Lucas S Marchand, Makoa Mau, Andrew Stephens, Justin M Haller, Thomas F Higgins, David L Rothberg
{"title":"Operative treatment of clavicle fractures results in more opioids prescribed as compared to non-operative management.","authors":"Lucas S Marchand, Makoa Mau, Andrew Stephens, Justin M Haller, Thomas F Higgins, David L Rothberg","doi":"10.1007/s00590-024-04058-7","DOIUrl":"10.1007/s00590-024-04058-7","url":null,"abstract":"<p><strong>Purpose: </strong>The operative treatment of mid-shaft clavicle fractures shows benefit in union rates, return to work, and lower pain scores relative to non-operative treatment. We sought to determine if the surgical treatment of isolated mid-shaft clavicle fractures would result in fewer opioids prescribed as compared to those managed non-operatively.</p><p><strong>Methods: </strong>All mid-shaft clavicle fractures treated at a Level 1 trauma center were identified from 2012 to 2016. Demographics, fracture characteristics, surgical complications/outcomes, non-operative outcomes, and all narcotics prescribed for 6 months post-injury were collected. Narcotic prescriptions, in morphine equivalents (ME), were obtained through the state prescription drug monitoring program (PDMP).</p><p><strong>Results: </strong>One hundred and ten operative and 48 non-operative patients were included. Age, gender, previous alcohol, tobacco or drug use, and final range of motion were similar between groups. Pre-treatment fracture shortening (1.8 cm vs. 0.7 cm, p < 0.001) and displacement (150% vs. 70%, p < 0.001) were greater in the operative group. Total ME's (604 vs. 187, p < 0.001) and post-operative ME's (420 vs. 187, p < 0.001) were greater for the operative group. In either group, no other variable influenced ME's prescribed.</p><p><strong>Conclusion: </strong>Clavicles treated operatively receive substantially more opiates than those treated non-operatively, despite data suggesting that operative treatment makes clavicle fractures less painful. The total amount of narcotic analgesics obtained by operatively treated patients was over three times that obtained by non-operatively managed patients, which equates to 55 5 mg oxycodone pills or 85 5 mg hydrocodone pills per patient. While there may certainly be advantages to the operative treatment of clavicle fractures, they must be weighed against the risks of a significant increase in opiate prescribing and potential consumption.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"3881-3887"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299940","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}
Samuel R Montgomery, Sharif Garra, Michael Moore, Sarah Levitt, Robyn Lipschultz, Eric Strauss, Daniel Kaplan, Laith Jazrawi
{"title":"Posterior tibial slope angle in contact versus non-contact anterior cruciate ligament injuries.","authors":"Samuel R Montgomery, Sharif Garra, Michael Moore, Sarah Levitt, Robyn Lipschultz, Eric Strauss, Daniel Kaplan, Laith Jazrawi","doi":"10.1007/s00590-024-04104-4","DOIUrl":"10.1007/s00590-024-04104-4","url":null,"abstract":"<p><strong>Background: </strong>Increased Posterior Tibial Slope (PTS) angle has been reported to be a risk factor for primary anterior cruciate ligament (ACL) tears. However, it is unknown whether increased PTS has an associated increased risk for non-contact versus contact ACL injury.</p><p><strong>Purpose: </strong>The purpose of this study is to determine whether patients with non-contact ACL injury have a higher PTS angle than those with contact ACL injury.</p><p><strong>Methods: </strong>A total of 1700 patients who underwent primary ACL reconstruction between January 2011 and June 2023 at a single academic institution were initially included. Electronic medical records were reviewed for demographic information as well as evidence that the patient sustained a contact or non-contact ACL injury. Patients in the contact cohort were propensity score matched to patients in the non-contact cohort by age, sex and BMI. Additionally, patients in the contact cohort were then propensity score matched to a control group of patients with intact ACLs also by age, sex and BMI.</p><p><strong>Results: </strong>One hundred and two patients with contact injury were initially identified and 1598 patients with non-contact injuries were identified. Of the 102, 67 had knee X-rays that were suitable for measurement. These 67 contact injury patients were propensity score matched to 67 noncontact patient and 67 patients with intact ACLs based on age, sex and BMI. There were no significant differences between contact and non-contact cohorts in age (28.7±6.3 vs. 27.1±6.5, p = 0.147), sex (Female: 36.0% vs. 34.3%, p = 0.858), or BMI (26.7±5.6 vs 26.1±3.4, p = 0.475). There was no significant difference in PTS angle between contact versus non-contact ACL injury patients (11.6±3.0 vs.11.6±2.8, p = 0.894). There was a significant difference in PTS between the contact ACL injury and the intact cohort (11.6±3.0 vs. 10.0±3.9, p = 0.010) and the non-contact ACL injury and the intact cohort (11.6±2.8 vs. 10.0±3.9, p = 0.010).</p><p><strong>Conclusion: </strong>There was no significant difference in the degree of PTS between patients who sustained contact versus non-contact ACL injuries. Additionally, there was a significantly increased PTS in both the contact and non-contact ACL injury cohorts compared to patients with intact ACLs.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"4037-4042"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362449","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":"Prevention of heterotopic ossification in primary total hip arthroplasty: a bone in the dark.","authors":"Filippo Migliorini, Nicola Maffulli","doi":"10.1007/s00590-024-04087-2","DOIUrl":"10.1007/s00590-024-04087-2","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"3805-3807"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331664","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":"Free bone fragments are associated with the development of heterotopic ossification after hemiarthroplasty for femoral neck fracture: a retrospective observational study.","authors":"Hiroyuki Yokoi, Yasuhiko Takegami, Satoshi Ochiai, Takumi Miyachi, Tetsuya Urasaki, Shiro Imagama","doi":"10.1007/s00590-024-04083-6","DOIUrl":"10.1007/s00590-024-04083-6","url":null,"abstract":"<p><strong>Purpose: </strong>Heterotopic ossification (HO) can occur after hemiarthroplasty (HA) for femoral neck fractures (FNF). This study aimed to investigate the frequency and factors contributing to the development of HO after HA.</p><p><strong>Methods: </strong>The study included data from 92 of 183 patients (26 male and 66 female) who sustained FNF and underwent HA between April 2019 and January 2022. HO was identified on postoperative radiographic images. Patient background, operative duration, blood loss, and presence of free bone fragments immediately after surgery were compared between the HO and non-HO groups. Statistical analyses included the independent-sample t-test for continuous variables and the chi-squared test for categorical variables. A multivariate logistic regression analysis was performed using HO as an objective variable.</p><p><strong>Results: </strong>HO occurred in 50 of the 92 (54%) patients. There were no statistically significant differences in patient backgrounds. Univariate analysis revealed significantly longer mean operative duration and greater blood loss in the HO group. Free bone fragments in the immediate postoperative period were observed in 29 of 50 (58%) patients in the HO group and in 3 of 42 (7.1%) patients in the non-HO group, a statistically significant difference. Logistic regression analysis revealed that the presence of free bone fragments was an independent explanatory factor for HO development.</p><p><strong>Conclusion: </strong>The presence of free bone fragments immediately after surgery may be significantly associated with the development of HO. Therefore, it is necessary to sufficiently remove such fragments during surgery because they may trigger HO.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"3947-3953"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114412","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":"Influence of statin use on progression of postoperative fatty infiltration in the arthroscopic rotator cuff repair.","authors":"Kotaro Yamakado","doi":"10.1007/s00590-024-04084-5","DOIUrl":"10.1007/s00590-024-04084-5","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the influence of hyperlipidemia and statin (hydroxyl-methylglutaryl-coenzyme-A reductase inhibitors) use on fatty infiltration (FI) of the rotator cuff muscle after arthroscopic rotator cuff repair (ARCR). The presence or absence of statin use and type of statins used (type 1 naturally derived statins and type 2 synthetic statins) were examined.</p><p><strong>Methods: </strong>This was a retrospective review of 620 cases (620 shoulders) who underwent arthroscopic rotator cuff repair. Total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG) levels, and statin use were reviewed with the medical records. FI of the cuff muscles and repair integrity were assessed by MRI. A generalized linear model was used to analyze the progression of fatty infiltration. Repair integrity was determined according to the Sugaya classification, with types 4 and 5 as retears.</p><p><strong>Results: </strong>The mean age was 66.9 years (272, females). The overall retear rate was 16.1%. There was no significant difference in retears between statin use and non-use with a trend toward higher retear rates in the type 2 statins. FI progressed postoperatively, and multivariate regression showed that type 2 statin use was a significant risk factor (p = 0.006). Other significant risk factor were large-to-massive tear (p = 0.02) and retear (p < .0001).</p><p><strong>Conclusions: </strong>The progression of FI after ARCR was observed. The new generation of strong statins (type 2 statins) was a significant risk factor for the progression of postoperative fatty infiltration, while neither serum lipid level (TC, LDL, and TG) was significant.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"3955-3960"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114414","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}
J Edwards, N D Clement, I Afzal, S Jones, D H Sochart
{"title":"Cancellation and short postponement of primary hip or knee arthroplasty does not influence postoperative joint specific function or health related quality of life.","authors":"J Edwards, N D Clement, I Afzal, S Jones, D H Sochart","doi":"10.1007/s00590-024-04088-1","DOIUrl":"10.1007/s00590-024-04088-1","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of cancellation and postponement of primary total hip arthroplasty (THA) or knee arthroplasty (TKA) on patient outcomes is unclear. The aim was to assess whether cancellation and delay to arthroplasty was associated with worse joint specific function and quality of life (QoL) 1-year postoperatively.</p><p><strong>Methods: </strong>A single centre retrospective case-control study was performed for all patients planned to undergo THA or TKA in 2019. A total of 3133 arthroplasties were scheduled for 2019 (1484 THA, 1649 TKA), of which 344 (11.0%) were cancelled (136 THA [9.2%], 208 TKA [12.6%]). Pre-operative and one-year post-operative EuroQol (EQ-5D) and Oxford hip (OHS) or knee (OKS) scores were collected.</p><p><strong>Results: </strong>The median time between the date of cancellation and the subsequent operation was 46.0 days for TKA and 45.5 days for THA. The cancelled group were more likely to be male (odds ratio [OR] 1.23, p = 0.03), older (mean difference [MD] 1.19, p = 0.03), with a higher ASA grade (OR 1.88 [ASA 3], OR 5.3 [ASA 4], p = 0.001) or planned for a TKA (OR 1.41, p = 0.003). There were no differences in pre-operative OKS (mean difference [MD] 0.19, p = 0.828) or EQ-5D (MD 0.028, p = 0.394) or in the one-year postoperative OKS (MD 1.51, p = 0.064) or EQ-5D (MD 0.041, p = 0.067) between groups undergoing TKA. However, cancelled THA patients had lower pre-operative OHS (MD 2.73, p = 0.018) and EQ-5D (MD 0.134, p = 0.0017) but at one-year postoperatively there was no difference in the absolute OHS (MD 2.07, p = 0.052) or EQ5D (MD 0.04, p = 0.142). The improvement in hip EQ-5D was greater (MD 0.096, p = 0.016) in the cancelled group.</p><p><strong>Conclusion: </strong>Cancellation and short delay did not influence joint specific outcome or QoL following THA or TKA at one-year. Preoperative hip specific pain, function and QoL were worse in cancelled THA patients, suggesting deterioration while waiting for their surgery, but this did not affect their postoperative outcome.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"3973-3979"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141600","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}
Christos Koukos, Vasileios Giannatos, Andreas Panagopoulos, Zinon Kokkalis, David Latz, Kerem Bilsel, Arrigoni Paolo, Fredy Montoya
{"title":"A match-pair analysis of single row vs transosseous equivalent double row in massive posterosuperior rotator cuff tears in patients > 70 years old.","authors":"Christos Koukos, Vasileios Giannatos, Andreas Panagopoulos, Zinon Kokkalis, David Latz, Kerem Bilsel, Arrigoni Paolo, Fredy Montoya","doi":"10.1007/s00590-024-04113-3","DOIUrl":"10.1007/s00590-024-04113-3","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the results of single versus double row (TEO) in massive tears of the posterosuperior rotator cuff in patients older than 70 years old.</p><p><strong>Methods: </strong>Between October 2019 and July 2022, 46 patients, older than 70 years old, were operated on, in two centers, by one surgeon (FM), in one center, we performed a single-row repair, while in the other a double row, transosseous equivalent. Patients were paired by age and gender. All patients were studied with a preoperative MRI along with preoperative age and gender adjusted constant score. Postoperative patients were evaluated at the end of the FU. Mean time of FU for single row was 3.2 years (2-4.1) and for TOE was 3.5 years (2.4-3). Mean age for SR patients was 71.15 years (70-82) and for TOE was 74.8 years (70-81). We were able to evaluate 20 pairs of patients (15 pairs of females and five pairs of males).</p><p><strong>Results: </strong>CS differed in both groups of patients. Patients operated on with TOE had a better, but non-significant CS 81.3 (TOE) versus 75.7 (SR) p > 0.05. The patients operated own with TOE showed statistically significant better arm abduction strength than patients operated on with SR (p < 0.05). There was a trend for patients operated on with TOE to have a better ROM and less pain.</p><p><strong>Discussion: </strong>The results of our work show that patients older than 70 years old, with repairable RCT operated on with a transosseous equivalent, have a trend to have a better CS and a significantly better strength than patients operated on with SR.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"4099-4104"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331658","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}
Wendell W Cole, Larry Chen, Isabel Wolfe, Ryan Isber, Robyn A Lipschultz, Michael R Moore, Thomas Youm
{"title":"Outcomes of sciatic neurolysis in chronic hamstring tears: a retrospective case series.","authors":"Wendell W Cole, Larry Chen, Isabel Wolfe, Ryan Isber, Robyn A Lipschultz, Michael R Moore, Thomas Youm","doi":"10.1007/s00590-024-04105-3","DOIUrl":"10.1007/s00590-024-04105-3","url":null,"abstract":"<p><strong>Purpose: </strong>Proximal hamstring tears may present with neurological dysfunction due to compression or stretching of the sciatic nerve. The purpose of this study was to evaluate the effectiveness of hamstring repair with concurrent sciatic nerve neurolysis for clinical outcomes and patient symptoms.</p><p><strong>Methods: </strong>A retrospective chart review of patients who were diagnosed with hamstring injury at a large tertiary care institution was conducted. Patients with chronic tears (> 6 weeks from injury to surgery) who underwent hamstring repair were reviewed for demographics, clinical variables including symptoms of sciatic neuritis, sciatic nerve abnormalities on MRI, and postoperative outcomes. Chi-square tests were used for categorical variables, t test for continuous variables. Pairwise t tests were used to compare average pre- and postoperative strength for patients with and without symptoms of sciatic neuritis.</p><p><strong>Results: </strong>Thirty-two patients with chronic hamstring tears were included in the analysis. Patients were 59.4% female with an average age of 51.4 years (SD 13.1). Preoperatively, 27 patients (84.4%) were noted to have symptoms of sciatic neuritis. These patients did not differ in age (p = .677) or sex (p = .374) from patients without preoperative symptoms. Sciatic nerve abnormalities were noted on MRI report in 7 patients who had sciatic nerve symptoms and 0 patients who did not have sciatic nerve symptoms. Symptomatic improvement was seen in 21/26 (81%) of patients who had preoperative neurological symptoms, and in 6/7 (86%) of patients with MRI findings. All patients had equivalent or improved strength postoperatively.</p><p><strong>Conclusion: </strong>A sciatic nerve neurolysis is a safe and effective procedure to perform on patients with preoperative sciatic nerve symptoms and chronic hamstring tears that leads to improvement in neurological symptoms and strength. In neurologically asymptomatic patients with chronic hamstring injuries and MRI findings indicating possible nerve damage, a discussion should be held about the risks and benefits of performing a sciatic nerve neurolysis.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"4043-4048"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331662","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}
Patrick Gahr, Josephine Wittmüß, Heiner Martin, Thomas Beyer, Dagmar-C Fischer, Thomas Mittlmeier
{"title":"Placing the tibial component of an ankle prosthesis: results of a CT-based simulation in healthy adults.","authors":"Patrick Gahr, Josephine Wittmüß, Heiner Martin, Thomas Beyer, Dagmar-C Fischer, Thomas Mittlmeier","doi":"10.1007/s00590-024-04112-4","DOIUrl":"10.1007/s00590-024-04112-4","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the 3D geometry of the distal tibia resection area from healthy individuals using CT-based digital implantation for proper preoperative sizing of TAA tibia component placement.</p><p><strong>Methods: </strong>Standardized CT images of healthy ankle joints serving as intra-individual references for treatment of contralateral injuries were identified. The tibial cross section dedicated to virtually host the tibial component was digitally prepared, and the size of the virtual contact surface was calculated. Finally, out of five prototypes the one fitting best in terms of size and alignment was identified.</p><p><strong>Results: </strong>CT scans taken from 319 subjects were used for the virtual implantation procedure. Body height and size of the distal tibia contact area correlated (r = 0.49 and 0.42 in females and males, each p < 0.001). Prosthesis sizes 2 and 3 fit well for the vast majority of patients, while the smallest and largest sizes are rarely required.</p><p><strong>Conclusions: </strong>Digital implantation of the tibial component should be considered a valuable tool for preoperative planning as well as for the development of new implant types.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"4093-4098"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331663","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}
Amir Human Hoveidaei, Amirhossein Ghaseminejad-Raeini, Mohammad Sadegh Fallahi, Adrina Habibzadeh, Mohammad Saeid Khonji, Basilia Onyinyechukwu Nwankwo, Sarensa Palikhey, Janet D Conway
{"title":"Preoperative SSRI use increases perioperative transfusion need in patients undergoing surgical procedures on the hip joint.","authors":"Amir Human Hoveidaei, Amirhossein Ghaseminejad-Raeini, Mohammad Sadegh Fallahi, Adrina Habibzadeh, Mohammad Saeid Khonji, Basilia Onyinyechukwu Nwankwo, Sarensa Palikhey, Janet D Conway","doi":"10.1007/s00590-024-04069-4","DOIUrl":"10.1007/s00590-024-04069-4","url":null,"abstract":"<p><strong>Purpose: </strong>Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for psychiatric conditions. Previous studies have shown that SSRIs can increase bleeding risk by affecting platelet aggregation. However, their impact on perioperative outcomes in hip surgery remains uncertain. This case-control study examines the link between preoperative SSRI use and perioperative transfusion requirements in hip surgery patients.</p><p><strong>Methods: </strong>Data from the M161Ortho dataset of Pearl Diver patient records database were utilized. Patients who underwent hip joint surgery between 2010 and 2022 and had documented preoperative SSRI use within one month prior to surgery were included. Patients with coagulopathy disorders or coagulopathy medication use were excluded. Perioperative transfusion need was defined as receiving red blood cell or whole blood transfusions on the same date or within 10 days following the surgery.</p><p><strong>Results: </strong>A total of 75,374 patients with preoperative SSRI use were matched with an equal number of non-SSRI users. Preoperative SSRI use was associated with an increased risk of requiring perioperative transfusion (5.7% vs. 5.1%, P < 0.001). Subgroup analysis demonstrated increased transfusion risk in patients undergoing pinning (2.6% vs. 1.8%, P = 0.02), open reduction with internal fixation (ORIF) (8.9% vs. 8.2%, P = 0.007), and total hip arthroplasty (THA) (3.8% vs. 3.4%, P < 0.001), but no significant difference was observed in patients undergoing hemiarthroplasty.</p><p><strong>Conclusion: </strong>Clinicians should be aware of the potential risk of increased perioperative transfusion requirements in hip surgery patients using SSRIs, especially during pinning, ORIF, and THA procedures. It is essential to consider this when managing patients on SSRIs before hip surgery.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":" ","pages":"3903-3908"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057136","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}