Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Online First™

Articles

Clinical Faceoff

Physician Burnout—Fact, Fantasy, or the Fourth Component of the Triple Aim?

Thomas K. Wuest MD, MMM, Michael J. Goldberg MD, John D. Kelly MD
8th December 2016, Clinical Faceoff

Perioperative Risk Adjustment for Total Shoulder Arthroplasty: Are Simple Clinically Driven Models Sufficient?

David N. Bernstein MA, Aakash Keswani BA, David Ring MD, PhD
30th November 2016, Symposium: Learning From Large-Scale Orthopaedic Databases

There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure. Comparing clinically driven with statistically derived risk models of total shoulder arthroplasty (TSA) offers insight into potential gaps between common practice and evidence-based medicine.

Editorial Comment: Symposium: Advances in Polyethylene Biomaterials

Steven M. Kurtz PhD, Pierangiola Bracco PhD
29th November 2016, Symposium: Advances in Polyethylene Biomaterials

What Are the Biomechanical Properties of the Taylor Spatial Frame™?

Daniel J. Henderson FRCS (Orth), Jeremy L. Rushbrook FRCS (Orth), Paul J. Harwood FRCS (Orth), Todd D. Stewart PhD
28th November 2016, Basic Research

The Taylor Spatial Frame™ (TSF) is a versatile variant of the traditional Ilizarov circular fixator. Although in widespread use, little comparative data exist to quantify the biomechanical effect of substituting the tried-and-tested Ilizarov construct for the TSF hexapod system.

Results of Database Studies in Spine Surgery Can Be Influenced by Missing Data

Bryce A. Basques MD, Ryan P. McLynn BS, Michael P. Fice BS, Andre M. Samuel MD, Adam M. Lukasiewicz MD, MSc, Daniel D. Bohl MD, MPH, Junyoung Ahn MD, Kern Singh MD, Jonathan N. Grauer MD
28th November 2016, Symposium: Learning From Large-Scale Orthopaedic Databases

National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies.

What is the Incidence of Suicide in Patients with Bone and Soft Tissue Cancer?

Brianna L. Siracuse BS, George Gorgy BA, Jeremy Ruskin MD, Kathleen S. Beebe MD
28th November 2016, Clinical Research

Patients with cancer in the United States are estimated to have a suicide incidence that is approximately twice that of the general population. Patients with bone and soft tissue cancer often have physical impairments and activity limitations develop that reduce their quality of life, which may put them at high risk for depression, anxiety, and suicidal ideation. To our knowledge, there have been no large studies determining incidence of suicide among patients with bone and soft tissue cancer; this information might allow screening of certain high-risk groups.

Are Readmissions After THA Preventable?

Douglas S. Weinberg MD, Matthew J. Kraay MD, Steven J. Fitzgerald MD, Vasu Sidagam MD, Glenn D. Wera MD
11th November 2016, Clinical Research

Readmissions after total joint arthroplasty have become a key quality measure in elective surgery in the United States. The Affordable Care Act includes the Hospital Readmission Reduction Program, which calls for reduced payments to hospitals with excessive readmissions. This policy uses a method to determine excess readmission ratios and calculate readmission payment adjustments to hospitals, however, it is unclear whether readmission rates are an effective quality metric. The reasons or conditions associated with readmission after elective THA have been well established but the extent to which readmissions can be prevented after THA remains unclear.

Lateral-compartment Osteophytes are not Associated With Lateral-compartment Cartilage Degeneration in Arthritic Varus Knees

Wenzel Waldstein MD, Maximilian F. Kasparek MD, Martin Faschingbauer MD, Reinhard Windhager MD, PhD, Friedrich Boettner MD
9th November 2016, Clinical Research

Progression of arthritis in the lateral compartment is one of the main failure modes of unicompartmental knee arthroplasty (UKA). The decision regarding whether to perform a medial UKA sometimes is made based on whether lateral-compartment osteophytes are visible on plain radiographs obtained before surgery, but it is not clear whether the presence of lateral-compartment osteophytes signifies that the cartilage in the lateral compartment is arthritic.

Classifications In Brief: American Spinal Injury Association (ASIA) Impairment Scale

Timothy T. Roberts MD, Garrett R. Leonard MD, Daniel J. Cepela MD
4th November 2016, In Brief