Patients with Medicaid insurance are at an increased risk of postoperative complications following total knee arthroplasty and total hip arthroplasty (TJA); however, their outcomes following revision TJA for periprosthetic joint infection (PJI) requires further study.

Total shoulder arthroplasty (TSA) is an increasingly common orthopaedic procedure. Expansion of TSA to outpatient surgical settings has the potential to reduce costs, although there is limited research on the cost and efficiency of this shift in surgical site of care. The purpose of this study is to compare costs and efficiency of TSA between an ambulatory surgical center (ASC) and a hospital.

Primary hip and knee total joint arthroplasties (TJAs) are among the most frequently performed orthopaedic surgeries in the United States, with demand projected to increase to two million cases per year by 2040. Despite the growing demand, previous studies have shown a declining value of Medicare surgeon reimbursements. Given recent inflationary trends, an updated analysis of the changing value of primary TJA reimbursement is necessary. This study examines surgeon reimbursement trends for primary TJA among Medicare patients from 2017 to 2022.

Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies with regard to the diagnosis and treatment of carpal tunnel syndrome in adult patients (≥18 years of age). The scope of this guideline addresses the diagnosis and treatment of carpal tunnel syndrome and contains nine recommendations to assist orthopaedic surgeons and all qualified clinicians managing patients presenting with signs and symptoms which may be attributable to carpal tunnel syndrome based on the best current available evidence. It is also intended to serve as an information resource for professional healthcare practitioners, health services researchers, and developers of practice guidelines and recommendations. In addition to providing pragmatic practice recommendations, this guideline also highlights gaps in the literature and informs areas for future research and quality measure development.

Atlantoaxial osteoarthritis (AAOA) is a clinical syndrome that consists of occipitocervical pain and cervical rotation limitation. Its clinical recognition is often deficient leading to misdiagnosis and suboptimal treatment. The incidence of AAOA varies from 5% in the sixth decade to as much as 18% in the ninth decade of life. Age, female sex, and excessive occupational cervical weight-bearing are the main risk factors for AAOA. Pain originates from the degeneration of the lateral C1-C2 joints and may be referred through the greater occipital nerve. Although AAOA is not easy to see on classic cervical spine views, the open mouth odontoid view has great diagnostic value. Magnetic resonance imaging, CT scan, and/or injections may be used for confirmatory testing. Initial treatment is conservative, including physiotherapy, pain medication, and imaging-guided injections. As many as two-thirds of patients improve with conservative treatment. Indication for surgery is incapacitating pain recalcitrant to nonoperative management. Surgeons' thorough knowledge of surgical anatomy and techniques is key for the notable clinical benefits expected with the surgery. New surgical technology helps C1-C2 fusion become safer and more reliable. This review aims to synthetize available data related to AAOA and to improve the understanding of this condition and its management in the orthopaedic community.

Currently, few investigations explore the connection between global mental health and recovery following total hip arthroplasty (THA). The increased utilization of patient-reported outcomes tools provides an opportunity to assess a patient's mental health without undue survey burden. The purpose of this study was to explore how mental health is associated with a patient's immediate in-hospital recovery regardless of a formally diagnosed mental illness.

Whether the kinematics of cadaveric knees recreate those of the patient's knees after total knee arthroplasty (TKA) remains unknown. This study compared in vivo and in vitro fluoroscopic kinematics of knees after TKA during knee bending using the same implant design.

Previous research has determined that objective and subjective internal rotation (IR) may be discordant. The purpose of this study was to identify predictors of patient-reported ability to perform IR-dependent activities of daily living (IRADLs) and favorable patient satisfaction after reverse shoulder arthroplasty (RSA) despite the loss of objective IR.

A large proportion of total knee arthroplasty (TKA) patients are on antidepressant medications at the time of surgery. Postoperative outcomes of this patient demographic have not been characterized. This study compared the risk of 90-day adverse events and 5-year survival to revision surgery between patients on antidepressants and those not on antidepressants at the time of surgery.

There has been an increasing demand for transparency between industry and physicians. Several studies have evaluated the distribution of payment value and types to orthopaedic surgeons, but little is known about the spending patterns from an industry-centric perspective. The purpose of this study was to describe the payment patterns of top medical device companies in orthopaedics while presenting a geospatial analysis of these trends.

Osteoporosis screening and subsequent treatment has been shown to be efficacious in decreasing the rates of fragility fractures and periprosthetic fractures (PPF). However, current screening and treatment rates are low. This study aims to determine (1) the prevalence of total shoulder arthroplasty (TSA) patients who meet criteria for osteoporosis screening, (2) the prevalence of those screened, and (3) the 5-year cumulative incidence of fragility fracture (FF) and periprosthetic fractures (PPF).

Medicaid coverage is associated with longer appointment wait times, decreased access to care, and poorer health outcomes compared with private insurance across medical subspecialties. The purpose of this study was to evaluate new patient appointment wait times for subspecialty Orthopaedic care based on insurance type and to identify factors influencing these wait times.

The purpose of this study was to evaluate the clinical outcomes in patients who underwent bilateral total shoulder arthroplasty (TSA) at a single institution. Secondarily, we evaluated the influence of the time interval between successive TSAs on clinical outcomes of the second TSA.

Cast saw injury is a notable source of medicolegal risk. Previous work with plaster casts demonstrated that cast saw injury was minimized by waiting 12 minutes before removal. In this study, we evaluate the safety parameters of fiberglass casting materials.

Orthopaedic surgery has been recognized as one of the least diverse surgical specialties. Previous studies have demonstrated that women are heavily underrepresented within orthopaedic surgery. The purpose of this study was to determine whether orthopaedic surgery residency programs with a higher presence of women faculty had a higher proportion of women residents.

Although longer surgical times in primary total hip arthroplasty (THA) are associated with higher complication rates, this has yet to be explored in conversion THA. The purpose of this study is to investigate the relationship between surgical time and complications in the setting of conversion THA with implant removal. We aim to establish a length of surgery after which the risk of complications increases.

Diabetes mellitus (DM) is a common comorbidity in total knee arthroplasty (TKA) patients, which has been associated with multiple complications. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are one class of medications recently approved to better manage DM. This study investigates the correlation of SGLT2i use on postoperative complications and revision rates for diabetic patients undergoing TKA.

Intramedullary nail fixation of unstable tibial diaphyseal fractures is commonly used with excellent clinical results. Indications for nailing have rapidly expanded over recent years, allowing for more difficult fractures to be addressed with "extreme nailing." Despite its widespread use, evolution of newer nailing systems and varying techniques for insertion bring new difficulties with tibial fracture reduction, and malalignment occurs with relative frequency. This highlights the need for a methodical approach for efficient and predictable tibial nailing. An algorithmic approach is essential, beginning with identifying challenging patterns in proximal and distal fractures and addressing any intra-articular elements initially. A semiextended approach is helpful to neutralize deforming forces. Optimizing the starting point and confirming lateral termination of the guidewire mitigate fracture malreduction after nail placement. Fracture reduction is facilitated with clamps, fibular or tibial plating, blocking screws or wires, external fixation, universal distractor, or manual manipulation to optimize outcomes and avoid pitfalls in an effective tibial nailing.

At present, there is uncertainty regarding the objective and subjective characteristics of competitive applicants for orthopaedic surgery residency (OSR). With the hope of enlightening future applicants and their orthopaedic surgeon mentors on what factors they ought to emphasize to successfully match into an OSR program, we summarized and analyzed the characteristics of OSR applicants between the 2020 and 2023 residency application cycles using data from the Texas Seeking Transparency in Application to Residency (STAR) database and insights from the 2020 National Resident Matching Program (NRMP) program director (PD) Survey. Factors considered in our analysis include standardized examination scores, class quartile, research output, extracurricular activities, and application characteristics, such as number of programs applied to, number of interviews attended, and match outcome. To elucidate the importance of more nonquantifiable metrics, we analyzed 423 subjective comments from OSR applicants found in the STAR database and compared them with relevant findings from the 2020 NRMP PD Survey. Of the 1,094 OSR applicants identified, 926 matched and 168 did not match, yielding a match rate of 84.64%. Matched applicants had markedly higher board examination scores, were more likely to be in the first and second quartiles of their class, had a higher number of honored clerkships, were more likely to have Alpha Omega Alpha (AOA) membership, and overall had more research, volunteer, and leadership experiences. Our logistics regression analysis showed that being in the first quartile had the greatest effect on odds of matching, sequentially followed by having a United States Medical Licensing Examination step 2 score above 250, having more leadership opportunities, and finally, more total research output. With respect to nonquantifiable metrics, applicants and PDs alike heavily emphasized performing well on subinternships and having desirable personal attributes such as a strong work ethic, willingness to learn, and understanding the importance of teamwork.