Level 1 studies for fracture management of upper extremity fractures remains rare. The influence of these studies on management trends has yet to be evaluated. The purpose of this study was to examine alterations in national trends managing mid-shaft clavicle and intra-articular distal humerus fractures (DHF) surrounding recent Level 1 publications. We retrospectively reviewed a comprehensive Medicare (2005–2012) and Humana (2007–2014) patient population database within the PearlDiver supercomputer (Warsaw, IN, USA) for DHF and mid-shaft clavicle fractures, respectively. Non-operative management and open reduction internal fixation (ORIF) were reviewed for mid-shaft clavicle fractures. ORIF and total elbow arthroplasty (TEA) were reviewed for DHF. Total use and annual utilization rates were investigated using age limits defined in the original Level 1 studies.Background
Methods
Locked anterior shoulders (LAS) with static instability and anterior glenoid bone loss are challenging in the elderly population. Reverse shoulder arthroplasty (RSA) has been employed in treating these patients. No study has compared RSA for LAS to classically indicated RSA. A case-control study of patients treated with RSA for LAS with glenoid bone loss and static instability was performed using matched controls treated with primary RSA for classic indications. Twenty-four cases and 48 controls were evaluated. Average follow-up was 25.5 months and median age was 76. Motion, outcome assessments, and postoperative radiographs were compared.Background
Methods
It is well established that diabetic patients undergoing total knee arthroplasty (TKA) are more susceptible to infection, problematic wound healing, and have overall higher complication rates. However there is a paucity in current literature investigating the effects of hypoglycemia on TKA. The purpose of this study was to determine the effect of hypoglycemia on TKA revision (rTKA) incidence analyzing a national private payer database for procedures performed between 2007 and 2015 Q1. A retrospective review of a national private payer database within the PearlDiver Supercomputer application (Warsaw, IN, USA) for patients undergoing TKA with blood glucose levels ranging from 20 to 219 mg/ml, in increments of 10 mg/ml, was conducted. Patients who underwent TKA were identified by Current Procedural Terminology (CPT)-27447 and International Classification of Disease (ICD) code 81.54. Glucose ranges were identified by filtering for lab identifier values unique to the PearlDiver database. Revision TKA and causes for revision, including mechanical loosening, failure/break, periprosthetic fracture, osteolysis, infection, pain, arthrofibrosis, instability, and trauma) were identified with CPT and ICD-9 Codes. Statistical analysis of this study was primarily descriptive.Introduction
Methods
Virtual planning of shoulder arthroplasty has gained recent popularity. Combined with patients specific instrumentation, several systems have been developed that allow the surgeon to accurately appreciate and correct glenoid deformities in version and inclination. While each virtual software platform utilizes a consistent algorithm for calculating these measurements, it is imperative for the surgeon to recognize any differences that may exist amongst software platforms and characterize any variability. A case-control study of all CT scans of patients previously pre-operatively planned using MatchPoint SurgiCase® software were uploaded into the BluePrint software. The cohort represents surgical planning for total shoulder arthroplasty and reverse shoulder arthroplasty with varying degrees of glenoid deformity. Glenoid version and inclination will be recorded for each CT scan using both software platforms.Background
Methods
