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Journals Journal of the American Academ...

Journal of the American Academy of Orthopaedic Surgeons

https://read.qxmd.com/read/38626441/declining-inflation-adjusted-medicare-physician-fees-an-unsustainable-trend-in-hip-arthroscopy
#1
JOURNAL ARTICLE
Andrew G Kim, Adam A Rizk, Jason G Ina, Steven J Magister, Michael J Salata
INTRODUCTION: Although hip arthroscopy continues to be one of the most used arthroscopic procedures, no focused, comprehensive evaluation of reimbursement trends has been conducted. The purpose of this study was to analyze the temporal Medicare reimbursement trends for hip arthroscopy procedures. METHODS: From 2011 to 2021, the Medicare Physician Fee Schedule Look-Up Tool was queried for Current Procedural Terminology (CPT) codes related to hip arthroscopy (29860 to 29863, 29914 to 29916)...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626438/risk-factors-associated-with-thromboembolic-complications-after-total-hip-arthroplasty-an-analysis-of-1-129-pulmonary-emboli
#2
JOURNAL ARTICLE
Kevin C Liu, Neelesh Bagrodia, Mary K Richardson, Amit S Piple, Nicholas Kusnezov, Jennifer C Wang, Jay R Lieberman, Nathanael D Heckmann
INTRODUCTION: Venous thromboembolism (VTE) remains a dangerous complication after total hip arthroplasty (THA), despite advances in chemoprophylactic measures. This study aimed to identify risk factors of developing pulmonary embolism (PE) and deep vein thrombosis (DVT) after THA using a modern cohort of patients reflecting contemporary practices. METHODS: The Premier Healthcare Database was queried for primary, elective THAs from January 1st, 2015, to December 31st, 2021...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626437/women-s-representation-as-principal-investigators-among-pediatric-orthopaedic-clinical-trials-an-analysis-of-clinicaltrials-gov
#3
JOURNAL ARTICLE
Amir H Karimi, Robert J Burkhart, Monish Lavu, Aakash K Shah, R Justin Mistovich
INTRODUCTION: Despite recent efforts to increase the participation of women in orthopaedic surgery, there remains a gender gap, particularly when compared with other medical specialties. Acting as a principal investigator (PI) in a clinical trial can give physicians notable exposure and national recognition, which can improve their chances of promotion and tenure. This study aims to assess the proportion of women serving as PIs in pediatric orthopaedic clinical trials, examine associated trial characteristics, and explore geographic distribution...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626434/treatment-of-shoulder-osteoarthritis-with-intact-rotator-cuff-and-severe-glenoid-retroversion
#4
JOURNAL ARTICLE
Melissa A Wright, Matthew J Smith, Christopher J Roach
The American Academy of Orthopaedic Surgeons has developed an Appropriate Use Criteria (AUC) for Treatment of Shoulder Osteoarthritis with Intact Rotator Cuff and Severe Glenoid Retroversion. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to determine the appropriateness of various treatments of shoulder osteoarthritis with intact rotator cuff and severe glenoid retroversion. The AUC for Treatment of Shoulder Osteoarthritis with Intact Rotator Cuff and Severe Glenoid Retroversion were derived by identifying scenarios evident during the clinical decision-making process on this topic...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626430/effect-of-depression-interventions-in-patients-undergoing-total-joint-arthroplasty-without-a-formal-diagnosis-of-depression-a-systematic-review
#5
JOURNAL ARTICLE
Faran Chaudhry, Samuel Morgan, Colin Kruse, Jesse Wolfstadt, Seper Ekhtiari
PURPOSE: Depression is a notable contributor to suboptimal outcomes after total joint arthroplasty (TJA). We conducted a systematic review of comparative studies to review the available evidence of interventions that affected depression scores and/or outcomes for patients undergoing TJA. METHODS: EMBASE, Ovid MEDLINE, PubMed, and Scopus were reviewed systematically from inception until November 15, 2022. Studies that were relevant for this review included comparative studies between patients who received an intervention within 3 months before or after their primary total hip or knee arthroplasty procedure...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626429/applications-of-natural-language-processing-for-automated-clinical-data-analysis-in-orthopaedics
#6
JOURNAL ARTICLE
Yasir AlShehri, Arashdeep Sidhu, Laks V S Lakshmanan, Kelly A Lefaivre
Natural language processing is an exciting and emerging field in health care that can transform the field of orthopaedics. It can aid in the process of automated clinical data analysis, changing the way we extract data for various purposes including research and registry formation, diagnosis, and medical billing. This scoping review will look at the various applications of NLP in orthopaedics. Specific examples of NLP applications include identification of essential data elements from surgical and imaging reports, patient feedback analysis, and use of AI conversational agents for patient engagement...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626413/cemented-stem-design-in-total-hip-arthroplasty-fixation-philosophies-biomechanics-and-an-updated-classification-system
#7
JOURNAL ARTICLE
Vishal Hegde, Andrew B Harris, Bryan D Springer, Harpal S Khanuja
There is renewed interest in cemented femoral fixation in total hip arthroplasty in the United States, and to fully appreciate the evolution of cemented femoral stem designs, an understanding of their history and design rationale is essential. To adequately study the outcomes of modern-day designs, a comprehensive classification system is also necessary. The biomechanical principles, failure mechanisms, and clinical outcomes associated with various cemented femoral stems are described in this comprehensive review...
April 10, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38626351/principles-of-minimally-invasive-reduction-and-nail-fixation-for-subtrochanteric-femur-fractures
#8
JOURNAL ARTICLE
Jeffrey Brewer, Francisco Fuster, Samantha Mosle, Marilyn Heng
Subtrochanteric femur fractures have a reputation as difficult orthopaedic injuries to treat. Strong deforming forces, including the hip musculature and high physiologic forces, must be counteracted to obtain and maintain reduction. Adding to the complexity is a wide variety of fracture morphologies that must be recognized to execute an appropriate surgical plan. The challenging nature of this injury is demonstrated by nonunion rates of 4% to 5%, but some series have reports of up to 15% and malunion rates of 10% to 15%...
April 9, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38595309/association-of-pharmacologic-treatment-of-depression-anxiety-with-initial-patient-reported-outcome-measures-in-patients-with-hip-and-knee-osteoarthritis
#9
JOURNAL ARTICLE
Alexander R Farid, Adriana P Liimakka, Emily B Parker, Jeremy T Smith, Christopher M Melnic, Antonia F Chen, Jeffrey K Lange
INTRODUCTION: Depression and anxiety are common comorbidities that may exacerbate osteoarthritis (OA)-related pain. We aim to evaluate the effect of pharmacologic treatment of depression/anxiety on hip and knee patient-reported outcome measures (PROMs). METHODS: A multi-institutional PROMs database was queried for patients with depression or anxiety and hip or knee OA who completed a PROMs questionnaire at an initial orthopaedic visit between January 2015 and March 2023...
April 9, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38595161/the-association-between-race-and-extended-length-of-stay-in-low-energy-proximal-humerus-fractures-in-elderly-patients
#10
JOURNAL ARTICLE
Kevin T Root, Alex J Burnett, Jaquelyn Kakalecik, Andrew B Harris, Lauren Ladehoff, Kamil Taneja, Matthew R Patrick, Jennifer E Hagen, Joseph J King
INTRODUCTION: Proximal humerus fractures (PHFs) are one of the most common fractures among patients aged 65 years and older, commonly due to low-energy mechanisms. It is essential to identify drivers of increased healthcare utilization in geriatric PHF patients and bring awareness to any disparities in care. Here, we identify factors associated with the likelihood of inpatient admission and prolonged hospital stay among patients aged 65 years and older who sustain PHF due to falls. METHODS: A national database was used to identify patients aged 65 years and older who suffered proximal humeral fractures due to a fall...
April 9, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38595147/similar-medium-term-revision-rates-following-acute-total-hip-arthroplasty-versus-open-reduction-and-internal-fixation-for-acetabular-fractures-in-the-elderly
#11
JOURNAL ARTICLE
Alexander Upfill-Brown, Brendan Shi, Bailey Mooney, Daniel Chiou, Dane Brodke, Akash A Shah, Benjamin V Kelley, Erik N Mayer, Sai K Devana, Christopher Lee, Nelson F SooHoo
BACKGROUND: The management of elderly acetabular fractures is complex, with high rates of conversion total hip arthroplasty (THA) after open reduction and internal fixation (ORIF), but potentially higher rates of complications after acute THA. METHODS: The California Office of Statewide Health Planning and Development database was queried between 2010 and 2017 for all patients aged 60 years or older who sustained a closed, isolated acetabular fracture and underwent ORIF, THA, or a combination...
April 9, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38595137/medicare-in-the-21st-century-understanding-the-program-to-promote-improvements
#12
JOURNAL ARTICLE
David M Kalainov, Cynthia Barnard, Jessica Walradt
Medicare is the largest single purchaser of health care in the United States and currently helps to pay medical expenses for approximately one-fifth of the US population. The impetus for Medicare to move away from fee-for-service and toward value-based care payments reflects the need to incentivize and improve healthcare quality while containing increasing costs. This primer provides a detailed overview of several interrelated topics for an improved understanding of the Medicare program for orthopaedic surgeons, other clinicians, healthcare administrators, policymakers, and business leaders...
April 9, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38595127/-trend-statement-use-in-the-orthopaedic-literature
#13
JOURNAL ARTICLE
Andrew J Luzzi, Natalia Czerwonka, Brandon Rogalski, Michael L Knudsen, William N Levine
INTRODUCTION: For research to effectively guide clinical decision making, appropriate interpretation of data is paramount. The P-value is a useful tool for guiding the interpretation of data. However, despite its utility, the P-value is not without limitations. Of particular concern is the use of "trend statements" to describe non-statistically significant findings, a practice which introduces subjectivity and variability into data interpretation and can lead to the drawing of undue conclusions...
April 9, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38595101/cervical-sagittal-alignment-and-related-factor-analysis-and-prediction-model-in-patients-undergoing-revision-surgery-after-anterior-cervical-fusion
#14
JOURNAL ARTICLE
Manini Daudi Romani, Hong-Qi Zhang, Qi-Le Gao, Shao-Hua Liu, Ang Deng
INTRODUCTION: Patients with myelopathy or radiculopathy commonly undergo anterior cervical fusion surgery (ACFS), which has a notable failure rate on occasion. The goal of this study was to compare revision and nonrevision surgery patients in cervical sagittal alignment (CSA) subsequent to ACFS; additionally, to identify the best CSA parameters for predicting clinical outcome after ACFS; and furthermore, to create an equation model to assist surgeons in making decisions on patients undergoing ACFS...
April 5, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38579315/opioid-sparing-nonsteroid-anti-inflammatory-drugs-protocol-in-patients-undergoing-intramedullary-nailing-of-tibial-shaft-fractures-a-randomized-control-trial
#15
JOURNAL ARTICLE
Hans Hess-Arcelay, Alexandra Claudio-Marcano, Norberto J Torres-Lugo, David Deliz-Jimenez, Jose Acosta-Julbe, Gabriel Hernandez, Daniel Deliz-Jimenez, Gamaliel Monge, Norman Ramírez, Luis Lojo-Sojo
INTRODUCTION: Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective analgesics commonly used in fracture management. Although previously associated with delayed fracture healing, multiple studies have demonstrated their safety, with minimal risks of fracture healing. Given the current opioid crisis in the United States, alternate pain control modalities are essential to reduce opioid consumption. This study aims to determine whether the combination of oral acetaminophen and intravenous ketorolac is a viable alternative to opioid-based pain management in closed tibial shaft fractures treated with intramedullary nailing...
April 4, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38574390/the-statistical-fragility-of-tranexamic-acid-use-in-the-orthopaedic-surgery-literature-a-systematic-review-of-randomized-controlled-trials
#16
JOURNAL ARTICLE
Ashley N Brown, Avanish Yendluri, Kyle W Lawrence, John K Cordero, Calin S Moucha, Brett L Hayden, Robert L Parisien
INTRODUCTION: Randomized controlled trials (RCTs) represent the highest level of evidence in orthopaedic surgery literature, although the robustness of statistical findings in these trials may be unreliable. We used the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to evaluate the statistical stability of outcomes reported in RCTs that assess the use of tranexamic acid (TXA) across orthopaedic subspecialties. METHODS: PubMed, EMBASE, and MEDLINE were queried for RCTs (2010-present) reporting dichotomous outcomes with study groups stratified by TXA administration...
April 3, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38569465/incidence-and-risk-factors-for-acid-fast-bacillus-fungal-culture-positivity-in-primary-conversion-and-revision-hip-and-knee-arthroplasty
#17
JOURNAL ARTICLE
William Oetojo, Marina Feffer, Michael Wesolowski, William J Hopkinson, Nicholas M Brown
INTRODUCTION: Previous literature has reported minimal incidences of positive fungal/AFB cultures, questioning the routine use of these tests. With growing concern for excessive use, predictive factors for patients at higher risk for intraoperative AFB/fungal infections would help surgeons limit unnecessary testing. This study evaluates the positivity rate and predictive factors of positive fungal and/or acid-fast bacillus (AFB) cultures after primary, conversion, or revision hip and knee arthroplasty...
April 2, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38569220/5-factor-modified-frailty-index-as-a-predictor-of-outcomes-after-hemiarthroplasty-or-total-hip-arthroplasty-for-femoral-neck-fracture
#18
JOURNAL ARTICLE
Andrew G Kim, Daniel Grits, Jeffrey Zhong, Austin M Chiu, Landon Reading, William Zuke, Atul F Kamath
INTRODUCTION: Although the 5-factor modified frailty index (mFI-5) has been shown to be an independent predictor of complications after primary total hip arthroplasty (THA), its predictive value has not been evaluated in the setting of hip fracture. We therefore assessed the utility of mFI-5 score as an independent predictor of morbidity and mortality in patients who underwent THA or hemiarthroplasty for femoral neck fracture. METHODS: The American College of Surgeons National Surgical Quality Improvement database was queried for all patients with femoral neck fractures treated with THA or hemiarthroplasty between 2006 and 2020...
April 2, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38502896/the-iliopsoas-anatomy-clinical-evaluation-and-its-role-in-hip-pain-in-the-athlete-a-scoping-review
#19
JOURNAL ARTICLE
Joseph S Tramer, Per Holmich, Marc R Safran
Disability due to iliopsoas (IP) pain and dysfunction is underdiagnosed in the athletic population. The IP unit consists of the psoas major and iliacus muscles converging to form the IP tendon and is responsible primarily for hip flexion strength but has a number of secondary contributions such as femoral movement, trunk rotation, core stabilization, and dynamic anterior stability to the hip joint. As the IP passes in front of the anterior acetabulum and labrum, the diagnosis of IP pain may be confused with labral tearing seen on magnetic resonance imaging...
March 19, 2024: Journal of the American Academy of Orthopaedic Surgeons
https://read.qxmd.com/read/38489764/outcomes-of-pediatric-proximal-phalanx-base-fractures
#20
JOURNAL ARTICLE
John Schutz, Hannah Korrell, Nicole Look, Andy Lalka, Johanna Hild, Gabriela Cleary, Micah K Sinclair, Sarah E Sibbel
INTRODUCTION: Extra-articular juxtaphyseal fractures of the proximal phalanx are among the most common finger fractures in children. Immobilization of the digit for 3 to 4 weeks after reduction of the fracture is the current standard of care. The purpose of this retrospective study was to evaluate outcomes after intervention among pediatric proximal phalanx base fractures and establish radiographic criteria to guide management. METHODS: A multi-institutional retrospective review of skeletally immature patients treated for proximal phalanx juxtaphyseal fractures between 2002 and 2019 was conducted...
March 14, 2024: Journal of the American Academy of Orthopaedic Surgeons
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