Aims. Understanding of open fracture management is skewed due to reliance on small-number lower limb, specialist unit reports and large, unfocused registry data collections. To address this, we carried out the Open Fracture Patient Evaluation
Aims. The Open-Fracture Patient Evaluation
The interest in day-case hip arthroplasty is increasing; however, there are conflicting results regarding readmission risk, and little is known about patients’ attitude towards day-case surgery. We aimed to investigate differences in 30-day readmission rates between day-case patients and single-overnight-stay patients following total hip arthroplasty (THA) and explore patients’ attitude towards day-case surgery. From the Danish National Patient Register we identified 29,486 THAs (1353 day-case THAs and 28,133 single-overnight-stay THAs) performed between 2010 and 2020. Day-case surgery was defined as discharge on the day-of-surgery. Overnight admissions within 30 days of surgery were considered readmissions. Differences in readmission rates between day-case and single-overnight-stay patients were investigated using logistic regression adjusted for patient characteristics and year of surgery. In a single-center descriptive study, 2395 hip arthroplasty patients from 2016 to start-2023 answered a questionnaire on patient characteristics, attitude towards day-case surgery and patient-reported outcome measures (PROM). The overall 30-day readmission rate was 4.4% (CI: 4.2–4.6%) with no difference between day-case (4.4%) and single-overnight-stay THAs (4.4%) (odds-ratio: 1.2 [CI: 0.91–1.6]). In the descriptive study answers to the question whether patients were interested in being discharged on the day of surgery, were: “Yes” = 41%, “Do not know” = 20%, “No” = 39%. Patients responding “No” had lower preoperative PROM-scores, were older (“No” = 70.2 y vs. “Yes” = 65.3 y), and more often female (“No” = 72% vs. “Yes” = 52% female). Based on
COVID-19 confers a three-fold increased mortality risk among hip fracture patients. The aims were to investigate whether vaccination was associated with: i) lower mortality risk, and ii) lower likelihood of contracting COVID-19 within 30 days of fracture. This
Aims. Slipped capital femoral epiphysis (SCFE) is one of the most common hip diseases of adolescence that can cause marked disability, yet there is little robust evidence to guide treatment. Fundamental aspects of the disease, such as frequency, are unknown and consequently the desire of clinicians to undertake robust intervention studies is somewhat prohibited by a lack of fundamental knowledge. Methods. The study is an anonymized
Periprosthetic femur fracture (PPF) are heterogeneous, complex, and thought to be increasingly prevalent. The aims were to evaluate PPF prevalence, casemix, management, and outcomes. This
Aims. Joint arthroplasties may be associated with a blood loss, which necessitates transfusion. Especially, hip arthroplasties are highly associate with transfusion to compensate perioperative bleeding. Orthopaedic surgeons and patients have increasing concerns regarding complications of blood transfusions. Although various methods to reduce transfusions have been attempted in TJA, a high percentage of patients require a transfusion during and after the procedures. The purposes of this study were to evaluate the trends of the transfusion(transfusion rates, transfusion amounts, economic burden) in hip arthroplasties, using
We present detailed information about early morbidity
after aseptic revision knee replacement from a
The aim was to determine the influence of COVID-19 on 30-day mortality in hip fracture. Secondary aims were to examine: (1) predictors of COVID-19 on presentation and later in the admission; (2) rate of hospital-acquired COVID-19; (3) predictive value of negative swabs on admission. A
The aim of this study was to examine perioperative blood transfusion practice, and associations with clinical outcomes, in a national cohort of hip fracture patients. A retrospective cohort study was undertaken using linked data from the Scottish Hip Fracture Audit and the Scottish National Blood Transfusion Service between May 2016 and December 2020. All patients aged ≥ 50 years admitted to a Scottish hospital with a hip fracture were included. Assessment of the factors independently associated with red blood cell transfusion (RBCT) during admission was performed, alongside determination of the association between RBCT and hip fracture outcomes.Aims
Methods
Background: Isolated patellofemoral arthroplasty has gained new attention after recently published positive results. It is considered an intermediate treatment for the patient with isolated arthritis of the anterior compartment of the knee. Aim of this
Although the clinical manifestation of ONFH is well summarized as forms of various stages, its etiology, natural history or epidemiology has not been clearly elucidated yet. With this study, we wanted to find out the estimated annual incidence, epidemiologic characteristics and the effect of known risk factors of ONFH. Therefore we can understand the disease better to provide optimal management to the patients. Among 133 189 patients who diagnosed as osteonecrosis of femoral head (ONFH) in database of national health insurance system in Korea from 2002 to 2006, three hundreds an eighty-two samples were randomly extracted with 5% error range in 95% confidence interval. With a structured worksheet, medical records and radiographs of each sample were reviewed at corresponding clinic or hospital by authors and trained orthopedic surgeons. With these data, we calculated the prevalence and associated risk factors. The mean number of annual requests was 23 466. Among 382 samples, two hundreds and seventy-four were confirmed to have ONFH. Diagnostic accuracy was 71.7 %. Diagnosis was more accurate when the patient was male or hospitalized. After the logistic regression analysis, calculated diagnostic accuracy during 2002 and 2006 was 60.3% (51 823/85 987). The annual predicted number of cases of ONFH during this period was 14 103. It corresponds to 28.91 patients per 100 000 populations. Alcohol abuse was noted in 45% and 22% was related to use of steroid. 37% showed bilateral involvement. Bone graft procedures in any kind was the most frequently performed joint preserving procedure. With this, the first epidemiologic study for ONFH in Korea, we estimated
Aims:
Introduction. Although a previous hip fracture is one of the strongest predictors for the next one this risk might be modified by other factors. The goal of this analysis was to compute a simple algorithm to assess the individual risk for a contralateral hip fracture. Materials and methods. The analysis is based on a
Aim: We determined 90 days mortality following primary total hip replacement (THR) and examined the impact of age and level of comorbidity. Methods: We used data from the
Purpose:. To investigate treatment patterns and efficacy of postoperative strong opioids in patients who underwent total knee arthroplasty (TKA) in Korea. Methods:. A prospective, non-interventional study of 301 patients who underwent TKA and received strong opioids following patient controlled analgesia (PCA) was conducted by reviewing patient charts and diaries from 19 teaching hospitals. Clinical characteristics, strong opioid treatment patterns, efficacy of strong opioid on a scale of 0–10, and opioid-related adverse events (AEs) were investigated during hospitalization and at first outpatient visit. Safety analysis was conducted on 301 patients, and efficacy analysis was conducted on full analysis set (FAS) which consisted of all the patients who had at least 1 efficacy result among 301 patients. Results:. Among the FAS population of 298 patients, 86.9% were female, and mean age was 68.7 ± 7.5 years. Average duration of PCA was 4.3 ± 1.7 days, and average length of hospital stay including surgery was 16.3 ± 7.6 days. The mean duration of strong opioid prescription on a regular basis between PCA discontinuation and discharge was 10.3 ± 6.7 days. At the initial treatment with strong opioid following PCA, mean pain intensity score was 6.1 ± 2.1 upon movement and 4.2 ± 2.4 at rest. At discharge, mean pain intensity score was 4.1 ± 1.9 upon movement and 2.3 ± 1.8 at rest. Meanwhile, pain intensity score at the first outpatient visit was assessed only in 146 patients (49.0%) treated with opioid, and mean pain intensity scores upon movement and at rest were 3.5 ± 2.1 and 1.7 ± 1.8, respectively. Most frequently prescribed opioid was oral oxycodone (47.4%), followed by pethidine injection (17.2%), oral oxycodone/naloxone (12.6%), and transdermal fentanyl (12.0%). Additionally, the most frequently prescribed opioid on a regular basis was oral oxycodone (53.3%), and that on a PRN (pro re nata) basis was pethidine injection (48.4%). Among treatments, mean duration and mean daily dose of oral oxycodone during hospitalization were 6.1 ± 5.6 days and 13.9 ± 8.2 mg, 1.6 ± 1.2 days and 45.5 ± 24.5 mg for pethidine injection, 7.3 ± 5.3 days and 16.2 ± 7.3 mcg/hr for transdermal fentanyl, and 9.4 ± 8.0 days and 23.2 ± 16.8 mg/11.6 ± 8.34 mg for oral oxycodone/naloxone. At discharge, 150 patients (50.3%) were prescribed opioids. The most frequently prescribed strong opioid as discharge medications and their mean daily dose were 17.9 ± 10.5 mg of oxycodone (56.6%), 26.8 ± 17.0 mg/13.4 ± 8.5 mg of oxycodone/naloxone (17.1%), and 15.9 ± 6.1 mcg/hr of fentanyl (11.4%). Of 301 patients, 36 opioid-related AEs were reported in 26 patients (8.6%); the most frequently reported opioid-related AEs were nausea/vomiting in 13 patients (4.3%) experiencing 17 events, constipation in 10 patients (3.3%) experiencing 10 events, and sedation in 3 patients (1.0%) experiencing 3 events. Conclusion:. The first
Aims: In 1999 we published a cohort of 24,638 polyethylene-on-metal total hip arthroplasty (THA) patients followed up for cancer, using Finnish Cancer Registry data, from 1980 to 1995. The number of person-years was then 173,022 (until 31st Dec, 1996). During follow-up, there were statistically significantly fewer cancers among the THA patients (standardized incidence ratio [SIR], 0.91; 95% confidence interval [Cl], 0.87–0.94). There was no significantly increased risk at any site, and for certain cancers that was even below the unity (lung and stomach). On the longer run, however, certain tendency for increased risk for cancer of the urinary bladder, myeloma, and leukemia could be observed; SIRs were greater than unity with the THA patients followed up 3 to 9 years. Further follow-up of the cohort is therefore needed. Methods: The follow-up of the same cohort, originally identified in the National Register of Arthroplasties, maintained by the National Agency for Medicines (primary THA with primary arthritis as the indication) was expanded with a four year period (from 1st of Jan 1997 to 31st of Dec 2000). Follow-up for cancer was undertaken using the files in the population-based,
The aim of this surgery was to determine current practice amongst orthopaedic surgeons in New Zealand with regard to Anterior Cruciate Ligament Reconstruction. All current members of the NZOA were sent a questionnaire on the numbers and proportions of grafts performed, methods of fixation, operative technique and return to sport. One hundred and ten of 140 questionnaires were returned completed. Ninety two orthopaedic surgeons were performing ACL reconstructions. Eight per cent performed patellar tendon grafts in preference to hamstring grafts, whereas 16% preferred hamstring over patellar tendon grafts. Almost 2000 patellar tendon grafts at an average of just over 20 per surgeon are performed each year compared to just over 500 hamstring grafts at an average of just over 15 per surgeon. Metal interference screws were the most common fixation device in patellar tendon and hamstring grafts. Patellar tendon grafts are the most common grafts used for ACL reconstruction with 80 % of those surveyed preferring to use patellar tendon over hamstring grafts. Metal interference screws were the most common fixation device. There is reasonable consensus regarding return to activity and sport.
The purpose of this study was to evaluate the effect of common medical comorbidities on the reimbursements of different shoulder arthroplasty procedures We conducted a retrospective query of a private payer insurance claims database of prospectively collected data (PealDiver). Our search included the Current Procedural Terminology Codes (CPT) and International Classification of Disease (ICD) ninth edition codes for Total Shoulder Arthroplasty (TSA), Hemiarthroplasty (HA) and Reverse Shoulder Arthroplasty (RSA). Medical comorbidities were also searched for through ICD codes. The comorbidities selected for analysis were obesity, morbid obesity, hypertension, smoking, diabetes mellitus, hyperlipidemia, atrial fibrillation, chronic obstructive pulmonary disease (COPD), cirrhosis, depression and chronic kidney disease (CKD) (excluding end stage renal disease). The study period comprised claims from 2010 to 2014. The reimbursement charges of the day of surgery, 90-day global period and 90-day period excluding the initial surgical day of each comorbidity were analyzed and compared. Statistical analysis was conducted trough analysis of variance (ANOVA) when the data was normally distributed or through Kruskal-Wallis comparison when it was not. An alpha value of less than 0.05 was deemed as significant.Purpose
Methods