Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Discovery of Posterior Oblique Ligament (POL) within the Distal Forearm Cruciate Complex (DFCC).","authors":"Amir R Kachooei","doi":"10.22038/ABJS.2025.85035.3872","DOIUrl":"10.22038/ABJS.2025.85035.3872","url":null,"abstract":"<p><strong>Objectives: </strong>To introduce a ligament in the posterior distal extent of the forearm interosseous membrane (IOM).</p><p><strong>Methods: </strong>Ten cadavers were dissected in which the ligament was consistently present extending obliquely from the distal radius metaphysis to the distal radioulnar joint capsule. The ligament was also explored in a patient during posterior interosseous nerve (PIN) excision.</p><p><strong>Results: </strong>The posterior oblique ligament (POL) is found consistently in all cadavers via a dorsal approach.</p><p><strong>Conclusion: </strong>This discovery highlights the complexity of forearm ligamentous structures and their role in the proximal, middle, and distal radio-ulnar stabilization.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 3","pages":"134-137"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732335","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":"Subspecialties and Characteristics of Leadership Position in Orthopaedic Surgery.","authors":"Mohammad Daher, Oscar Covarrubias, Tarishi Parmar, Marc Boutros, Pedro Yammine, Peter BouFadel, Ryan Lopez, Mohamad Y Fares, Adam Z Khan, Joseph A Abboud","doi":"10.22038/ABJS.2024.80029.3654","DOIUrl":"10.22038/ABJS.2024.80029.3654","url":null,"abstract":"<p><strong>Objectives: </strong>The composition of department leadership, notably the Department Chair and Program Director, plays a pivotal role in \"Match\" decision making and further residency training. This study aims to examine the current landscape of subspecialties and other demographic characteristics of the Department Chairs and Program Directors of orthopaedic surgery residency programs across the United States.</p><p><strong>Methods: </strong>A list of Department Chairs and Program Directors of all 201 ACGME orthopaedic surgery residency programs was generated from the Orthopaedic Residency Information Network (ORIN) website. Demographic information, years of practice, research productivity (H-Index), and subspecialty for both Chairpersons and Program Directors were gathered. Information was available on 163/201 department chairs and 199/201 program directors.</p><p><strong>Results: </strong>Among the 163 Department Chairs, Sports (24.5%), Adult Reconstruction (16.6%), and Trauma (13.5%) emerged as the most prevalent subspecialties, while Shoulder and Elbow (5.5%), Pediatrics (3.7%), and General Orthopedics (1.8%) were the least represented. Among the 199 Program Directors, Trauma (22.1%), Sports (17.1%), and Hand and Upper Extremity (14.1%) were the most common, while Shoulder and Elbow (6.0%), Foot and Ankle (5.5%), and General Orthopedics (1.0%) were the least represented. Chairpersons exhibited notably higher mean years of practice, mean H-index, and were more commonly male compared to Program Directors. However, in the multivariable regression model predicting leadership position, only years of practice and H-index were found to be significant predictors.</p><p><strong>Conclusion: </strong>Sports, trauma, joint reconstruction, and hand were the most common subspecialities among those in positions of leadership explained by their higher prevalence among American-board orthopedic surgeons. Furthermore, H-index and years of practice were both predictors of being a chairperson.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 1","pages":"39-46"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068821","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":"Artificial Intelligence and the State of the Art of Orthopedic Surgery.","authors":"Mohammad Amin Khojastehnezhad, Pouya Youseflee, Ali Moradi, Mohammad H Ebrahimzadeh, Nafiseh Jirofti","doi":"10.22038/ABJS.2024.84231.3829","DOIUrl":"10.22038/ABJS.2024.84231.3829","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is rapidly transforming healthcare, particularly in orthopedics, by enhancing diagnostic accuracy, surgical planning, and personalized treatment. This review explores current applications of AI in orthopedics, focusing on its contributions to diagnostics and surgical procedures. Key methodologies such as artificial neural networks (ANNs), convolutional neural networks (CNNs), support vector machines (SVMs), and ensemble learning have significantly improved diagnostic precision and patient care. For instance, CNN-based models excel in tasks like fracture detection and osteoarthritis grading, achieving high sensitivity and specificity. In surgical contexts, AI enhances procedures through robotic assistance and optimized preoperative planning, aiding in prosthetic sizing and minimizing complications. Additionally, predictive analytics during postoperative care enable tailored rehabilitation programs that improve recovery times. Despite these advancements, challenges such as data standardization and algorithm transparency hinder widespread adoption. Addressing these issues is crucial for maximizing AI's potential in orthopedic practice. This review emphasizes the synergistic relationship between AI and clinical expertise, highlighting opportunities to enhance diagnostics and streamline surgical procedures, ultimately driving patient-centric care.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 1","pages":"17-22"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068771","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":"Factors Associated with the Clinical Outcomes of Ankle Instability Surgery.","authors":"Yashar Shahbaz, Mahla Daliri, Mohammad H Ebrahimzadeh, Sayyed Hadi Sayyed Hosseinian","doi":"10.22038/ABJS.2024.74008.3427","DOIUrl":"10.22038/ABJS.2024.74008.3427","url":null,"abstract":"<p><strong>Objectives: </strong>More than 20% of patients experience chronic lateral ligamentous instability of the ankle (CLLIOTA) following the appropriate management of an ankle sprain. The modified Broström-Gould (MBG) procedure has become the standard treatment for the anatomic repair of symptomatic CLLIOTA.</p><p><strong>Methods: </strong>This retrospective, single-group study included all patients with CLLIOTA who underwent surgery using the MBG technique in Shahid Kamyab Hospital, Mashhad, Iran, between July 2015 and August 2020. The American Orthopedic Foot and Ankle Score (AOFAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and Pain Visual Analog Scale (VAS) were used to evaluate the outcome. The correlation between patient-related factors and each outcome measure was also analyzed.</p><p><strong>Results: </strong>In total, 38 patients underwent the MBG procedure. The mean follow-up was 40.1 (18-67) months. Overall, 15 patients (39.47%) had a history of sports-related ankle sprains, and 15 (39.47%) had ankle osteochondral lesions. The AOFAS score improved significantly (51.23±13.49 to 91.92±12.077, P<0.001), while MOXFQ and VAS scores decreased significantly in the follow-up evaluation (50.28±9.33 to 27.5±13.35, P<0.001, and 6.2±1.47 to 2.18±1.86, P<0.001, respectively). No significant correlation was found between pre-operative ankle osteoarthritis, talus osteochondral lesion, duration of the follow-up, ankle sprain etiology (sports vs. non-sports), age, body mass index, gender, and the interval between the first sprain and surgery on the one hand, and post-operative outcomes, on the other hand. The more time passed after the surgery, the less painful the ankle of the patient was (P=0.038). No failure was observed among the patients.</p><p><strong>Conclusion: </strong>This study showed that the open MBG technique for CLLIOTA can improve clinical outcomes with no major complications following surgery in the Iranian population.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 1","pages":"30-38"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068787","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":"Trends in Orthopaedic Surgery on Patients 90 Years Old and Older 2014-2023.","authors":"Lilah Fones, Amir R Kachooei, Pedro K Beredjiklian","doi":"10.22038/ABJS.2024.82754.3768","DOIUrl":"10.22038/ABJS.2024.82754.3768","url":null,"abstract":"<p><strong>Objectives: </strong>The United States (US) population is aging with an increasing number of older adults over 90 years old. The primary purpose of this study is to evaluate trends in orthopaedic surgeries in patients 90 years old and greater over the past decade from 2014-2023.</p><p><strong>Methods: </strong>Patients ≥90 years old at the time of surgery at a single orthopaedic specialty practice from 2014 through 2023 were identified. All patients that underwent nonsurgical treatment were excluded. Surgeries were categorized by musculoskeletal area and procedure type by CPT codes. Musculoskeletal areas include Shoulder, Humerus/Elbow, Forearm/Wrist, Hand/Fingers, Pelvis/Hip, Femur/Knee, Leg/Ankle, Foot/Toes, Spine, Integumentary, Nervous System, and Other.</p><p><strong>Results: </strong>Over the last decade, 5,291 orthopaedic surgeries were performed on 4,807 patients 90 years old and older (age range 90-107 years old; 75% female). Of these patients, 91% underwent only one surgery while ≥90 years old, while the remaining underwent between two to five surgeries. The number of surgeries each year ranged from 180 to 680 with a positive correlation between year and number of surgeries and a greater than threefold increase in surgeries 2014-2023. The Pelvis and Hip were the primary musculoskeletal areas of surgery, accounting for 69% of surgeries overall, followed by femur and knee (11%) and nervous system (which includes carpal tunnel release, 5.2%). Most surgeries (69%) were for a fracture or dislocation.</p><p><strong>Conclusion: </strong>There is an increase in volume of orthopaedic surgery on patients ≥90 years old over the last decade between 2014-2023, the majority of which were performed on the hip and pelvis and for fractures or dislocations. As older adults ≥90 years old continue to increase in the population, we project the surgical volume will continue to grow and place a large financial burden on the US healthcare system.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 3","pages":"157-163"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732369","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":"Outcomes and Complications of Arthroscopic Treatment for Septic Arthritis of the Hip: A Systematic Review.","authors":"Mohammad Poursalehian, Sina Hajiaghajani, Amirhosein Sabaghian, Amir Human Hoveidaei, Janet D Conway","doi":"10.22038/ABJS.2024.80263.3668","DOIUrl":"10.22038/ABJS.2024.80263.3668","url":null,"abstract":"<p><strong>Objectives: </strong>The exact role and safety of arthroscopy in SAH management remain contentious. This systematic review aims to assess the outcomes and complications of arthroscopic treatment, shedding light on its efficacy and safety profile.</p><p><strong>Methods: </strong>Following PRISMA guidelines, searches were conducted in PubMed, Scopus, Embase, and Web of Science until January 25, 2024. Eligible studies included SAH patients undergoing arthroscopic treatment. Data extraction covered demographics, clinical findings, and functional outcomes. Quality assessment used NIH case series assessment and Newcastle-Ottawa Scale. Quantitative analysis focused on Hip Harris Score, post-operative pain rate, and revision rate using a random-effects model. Comprehensive Meta-Analysis (CMA) software version 3.3 facilitated analyses.</p><p><strong>Results: </strong>The primary search yielded 1,662 articles, after screening the records, 35 study included. In case report studies, 18 patients were analyzed with an average age of 33.7 years. Complications included joint ankylosis, osteonecrosis, muscle atrophy, and osteopenia. Revision surgery was performed in three cases, with one due to infection. In case series studies, 295 patients with an average age of 15.6 years had complications such as joint collapse, femoral nerve palsy, and avascular necrosis. Thirteen revision cases were reported. Among 18 case series, arthroscopic complications were noted in nine studies, while six studies reported none. Full range of motion was achieved in 13 studies, and pain resolution in 11.</p><p><strong>Conclusion: </strong>Utilizing arthroscopic techniques for treating septic arthritis of the hip represents a safe, effective, and minimally invasive choice, demonstrating favorable clinical results, relatively low rates of revision and complications, and rapid rehabilitation periods.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 2","pages":"62-74"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469504","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":"Patient Reported Outcomes of Total Knee Arthroplasty with Ultra-congruent Lipped Polyethylene Liners: A Randomized Study.","authors":"Jonathan Liu, Mohammad Daher, Jacob Laperche, Drew Clippert, Zainab Ibrahim, Thomas J Barrett, Valentin Antoci","doi":"10.22038/ABJS.2024.80407.3674","DOIUrl":"10.22038/ABJS.2024.80407.3674","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to compare the Depuy curved (CVD) polyethylene insert to the curved plus (CVD+) design in TKA, which has an increased dished curve for increased articulation congruence and thus secondary anterior to posterior stability.</p><p><strong>Methods: </strong>A randomized controlled trial with 100 patients was conducted to compare two knee replacement designs (CVD and CVD+ polyethylene inserts) using the Johnson and Johnson DePuy PFC Sigma total knee replacement. All participants, were randomized and blinded to reduce bias. The trial achieved 100% recruitment and maintained blinding throughout the study. Demographics, baseline characteristics, and KOOS scores were recorded pre-operatively, and at 3 and 12 months postoperatively. In addition, physical and mental component scores (PCS and MCS) were collected at 12 months post-operatively.</p><p><strong>Results: </strong>Sixty patients had preoperative data, split equally into CVD and CVD+ groups. The cohort's average age was 71.47 years, and 72% were female, with no statistically significant demographic differences between groups. Preoperative measures showed no differences in Pain, ADL, or QOL. At 3 months, no significant differences were noted, though the QOL difference was 64.45 ± 16.57 for CVD and 52.94 ± 27.1 for CVD+ (p = 0.15). At 12 months, trends favored the CVD group, but differences in Pain, ADL, QOL, PCS, and MCS were not significant. Complications were similar, except for stiffness, with 0 cases in the CVD group and 3 in the CVD+ group at 3 months; both had 2 additional cases at 12 months.</p><p><strong>Conclusion: </strong>In our study, there was no difference between designs in terms of pain, activities of daily living, and standard outcomes. Further studies are required to support the benefit of increased congruence in the CVD+ design, even though widespread adoption has been common across the industry.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 2","pages":"100-105"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469505","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":"Amputation after Multiple Times Failed Total Knee Arthroplasties: The Last Resort.","authors":"Bushu Harna, Shivali Arya, Anil Arora","doi":"10.22038/ABJS.2024.80181.3659","DOIUrl":"https://doi.org/10.22038/ABJS.2024.80181.3659","url":null,"abstract":"<p><strong>Objectives: </strong>The study assessed the clinical and functional outcomes of transfemoral amputations following TKA complications, shedding light on a procedure often considered in extreme cases.</p><p><strong>Methods: </strong>In this retrospective study, six patients undergoing above-knee amputation due to TKA complications were analysed. Diagnosis of periprosthetic joint infection relied on clinical presentation and the Musculoskeletal Infection Society Definition (2011). Patient demographics, comorbidities, and surgical interventions were meticulously recorded. The study aimed to contribute valuable insights into the intricacies of managing complications post-TKA.</p><p><strong>Results: </strong>The study cohort, constituting 0.002% of total TKA cases, exhibited a mean age of 78.8 years. Comorbidities, predominantly diabetes, were prevalent. The duration between TKA and amputation averaged 6.3 years. Surgical interventions, including revisions, debridements, and aspirations, were numerous, reflecting the complexity of managing complications. All patients underwent above-knee amputation using a single-stage approach, with careful consideration of the surgical site's condition. Post-amputation care, including stump care and prosthetic leg options, was tailored to individual patients' needs. Patients were diligently followed for a minimum of 12 months. Stump wounds healed without requiring revisions, and prosthetic limbs were successfully applied to three patients. Mobility status and disability scores, evaluated through the Sickness Impact Profile (SIP), showed significant improvement.</p><p><strong>Conclusion: </strong>The study highlights periprosthetic joint infection as the primary cause of multiple failed procedures leading to amputation. Microbiological findings identified common pathogens, including Staphylococcus aureus and Pseudomonas aeruginosa. Challenges posed by biofilm formation underscored the complexities of antibiotic treatment. Transfemoral amputation emerges as a feasible option for patients with multiple failed TKAs, particularly in cases of persistent infection. The decision-making process should encompass a thorough consideration of the number of failed procedures, cost-benefit analysis, and various psychosocial and economic factors. Further research and extensive multicentric studies are imperative to validate and expand upon these findings.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 4","pages":"188-195"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040953","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":"Early Clinical Outcomes of Polyaxial Locking Cap Plate Fixation for Fixation of Displaced Olecranon Fractures.","authors":"Michael Jason Gutman, Manan Sunil Patel, James William Connelly, Edward Scott Paxton, Surena Namdari, John Gabriel Horneff","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to evaluate the outcomes of a polyaxial locking plate utilizing locking-cap fixation for treatment of patients with displaced olecranon fractures.</p><p><strong>Methods: </strong>A retrospective review was performed for all consecutive patients at two institutions with displaced olecranon fractures treated with a polyaxial locking plate. Patients were required to have at least 1-year follow up. Clinical outcomes including the Disabilities of the Arm, Shoulder, and Hand (DASH) score, Single Assessment Numeric Evaluation (SANE), along with a Likert-scaled satisfaction survey ranging between 1-5 (1= very unsatisfied and 5= very satisfied) were collected.</p><p><strong>Results: </strong>The plate osteosynthesis was performed on 24 patients with displaced olecranon fractures. Functional outcome scores were collected on 19 (79.2%) patients. The mean age at the time of surgery was 57.9 years (range, 23 to 78) and mean clinical follow-up was 21.0 ± 6.6 months (range, 12-34 months). All patients achieved osseous union in an acceptable position. Four (16.7%) patients complained of plate related pain and 6 (25%) patients complained of postoperative stiffness. Complications were found in 3 (12.5 %) patients, which included two neuropathies and one hardware failure in which a patient presented following a fall with a broken screw. No patients required revision surgery nor removal of hardware. A total of 16 (84%) patients were somewhat to very satisfied. The mean SANE score was 87.8 ± 14.6 (range: 45-100) and the mean DASH score was 13.8 + 17.5 (range: 0-55.8). Seventeen (89%) patients rated their elbows as 75% or better on SANE assessment and 16 (84%) patients achieved DASH scores of less than 30.</p><p><strong>Conclusion: </strong>Polyaxial plate fixation utilizing locking-cap technology resulted in excellent short-term functional outcomes in patients with displaced olecranon fractures. Further follow-up is needed to determine the long-term outcomes of locking-cap constructs for olecranon fractures.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 1","pages":"23-29"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068776","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":"Risk Factors and Outcomes Associated with Emergency Abdominal Surgery following Lower Extremity Total Joint Arthroplasty.","authors":"Annie Lu, Senthil Sambandam, Marc Gadda, Terrul Ratcliff, Sergio Huerta","doi":"10.22038/ABJS.2024.82090.3743","DOIUrl":"https://doi.org/10.22038/ABJS.2024.82090.3743","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to identify potential risk factors and assess postoperative outcomes associated with requiring emergency abdominal surgery (EAS) within 30 days following total hip arthroplasty (THA) and total knee arthroplasty (TKA). We hypothesized that patients requiring EAS would carry a higher morbidity and mortality rates compared to patients that underwent the index operation alone.</p><p><strong>Methods: </strong>We conducted a retrospective analysis using TriNetX, examining data from 2016-2024 from patients over 18 years old who underwent THA/TKA and required EAS within 30 days. Postoperative outcomes, including mortality and hospital readmission, were compared between patients requiring EAS and those who did not. Statistical analyses included measures of association and chi-squared tests. Patient demographic data, including age, sex, and comorbidities were analyzed.</p><p><strong>Results: </strong>Patients requiring EAS within 30 days of a joint arthroplasty were significantly more likely to be older, overweight or obese, and to be diagnosed with comorbidities including diverticular disease, cholelithiasis, alcohol use disorders, and tobacco use. These patients had significantly higher mortality rates within 60 days of joint arthroplasty compared to patients without EAS, suggesting that the second operation contributed significantly to the increase in adverse outcomes.</p><p><strong>Conclusion: </strong>This study emphasizes the importance of recognizing key risk factors for severe GI complications that require EAS. These findings highlight the need for careful patient selection, pre-operative evaluation of risk, and vigilant post-operative management, especially in those with many risk factors. Improved identification and management of high-risk patients may help reduce the likelihood of EAS and its associated mortality.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"13 4","pages":"196-203"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051035","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}