Response to: "Regarding 'Risk Factors for Postoperative Opioid Use in Arthroscopic Meniscal Surgery'"
We would like to thank Dr. Park for his valuable comments on our article concerning postoperative opioid use in arthroscopic meniscal surgery. He inquired about the role of comorbid psychiatric diseases, intraoperative and postoperative nerve blocks, and adjustment for the role of postoperative nonopioid analgesics in the outcomes of our study.
Results of total shoulder arthroplasty in patients aged 55 years or younger versus those older than 55 years: an analysis of 1135 patients with over 2 years of follow-up
BACKGROUND: The results of anatomic total shoulder arthroplasty (TSA) in younger patients have not been clearly elucidated. The purpose of this study was to compare early outcomes after TSA in patients aged 55 years or younger versus patients older than 55 years.
METHODS: A total of 1135 patients who were treated with TSA for glenohumeral arthritis and had a mean follow-up period of over 4 years were retrospectively reviewed. Etiologies included osteoarthritis (n = 1044), osteonecrosis (n = 35), inflammatory arthritis (n = 34), and post-traumatic arthritis (n = 22). Validated outcome measures, range of motion, and patient satisfaction were recorded. Preoperative and postoperative metrics were compared, and a multivariate analysis was performed to isolate age from sex, body mass index, previous surgery, and diagnosis as independent factors.
How Much Do Psychological Factors Affect Lack of Return to Play After Anterior Cruciate Ligament Reconstruction? A Systematic Review
BACKGROUND: Variables affecting return to sport after anterior cruciate ligament reconstruction (ACLR) are multifactorial. The nonphysical factors germane to successful return to play (RTP) are being increasingly recognized.
PURPOSE: To (1) evaluate the available evidence base for psychological factors relating to RTP after ACLR, (2) identify psychological factors affecting RTP after ACLR, and (3) understand currently available metrics used to assess psychological RTP readiness.
Influence of Acetabular Labral Tear Length on Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome With Capsular Plication
BACKGROUND: The literature on the effects of labral tear on patient-reported outcomes, midterm pain, and overall patient satisfaction is limited.
PURPOSE: To determine the effect of labral tear length on postoperative outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
Early outcomes of shoulder arthroplasty according to sex
HYPOTHESIS: Among patients undergoing shoulder arthroplasty (SA), female patients would have worse outcomes than their male counterparts.
METHODS: A multicenter prospective cohort of 2364 patients (1365 female and 999 male patients) treated with total SA or reverse total SA from 2007 to 2015 was retrospectively analyzed. Results were assessed using several validated outcome measures and range-of-motion testing. A multivariable analysis identified differences in preoperative values, postoperative values, and preoperative-to-postoperative improvements while adjusting for possible confounders.
Social Media Use for Orthopaedic Surgeons
Abstract There has been increasing use of social media in recent years by hospitals and health-care providers. Social media can provide an extension of the physician to an online presence and have potential practice-building implications.
Pain After Anatomic Total Shoulder Arthroplasty Versus Reverse Total Shoulder Arthroplasty
Abstract As anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) become increasingly common, differences between the 2 procedures are of importance. The purpose of this study was to determine differences in acute pain levels between patients undergoing aTSA and rTSA. Sixty patients undergoing aTSA or rTSA were assessed for participation. The primary outcome was postoperative daily visual analog scale scores, which were initially collected for 4 days postoperatively. Secondary outcomes included opioid consumption, length of stay, and complications. Comparisons between the 2 groups were assessed using a multivariable analysis, which controlled for sex, age, body mass index, and type of anesthetic
Abnormal tibial alignment is a risk factor for lateral meniscus posterior root tears in patients with anterior cruciate ligament ruptures
PURPOSE: The purpose of this study was to identify if abnormal tibial alignment was a risk factor for lateral meniscus posterior root tears (LMPRT) in patients with acute anterior cruciate ligament (ACL) ruptures.
METHODS: The medical charts of 200 patients treated for ACL ruptures between 2013 and 2016 were retrospectively reviewed and evaluated. MRI images and reports were assessed for concurrent meniscal tears. Radiographs were reviewed for tibia vara and tibial slope angles and MRI reports identifying lateral root tears were compared to intraoperative reports to determine accuracy. Multiple logistic regression models were constructed to identify potential risk factors for LMPRTs.
Adductor Canal Block Versus Femoral Nerve Block for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Trial
BACKGROUND: Femoral nerve block (FNB) is a commonly performed technique that has been proven to provide effective regional analgesia after anterior cruciate ligament (ACL) reconstruction. The adductor canal block (ACB) uses a similar sensory block around the knee while avoiding motor blockade of the quadriceps muscles.
PURPOSE/HYPOTHESIS: The purpose of our study was to compare the efficacy of FNB versus ACB for pain control after ACL reconstruction. It was hypothesized that there would be no difference in pain levels or opioid requirements between the 2 groups.
Risk Factors for Postoperative Opioid Use in Arthroscopic Meniscal Surgery
PURPOSE: (1) To evaluate the influence of preoperative opioid use on postoperative consumption after arthroscopic meniscal surgery and (2) to determine preoperative patient factors associated with increased opioid use after meniscal surgery.
METHODS: We performed a retrospective review of all patients with a primary diagnosis of a meniscal tear at a single institution between August 2013 and February 2017. Patients were classified as opioid nonusers if they had not received any opioid medications in the 3 months before meniscal surgery, as acute users if they received at least 1 opioid prescription within 1 month preceding meniscal surgery, or as chronic users if they received at least 1 opioid prescription within 3 months preceding meniscal surgery.