Journal of surgical orthopaedic advances最新文献_第2页

Preoperative Dehydration Is an Underrecognized Modifiable Risk Factor in Total Hip Arthroplasty. 术前脱水是全髋关节置换术中一个未被充分认识的可调整风险因素。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Brandon E Lung, Matthew Kim, Kylie Callan, Maddison McLellan, Edward D Wang, William McMaster, Steven Yang, David H So

{"title":"Preoperative Dehydration Is an Underrecognized Modifiable Risk Factor in Total Hip Arthroplasty.","authors":"Brandon E Lung, Matthew Kim, Kylie Callan, Maddison McLellan, Edward D Wang, William McMaster, Steven Yang, David H So","doi":"","DOIUrl":"","url":null,"abstract":"Dehydration is an overlooked modifiable risk factor that should be optimized prior to elective total hip arthroplasty (THA) to reduce postoperative complications and inpatient costs. All primary THA from 2005 - 2019 were queried from the National Surgical Quality Improvement Program database, and patients were compared based on dehydration status: blood urea nitrogen (BUN): creatinine ratio (Cr) (BUN/Cr) < 20 (nondehydrated), 20 ≤ BUN/Cr ≤ 25 (moderately dehydrated), 25 < BUN/Cr (severely dehydrated). A subgroup analysis involving only elderly patients > 65 years and normalized gender-adjusted Cr values was also performed. The analysis included 212,452 patients who underwent THA. Adjusted multivariate logistic regression analysis showed that the severely dehydrated cohort had a greater risk of overall complications, postoperative anemia requiring transfusion, nonhome discharge, and increased length of stay (all p < 0.01). Among the elderly, dehydrated patients had a greater risk of postoperative transfusion, cardiac complications, and nonhome discharge (all p < 0.01). BUN/Cr > 20 is an important preoperative diagnostic tool to identify at-risk dehydrated patients. Providers should optimize dehydration to prevent complications, decrease costs, and improve discharge planning. (Journal of Surgical Orthopaedic Advances 33(1):017-025, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181702","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}

引用次数: 0

Tranexamic Acid in Shoulder and Knee Arthroscopy. 氨甲环酸在肩关节和膝关节镜检查中的应用

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Daniel J Song, Emily R McDermott, Brian F Grogan, David J Tennent, Justin J Ernat

引用次数: 0

Enhanced Recovery Pathway Reduced Opioid Use and Pain Scores in Elective Spine Surgery. 强化康复路径减少了脊柱外科手术中阿片类药物的使用和疼痛评分。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Logan A Reed, Kevin Luque-Sanchez, Alexander Mihas, Eli B Levitt, Roland T Short, Christopher A Godlewski, Steven M Theiss

引用次数: 0

Effect of CURES Legislation on Narcotic Prescriptions After Soft-tissue Hand Surgery. CURES 立法对手部软组织手术后麻醉剂处方的影响。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Conor Spady, Damien Cannon, Montri Daniel Wongworawat, David E Ruckle, Rusheel Nayak, Brittany McPhee

引用次数: 0

Primary Total Knee and Total Hip Arthroplasty in the Rural Patient. 农村患者的初级全膝关节和全髋关节置换术。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

David A Forgas, Sowmyanarayanan Thuppal, Steven L Scaife, Anthony Sleiman, Youssef El Bitar

{"title":"Primary Total Knee and Total Hip Arthroplasty in the Rural Patient.","authors":"David A Forgas, Sowmyanarayanan Thuppal, Steven L Scaife, Anthony Sleiman, Youssef El Bitar","doi":"","DOIUrl":"","url":null,"abstract":"Rural patients have poorer health indicators, including higher risk of developing osteoarthritis. The objective of this study is to compare rural patients undergoing primary total joint arthroplasty (TJA) at rural hospitals with those undergoing primary TJA at urban hospitals with regards to demographics, comorbidities, and complications and to determine the preferred location of care for rural patients. Data from the Healthcare Cost and Utilization Project National Inpatient Sample between 2016 and 2018 were analyzed. Demographics, comorbidities, inpatient complications, hospital length of stay, inpatient mortality, and discharge disposition were compared between rural patients who underwent TJA at rural hospitals and urban hospitals. Rural patients undergoing primary TJA in rural hospitals were more likely to be women, to be treated in the South, to have Medicaid payer status, to have dementia, diabetes mellitus, lung disease, and postoperative pulmonary complications, and to have a longer hospital length of stay. Those patients were also less likely to have baseline obesity, heart disease, kidney disease, liver disease, cancer, postoperative infection, and cardiovascular complications, and were less likely to be discharged home. Rural patients undergoing primary TJA tend to pursue surgery in their rural hospital when their comorbidity profile is manageable. These patients get their surgery performed in an urban setting when they have the means for travel and cost, and when their comorbidity profile is more complicated, requiring more specialized care, Rural patients are choosing to undergo their primary TJA in urban hospitals as opposed to their local rural hospitals. (Journal of Surgical Orthopaedic Advances 33(2):061-067, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592569","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}

引用次数: 0

Efficacy and Accuracy of Diagnosing Septic Arthritis: How Effective are Current Methods for Timely Diagnosis of Septic Arthritis? 诊断化脓性关节炎的有效性和准确性：目前及时诊断化脓性关节炎的方法有多有效？

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

John G Weeks, Thomas J Revak

{"title":"Efficacy and Accuracy of Diagnosing Septic Arthritis: How Effective are Current Methods for Timely Diagnosis of Septic Arthritis?","authors":"John G Weeks, Thomas J Revak","doi":"","DOIUrl":"","url":null,"abstract":"The diagnosis of septic arthritis requires a reliance on ancillary tests, including synovial fluid white blood cell count (jWBC), percentage of polymorphonuclear leukocytes (%PMN), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). This study evaluated these tests to determine their diagnostic utility in suspected septic arthritis. A retrospective chart review was performed on patients admitted to an urban hospital who underwent arthrocentesis. The authors evaluated the jWBC, %PMN, ESR, and CRP with receiver operating characteristic (ROC) curve analyses. Two hundred sixty-five patients met inclusion criteria. Sixty-three had a culture-positive aspirate. ROC curve analysis resulted in an area under the curve (AUC) of 0.80 for jWBC with cutoff point of 22,563 cells/mm3 and an AUC of 0.71 for %PMN with cutoff point of 90.5%. CRP and ESR had AUC values of 0.62 and 0.61, respectively. The culture-positive cohort had higher elevations in all assessed diagnostic tests. However, AUC data for ESR and CRP showed little diagnostic utility. Additionally, sensitivities and specificities of jWBC and %PMN were too low. Associated cutoff points would result in excessive unnecessary operative intervention. Further studies should incorporate synovial fluid biomarkers into the workup of a suspected septic joint. (Journal of Surgical Orthopaedic Advances 33(2):108-111, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592565","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}

引用次数: 0

Isolated Lateral Plating for Bicondylar Tibial Plateau Fractures: Factors Influencing Decision Making. 双髁胫骨平台骨折的分离式外侧钢板置换术：影响决策的因素。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Mandip Singh, Mikel Headford, Krishna Vangipuram Suresh, Thomas Revak

{"title":"Isolated Lateral Plating for Bicondylar Tibial Plateau Fractures: Factors Influencing Decision Making.","authors":"Mandip Singh, Mikel Headford, Krishna Vangipuram Suresh, Thomas Revak","doi":"","DOIUrl":"","url":null,"abstract":"Lateral plating alone has been postulated as an alternative for fixation of bicondylar tibial plateau fractures in attempts to limit morbidity associated with dual plating. Characterization of fracture patterns that may facilitate lateral plating alone for bicondylar tibial plateau fractures is not well established. The authors analyzed radiographic and clinical outcomes of isolated lateral plating in patients with at least 6 months of follow-up. Of 56 patients identified, 37 (66%) had 41 AO Foundation (AO)/Orthopaedic Trauma Association (OTA) C1/C2 fractures with 19 (34%) presenting with 41 C3 fractures. Mean posteromedial articular fracture angle (PMAFA) was 69.9 degrees, with an average of 1.3 medial articular fragments. Only 16 patients (28%) had a PMAFA under 45 degrees. There were no cases of nonunion, and five patients (8.9%) developed wound infection during follow-up. Four patients (7.1%) experienced malreduction over three degrees, and eight patients (14.3%) experienced change in alignment over the follow-up duration, indicating some risk of inadequate fixation with this technique. (Journal of Surgical Orthopaedic Advances 33(2):088-092, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592566","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}

引用次数: 0

Civilian Ballistic Distal Femur Intraarticular Fracture Patterns. 平民弹道股骨远端关节内骨折模式。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Colin Cantrell, Gregory Versteeg, Haley Smith, Daniel Johnson, Erik Gerlach, Michael Stover, Bennet Butler

引用次数: 0

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Joseph Cline, Dmitri Falkner, Tyler Brolin, Richard Smith, Frederick Azar, Thomas Throckmorton

{"title":"Patient-Related Risk Factors Predict Outcomes After Arthroscopic Rotator Cuff Repair.","authors":"Joseph Cline, Dmitri Falkner, Tyler Brolin, Richard Smith, Frederick Azar, Thomas Throckmorton","doi":"","DOIUrl":"","url":null,"abstract":"The objective of this study was to determine if preoperative patient characteristics have an effect on pain and function after primary arthroscopic rotator cuff repair. Seventy-five arthroscopic primary rotator cuff repairs with at least 2 years of follow-up were identified. Studied variables were preoperative tobacco, opioid, and alcohol use; obesity; mood disorders; disability claim; and Workers' Compensation status. Outcome measures included visual analog pain scores, American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, range of motion, and strength. Preoperative smoking was significantly associated with worse pain (p = 0.009), ASES (p = 0.004), and SANE (p = 0.011) scores. Opioid use showed no statistically significant difference in pain or functional scores. Alcohol use did predict improved ASES scores at long-term follow-up (p = 0.046). The other variables were not associated with inferior outcomes. Smoking and preoperative opioid use represent modifiable risk factors that can be corrected before surgery to optimize outcomes. (Journal of Surgical Orthopaedic Advances 33(1):005-009, 2024).","PeriodicalId":516534,"journal":{"name":"Journal of surgical orthopaedic advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181698","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}

引用次数: 0

Indirect Coronal Reduction Technique Using a Volar Locking Plate in Distal Radius Fractures: A Case Series. 桡骨远端骨折中使用沃尔锁定钢板的间接冠状复位技术：病例系列。

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Nicholas Andring, T David Luo, Suman Medda, Kelly Stumpff, Eben Carroll

引用次数: 0