Publisher: American Academy of Orthopaedic Surgeons   (Total: 1 journals)   [Sort alphabetically]

Showing 1 - 1 of 1 Journals sorted by number of followers
J. of the American Academy of Orthopaedic Surgeons     Hybrid Journal   (Followers: 12, SJR: 1.41, CiteScore: 3)
Similar Journals
Journal Cover
Journal of the American Academy of Orthopaedic Surgeons
Journal Prestige (SJR): 1.41
Citation Impact (citeScore): 3
Number of Followers: 12  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1067-151X - ISSN (Online) 1940-5480
Published by American Academy of Orthopaedic Surgeons Homepage  [1 journal]
  • Subscapularis Tears: Evolution in Treatment Options

    • Free pre-print version: Loading...

      Authors: Lee; Brian; Patel, Vikas; Itamura, John
      Abstract: imageSubscapularis tears occur more commonly than previously reported. Owing to the importance of the subscapularis in shoulder function, strong consideration should be given to repairing a full-thickness subscapularis tear when present. Historically, subscapularis repairs were done through a deltopectoral approach with good results. More recently, arthroscopic techniques have been developed with similar outcomes. When tears of the subscapularis are irreparable, reconstructive options, including tendon transfers, capsular reconstruction, and reverse shoulder arthroplasty, exist and continue to evolve.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Musculoskeletal Metastasis From Soft-tissue Sarcomas: A Review of the
           Literature

    • Free pre-print version: Loading...

      Authors: Pretell-Mazzini; Juan; Seldon, Crystal S.; D'Amato, Gina; Subhawong, Ty K.
      Abstract: imageSoft-tissue sarcomas are a rare and extremely heterogeneous group of cancers, representing
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Environmental Sustainability in Orthopaedic Surgery

    • Free pre-print version: Loading...

      Authors: Engler; Ian D.; Curley, Andrew J.; Fu, Freddie H.; Bilec, Melissa M.
      Abstract: imageClimate change has been increasingly recognized in the healthcare sector over recent years, with global implications in infrastructure, economics, and public health. As a result, a growing field of study examines the role of healthcare in contributing to environmental sustainability. These analyses commonly focus on the environmental impact of the operating room, due to extensive energy and resource utilization in surgery. While much of this literature has arisen from other surgical specialties, several environmental sustainability studies have begun appearing in the field of orthopaedic surgery, consisting mostly of waste audits and, less frequently, more comprehensive environmental life cycle assessments. The present study aims to review this limited evidence. The results suggest that methods to reduce the environmental impact of the operating room include proper selection of anesthetic techniques that have a smaller carbon footprint, minimization of single use instruments, use of minimalist custom-design surgical packs, proper separation of waste, and continuation or implementation of recycling protocols. Future directions of research include higher-level studies, such as comprehensive life cycle assessments, to identify more opportunities to decrease the environmental impact of orthopaedic surgery.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • The Utility of Machine Learning Algorithms for the Prediction of Early
           Revision Surgery After Primary Total Hip Arthroplasty

    • Free pre-print version: Loading...

      Authors: Klemt; Christian; Laurencin, Samuel; Alpaugh, Kyle; Tirumala, Venkatsaiakhil; Barghi, Ameen; Yeo, Ingwon; Subih, Murad Abdullah; Kwon, Young-Min
      Abstract: imageBackground: Revision total hip arthroplasty (THA) is associated with increased morbidity, mortality, and healthcare costs due to a technically more demanding surgical procedure when compared with primary THA. Therefore, a better understanding of risk factors for early revision THA is essential to develop strategies for mitigating the risk of patients undergoing early revision. This study aimed to develop and validate novel machine learning (ML) models for the prediction of early revision after primary THA.Methods: A total of 7,397 consecutive patients who underwent primary THA were evaluated, including 566 patients (6.6%) with confirmed early revision THA (35 kg/m2, and depression. The six ML models all achieved excellent performance across discrimination (area under the curve>0.80), calibration, and decision curve analysis.Conclusion: This study developed ML models for the prediction of early revision surgery for patients after primary THA. The study findings show excellent performance on discrimination, calibration, and decision curve analysis for all six candidate models, highlighting the potential of these models to assist in clinical practice patient-specific preoperative quantification of increased risk of early revision THA.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Total Joint Arthroplasty in Homeless Patients at an Urban Safety Net
           Hospital

    • Free pre-print version: Loading...

      Authors: Niu; Ruijia; Egan, Cameron; Fang, Christopher; Duru, Nneoma; Alley, Maxwell C.; Freccero, David M.; Smith, Eric L.
      Abstract: imageIntroduction: Homelessness is a key social determinant of health, and the patient population has grown to over 580,000. Total joint arthroplasty (TJA) is an effective treatment of symptomatic end-stage osteoarthritis of the hip and knee and has been shown to improve health-related quality of life in the general population. However, the literature on the outcomes of TJA among homeless patients is limited.Methods: We retrospectively reviewed 442 patients who underwent primary, unilateral TJA between June 1, 2016, and August 31, 2017, at an urban, tertiary, academic safety net hospital. Based on self-reported living status, we classified 28 homeless patients and 414 control nonhomeless patients. Fisher exact tests, Student t-tests, and multivariate logistic regression were used to compare the demographics, preoperative conditions, and surgical outcomes between the two groups.Results: The homeless group were younger, more often male, and smokers; had alcohol use disorder; and used illicit drugs. After controlling for age, sex, and preoperative medical and social conditions, homeless patients were 15.83 times more likely to have an emergency department visit (adjusted odds ratio, 15.83; 95% confidence interval, 5.05 to 49.59; P < 0.0001) within 90 days but had similar rates of readmission (P = 0.25), revision surgery (P = 0.38), and prosthetic joint infection (P = 0.25) when compared with nonhomeless patients.Discussion: Although homeless patients did not have higher rates of readmission or revision surgery, homelessness still presents unique challenges for the TJA patients and providers. With careful preoperative optimization and collaborative support, however, the benefits of TJA may outweigh the risk of poor outcomes for these patients.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Adverse Events After Posterior Lumbar Fusion Are Not Sufficiently
           Characterized With 30-day Follow-up: A Database Study

    • Free pre-print version: Loading...

      Authors: Kammien; Alexander J.; Zhu, Justin R.; Gillinov, Stephen M.; Gouzoulis, Michael J.; Grauer, Jonathan N.
      Abstract: imageIntroduction: Many studies track outcomes after procedures, such as posterior lumbar fusion (PLF), for only 30 days because of database limitations. However, adverse events may not have plateaued by this time. Thus, this study used an alternate database to evaluate the timing of adverse events for 90 days after PLF.Methods: Adult PLF patients were identified from the 2010 to 2020 Q2 M53Ortho PearlDiver administrative data set. Ninety-day rates of multiple adverse events were determined. The time of diagnosis for each event in the 90-day postoperative period was determined. Data were dichotomized by occurrence in days 0 to 30 and 31 to 90. Median, interquartile range, and middle 80% for the time of diagnosis were determined for each adverse event.Results: Of 51,915 patients undergoing PLF, 7,141 (13.8%) had an adverse event within 90 days of PLF. Of these, 5,174 (72.5%) experienced an event within 30 days and 2,544 (35.6%) after 30 days. For individual adverse outcomes studied, the percent that occurred 31 to 90 days after surgery ranged from 9% to 42%. The time of diagnosis (median; interquartile range; middle 80%) for each adverse event was as follows: transfusion (2 days; 2 to 5 days; 1 to 26 days), acute kidney injury (9; 2 to 29; 1 to 60), hematoma (9; 4 to 20; 3 to 39), cardiac event (11; 3 to 43; 1 to 71), pneumonia (12; 4 to 38; 2 to 68), venous thromboembolism (15; 6 to 33; 3 to 62), sepsis (19; 9 to 39; 4 to 63), surgical site infection (21; 14 to 34; 8 to 48), urinary tract infection (22; 8 to 49; 4 to 72), and wound dehiscence (27; 17 to 39; 9 to 54).Discussion: This study highlights the importance of looking past the 30-day mark for adverse events after PLF because approximately one-third of adverse events in this study were diagnosed 31 to 90 days after surgery. This can affect research studies, patient counseling about the incidence of specific adverse events, and the development of mechanisms for surveillance at key time points.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Total Joint Arthroplasty Training (Prehabilitation and Rehabilitation) in
           Lower Extremity Arthroplasty

    • Free pre-print version: Loading...

      Authors: Ginnetti; John G.; O'Connor, Mary I.; Chen, Antonia F.; Myers, Thomas G.
      Abstract: imageLower extremity total joint arthroplasty (TJA) has an established track record of success and a subset of patients who fail to experience desired improvements. Current TJA success can be attributed to refined surgical techniques, improved preparation of patients for surgery, and enhanced postoperative recovery protocols. One aspect of preoperative patient preparation and enhanced postoperative recovery includes training regimens intended to prepare patients for TJA and facilitate TJA functional recovery (often referred to as using the jargon prehabilitation and rehabilitation). The importance of prehabilitation and rehabilitation is open to debate because of historically insufficient and inconsistent evidence. This review aims to provide direction for future investigative efforts by presenting an overview of current preoperative and postoperative TJA training/exercise programs within the framework of utility, timing, form, setting, and cost.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • AAOS Appropriate Use Criteria: Management of Rotator Cuff Pathology

    • Free pre-print version: Loading...

      Authors: Raizman; Noah Matthew; Kane, Shawn F.
      Abstract: No abstract available
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Effects of Hospital and Surgeon Volume on Patient Outcomes After Total
           

    • Free pre-print version: Loading...

      Authors: Siddiqi; Ahmed; Alamanda, Vignesh K.; Barrington, John W.; Chen, Antonia F.; De, Ayushmita; Huddleston, James I. III; Bozic, Kevin J.; Lewallen, David; Piuzzi, Nicolas S.; Mullen, Kyle; Porter, Kimberly R.; Springer, Bryan D.
      Abstract: imageBackground: The purpose of this study was to evaluate outcomes and complications because it relates to surgeon and hospital volume for patients undergoing primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) using the American Joint Replacement Registry from 2012 to 2017.Methods: A retrospective study was conducted on Medicare-eligible cases of primary elective THAs and TKAs reported to the American Joint Replacement Registry database and was linked with the available Centers of Medicaid and Medicare Services claims and the National Death Index data from 2012 to 2017. Surgeon and hospital volume were defined separately based on the median annual number of anatomic-specific total arthroplasty procedures performed on patients of any age per surgeon and per hospital. Values were aggregated into separate surgeon and hospital volume tertile groupings and combined to create pairwise comparison surgeon/hospital volume groupings for hip and knee.Results: Adjusted multivariable logistic regression analysis found low surgeon/low hospital volume to have the greatest association with all-cause revisions after THA (odds ratio [OR], 1.63, 95% confidence interval [CI], 1.41-1.89, P < 0.0001) and TKA (OR, 1.72, 95% CI, 1.44-2.06, P < 0.0001), early revisions because of periprosthetic joint infection after THA (OR, 2.50, 95% CI, 1.53-3.15, P < 0.0001) and TKA (OR, 2.18, 95% CI, 1.64-2.89, P < 0.0001), risk of early THA instability and dislocation (OR, 2.47, 95% CI, 1.77-3.46, P < 0.0001), and 90-day mortality after THA (OR, 1.72, 95% CI, 1.27-2.35, P = 0.0005) and TKA (OR, 1.47, 95% CI, 1.15-1.86, P = 0.002).Conclusion: Our findings demonstrate considerably greater THA and TKA complications when performed at low-volume hospitals by low-volume surgeons. Given the data from previous literature including this study, a continued push through healthcare policies and healthcare systems is warranted to direct THA and TKA procedures to high-volume centers by high-volume surgeons because of the evident decrease in complications and considerable costs associated with all-cause revisions, periprosthetic joint infection, instability, and 90-day mortality.Level of Evidence: III
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Extended Postoperative Prophylactic Antibiotics for Primary and Aseptic
           Revision Total Joint Arthroplasty: A Systematic Review

    • Free pre-print version: Loading...

      Authors: Yakkanti; Ramakanth R.; Vanden Berge, Dennis; Summers, Spencer H.; Mansour, Kailey L.; Lavin, Alessia C.; Hernandez, Victor H.
      Abstract: imageIntroduction: Limited literature is available about the effects of extended (>24 hours) antibiotic use after primary and aseptic revision total joint arthroplasty (TJA) on rates of periprosthetic joint infection (PJI). The purpose of this study was to systematically review the outcomes of extended prophylactic antibiotic use.Methods: A systematic search on PubMed and EMBASE databases was done in August 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles that met inclusion criteria were screened by two separate authors. Basic patient demographics, route of delivery, type, dose, frequency of the antibiotic, rates of PJI, and length of stay were extracted.Results: A total of 11 articles published from 1979 to 2021 were included in the final analysis. Two studies evaluated aseptic revisions, seven evaluated primary TJA, and two studies evaluated both. Five studies were randomized controlled trials, one multicenter nonrandomized trial, and five retrospective cohort studies. All 11 studies used a cephalosporin or a penicillin antibiotic in both the control and cohort groups. Five studies used intravenous (IV) antibiotics, one study used oral (PO) antibiotics, and the other five studies used both IV and PO antibiotics. Length of stay was reported in three studies, all using IV antibiotics. All 11 studies evaluated rates of PJI, while four studies evaluated included rates of superficial surgical site infections. Four studies showed a statistically significant decrease in PJI when compared with a control group, while seven studies showed no statistically significant difference.Conclusion: There is conflicting evidence regarding the benefit of extended (>24 hours) antibiotics, IV or PO, after TJA. As of now, current guidelines do not support the use of extended antibiotics; future prospective clinical trials are needed to help support these claims.
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
  • Effects of Preoperative Carbohydrate-rich Drinks on Immediate
           Postoperative Outcomes in Total Knee Arthroplasty: A Randomized Controlled
           Trial

    • Free pre-print version: Loading...

      Authors: Kadado; Allen; Shaw, Jonathan H.; Ayoola, Ayooluwa S.; Akioyamen, Noel O.; North, W. Trevor; Charters, Michael A.
      Abstract: imageBackground: This study investigates the effects of preoperative carbohydrate-rich drinks on postoperative outcomes after primary total knee arthroplasty.Methods: We prospectively randomized 153 consecutive patients undergoing primary total knee arthroplasty at one institution. Patients were assigned to one of three groups: group A (50 patients) received a carbohydrate-rich drink; group B (51 patients) received a placebo drink; and group C (52 patients) did not receive a drink (control). All healthcare personnel and patients were blinded to group allocation. Controlling for demographics, we analyzed the rate of postoperative nausea and vomiting, length of stay, opiate consumption, pain scores, serum glucose, adverse events, and intraoperative and postoperative fluid intake.Results: Demographics and comorbidities were similar among the groups. There were no significant differences in surgical interventions or experience. Surgical fluid intake and total blood loss were similar among the three groups (P = 0.47, P = 0.23). Furthermore, acute postoperative outcomes (ie, pain, episodes of nausea, and length of stay) were similar across all three groups. There were no significant differences in adverse events between the three groups (P = 0.13). There was a significant difference in one-time postoperative bolus between the three groups (P = 0.02), but after multivariate analysis, it did not demonstrate significance. None of the intervention group were readmitted, whereas 5.9% and 11.5% were readmitted in the placebo and control groups, respectively (P = 0.047). The chance of 90-day readmission was reduced in group A compared with group C (odds ratio, 0.08; 95% confidence interval, 0.01 to 0.72; P = 0.02). There were no differences in other postoperative outcome measurements.Conclusion: This randomized controlled trial demonstrated that preoperative carbohydrate loading does not improve immediate postoperative outcomes, such as nausea and vomiting; however, it demonstrated that consuming fluid preoperatively proved no increased risk of adverse outcomes and there was a trend toward decrease of one-time boluses postoperatively.Clinical Trials Registry: NCT03380754
      PubDate: Wed, 01 Jun 2022 00:00:00 GMT-
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 18.208.186.139
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-