Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Online First™

Articles

Increased Risk of Revision, Reoperation, and Implant Constraint in TKA After Multiligament Knee Surgery

Steven I. Pancio MD, Paul L. Sousa MD, Aaron J. Krych MD, Matthew P. Abdel MD, Bruce A. Levy MD, Diane L. Dahm MD, Michael J. Stuart MD
13th January 2017, Clinical Research

The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized.

High Risk of Readmission in Octogenarians Undergoing Primary Hip Arthroplasty

Arthur L. Malkani MD, Brian Dilworth MD, Kevin Ong PhD, Doruk Baykal PhD, Edmund Lau MS, Theresa N. Mackin BA, Gwo-Chin Lee MD
12th January 2017, Symposium: Learning From Large-Scale Orthopaedic Databases

As life expectancy increases, more elderly patients with end-stage hip arthritis are electing to undergo primary THA. Octogenarians undergoing THA have more comorbidities than younger patients, but this is not reflected in risk adjustment models for bundled care programs. The burden of care associated with THA in octogenarians has not been well characterized, and doing so may help these value-based programs make adjustments so that this vulnerable patient population does not risk losing access under accountable care models.

Definitional Differences of ‘Outpatient’ Versus ‘Inpatient’ THA and TKA Can Affect Study Outcomes

Patawut Bovonratwet BS, Matthew L. Webb MD, MHS, Nathaniel T. Ondeck BS, Adam M. Lukasiewicz MD, MSc, Jonathan J. Cui BS, Ryan P. McLynn BS, Jonathan N. Grauer MD
12th January 2017, Symposium: Learning From Large-Scale Orthopaedic Databases

There has been great interest in performing outpatient THA and TKA. Studies have compared such procedures done as outpatients versus inpatients. However, stated “outpatient” status as defined by large national databases such as the National Surgical Quality Improvement Program (NSQIP) may not be a consistent entity, and the actual lengths of stay of those patients categorized as outpatients in NSQIP have not been specifically ascertained and may in fact include some patients who are “observed” for one or more nights. Current regulations in the United States allow these “observed” patients to stay more than one night at the hospital under observation status despite being coded as outpatients. Determining the degree to which this is the case, and what, exactly, “outpatient” means in the NSQIP, may influence the way clinicians read studies from that source and the way hospital systems and policymakers use those data.

Is There Variation in Procedural Utilization for Lumbar Spine Disorders Between a Fee-for-Service and Salaried Healthcare System?

Andrew J. Schoenfeld MD, MSc, Heeren Makanji MD, Wei Jiang MS, Tracey Koehlmoos PhD, Christopher M. Bono MD, Adil H. Haider MD, MPH
10th January 2017, Symposium: Learning From Large-Scale Orthopaedic Databases

Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated.

What Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty?

Daniel D. Bohl MD, MPH, Nathaniel T. Ondeck BS, Bryce A. Basques MD, Brett R. Levine MD, Jonathan N. Grauer MD
4th January 2017, Symposium: Learning From Large-Scale Orthopaedic Databases

Despite extensive research regarding risk factors for adverse events after total joint arthroplasty (TJA), there are few publications describing the timing at which such adverse events occur.

Obesity Epidemic: Is Its Impact on Total Joint Arthroplasty Underestimated? An Analysis of National Trends

Jaiben George MBBS, Alison K. Klika MS, Suparna M. Navale MS, MPH, Jared M. Newman MD, Wael K. Barsoum MD, Carlos A. Higuera MD
4th January 2017, Symposium: 2016 Musculoskeletal Infection Society Proceedings

Obesity is a well-established risk factor for total joint arthroplasty (TJA) and a number of complications including prosthetic joint infection. The annual changes in the prevalence of obesity among primary, revision, and infected TJA has not been studied at a national level. Given the higher costs of complications of TJA, it is important to understand the association of obesity with the annual trends of revision and infected TJA.

Classifications in Brief: Rüedi-Allgöwer Classification of Tibial Plafond Fractures

T. David Luo MD, J. Matthew Eady PharmD, Arun Aneja MD, PhD, Anna N. Miller MD
4th January 2017, In Brief