Hypoalbuminemia associated perioperative mortality, reoperation, and readmission rates among total joint arthroplasty procedures: a systematic review and meta-analysis.

Background: Albumin had consistently demonstrated an association with readmission, reoperation and mortality rates among total joint arthroplasty (TJA) patients. The currently literature demonstrates variable effect sizes of hypoalbuminemia and postoperative outcomes.

Methods: PubMed/MEDLINE, Embase, Ovid, CENTRAL, the trial register, and Scopus were searched.

The implications of preoperative hypoalbuminemia on postoperative readmission, reoperation, and mortality among orthopaedic trauma patients: A systematic review and meta-analysis.

Background/aims: Preoperative serum hypoalbuminemia (<3.5 g/dL) is the blanketed referenced threshold associated with postoperative readmission, reoperation, and mortality among medical and surgical patients. This systematic review and meta-analysis evaluates the specific role of preoperative serum albumin and readmission, reoperation, and mortality among orthopaedic trauma patients.

One Size Does Not Fit All: Reassessment of The Prognostic Nutritional Index Among Geriatric Distal Femur Fracture Patients.

Background: Poor Nutrition status is often associated with perioperative complications and poor outcomes following orthopedic surgical interventions. The prognostic nutrition index (PNI), based on serum albumin and lymphocyte count, is commonly used to appraise nutrition status, with an index score > 38 indicating healthy nourishment, and lower scores generally indicating worse nutrition status. However, in many pathological settings, the components of PNI can often be acutely influenced.

Orthopaedic fracture site and wound healing risk among end-stage renal disease patients undergoing open reduction internal fixation: A database analysis.

Introduction: The aims of this study are to 1) identify incidence rate of fracture occurrence among end-stage renal disease (ESRD) patients requiring open reduction internal fixation (ORIF) stratified by anatomic site and 2) assess the risk of perioperative wound complications among ESRD fracture patients requiring ORIF compared to non-ESRD patients.

Materials And Methods: This retrospective cohort study utilized the Nationwide Inpatient Sample database, covering the period from January 2002 to December 2014, to examine patients over 18 years of age who underwent ORIF for extremity fractures in the United States. Two-sample Z-tests were employed to assess differences in patient demographics, comorbidities, and anatomical fracture sites between ESRD and non-ESRD cohorts.

All-Polyethylene Tibias Equal to Metal-Backed Tibias in Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

We sought to conduct a systematic review of the literature and a meta-analysis of post-operative outcomes following TKA with an all-polyethylene tibial (APT) or a metal-backed tibial component (MBT). A systematic review of the literature was conducted to identify all studies comparing APT and MBT for TKA based upon rates of complications, revisions, reoperation, and patient-reported outcomes. Data was pooled and relative risk of each outcome measure at short (< 5 year), mid (5-10 year), and long (> 10 year) follow-up was calculated.

Is it time to Reassess The Role of Preoperative HypoalbuminemiaAmong Geriatric Distal Femur Fracture Patients?

Background: Hypoalbuminemia, blanketly defined as Albumin < 3.5 g/dL, is often utilized as a threshold associated with postoperative complications and mortality among orthopedic and non-orthopedic surgical procedures. Albumin level is influenced by a myriad of factors including liver function, malnutrition, and inflammation.

The Association of Glycemic Control Medication Regimens and Preoperative Fructosamine Among Total Joint Artrhoplasty Patients.

Background: Although glycated hemoglobin A1C (HbA1c) has classically been used for glycemic control screening before surgery, fructosamine, a short-term glucose variability indicator, has been reported to be a more accurate predictor of postoperative periprosthetic joint infection among patients with diabetes mellitus (DM). Given the variability of diabetic medication management, this study aims to identify the associated effect of glycemic control medication regimen (GCMR) on the incidence rate and associated odds of abnormal preoperative fructosamine levels among diabetic primary total knee arthroplasty or total hip arthroplasty patients.

Methods: Between 2017 and 2018, consecutive series of total hip arthroplasty and total knee arthroplasty patients were identified, and the final cohort included only diabetic patients.

Shots fired: evaluation of vascular injury, compartment syndrome, and transfusion rates among civilian ballistic orthopaedic fracture patients presenting to two Level I trauma centres.

Purpose: This study investigates baseline patient demographics and predictors of vascular injury, blood transfusion, and compartment syndrome in patients with orthopaedic fractures secondary to GSWs at two high-volume Level I trauma centres.

Methods: A retrospective chart review of all GSW-related trauma patients at two Level I trauma centres between July 2019 and September 2021 was conducted. Chi-squared and two-tailed independent t tests were used for data analysis, and logistic regression with odds ratios (OR) determined predictors of primary outcomes.

Predictors of 30-day mortality, unplanned related readmission and reoperation among isolated closed femoral shaft fractures.

Background: Isolated, closed, femoral shaft fractures are dangerous injuries that commonly occur in the setting of high energy trauma or among older patients with significant comorbidities. Despite their prevalence, relatively little data exists connecting patient independent risk factors to the time to 30-day mortality, unplanned reoperations and unplanned readmissions in these fractures.

Methods: Using National Surgical Quality Improvement Program (NSQIP) database, isolated close femoral shaft fractures were identified using ICD-10 codes.

Use of Direct Oral Anticoagulants Among Patients With Hip Fracture Is Not an Indication to Delay Surgical Intervention.

Objectives: To compare outcomes in patients on direct oral anticoagulants (DOACs) treated within 48 hours of last preoperative dose with those with surgical delays >48 hours.

Design: Retrospective cohort study.

Setting: Three academic Level 1 trauma centers.

Early versus delayed mobilization for arthroscopic rotator cuff repair (small to large sized tear): a meta-analysis of randomized controlled trials.

Background: The timing to start passive or active range of motion (ROM) after arthroscopic rotator cuff repair remains unclear. This systematic review and meta-analysis evaluated early versus delayed passive and active ROM protocols following arthroscopic rotator cuff repair. The aim of this study is to systematically review the literature on the outcomes of early active/passive versus delayed active/passive postoperative arthroscopic rotator cuff repair rehabilitation protocols.

Comparative Analysis of Posterior Approach Versus Anterior Approach for Posterior Tibial Plateau Fractures: A Systematic Review and Meta-analysis.

Background: Posterior tibial plateau fractures can lead to significant posttraumatic instability if not treated properly. It remains unclear which surgical approach achieves better patient outcomes. The objective of this systematic review and meta-analysis was to assess postoperative outcomes in patients undergoing anterior, posterior, or combined approach for posterior tibial plateau fractures.

E-scooter use continues to rev up fracture diagnoses and hospital admissions compared to other modes of transportation.

Introduction: The COVID-19 pandemic was associated with an increase in popularity of e-scooter usage and a rise in e-scooter related injuries. Recent studies have elucidated trends within e-scooter injuries but there are few epidemiological studies that evaluate injury rates amongst multiple modes of transportation. This study seeks to investigate trends of e-scooter orthopedic fracture injuries compared to other traditional methods of transportation using a national database.

Is There a Role for Anti-factor Xa Activity Assay in Venous Thromboembolism Prophylaxis Management Among Orthopaedic Trauma Patients? Systematic Review and Meta-analysis.

Objectives: To determine the effect of anti-factor Xa assay dosing of low-molecular-weight heparin (LMWH) on rates of venous thromboembolism (VTE), deep vein thrombosis (DVT), pulmonary embolism (PE), bleeding, and mortality among orthopaedic trauma patients.

Data Sources: PubMed/MEDLINE, Embase, Ovid, Cochrane Central Register of Controlled Trials (CENTRAL), clinicaltrials.gov , and Scopus were systematically searched from inception of the database to 2021.

A review of open pelvic fractures with concurrent genitourinary injuries.

Introduction: Open pelvic fractures (OPFs) are uncommon but potentially lethal traumatic injuries. Often caused by high energy blunt trauma, they can cause severe injury to abdominal and pelvic structures. We sought to conduct a review of the literature in order to ascertain the rates of genitourinary injury and vaginal laceration after OPF and the rates of resulting infection and mortality.

Fat Embolism Syndrome and in-Hospital Mortality Rates According to Patient Age: A Large Nationwide Retrospective Study.

Introduction: Fat embolism syndrome (FES) is a rare life-threatening condition that can develop after traumatic orthopedic injuries. Controversy remains concerning the epidemiology in the elderly population. Therefore, this study aims to report FES related to in-hospital mortality stratified by age.

Comparative Risks of Fracture Among Direct Oral Anticoagulants and Warfarin: A Systematic Review and Network Meta-Analysis.

Importance: Previous studies have shown the effectiveness and safety of direct oral anticoagulants (DOACs), including lower fracture risks, compared to warfarin. However, direct or indirect comparisons between different DOACs are scarce in the literature.

Objective: This study aims to compare fracture risks among different DOACs and warfarin, including apixaban, rivaroxaban, dabigatran, and edoxaban, in patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE).

Does Surgical Repair Benefit Pipkin Type I Femoral Head Fractures?: A Systematic Review and Meta-Analysis.

: Femoral head fractures are rare injuries with or without traumatic dislocations. The management of these fractures is crucial to prevent the development of severe complications and to achieve optimal functional outcomes. Wide treatment options for Pipkin 1 femoral head fractures range from fragment excision, fixation following open reduction with internal fixation, or conservative treatment such as close reduction alone after fracture dislocation.

Crohn's disease in total knee arthroplasty patients correlates with increased rates of 90-day and overall postoperative complications and readmissions.

Background: Joint involvement is a common extraintestinal manifestation of Crohn's Disease (CD) that may require total knee arthroplasty (TKA). There is a paucity of evidence regarding the relationship between CD and postoperative outcomes after TKA surgery. This study seeks to evaluate the impact of CD on 90-day and ≥2-year follow-up postoperative outcomes of TKA patients.

Orthopedic fracture hospitalizations are revving up from E-Scooter related injuries.

Introduction: Due to market expansion of electric-scooter companies, a significant rise of personal e-scooter use in dense, urban communities has been observed. No literature has specifically focused on e-scooter fracture epidemiology and risk factors associated with direct hospital admission. The aims of this study were to evaluate the 1) patterns of e-scooter related orthopaedic fractures 2) risk factors associated with direct hospital admission.

Current Concepts and Advances of Three-Dimensional Printing in Reconstructive Musculoskeletal Oncology: A Systematic Review.

Three-dimensional printing has the potential to advance current surgical practice, by way of anatomical and pathological structure analysis and customized implant manufacturing. Applications for this technology include pre-operative planning, prosthesis customization, and bioprinting. A comprehensive literature review of PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases was conducted to extract all studies adopting three-dimensional printing in the operative management of primary and metastatic musculoskeletal tumors.