Safety and early outcomes of simultaneous bilateral TKA in patients with BMI > 40: A retrospective comparative study.

Introduction: Simultaneous bilateral total knee arthroplasties (SBTKA) are common in Asia, but surgeons may have a body mass index (BMI) threshold for performing these procedures. However, no guidelines regarding patient weight and SBTKA exist in the literature. We hypothesized that SBTKA can be performed safely and efficiently for morbidly obese patients.

Higher Pulmonary Embolism Risk in Morbidly Obese Patients on Aspirin Monotherapy after Total Knee Arthroplasty: A Claims Database Analysis.

Background: Aspirin is the most common drug used for venous thromboembolism (VTE) prophylaxis after total knee arthroplasty (TKA). Morbid obesity is a potential risk factor for VTE, prompting some to use stronger anticoagulants. However, there are no established guidelines for VTE prevention in obese or morbidly obese patients undergoing primary TKA.

Post-Traumatic Stress Disorder as a Risk Factor for Adverse Outcomes in Total Knee Arthroplasty.

Background: There is a scarcity of literature concerning individuals who have existing post-traumatic stress disorder (PTSD) and their outcomes after primary total knee arthroplasty (TKA). This study compared outcomes in patients undergoing primary TKA who have a previous history of PTSD.

Methods: An electronic health care database was used to identify patients diagnosed with PTSD undergoing TKA.

Geographical and Specialty-specific Variation in the Utilization of Laminoplasty for Cervical Myelopathy.

Study Design: Level IV retrospective cohort study.

Objectives: Despite the positive outcomes associated with laminoplasty, there is significant surgeon variability in the use of laminoplasty for cervical myelopathy in the United States. In this study, we explored how geographic and specialty-specific differences may influence the utilization of laminoplasty to treat cervical myelopathy.

Using Next-Generation Sequencing to Understand Infection Prevention in Surgical Treatment of Upper Extremity Fractures-A Prospective Cohort Study.

Introduction: Postoperative fracture site infection can lead to notable patient morbidity, increase cost of care, and further contribute to healthcare disparities globally. Dogma suggests surgical blades as a vehicle for introducing bacteria into the surgical site; however, there is a paucity of literature to support this claim. This study uses advanced DNA sequencing to detect bacterial DNA on surgical blades used in upper extremity fracture surgeries.

The hip fracture assessment tool: A scoring system to assess high risk geriatric hip fracture patients for post-operative critical care monitoring.

Introduction: Intensive care unit risk stratification models have been utilized in elective joint arthroplasty; however, hip fracture patients are fundamentally different in their clinical course. Having a critical care risk calculator utilizing pre-operative risk factors can improve resourcing for hip fracture patients in the peri‑operative period.

Methods: A cohort of geriatric hip fracture patients at a single institution were reviewed over a three-year period.

Acute Total Hip Arthroplasty Following Acetabular Fracture is Associated With a High Risk of Revision, Dislocation, and Periprosthetic Fracture.

Background: The aim of this study was to compare outcomes between acute, subacute, and delayed arthroplasty for acetabular fractures occurring within 1 week, from 1 week to 6 months, or more than 6 months before the index total hip arthroplasty (THA), versus THA without a history of acetabular fracture as a control.

Methods: We analyzed the records of patients undergoing primary THA who were enrolled in a national database for at least 2 years before and after the index procedure. Patients who had an initial diagnostic code for acetabular fracture occurring less than 1 week, from 1 week to 6 months, or at least more than 6 months before the THA were classified as acute THA (aTHA), subacute THA (saTHA), or delayed THA (dTHA), respectively.

Medicaid Insurance is Associated With Decreased MRI Use for Ankle Sprains Compared With Private Insurance: A Retrospective Large-database Analysis.

Background: Advanced imaging modalities are expensive, and access to advanced imaging services may vary by socioeconomic factors, creating the potential for unwarranted variations in care. Ankle sprains are a common injury for which variations in MRI use can occur, both via underuse of indicated MRIs (appropriate use) and overuse of nonindicated MRIs (inappropriate use). High-value, equitable healthcare would decrease inappropriate use and increase appropriate use of MRI for this common injury.

Impact of Postoperative Opioid Use on 2-Year Patient-Reported Outcomes in Knee Surgery Patients.

The purposes of this study were to identify the patient characteristics associated with refilling a postoperative opioid prescription after knee surgery and to determine whether refilling opioids is associated with 2-year patient-reported outcomes. We hypothesized that postoperative refill of opioids would be associated with worse 2-year patient-reported outcomes. We studied 192 patients undergoing knee surgery at a single urban academic institution.

Impact of Preoperative Opioid Use on 2-Year Patient-Reported Outcomes in Knee Surgery Patients.

The objectives of this study are to assess perioperative opioid use in patients undergoing knee surgery and to examine the relationship between preoperative opioid use and 2-year postoperative patient-reported outcomes (PROs). We hypothesized that preoperative opioid use and, more specifically, higher quantities of preoperative opioid use would be associated with worse PROs in knee surgery patients. We studied 192 patients undergoing knee surgery at a single urban institution.

Oxaliplatin disrupts pathological features of glioma cells and associated macrophages independent of apoptosis induction.

Introduction: Emerging evidence suggests that effective treatment of glioblastoma (GBM), the most common and deadly form of adult primary brain cancer, will likely require concurrent treatment of multiple aspects of tumor pathobiology to overcome tumor heterogeneity and the complex tumor-supporting microenvironment. Recent studies in non-central nervous system (CNS) tumor cells have demonstrated that oxaliplatin (OXA) can induce multi-faceted anti-tumor effects, in particular at drug concentrations below those required to induce apoptosis. These findings motivated re-investigation of OXA for the treatment of GBM.

The synthetic neuroactive steroid SGE-516 reduces status epilepticus and neuronal cell death in a rat model of soman intoxication.

Organophosphorus nerve agents (OPNAs) are irreversible inhibitors of acetylcholinesterase that pose a serious threat to public health because of their use as chemical weapons. Exposure to high doses of OPNAs can dramatically potentiate cholinergic synaptic activity and cause status epilepticus (SE). Current standard of care for OPNA exposure involves treatment with cholinergic antagonists, oxime cholinesterase reactivators, and benzodiazepines.