The Journal of arthroplasty
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The proximal femur represents the most common site of metastatic bone disease in the appendicular skeleton, and associated pathologic pertrochanteric femur fractures contribute to cancer-related morbidity and mortality. Controversy exists as to whether these injuries are best managed with intramedullary nailing (IMN) or with arthroplasty. ⋯ Level III.
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Improved narcotic pain management after total joint arthroplasty (TJA) is necessary to help battle the opioid epidemic. The goal of this study was to determine the sources of prescriptions prescribed to TJA patients. ⋯ Patients receive opioid prescriptions from multiple physician types before, and after, TJA. The majority of preoperative, and late postoperative, narcotics were not provided by their surgeons. Orthopedic surgeons may not even know that their TJA patients continue to receive opioids. Coordination of opioid care with health-care providers and greater communication with patients on narcotic use expectations should be promoted.
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Comparative Study
Comparing the 30-Day Risk of Venous Thromboembolism and Bleeding in Simultaneous Bilateral vs Unilateral Total Knee Arthroplasty.
Simultaneous bilateral total knee arthroplasty (SBTKA) may offer certain benefits; however, its overall safety is still disputed. This study aimed at comparing the risk of thromboembolism and bleeding in patients who underwent SBTKA vs unilateral total knee arthroplasty (TKA). ⋯ SBTKA confers an increased risk of postoperative VTE, bleeding, and composite morbidity at 30 days, with no increase in mortality.
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Retraction Of Publication
Withdrawn: A Randomized Controlled Trial Comparing Modular and Nonmodular Neck Versions of a Titanium Stem.
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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After the first year in the Comprehensive Care for Joint Replacement (CJR) model, hospitals must repay Medicare for spending above a target price. Hospitals are incentivized to reduce spending in a 90-day episode and generate internal cost savings through, for example, the use of lower-cost implants. ⋯ The CJR model holds great promise. However, it incentivizes hospitals to choose lower-cost implants and adopt newer technology more slowly, which could potentially increase revision rates and offset benefits of the program. Policy makers should monitor revision rates and consider changes to the CJR model to ensure beneficiary access to valuable technology.