Patients Who Have Cannabis Use Disorder Have Higher Rates of Venous Thromboemboli, Readmission Rates, and Costs Following Primary Total Knee Arthroplasty

2020 ◽  
Vol 35 (4) ◽  
pp. 997-1002 ◽  
Author(s):  
Rushabh M. Vakharia ◽  
Nipun Sodhi ◽  
Hiba K. Anis ◽  
Joseph O. Ehiorobo ◽  
Michael A. Mont ◽  
...  
Author(s):  
Kevin B. Marchand ◽  
Rushabh Vakharia ◽  
Nipun Sodhi ◽  
Hiba Anis ◽  
Hytham S. Salem ◽  
...  

AbstractLarge-scale studies evaluating the effects of Parkinson's disease (PD) on primary total knee arthroplasty (TKA) are limited. The purpose of this study was to determine if PD patients undergoing primary TKA have increased: (1) medical complications; (2) implant-related complications; (3) readmission rates; and (4) costs. A query was performed using an administrative claims database. The study group consisted of all patients undergoing primary TKA who had a history of PD. Matched non-PD patients undergoing primary TKA served as a control group. The query yielded 72,326 patients (PD = 18,082; matching cohort = 54,244). Pearson's chi-square tests, logistic regression analyses, and Welch's t-tests were used to test for significance between the cohorts. Primary TKA patients who had PD were found to have greater incidences and odds of medical complications (4.21 vs. 1.24%; odds ratio [OR]: 3.50, 95% confidence interval [CI]: 3.15–3.89, p < 0.0001) and implant-related complications (5.09 vs. 3.15%; OR: 1.64, 95% CI: 1.51–1.79, p < 0.0001) compared with the matching cohort. Additionally, the rates and odds of 90-day readmission were higher (16.29 vs. 12.66%; OR:1.34, p < 0.0001) and episodes of care costs were significantly greater ($17,105.43 vs. $15,252.34, p < 0.0001) in patients who had PD. Results demonstrate that PD patients undergoing primary TKA had higher incidences of medical and implant-related complications. They also had increased 90-day readmission rates and costs compared with controls. The findings of this study should be used in risk stratification and should inform physician–patient discussion but should not be arbitrarily used to deny access to care.


Author(s):  
Filippo Migliorini ◽  
Paolo Aretini ◽  
Arne Driessen ◽  
Yasser El Mansy ◽  
Valentin Quack ◽  
...  

A correction to this paper has been published: https://doi.org/10.1007/s00590-021-03026-9


2009 ◽  
Vol 24 (4) ◽  
pp. 620-624 ◽  
Author(s):  
David F. Dalury ◽  
Donald L. Pomeroy ◽  
Ricardo A. Gonzales ◽  
Thomas A. Gruen ◽  
Mary Jo Adams ◽  
...  

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hans Bösebeck ◽  
Anna-Maria Holl ◽  
Peter Ochsner ◽  
Manuel Groth ◽  
Kevin Stippich ◽  
...  

Abstract Background In cemented primary total knee arthroplasty (TKA), aseptic loosening remains a major cause for failure. Cementing techniques and characteristics of a chosen cement play a key role for good fixation and implant survival. A pastry bone cement was developed to facilitate the cement preparation and to rule out most of preparation-associated application errors. The pastry bone cement was compared to a conventional polymethyl methacrylate cement in a TKA setting. Methods Standardized implantations of total knee endoprostheses were performed in bilateral knee cadavers to investigate handling properties, variables of cement application, working time, and temperature development. Mechanical aspects and cementation quality were assessed by pull-out trials and microscopic interface analysis. Results Both cements expressed similar characteristics during preparation and application, only the curing time of the pastry cement was about 3 min longer and the temperature peak was lower. Fractures of the conventional cement specimens differed from the pastry cement specimens in the tibial part, while no differences were found in the femoral part. Penetration depth of the pastry cement was similar (tibia) or deeper (femur) compared to the conventional cement. Conclusions The pastry cement facilitates the feasibility of cemented TKA. The pre-clinical tests indicate that the pastry bone cement fulfills the requirements for bone cement in the field of knee arthroplasty. A clinical trial is needed to further investigate the approach and ensure patient safety.


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