The Journal of arthroplasty
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Review Meta Analysis
Surgical Approaches and Hemiarthroplasty Outcomes for Femoral Neck Fractures: A Meta-Analysis.
The lateral approach (LA), posterior approach (PA), and anterior approach (AA) are conventional surgical access routes for hemiarthroplasty in proximal femoral fractures. This meta-analysis assesses and compares the outcomes and attempts to identify the best approach for hemiarthroplasty in the treatment of proximal femoral fractures. ⋯ The PA for hemiarthroplasty in proximal femoral fractures poses an increased risk of dislocation and reoperation compared to the LA and AA. There are no evident advantages of the PA and its routine use for fracture-related hemiarthroplasty should be questioned.
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Multicenter Study
The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria.
The introduction of the Musculoskeletal Infection Society (MSIS) criteria for periprosthetic joint infection (PJI) in 2011 resulted in improvements in diagnostic confidence and research collaboration. The emergence of new diagnostic tests and the lessons we have learned from the past 7 years using the MSIS definition, prompted us to develop an evidence-based and validated updated version of the criteria. ⋯ This study offers an evidence-based definition for diagnosing hip and knee PJI, which has shown excellent performance on formal external validation.
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Little is known regarding the occurrence of pneumonia after hip fracture surgery. The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia after surgery for geriatric hip fracture. ⋯ Pneumonia is a serious complication after geriatric hip fracture surgery, which increases the readmission and mortality risks. Evidence-based pneumonia prevention programs should be implemented among high-risk patients-males, patients ≥90 years, body mass index <18.5 kg/m2, and/or patients with chronic obstructive pulmonary disease-to decrease morbidity and mortality.
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The benefits of discharge to a skilled nursing facility (SNF) in Medicare-eligible patients after total joint arthroplasty (TJA) have recently been scrutinized. The purpose of this study was to determine short-term complication and readmission rates for SNF versus home discharge in patients eligible for Medicare and SNF discharge. ⋯ In a cohort of Medicare- and SNF-eligible patients, SNF discharge was the strongest predictor of 30-day complication after TJA. SNF discharge was also an independent predictor of readmission after TJA.
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Randomized Controlled Trial
Multiple Low-Dose Dexamethasone Further Improves Clinical Outcomes Following Total Hip Arthroplasty.
The recommended dose regimen of dexamethasone in total hip arthroplasty (THA) has not been determined. This study was performed to assess the effects of multiple low-dose dexamethasone on clinical outcomes after THA. ⋯ The 3-dose dexamethasone regimen can further relieve postoperative pain, ameliorate postoperative nausea, provide additional inflammatory control, enhance mobility, and shorten LOS following THA.