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Book: Complications in orthopaedics - adult reconstruction

Courtney, P. Maxwell / Fillingham, Yale A.

(Complications in orthopaedics)

2022

Title variant	Adult reconstruction
Author's details	P. Maxwell Courtney, MD, Yale A. Fillingham, MD
Series title	Complications in orthopaedics
Keywords	Hip/Surgery/Complications ; Knee/Surgery/Complications
Subject code	617.581059
Language	English
Size	xix, 311 Seiten, Illustrationen, 28 cm
Publisher	Elsevier
Publishing place	Philadelphia, PA
Publishing country	United States
Document type	Book
Note	Zugang zu Online-Ausgabe über Code
HBZ-ID	HT021477041
ISBN	978-0-323-82437-8 ; 9780323824385 ; 0-323-82437-4 ; 0323824382
Database	Catalogue ZB MED Medicine, Health

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Shelf mark	Loan status	Location
2022 A 1127	available for loan (reading room)	Lesesaal EG
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Article ; Online: AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition.

Brophy, Robert H / Fillingham, Yale A

The Journal of the American Academy of Orthopaedic Surgeons

2022 Volume 30, Issue 9, Page(s) e721–e729

Abstract: Management of Osteoarthritis of the Knee (nonarthroplasty) Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies for the nonarthroplasty treatment of osteoarthritis of the knee in adults (ages 17 years and older). ...

Abstract	Management of Osteoarthritis of the Knee (nonarthroplasty) Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies for the nonarthroplasty treatment of osteoarthritis of the knee in adults (ages 17 years and older). The purpose of this clinical practice guideline is to evaluate current best evidence associated with treatment. The scope of this guideline contains nonpharmacologic and pharmacologic interventions for symptomatic osteoarthritis of the knee, including surgical procedures less invasive than knee arthroplasty. It does not provide recommendations for patients with rheumatoid arthritis, arthritis of other joints, or other imflammatory athropathies. This guideline contains 29 recommendations to assist all qualified and appropriately trained healthcare professionals involved in the nonarthroplasty management of osteoarthritis of the knee and provide information for patients. In addition, the work group highlighted the need for better research into intra-articular corticosteroid, hyaluronic acid, and platelet-rich plasma detailing osteoarthritis characterization, including subgroup analyses and osteoarthrosis severity stratification, and clinically relevant outcomes with control subjects for bias and cost-effectiveness analysis. Studies comparing outcomes in patients with mild-to-moderate knee osteoarthritis and an MRI confirmed meniscal tear who have undergone partial meniscectomy after failing to improve with a course of conservative treatment (nonsteroidal anti-inflammatory drugs, steroid injection, and physical therapy) versus those who have undergone partial meniscectomy without a dedicated course of conservative treatment. Prospective randomized trials or prospective cohort studies are still needed to establish efficacy of individual oral nonsteroidal anti-inflammatory drugs within specific subgroups and populations to tailor systemic medications to help increase efficacy and decrease the risk of adverse effects.
MeSH term(s)	Adolescent ; Adult ; Anti-Inflammatory Agents/therapeutic use ; Humans ; Injections, Intra-Articular ; Knee Joint ; Meniscectomy ; Osteoarthritis, Knee/drug therapy ; Osteoarthritis, Knee/therapy ; Prospective Studies
Chemical Substances	Anti-Inflammatory Agents
Language	English
Publishing date	2022-04-06
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-21-01233
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Article ; Online: Letter to the Editor: Editor's Spotlight/Take 5: Has Arthroscopic Meniscectomy Use Changed in Response to the Evidence? A Large-database Study from Spain.

Brown, Gregory A / Brophy, Robert H / Fillingham, Yale A / Jevsevar, David S

Clinical orthopaedics and related research

2023 Volume 481, Issue 6, Page(s) 1240–1244

MeSH term(s)	Humans ; Meniscectomy/adverse effects ; Spain ; Arthroscopy/adverse effects
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Interview ; Comment
ZDB-ID	80301-7
ISSN	1528-1132 ; 0009-921X
ISSN (online)	1528-1132
ISSN	0009-921X
DOI	10.1097/CORR.0000000000002682
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Article: Delta hemoglobin cutoffs do not predict readmission in patients undergoing primary simultaneous bilateral total hip or knee arthroplasty: A retrospective cohort study.

Khan, Irfan A / Kahlon, Sundeep / Theosmy, Edwin / Ciesielka, Kerri-Anne / Fillingham, Yale A

Journal of clinical orthopaedics and trauma

2024 Volume 49, Page(s) 102334

Abstract: Background/aims: Primary simultaneous bilateral total joint arthroplasty (simBTJA) can cause postoperative anemia. Clinicians might hesitate to discharge patients who have large changes in hemoglobin [Hgb], despite Hgb levels remaining above transfusion ...

Abstract	Background/aims: Primary simultaneous bilateral total joint arthroplasty (simBTJA) can cause postoperative anemia. Clinicians might hesitate to discharge patients who have large changes in hemoglobin [Hgb], despite Hgb levels remaining above transfusion thresholds. This study was conducted to evaluate if delta Hgb or perioperative blood loss correspond with readmission in primary simBTJA patients not transfused perioperatively. Methods: From 2015 - 2020, a retrospective chart review of primary simultaneous bilateral total hip/knee arthroplasty cases was conducted. Preoperative and postoperative Hgb levels were obtained from our database or chart review. Exclusion criteria comprised patients who had a preoperative transfusion or transfusion postoperatively during their surgical admission, and patients not discharged home. Outcomes included whether delta Hgb or perioperative blood loss were predictive of 90-day readmission postoperatively, postoperative anemia, and transfusion during readmission. Results: The 510 individuals undergoing primary simBTJA possessed an average preoperative Hgb of 14.1 g/dL, starting blood volume of 5012 mL, postoperative Hgb of 10.0 g/dL, delta Hgb of 3.90 g/dL, and perioperative blood loss of 1403 mL. 19 patients (3.73 %) were readmitted, with none requiring transfusion. When constructing receiver operating characteristic (ROC) curves predicting readmission from delta Hgb, a threshold of 4.1 g/dL had an area under the curve (AUC) of 0.454, a sensitivity of 0.473, and a specificity of 0.56. For ROC curves predicting readmission from perioperative blood loss, a threshold of 1144 mL had an AUC of 0.453, a sensitivity of 0.842, and a specificity of 0.297. Similar AUCs, sensitivities, and specificities were obtained when adjusting ROC curves for preoperative Hgb or starting blood volume. Conclusions: Delta Hgb and perioperative blood loss do not predict 90-day readmission after primary simBTJA in patients not transfused perioperatively. Patients with a large delta Hgb but stay higher than a 7 g/dL restrictive transfusion threshold may have a strong capacity to overcome postoperative anemia.
Language	English
Publishing date	2024-01-05
Publishing country	India
Document type	Journal Article
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2024.102334
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Article ; Online: Does the Use of Tranexamic Acid in Patients Who Have Preoperative Coagulopathy Undergoing Total Joint Arthroplasty Normalize Their Risk of Complications? A Matched Equivalence Analysis.

Meghpara, Michael M / Goh, Graham S / Ciesielka, Kerri-Anne / Fillingham, Yale A

The Journal of arthroplasty

2023 Volume 38, Issue 11, Page(s) 2264–2268

Abstract: Background: While patients who have a preoperative coagulopathy have an increased risk of perioperative blood loss, tranexamic acid (TXA) has been shown to decrease the risk of complications in this subset. However, a direct comparison of the use of TXA ...

Abstract	Background: While patients who have a preoperative coagulopathy have an increased risk of perioperative blood loss, tranexamic acid (TXA) has been shown to decrease the risk of complications in this subset. However, a direct comparison of the use of TXA in coagulopathic and noncoagulopathic patients has not been performed. In addition to comparing differences in decreases in hemoglobin, transfusions, and complications, this study examined whether the use of TXA in coagulopathic patients normalized the risk of blood loss relative to matched noncoagulopathic patients. Methods: We performed a retrospective review of 230 patients who had a preoperative coagulopathy and underwent primary total joint arthroplasty (127 hips, 103 knees) from 2012 to 2019 and received TXA. Coagulopathy was defined as international normalized ratio >1.2, partial thromboplastin time >35 seconds, or platelet count <150,000/mL (mL). A matched comparison group of 689 patients who did not have a coagulopathy and received TXA was identified. A 2 1-sided test (TOST) analysis was performed to test for equivalence. Assuming a clinically relevant difference of 1 g/dL in postoperative decrease in hemoglobin, the equivalence margin was set as ±1 g/dL between the groups. Results: When comparing coagulopathic and noncoagulopathic patients, total hip arthroplasty (THA) patients had no differences in hemoglobin, but had an increased reported estimated blood loss (243 versus 207 mL, P = .040) as well as an increased percent of patients requiring blood transfusions (11.8 versus 5.32%, P = .022). Total knee arthroplasty (TKA) patients had no differences in hemoglobin, estimated blood loss, or percent of patients requiring transfusion. There were no differences in medical or surgical complications for both groups for THA and TKA patients. Equivalence testing for both groups revealed statistical significance that THA and TKA coagulopathic patients receiving TXA had an equivalent risk of blood loss compared to noncoagulopathic patients receiving TXA. Conclusion: Coagulopathic patients receiving TXA and undergoing THA had an increased risk of receiving a transfusion; however, there were no differences in complications for both TKA and THA, as well as a normalized risk of blood loss when compared to noncoagulopathic patients. Level of evidence: III.
MeSH term(s)	Humans ; Tranexamic Acid/therapeutic use ; Antifibrinolytic Agents/therapeutic use ; Blood Loss, Surgical/prevention & control ; Arthroplasty, Replacement, Hip/adverse effects ; Retrospective Studies ; Hemoglobins ; Administration, Intravenous
Chemical Substances	Tranexamic Acid (6T84R30KC1) ; Antifibrinolytic Agents ; Hemoglobins
Language	English
Publishing date	2023-05-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.05.035
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Article ; Online: What Are Social Determinants of Health and Why Should They Matter to an Orthopaedic Surgeon?

Meacock, Samantha S / Khan, Irfan A / Hohmann, Alexandra L / Cohen-Rosenblum, Anna / Krueger, Chad A / Purtill, James J / Fillingham, Yale A

The Journal of bone and joint surgery. American volume

2024

Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.23.01114
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Article: Return to Sport After Hip and Knee Arthroplasty: Counseling the Patient on Resuming an Active Lifestyle.

Arshi, Armin / Hughes, Andrew J / Robin, Joseph X / Parvizi, Javad / Fillingham, Yale A

Current reviews in musculoskeletal medicine

2023 Volume 16, Issue 8, Page(s) 329–337

Abstract: Purposeof review: The purpose of this review is to summarize the available literature on the epidemiology, biomechanics, clinical outcomes, and complications of return to sport after TJA, as well as provide guidelines for patients' safe return to ... ...

Abstract	Purposeof review: The purpose of this review is to summarize the available literature on the epidemiology, biomechanics, clinical outcomes, and complications of return to sport after TJA, as well as provide guidelines for patients' safe return to athletic activity. Recent findings: As volume and indications for total joint arthroplasty (TJA) expand, arthroplasty candidates today are demographically younger, more physically active, and have higher expectations for postoperative function. Many TJA patients wish to resume sports activity that may theoretically place their reconstruction under more biomechanical stress and risk for early wear or failure. Recommendations for postoperative patient activity following TJA have historically largely been surgeon-dependent and in the context of evolving prosthetic design and surgical techniques. We endorse a three-tiered framework for return to sporting activities: (1) low-impact sports are generally recommended, (2) intermediate-impact sports are generally recommended with experience, and (3) high-impact sports are generally not recommended though activity-specific joint decisions between patient and surgeon can be made.
Language	English
Publishing date	2023-05-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2407827-X
ISSN	1935-9748 ; 1935-973X
ISSN (online)	1935-9748
ISSN	1935-973X
DOI	10.1007/s12178-023-09839-x
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Article ; Online: Return to Sport After Unicompartmental Knee Arthroplasty and Patello-Femoral Arthroplasty.

Cozzarelli, Nicholas F / Khan, Irfan A / Arshi, Armin / Sherman, Matthew B / Lonner, Jess H / Fillingham, Yale A

The Journal of arthroplasty

2024

Abstract: Background: Data on sports/physical activity participation following unicompartmental knee arthroplasty (UKA) and patello-femoral arthroplasty (PFA) is variable and limited. The purpose of this study was to assess participations, outcomes, and ... ...

Abstract	Background: Data on sports/physical activity participation following unicompartmental knee arthroplasty (UKA) and patello-femoral arthroplasty (PFA) is variable and limited. The purpose of this study was to assess participations, outcomes, and limitations in sports following UKA and PFA. Methods: Patients who underwent UKA and PFA at a single institution from 2015 to 2020 were surveyed on sports participation before and after surgery. Data was correlated with perioperative patient characteristics and outcome scores. Among 776 patients surveyed, 356 (50%) patients responded. Of respondents, 296 (83.1%) underwent UKA, 44 (12.6%) underwent PFA, and 16 (4.5%) underwent both UKA/PFA. Results: Activity participation rates were 86.5, 77.3, and 87.5% five years prior, and 70.9, 61.4, and 75% at one year prior to UKA, PFA, and UKA/PFA, respectively. Return to sports rates were 81.6, 64.7, and 62.3% at mean 4.6 years postoperatively, respectively. The most common activities were recreational walking, swimming, cycling, and golf. Patients returned to a similar participation level for low-impact activities, whereas participation decreased for intermediate- and high-impact activities. Patients participating in activities had higher postoperative Knee Injury and Osteoarthritis Outcome Score Joint Replacement (P < .001), 12-Item Short Form Physical Component Score (P = .045) and Mental Component Score (P = .012). Activity restrictions were reported among 25, 36.4, and 25% of UKA, PFA, and UKA/PFA patients, respectively, and were more commonly self-imposed than surgeon-directed. Conclusions: Though UKA patients' postoperative sports participation may improve compared to one year preoperatively, participation for patients surgically treated for isolated osteoarthritis is decreased compared to 5 years preoperatively and varies among patient subsets.
Language	English
Publishing date	2024-02-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2024.02.004
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Article ; Online: Patients Requiring Both Total Hip Arthroplasty and Lumbar Spinal Fusion Have Lower Hip Functional Outcome Scores: A Matched Case-Control Study.

Khan, Irfan A / Cozzarelli, Nicholas F / Sutton, Ryan / Ciesielka, Kerri-Anne / Arshi, Armin / Fillingham, Yale A

The Journal of arthroplasty

2023 Volume 39, Issue 5, Page(s) 1291–1297

Abstract: Background: While patients who undergo both lumbar spinal fusion (LSF) and total hip arthroplasty (THA) have increased complication rates compared to patients who have not undergone LSF, there is a paucity of literature evaluating THA functional ... ...

Abstract	Background: While patients who undergo both lumbar spinal fusion (LSF) and total hip arthroplasty (THA) have increased complication rates compared to patients who have not undergone LSF, there is a paucity of literature evaluating THA functional outcomes in patients with a history of LSF. This study was conducted to determine whether patients undergoing THA with a history of LSF have inferior functional outcomes compared to patients having no history of LSF. Methods: A retrospective matched case-control study was conducted at an academic center. Patients who underwent both THA and LSF (cases) were matched with controls who underwent THA without LSF. Inclusion criteria required a minimum of 1-year follow-up for the Hip Disability and Osteoarthritis Outcome Score Joint Replacement [HOOS-JR]. Following propensity matching for age, sex, race, body mass index, and comorbidities, 291 cases and 1,164 controls were included, with no demographic differences. Results: Patients who underwent both THA and LSF had a significantly lower preoperative HOOS-JR (47 versus 50; P < .001), postoperative HOOS-JR (77 versus 85; P < .001), a significant lower rate of achieving the patient acceptable symptom state (55 versus 67%; P < .001), with no significant difference in delta HOOS-JR (34 versus 34; P = .834). When comparing patients undergoing THA before LSF or LSF before THA, no differences existed for preoperative HOOS-JR (50 versus 47; P = .304), but patients undergoing THA before LSF had lower postoperative HOOS-JR scores (74 versus 81; P = .034), a lower-delta HOOS-JR (27 versus 35; P = .022), and a lower rate of reaching the HOOS-JR minimal clinically important difference (62 versus 76%; P = .031). Conclusions: Patients who have a history of LSF experience a similar improvement in hip function when undergoing THA compared to patients who do not have a history of LSF. However, due to lower preoperative function, they may have a lower postoperative functional outcome ceiling. Additionally, patients undergoing THA before LSF have worse hip functional outcomes than patients undergoing LSF before THA.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Hip/adverse effects ; Retrospective Studies ; Case-Control Studies ; Spinal Fusion/adverse effects ; Postoperative Period ; Treatment Outcome ; Patient Reported Outcome Measures
Language	English
Publishing date	2023-11-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2023.11.004
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Article ; Online: Multimodal Analgesia and Anesthesia: Enabling Safe and Rapid Recovery for Total Joint Arthroplasty Patients.

Hannon, Charles P / Fillingham, Yale A / Hamilton, William G / Della Valle, Craig J

The Journal of arthroplasty

2022 Volume 37, Issue 9, Page(s) 1669–1670

MeSH term(s)	Analgesia ; Analgesics, Opioid ; Anesthesia ; Arthroplasty ; Humans ; Pain Management ; Pain, Postoperative/etiology
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2022-08-12
Publishing country	United States
Document type	Editorial
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2022.07.016
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