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This retrospective study of prophylactically stabilized metastatic lesions revealed that more than 90% of patients had Mirels scores greater than 8, suggesting a substantial risk of pathologic fracture. Over half of all stabilized lesions were peritrochanteric and lytic. These criteria alone achieve a minimum Mirels score of 8; however, one-third of these lacked functional pain. Notably, Mirels' original paper found location and type criteria to be the least predictive of impending fracture. Contrariwise, functional pain was the most accurate predictor. Multiple studies have found poor specificity of the Mirels criteria. The high scores achievable by the location and type criteria may represent an overrepresentation of their contribution to fracture risk. Reconsideration of the relative weights of each criterion warrants further examination.

Pediatric septic arthritis (SA) is a condition that can be associated with significant morbidity. Although previous research has been on predictive care pathways, scrutiny of the literature continues to reveal wide differences in the patient evaluation and management. The purpose of this study was to define the differences in joint aspiration for the evaluation of pediatric SA across pediatric tertiary care institutions in the United States.

Surgeons from 18 pediatric tertiary care centers across the United States were surveyed on current institutional practices regarding joint aspiration, laboratory studies, MRI usage, and treatment timing in the evaluation for SA. Responses were recorded by institution and analyzed to generate descriptive statistics.

Responses were received from all institutions asked to participate. Overall, joint specific practice variation exists regarding the person completing the aspiration, where the aspiration is performed, utilization of image guidance, and the utilization of anesthesia. Additional areas of variation included the method and calculation of cell count and the routine use of MRI.

Significant practice variations exist across pediatric tertiary care centers for the evaluation of pediatric SA. Using these data, future prospective studies can be used to unify institutional practices to minimize practice variation and ultimately improve the care delivery to pediatric patients presenting with SA.

Significant practice variations exist across pediatric tertiary care centers for the evaluation of pediatric SA. Using these data, future prospective studies can be used to unify institutional practices to minimize practice variation and ultimately improve the care delivery to pediatric patients presenting with SA.

The objectives of this study were to quantify adoption of social media for the dissemination of original research in orthopaedic research and to determine the correlation between academic citations and social medial posts among recent orthopaedic publications.

An Internet-based study was performed of 835 articles from three orthopaedic journals from 2018 to 2019. The number of academic citations for each article was determined using Google Scholar and Web of Science. The number of social media posts was determined using Twitter. The correlation between academic citations and social media posts was calculated using the Spearman rank correlation coefficient.

The average number of academic citations per article was 4.6 on Google Scholar and 2.6 on Web of Science. The average number of social media posts per article was 3.6, which consisted of 1.1 tweets and 2.5 retweets. The number of academic citations per article was weakly correlated with the number of social media posts, tweets, and retweets.

There is a positive relationship between social media posts and academic citations of recent orthopaedic research. Use of social media differs among journals and authors, which may represent opportunities to leverage social media platforms to more effectively dissemination novel research findings.

There is a positive relationship between social media posts and academic citations of recent orthopaedic research. Use of social media differs among journals and authors, which may represent opportunities to leverage social media platforms to more effectively dissemination novel research findings.

Preoperative laboratory studies are often obtained as part of the workup for surgeries such as total hip arthroplasty (THA). An increasing need exists to be able to identify patients at risk for adverse outcomes. Thus, metrics that correlate with postoperative adverse events and readmissions are increasingly important to optimize patient care. The implications of varying abnormal platelet counts, especially on the high end of the spectrum, have yet to be assessed in large, multicenter patient populations. This study aims to risk stratify THA patients with varying preoperative platelet counts to address these questions. The purposes of this study were to (1) evaluate cutoffs for normal versus abnormal platelet counts for patients undergoing THA by using postoperative complications data and (2) assess the correlation of such values with readmission data using the National Surgical Quality Improvement Program database.

Patients who underwent elective primary THA were identified in the 2011 to 2015 National Stients with these laboratory findings warrant further attention with possible preoperative and postoperative optimization.

This study suggests that preoperative high, as well as low, platelet counts are correlated with perioperative complications after THA, including hospital readmissions. Patients with these laboratory findings warrant further attention with possible preoperative and postoperative optimization.

The relative indications for removing symptomatic implants after osseous healing are not fully agreed on. The purpose of this study was to (1) determine whether patients showed improvement in functional outcomes after the removal of symptomatic orthopaedic implants, (2) compare the outcomes between upper and lower extremity implant removal, and (3) determine the rate of implant removal complications.

A prospective study was conducted between 2013 and 2016. Bafilomycin A1 manufacturer Patients completed a Short Musculoskeletal Function Assessment outcome questionnaire before implant removal and at the 6-month follow-up. Demographic data were stratified and compared between upper and lower extremity groups and between preimplant removal and 6-month postremoval.

Of the 119 patients included in the study, 85 (71.4%) were lower extremity and 34 (28.6%) were upper extremity. Significant improvement after implant removal was seen in the dysfunction index (P ≤ 0.001), bother index (P ≤ 0.001), and daily activities domain (P ≤ 0.001). Depression or anxiety (P = 0.016) were statistically significant predictors for an improved Short Musculoskeletal Function Assessment dysfunction index score at 6 months. The complication rate was 10.1% (n=12) for the cohort.

Implant removal in both the upper and lower extremity presented notable improvement in dysfunction. Complications that require surgical intervention are extremely rare.

Implant removal in both the upper and lower extremity presented notable improvement in dysfunction. Complications that require surgical intervention are extremely rare.Sickle cell disease (SCD) is an autosomal recessive disorder that is characterized by abnormal "sickle-shaped" erythrocytes. Because of their shape, these erythrocytes are more likely to become trapped in small slow-flowing vessels, leading to vaso-occlusion. Because this commonly happens in the bones, patients with SCD are at an increased risk for orthopaedic manifestations such as osteomyelitis, septic joint, or osteonecrosis. Osteomyelitis is a serious and potentially disabling condition but can be difficult to differentiate from benign conditions of SCD, such as vaso-occlusive crisis. Diagnosis of osteomyelitis requires careful evaluation of the clinical presentation, laboratory testing, and imaging. Treatment of osteomyelitis in patients with SCD may be medical or surgical, but considerations in antibiotic selection and management preoperatively and postoperatively must be taken to ensure optimal outcomes.

Flexor tendon lacerations in zone II have been reported to be the most complicated of all tendon injuries. Currently, there is no consensus on treatment in surgical management for patients with flexor tendon laceration of flexor digitorum profundus and flexor digitorum superficialis (FDS). The aim of this study was to evaluate whether the repair of FDS tendons provided superior functional outcomes compared with FDS excision in Hispanic patients.

Total active motion, original Strickland criteria, and the disability of arm shoulder and hand questionnaire were provided postoperatively at 3 and 6 months to all consecutive Hispanic patients who underwent zone II flexor tendon repair. The cohort was divided into two groups, those who underwent FDS repair and those underwent FDS excision.

Functional and disability outcome analysis showed a notable improvement with FDS repair using total active motion, Strickland criteria, and disability of arm shoulder and hand score at the 3 months postoperative interval. No statistical differences were identified regarding functional and disability outcomes at the 6-month evaluation between both groups.

Among Hispanics, the FDS-repaired group had similar functional and disability outcomes at their 6 months postoperative evaluation compared with the FDS-excised group. Increased awareness for tendon rerupture during the initial 3 months of index surgery is recommended for FDS-excised patients.

Among Hispanics, the FDS-repaired group had similar functional and disability outcomes at their 6 months postoperative evaluation compared with the FDS-excised group. Increased awareness for tendon rerupture during the initial 3 months of index surgery is recommended for FDS-excised patients.Little is known about how home health aides (HHAs) perceive the daily physical challenges and risks of injury they face in their line of work. The objectives of this study were to 1) gain detailed information about the daily experiences of HHAs, 2) identify physical challenges of their work, and 3) determine if there is a role for occupational therapists (OTs) in injury prevention through education. A qualitative descriptive approach using semistructured phone interviews that were recorded and transcribed was used. Colaizzi's descriptive phenomenological method was used to guide data analysis. Participants were recruited through convenience sampling and included eight female HHAs with an age range of 35 to 65 years. The following themes were identified HHAs valued the use of a client-centered approach with their clients (Know the rules and know your clients even better), HHAs assisted their patients with a wide range of activities of daily living and instrumental activities of daily living to support their independence within their home (More than Activities of Daily Living), transferring clients was considered the most physically demanding task (Would you like a hand with your transfer?), and participants believed new HHAs could benefit from training in patient positioning, appropriate use of adaptive equipment, and proper lifting mechanics in various contexts (Let's get physical!). The areas of overlap between HHAs' needs and OTs' skills provide an opportunity for OTs to consult with home care agencies as educators.