Coronal Alignment Does Not Adequately Predict Femoral Rotation Axes in Total Knee Arthroplasty: Application of a 3D Image-Based Robotic-Assisted Arthroplasty Platform.

(1) Introduction: Precise femoral component rotation is critical for achieving symmetric flexion-gap balance and physiologic patellofemoral tracking in mechanically aligned total knee arthroplasty (TKA). Surgeons often infer an appropriate rotational target from the patient's coronal limb alignment, yet the strength of this relationship remains uncertain. (2) Methods: We identified 695 consecutive patients undergoing primary TKA with a preoperative planning CT scan.

High-volume revision surgeons are more cost-effective following revision total hip and knee arthroplasty.

Background: With the increased rates of revision total hip (rTHA) and total knee arthroplasty (rTKA), the financial burden of these procedures is at risk of straining the healthcare system. Our study sought to create a model to evaluate the cost-effectiveness of rTKA and rTHA performed by high-volume (HV) and low-volume (LV) surgeons.

Methods: The database of rTKA and rTHA from April 2018 to March 2021 at our academic institution was retrospectively reviewed.

Investigating the Impact of Health Insurance on the Treatment of Distal Radius Fractures in New York State.

Background: Prior studies have demonstrated that socioeconomic factors can influence decisions regarding care. The purpose of this study is to evaluate the impact of insurance type on the treatment of distal radius fractures.

Methods: This was a retrospective study of patients in the New York Statewide Planning and Research Cooperative System database undergoing treatment for distal radius fractures.

High volume total hip arthroplasty surgeons have improved perioperative outcomes and short-term cumulative revision rates.

Background: The relationship between total hip arthroplasty (THA) surgeon volume and outcomes is informative in this era of health care value optimisation. The purpose of this study was to evaluate outcomes based on modern-day surgeon practice volumes.

Methods: The SPARCS database was queried for patients undergoing primary THA from 2010 to 2020.

Surgical treatment of chronic exertional compartment syndrome - A flash in the pan?

Objective: To quantify the changes in incidence and procedural volume of elective fasciotomies for chronic exertional compartment syndrome (CECS) in New York State from 2010 to 2018, identifying key demographic and geographic contributors to these trends.

Design: Retrospective epidemiological study.

Method: The New York Statewide Planning and Research Cooperative System (SPARCS) was queried for patients who underwent outpatient fasciotomy procedures between January 1, 2010, and December 31, 2018 for CECS.

Total Hip Arthroplasty in Challenging Settings: Acetabular Fractures, Adolescents, Conversions, and Developmental Dysplasia of the Hip.

Background: Total hip arthroplasty (THA) is one of the most common and successful procedures for the treatment of end-stage hip arthritis. However, in certain complex scenarios, THA can present important and unique challenges, specifically following acetabular fractures in adolescent patients, following failed fixation of proximal femoral fractures, and in developmental dysplasia of the hip. As these cases involve distorted anatomy, poor bone quality, retained hardware, and previous surgeries, detailed planning, specialized instrumentation and implants, and novel surgical techniques are required.

Kienbock's Disease and the Risk Factors Associated with Reoperation: A SPARCS Database Review over 10 Years.

 The purpose of this study was to utilize a large multi-institutional database to identify risk factors associated with the need for revision surgery and to determine revision rate in patients who underwent operative treatment of Kienbock's disease (KD).  The New York Statewide Planning and Research Cooperative System database was reviewed to identify patients who underwent any surgical procedure with a diagnosis of KD from 2011 to 2021. The control cohort diagnoses included primary osteoarthritis of the carpus or wrist.

Treatment of Femoral Neck Fracture Depends on Surgeon Subspecialty Training.

Background: Femoral neck fractures pose a notable health challenge globally, with a projected rise in cases due to aging populations. While treatment protocols are established, the effect of surgeon training on treatment decisions, particularly trauma versus arthroplasty fellowship training, remains less clear.

Methods: This study, using data from the Statewide Planning and Research Cooperative System in New York State, examined 26,761 patients meeting inclusion criteria.

Knee Arthroplasty Risk After Arthroscopy in Patients Older Than Age 50 Years Correlates With the Presence of Diagnosis Codes for Osteoarthritis and Obesity.

Purpose: To assess the 10-year arthroplasty-free survivorship of patients older than 50 years of age who underwent knee arthroscopy and to assess whether this survivorship is affected by the diagnoses of knee osteoarthritis (OA) or obesity at the time of arthroscopy.

Methods: The New York Statewide Planning and Research Cooperative System administrative database from 2010 to 2020 was queried to identify all patients over the age of 50 who underwent knee arthroscopy. Kaplan-Meier survival analysis was used to assess arthroplasty-free survivorship.

Hypoalbuminemia increases risks for complications after surgical repair of nonunions and malunions.

Objective: The purpose of this study was to determine the association of hypoalbuminemia with adverse outcomes in patients undergoing surgical repair of nonunions or malunions of upper and lower extremity long bones.

Methods: DESIGN: Retrospective.

Setting: Hospitals participating in American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2005 to 2019.

Traumatic arthrotomy: A systematic review evaluating diagnostic strategies.

Objectives: The purpose of this study was to systematically review available strategies for diagnosing traumatic arthrotomy.

Methods: A comprehensive literature search was conducted on October 8th, 2023 using Ovid Medline, Cochrane Central Register of Controlled Trials, Embase, and Embase Classic. Studies were included in the review if they evaluated a diagnostic strategy for traumatic arthrotomy.

Preoperative Workup of Operative Hip Fracture Patients: A Survey.

There may be disagreement among stakeholders on the need for preoperative cardiac screening for elderly hip fracture patients. : We sought to assess preoperative workup perceptions among physicians for hip fracture patients across specialties, specifically considering a patient's cardiovascular risk. : A case-based survey was distributed to 50 physicians in each of the 4 departments involved in preoperative patient care: orthopedic surgery (OS), anesthesiology (A), cardiology (C), and hospital medicine (HM).

Synovial Fluid Biomarker Alternatives Can Plasma and Urine Samples Shed Light on the Post-Traumatic Intra-Articular Microenvironment?

The purpose of this study was to analyze the relationship between the intra-articular inflammatory response and any associated systemic inflammatory response following knee injury requiring operative management. Patients undergoing primary knee arthroscopy provided synovial fluid, blood, and urine samples immediately prior to surgery. Samples were analyzed using a multiplex magnetic bead immunoassay for the concentrations of cytokines and growth factors that have been shown to be associated with post-injury inflammation.

Orthopedic pelvic and extremity injuries increase overall hospital length of stay but not in-hospital complications or mortality in trauma ICU patients: Orthopedic Injuries in Trauma ICU Patients.

Background: The purpose of this study was to compare the ICU length of stay (LOS), overall hospital LOS, in-hospital complications, and mortality rate between trauma ICU patients with orthopedic injuries versus those without.

Methods: This was a retrospective cohort study in which the trauma registry of a single level 1 trauma center was queried over a 6-year period for patients admitted to the ICU during hospitalization. Patients were stratified based on the presence/absence of an orthopedic fracture.

Total Hip Arthroplasty Patients Who Have Ostomies Have an Increased Risk of Revisions for Periprosthetic Joint Infection, but Total Knee Arthroplasty Patients Do Not.

Background: Patient comorbidities can lead to worse outcomes and increase the risk of revisions after total hip arthroplasty (THA) and total knee arthroplasty (TKA). Sparse research is available on the effects of ostomies on postoperative outcomes. Our study aimed to assess whether patients who have ostomies, who underwent TKA or THA, have worse outcomes and increased rates of all-cause and periprosthetic joint infection (PJI)-related revisions.

Equivalent Survivorship of Total Hip Arthroplasty in Patients Who Have Inflammatory Bowel Disease.

Background: Inflammatory bowel disease (IBD) can have orthopaedic manifestations related to decreased bone mineral density and increased fracture risk. The impact of IBD-spectrum diseases, including Crohn's disease (CD) and ulcerative colitis (UC), on the overall performance of total hip arthroplasty (THA), is not well understood. The present study sought to evaluate whether patients who have IBD were at an increased risk of THA failure compared to those who did not have IBD.

Relative contribution of the nail and plate to a nail-plate construct for comminuted distal femoral fractures.

The purpose of this study was to assess the biomechanical contributions of the nail and the plate individually to a complete nail-plate construct in the setting of comminuted distal femur fractures. For this biomechanical study, comminuted extra-articular distal femur fractures were created in 24 synthetic osteoporotic femur models. These were then split into three groups: the nail-only group, the plate-only group, and the nail-plate group.

Optimal combination of arthroplasty type, fixation method, and postoperative rehabilitation protocol for complex proximal humerus fractures in the elderly: a network meta-analysis.

Background: The purpose of this study was to define the optimal combination of surgical technique and postoperative rehabilitation protocol for elderly patients undergoing either hemiarthroplasty (HA) or reverse total shoulder arthroplasty (rTSA) for acute proximal humerus fracture (PHF) by performing a network meta-analysis of the comparative studies in the literature.

Methods: A systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines of MEDLINE, EMBASE, and Cochrane Library was screened from 2007 to 2023. Inclusion criteria were level I-IV studies utilizing primary HA and/or rTSA published in a peer-reviewed journal, that specified whether humeral stems were cemented or noncemented, specified postoperative rehabilitation protocol, and reported results of HA and/or rTSA performed for PHF.

Total hip arthroplasty outcomes in Ehlers-Danlos patients: data from the Statewide Planning and Research Cooperative System.

Introduction: Ehlers-Danlos syndromes (EDS) are genetic connective tissue disorders affecting multiple organ systems that frequently result in connective tissue hyperlaxity and early osteoarthritis. Short- and long-term outcomes after primary total hip arthroplasty (THA) in this patient population remain poorly characterised. The primary purpose of this study is to compare postoperative outcomes and survivorship after primary THA in patients with and without EDS.

Management of Humeral Shaft Fracture: A Network Meta-Analysis of Individual Treatment Modalities.

Objective: The purpose of this study was to perform a network meta-analysis of level I and II evidence comparing different management techniques to define the optimum treatment method for humeral shaft fractures (HSFs).

Data Sources: A systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of MEDLINE, Embase, and Cochrane Library was screened from 2010 to 2023.

Study Selection: Inclusion criteria were evidence level I or II studies comparing nonoperative and/or operative repair techniques including open reduction internal fixation plate osteosynthesis (ORIF-Plate), minimally invasive percutaneous plating (MIPO), and intramedullary nail (IMN) fixation for the management of HSFs (OTA/AO 12A, B, C).

Tranexamic acid reduces perioperative blood loss and postoperative hemoglobin loss during total ankle arthroplasty: A systematic review and meta-analysis of clinical comparative studies.

Importance: Peri-operative blood loss during joint replacement procedures is a modifiable risk factor that impacts wound complications, hospital stay and total costs. Tranexamic acid (TXA) is an anti-fibrinolytic that has been widely used in orthopedic surgery, but its efficacy in the setting of total ankle arthroplasty (TAA) has not been quantified to date.

Aim: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of administering TXA in patients undergoing TAA.