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Geriatric Orthopaedic Surgery & Rehabilitation

Wei Liu, Huangdong Hui, Yunhai Zhang, Weilong Lin, Yongqian Fan
Introduction: The objective was to evaluate the safety and efficacy of intra-articular injection of tranexamic acid (TXA) in patients between 80 and 100 years of age with femoral neck fracture undergoing hip hemi-arthroplasty (HA). Material and Methods: We conducted a retrospective review to assess perioperative blood loss and transfusion rate after intra-articular injection of TXA during HA. This was a single-center, retrospective, single-surgeon, and standard care cohort study covering the period between January and December 2016...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Ján Dixon, Fiona Ashton, Paul Baker, Karl Charlton, Charlotte Bates, William Eardley
Introduction: As the number of patients sustaining hip fractures increases, interventions aimed at improving patient comfort and reducing complication burden acquire increased importance. Frailty, cognitive impairment, and difficulty in assessing pain control characterize this population. In order to inform future care, a review of pain assessment and the use of preoperative intravenous paracetamol (IVP) is presented. Materials and Methods: Systematic review of preoperative IVP administration in patients presenting with a hip fracture...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Paul D Crook, William C Foster, Stephen L Kates, Jonathan R Korpon, Gustavo A Ortega, Douglas N Boardman
Introduction: As life expectancy increases, the incidence of shoulder arthroplasty continues to increase as well. There are few shoulder arthroplasty studies investigating perioperative complication, readmission, and mortality. Furthermore, with bundled payments on the horizon, the cost of shoulder arthroplasty has become a significant issue. Clarifying risk factors for the need for postdischarge acute care will be critical information due to the high cost of such care. The goal of this study was to compare discharge disposition, length of stay (LOS), perioperative complications, readmission, and mortality in elderly and nonelderly cohorts to determine whether age is a risk factor for shoulder arthroplasty...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Michele Fang, Eric Hume, Said Ibrahim
Background: Total knee arthroplasty (TKA) provides good clinical outcomes for the treatment of end-stage osteoarthritis; however, discharge destination after TKA has major implications on postoperative adverse outcomes and readmissions. With the initiation of Bundled Payments for Care Improvement (BPCI), it is unclear how racial disparities in discharge destination after TKA will be affected by the new bundled payment for TKA. Methods: Bundled Payments for Care Improvement was implemented in July 01, 2014, at the University of Pennsylvania...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Guan-Ming Kuang, Tak Man Wong, Jun Wu, Jun Ouyang, Haihua Guo, Yapeng Zhou, Christian Fang, Frankie K L Leung, William Lu
Introduction: The purpose of this study was to test whether local filling of a novel strontium-containing hydroxyapatite (Sr-HA) bone cement can augment the fixation of a locking plate system in a cadaveric proximal humeral facture model. Materials and Methods: Twelve pairs of formalin-treated cadaveric humeri were used. One side in each pair was for cemented group, while the other side was for the control group. The bone mineral density (BMD) of the samples was tested...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Sanjit R Konda, Ariana Lott, Kenneth A Egol
Introduction: In response to increasing health-care costs, Centers for Medicare & Medicaid Services has initiated several programs to transition from a fee-for-service model to a value-based care model. One such voluntary program is Bundled Payments for Care Improvement Advanced (BPCI Advanced) which includes all hip and femur fractures that undergo operative fixation. The purpose of this study was to analyze the current cost and resource utilization of operatively fixed (nonarthroplasty) hip and femur fracture procedure bundle patients at a single level 1 trauma center within the framework of a risk stratification tool (Score for Trauma Triage in the Geriatric and Middle-Aged [STTGMA]) to identify areas of high utilization before our hospitals transition to bundle period...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Naoki Yamaguchi, Tsuneari Takahashi, Takashi Ueno, Shuhei Hiyama, Masaya Ogawa, Tomohiro Matsumura, Hideyuki Sasanuma, Katsushi Takeshita
Introduction: Knee osteoarthritis (KOA) is commonly a main cause of locomotive syndrome. Consequently, appropriate timing of intervention is clinically important. Materials and Method: Fifty female patients of a primary care clinic in a rural district fulfilled the criteria for KOA and were recruited and underwent knee medical checkups. They initially underwent physical examination bilaterally of knees by an orthopedic surgeon, radiological evaluation, and they answered the outcome of Japanese Knee Osteoarthritis Measurement (JKOM)...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Masakazu Ishikawa, Kenji Kobayashi, Nobuo Adachi
Femoral avulsion fracture of the posterior cruciate ligament (PCL) is less common compared to the tibial side. Especially, femoral avulsion in an elderly patient is an extremely rare condition. Until now, there is no report that describes its treatment and clinical outcome in elderly patients. We demonstrate an 82-year-old female who presented with osteochondral avulsion fracture of the femoral attachment of the PCL. The osteochondral fragment was fixed with an arthroscopic transfemoral suture technique. After treatment, the pain was improved and the patient achieved previous daily activity within 6 weeks...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Andrew Bennett, Hsin Li, Aakash Patel, Kevin Kang, Piyush Gupta, Jack Choueka, Dennis E Feierman
Introduction: Hip fractures are common in elderly patients. However, this population frequently presents with significant medical comorbidities requiring extensive medical optimization. Methods: This study sought to elucidate optimal time to surgery and evaluate its effect on postoperative morbidity, mortality, and length of stay (LOS). We performed a retrospective analysis of data collected from 2008 to 2010 on 841 patients who underwent hip fracture surgery. Patients were classified based on time to surgery and were also classified and analyzed according to the American Society of Anesthesiologists (ASA) physical classification system...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Dani Rotman, Ornit Giladi, Adi Berliner Senderey, Alison Dallich, Oleg Dolkart, Assaf Kadar, Eran Maman, Ofir Chechik
Introduction: Proximal humerus fractures (PHFs) are a common fragility fracture and have been shown to increase mortality in elderly patients. In the last decade, reverse total shoulder arthroplasty (RTSA) was introduced as a reliable operative treatment option for this indication. In other fragility fractures, most notably hip fractures, urgent surgical treatment can reduce mortality. The purpose of this study is to evaluate whether treatment with RTSA can reduce 1-year mortality in elderly patients with complex displaced PHFs...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
(no author information available yet)
[This corrects the article DOI: 10.1177/2151459318770561.].
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Carmen E Quatman, Michael Mondor, Jodi Halweg, Julie A Switzer
Objective: To determine whether fall calls, lift assists, and need for transport to the hospital over the past 10 years in one emergency medical services (EMS) system have altered coincident with demographic changes and to estimate health-care cost for lift assists. Methods: We conducted a retrospective chart review of EMS fall-related care. The HealthEMS database for a suburban community surveyed was queried from March 1, 2007, to March 1, 2017. Fall-related calls in patients 60 years or older were identified and determined to be either lift assists (calls that do not result in transport) or fall calls that resulted in transport to the hospital...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Andrew Davies, Thomas Tilston, Katherine Walsh, Michael Kelly
Background: Patients with a neck of femur fracture have a high mortality rate. National outcomes have improved significantly as the management of this patient group is prioritized. In 2016, however, 4398 (6.7%) patients died within 30 days of admission. Objective: To investigate whether palliative care could be integrated early in the care plan for high-risk patients. Methods: All cases of inpatient mortality following neck of femur fracture at North Bristol Major Trauma Centre over a 24-month period were reviewed...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Wahid Rezaie, Gert Roukema, Bart Van de Meulebroucke
Introduction: For a number of emergency conditions, admission over the weekend has been associated with rising morbidity and mortality rates. However, different studies have provided conflicting results regarding the increased rates of mortality and morbidity for patients with intracapsular femoral fracture who were admitted over the weekend, compared to weekdays. This study investigated the effect of weekend admissions on the surgical outcomes of patients with intracapsular femoral neck fractures...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Elspeth Kinnucan, Matthew T Molcjan, David M Wright, Julie A Switzer
Introduction: The relationship between shoulder function and overall function in the elderly patients is not well understood. It is hypothesized that there is an increased tolerance of shoulder dysfunction in this population. The purpose of our study was to investigate and better understand the relationship between shoulder function, general musculoskeletal health, and frailty in the elderly patients. Materials and Methods: The dominant shoulders of 75 individuals aged ≥65 years without known dominant shoulder pathology were assessed...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Mary Kate Thayer, Conor P Kleweno, Vivian H Lyons, Lisa A Taitsman
Background: Elderly patients with low-energy hip fractures have high rates of morbidity and mortality, but it is not well known how often concurrent upper extremity fractures occur and how this impacts outcomes. We used the National Trauma Databank (NTDB), the largest aggregation of US trauma registry data available, to determine whether patients with concurrent upper extremity and hip fractures have worse outcomes than patients with hip fractures alone. Methods: We accessed the NTDB to identify patients aged 65 to 100 who sustained a hip fracture...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Anaar Siletz, Christopher P Childers, Claire Faltermeier, Emily S Singer, Q Lina Hu, Clifford Y Ko, Stephen L Kates, Melinda Maggard-Gibbons, Elizabeth Wick
Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or "bins." For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Eric Wei Liang Cher, Kae Sian Tay, Karen Zhang, Seang Beng Tan, Tet Sen Howe, Joyce Suang Bee Koh
Introduction: According to the World Health Organization data repository, the average life expectancy at birth for Singapore in 2015 has risen to 83.4 years, and many octogenarians (OG) remain active socioeconomically. The aim of this study is to compare the improvement and the impact of comorbidities on functional recovery after total knee arthroplasty (TKA) between OG and their younger counterparts. Methods: This is a retrospective study of prospectively collected data from a single institution arthroplasty register...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Matthew Bank, Katie Gibbs, Cristina Sison, Nawshin Kutub, Angelos Paptheodorou, Samuel Lee, Adam Stein, Ona Bloom
Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Mark Bugeja, Simon Aquilina, Charles Farrugia, Ivan Esposito
Introduction: Despite hip fractures being a great public health burden, only few studies have analyzed the relationship between hip fracture incidence and socioeconomic status. Many studies found an association; however, results are in part conflicting. Objective: To analyze the impact of regional-level socioeconomic status on the incidence of hip fractures in the Maltese Islands. Method: All individuals older than 50 years who presented to the acute care hospitals in Malta and Gozo with low-energy hip fractures between December 1, 2015, and November 30, 2016, were selected...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
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