Femoral Neck System Compared with 3 Cannulated Screws in the Treatment of Femoral Neck Fracture in Patients Aged 60 and Older: A Multicenter Registry-Based Study.

Background: While the Femoral Neck System (FNS) is increasingly utilized for the fixation of femoral neck fractures in elderly patients, studies comparing the device to the historical standard (that is, multiple cannulated screws) are lacking. The purpose of this study was to determine the risk of all-cause revision following fixation with the FNS device compared with multiple cannulated screws in patients ≥60 years of age with a femoral neck fracture.

Methods: Patients ≥60 years of age who underwent fixation of a femoral neck fracture with the FNS or 3 cannulated screws (2017 to 2022) were identified using the Kaiser Permanente Hip Fracture Registry.

Low-Demand Cemented Femoral Stem Designs and Revision Risk Following the Hemiarthroplasty Treatment of Geriatric Hip Fracture.

Background: Cemented fixation is recommended in the hemiarthroplasty treatment of geriatric femoral neck fractures. Certain cemented stems have similarly designed "low-demand" counterparts, but it is unclear whether they yield comparable clinical outcomes. The purpose of this study was to evaluate the revision risk associated with two low-demand stems, Summit Basic (DePuy Synthes) and Versys LD/Fx (Zimmer Biomet), in comparison to their standard counterparts, Summit (DePuy Synthes) and Versys Advocate (Zimmer Biomet).

Association Between Nail Type and Aseptic Revision Risk After Cephalomedullary Nailing for Hip Fracture.

Background: Although the majority of intertrochanteric femoral fractures in the United States are now treated with cephalomedullary nailing, it remains uncertain whether differences in clinical performance by nail type exist. The purpose of this study was to compare the aseptic revision rates associated with the 3 most commonly utilized cephalomedullary nails in the United States today: the Gamma nail (Stryker), the INTERTAN (Smith+Nephew), and the Trochanteric Fixation Nail/Trochanteric Fixation Nail Advanced (TFN/TFNA; DePuy Synthes).

Methods: Using an integrated health-care system's hip fracture registry, patients ≥60 years of age who were treated with 1 of these 3 commonly used cephalomedullary nail devices were identified.

Are There Differences in Performance Among Femoral Stem Brands Utilized in Cementless Hemiarthroplasty for Treatment of Geriatric Femoral Neck Fractures?

Background: For the vast majority of displaced femoral neck fractures in older patients, cemented femoral fixation is indicated because it is associated with a lower risk of periprosthetic fracture than cementless fixation. Nevertheless, cementless fixation continues to be utilized with high frequency for hip fractures in the United States. It is therefore helpful to understand the performance of individual cementless brands and models.

Predictors of quality of life, economic impact, and loss to follow-up after open tibial shaft fractures in Ghana.

Objectives: Open tibia fractures are associated with substantial morbidity and impact on quality of life. Despite increasing incidence in low-resource settings, most open tibia fracture research comes from high-resource settings. This study aimed to assess the impact of socioeconomic status on treatment modality and evaluate predictors of health-related quality of life following open tibia fractures in Ghana.

Improvements in Quality, Safety and Costs Associated with Use of Implant Registries Within a Health System.

Background: Clinical quality registries (CQRs) are intended to enhance quality, safety, and cost reduction using real-world data for a self-improving health system. Starting in 2001, Kaiser Permanente established several medical device CQRs as a quality improvement initiative. This report examines the contributions of these CQRs on improvement in health outcomes, changes in clinical practice, and cost-effectiveness over the past 20 years.

Unipolar Hemiarthroplasty, Bipolar Hemiarthroplasty, or Total Hip Arthroplasty for Hip Fracture in Older Individuals.

Background: Practice patterns regarding the use of unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty (THA) for femoral neck fractures in older patients vary widely. This is due in part to limited data stipulating the specific circumstances under which each form of arthroplasty provides the most predictable outcome. The purpose of this study was to investigate the patient characteristics for which unipolar hemiarthroplasty, bipolar hemiarthroplasty, or THA might be preferable due to a lower risk of all-cause revision.

Racial/Ethnic and Gender Diversity of Orthopaedic Journal Editorial Boards.

Background: In the current era of evidence-based medicine, scientific publications play a crucial role in guiding patient care. While the lack of diversity among orthopaedic surgeons has been well documented, little is known about the diversity of orthopaedic journal editorial boards. The purpose of this study was to assess the racial/ethnic and gender diversity of U.

Utilization of Total Joint Arthroplasty by Rural-Urban Designation in Patients With Osteoarthritis in a Universal Coverage System.

Background: Utilization of total joint arthroplasty (TJA) is affected by differences linked to sex, race, and socioeconomic status; there is little information about how geographic variation contributes to these differences. We sought to determine whether discrepancies in TJA utilization exist in patients diagnosed with osteoarthritis (OA) based upon urban-rural designation in a universal coverage system.

Methods: We conducted a cohort study using data from a US-integrated healthcare system (2015 to 2019).

Risk of Aseptic Revision and Periprosthetic Fracture Following Bipolar Versus Unipolar Hemiarthroplasty.

Unlabelled: Hemiarthroplasty is currently the most common treatment for displaced femoral neck fractures in the elderly. While bipolar hemiarthroplasty was developed to reduce the risk of acetabular erosion that is associated with traditional unipolar hemiarthroplasty, meta-analyses have reported similar outcomes for bipolar and unipolar hemiarthroplasty devices. The primary objective of this study was to evaluate the risks of aseptic revision and periprosthetic fracture following bipolar versus unipolar hemiarthroplasty in a large integrated health-care system in the United States.

Prolonged Opioid Usage Following Hip Fracture Surgery in Opioid-Naïve Older Patients.

Background: While the risk of long-term dependence following the opioid treatment of musculoskeletal injury is often studied in younger populations, studies in older patients have centered on short-term risks such as oversedation and delirium. This study investigated prolonged opioid usage after hip fracture in older individuals, focusing on prevalence, risk factors, and changes over time.

Methods: In this retrospective cohort study of 47,309 opioid-naïve patients aged ≥ 60 years who underwent hip fracture surgery (2009 to 2020), outpatient opioid use was evaluated in 3 postoperative time periods: P1 (day 0 to 30 postsurgery); P2 (day 31 to 90); and P3 (day 91 to 180).

Association Between Race/Ethnicity and Total Joint Arthroplasty Utilization in a Universally Insured Population.

Introduction: Previous studies have documented racial and ethnic disparities in total joint arthroplasty (TJA) utilization in the United States. A potential mediator of healthcare disparities is unequal access to care, and studies have suggested that disparities may be ameliorated in systems of universal access. The purpose of this study was to assess whether racial/ethnic disparities in TJA utilization persist in a universally insured population of patients enrolled in a managed healthcare system.

Risk of Revision After Hip Fracture Fixation Using DePuy Synthes Trochanteric Fixation Nail or Trochanteric Fixation Nail Advanced: A Cohort Study of 7,979 Patients.

Background: Prior reports of the DePuy Synthes Trochanteric Fixation Nail Advanced (TFNA) revealed a potential mode of fatigue failure at the proximal screw aperture following fixation of extracapsular hip fractures. We sought to compare the revision risk between the TFNA and its prior-generation forebear, the Trochanteric Fixation Nail (TFN).

Methods: A retrospective cohort study was performed using data from a U.

Association Between the Femoral Stem Design Type and the Risk of Aseptic Revision After Hemiarthroplasty.

Introduction: Although noncemented hemiarthroplasty has been associated with a higher risk of revision surgery as compared with cemented fixation, it remains uncertain whether this increased risk applies to all noncemented stem design types or only a subset. The purpose of this study was to assess the risk of aseptic revision associated with three common types of noncemented stem designs as compared with cemented fixation in the hemiarthroplasty treatment of femoral neck fractures in the elderly patients.

Methods: This was a retrospective cohort study of patients aged 60 years and older who sustained a hip fracture and underwent hemiarthroplasty between 2009 and 2018 at one of 35 hospitals owned by a large US health maintenance organization.

Hip Fracture Surgery Volumes Among Individuals 65 Years and Older During the COVID-19 Pandemic.

This study assesses hip fracture surgery volumes among older individuals in California during the pandemic compared with prepandemic rates.

Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip.

Background: While recent reports have suggested that hip corticosteroid injections can hasten joint degeneration, there are few published data on the topic. The purpose of the present study was to evaluate for an association between corticosteroid injection and rapidly destructive hip disease (RDHD) and to determine the rate of, and risk factors for, occurrence.

Methods: This study was conducted in 2 parts.

The effect of a statewide COVID-19 shelter-in-place order on shoulder arthroplasty for proximal humerus fracture volume and length of stay.

Background: Although the COVID-19 pandemic has disrupted elective shoulder arthroplasty throughput, traumatic shoulder arthroplasty procedures are less apt to be postponed. We sought to evaluate shoulder arthroplasty utilization for fracture during the COVID-19 pandemic and California's associated shelter-in-place order compared to historical controls.

Methods: We conducted a cohort study with historical controls, identifying patients who underwent shoulder arthroplasty for proximal humerus fracture in California using our integrated electronic health record.

Current Trends in the Evaluation and Management of Nondisplaced Femoral Neck Fractures in the Elderly.

Nondisplaced (Garden I and II) femoral neck (FN) fractures are commonly encountered by the practicing orthopaedic surgeon. Although these fractures are primarily classified based on the AP radiograph, the lateral radiograph should be closely scrutinized as well because posterior tilt has emerged as a consistent predictor of fixation failure. Internal fixation has for many years been the standard of care, with both cannulated screws and the sliding hip screw representing acceptable options.