Article
Orthopedics
Ashley E. Creager, Andrew D. Kleven, Ziynet Nesibe Kesimoglu, Austin H. Middleton, Meaghan N. Holub, Serdar Bozdag, Adam Edelstein
Summary: The study examines the relationship between pre-operative healthcare utilization and outcomes following total joint arthroplasty (TJA). The findings suggest that patients who utilize non-elective healthcare in the 90 days prior to TJA are at an increased risk of readmission, complications, and unplanned post-HU.
JOURNAL OF ARTHROPLASTY
(2022)
Article
Orthopedics
Emanuele Chisari, Austin S. Yu, Michael Yayac, Chad A. Krueger, Jess H. Lonner, P. Maxwell Courtney
Summary: This study found that patients undergoing outpatient TKA had higher implant and overall hospital costs compared to UKA patients, with increased postoperative personnel costs leading to a higher overall facility cost.
JOURNAL OF ARTHROPLASTY
(2021)
Review
Anesthesiology
Jaime L. Baratta, Eric S. Schwenk
Summary: This review examines the impact of spinal versus general anesthesia on outcomes in outpatient total joint arthroplasty. The overall complication rates are low in this patient population, and there is some suggestion that spinal anesthesia may lead to better same-day discharge success. However, direct comparisons in prospective studies are lacking. Existing evidence suggests that both spinal and general anesthesia can lead to successful outcomes in ambulatory total joint arthroplasty.
CURRENT OPINION IN ANESTHESIOLOGY
(2022)
Article
Medicine, General & Internal
SeungYoung Lee, Min Kyoung Kim, EunJin Ahn, YongHun Jung
Summary: This retrospective study compared mortality and short-term complications in patients undergoing total knee arthroplasty (TKA) under general anesthesia or regional anesthesia. The study found that regional anesthesia was associated with lower rates of major complications such as myocardial infarction and acute renal failure, as well as lower admission to the intensive care unit and medical costs.
Article
Medicine, General & Internal
Anne R. Bass, Huong T. Do, Bella Mehta, Stephen Lyman, Serene Z. Mirza, Michael Parks, Mark Figgie, Lisa A. Mandl, Susan M. Goodman
Summary: Black patients undergoing revision total knee replacement (TKR) were found to have a higher risk of both septic and aseptic revision compared to White patients, particularly in hospitals with very high TKR volumes. Racial disparities in TKR revision risk were evident, highlighting the importance of addressing healthcare inequalities.
Article
Medicine, General & Internal
Derek T. Schloemann, Thomas Sajda, Benjamin F. Ricciardi, Caroline P. Thirukumaran
Summary: This study aimed to evaluate the impact of the Medicare inpatient-only (IPO) policy implemented in 2018 on postoperative outcomes for patients undergoing total knee replacement (TKR), as well as to identify patient factors associated with outpatient TKR use. The results showed that older, Black, and female patients, as well as those treated in safety-net hospitals, were less likely to undergo outpatient TKR. The implementation of the IPO policy did not significantly affect postoperative outcomes for TKR patients, except for an increase in TKR cost compared to total hip replacement.
Article
Orthopedics
Anthony C. Gemayel, Thomas Bieganowski, Thomas H. Christensen, Claudette M. Lajam, Ran Schwarzkopf, Joshua C. Rozell
Summary: The study compared perioperative outcomes in patients undergoing total knee arthroplasty who prefer English as their first language versus those who prefer a different language. The results showed that patients whose primary language was not English had lower rates of readmission, overall revision, and manipulation under anesthesia within 90 days postoperatively. Sub analyses showed that among non-English speakers, those who requested interpreter services also had lower rates of revision and overall manipulation under anesthesia within 1 year.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Orthopedics
Fabio A. Rodriguez-Patarroyo, Nadin Cuello, Robert Molloy, Viktor Krebs, Alparslan Turan, Nicolas S. Piuzzi
Summary: Regional analgesia has shown success in postoperative pain management after total knee arthroplasty, reducing pain scores, opioid use and adverse effects. Combining different regional analgesia techniques can lead to better pain management with lower side effects. Adductor canal block provides good analgesia with less impact on muscular strength compared to femoral nerve block, enhancing recovery post-surgery.
EFORT OPEN REVIEWS
(2021)
Article
Orthopedics
Wayne B. Cohen-Levy, Matthew Sloan, Jamie M. Shoag, Antonia F. Chen, Hany S. Bedair
Summary: The study found that variations in IAT scores by geographical region in the United States did not correlate with racial disparities in the utilization of total hip and total knee arthroplasty (THA, TKA). However, significant differences in THA and TKA utilization were observed between different geographic divisions.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Anesthesiology
Anyon Chan, Tony K. T. Ng, Bruce Y. H. Tang
Summary: In a double-blinded randomized clinical trial investigating the effect of lumbar ESPB at L1 on analgesia following THR, the results indicated that there was no significant advantage in terms of postoperative fentanyl use and pain scores compared to no block.
ANESTHESIA AND ANALGESIA
(2022)
Article
Orthopedics
Joseph P. Barbera, Hayley E. Raymond, Nicole Zubizarreta, Jashvant Poeran, Darwin D. Chen, Brett L. Hayden, Calin S. Moucha
Summary: This study analyzed the racial disparities and annual trends in manipulation under anesthesia (MUA) after total knee arthroplasty (TKA). The results showed that Black patients had a higher likelihood of requiring MUA after TKA and had a longer time to MUA compared to White patients. These disparities persisted from 2013 to 2018.
JOURNAL OF ARTHROPLASTY
(2022)
Review
Orthopedics
Nora Bakaa, Lu Hsi Chen, Lisa Carlesso, Julie Richardson, Luciana Macedo
Summary: The study evaluated the reporting completeness of exercise adherence and interventions in clinical trials of post-operative TKA rehabilitation. A total of 112 RCTs were included, with poor reporting on exercise adherence and interventions. Future RCTs should use valid measures and proper tools for reporting.
BMC MUSCULOSKELETAL DISORDERS
(2021)
Article
Orthopedics
Chloe C. Dlott, Xun Pei, Jennifer L. Ittner, Steven L. Lefar, Mary O'Connor
Summary: Socioeconomic status plays a significant role in the utilization and outcomes of total hip arthroplasty and total knee arthroplasty, with patients with a net worth below $10,000 less likely to undergo these surgeries and those with a net worth between $100-250K and $250-500K more likely to do so.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Orthopedics
Janet O. Adeola, Pelle V. Wall, Soraya Mehdipour, Alvaro A. Macias, Rodney A. Gabriel
Summary: This study found that among patients undergoing total knee arthroplasty, Black patients had a lower odds of receiving regional anesthesia compared to White patients, while Hispanic patients also had lower odds compared to non-Hispanic patients. Native Hawaiian/Pacific Islander patients had increased odds of receiving regional anesthesia. Overall, this study highlights racial and ethnic disparities in the provision of regional anesthesia for patients undergoing total knee arthroplasty. Rating: 8/10.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Surgery
Wilson M. Alobuia, Tong Meng, Robin M. Cisco, Dana T. Lin, Insoo Suh, Manjula Kurella Tamura, Amber W. Trickey, Electron Kebebew, Carolyn D. Seib
Summary: The study found that racial/ethnic disparities exist in the management of primary hyperparathyroidism among older adults, with Black and Hispanic patients less likely to be evaluated by a surgeon and undergo parathyroidectomy compared to White patients. Urgent attention is needed to address the factors contributing to these disparities in order to achieve parity in the management of primary hyperparathyroidism.