Hip arthroplasty is one of the most common procedures performed every year however complications do occur. Prior studies have examined the impact of insurance status on complications after TJA in small or focused cohorts. The purpose of our study was to utilize a large all-payer inpatient healthcare database to evaluate the effect of patient insurance status on complications following hip arthroplasty. Data was obtained from the Nationwide Inpatient Sample between 2004 and 2011. Analysis included patients undergoing hip arthroplasty procedures determined by ICD-9 procedure codes. Patient demographics and comorbidities were analyzed and stratified by insurance type. The primary outcome was medical complications, surgical complications and mortality during the same hospitalization. A secondary analysis was performed using a matched cohort comparing patients with Medicare vs private insurance using the coarsened exact matching algorithm. Pearson's chi-squared test and multivariate regression were performed.Introduction
Methods
Shoulder arthroplasty (SA) is an effective procedure for managing patients with shoulder pain secondary to degenerative joint disease or end stage arthritis that has failed conservative treatment. Insurance status has been shown to be an indicator of patient morbidity and mortality. The objective of the current study is to evaluate the effect of patient insurance status on outcomes following shoulder replacement surgery. Data was obtained from the Nationwide Inpatient Sample between 2004 and 2011. Analysis included patients undergoing shoulder arthroplasty procedures determined by ICD-9 procedure codes. Patient demographics and comorbidities were analyzed and stratified by insurance type. The primary outcome was medical and surgical complications occurring during the same hospitalization with secondary analysis of mortality. Pearson's chi¬squared test and multivariate regression were performed.INTRODUCTION
METHODS
Knee arthroplasty is one of the most common inpatient surgeries procedures performed every year however complications do occur. Prior studies have examined the impact of insurance status on complications after TJA in small or focused cohorts. The purpose of our study was to utilize a large all-payer inpatient healthcare database to evaluate the effect of patient insurance status on complications following knee arthroplasty. Data was obtained from the Nationwide Inpatient Sample between 2004 and 2011. Analysis included patients undergoing knee arthroplasty procedures determined by ICD-9 procedure codes. Patient demographics and comorbidities were analyzed and stratified by insurance type. The primary outcome was medical complications, surgical complications and mortality during the same hospitalization. A secondary analysis was performed using a matched cohort comparing patients with Medicare vs private insurance using the coarsened exact matching algorithm. Pearson's chi-squared test and multivariate regression were performed.Introduction
Methods
Due to improvement in overall prosthesis designs and surgical methods, there have been increasing numbers of total ankle arthroplasty performed with encouraging intermediate results. While European registries have been able to perform long term follow-ups and analysis on total ankle arthroplasty patients, majority of the US studies have been based on experiences at a single institution. There is currently limited data on the recent trends of total ankle arthroplasty. The purpose of our study is to evaluate the in-patient demographics, complications and readmission rate in patients after total ankle arthroplasty at academic medical centers in United States. We queried the University Healthsystems Consortium (UHC) administrative database from 2007 to 2011 for patients who underwent total ankle arthrolasty by ICD-9 procedure code 81.56. A descriptive analysis of demographics was performed, followed by a similar analysis of patient clinical benchmarks, including hospital length of stay, hospital direct cost, in-hospital mortality, and 30-day readmission rates.Introduction:
Patients & Methods:
There is a high prevalence of obesity in the United States and the numbers are increasing. These patients comprise a significant portion of the shoulder arthroplasty patient population. There are several reports of outcomes in the literature on obese patients after total knee or hip replacement, however, this data is lacking in the shoulder arthroplasty patient population. The purpose of this study is to compare the functional outcomes and complications of obese patients undergoing shoulder arthroplasty with the non-obese population. Between 2009 to 2010, 76 patients that had a primary total shoulder replacement were grouped according to their Body Mass Index (BMI) and followed prospectively for 2 years. The groups were divided as normal (BMI <25, N=26), overweight (25 to 30 BMI, N=25), and obese (>30 BMI, N=25) according to the World Health Organization classifications. Preoperative demographics, age, comorbidities and postoperative complications were recorded. Perioperative operating room and hospital data were analyzed. Functional outcome measurements including ASES, SF-36 physical component (PC) scores, mental component (MC) scores and visual analog scale along with general health and fatigue were evaluated at the 0 and 2 year time period. Statistical analyses were performed.Introduction
Methods
While shoulder elevation can be reliably restored following reverse total shoulder arthroplasty (RTSA), patients may experience a loss of internal and external rotation. Several recent studies have investigated scapular notching and have made suggestions regarding glenosphere placement in order to minimize its occurrence. However, very few studies have looked at how changes in glenosphere placement in RTSA affect internal and external rotation. The purpose of this study was to determine the effect of glenosphere position on internal and external rotation range of motion at various degrees of scaption following RTSA. We hypothesized that alteration in glenosphere position will affect the amount of impingement-free internal and external rotation. CT scans of the scapula and humerus were obtained from seven cadaver specimens and 3-Dimensional (3D) reconstructions were created. A corresponding 3D RTSA model was created by laser scanning the baseplate, glenosphere, humeral stem and bearing. The RTSA models were then virtually implanted into each specimen. The glenosphere position was determined in relation to the neutral position in 6 different settings: Medialization (5 mm), lateralization (10 mm), superior translation (6mm), inferior translation (6 mm), superior tilt (20°), and inferior tilt (15° and 30°). The humerus in each virtual model was allowed to freely rotate at a fixed scaption angle until encountering bone-bone or bone-implant impingement (180 degrees of limitation). Each model was tested at 0, 20, 40, and 60 degrees of scaption and the impingement-free internal and external rotation range of motion for each scaption angle was recorded.Introduction
Methods
