Surgical Trends in Articular Cartilage Injuries of the Knee, Analysis of the Truven Health MarketScan Commercial Claims Database from 2005-2014

Bonazza, Nicholas A.; Smuin, Dallas M.; Joshi, Rajat; Ba, Djibril M.; Liu, Guodong; Leslie, Douglas L.; Dhawan, Aman

doi:10.1016/j.asmr.2019.08.002

Cited by 13 publications

(17 citation statements)

References 32 publications

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“…32,33 Meniscal surgery, either through transplant or repair, has significantly increased over the past decade, even with cartilage restoration procedures. [34][35][36][37] Addressing the meniscus allows repaired cartilage to have the greatest likelihood of successful implantation and preservation of joint integrity. 38 Lee et al 39 performed meniscal allograft transplant (MAT) alone on 222 patients and found this treatment to be effective in managing patients with advanced cartilage disease.…”

Section: Discussionmentioning

confidence: 99%

“…32 , 33 Meniscal surgery, either through transplant or repair, has significantly increased over the past decade, even with cartilage restoration procedures. 34 , 35 , 36 , 37 Addressing the meniscus allows repaired cartilage to have the greatest likelihood of successful implantation and preservation of joint integrity. 38 Lee et al.…”

Section: Discussionmentioning

confidence: 99%

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Cartilage Restoration for Tibiofemoral Bipolar Lesions Results in Promising Failure Rates: A Systematic Review

Gowd

Weimer

Rider

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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The purpose of the present study is to systematically review the available literature for management of bipolar lesions within the tibiofemoral joint and determine whether tibiofemoral cartilage restoration is an effective treatment modality. Methods: PubMed and MEDLINE databases were queried between 2000 and 2020 using the following keywords: "osteochondral" and "knee" and "microfracture," "autologous chondrocyte implantation (ACI)," or "transplantation." Articles were reviewed for the presence of a bipolar or "kissing" tibiofemoral lesion and reported lesion size, concomitant procedures, failure rates, and time to failure. Results: After screening 1,295 articles, there were 4 articles available for analysis and a total of 152 knees involving the management of bipolar tibiofemoral lesions. Age ranged from 14 to 60 years, and mean follow-up was between 12 and 240 months. There was 1 retrospective cohort study (36 knees) and 3 case series (mean, 38.7 AE 17.5 knees). There were 58 knees treated with bipolar osteochondral allograft (OCA) transplantation, 58 knees treated with bipolar ACI, 20 knees treated with femoral OCA and tibial debridement, and 16 knees treated with femoral OCA and tibial microfracture. There were 37 failures (24.3%): 16 patients (10.5%) were converted to unicompartmental or total knee arthroplasty, 4 restorative procedures (2.6%) were revised, and 8 patients (1.6%) had unsatisfactory outcomes only. The remaining 15 failures (9.9%) had an unspecified combination of objective failure. The mean rate of failure ranged between 0% and 44.1% (I 2 ¼ 83.2%). The mean time to failure ranged between 2.7 and 4.1 years (I 2 ¼ 79.1%). Conclusions: Cartilage restoration, through both ACI and OCA, had failure rates between 0% and 44% in patients with bipolar lesions of the tibiofemoral compartment. Although a higher level of evidence is required to prove efficacy, the current study demonstrates midterm survivorship rates between 55% and 100%, which may delay the need for secondary arthroplasty. Level of Evidence: Level IV, systematic review of Level IV studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cartilage Restoration for Tibiofemoral Bipolar Lesions Results in Promising Failure Rates: A Systematic Review

Gowd

Weimer

Rider

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

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“…This database has been used for various clinical and epidemiological studies, specifically in the field of orthopedics. 14 , 15 …”

Section: Methodsmentioning

confidence: 99%

“…This database has been used for various clinical and epidemiological studies, specifically in the field of orthopedics. 14,15 The database was queried for patients who underwent either ORIF or IMN of an intertrochanteric, peritrochanteric or subtrochanteric femur fracture using the Current Procedural Terminology (CPT) codes 27244 and 27245 (Table 1). Patients were excluded based on several criteria including (1) 6-month noncontinuous preoperative enrollment (ie, patients who were not continuously enrolled in the database for the 6-month period preceding surgery), (2) 12-month noncontinuous postoperative enrollment, (3) open fracture, and (4) those aged less than 65 years.…”

Section: Data Source and Cohort Selectionmentioning

confidence: 99%

Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures

Broggi

Oladeji

Tahmid

et al. 2021

Geriatr Orthop Surg Rehabil

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Introduction: Intertrochanteric hip fractures are a common injury treated by orthopedic surgeons and the incidence rate is rising. Preoperative depression is a known risk factor for postoperative complications in orthopaedic surgery, however its effects on outcomes after geriatric hip fractures is relatively unknown. The purpose of this study was to investigate the relationship between preoperative depression and potential complications following open reduction internal fixation (ORIF) and intramedullary nailing (IMN) of geriatric hip fractures. Methods: In this retrospective study, the Truven Marketscan claims database was used to identify patients over age 65 who underwent ORIF or IMN for a hip fracture from January 2009 to December 2019. Patient characteristics, such as medical comorbidities, were collected and from that 2 cohorts were established (one with and one without depression). Chi-squared and multivariate analysis was performed to investigate the association between preoperative depression and common postoperative complications following intertrochanteric hip fracture surgery. Results: In total, 78,435 patients were identified for analysis. In those patients with preoperative depression, the complications associated with the greatest increased odds after undergoing ORIF were surgical site infections (OR 1.32; CI 1.23-1.44), ED visit for pain (OR 1.27; CI 1.16-1.39), wound complications (OR 1.26; CI 1.14-1.35), and non-union (OR 1.25; CI 1.17-1.33). In the patients with preoperative depression undergoing IMN, the complications associated with the greatest increased odds after were surgical site infections (OR 1.37; CI 1.31- 1.45), ED visit for pain (OR 1.31; CI 1.19-1.44), wound complications (OR 1.23; CI 1.10-1.39), and pneumonia (OR 1.22; CI 1.10-1.31). Conclusions: Preoperative depression in patients undergoing hip fracture surgery is associated with increased complications. Recognizing a patients’ preoperative depression diagnosis can allow physicians to adapt perioperative and postoperative surveillance protocols for these higher risk patients. Further studies are warranted to investigate the degree to which depression is a modifiable risk factor

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“…This specific database has been utilized for various clinical and epidemiological studies, specifically within the field of orthopedics. 13,14 We searched the database for patients who underwent surgical fixation of a pelvic ring and/or acetabular fracture by using the most used Current Procedural Terminology (CPT) codes (Table 1). Exclusion criteria regarding patient selection consisted of six months of non-continuous pre-operative enrollment (ie.…”

Section: Data Source and Cohort Selectionmentioning

confidence: 99%

Higher altitude leads to increased risk of venous thromboembolism after acetabular and pelvic ring injury

Broggi

Yoon

Allen

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Introduction: There is a high post-operative incidence of venous thromboembolisms (VTEs), specifically deep vein thrombosis (DVT) and pulmonary embolism (PE), in pelvic ring and acetabular fractures, and identification of risk factors for VTEs is crucial to decrease this highly morbid complication. High altitudes have a known physiological effect on the body that may predispose patients to developing VTEs in the postoperative period. The purpose of this study was to investigate the relationship between pelvic ring and acetabular fractures occurring at high altitudes and the development of postoperative VTEs. Methods: In this retrospective study, the Truven MarketScan claims database was used to identify patients who underwent surgical fixation of a pelvic ring and/or acetabular fracture from January 2009 to December 2018 using Current Procedural Terminology (CPT) codes. Patient characteristics, including medical comorbidities, were collected. The zip codes of where the surgeries took place were used to determine recovery altitude and patients were separated into either the high altitude (>4000 feet) or low altitude (<100 feet) cohorts. Chi-squared and multivariate analyses were performed to investigate the association between altitude and the development of VTE postoperatively. Results: In total, 68,923 patients were included for analysis. At 30-days postoperatively, a higher altitude was associated with increased odds of developing a PE (OR 1.47, p ¼ 0.019). At 90-days postoperatively, a higher altitude was associated with increased odds of DVT (OR 1.24, p ¼ 0.029) and PE (OR 1.63, p < 0.001). Conclusion: Surgical fixation of pelvic ring and acetabular fractures performed at a higher altitude (>4,000feet) are associated with increased odds of developing a PE in the first 30 days as well as developing a DVT or PE at 90 days postoperatively. Future prospective studies are needed to further elucidate the causality of altitude on the development of postoperative VTEs.

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Surgical Trends in Articular Cartilage Injuries of the Knee, Analysis of the Truven Health MarketScan Commercial Claims Database from 2005-2014

Cited by 13 publications

References 32 publications

Cartilage Restoration for Tibiofemoral Bipolar Lesions Results in Promising Failure Rates: A Systematic Review

Cartilage Restoration for Tibiofemoral Bipolar Lesions Results in Promising Failure Rates: A Systematic Review

Depressive Disorders Lead to Increased Complications After Geriatric Hip Fractures

Higher altitude leads to increased risk of venous thromboembolism after acetabular and pelvic ring injury

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