Spiveyziegler4802

The purpose of this study is to compare perception of leg length discrepancy (LLD) and clinical results of total knee arthroplasties (TKA) in patients with or without previous ipsilateral hip arthroplasty. Between 2008 and 2015, navigation-assisted TKA was performed in 43 patients with previous hip arthroplasty after hip fracture. After 13 propensity score matching was performed, 108 patients of primary navigation-assisted TKA (group 1) and 36 patients with hip arthroplasty (group 2) were included. Knee Society (KS) scores, Western Ontario and McMaster Universities Index (WOMAC) scores, and patients' satisfaction including perception of LLD were evaluated. Radiographic evaluation included mechanical axis, component position, and LLD. Logistic regression analysis was performed to find the factors that affect the clinical outcomes. No significant differences in radiologic and clinical evaluations, except for KS function score, patient's satisfaction and LLD (p less then 0.001), were detected between the groups. LLD and its perception were significantly higher in group 2 (1.8 ± 3.4 mm in group 1 and 9.7 ± 4.1 mm in group 2, p = 0.000). Risk factors for the low KS function score were found as LLD (odds ratio [OR] 1.403, p = 0.008) and previous hip arthroplasty itself (OR 15.755, p = 0.002), but much higher OR was found in previous hip arthroplasty. OUL232 Although the outcomes of TKA in patients with ipsilateral hip arthroplasty are comparable to those of primary TKA, LLD was high and patient's satisfaction and functional outcomes were low in patients with previous ipsilateral hip arthroplasty. Care should be taken when considering TKA in patients with previous hip arthroplasty. This is a Level III, case control study.As the United States' octogenarian population (persons 80-89 years of age) continues to grow, understanding the risk profile of surgical procedures in elderly patients becomes increasingly important. The purpose of this study was to compare 30-day outcomes following unicompartmental knee arthroplasty (UKA) in octogenarians with those in younger patients. The American College of Surgeons National Surgical Quality Improvement Program database was queried. All patients, aged 60 to 89 years, who underwent UKA from 2005 to 2016 were included. Patients were stratified by age 60 to 69 (Group 1), 70 to 79 (Group 2), and 80 to 89 years (Group 3). Multivariate regression models were estimated for the outcomes of hospital length of stay (LOS), nonhome discharge, morbidity, reoperation, and readmission within 30 days following UKA. A total of 5,352 patients met inclusion criteria. Group 1 status was associated with a 0.41-day shorter average adjusted LOS (99.5% confidence interval [CI] 0.67-0.16 days shorter, p  less then  0.001) relative to Group 3. Group 2 status was not associated with a significantly shorter LOS compared with Group 3. Both Group 1 (odds ratio [OR] = 0.15, 99.5% CI 0.10-0.23) and Group 2 (OR = 0.33, 99.5% CI 0.22-0.49) demonstrated significantly lower adjusted odds of nonhome discharge following UKA compared with Group 3. There was no significant difference in adjusted odds of 30-day morbidity, readmission, or reoperation when comparing Group 3 patients with Group 1 or Group 2. While differences in LOS and nonhome discharge were seen, octogenarian status was not associated with increased adjusted odds of 30-day morbidity, readmission, or reoperation. Factors other than age may better predict postoperative complications following UKA.Enhanced recovery after surgery (ERAS) represents a paradigm shift in perioperative care, aimed at achieving early recovery for surgical patients, reducing length of hospital stay, and complications. The purpose of this study was to provide an insight of the impact of the COVID-19 on ERAS protocols for knee arthroplasty patients in a tertiary hospital and potential strategy changes for postpandemic practice. We retrospectively reviewed all cases that underwent surgery utilizing ERAS protocols in the quarter prior to the pandemic (fourth quarter of 2019) and during the first quarter of 2020 when the pandemic started. A review of the literature on ERAS protocols for knee arthroplasty during the COVID-19 pandemic was also performed and discussed. A total of 199 knee arthroplasties were performed in fourth quarter of 2019 as compared with 76 in the first quarter of 2020 during the COVID-19 outbreak. Patients who underwent surgery in the first quarter of 2020 had shorter inpatient stays (3.8 vs. 4.5 days), larger percentage of discharges by postoperative day 5 (86.8 vs. 74.9%), and a larger proportion of patients discharged to their own homes (68 vs. 54%). The overall complication rate (1.3 vs. 3%) and readmission within 30 days (2.6 vs. 2%) was similar between both groups. ERAS protocols appear to reduce hospital lengths of stay for patients undergoing knee arthroplasty without increasing the risk of short-term complications and readmissions. The beneficial effects of ERAS appear to be amplified by and are synchronous with the requirements of operating in the era of a pandemic.Total knee arthroplasty (TKA) is one of the most frequent orthopaedic surgeries. The purpose of this study was to determine the 30-day postoperative mortality rate, total episode-of-care costs, and prognostic factors associated with these outcomes, for adult patients who underwent TKA in Colombia's contributory health care system. A retrospective cohort study of all adult patients enrolled in Colombia's contributory health system, who underwent TKA between January 1, 2012 and November 30, 2015 was performed. Thirty-day postoperative mortality rates, 30-day ICU admissions rates, 30-day hospital readmission rates, 1-year arthroplasty revision rates, and total episode-of-care costs were estimated. Multilevel, generalized linear models were generated, to determine the prognostic factors associated with outcomes presented. A total of 12,453 patients were included. The 30-day mortality rate was 0.13 per 100 surgeries and the ICU admissions rate at 30 days postoperative was 4.44 per 100 surgeries. The 30-day hospital readmission rate was 4.