Opioid use in impending versus pathologic proximal femur fractures.

Objectives: To investigate post-operative opioid use, functionality, and overall survival following internal fixation for pathologic or impending fractures at 3 and 6 months.

Background: Pathologic and impending fractures commonly occur in the proximal femur, and patients may be prescribed opioids prior to surgery and often require opioids for post-operative pain relief. This study compared post-operative opiate usage and ambulatory functional status in patients with impending versus pathologic fractures in the proximal femur.

Travel Distance Does Not Affect Patient-Reported Outcomes Following Primary Total Knee Arthroplasty.

Background: An increasing volume of total knee arthroplasties (TKAs) is being performed at high-volume specialty centers. Concerns exist that this may increase travel burden for patients, which may result in fragmented postoperative care and impact outcomes. The purpose of this study was to evaluate the impact of travel distance on patient-reported outcomes (PROs) and change in range of motion (ROM).

Trends in Medicare Arthroplasty Procedure Volume: Projecting From 2025 to 2040.

Background: Characterizing and forecasting trends in total joint arthroplasty (TJA) utilization among Medicare beneficiaries has important implications for resource allocation. This study reports and predicts trends in primary and revision TJA among Medicare patients.

Methods: Patients were retrospectively identified from 2013 to 2022, which were published by the Centers for Medicare and Medicaid Services.

Travel Distance Does Not Impact Outcomes Following Unicompartmental Knee Arthroplasty.

Background: Unicompartmental knee arthroplasty (UKA) is less frequently performed than total knee arthroplasty, and hence some patients may need to travel to a distant location to have this procedure performed. The purpose of this study was to determine the impact of travel distance on the 90-day outcomes of UKA.

Methods: Patients undergoing primary, elective UKA at a single center by one of three fellowship-trained adult reconstruction surgeons between 2017 and 2020 were retrospectively reviewed.

Repeat Exposure to Mesh-Glue Dressing Is Associated With Allergic Contact Dermatitis: A Prospective Cohort Study.

Background: Certain postoperative dressing types have been associated with allergic contact dermatitis (ACD), presenting as a peri-incisional eczematous skin reaction. The purpose of this study was to compare rates of ACD following arthroplasty between patients who have prior exposure and those naïve to a specific dressing type (self-adhesive polyester mesh and 2-octyl cyanoacrylate liquid adhesive).

Methods: There were 222 patients undergoing 245 procedures (163 total knee arthroplasties, 69 total hip arthroplasties, and 13 unicompartmental knee arthroplasties) who were prospectively evaluated between August 2023 and May 2024 at a single institution.

Comparable outcomes between lateral and medial unicompartmental arthroplasty at 2-year follow-up.

Introduction: Our study sought to evaluate (1) national rates of lateral unicompartmental knee arthroplasty (UKA) relative to medial UKA and compare, (2) 90-day medical complications and (3) 1- and 2-year surgical complications between matched lateral and medial UKA cohorts.

Methods: The PearlDiver Mariner database was queried for patients undergoing primary UKA between 2016 and 2022. ICD-10 procedure codes were utilized to segregate patients into lateral and medial compartment cohorts.

Trends and Epidemiology in Revision Total Hip Arthroplasty: A Large Database Study.

Background: The clinical and financial burden of revision total hip arthroplasty (rTHA) continues to grow. Therefore, further investigation is needed to characterize case volume, reason for failure, and postoperative complications. The purpose of this study was to characterize contemporary indications for and complications following rTHA.

Trends in Payments for Ambulatory Surgery Center Facility Fees and Surgeon Professional Fees for Hip and Knee Arthroplasty.

Background: Ambulatory surgery centers (ASCs) have been shown to deliver high-quality care to patients at major cost savings to the health care system. The objective of this investigation was to examine trends in the Medicare facility and surgeon professional fee payments for hip and knee arthroplasty.

Methods: Publicly available Medicare data were analyzed to determine professional and facility fee payments for unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and total hip arthroplasty (THA) to ASCs and hospitals between 2018 and 2024.

Hyaluronic acid injections administered within two months prior to total knee arthroplasty increase the risk for periprosthetic joint infection.

Background: It remains unknown how timing of preoperative intra-articular knee hyaluronic acid (HA) injections impacts risk for developing postoperative periprosthetic joint infection (PJI) following total knee arthroplasty (TKA).

Methods: The PearlDiver Mariner database was utilized to identified patients undergoing primary TKA between 2015 and 2022 who received an HA injection without a corticosteroid injection within 12 months prior to surgery. The HA cohort was matched 1:1 to a control cohort undergoing no preoperative injections (corticosteroid or HA).

Trends and Epidemiology in Revision Total Knee Arthroplasty: A Large Database Study.

Background: As the volume of primary total knee arthroplasty (TKA) continues to grow, the clinical and financial burden of revision total knee arthroplasty (rTKA) is expected to increase. The purpose of this investigation was to characterize contemporary indications and complications for rTKA.

Methods: Patients undergoing rTKA between 2010 and 2021 were identified within an administrative claims database.

The Impact of Travel Distance on Patient-Reported Outcomes Following Primary Total Hip Arthroplasty.

Background: Total hip arthroplasties (THAs) are increasingly being performed at high-volume centers, causing some patients to travel further distances to receive care. Concerns remain that increased travel distance limits follow-up, which may impact outcomes and early return to the hospital. The purpose of this study is to evaluate the impact of travel distance on 90-day patient-reported outcomes (PROs) and 90-day complication rates.

Radiotherapy leads to improved overall survival in patients undergoing resection for Undifferentiated pleomorphic sarcoma.

Background And Objectives: Undifferentiated pleomorphic sarcoma (UPS) is a frequent subtype within the heterogeneous group of soft tissue sarcomas (STS). The use of radiotherapy (RT) has become an important component of a multimodal approach to treating STS. Key studies have demonstrated that the addition of RT improves rates of local control in STS, though the effect on overall survival (OS) is less clear.

Novel MRI scoring system to assess osseous malignancy in soft tissue sarcoma patients following radiotherapy.

Purpose: Radiation induced changes in bone such as radiation osteitis are commonly identified on magnetic resonance imaging (MRI) in patients who receive radiotherapy for soft tissue sarcoma (STS) management. This study proposes a novel MRI scoring system to assess osseous lesions and predict potential for malignancy based on MRI score in STS patients who received radiotherapy.

Methods: The MRI score consisted of 3 parameters: morphology, signal intensity, and progression.

Total Knee Arthroplasty in Patients with Cerebral Palsy: A Large Database Analysis.

Cerebral palsy (CP) is a neurodevelopmental condition that can result in altered gait biomechanics, joint dysfunction, and imbalance. The complications associated with total knee arthroplasty (TKA) in patients with CP have not yet been well described. Therefore, our analysis sought to compare the 90-day and 2-year complications following TKA in patients with and without CP.

Evaluating Modern Spacer Options and Outcomes in Revision Hip Arthroplasty.

Background: A 2-stage revision continues to be the standard treatment for periprosthetic joint infection (PJI) in hip arthroplasty. The use of "functional" spacers may allow patients to return to daily living while optimizing their health for revision surgery. We aimed to evaluate the clinical outcomes of different spacer types regarding infection eradication, mechanical complications, and functional outcomes.

Validation of a Classification System for Optimal Application of Debridement, Antibiotics, and Implant Retention in Prosthetic Joint Infections following Total Knee Arthroplasty: A Retrospective Review.

Introduction: Periprosthetic joint infection (PJI) remains a serious complication after total knee arthroplasty (TKA). While debridement, antibiotics, and implant retention (DAIR) are considered for acute PJI, success rates vary. This study aims to assess a new scoring system's accuracy in predicting DAIR success.

Evaluation of Local Recurrence and Diagnostic Discordance in Chondrosarcoma Patients Undergoing Preoperative Biopsy.

Background/aim: Preoperative biopsy of chondroid lesions has demonstrated discordance between biopsy grade and surgical resection grade. Furthermore, there is evidence to suggest risk of tumor contamination during biopsy. We evaluated our large chondrosarcoma institutional cohort to compare the rates of local recurrence based on pre-surgical biopsy, as well as other tumor characteristics and disease-related outcomes.

Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and survival in undifferentiated pleomorphic sarcoma (NLR, PLR, and overall survival in UPS).

Background And Objectives: Cancer-related inflammation has been shown to be a driver of tumor growth and progression, and there has been a recent focus on identifying markers of the inflammatory tumor microenvironment. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are inflammatory indices that have been identified as prognostic biomarkers in various malignancies. However, there is limited and conflicting data regarding their prognostic value in soft tissue sarcoma (STS) and specifically in undifferentiated pleomorphic sarcoma (UPS).

Radiation osteitis: incidence and clinical impact in the setting of radiation treatment for soft tissue sarcoma.

Objective: Radiotherapy is an important component of soft tissue sarcoma management. Radiation osteitis is a common radiographic finding identified in the setting of radiotherapy on magnetic resonance imaging (MRI). This study aims to identify the incidence of radiation osteitis in patients who received radiotherapy for soft tissue sarcoma and if a further workup, including a biopsy, was performed for concerning MRI findings.

Barriers and Opportunities for Patient-Reported Outcome Implementation: A National Pediatrician Survey in the United States.

Purpose: To characterize pediatricians' perceived barriers and areas of confidence in assessing patient-reported outcomes (PROs) in the U.S., and to test associations of these factors with implementing PRO assessment.

Importance ratings on patient-reported outcome items for survivorship care: comparison between pediatric cancer survivors, parents, and clinicians.

Purpose: To compare importance ratings of patient-reported outcomes (PROs) items from the viewpoints of childhood cancer survivors, parents, and clinicians for further developing short-forms to use in survivorship care.

Methods: 101 cancer survivors, 101 their parents, and 36 clinicians were recruited from St. Jude Children's Research Hospital.

Development of the functional social network index for adolescent and young adult cancer survivors.

Background: To the authors' knowledge, social network status in adolescent and young adult (AYA) cancer survivors has not been adequately studied to date. The authors developed and validated a functional social network index (FSNI) for AYA survivors, and compared its performance with that of 2 traditional indices (density and betweenness centrality).

Methods: A total of 102 AYA survivors and 102 noncancer controls who were matched for age, sex, and race were recruited from an Internet panel.

Impaired Patient-Reported Outcomes Predict Poor School Functioning and Daytime Sleepiness: The PROMIS Pediatric Asthma Study.

Objective: Poor asthma control in children is related to impaired patient-reported outcomes (PROs; eg, fatigue, depressive symptoms, anxiety), but less well studied is the effect of PROs on children's school performance and sleep outcomes. In this study we investigated whether the consistency status of PROs over time affected school functioning and daytime sleepiness in children with asthma.

Methods: Of the 238 children with asthma enrolled in the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Asthma Study, 169 children who provided survey data for all 4 time points were used in the analysis.

Does personality affect health-related quality of life? A systematic review.

Background: Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear.

Natatory-stage cymothoid isopods: description, molecular identification and evolution of attachment.

Cymothoid isopods are parasites that have a biphasic life cycle comprised of free-swimming micropredatory stages that eventually attach permanently to fishes, on which they change sex and morphology. Thus, matching free-swimming and permanently attached life-history stages is difficult. We attempted to identify natatory-stage cymothoids by seeking matches of partial 16S rRNA gene sequences from these stages and described adult cymothoids.