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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_10 | Pages 47 - 47
1 Oct 2020
Quinlan ND Werner BC Novicoff WM Browne JA
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Introduction. Elective surgery elicits a systemic immune response and may result in immunosuppression in certain patients. It is currently unknown whether patients are at an increased risk for viral infection and associated illness in the immediate postoperative period following total joint arthroplasty. This question has become more important given the ongoing coronavirus disease 2019 (COVID-19) pandemic. Methods. We analyzed 3 large administrative datasets (Medicare 5% and 100% standard analytic files, Humana claims database) to identify patients who underwent total knee arthroplasty (TKA) and total hip arthroplasty (THA) from 2005 to 2013. The influenza vaccination status of each patient was defined using the presence or absence of a code for vaccination. The incidence of a flu diagnosis was recorded in both vaccinated and unvaccinated patients at 1 month, 3 months, and 6 months following the date of surgery and was compared to a cohort of vaccinated patients who did not undergo surgery. Results. The incidence of postoperative influenza diagnoses codes in TKA and THA patients were similar to that of vaccinated patients who did not undergo TJA at all time points. The results were largely consistent across all three datasets. Conclusion. Large administrative databases fail to show an increased incidence of influenza codes in patients who have recently undergone total joint arthroplasty. While the lack of signal is reassuring and provides evidence, these findings are limited by the nature of large administrative datasets and the accuracy of coding for influenza. Further studies will be necessary to fully understand an individual patient's postoperative risk for contracting a viral illness


Bone & Joint Open
Vol. 2, Issue 9 | Pages 696 - 704
1 Sep 2021
Malhotra R Gautam D Gupta S Eachempati KK

Aims

Total hip arthroplasty (THA) in patients with post-polio residual paralysis (PPRP) is challenging. Despite relief in pain after THA, pre-existing muscle imbalance and altered gait may cause persistence of difficulty in walking. The associated soft tissue contractures not only imbalances the pelvis, but also poses the risk of dislocation, accelerated polyethylene liner wear, and early loosening.

Methods

In all, ten hips in ten patients with PPRP with fixed pelvic obliquity who underwent THA as per an algorithmic approach in two centres from January 2014 to March 2018 were followed-up for a minimum of two years (2 to 6). All patients required one or more additional soft tissue procedures in a pre-determined sequence to correct the pelvic obliquity. All were invited for the latest clinical and radiological assessment.


Bone & Joint Open
Vol. 2, Issue 5 | Pages 314 - 322
1 May 2021
Alcock H Moppett EA Moppett IK

Aims

Hip fracture is a common condition of the older, frailer person. This population is also at risk from SARS-CoV-2 infection. It is important to understand the impact of coexistent hip fracture and SARS-CoV-2 for informed decision-making at patient and service levels.

Methods

We undertook a systematic review and meta-analysis of observational studies of older (> 60 years) people with fragility hip fractures and outcomes with and without SARS-CoV-2 infection during the first wave of the COVID-19 pandemic. The primary outcome was early (30-day or in-hospital) mortality. Secondary outcomes included length of hospital stay and key clinical characteristics known to be associated with outcomes after hip fracture.


The Bone & Joint Journal
Vol. 100-B, Issue 6 | Pages 733 - 739
1 Jun 2018
DeDeugd CM Perry KI Trousdale WH Taunton MJ Lewallen DG Abdel MP

Aims

The aims of this study were to determine the clinical and radiographic outcomes, implant survivorship, and complications of patients with a history of poliomyelitis undergoing total hip arthroplasty (THA) in affected limbs and unaffected limbs of this same population.

Patients and Methods

A retrospective review identified 51 patients (27 male and 24 female, 59 hips) with a mean age of 66 years (38 to 88) and with the history of poliomyelitis who underwent THA for degenerative arthritis between 1970 and 2012. Immigrant status, clinical outcomes, radiographic results, implant survival, and complications were recorded.