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  • SLACK, Inc.  (3)
  • Delanois, Ronald E.  (3)
  • 1
    In: Orthopedics, SLACK, Inc., Vol. 46, No. 1 ( 2023-01), p. 19-26
    Abstract: Intra-articular injections prior to total hip arthroplasty (THA) have been associated with postoperative infections. The purpose of this study was to determine whether a temporal relationship exists between hip injections prior to THA and infection. Specifically, we asked (1) Do patients who receive hip injections within 3 months of THA have a higher incidence of prosthetic joint infections (PJIs) or surgical site infections (SSIs)? and (2) Do these patients incur higher 90-day costs? Patients with hip injections prior to THA were identified using a national database from 2010 to 2019. Three laterality-specific groups (injection 0 to 3 months, 3 to 6 months, and 6 to 12 months prior to THA)were compared with a matched cohort without prior injection (n=277,841). Primary outcomes included PJIs, SSIs, and costs. Patients who had injections within 3 months of THA had a higher incidence of PJIs at 90 days (5.1% vs 1.6%, P 〈 .01) and 1 year (6.8% vs 2.1%, P 〈 .01), when compared with the matched cohort. They also had a higher incidence of SSIs at 90 days (2.8% vs 1.2%, P 〈 .01) and 1 year (3.7% vs 1.7%, P 〈 .01). Mean costs were 13.7% higher in this injection cohort. Patients who had injections between 3 and 6 months prior to THA had higher incidence and odds of postoperative PJIs at 90 days (2.6% vs 1.6%, P 〈 .04), whereas those with injections beyond 6 months had no differences in PJIs ( P ≥.46). Patients who receive hip injections within 3 months of undergoing primary THA are at increased risk for postoperative PJIs, SSIs, and higher costs. This study reaffirms guidelines for when to perform THAs in these populations. [ Orthopedics . 2023;46(1):19–26.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2023
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  • 2
    In: Orthopedics, SLACK, Inc., Vol. 40, No. 6 ( 2017-11), p. 377-380
    Abstract: Patient satisfaction assessments, such as the Press Ganey surveys, have been adopted by the Centers for Medicare & Medicaid Services to help determine reimbursements. It is uncertain what facets most affect survey scores among patients who have received total joint arthroplasty (TJA). This study explored which factors guide scores for TJA patients. Specifically, the authors assessed (1) which Press Ganey survey features affected the patients' overall hospital rating and (2) whether survey scores were disparate between patients who did and patient who did not have complications. The authors' institutional Press Ganey database was queried for lower-extremity TJAs that occurred between November 2009 and January 2015. This yielded 1454 patients with a mean age of 63 years (range, 15–92 years; 60% women and 40% men). The database contains information related to American Society of Anesthesiologists scores, Press Ganey question responses, and demographics. Multiple regression analysis was performed to assess the association (beta weight) between Press Ganey domains and overall hospital rating. The weighted mean for each domain was calculated. The authors' analysis revealed that overall hospital rating was significantly influenced by communication with nurses (beta weight=0.434, P 〈 .001), responsiveness of hospital staff (beta weight=0.181, P =.001), communication with doctors (beta weight=0.115, P =.014), and hospital environment (beta weight=0.100, P =.039). No significant differences were found when comparing the Press Ganey scores of patients with and without complications. By recognizing these elements, physicians can direct measures appropriately, which may help avoid financial penalties and possibly increase patient satisfaction after TJA. [ Orthopedics. 2017; 40(6):377–380.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2017
    Location Call Number Limitation Availability
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  • 3
    In: Orthopedics, SLACK, Inc., Vol. 36, No. 4 ( 2013-04)
    Abstract: Cementless acetabular cups for primary total hip arthroplasty have had excellent results, with failure rates typically less than 5% at up to 10-year follow-up. Tritanium is a 3-dimensional metal interface that has been used for porous biological fixation. The purpose of this study was to review the clinical and radiographic results of the use of Tritanium cups (Stryker Orthopaedics, Mahwah, New Jersey) for primary total hip arthroplasty. Two hundred eighty-eight total hip arthroplasties performed using a porous titanium acetabular cup in 252 patients between 2008 and 2010 were reviewed. One hundred thirty-three men and 119 women with a mean age of 58 years (range, 18–88 years) were included. Mean follow-up was 36 months (range, 24–56 months). Outcomes evaluated were implant survivorship, Harris Hip Score, complications, and radiographic outcomes. At final follow-up, no cup failures had occurred. Mean Harris Hip Score improved from 53 points (range, 33–82 points) preoperatively to 91 points (range, 64–100 points) postoperatively. One complication occurred; a 64-year-old woman with recurrent postoperative effusions underwent hip exploration and required abductor mechanism repair. On radiologic evaluation, no signs existed of progressive radiolucencies or changes in cup position. The survivorship of the Tritanium cup and the low complication rate is comparable with previous studies using other porous-metal prostheses. Longer follow-up study is needed and assessment of the results of using this implant in the revision setting is important.
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2013
    Location Call Number Limitation Availability
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