Risk Factors for Periprosthetic Fractures Following Total Hip Arthroplasty in Patients Younger Than 50 Years.

Introduction: With the expansion of total hip arthroplasty (THA) into younger populations, the number of periprosthetic fractures (PPF) seen amongst young patients is expected to increase. Therefore, the aim of this study was to identify risk factors for PPF following THA in patients under 50 years.

Methods: In total, 270,986 patients were included in this study.

Vitamin D deficiency and periprosthetic fractures.

Background: Post-operative periprosthetic fractures (PPF) are a serious complication following total hip (THA) and knee (TKA) arthroplasty. As vitamin D is involved in the pathogenesis of osteoporosis, a risk factor for PPF, it has been assumed that the incidence of vitamin D deficiency is high among patients who experience PPF. The purpose of this study was to evaluate the cumulative incidence and risk of PPF within 10 years after THA or TKA in patients with vitamin D deficiency.

Prior Cellulitis as a Risk Factor for Periprosthetic Joint Infection in Total Knee Arthroplasty: Influence of Timing and Antibiotic Prophylaxis.

Background: Periprosthetic joint infection (PJI) is a leading cause of implant failure and revision surgery after total knee arthroplasty (TKA), occurring in 1 to 3% of patients. Despite the high incidence of cellulitis and shared causative organisms with PJI, little is known about its impact on PJI risk. This study aimed to assess whether a prior history of cellulitis is associated with an increased risk of PJI after TKA, with attention to timing, and to evaluate the role of extended oral antibiotic (EOA) prophylaxis in reducing PJI risk.

Predicting Complications Following Patella Fracture Repair Using the 5-Item Modified Frailty Index.

Background: Several studies have found the 5-item modified frailty index (mFI-5) to be a reliable indicator of poor postoperative outcomes following various surgical procedures. This study aims to evaluate whether the mFI-5 continues to serve as a reliable predictor for patients undergoing patella fracture repair.

Methods: The NSQIP database was queried to identify patients ages 50 or older who underwent surgery for patella fractures between 2006-2019.

The growing burden of periprosthetic fractures after total hip arthroplasty: identifying overall trends and at-risk groups.

Unlabelled: Rates of periprosthetic fracture (PPF) after total hip arthroplasty (THA) have doubled since 2010, especially among those with osteoporosis, those under the age of 50, and those with Medicaid insurance. Further work must be done to implement prevention strategies and mitigate the rise in PPF after THA in the United States.

Purpose: Periprosthetic fractures (PPFs) following primary total hip arthroplasty (THA) contribute significantly to postoperative morbidity, mortality, and healthcare costs.

Have We Succeeded in Reducing the 2-Year Periprosthetic Joint Infection Incidence Rate Following Total Hip Arthroplasty? A National Database Analysis from 2011 to 2019.

Background: Current clinical practice guidelines to reduce periprosthetic joint infection following total hip arthroplasty (THA) advocate for preventative methods including preoperative antibiotics, nasal decolonization, meticulous antiseptic preparation, and preoperative risk stratification. However, it remains unclear if the implementation of these methods has impacted the incidence of septic revision following THA. Therefore, the purpose of this study was to examine the change in the 2-year incidence rate of septic revisions following THA from 2011 to 2019.

Impact of social determinants on osteoporosis treatment and secondary fracture risk after primary fragility fractures.

Unlabelled: This study examined the impact of social determinants of health (SDOH) on osteoporosis management and secondary fractures after primary fragility fractures. Despite similar osteoporosis treatment rates between patients with and without adverse SDOH, patients with adverse SDOH experienced significantly higher secondary fracture rates, highlighting the need for targeted interventions to improve post-fracture care in socioeconomically disadvantaged populations.

Purpose: Osteoporosis is a global health concern affecting over 500 million people.

STAR/STARD1: a mitochondrial intermembrane space cholesterol shuttle degraded through mitophagy.

The import of cholesterol to the inner mitochondrial membrane by the steroidogenic acute regulatory protein (STAR/STARD1) is essential for de novo steroid hormone biosynthesis and the acidic pathway of bile acid synthesis. This robust system, evolved to start and stop colossal cholesterol movement, ensures pulsatile yet swift mitochondrial steroid metabolism in cells. Nonetheless, the proposed mechanism and components involved in this process has remained a topic of ongoing debate.

Low-Dose Aspirin Is Safe and Effective for Prevention of Venous Thromboembolism After Femoral Neck Fracture.

Background: Although patients who undergo arthroplasty for hip fractures are at high risk of venous thromboembolism (VTE), current guidelines do not specify the optimal VTE prophylactic agent. Recent evidence demonstrates that aspirin (ASA) may be safe and effective for VTE prevention in these patients. The purpose of this study was to determine the safety and efficacy of low-dose ASA (81 mg) compared to non-ASA agents after arthroplasty for femoral neck fracture.

eNAMPT Is a Novel DAMP and Therapeutic Target in Human and Murine Pulmonary Fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal disorder without curative therapies, underscoring the critical unmet need for identification of novel therapeutics. Extracellular nicotinamide phosphoribosyltransferase (eNAMPT) is a damage-associated molecular pattern protein (DAMP) and Toll-Like Receptor 4 (TLR4) ligand that contributes to the severity of radiation-induced lung fibrosis and NASH-associated hepatic fibrosis. This study investigates eNAMPT as a druggable target in human and preclinical IPF utilizing the eNAMPT-neutralizing ALT-100 monoclonal antibody (mAb).

Connecting Underrepresented Medical Students to Resources and Role Models in Orthopaedic Surgery: A Virtual Diversity, Equity, Inclusion, and Accessibility Summit.

Introduction: Limited access to resources and stereotypes about orthopaedic surgeons may contribute to the low percentage of women and people of underrepresented in medicine (URiM) backgrounds in orthopaedic surgery. Several organizations have created resources to address these barriers, but medical students are unlikely to be exposed to the initiatives through traditional curricula. The purpose of this study was to (1) evaluate the ability of a 1-day virtual Diversity, Equity, Inclusion, and Accessibility (DEIA) summit to effectively reach URiM medical students, (2) increase medical students' knowledge of DEIA resources, and (3) augment the perception of diverse backgrounds in orthopaedic surgery.

Machine-learning diagnostics of breast cancer using piRNA biomarkers.

Background And Objectives: Prior studies have shown that small non-coding RNAs (sncRNAs) are associated with cancer occurrence or development. Recently, a newly discovered class of small ncRNAs known as PIWI-interacting RNAs (piRNAs) have been found to play a vital role in physiological processes and cancer initiation. This study aims to utilize piRNAs as innovative, noninvasive diagnostic biomarkers for breast cancer.

Damage sensing through TLR9 regulates inflammatory and antiviral responses during influenza infection.

Host response aimed at eliminating the infecting pathogen, as well as the pathogen itself, can cause tissue injury. Tissue injury leads to the release of a myriad of cellular components including mitochondrial DNA (mtDNA), which the host senses through pattern recognition receptors. How the sensing of tissue injury by the host shapes the anti-pathogen response remains poorly understood.

Data-Driven Estimated Glomerular Filtration Rate Strata Predict 90-Day Major Complications Following Total Knee Arthroplasty in Patients With Chronic Kidney Disease.

Introduction: Lower estimated glomerular filtration rate (eGFR) in patients who have chronic kidney disease (CKD) is associated with increased risk of complications following total knee arthroplasty (TKA). However, there is a lack of literature that identifies eGFR levels those are associated with notable differences in risk of these complications. The purpose of this study was to create eGFR strata for CKD patients that are associated with varying risks of 90-day major complications following TKA.

Trends in screening and treatment of osteoporosis after periprosthetic fractures from 2010 to 2020.

Unlabelled: Osteoporosis is often underrecognized and undertreated following periprosthetic fractures (PPF). Our study found that between 2010 and 2020, there has been no significant change in the rates of osteoporosis screening or treatment within 1 year following PPF. Orthopedic surgeons can play an integral role in helping to curtail the osteoporosis epidemic.

Hormone Replacement Therapy in Postmenopausal Women Undergoing Total Hip Arthroplasty is Associated With Reduced 10-Year Periprosthetic Femoral Fracture Rate.

Background: In postmenopausal women who are estrogen deficient, hormone replacement therapy (HRT) has been shown to improve fragility fracture risk. However, few studies have examined the relationship between HRT and periprosthetic fracture (PPF) risk after total hip arthroplasty (THA). The purpose of this study was to determine the impact of HRT use on 10-year PPF risk following THA.

Identifying 10-year cumulative incidence and risk of revision following total hip arthroplasty in patients with and without a diagnosis of human immunodeficiency virus.

Introduction: Prior studies have shown human immunodeficiency virus (HIV) may be a risk factor for early revision following THA, but little data exists looking at long-term implant survivorship. Therefore, the purpose of this study was to compare the 10-year cumulative incidence rate for revision following THA in patients with and without HIV.

Methods: A retrospective cohort analysis of patients with HIV undergoing elective THA was conducted using a national database.

Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty.

Background: Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA).

Methods: Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019.

Increasing Utilization of Extended Oral Antibiotic Prophylaxis Following Total Knee Arthroplasty From 2010 to 2022.

Background: Extended oral antibiotic (EOA) prophylaxis has been shown to reduce rates of periprosthetic joint infection in high-risk patients following total knee arthroplasty (TKA). Although national societies' recommendations against their use and clinical efficacy remain controversial, the increase in the literature surrounding EOA prophylaxis suggests a potential change in practice patterns that may warrant the creation of national guidelines. The purpose of this study was to investigate the trends in the utilization of EOA prophylaxis following TKA from 2010 to 2022.

Reassessing Glycemic Control: A Novel Method for 90-Day Major Complication Stratification Based on Hemoglobin A1c and Same-Day Glucose Levels for Patients Undergoing Total Knee Arthroplasty.

Background: Glucose levels obtained on the day of surgery may be predictive of complications following total knee arthroplasty (TKA). Established glucose thresholds for TKA are either nonspecific or have low predictive power. Therefore, the purpose of this study was to create data-driven hemoglobin A1c (HbA1c) and same-day glucose thresholds associated with varying risks of 90-day major and surgical site infection (SSI) complications following TKA.

The transcriptome of CD14 CD163 HLA-DR monocytes predicts mortality in Idiopathic Pulmonary Fibrosis.

Rationale: The association between immune-cell-specific transcriptomic profiles and Idiopathic Pulmonary Fibrosis (IPF) mortality is unknown.

Objectives: To determine immune-cell-specific transcriptomic profiles associated with IPF mortality.

Methods: We profiled peripheral blood mononuclear cells (PBMC) in 18 participants [University of South Florida: IPF, COVID-19, post-COVID-19 Interstitial Lung Disease (Post-COVID-19 ILD), controls] by single-cell RNA sequencing (scRNA-seq) and identified 16 immune-cell-specific transcriptomic profiles.