Article
Orthopedics
Murillo Adrados, Linsen T. Samuel, Tonja M. Locklear, Joseph T. Moskal
Summary: In 2013, the American Association of Hip and Knee Surgeons recommended preoperative weight reduction for patients with BMI>=40 seeking hip/knee arthroplasty. This study reported the effect of instituting a BMI<40 threshold in 2014 on total knee arthroplasties (TKAs) and found that preoperative weight reduction was effective in mitigating risks for obese patients.
JOURNAL OF ARTHROPLASTY
(2023)
Review
Chemistry, Multidisciplinary
Simone Franzoni, Stefano Marco Paolo Rossi, Angela Cassinadri, Rudy Sangaletti, Francesco Benazzo
Summary: This article provides a summary of current multimodal analgesia protocols for primary total knee arthroplasty, focusing on pain scores, opioid sparing, functional recovery, and patient-reported outcomes. Multimodal analgesia, including pre-emptive analgesia, local infiltration analgesia, peripheral nerve blocks, and specific systemic drugs, is considered the optimal regimen for perioperative pain management of TKA.
APPLIED SCIENCES-BASEL
(2023)
Article
Orthopedics
Vivek Singh, David Yeroushalmi, Katherine A. Lygrisse, Ran Schwarzkopf, Roy Davidovitch
Summary: This study aimed to explore the impact of body mass index (BMI) on postoperative Forgotten Joint Score-12 (FJS-12) in patients undergoing primary total hip arthroplasty. The results showed that although obese patients tended to have lower FJS-12 scores, the differences were not statistically significant compared to nonobese patients. BMI did not influence overall FJS-12 scores, but obese patients had slightly smaller statistical improvement during the first two years.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Orthopedics
Ittai Shichman, Christian T. Oakley, Jaclyn A. Konopka, Itay Ashkenazi, Joshua Rozell, Ran Schwarzkopf
Summary: This study examined the impact of Metabolic Syndrome (MetS) on complications and clinical outcomes after primary total knee arthroplasty (TKA) in morbidly obese patients (BMI>40). The results showed that patients with MetS had longer hospital stays and were more likely to be discharged to skilled nursing facilities. However, the 90-day complication rates, readmission rates, revision rates, and patient-reported outcomes were similar between MetS and non-MetS patients. Rating: 7 out of 10
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Joshua R. Harmer, Cody C. Wyles, Kristin C. Mara, Nafisseh S. Warner, Robert T. Trousdale
Summary: After TKA surgery, 44% of patients showed improved ROM at 3 months follow-up, 29% had no change, and 27% had worsened ROM. The study found no significant association between in-hospital pain levels and ROM, rates of soft tissue contracture, and need for MUA.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Orthopedics
Patrick J. Kelly, Jack N. Twomey-Kozak, Daniel E. Goltz, John R. Wickman, Jay M. Levin, Zoe Hinton, Tally E. Lassiter, Christopher S. Klifto, Oke A. Anakwenze
Summary: This study aimed to understand and quantify patient knowledge of and concerns for outpatient total shoulder arthroplasty (TSA). The study found that majority of patients were unaware of outpatient TSA as a realistic option and their primary concern was postoperative pain control.
JOURNAL OF SHOULDER AND ELBOW SURGERY
(2022)
Article
Orthopedics
Murillo Adrados, Linsen T. Samuel, Tonja M. Locklear, Joseph T. Moskal
Summary: The American Association of Hip and Knee Surgeons established a workgroup in 2013 to provide obesity-related recommendations for total joint arthroplasty. In this study, the effect of implementing a BMI threshold of less than 40 in 2014 on primary total hip arthroplasties was evaluated.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Jay M. Levin, Lefko T. Charalambous, Alex Girden, Jack Twomey-Kozak, Daniel Goltz, John Wickman, W. Michael Bullock, Jeff C. Gadsden, Christopher S. Klifto, Oke A. Anakwenze
Summary: Compared with continuous interscalene catheters, liposomal bupivacaine shows lower pain scores and fewer occurrences of severe postoperative pain in patients undergoing total shoulder arthroplasty. LB patients also demonstrate a higher proportion of opioid-free pain regimens.
JOURNAL OF SHOULDER AND ELBOW SURGERY
(2022)
Article
Orthopedics
Perna Ighani Arani, Per Wretenberg, Annette W-Dahl
Summary: This study investigated the criteria and routines used by Swedish knee arthroplasty surgeons when considering patients with obesity for knee arthroplasty. Results showed that the majority of surgeons inform patients with obesity about the risks associated with knee arthroplasty, and most centers have an upper BMI limit for performing the surgery.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2022)
Article
Medicine, General & Internal
Mihai O. Botea, Diana Lungeanu, Alina Petrica, Mircea I. Sandor, Anca C. Huniadi, Claudiu Barsac, Adina M. Marza, Ramona C. Moisa, Laura Maghiar, Raluca M. Botea, Codruta I. Macovei, Erika Bimbo-Szuhai
Summary: Perioperative analgesia for cesarean section is crucial for the comfort, success, and recovery of mothers. Adding morphine to bupivacaine significantly improves pain management and satisfaction levels but also increases the risk of adverse reactions. Further research is needed to determine appropriate dosages.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Orthopedics
William F. Sherman, Akshar H. Patel, Nisha N. Kale, Christina M. Freiberger, C. Lowry Barnes, Olivia C. Lee
Summary: Surgeon BMI thresholds for offering elective TJA are influenced by various factors, including outcomes, hospital restrictions, financial considerations, and patient well-being.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Surgery
Hira Shafeeq, Jody C. DiGiacomo, Kelley A. Sookraj, Noam Gerber, Alaa Bahr, Om N. Talreja, Swapna Munnangi, Sarah Cardozo-Stolberg, L. D. George Angus
Summary: The study demonstrates that implementing a multimodal pain management approach with IV APAP as the first-line therapy in older polytrauma patients can significantly reduce opioid use and is associated with a shorter hospital stay.
JOURNAL OF SURGICAL RESEARCH
(2022)
Review
Clinical Neurology
Jacquelyn A. Corley, Lefko T. Charalambous, Vikram A. Mehta, Timothy Y. Wang, Jihad Abdelgadir, Khoi D. Than, Muhammad M. Abd-El-Barr, C. Rory Goodwin, Christopher Shaffrey, Isaac O. Karikari
Summary: In recent years, there has been a significant shift in opioid prescribing patterns due to the recognition of the opioid epidemic in the United States. The lack of alternative treatment regimens has resulted in a high burden of opioid addiction and a substantial economic impact on the country. Spine surgery patients, who often experience chronic pain preoperatively and postoperatively, require comprehensive multimodal pain management approaches.
WORLD NEUROSURGERY
(2022)
Article
Orthopedics
Mark Wu, Niall H. Cochrane, Billy Kim, Elshaday S. Belay, Jeffrey O'Donnell, Sean P. Ryan, William A. Jiranek, Thorsten M. Seyler
Summary: In Class 2 and 3 obese patients, most maintained their body mass index (BMI) between their first preoperative visit and final postoperative visit after total hip arthroplasty (THA). Preoperative weight loss was the primary predictor of postoperative weight gain. However, BMI change preoperatively and postoperatively did not affect clinical outcomes.
JOURNAL OF ARTHROPLASTY
(2022)
Review
Medicine, General & Internal
Ying Ye, Rodney A. Gabriel, Edward R. Mariano
Summary: Surgery can be a risk factor for chronic pain and long-term opioid use, and perioperative pain management should consider combining traditional pain treatment methods with new interventions and pharmacological agents. Integrative medicine therapies such as acupuncture and music therapy may also play a role in perioperative pain management.
POSTGRADUATE MEDICINE
(2022)
Article
Orthopedics
Richard Iorio, C. Lowry Barnes, Matthew P. Vitale, James Huddleston, Derek A. Haas
JOURNAL OF ARTHROPLASTY
(2020)
Article
Orthopedics
Derek A. Haas, Xiaoran Zhang, Charles M. Davis, Richard Iorio, C. Lowry Barnes
JOURNAL OF ARTHROPLASTY
(2020)
Review
Orthopedics
Ryan P. Roach, Andrew J. Clair, Omar A. Behery, Savyasachi C. Thakkar, Richard Iorio, Ajit J. Deshmukh
Summary: A systematic review comparing porous-coated metaphyseal sleeves and tantalum cones in revision total knee arthroplasty found similar rates of aseptic loosening between the two implants, but nearly double the reoperation rate in TKAs utilizing tantalum cones. More research is needed to fully understand the effectiveness of different implants in revision TKAs.
JOURNAL OF KNEE SURGERY
(2021)
Article
Orthopedics
Mikhail Zusmanovich, Kamali Thompson, Abigail Campbell, Thomas Youm
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
(2020)
Article
Orthopedics
Daniel B. Buchalter, David J. Kirby, Greg M. Teo, Richard Iorio, Vinay K. Aggarwal, William J. Long
Summary: The study demonstrated that VIP can reduce early PJI incidence in all primary TKA patients, regardless of preoperative risk. After VIP implementation, the PJI incidence decreased by 44.6% and 56.4% in high-risk and all-risk TKA cohorts, respectively.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Orthopedics
Jaret M. Karnuta, Bryan C. Luu, Alexander L. Roth, Heather S. Haeberle, Antonia F. Chen, Richard Iorio, Jonathan L. Schaffer, Michael A. Mont, Brendan M. Patterson, Viktor E. Krebs, Prem N. Ramkumar
Summary: A deep learning algorithm is able to accurately identify the manufacturer and model of knee arthroplasty implants, with near-perfect accuracy. This technology has the potential to provide cost-effective care for revision arthroplasty.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Orthopedics
Alex Tang, Stephen Zak, Richard Iorio, James Slover, Joseph Bosco, Ran Schwarzkopf
Summary: In patients undergoing revision total knee arthroplasty (rTKA), a protocol of 81-mg aspirin twice daily is as effective as 325-mg aspirin twice daily in preventing venous thromboembolism (VTE) and has similar rates of postoperative complications.
JOURNAL OF KNEE SURGERY
(2022)
Article
Orthopedics
Richard Iorio, Patrick R. Peavy, David W. Keyes, Susan M. Dempsey, David O. McCready, James D. Kang
Summary: By transferring uncomplicated surgeries to a community-based hospital and keeping complex surgeries at an academic medical center, one hospital increased surgical volume, improved quality metrics, and boosted profits. While this strategy reduced per case revenue, the increased efficiency and lower costs led to overall profit growth for the system.
JOURNAL OF ARTHROPLASTY
(2021)
Review
Orthopedics
Joseph J. Kavolus, Michael A. Moverman, Vasili Karas, Richard Iorio
Summary: The increasing use of smartphones has led to a growing interest and growth in mobile health applications, particularly in the area of patient engagement platforms. These platforms offer various features that can improve healthcare, and this article provides an overview of this technology sector, the potential benefits they offer to patients and surgeons, and how to evaluate different platforms.
JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS
(2021)
Article
Orthopedics
Jaret M. Karnuta, Heather S. Haeberle, Bryan C. Luu, Alexander L. Roth, Robert M. Molloy, Lukas M. Nystrom, Nicolas S. Piuzzi, Jonathan L. Schaffer, Antonia F. Chen, Richard Iorio, Viktor E. Krebs, Prem N. Ramkumar
Summary: A deep-learning system using AP plain radiographs accurately differentiated among 18 hip arthroplasty models from four industry leading manufacturers.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Orthopedics
Christopher D. Skeehan, Dionisio Ortiz, Chelsea Sue Sicat, Richard Iorio, James Slover, Joseph A. Bosco
Summary: The study analyzed the impact of a rule finalized by CMS on Medicare reimbursement for total joint arthroplasty using a mathematical model. Results showed an increase in annual wRVUs, but any growth lower than 3.35% led to a decrease in reimbursement. Factors affecting the impact included the proportion of surgeries, revision vs primary arthroplasty cases, and office-based productivity.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Medicine, General & Internal
Neal L. Millar, Adam Meakins, Filip Struyf, Elaine Willmore, Abigail L. Campbell, Paul D. Kirwan, Moeed Akbar, Laura Moore, Jonathan C. Ronquillo, George A. C. Murrell, Scott A. Rodeo
Summary: Frozen shoulder is a common and debilitating disorder characterized by shoulder pain and loss of mobility. Its pathophysiology involves fibroproliferation and inflammation. Diagnosis and treatment can be challenging, and current interventions have uncertain effectiveness. Further research is needed to develop novel therapies.
NATURE REVIEWS DISEASE PRIMERS
(2022)
Article
Orthopedics
Lauren M. Chu, Peter S. Walker, Richard Iorio, Joseph D. Zuckerman, James D. Slover, Claudette M. Lajam, Ran Schwarzkopf
Summary: The study found that biomechanical data is largely independent of PROM data, and using instrumented insoles can effectively supplement functional evaluation. Comparisons showed that the left-right force ratios and time during sit-to-stand and timed-up-and-go tests were the most useful parameters for assessing postoperative knee replacements.
BULLETIN OF THE HOSPITAL FOR JOINT DISEASES
(2021)
Article
Sport Sciences
Abigail Campbell, Samuel A. Taylor, Evan O'Dea, Mary Shorey, Russell F. Warren, Stephen J. O'Brien
Summary: The study assessed the pathophysiology of extra-articular biceps disease, finding upregulated expression of inflammatory, degenerative, and pain molecules within the extra-articular long head of biceps tendon and its confining tunnel. These conditions are commonly found in patients with biceps-labral complex disease.
TRANSLATIONAL SPORTS MEDICINE
(2021)
Article
Orthopedics
David B. Merkow, Alex Tang, Richard Iorio, James D. Slover, Joseph A. Bosco, Ran Schwarzkopf
Summary: The study demonstrated that 81 mg aspirin twice daily significantly decreased post-operative VTE rates compared to 325 mg aspirin twice daily.
JOURNAL OF ORTHOPAEDICS
(2021)