Arthroplasty Today最新文献_第5页

A Modified Wagner Stem Design Increases the Primary Stability in Cementless Revision Hip Arthroplasty

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-03 DOI: 10.1016/j.artd.2025.101622

Julius M. Boettcher MSc , Kay Sellenschloh Dipl. Ing , Gerd Huber Dr. , Benjamin Ondruschka Professor , Michael M. Morlock Professor

Background

Primary stability is of great importance for the longevity of the implant in cementless revision total hip arthroplasty, since instability is a major cause of rerevision. The purpose of this study was to evaluate the effect of an additional set of less prominent, wider splines added to an established conical stem design with sharp splines on axial stability in a model with significant proximal bone defects.

Methods

Twenty fresh-frozen human femurs were implanted with either the established or the additional spline design, dynamically loaded and tested in a load-to-failure configuration. Cortical contact in the femoral canal after implantation was evaluated by superimposing computed tomography scans and 3-dimensional laser scans. Stem subsidence and micromotion were evaluated to assess primary stability.

Results

Stems remained stable during cyclic loading of up to 200% body weight, except in bones with cortical bone mineral density below 1000 mgHA/mL. A significant reduction of more than 85% in stem subsidence (P = .040), axial micromotion (P = .007), and rotational micromotion (P = .010) was achieved with the new spline design. Load-to-failure testing exceeded 400% body weight.

Conclusions

The new spline design increased the cortical contact which resulted in increased axial primary stability in this in vitro experiment. Bone mineral density as a measure of bone quality proved to be a decisive factor for achieving immediate postoperative stability. Further variations of the established stem designs could further improve the longevity of artificial joint replacements.

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引用次数: 0

A Novel Robotic Technique for Mapping Patellofemoral Kinematics in Total Knee Arthroplasty

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101610

Edward O’Bryan MBBS (Hons), FRACS, FAOA , Christopher Jones MBBS, FRACS, FAOA , Samuel Joseph MBBS, FRACS, FAOrthoA

Computer assistance has significantly improved precision in total knee arthroplasty (TKA). Current robotic systems address tibiofemoral kinematics, ignoring the patellofemoral joint. This described TKA technique allows assessment and adjustment of patellofemoral kinematics. Reproducible landmarks on the tibial tubercle, trochlea, and patella are defined. With the “Special Point” function of the CORI surgical system, arcs of points are recorded dynamically. This records trochlear groove translation, patellar tracking, patellar tilt, and tibial tubercle rotation. During implant trials, special points are recollected to determine how these four parameters have changed compared to the native knee. Component adjustments can be made to optimize patellofemoral kinematics without compromising tibiofemoral balance. This may be a tool to mitigate patellofemoral maltracking and may improve TKA outcomes. Further studies are required to investigate outcomes.

引用次数: 0

Performance of Cementless Hip Arthroplasty Stem Types Based on Consolidated Large Registry Data 基于整合大注册表数据的无骨水泥髋关节置换术干型的性能。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101582

Logan E. Finger MD , Matthew F. Gong MD , Asher Mirvish BS , Alexandra S. Gabrielli MD , Ahmad P. Tafti PhD , Michael J. O’Malley MD , Brian A. Klatt MD , Johannes F. Plate MD, PhD

Background

Improvements in cementless total hip arthroplasty have been directed at optimizing osseointegration of the femoral implant to reduce aseptic loosening rates. Stem design plays a critical role in the performance of these implants. Given the increase in new stem designs and the creation of an updated classification system, improved understanding of the outcomes of each stem type is warranted. The purpose of this study was to determine overall revision rates based on stem design and proprietary model.

Methods

Joint registry data on the reported overall cases and revisions for each cementless stem brand were collected from the annual reports of the American Joint Replacement Registry (2021), United Kingdom National Joint Registry (2021), New Zealand Joint Registry (2020), and Australian Orthopaedic Association National Joint Replacement Registry (2021). Each individual stem brand was classified into a stem type derived from the classification system described by Radaelli et al.

Results

The most utilized stem types were (1) type B2 stems, (2) type A stems, and (3) type C1 stems. The most utilized stem models were the (1) Corail stem (B2), (2) Accolade II (type A), and (3) Taperloc 133 (type A). The highest and lowest overall revision rates observed were in the type B1 stems (8.09%) and type C3 stems (1.12%), respectively. The 3 stem models with the highest overall revision rates were the Synergy HA stem (9.04%), CBC stem (8.59%), and CLS stem (7.96%). The 3 stems with the lowest respective overall revision rates were the C2 stem (0.00%, 0 of 933 cases), Actis Duofix (0.59%), and VerSys stem (0.89%).

Conclusions

Based on consolidated large registry data, some cementless femoral stem types and models appear to perform better than others when compared on the basis of stem design.

背景：无骨水泥全髋关节置换术的改进旨在优化股骨植入物的骨整合以减少无菌性松动率。干设计在这些植入物的性能中起着关键作用。鉴于新系统设计的增加和更新分类系统的创建，有必要改进对每种系统类型结果的理解。本研究的目的是确定基于茎设计和专有模型的总体修改率。方法：从美国关节置换注册中心（2021年）、英国国家联合注册中心（2021年）、新西兰联合注册中心（2020年）和澳大利亚骨科协会国家关节置换注册中心（2021年）的年度报告中收集报告总体病例的联合注册数据和每个无水泥茎品牌的修订数据。根据Radaelli等人描述的分类系统，将每个单独的茎品牌划分为茎类型。结果：利用最多的茎类型是(1)B2型茎，(2)a型茎和(3)C1型茎。使用最多的茎模型是(1)Corail茎（B2）， (2) Accolade II （A型）和(3)Taperloc 133 （A型）。总体修正率最高和最低的是B1型茎（8.09%）和C3型茎（1.12%）。总体修正率最高的3个主干模型分别是Synergy HA主干（9.04%）、CBC主干（8.59%）和CLS主干（7.96%）。总体翻修率最低的3个茎分别是C2茎（0.00%，933例中有0例）、Actis Duofix（0.59%）和VerSys茎（0.89%）。结论：基于合并的大型注册数据，在基于茎设计的比较中，一些无骨水泥的股骨干类型和模型似乎比其他类型和模型表现更好。

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引用次数: 0

The Impact of Cementing Techniques on Implant Longevity in Relation to Keel Length in Persona and NexGen Knee Arthroplasty: A Comprehensive Study

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101608

Arash Sharafat Vaziri MD , Mohammad Naghi Tahmasebi MD , Hoseinali Hadi MD , Sina Javidmehr MD , Sohrab Keyhani MD , Zahra Vahdati MD , Hossein Nematian MD , Yalda Farahmand MD

Background

The aim of this study was to investigate the efficacy of our modified cementing technique in reducing the rate of aseptic tibial loosening focusing on its relationship with keel length.

Methods

Every participant who underwent primary total knee arthroplasty (TKA) between August 2014 and September 2022 with a minimum of 4-year follow-up using 1 of 3 implants were included: Persona + conventional cementing technique; Persona + modified cementing technique; and NexGen LPS-Flex. The modifications applied include better preparation of the bone surfaces and the cancellous bone cavities, pressurizing the cement and interstitial fluid suction at the same time, applying a layer of cement on the surfaces of the tibia and implant, and immobilizing the limb. Kaplan-Meier analyses were performed to estimate survivorship.

Results

A total of 988 of 1039 primary TKAs (95.1%) were included with follow-up of 89.26 ± 7.32 months. Twenty eight (2.83%) TKA required revisions due to aseptic tibial loosening; 3 (1.1%) in the NexGen group, 21 (6.9%) in the conventionally cemented Persona group, and 4 (0.9%) within the modified cemented Persona group. Aseptic loosening occurred at a mean of 69.00 ± 2.65, 34.57 ± 22.90, and 68.50 ± 3.42, respectively. Survivorship for aseptic loosening was 98.9%, 93.1%, and 99.1% at 8 years, respectively. The revision rate for early (during the first 24 months) aseptic loosening was 4.6% in the conventionally cemented Persona group. No early aseptic loosening reported in other 2 groups.

Conclusions

In conclusion, meticulous cementing techniques can reduce the rate of tibial loosening in shorter keel designs.

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引用次数: 0

Simultaneous vs Staged Procedures for Bilateral Total Knee Arthroplasty: Reduced Infection, Cost, and Readmission Rates Associated With Simultaneous Procedures

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101611

Aaron Singh BA, Travis M. Kotzur BS, Kathleen Lundquist MD, Blaire C. Peterson BS, William H. Young MD, Chance C. Moore MD, Frank Buttacavoli MD

Background

Many patients require total knee arthroplasty (TKA) bilaterally; however, there is limited data on bilateral procedures. This study aims to compare medical and surgical complications and hospital-related outcomes between simultaneous and staged bilateral TKA. We hypothesize that staged procedures will have superior outcomes.

Methods

This retrospective cohort study queried the National Readmissions Database, years 2016-2020, for patients undergoing bilateral TKA via ICD-10 codes. For patients undergoing staged procedures, outcomes were compared in aggregate for comparison to simultaneous operations. Multivariate regression was performed to assess complications. Negative binomial regression was utilized for 30-day readmission, reoperation, and discharge disposition. Quasi-Poisson regression was performed to assess total charges. Demographics and comorbidities, measured via Elixhauser Comorbidity Index, were controlled for in our analysis.

Results

A total of 210,682 patients, 89,568 (42.51%) undergoing simultaneous bilateral and 121,115 (57.49%) undergoing staged bilateral TKA, were included. The staged cohort had higher odds of medical complications (odds ratio (OR), 1.14; P < .001), reduced surgical complications (OR, 0.51; P < .001), and increased odds of routine discharges (OR, 1.39; P < .001). They also had increased odds of readmission (OR, 1.25; P < .001), reoperation (OR, 1.56; P < .001), and greater total charges (OR, 1.18; P < .001).

Conclusions

Our results demonstrate that, for some patients, simultaneous procedures may be a viable option. While staged operations were associated with reduced surgical complications and resulted in better discharge dispositions, they were also associated with greater medical complications, readmissions, reoperations, and total cost. Surgeons should consider individual patient risks and preferences when planning bilateral TKA.

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引用次数: 0

A Tribute to Greg J. Golladay, MD, FAOA: Big Shoes to Fill!

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2025.101639

Brett R. Levine MD, MS (Editor-in-Chief)

引用次数: 0

A Contemporary Analysis of Discharge Disposition Following Total Joint Arthroplasty 全关节置换术后出院处置的当代分析。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101592

Swaroopa Vaidya MS , Gregory Panza PhD , Jake Laverdiere BS , Dianne Vye MSN, RN, ONC , Jenna Bernstein MD

Background

Total joint arthroplasty (TJA) represents the single largest procedural cost for the Centers for Medicare & Medicaid Services. Discharge to a skilled nursing facility (SNF) remains a primary driver of post-acute care costs. The COVID-19 pandemic led to a decrease in number of discharges to SNFs. Examining preoperative patient characteristics of those who are still admitted to SNFs, despite cultural shifts, may help providers identify patients still at high risk for SNF discharge.

Methods

This retrospective study included patients who had elective total hip arthroplasty or total knee arthroplasty from January through December 2022 at a high-volume orthopaedic institute. Preoperative patient-reported outcome scores, demographics, and clinical characteristics were collected from patient charts and compared between patients who were discharged home vs SNF. Multivariate logistic regression analyses were used to determine potential predictors for discharge to SNF.

Results

In the total sample (N = 2795), 96.4% of patients were discharged home, and 3.6% were discharged to a SNF. Medicare insurance was associated with being discharged to a SNF (P < .05), while having commercial insurance was associated with being discharged home (P < .05). Being older, having longer procedure length, longer hospital length of stay, and a lower preoperative Patient-Reported Outcomes Measurement Information System (PROMIS 10) score were significant predictors of discharge to SNF (P < .05).

Conclusions

This was the first study to identify PROMIS 10 score as a potential predictor of discharge to a SNF after TJA. Findings from this study may help providers redefine contemporary predictors of SNF admission following TJA.

背景：全关节关节置换术（TJA）是美国医疗保险与医疗补助服务中心（Centers for Medicare & Medicaid Services）最大的一项手术费用。出院到专业护理机构（SNF）仍然是急性期后护理费用的主要驱动因素。COVID-19 大流行导致出院到专业护理机构的人数减少。尽管文化发生了转变，但研究那些仍被送往专业护理机构的患者的术前特征，可能有助于医疗服务提供者识别仍处于专业护理机构出院高风险的患者：这项回顾性研究纳入了 2022 年 1 月至 12 月期间在一家大医院骨科接受择期全髋关节置换术或全膝关节置换术的患者。研究人员从患者病历中收集了术前患者报告的结果评分、人口统计学特征和临床特征，并对出院回家与SNF患者进行了比较。多变量逻辑回归分析用于确定出院到SNF的潜在预测因素：在全部样本（N = 2795）中，96.4%的患者出院回家，3.6%的患者出院到SNF。医疗保险与出院后入住SNF有关（P < .05），而商业保险与出院后回家有关（P < .05）。年龄越大、手术时间越长、住院时间越长以及术前患者报告结果测量信息系统（PROMIS 10）评分越低，都是出院后转入SNF的重要预测因素（P < .05）：这是第一项将 PROMIS 10 评分确定为 TJA 术后出院转入 SNF 的潜在预测因素的研究。这项研究的结果可能有助于医疗服务提供者重新定义 TJA 术后入住 SNF 的当代预测因素。

{"title":"A Contemporary Analysis of Discharge Disposition Following Total Joint Arthroplasty","authors":"Swaroopa Vaidya MS , Gregory Panza PhD , Jake Laverdiere BS , Dianne Vye MSN, RN, ONC , Jenna Bernstein MD","doi":"10.1016/j.artd.2024.101592","DOIUrl":"10.1016/j.artd.2024.101592","url":null,"abstract":"<div><h3>Background</h3><div>Total joint arthroplasty (TJA) represents the single largest procedural cost for the Centers for Medicare & Medicaid Services. Discharge to a skilled nursing facility (SNF) remains a primary driver of post-acute care costs. The COVID-19 pandemic led to a decrease in number of discharges to SNFs. Examining preoperative patient characteristics of those who are still admitted to SNFs, despite cultural shifts, may help providers identify patients still at high risk for SNF discharge.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who had elective total hip arthroplasty or total knee arthroplasty from January through December 2022 at a high-volume orthopaedic institute. Preoperative patient-reported outcome scores, demographics, and clinical characteristics were collected from patient charts and compared between patients who were discharged home vs SNF. Multivariate logistic regression analyses were used to determine potential predictors for discharge to SNF.</div></div><div><h3>Results</h3><div>In the total sample (<em>N</em> = 2795), 96.4% of patients were discharged home, and 3.6% were discharged to a SNF. Medicare insurance was associated with being discharged to a SNF (<em>P</em> < .05), while having commercial insurance was associated with being discharged home (<em>P</em> < .05). Being older, having longer procedure length, longer hospital length of stay, and a lower preoperative Patient-Reported Outcomes Measurement Information System (PROMIS 10) score were significant predictors of discharge to SNF (<em>P</em> < .05).</div></div><div><h3>Conclusions</h3><div>This was the first study to identify PROMIS 10 score as a potential predictor of discharge to a SNF after TJA. Findings from this study may help providers redefine contemporary predictors of SNF admission following TJA.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101592"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intraprosthetic Dislocation Following Dual Mobility Total Hip Arthroplasty: A Retrieval Analysis Study 双活动全髋关节置换术后假体内脱位：一项检索分析研究。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101596

Salar Sobhi BSc, MD , Alan Kop MSc, PhD , Moreica Pabbruwe PhD , Christopher W. Jones BCom, BEng(Hons), MBBS(Hons), PhD, FRACS, FAOrthA , Michael A. Finsterwald MD, FMH, FRACS, FAOrthA

Background

Dual mobility (DM) implants in total hip arthroplasty provide excellent range of motion with low dislocation rates. A complication of this design is intraprosthetic dislocation (IPD), where the polyethylene (PE) liner dissociates from the femoral head. In older designs, IPD occurred due to a small head size and late PE wear with head-capture-mechanism failure. Routine retrieval analysis identified concerns regarding IPD of modern implants, and scant reporting in the literature led to this retrospective study.

Methods

A total of 124 (110 primary, 14 revision) DM implants (mean in situ time 2.0 ± 3.1 years) revised by 20 surgeons across Western Australia between July 2014 and August 2023 were assessed. Demographics, clinical information, mechanisms of failure, and observations at revision arthroplasty were analyzed. The retrieval analysis included an assessment of metal and PE wear mechanisms, corrosion between modular components, and extent of bony attachment to acetabular shells.

Results

There were 11 cases of IPD. Of these, 8 (73%) had a documented preceding failed closed reduction, with the remaining 3 revised due to trunnionosis, loosening, and joint instability. Nine out of 11 (82%) cases were female. Although metallic wear and inner-lip impingement of PE bearings were observed, there was no obvious failure mechanism for the other 3 retrieved IPD implants.

Conclusions

Most cases of IPD in DM implants occur after failed closed reduction in the setting of a hip dislocation, suggesting an iatrogenic cause of IPD. No implant-related features could be defined for the remaining cases. Recognizing common failure modes can help with the prevention and treatment of this complication.

背景：双活动（DM）假体在全髋关节置换术中提供良好的活动范围和低脱位率。这种设计的一个并发症是假体内脱位（IPD），聚乙烯（PE）衬垫与股骨头分离。在较早的设计中，IPD的发生是由于头部尺寸小和后期PE磨损以及头部捕获机制失效。常规检索分析确定了对现代植入物IPD的关注，文献报道不足导致了这项回顾性研究。方法：对2014年7月至2023年8月期间由西澳大利亚州20名外科医生翻修的124例（110例原发性，14例翻修）DM种植体（平均原位时间2.0±3.1年）进行评估。分析了人口统计学、临床信息、失败机制和关节置换术的观察结果。检索分析包括评估金属和PE磨损机制，模块组件之间的腐蚀以及骨附着到髋臼壳的程度。结果：11例IPD。其中，8例（73%）患者先前有记录的闭合复位失败，其余3例因耳膜萎缩、松动和关节不稳定而进行了复位。11例中有9例（82%）为女性。虽然观察到PE轴承的金属磨损和内唇撞击，但其他3个回收的IPD种植体没有明显的失效机制。结论：大多数DM植入物的IPD发生在髋关节脱位闭合复位失败后，提示IPD的医源性原因。其余病例无植入物相关特征。认识常见的失效模式有助于预防和治疗这种并发症。

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引用次数: 0

Optimizing Operating Room Efficiency for Primary Hip and Knee Arthroplasty Using Performance Benchmarks 使用性能基准优化初级髋关节和膝关节置换术的手术室效率。

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101590

Koorosh Kashanian BMSc , Matey Juric BSc , Tim Ramsay PhD , Pascal Fallavollita PhD , Paul E. Beaulé MD, FAAOS, FRCSC

Background

With increasing demand for total hip arthroplasty (THA) and total knee arthroplasty (TKA), maximizing operating room (OR) efficiency is critical. This paper sought to examine the implementation of time benchmarks when performing primary TKA and THA. We hypothesized that implementing benchmarks would improve efficiency and the number of joints performed per day.

Methods

Two hundred ninety-five patients from 59 OR days were reviewed. All surgeries were performed as outpatients and included 160 females and 135 males; 161 TKA and 134 THA; mean age, 66.1; mean body mass index, 28.6 kg/m²; American Society of Anesthesia, 2. Time points, demographics, and adverse events were recorded. Benchmarks to complete 4 joints in 8 h were: anesthesia preparation time (APT) of <11 min, procedure time of <72 min, anesthesia finish time (AFT) of <21 min, and turnover of <22 min.

Results

The percentage of cases meeting individual benchmarks for APT was 50.17%; procedure time was 95.25%; AFT was 99.67%; turnover was 65.25%. The means were: APT 11:00 min, Surgical Prep Time 9:00 min, procedure time 55:00 min, AFT 3:00 min, and turnover 19:00 min. Overall, 98.3% (58/59) of ORs had 4 cases completed within 8 h and 52.5% (31/59) had 5 cases within 8 h. Age, body mass index, and consecutive laterality of surgery were determined to affect the likelihood of meeting benchmarks for case time, APT, and turnover.

Conclusions

Establishing time benchmarks permitted the introduction of 5 joint days within an 8-h OR without increasing resource utilization. Factors that influence OR efficiency for high-volume primary hip and knee replacements were identified.

背景：随着全髋关节置换术（THA）和全膝关节置换术（TKA）需求的增加，手术室（OR）效率的最大化是至关重要的。本文试图检查执行主要TKA和THA时的时间基准的实施。我们假设实现基准将提高效率和每天执行的关节数量。方法：回顾性分析住院59天295例患者的临床资料。所有手术均为门诊患者，包括160名女性和135名男性；TKA 161个，THA 134个；平均年龄66.1岁；平均体重指数28.6 kg/m2；美国麻醉学会，2。记录时间点、人口统计数据和不良事件。8 h内完成4个关节的基准为：麻醉准备时间（APT）的结果：达到个体APT基准的病例占50.17%；手术时间为95.25%；AFT为99.67%；流动率65.25%。平均时间为：手术时间11:00 min，手术准备时间9:00 min，手术时间55:00 min，手术时间3:00 min，手术时间19:00 min。总体而言，98.3%（58/59）的手术室在8小时内完成4例，52.5%（31/59）的手术室在8小时内完成5例。确定年龄，体重指数和连续手术侧侧影响达到病例时间，APT和手术时间基准的可能性。结论：建立时间基准可以在不增加资源利用率的情况下，在8小时的手术室内引入5个联合天。确定了影响大容量原发性髋关节和膝关节置换术OR效率的因素。

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引用次数: 0

Patient “No-Show” Prior to Elective Primary Total Hip Arthroplasty Increases Risk of Postoperative Anemia

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2025-02-01 DOI: 10.1016/j.artd.2024.101602

Jeffrey S. Mun BA , Matthew W. Parry MD, MS , Alex Tang MD , Jesse J. Manikowski MS , Cory Crinella PA-C , John J. Mercuri MD, MA

Background

Patients who “no-show” (NS) clinical appointments are at a higher risk of poor healthcare outcomes. The objective of this study was to evaluate and characterize the relationship between patient NS prior to primary total hip arthroplasty (THA) and 90-day complication risk after THA.

Methods

We retrospectively reviewed 4147 patients undergoing primary THA. Patients were divided based on whether they NS at least 1 appointment vs always attend (AA) appointments. Information collected included number of NS and attended appointments, demographics, comorbidities, and 90-day postoperative complications. Regression analyses were run to identify relationships between NS status and postoperative outcomes, as well as factors that would predict NS status.

Results

Compared to AA patients, NS patients had an increased odds of a postoperative complication (odds ratio:1.3, P = .0005), specifically postoperative anemia (odds ratio: 1.3, P = .0004). When comparing NS and AA patients who both experienced postoperative anemia-related complications, the NS patients had significantly greater intraoperative blood loss compared to AA patients (mean ± standard deviation: 412.6 mL ± 310.2 vs 357.3 mL ± 269.0, P = .028). NS patients also had a greater rate of symptomatic anemia compared to AA patients (100 [3%] vs 25 cases [2%], P = .018). Age, smoking status, gender, race, body mass index, Charlson Comorbidity Index, and insurance status were independent predictors of missing clinical appointments.

Conclusions

There was an increased risk for complications, specifically anemia-related complications, in THA patients who NS preoperatively. Demographic factors were independently associated with higher odds of missing a scheduled clinical appointment. The results suggest orthopedic surgeons should consider NS data to pre-emptively assess risk for complications following THA.

Level of Evidence

Level III.

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引用次数: 0