Understanding the Carbon Footprint of the American Academy of Orthopaedic Surgeons Annual Meeting.

Background: This study's aim was to quantify the carbon footprint of the 2023 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting and compare it to an alternative meeting structure.

Materials And Methods: We conducted a retrospective analysis of estimated greenhouse gas emissions from the AAOS 2023 Annual Meeting in Las Vegas, NV. We also modeled theoretical meetings held in locations including Chicago, IL, New Orleans, LA, and New York City, NY, as well as a hybrid meeting occurring across four regional hubs.

Conversion of Failed Anatomic Total Shoulder Arthroplasty to Reverse Shoulder Arthroplasty Yields Similar Pain and Functional Outcomes to Primary Reverse Shoulder Arthroplasty But has a Higher Baseplate Failure Rate: A Matched Cohort Study.

Background: To investigate whether patients who initially underwent anatomic total shoulder arthroplasty (aTSA) for glenohumeral osteoarthritis and were subsequently revised to reverse TSA (rTSA) due to rotator cuff failure or glenoid loosening ultimately attained a similar clinical outcome compared with those who underwent primary rTSA and identify predictors of poor outcomes in the former population.

Methods: We did a single-center retrospective review of 63 shoulders who underwent revision rTSA after primary aTSA that failed due to glenoid component loosening (n = 32), rotator cuff failure (n = 24), or recurrent instability (n = 7). Pain and functional outcomes at minimum 2-year follow-up were compared between patients undergoing revision rTSA (n = 45) and a matched control group of primary rTSAs performed for primary osteoarthritis with an intact rotator cuff.

What Provides the Best Value for Your Time in Spine Surgery? An Analysis of Relative Value Units.

Design: Retrospective database analysis.

Objective: This study aims to assess the RVU compensation model for the most common spine surgeries.

Background: Physician work is commonly valued by utilizing the relative value unit (RVU) model for compensation.

Survivorship and clinical outcomes of reverse total shoulder arthroplasty in patients with large glenoid defects using the stilting technique and a baseplate with central ingrowth cage and peripheral locking screws.

Background: Stilting is a novel technique used in reverse shoulder arthroplasty (RSA) in patients with significant glenoid bone loss. This technique utilizes peripheral locking screws placed behind an unseated portion of the baseplate to transmit forces from the baseplate to the cortical surface of the glenoid, without the need for bone grafting. The stilted screw, once locked, provides a fixed angle point of support for this unseated aspect of a baseplate.

Comparison of trends of inpatient charges among primary and revision shoulder arthroplasty over a decade: a regional database study.

Background: This study examined trends in inpatient charges for primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA), hemiarthroplasty (HA), and revision total shoulder arthroplasty (revTSA) over the past decade.

Methods: The New York Statewide Planning and Research Cooperative System was queried for patients undergoing primary aTSA, rTSA, HA, and revTSA from 2010 to 2020 using International Classification of Diseases procedure codes. The primary outcome measured was total charges per encounter.

Effects of increased body mass index on one year outcomes following soft tissue arthroscopic shoulder instability repair.

Background: The purpose of this study was to investigate the impact of high body mass index on the 1-year minimal outcome following arthroscopic shoulder stabilization.

Methods: Patients who underwent arthroscopic Bankart repair (ABR) between 2017 and 2021 were identified and assigned to 1 of 3 cohorts based on their preoperative body mass index: normal (18-25), overweight (25-30), and obese (>30). The primary outcomes assessed were postoperative shoulder instability and revision rates.

Trends in the treatment of proximal humerus fractures from 2010 to 2020.

Background: The incidence of proximal humerus fractures (PHF) is continuing to rise due to shifts towards a more aged population as well as advancements in surgical treatment options. The purpose of this study is to examine and compare trends in the treatment of PHFs (nonoperative vs. operative; different surgical treatments) across different age groups over the last decade (2010-2020).

Inpatient charges, complication, and revision rates for shoulder arthroplasty in Parkinson disease: a regional database study.

Background: Parkinson disease (PD) is an established risk factor for higher rates of complications and revision surgery following shoulder arthroplasty, yet the economic burden of PD remains to be elucidated. The purpose of this study is to compare rates of complication and revisions as well as inpatient charges for shoulder arthroplasty procedures between PD and non-PD patients using an all-payer statewide database.

Methods: Patients undergoing primary shoulder arthroplasty from 2010 to 2020 were identified from the New York (NY) Statewide Planning and Research Cooperative System (SPARCS) database.

Is fantasy baseball score a viable outcome measure for professional baseball pitchers after undergoing Tommy John surgery?

Hypothesis And Background: Although on-field performance metrics are useful in measuring overall success of ulnar collateral ligament (UCL) reconstruction (UCLR) in professional baseball pitchers, they may not comprehensively quantify athletic performance after returning to playing in the league. To utilize fantasy baseball score (FBS) as a novel and objective outcome to assess the quality of return to play in major league baseball (MLB) pitchers who went back to professional pitching after UCLR.

Methods: This is a retrospective observational cohort study of 216 established MLB pitchers who underwent UCLR while in the MLB between the years 1974 and 2018.

Does Surgical Approach to the Hip Play a Role in Same-Day Discharge Outcomes?

Background: Different approaches for total hip arthroplasty (THA) may offer advantages in regard to achieving same-day-discharge (SDD) success.

Methods: We retrospectively identified patients aged ≥ 18 years who underwent elective primary THA from 2015 to 2020 who were formally enrolled in a single institution's SDD program. A total of 1,127 and 207 patients underwent THA via direct anterior approach and posterior approach, respectively, were included.

A Formal Same-Day Discharge Total Joint Arthroplasty Program May Not Be Necessary: A Propensity-Matched Cohort Study.

Background: Same-day discharge (SDD) total joint arthroplasty (TJA) programs often have stringent selection criteria. Some patients deemed ineligible may nonetheless be discharged on the day of surgery. This study compares the outcomes between patients enrolled in our SDD TJA program who were SDD to those who did not participate in the program but were also SDD.

Comparison of Utilization and Short-term Complications Between Technology-assisted and Conventional Total Hip Arthroplasty.

Introduction: Although technology-assisted total hip arthroplasty (TA-THA) may improve implant positioning, it remains unknown whether TA-THA confers improved clinical outcomes. We sought to examine national TA-THA utilization trends and compare clinical outcomes between TA-THA and unassisted THA (U-THA).

Methods: Patients who underwent primary, elective THA from 2010 to 2018 were identified using the American College of Surgeons National Surgical Quality Improvement Program database.

Are Orthopedic Hand Surgeons Undercompensated for Time Spent in the Operating Room? A Study of Relative Value Units.

Background: This study aims to investigate whether compensation is equitable among the most commonly performed orthopedic hand surgeries and when compared with general orthopedic procedures.

Methods: The National Surgical Quality Improvement Program database was queried for all orthopedic procedures, from 2016 to 2018, performed more than 150 times using Current Procedural Terminology (CPT) codes. Physician work relative value unit (wRVU) data were obtained from the 2020 US Centers for Medicare and Medicaid Services fee schedule.

Current Relative Value Unit Scale Does Not Appropriately Compensate for Longer Orthopedic Sports Surgeries.

Purpose: To assess whether reimbursement for orthopaedic sports procedures adequately compensates for operative time and surgical complexity.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for all orthopedic sports medicine procedures performed greater than 150 times from 2016 to 2018 with regard to operative time, preoperative risk factors, morbidity, and mortality data. Physician work relative value units (wRVU) data were obtained from the 2020 Centers for Medicare & Medicaid Services (CMS) fee schedule.

Are Orthopaedic Trauma Surgeons Adequately Compensated for Longer Procedures? An Analysis of Relative Value Units and Operative Times From the American College of Surgeons National Surgical Quality Improvement Program Database.

Background: The physician work relative value unit (wRVU) scale is the primary determinant of compensation. Operative time, technical skill, effort, and surgical complexity contribute to wRVU allocation. The aim of this study was to identify the relationship between these factors and reimbursement for trauma procedures.

Improved Implant Positioning of Cephalomedullary Nail for Trochanteric Fractures Using the Stryker ADAPT Navigation System.

Background: Tip-apex distance (TAD) of greater than 25 mm increases the risk of cephalomedullary nail (CMN) cutout for trochanteric hip fractures. The Stryker ADAPT navigation system provides intraoperative feedback to guide implant positioning. This study compares lag screw positioning using the ADAPT to conventional methods and investigates if the use of ADAPT impacts operating room efficiency.

Palmar Musculature: Does It Affect the Development of Carpal Tunnel Syndrome? A Pilot Study.

 The etiology of carpal tunnel syndrome (CTS) is multifactorial. Static mechanical characteristics of CTS have been described, but dynamic (muscular) parameters remain obscure. We believe that musculature overlying the transverse carpal ligament may have an effect on carpal tunnel pressure and may explain the prevalence of CTS in manual workers.