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Effects of Patient Comorbidities and Demographics on Episode-of-Care Costs Following Total Shoulder Arthroplasty
CONCLUSION: Providers should be aware that certain demographic variables and comorbidities (history of stroke, dementia, chronic pulmonary disease, anemia, heart disease, advanced age, and elevated body mass index) are associated with an increase in total costs following primary shoulder arthroplasty. Further study is required to determine whether bundled payment target costs should be adjusted to better compensate for specific comorbidities.LEVEL OF EVIDENCE: Level IV case series.PMID:36749879 | DOI:10.5435/JAAOS-D-22-00450
Source: The Journal of the American Academy of Orthopaedic Surgeons - February 7, 2023 Category: Orthopaedics Authors: Dominic M Farronato Joshua D Pezzulo Alexander J Rondon Sean Porrini Diane McGonigal Charles L Getz Daniel E Davis Source Type: research

Comparison of Extramedullary and Intramedullary Implants for Stable Intertrochanteric Fractures: Have We Swung the Pendulum Too Far the Other Way?
DISCUSSION: Our study found that extramedullary implants were associated with lower transfusions rates, lower readmissions, and better patient disposition. We recommend surgeons to consider extramedullary implants when treating stable IT fractures, especially if the patient is anemic or at high risk for hospital readmission.LEVEL OF EVIDENCE: Level III. Retrospective cohort study.PMID:35196299 | DOI:10.5435/JAAOS-D-21-00657
Source: The Journal of the American Academy of Orthopaedic Surgeons - February 23, 2022 Category: Orthopaedics Authors: Aria Darius Darbandi Ghulam H Saadat Ahmed Siddiqi Bennet A Butler Source Type: research

Postoperative Complications in Patients With Hereditary Hemochromatosis Undergoing Total Joint Arthroplasty: A Matched Cohort Analysis
This study addresses a paucity in the current literature concerning the complication profile in HH patients with destructive joint arthropathy undergoing joint arthroplasty surgery.PMID:34932508 | DOI:10.5435/JAAOS-D-21-00105
Source: The Journal of the American Academy of Orthopaedic Surgeons - December 21, 2021 Category: Orthopaedics Authors: Amil R Agarwal Kevin Y Wang Amy L Xu Matthew J Best Varun Puvanesarajah Umasuthan Srikumaran Gregory J Golladay Savya C Thakkar Source Type: research

Mortality and Morbidity of Surgical Management of Geriatric Ankle Fractures.
DISCUSSION: After controlling for comorbidities (ie, the ASA class), no increased risk is observed for the 30-day mortality or complication rate between geriatric ankle fracture in the 65 to 79 years old and the 80 to 99 years old age groups. LEVEL OF EVIDENCE: Prognostic level III, retrospective study. PMID: 32769723 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - August 13, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Effects of Diabetes Mellitus on Functional Outcomes and Complications After Torsional Ankle Fracture.
CONCLUSIONS: Diabetes was associated with more complications and secondary operations. However, functional outcomes including pain and dysfunction were not markedly affected by these clinical outcomes, potentially due to diminished sensory function and less baseline physical activity among diabetic patients. LEVEL OF EVIDENCE: Prognostic level III. PMID: 32769721 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - August 13, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Risk Adjustment for Episode-of-Care Costs After Total Joint Arthroplasty: What is the Additional Cost of Individual Comorbidities and Demographics?
DISCUSSION: Providers participating in alternative payment models should be aware of factors (cardiac history, age, and elevated BMI) associated with increased costs. Further study is needed to determine whether risk adjustment in alternative payment models can prevent problems with access to care for these high-risk patients. PMID: 32701687 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - July 25, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Effect of Heart Failure With Preserved Ejection Fraction on Perioperative Outcomes in Patients Undergoing Hip Fracture Surgery.
CONCLUSION: HFpEF confers a significant perioperative risk of MACCE in patients undergoing hip fracture surgery. PMID: 31977615 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - January 26, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Effects of Diabetes Mellitus on Functional Outcomes and Complications After Torsional Ankle Fracture.
CONCLUSIONS: Diabetes was associated with more complications and secondary operations. However, functional outcomes including pain and dysfunction were not markedly affected by these clinical outcomes, potentially due to diminished sensory function and less baseline physical activity among diabetic patients. LEVEL OF EVIDENCE: Prognostic level III. PMID: 31922995 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - January 12, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Effect of Heart Failure With Preserved Ejection Fraction on Perioperative Outcomes in Patients Undergoing Hip Fracture Surgery.
CONCLUSION: HFpEF confers a significant perioperative risk of MACCE in patients undergoing hip fracture surgery. PMID: 31259845 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - July 3, 2019 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Early Lessons on Bundled Payment at an Academic Medical Center.
CONCLUSION: Opportunities for savings under bundled payment may be greater for lower extremity joint arthroplasty than for other conditions. PMID: 28837458 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - August 25, 2017 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Swimmer's Shoulder: Painful Shoulder in the Competitive Swimmer.
Authors: Matzkin E, Suslavich K, Wes D Abstract Swimmer's shoulder is a broad term often used to diagnose shoulder injury in swimmers. However, research has elucidated several specific shoulder injuries that often are incurred by the competitive swimmer. Hyperlaxity, scapular dyskinesis, subacromial impingement, labral damage, os acromiale, suprascapular nerve entrapment, and glenohumeral rotational imbalances all may be included within a differential diagnosis for shoulder pain in the competitive swimmer. An understanding of the mechanics of the swim stroke, in combination with the complex static and dynamic prope...
Source: The Journal of the American Academy of Orthopaedic Surgeons - June 30, 2016 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Tennis Injuries: Epidemiology, Pathophysiology, and Treatment.
Authors: Dines JS, Bedi A, Williams PN, Dodson CC, Ellenbecker TS, Altchek DW, Windler G, Dines DM Abstract Tennis places high loads on the joints of players, with supraphysiologic forces being generated at the shoulder and elbow hundreds of times per match. Acute injuries tend to affect the lower extremity; chronic injuries usually involve the upper extremity. Commonly encountered upper extremity conditions include rotator cuff injury, internal impingement, superior labral tears, and epicondylitis of the elbow. Serving is the most strenuous stroke in tennis, with the highest peak muscle activity in the shoulder an...
Source: The Journal of the American Academy of Orthopaedic Surgeons - February 15, 2015 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research