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5%) were asymptomatic heterotopic ossification (3.3%). Patients were lengthened on the surgical side an average of 1.4 cm with no nerve palsies. All patient PROs improved from preoperative to postoperative time points with the modified Harris Hip Score improving from 46.9 preoperatively to 85.4 postoperatively (P < .01). Patients free from revision for any reason at final follow-up (5.6 years; range 2-13 years) was 98.4% with one patient needing a revision of their femoral component.

THA for the sequelae of the LCPD has an acceptable complication rate and provides excellent patient reported outcomes at mid-term follow-up.

THA for the sequelae of the LCPD has an acceptable complication rate and provides excellent patient reported outcomes at mid-term follow-up.

The optimum venous thromboembolism (VTE) prophylaxis strategy to minimize risk of VTE and bleeding complications following revision total hip and knee arthroplasty (rTHA/rTKA) is controversial. The purpose of this study is to describe current VTE prophylaxis patterns following revision arthroplasty procedures to determine efficacy, complication rates, and prescribing patterns for different prophylactic strategies.

The American Board of Orthopaedic Surgery Part II (oral) examination case list database was analyzed. Current Procedural Terminology codes for rTHA/rTKA were queried and geographic region, VTE prophylaxis strategy, and complications were obtained. Less aggressive prophylaxis patterns were defined if only aspirin and/or sequential compression devises were utilized. More aggressive VTE prophylaxis patterns were considered if any of low-molecular-weight heparin (enoxaparin), warfarin, rivaroxaban, fondaparinux, or other strategies were used.

In total, 6387 revision arthroplasties were included. Tications. Less aggressive strategies were not associated with a higher rate of thrombosis.

Therapeutic Level III.

Therapeutic Level III.

Chronic obstructive pulmonary disease (COPD) has been associated with impaired bone metabolism. The purpose of this study is to investigate rates of readmission, respiratory complications, implant-related complications, and revision after total hip arthroplasty (THA) in patients with and without underlying COPD.

The PearlDiver Mariners database was used to divide patients undergoing primary THA (CPT-27130) into two cohorts 1) THA with COPD (including asthma) or 2) THA without COPD. The incidence of 30-day readmission, COPD exacerbation, pneumonia, other respiratory complications as well as dislocations, mechanical loosening, and joint prosthetic infection was calculated through logistic regression. The risk of THA revision was also assessed through Cox-proportional hazards regression. All regression controlled for age, gender, and medical comorbidities found to be associated with COPD.

Between 2010 and 2018, 97,784 THA patients with COPD and 338,243 THA patient without COPD were studied. THA patients with COPD had higher risk of 30-day readmission (aOR= 1.17, 95% CI 1.11-1.23, P < .0001). There was higher risk of 30-day pneumonia (aOR= 2.07, 95% CI 1.76-2.44, P < .0001). THA patients with COPD also faced higher risk of 30-day dislocations (aOR= 1.31, 95% CI 1.19-1.45, P < .0001), joint prosthetic infections (aOR= 1.25, 95% CI 1.14-1.37, P < .0001), and periprosthetic fracture (aOR= 1.19, 95% CI 1.07-1.32, P= .0015). Regarding revisions, 3.3% of THA patients with COPD underwent THA revision at 1 year, a higher risk than THA patients without COPD (aOR= 1.11, 95% CI 1.06-1.16, P < .0001).

Patients undergoing THA with underlying COPD face a higher rate of comorbidities, respiratory complications, implant complications, and revision surgeries, than patients without COPD.

III.

III.

The use of less invasive approaches and broach only press-fit femoral stems in total hip arthroplasty (THA) may increase the risk for periprosthetic fracture. Proximal femoral nutrient arteries (FNAs) can be mistaken for fractures after THA. Description of FNAs in relation to THA implants is important to better distinguish between FNAs and periprosthetic fractures. The purpose of this study was to evaluate the frequency, location, and morphology of FNAs visible on radiographs after primary THA with a broach-only stem design.

A retrospective cohort study was performed. Patients ≥18 years who underwent primary THA with a cementless, broach-only stem, and had 6-week follow-up radiographs were included. Patient demographics were recorded. Anteroposterior and lateral radiographs at 6 weeks postoperatively were assessed for the presence of FNA; if present, measurements of vessel location and morphology were obtained. Descriptive statistics were reported. Univariate and multivariate analyses were performed to identify patient characteristics associated with the radiographic presence of perforating vessel.

A total of 378 hips were evaluated (332 patients). FNAs were identified radiographically in 46.3% (175 hips/378 hips). learn more All FNAs were found to be unicortical, most observed in the posterior and lateral cortices. Gender, age, BMI, stem position, and surgical approach did not correlate with a presence of FNA on radiograph.

FNA was seen on postoperative radiographs in 46% of patients after THA with one broach-only stem design. The FNA was unicortical and present on preoperative radiographs. Surgeons should consider this when evaluating postoperative radiographs.

FNA was seen on postoperative radiographs in 46% of patients after THA with one broach-only stem design. The FNA was unicortical and present on preoperative radiographs. Surgeons should consider this when evaluating postoperative radiographs.A 13-year-old patient presented to the emergency department with a history of abdominal pain and right flank pain. Two days before, she was evaluated at her pediatrician's office and was diagnosed with acute gastroenteritis and sent home. In the emergency department, the patient was diagnosed with ureterolithiasis after a physical examination, laboratory work, and imaging findings. She was treated successfully with conservative medical management. Symptomatic presentation of ureterolithiasis can include abdominal pain, flank pain, hematuria, dysuria, urgency, nausea, and vomiting. Nurse practitioners need to recognize nonspecific symptoms of ureterolithiasis for accurate diagnosis and treatment. Risk factors, signs and symptoms, prevention, and treatment options for ureterolithiasis are discussed.