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Geriatric Orthopaedic Surgery & Rehabilitation

Jennifer M T A Meessen, Marta Fiocco, Claudia S Leichtenberg, Thea P M Vliet Vlieland, P Eline Slagboom, Rob G H H Nelissen
Introduction: Up to 33% and 25% of patients with end-stage hip and knee osteoarthritis (OA) are considered frail by the Groningen Frailty Indicator (GFI). This study aims to assess whether frail patients have lower functional gains after arthroplasty and to assess GFI as a tool to discriminate between good and adverse change score. Materials and Methods: Patients with end-stage hip/knee OA scheduled for arthroplasty were recruited from the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis Study ...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
James W A Fletcher, Adam Smith, Katherine Walsh, Andrew Riddick
Introduction: Despite awareness of overall poor survival rates following cardiopulmonary resuscitation (CPR), some orthopedic patients with significant comorbidities continue to have inappropriate resuscitation plans. Furthermore, in certain injury groups such as patients with hip fractures, survival outcome data are very limited; current discussions regarding resuscitation plans may be inaccurate. This study assesses survival in orthopedic patients following CPR, to inform decision-making between physicians, surgeons, and patients...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
Kevin Rezzadeh, Omar A Behery, Benjamin S Kester, William J Long, Ran Schwarzkopf
Introduction: Preliminary analysis of accelerometry measurements has shown physical activity may not increase significantly after total knee arthroplasty (TKA). This study evaluates the effect of TKA on physical activity accelerometry measurements and body mass index (BMI). Methods: Using the multicenter Osteoarthritis Initiative (OAI) database, a cohort of patients with physical activity level accelerometry measurements and BMI before and after TKA was identified...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
Tochukwu C Ikpeze, James D Brodell, Raymond E Chen, Irvin Oh
Introduction: Posterior tibialis tendon insufficiency is the most common cause of adult acquired flatfoot deformity in elderly patients. We performed a literature search of primary and secondary journal articles pertaining to posterior tibialis tendon insufficiency in the geriatric population. We examined relevant data from these articles regarding current evaluation in addition to both conservative and advanced treatment approaches that correspond to disease severity. Significance: There is a paucity of literature to guide treatment of posterior tibialis tendon insufficiency in the elderly, and this condition may be more prevalent in geriatric patients than previously realized...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
John Williams, Felix Allen, Marta Kedrzycki, Yathish Shenava, Renu Gupta
Introduction: The National Institute of Health and Clinical Excellence guidelines in the United Kingdom recommend magnetic resonance imaging (MRI) as the first-line investigation for radiographically occult hip fractures, if available within 24 hours. In our department, however, multislice computerized tomography (MSCT) is instead used as a first-line investigation due to significant delays associated with obtaining MRI. Our aim was to determine the validity and practicality of MSCT for diagnosis of occult hip fractures and its impact on timing of surgery...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
William Belangero, Jorge Daniel Barla, Daniel Horacio Rienzi Bergalli, Carlos Mario Olarte Salazar, Daniel Schweitzer Fernandez, Miguel Angel Mite Vivar, Alejandro Zylberberg, Guido Sebastian Carabelli, Maurício Kfuri
Introduction: Hip fracture is a common and devastating event in older adults causing increased dependence, comorbidity, and mortality. Since new surgical techniques have not significantly improved the mortality rate, a better understanding of patient risk factors could improve the treatment algorithm and outcomes. This prospective study aimed to document the 1-year survival rate of patients with intertrochanteric fracture treated surgically in Latin America and to investigate risk factors associated with 1-year mortality...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
Jordan C Villa, Joseph Koressel, Jelle van der List, Matthew Cohn, David S Wellman, Dean G Lorich, Joseph M Lane
Introduction: Twenty-five percent to seventy-five percent of independent patients do not walk independently after hip fracture (HF), and many patients experience functional loss. Early rehabilitation of functional status is associated with better long-term outcomes; however, predictors of early ambulation after HF have not been well described. Purposes: To assess the impact of perioperative and patient-specific variables on in-hospital ambulatory status following low-energy HF surgery...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
Franz Müller, Michael Galler, Michael Zellner, Christian Bäuml, Stephan Grechenig, Tanja Kottmann, Bernd Füchtmeier
Introduction: There are increasing demands to perform surgery of hip fractures without delay. However, few studies have assessed the time to surgery in relation to outcome measurements. Methods: A total of 643 consecutive patients with a minimum age of 60 years underwent total hip arthroplasty (THA) for an intracapsular hip fracture. For this retrospective case series, demographic data and the outcome measurements-(1) any surgical revision, (2) implant failure, and (3) mortality-were documented from a prospective clinical database...
2019: Geriatric Orthopaedic Surgery & Rehabilitation
Dominic Davenport, James Duncan, Robert Duncan, Alastair Dick, Mohit Bansal, Max R Edwards
Introduction: Despite increasing recognition of atypical femoral fractures (AFFs), there's conflicting evidence about incidence, aetiology, and short-term outcomes of these injuries. This study reports the incidence of AFFs at our center and compares the early postoperative outcomes against typical femoral fractures (TFFs). Methods: A retrospective observational cohort study of patients presenting to our trauma unit between November 2015 and July 2016 was undertaken...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Trevor J Shelton, Amy E Steele, Augustine M Saiz, Kent N Bachus, John G Skedros
Background: Although proximal humerus strength/quality can be assessed using cortical thickness measurements (eg, cortical index), there is no agreement where to make them. Tingart and coworkers used measurements where the proximal endosteum becomes parallel, while Mather and coworkers used measurements where the periosteum becomes parallel. The new circle-fit method (CFM) makes 2 metaphyseal (M1-M2) and 6 diaphyseal (D1-D6) measurements referenced from humeral head diameter (HHD). However, it is unknown whether these locations correlate to humeral length (HL)...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Betty M Luan Erfe, Jacqueline Boehme, J Mark Erfe, Ethan Y Brovman, Angela M Bader, Richard D Urman
Introduction: To evaluate the body of evidence on the predictive value of preoperative cognitive impairment on in-hospital, short-term, and midterm postoperative outcomes for elderly patients undergoing total knee arthroplasty (TKA). Significance: With an aging population, an increasing percentage of the U.S. patient population will be living with cognitive impairment. There is currently no systematic review that assesses postoperative outcomes of patients with mild cognitive impairment (MCI) or preexisting diagnosis of dementia while undergoing elective primary TKA...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Armin Arshi, Wilson C Lai, James B Chen, Susan V Bukata, Alexandra I Stavrakis, Erik N Zeegen
Introduction: Perioperative delirium in elderly hip fracture patients has been correlated with significant morbidity. The purpose of this study was to determine the preoperative risk factors for and short-term sequelae of postoperative delirium in geriatric hip fracture patients. Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program to identify geriatric (≥65 years) patients who sustained operative hip fractures in 2016...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Nicholas Yohe, August Funk, Matthew Ciminero, Orry Erez, Ahmed Saleh
Introduction: From 2000 to 2010, the cohort of patients aged 85 to 94 years had the fastest growth rate increasing in size by approximately 30%. The need for total knee arthroplasty (TKA) continues to increase with a larger percentage of patients older than 80 years requiring TKA. The purpose of our study was to examine the rate and risks of 30-day complications and unplanned readmission in patients older than 80 years. Materials and Methods: The National Surgical Quality Improvement Project database for the years 2008 to 2014 was queried for patients older than 80 years undergoing TKA...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Aunaly Palmer, Lisa A Taitsman, May J Reed, Bala G Nair, Itay Bentov
Hip fractures result in significant morbidity and mortality in elders. Indicators of frailty are associated with poor outcomes. Commonly used frailty tools rely on motor skills that cannot be performed by this population. We determined the association between the Charlson Comorbidity Score (CCS), intraoperative hypotension (IOH), and a geriatric medicine consult index (GCI) with short-term mortality in hip fracture patients. A retrospective cohort study was conducted at a single institution over a 2-year period...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Radwan G Metwaly, Zeiad M Zakaria
Introduction: Distal femoral fractures in elderly population had recorded an increase in incidence in the last 2 decades. Lateral distal femoral locking plating is considered one of the best options especially when dealing with comminuted fractures but varus collapse of the medial femoral condyle occurs frequently in patients with osteoporosis. Anatomical reduction of the fracture with stable rigid fixation using double-plating approach allows early mobilization of geriatric population and prevents varus collapse minimizing the comorbidities in such fractures...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Ariana Lott, Jack Haglin, Rebekah Belayneh, Sanjit R Konda, Kenneth A Egol
Introduction: The purpose of this study was to analyze the effect of the admitting service on cost of care for hip fracture patients by comparing the cost difference between patients admitted to the medicine service versus those admitted to a surgical service. Methods: A 2-year cohort of patients 55 years or older who were admitted to a single level 1 trauma center with an operative hip fracture were included. Patient demographics, comorbidities, admitting service, complications, and hospital length of stay were recorded for each patient...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Lei Jiang, Andrew Chia Chen Chou, Nivedita Nadkarni, Caris En Qi Ng, Yun San Chong, Tet Sen Howe, Joyce Suang Bee Koh
Introduction: This study aims to assess the correlation of the age-adjusted Charlson comorbidity index (ACCI) with 5-year mortality in a surgically treated hip fracture population. Materials and Methods: A retrospective analysis was performed on 1057 patients aged 60 years and above who underwent surgery for hip fracture with a minimum of 5-year follow-up (92.2% 5-year follow-up rate) in a tertiary hospital. Manual review of patients' electronic hospital records was performed to record demographic data, comorbidities, and length of stay...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Mohamed Mediouni, Daniel R Schlatterer
No abstract text is available yet for this article.
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Wei Liu, Huangdong Hui, Yunhai Zhang, Weilong Lin, Yongqian Fan
Introduction: The objective was to evaluate the safety and efficacy of intra-articular injection of tranexamic acid (TXA) in patients between 80 and 100 years of age with femoral neck fracture undergoing hip hemi-arthroplasty (HA). Material and Methods: We conducted a retrospective review to assess perioperative blood loss and transfusion rate after intra-articular injection of TXA during HA. This was a single-center, retrospective, single-surgeon, and standard care cohort study covering the period between January and December 2016...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Ján Dixon, Fiona Ashton, Paul Baker, Karl Charlton, Charlotte Bates, William Eardley
Introduction: As the number of patients sustaining hip fractures increases, interventions aimed at improving patient comfort and reducing complication burden acquire increased importance. Frailty, cognitive impairment, and difficulty in assessing pain control characterize this population. In order to inform future care, a review of pain assessment and the use of preoperative intravenous paracetamol (IVP) is presented. Materials and Methods: Systematic review of preoperative IVP administration in patients presenting with a hip fracture...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
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