European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Predicting cut-out in intertrochanteric fractures fixed with cephalomedullary nails: the role of tip-to-apex distance referenced to calcar (calTAD)--A retrospective analysis of 158 cases.","authors":"Germán Garabano, Andres Juri, Leonel Perez Alamino, Joaquin Anibal Rodriguez, Cesar Angel Pesciallo","doi":"10.1007/s00590-024-04130-2","DOIUrl":"https://doi.org/10.1007/s00590-024-04130-2","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal positioning of the cephalic screw in intertrochanteric fractures (ITFs) is crucial for minimizing the risk of cut-out. This study assesses the predictive value of the tip-to-apex distance (TAD) and tip-to-apex distance referenced to calcar (calTAD) for cut-outs in patients undergoing fixation with cephalomedullary nails.</p><p><strong>Method: </strong>We analyzed 158 consecutive patients aged over 65 years (mean 83.6 ± 15.9) with intertrochanteric hip fractures who underwent cephalomedullary nailing between January 2016 and July 2022. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off points for TAD and calTAD. Uni- and multivariate logistic regression analyses were conducted to identify independent predictors of cut-out, considering demographic data, comorbidities, fracture type (AO/OTA), reduction quality (according to Baumgartner classification), TAD, and calTAD.</p><p><strong>Results: </strong>Cut-out occurred in 12 patients (7.5%). ROC analysis identified 18.99 mm as the optimal cut-off for TAD (sensitivity 83.3%, specificity 63.7%; area under the curve-AUC- 0.703, p = 0.009) and 24.95 mm for calTAD (sensitivity 100%, specificity 82.9%, AUC = 0.906, p =  < 0.0001). Univariate analysis revealed no significant differences in demographics, fracture type, or reduction quality between patients with and without cut-outs. Multivariate analysis identified calTAD > 24.95 mm as the only independent predictor of cut-out, with an Odds ratio of 24.62 (95% Confidence Interval 27.61-68.92, p = 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that calTAD is a helpful measure for predicting cut-outs in intertrochanteric fracture fixation using cephalomedullary nails in the context of good fracture reduction. Surgeons should aim to keep calTAD values below 24.95 mm to reduce the risk of cut-out, as values above this threshold significantly increase the risk.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"24"},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711854","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":"Surgeons' perspective on the use of carbon fibre plates for extremity fracture fixation.","authors":"F Shiers-Gelalis, V Giannoudis, P Rodham, P V Giannoudis","doi":"10.1007/s00590-024-04131-1","DOIUrl":"10.1007/s00590-024-04131-1","url":null,"abstract":"<p><strong>Introduction/purpose: </strong>Carbon fibre plating (CFR-PEEK) became available to orthopaedic surgeons in 1998 as a competitor to the traditional metal implants. Despite this, the use of such implants has been limited globally. The aim of this study was therefore to explore the barriers to more widespread use of CFR-PEEK, specifically by examining orthopaedic surgeons' perceptions and opinions of its use through a cross-sectional survey.</p><p><strong>Methods: </strong>An online questionnaire with basic information attached regarding similarities and differences between CFR-PEEK and metal implants was sent out internationally, with 106 responses gained from 26 countries. Specific questions were asked to ascertain orthopaedic surgeons' current knowledge of advantages and disadvantages of CFR-PEEK, the barriers they perceive to its more widespread use, and own personal preferences. Free-text responses were analysed and the results discussed.</p><p><strong>Results: </strong>A minority of orthopaedic surgeons surveyed would choose CFR-PEEK over traditional metal implants (10.38%). The most common disadvantage of CFR-PEEK reported was increased cost, with 46.23% respondents identifying this. Concerns regarding structural integrity of the implant were second most commonly perceived disadvantage, with 34% of surgeons citing one or more of 'stiffness/breakage/durability/contourability' as a disadvantage. A small number of surgeons (3.8%) listed unfamiliarity as a potential disadvantage to the use of carbon fibre plates. The main barrier identified to their use was poor knowledge (education) in relation to the properties and existing evidence of their performance.</p><p><strong>Conclusions: </strong>More work is needed to make CFR-PEEK more acceptable to surgeons including examination of perceived increased cost and increasing education of these implants. Further high-level evidence confirming carbon fibre non-inferiority may increase the usage of CFR-PEEK for extremity fracture fixation in the future.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"26"},"PeriodicalIF":1.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711855","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 reestablishing greater tuberosity angle on patient outcomes following greater tuberosity fractures.","authors":"André Castanheira, Pedro Amaro, Raul Alonso, Luís Pires","doi":"10.1007/s00590-024-04152-w","DOIUrl":"https://doi.org/10.1007/s00590-024-04152-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess whether higher values of GTA after osteosynthesis of isolated greater tuberosity fractures were associated with worse functional and symptomatic outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted from 2012 to 2024, including all patients with isolated greater tuberosity fractures undergoing osteosynthesis at a single institution. GTA measurements before and after osteosynthesis were recorded, along with the latest QuickDash score and constant shoulder score.</p><p><strong>Results: </strong>Thirty-four patients were recruited, with 25 undergoing osteosynthesis with cannulated screws and eight with anchors. Twenty-two patients self-administered the QuickDash score and completed the constant shoulder score. The average GTA before surgery was 84.2°, reducing to 62.2° post-surgery. The average constant score was 86.8, and the mean QuickDash score was 7.65. The method of osteosynthesis did not significantly influence GTA or the QuickDash and constant scores. Additionally, post-surgery GTA negatively correlated with the constant score (r = - 0.65, p < 0.01).</p><p><strong>Conclusions: </strong>Patients with isolated greater tuberosity fractures undergoing osteosynthesis experience a change in GTA after surgery. However, they achieved satisfactory symptomatic and functional scores post-surgery. The method of osteosynthesis did not significantly influence the GTA or the QuickDash and constant scores. Furthermore, post-surgery GTA negatively correlated with the constant score.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"22"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696034","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":"Does contemporary total knee designs replicate the anatomy of the native trochlea?","authors":"Nikhil Gattu, David B Doherty, Hongjia He, David Rodriguez-Quintana, Sabir K Ismaily, Nicholas D Lanfermeijer, Camryn A Pletka, Shuyang Han","doi":"10.1007/s00590-024-04159-3","DOIUrl":"https://doi.org/10.1007/s00590-024-04159-3","url":null,"abstract":"<p><strong>Purpose: </strong>Registry data shows that less surgeons are resurfacing the patella during total knee arthroplasty (TKA). This tendency highlights the importance of matching trochlear and native patellar anatomy. Currently, there is a lack of consensus on implant design that best accommodates native patellae. The objective of this study was to compare the trochlear morphology of a large selection of contemporary TKA designs with the native trochlear anatomy.</p><p><strong>Methods: </strong>Three-dimensional models of 13 femoral component designs from seven manufacturers and 37 healthy human femora (average age: 31.2 ± 13.4 years) were reconstructed. The trochlear morphology, including trochlear length, sulcus angle, trochlear groove angle, and height and width of the medial and lateral facets, was measured along the trochlea at 15° increments.</p><p><strong>Results: </strong>The prosthetic trochlea was shorter and shallower compared to the native trochlea (p < 0.01). The native trochlea was bilinear and had a medial orientation proximally, whereas all asymmetrical TKA designs had a laterally oriented trochlea, resulting in opposite trochlear groove orientation (TKA, 5.8 ± 3.7°; native -3.1 ± 4.1°, p < 0.001). In addition, a strong correlation (R² = 0.89) was found in TKA models between the heights of the medial and lateral facets, which was not observed for the native femora (R² = 0.06).</p><p><strong>Conclusion: </strong>This study highlights that the lateral trochlear orientation in existing TKA models is not anatomical. Given the rising trend in patellar non-resurfacing during TKA, further studies are necessary to improve trochlear design that better accommodates the native patellar morphology.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"21"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696031","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":"Multidisciplinary standardized protocol decreases time to antibiotic administration for open fractures.","authors":"Dustin Morgan, Ellen Lutnick, Christopher Mutty, Mark Anders","doi":"10.1007/s00590-024-04141-z","DOIUrl":"https://doi.org/10.1007/s00590-024-04141-z","url":null,"abstract":"<p><strong>Purpose: </strong>Wound complications after open fracture are common, including superficial and deep infections. Many factors may contribute to outcomes after open fracture, including comorbidities, injury location and characteristics, timing and quality of surgical debridement, and soft tissue coverage. Early prophylactic antibiotic administration is one of the few modifiable factors demonstrated to reduce infection rates.</p><p><strong>Methods: </strong>Retrospective comparative study at a single Level 1 Trauma Center evaluated patients age > 18 who presented directly to and were admitted with open long-bone fracture. Primary outcome measure was time from arrival to antibiotic administration pre- and post-implementation of a standardized open fracture protocol. Secondary analysis evaluated percentage of patients receiving antibiotics within one hour for open long-bone fracture, injury characteristics and patient demographics influence on time to antibiotics.</p><p><strong>Results: </strong>Median time to antibiotic administration improved post-protocol (69 min vs. 39 min, p < 0.001). Patients receiving antibiotics within one hour improved after protocol implementation (42.9% vs. 79.0%, p < 0.001). Antibiotic administration was more often delayed for patients with penetrating injuries compared to blunt injuries (80 min vs. 54 min, p = 0.003). Patients with penetrating injuries were less likely to receive antibiotics within one hour (46% vs 56%, p < 0.001).</p><p><strong>Conclusions: </strong>The implementation of a standardized protocol reduced the time to antibiotic administration and increased the percentage of patients with open fractures receiving antibiotics within one hour. Penetrating injuries were often not appreciated as open fractures during the initial evaluation, which led to a delay in antibiotic administration.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic/Care Management.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"23"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696040","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":"Intra-articular injections of ozone versus hyaluronic acid for knee osteoarthritis: a level I meta-analysis.","authors":"Filippo Migliorini, Riccardo Giorgino, Manuel Giovanni Mazzoleni, Luise Schäfer, Francesca Alzira Bertini, Nicola Maffulli","doi":"10.1007/s00590-024-04135-x","DOIUrl":"10.1007/s00590-024-04135-x","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-articular injections of ozone and hyaluronic acid (HA) are routinely performed for the management of knee osteoarthritis. The present meta-analysis compared intra-articular injections of HA versus ozone in patients with knee osteoarthritis (OA) in patient-reported outcome measures (PROMs). The outcomes of interest were to determine if intra-articular ozone injections show comparable visual analogue scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores compared to intra-articular HA injections.</p><p><strong>Methods: </strong>This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) comparing intra-articular HA versus ozone injections in patients with knee OA were accessed. Only studies which clearly stated that injections were performed in patients with knee OA were considered. Data concerning the VAS and WOMAC were retrieved at baseline and the last follow-up. Studies with a follow-up shorter than 4 months or longer than 6 months were not included.</p><p><strong>Results: </strong>Data from 424 patients were collected. 74% (314 of 424 patients) were women. The mean age of the patients was 61.1 ± 4.5 years, and the mean BMI was 27.8 ± 0.8 kg/m². Compatibility was found in the mean age, mean BMI, PROMs, and the percentage of women. No difference was found in VAS at follow-up (P = 0.4).</p><p><strong>Conclusion: </strong>The current level I evidence suggests that ozone and HA intra-articular injections achieve similar pain control between 4 and 6 months of follow-up.</p><p><strong>Level of evidence: </strong>Level I.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"20"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696037","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":"Diagnostic evaluation of open knee injuries: a comparison of arthrography and CT scans.","authors":"Pariwat Taweekitikul, Sutthisak Chatthammarak, Patcharee Hongsmatip, Techit Leelasestaporn, Chavithorn Ongkanchana, Chittawee Jiamton","doi":"10.1007/s00590-024-04156-6","DOIUrl":"https://doi.org/10.1007/s00590-024-04156-6","url":null,"abstract":"<p><strong>Purpose: </strong>Currently, traumatic arthrotomy of the knee could be diagnosed by saline loading test and computed tomography (CT) which reported excellent sensitivity and specificity. However, there are drawbacks associated with CT, such as cost and radiation hazards. This study aims to evaluate a new diagnostic tool using knee arthrography for individuals with suspected open knee injury and reported sensitivity and specificity using CT scan as the gold standard.</p><p><strong>Method: </strong>A prospective diagnostic study, involving 43 patients who sustained laceration wounds over the knee, was conducted. The physical examination and conventional radiographic imaging were inconclusive in determining the presence of open joint injury. The established protocol involved directing the patients to undergo a CT scan, which is considered the gold standard for detecting open knee injuries. Subsequently, arthrography of the affected knee was performed. The diagnostic value was subsequently determined based on the outcomes derived from these procedures.</p><p><strong>Results: </strong>There were 5/43 cases (11.6%) that diagnosed open knee injuries as determined by CT scans. The calculated diagnostic parameters of arthrography derived from these findings are as follows: The sensitivity was 83.3%, the specificity was 96.5%, the negative predictive value was 96.5%, the positive predictive value was 83.3%, the accuracy is 94.3%, the false positive rate is 16.7%, and the false negative rate was 3.4%. Interobserver reliability was substantial (Kappa 0.617). No complication was observed during the arthrography procedure.</p><p><strong>Conclusions: </strong>Knee arthrography demonstrated high sensitivity, specificity and accuracy for diagnosing open knee injuries, offering a viable alternative to CT scans in certain situations, such as when minimizing radiation exposure is a priority and cost considerations are paramount. Ultimately, careful clinical judgement should guide the choice of diagnostic modality based on individual patient circumstances.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"19"},"PeriodicalIF":1.4,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696029","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":"Trends in Medicare Utilization and Reimbursement for Intertrochanteric Femur Fractures: A 21-Year Review.","authors":"Evan H Richman, Joseph C Brinkman, Benjamin R Paul, Nicole Griffin, Nicholas Alfonso","doi":"10.1007/s00590-024-04147-7","DOIUrl":"https://doi.org/10.1007/s00590-024-04147-7","url":null,"abstract":"<p><strong>Purpose: </strong>Sliding hip screw (SHS) and intramedullary (IMN) constructs are commonly utilized treatments for intertrochanteric (IT) femur fractures. The aim of this study was to assess the economic and utilization trends in the management of IT fractures among the Medicare population over the last 21 years.</p><p><strong>Methods: </strong>A review of the publicly available Medicare Part B National Summary Data File for years 2000-2021 was performed. Collected data included true physician reimbursement and utilization numbers for all CPT codes pertaining to fixation of IT fractures with either SHS or IMN.</p><p><strong>Results: </strong>A total of 1,361,112 IMN implants and 739,032 SHS implants were billed to Medicare for intertrochanteric femur fractures during the studied timeline. In this 21-year span, utilization of IMN increased 695% (9648-76,667), while utilization of SHS decreased by 96% (94,223-4224). After adjusting for inflation, the average physician reimbursement for SHS decreased by 34%, while IMN decreased by 41%. Absolute physician reimbursement was found to be $943.36 for SHS and $999.88 for IMN constructs.</p><p><strong>Conclusion: </strong>Intramedullary implants are being increasingly utilized while sliding hip screw, and intramedullary construct reimbursement continues to decrease for intertrochanteric femur fracture fixation. These trends suggest that opting for a sliding hip screw may be more cost-effective when the fracture pattern allows for either construct.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"13"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683406","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":"Management of aseptic nonunions of bicondylar tibial plateau fractures.","authors":"Andrew M Hresko, Mihir Dekhne, Phillip Grisdela, Sravya Challa, Theodore Guild, Upender M Singh, Michael J Weaver, Derek Stenquist, Arvind von Keudell","doi":"10.1007/s00590-024-04126-y","DOIUrl":"https://doi.org/10.1007/s00590-024-04126-y","url":null,"abstract":"<p><strong>Purpose: </strong>Nonunion of bicondylar tibial plateau (BTP) fractures following open reduction internal fixation (ORIF) is rare but challenging. We report a case series of aseptic BTP nonunions, approaches to treatment, and long-term outcomes.</p><p><strong>Methods: </strong>Retrospective case series of aseptic nonunion in operatively treated BTP fractures. Cases with deep infection prior to a revision were excluded. Demographic, injury, and initial fixation characteristics were collected. Clinical course following diagnosis of nonunion was reviewed. Revision operation characteristics, timing, and outcomes were recorded.</p><p><strong>Results: </strong>13 patients with aseptic nonunion were identified from 508 BTP fractures. Mean (SD) follow-up was 5.2 years (4.6) from the first revision operation for nonunion. Nine patients underwent revision ORIF, which led to union in 6/9 cases. Two patients had total knee arthroplasty (TKA) performed as the initial revision operation for nonunion. One patient was treated with bone grafting without revision of implants and one patient was lost to follow-up after diagnosis of nonunion. Three patients subsequently had TKA performed following failed revision ORIF. In total 5/13 patients underwent TKA.</p><p><strong>Conclusions: </strong>Revision ORIF of aseptic nonunion of a BTP fracture often leads to successful union. However, TKA may be utilized in select cases and at a higher rate than in primary tibial plateau fractures.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"17"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683358","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":"Chronic corticosteroid use does not increase short-term complications following carpometacarpal arthroplasty.","authors":"Kenny Ling, Nishank Mehta, Lekha Yaramada, Nishanth Muthusamy, Taylor VanHelmond, Edward D Wang","doi":"10.1007/s00590-024-04127-x","DOIUrl":"https://doi.org/10.1007/s00590-024-04127-x","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic steroid use has been found to be significantly associated with postoperative complications following total joint arthroplasty. The purpose of this study was to investigate the relationship between chronic steroid and immunosuppressant use and postoperative complications following carpometacarpal (CMC) arthroplasty.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program database was queried for all records of patients who underwent carpometacarpal (CMC) arthroplasty between 2015 and 2020. The initial pool of records was divided into two cohorts: chronic steroid and no chronic steroid use. Patient demographics and comorbidities were compared between cohorts using bivariate logistic regression.</p><p><strong>Results: </strong>A total of 6624 records of CMC arthroplasty were identified in NSQIP from 2015 to 2020. Of the 6432 records remaining after exclusion criteria, 223 (3.5%) were chronic steroid use and 6209 (96.5%) were without chronic steroid use. The patient demographics and comorbidities significantly associated with chronic steroid use were ASA classification ≥ 3 (p < 0.001), insulin-dependent diabetes mellitus (p = 0.032), and COPD (p < 0.001). Compared to no chronic steroid use, chronic steroid use had higher rates of any complication (2.24% vs. 2.01%), superficial incisional SSI (1.35% vs. 0.63%), urinary tract infection (0.45% vs. 0.31%), sepsis (0.45% vs. 0.05%), and mortality (0.45% vs. 0.05%). However, these differences in complication rates were not statistically significant.</p><p><strong>Conclusion: </strong>Chronic preoperative steroid use was not significantly associated with any increased postoperative complication within 30 days following CMC arthroplasty.</p><p><strong>Level of evidence: </strong>Level III; Retrospective Cohort Comparison; Prognosis Study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"18"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683339","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}