment Syndrome: Response.","authors":"Ishaan Swarup","doi":"10.1177/15563316261433550","DOIUrl":"https://doi.org/10.1177/15563316261433550","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261433550"},"PeriodicalIF":1.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Spin Bias in the Abstracts of Systematic Reviews and Meta-Analyses on Robotic-Assisted Total Hip Arthroplasty: A Systematic Review.","authors":"Ayomide Michael Ade-Conde, Hassaan Abdel Khalik, James Abesteh, Wayne E Moschetti, Olufemi R Ayeni","doi":"10.1177/15563316261430336","DOIUrl":"https://doi.org/10.1177/15563316261430336","url":null,"abstract":"<p><strong>Background: </strong>Interest in robotic-assisted total hip arthroplasty (RA-THA) continues to grow, despite inconsistent evidence on its effectiveness.</p><p><strong>Purpose: </strong>We sought to assess for the presence of spin bias in abstracts of systematic reviews and meta-analyses (SRMAs) comparing RA-THA to conventional total hip arthroplasty (C-THA).</p><p><strong>Methods: </strong>We conducted a systematic review of studies identified in a comprehensive search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from each database's inception to June 23, 2025. Search terms included \"robotic,\" \"hip,\" \"arthroplasty,\" \"systematic review,\" and \"meta-analysis.\" Inclusion criteria were (1) SRMAs evaluating outcomes of RA-THA, (2) studies comparing RA-THA to conventional techniques, and (3) publications in English. Studies were excluded if they (1) assessed RA-THA with other robotic-assisted joint arthroplasty procedure, or (2) assessed RA-THA surgery alongside other technologies. Abstracts were assessed for the 15 most severe forms of spin as defined by Yavchitz et al. Methodological quality was assessed using the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2) tool.</p><p><strong>Results: </strong>Twelve SRMAs were eligible for inclusion. Eleven SRMAs (91.7%) contained at least 1 of the 15 most severe forms of spin. Type 3 spin (<i>selective reporting of efficacy outcomes favoring the intervention</i>) was the most common (58%), followed by type 5 (<i>conclusion claims the beneficial effect of the experimental intervention despite high risk of bias in primary studies</i>; 50%), and type 11 (<i>conclusion focuses selectively on statistically significant efficacy outcome;</i> 33.3%). No differences in study characteristics were found between SRMAs with and without the aforementioned types of spin. All SRMAs were rated as \"critically low\" in methodological quality, with most not reporting funding source of included studies (91.7%).</p><p><strong>Conclusion: </strong>This systematic review found there is a high prevalence of spin bias in abstracts of SRMAs evaluating RA-THA. The most common type of spin involved selective reporting of outcomes favoring RA-THA (type 3). Future SRMAs can minimize spin by presenting balanced reporting of efficacy, or lack thereof, in their abstracts and strengthen methodological rigor by consistently reporting study funding sources.</p><p><strong>Level of evidence: </strong>Level IV, Systematic review of level-I to level-IV studies.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261430336"},"PeriodicalIF":1.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction According to Zonal Fixation and Adequate Imaging Techniques in Revision Total Knee Arthroplasty: A Narrative Review.","authors":"Johannes M Herold, Christian Manuel Sterneder, Peter K Sculco, Friedrich Boettner","doi":"10.1177/15563316261432646","DOIUrl":"https://doi.org/10.1177/15563316261432646","url":null,"abstract":"<p><p>Aseptic loosening is one of the main causes of failure for both primary and revision total knee arthroplasty (rTKA). Bone loss and bone quality can vary significantly across anatomical regions, potentially challenging long-term fixation. In recent years, zonal fixation in rTKA has become increasingly popular; this approach divides areas of fixation based on anatomy into 3 zones: epiphysis, metaphysis, and diaphysis. This system emphasizes the importance of preoperative planning and encourages surgeons to carefully select the fixation method for each respective zone. To plan proper fixation, adequate imaging is required to document bone defects and areas of sclerosis. While anteroposterior and lateral radiographs remain the gold standard for defect classification, computed tomography imaging has facilitated 3-D defect evaluation and bone density assessment. For many years cemented and hybrid fixation have been the main modes of fixation in rTKA, but recently these modes of fixation have been augmented by the use of uncemented cones and sleeves. Through bone ingrowth this type of fixation provides lasting fixation in the metaphysis and seems to reduce the need for longer stem fixation in the diaphysis. This narrative review provides an overview of advanced imaging techniques, defect grading, and principles of implant fixation using the concept of zonal fixation.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261432646"},"PeriodicalIF":1.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Outpatient Surge in Total Hip Arthroplasty: National Trends in Volume Migration, Demographic Disparities, and Comorbidity Profiles (2019-2022).","authors":"Joseph S Geller, Aneesh Samineni, Ronald M Swonger, David Constantinescu, Natalia Cruz-Ossa, Michele R D'Apuzzo","doi":"10.1177/15563316261431234","DOIUrl":"10.1177/15563316261431234","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) continues to shift from inpatient to outpatient facilities.</p><p><strong>Purpose: </strong>We sought to examine trends in THA settings, demographic differences, and comorbidity variations to inform patient selection, outcomes, and policy.</p><p><strong>Methods: </strong>We performed a retrospective study using data from January 1, 2019, to December 31, 2022, which we obtained from the Nationwide Inpatient Sample database and Nationwide Ambulatory Surgery Sample, from the U.S. Agency for Healthcare Research and Quality. Patients undergoing primary, elective THA were identified.</p><p><strong>Results: </strong>Of the 1 449 639 patients we identified who underwent elective THA, 843 824 underwent the procedure in a hospital-owned ambulatory facility and 605 815 in a hospital (inpatient setting). A total of 86% of THA volume migrated to outpatient centers from 2019 to 2022. Patients who underwent THA at an outpatient facility versus an inpatient setting were younger (65.3 vs 66.3 years). A higher percentage of female versus male patients had surgery in a hospital than in an outpatient center (56.2% vs 53.8%). White and black patients were more likely to be treated at an inpatient facility, whereas Hispanic patients were more likely to be treated at an outpatient facility. Medicare and Medicaid patients were more likely to undergo surgery as inpatients. Patients with medical comorbidities, as well as smokers and patients with opioid use disorder, were overwhelmingly more likely to undergo inpatient THA.</p><p><strong>Conclusion: </strong>This retrospective database analysis found that from 2019 through 2022, outpatient THA numbers increased each year, with 90% of THAs being performed in hospital-owned ambulatory facilities in 2022. Patients with significant medical comorbidities and Medicare/Medicaid insurance, as well as white and black patients, were more likely to have inpatient surgery.</p><p><strong>Level of evidence: </strong>Level III, Retrospective Database Study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261431234"},"PeriodicalIF":1.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative GLP-1 Receptor Agonist Use Is Not Associated With Complications in Non-Obese Patients Undergoing Total Shoulder Arthroplasty: A Propensity Score Matched Large Database Analysis.","authors":"Alexander E White, Tyler Khilnani, Argen Omurzakov, Arsen M Omurzakov, Samuel A Taylor","doi":"10.1177/15563316261439127","DOIUrl":"10.1177/15563316261439127","url":null,"abstract":"<p><strong>Background: </strong>As the demand for total shoulder arthroplasty (TSA) increases, it is imperative to optimize preoperative risk factors. While glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are used for glycemic control or weight management in patients with obesity or diabetes, the impact of preoperative use on postoperative TSA outcomes in non-obese patients is unknown.</p><p><strong>Purpose: </strong>We sought to answer the question: Does preoperative use of GLP-1 RAs lead to increased risk of medical or surgical complications after TSA?</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the TriNetX Network to analyze non-obese patients (BMI <30 kg/m²) who underwent anatomic or reverse shoulder arthroplasty between 2013 (the inception of the network) and January 2024 and had at least 1 year of follow up. Patients were categorized by preoperative GLP-1 RA use and matched 1:1 using propensity scores to balance the cohorts based on demographic variables and comorbidities. Outcomes assessed at 90 days and 1 year included revision surgery, emergency department visits, readmission, venous thromboembolism, pulmonary embolism, acute kidney injury, prosthetic joint stiffness, postoperative rotator cuff tear, dislocation, periprosthetic fracture or joint infection, surgical site infection, aspiration, cardiac arrest, and blood transfusion.</p><p><strong>Results: </strong>Among 108 352 non-obese patients, 845 used GLP-1 RAs preoperatively. After propensity score matching, 845 patients remained in each cohort with no significant baseline differences. In the 90 day postoperative period, there were no significant differences in any medical complications between the GLP-1 RA and control groups. Similarly, at 1 year, there were no significant differences in any medical or surgical complications between groups.</p><p><strong>Conclusion: </strong>This retrospective cohort study found that preoperative GLP-1 RA use in non-obese TSA patients was not associated with an increased rate of major postoperative medical or surgical complications.</p><p><strong>Level of evidence: </strong>Level III: retrospective cohort study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261439127"},"PeriodicalIF":1.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Annular Closure Device Reduces Symptomatic Reherniation Rates: Results of a Meta-analysis.","authors":"","doi":"10.1177/15563316261439563","DOIUrl":"https://doi.org/10.1177/15563316261439563","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1177/15563316231215796.].</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261439563"},"PeriodicalIF":1.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Challenges of Using Administrative Data to Study Pediatric Tibial Tubercle Fracture-Associated Compartment Syndrome.","authors":"Marko Bašković, Domagoj Pešorda","doi":"10.1177/15563316261433582","DOIUrl":"10.1177/15563316261433582","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261433582"},"PeriodicalIF":1.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixation of Basicervical Hip Fractures: Are Outcomes Distinct from Neighboring Valgus Neck and Intertrochanteric Fractures?","authors":"Benjamin Hammond, Chloe Fong, Dillon Murugesan, Abhishek Ganta, Sanjit Konda, Kenneth Egol","doi":"10.1177/15563316261429896","DOIUrl":"10.1177/15563316261429896","url":null,"abstract":"<p><strong>Background: </strong>Basicervical (BC) hip fractures represent a unique proximal femur fracture pattern for which the optimal treatment approach remains uncertain.</p><p><strong>Purpose: </strong>We sought to evaluate demographic, perioperative, and outcome differences among patients with BC (31B3), intertrochanteric (IT; 31A1.2), and valgus femoral neck (VFN; 31B1.1) fractures treated with internal fixation.</p><p><strong>Methods: </strong>We conducted a retrospective review using prospectively collected data from October 2014 to March 2025 from a hip fracture database comprising 2 urban trauma centers. Patients with AO/OTA-classified 31B3, 31A1.2, or 31B1.1 fractures treated with non-arthroplasty fixation were included. Demographics, comorbidities, fracture characteristics, surgical constructs, and short- and long-term outcomes were compared. Multivariate regressions adjusted for baseline health and procedure type.</p><p><strong>Results: </strong>Of the 875 patients who met inclusion criteria, 122 had BC fractures, 523 had IT fractures, and 230 had VFN fractures. Patients with BC fractures were significantly younger than those with IT fractures; they had higher American Society of Anaesthesiologist scores and a greater proportion of household ambulators compared to those with VFN fractures, but were otherwise similar in comorbidity status. The BC cohort had significantly more minor in-hospital complications compared to the VFN cohort, even after multivariate adjustment. No significant differences were observed in 30-day mortality or major complications. Long-term outcomes were comparable across all groups. No significant differences in short- or long-term outcomes were observed across surgical constructs within the BC cohort.</p><p><strong>Conclusion: </strong>Despite differing in baseline health status and surgical fixation strategies, BC fractures demonstrated comparable long-term outcomes to IT and VFN fractures. However, higher rates of minor complications in the BC group, even after adjustment, highlight a potentially greater perioperative risk. These findings suggest that while fixation may be effective long-term, further research is warranted to optimize acute management strategies for this anatomically and clinically distinct fracture pattern.</p><p><strong>Level of evidence: </strong>Level IV: Prognostic retrospective study.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261429896"},"PeriodicalIF":1.3,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thomas A. Sculco, MD: A Commitment to Diversity and Inclusion.","authors":"Charles N Cornell","doi":"10.1177/15563316261433546","DOIUrl":"10.1177/15563316261433546","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316261433546"},"PeriodicalIF":1.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}