Dysphagia Following Anterior Cervical Discectomy and Fusion: A PearlDiver Analysis of Incidence, Risk Factors, and Interventions.

Anterior cervical discectomy and fusion (ACDF) is a well-established surgical procedure, with wide variation in reported postoperative dysphagia rates (1-79%). No standardized guidelines exist for screening, diagnosis, and treatment of postoperative ACDF dysphagia. The goal of the current study is to utilize a large database of US healthcare insurance claims to investigate incidence of dysphagia post-ACDF as well as risk factors for dysphagia and interventions performed in a large patient cohort.

Teriparatide use is associated with increased odds of 2-year implant failure and revision in osteopenic patients undergoing cervical fusion.

Context: Cervical fusion outcomes are influenced by bone quality, with osteopenia increasing the risk of implant failure and revision surgery. The impact of teriparatide in this population remains unclear.

Aims: The aim of this study was to investigate the association between teriparatide use and 90-day medical complications, 2-year surgical complications, and hospital readmissions in this population.

No difference in clinical outcomes in robotic-assisted vs. computer-navigated total hip arthroplasty.

Background: Robotic-assisted (RA) and computer-navigated (CN) total hip arthroplasty (THA) are increasingly performed, but prior studies comparing the two techniques and their outcomes were limited. This study aimed to compare clinical outcomes and costs of receiving THA using RA and CN technology.

Methods: We conducted a retrospective cohort study using a nationwide administrative database from January 1, 2010, to October 31, 2022.

Semaglutide use is associated with higher rates of pseudarthrosis and dysphagia in patients undergoing posterior cervical fusion.

Background Context: Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has shown efficacy in managing glycemic control and obesity but its effects on surgical outcomes, particularly in posterior cervical fusion (PCF), are underexplored.

Purpose: To evaluate the association between semaglutide use and postoperative complications, costs, and readmissions in patients undergoing PCF.

Design: Retrospective cohort study.

Outcomes of ambulatory versus outpatient hospital-based surgical center shoulder arthroplasty: complications, readmissions, and charges.

Purpose: The rising demand for primary total shoulder arthroplasty (TSA) has spurred interest in comparing the safety and cost-effectiveness of outpatient TSA in ambulatory surgical centers (ASCs) versus hospital-based centers (HSCs). This study evaluates ASCs and HSCs for medical complications, readmission rates, implant complications, and costs.

Methods: This retrospective cohort study used the PearlDiver Mariner Database to identify patients undergoing primary TSA in ASCs or HSCs, assessing medical complications, readmissions, implant issues, and costs.

Patient Frailty in Total Knee Arthroplasty: The Implementation of a Frailty Score Using an Electronic Medical Record.

Background: Frailty has been associated with poor outcomes and higher costs after primary total knee arthroplasty (TKA). However, the implementation of a frailty score at a level one tertiary care facility to evaluate patient outcomes has not been well described. This study examined the retrospective implementation of the Hospital Frailty Risk Score (HFRS) and the relationship of the HFRS score with 90-day readmission, revision at any time point, and length of initial hospitalization.

Lower ACLR Failure Rates in Bone-Soft Tissue Versus Soft Tissue-Only Allografts in Adults: A Systematic Review and Meta-analysis.

Background: While allografts are commonly used for anterior cruciate ligament reconstruction (ACLR), evidence to guide specific allograft selection is lacking.

Purpose: To compare clinical and graft failure rates after ACLR using soft tissue-only allografts and bone-soft tissue allografts in adults.

Study Design: Systematic review and meta-analysis; Level of evidence, 4.

Surgical Trends in Use of Lumbar Disk Arthroplasty Versus Lumbar Fusion From 2010 to 2021.

Introduction: Lumbar disk arthroplasty (LDA) is a relatively novel procedure with limited indications and use in the United States, especially relative to lumbar fusion (LF). This study aimed to determine surgical trends between LDA versus LF over the past 10 years to quantify absolute/relative surgical volume over time and compare baseline patient demographics, readmission, 2-year revision rates, and costs-of-care.

Methods: A total of 714,268 patients were identified from a nationwide database who underwent LF (n = 710,527) or LDA (n = 3,741) from 2010 to 2021.

Hip Resection Arthroplasty as Definitive Treatment: Indications, Outcomes, and Complications in Paraplegic and Non-Paraplegic Patients.

Background: Hip resection arthroplasty (HRA) serves as a salvage treatment option for various conditions affecting paraplegic patients. In nonparaplegic individuals, it is often utilized to manage complex infections. There exists a paucity of studies comparing outcomes between paraplegic and nonparaplegic patients undergoing HRA as definitive treatment.

Osteoporosis May Not Be an Absolute Contraindication for Cementless Total Knee Arthroplasty.

Background: Cementless total knee arthroplasty (TKA) has received growing interest, particularly in younger populations, due to potential long-term survivability and improved bone preservation. Poor bone stock, as seen in osteoporosis, is considered a contraindication for this technique. This study evaluated whether osteoporotic patients < 75 years undergoing cementless TKA demonstrate similar: 1) implant-related complications, 2) medical complications, 3) readmission rates, and 4) 3-year implant survivability.

Complications and Healthcare Cost of Total Hip Arthroplasty in Patients with Depressive Disorder.

Purpose: The purpose of this study was to determine whether the rates of (1) in-hospital lengths of stay (LOS), (2) readmissions, (3) medical complications, and (4) costs of care are higher for patients with depressive disorder (DD) undergoing primary total hip arthroplasty (THA) for treatment of femoral neck fractures (FNFs).

Materials And Methods: A retrospective query of a national administrative claims database for patients undergoing primary THA from 2006 to 2014 was conducted. Patients with DD undergoing THA for treatment of FNF were 1:5 ratio propensity score matched to a cohort (DD=6,758, controls=33,708).

Depressive Disorder and Trimalleolar Fractures: An Analysis of Outcomes and Costs.

Introduction: Studies have suggested a strong association between depression and poor outcomes following various orthopaedic surgeries. However, depression's impact on complications following open reduction/internal fixation (ORIF) of trimalleolar fractures has not been elucidated. Therefore, this study aimed to determine whether depression is associated with higher rates of readmissions and medical complications following ORIF of trimalleolar fractures.

Patient Frailty is Correlated With Increased Adverse Events and Costs After Revision Total Hip Arthroplasty.

Background: Frailty has been associated with poor outcomes and higher costs after primary total hip arthroplasty. However, frailty has not been studied in relation to outcomes after revision total hip arthroplasty (rTHA). This study examined the relationship between the Hospital Frailty Risk Score (HFRS), postoperative outcomes, and cost profiles following rTHA.

Glenoid-based reference system to differentiate shoulder pathologies on plain radiographs.

Background: Shoulder radiographs are used for evaluation and the planning of treatment of various pathologies. Making a diagnosis of these pathologies on plain radiographs occurs by recognizing the relationship of the humeral head on the registry of the glenoid. Quantification of these changes in registry does not currently exist.