Trends in Lateral Retinacular Release from 2010 to 2017

2021 ◽  
Author(s):  
Hailey P. Huddleston ◽  
Justin Drager ◽  
William M. Cregar ◽  
Justin M. Walsh ◽  
Adam B. Yanke
Keyword(s):  
Patellar Instability ◽  
Lateral Release ◽  
National Database ◽  
Lateral Retinacular Release ◽  
Improvement Program ◽  
Concomitant Procedure ◽  
Icd 10 ◽  
Acs Nsqip Database ◽  
And Gender ◽  
Patellar Stability

AbstractHistorically, lateral retinacular release (LRR) procedures have been utilized in the treatment of a variety of patellofemoral disorders, including lateral patellar instability. However, in the past decade, there has been an increasing awareness of the importance of the lateral stabilizers in patellar stability, as well as the complications of LRR, such as recurrent medial patellar instability. The purpose of this study was to investigate current trends in LRR procedures from 2010 through 2017 using a large national database. The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for arthroscopic LRR procedures (the Current Procedural Terminology [CPT] code, 29873) from 2010 to 2017. The number and incidence of lateral release procedures, both isolated and nonisolated, were analyzed and separated into cohorts for analysis. Age and gender of the LRR cohort was investigated and compared with all other orthopaedic procedures during the same time period in the NSQIP database. In addition, concomitant procedures and associated International Classification of Disease-9th Revision (ICD-9) and ICD-10th Revision (ICD-10) codes were analyzed over time and between LRR groups. From 2010 to 2017, 3,117 arthroscopic LRRs were performed. The incidence for LRR was 481.9 per 100,000 orthopaedic surgeries in 2010 and significantly decreased to 186.9 per 100,000 orthopaedic surgeries in 2017 (p < 0.01). LRR was more commonly performed in females (66%) and 58% of patients were under 44 years of age. In addition, LRR was most commonly performed with a concomitant meniscectomy (36%), synovectomy (19%), or microfracture (13%), and for a diagnosis of pain (22%). The overall incidence of LRR procedures significantly decreased from 2010 to 2017. LRRs were more commonly performed in younger, female patients for a diagnosis of pain with the most common concomitant procedure being meniscectomy, synovectomy, or microfracture.

Congenital Diaphragmatic Hernia: Demographics and 30-day Outcomes in Adults

2020 ◽  
pp. 000313482096006
Author(s):  
Joseph G. Brungardt ◽  
Quinn A. Nix ◽  
Kurt P. Schropp
Keyword(s):  
Postoperative Complications ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Pediatric Population ◽  
Case Series ◽  
National Database ◽  
Improvement Program ◽  
American College Of Surgeons ◽  
Postoperative Diagnosis ◽  
Acs Nsqip Database

Background Congenital diaphragmatic hernia (CDH) is a pathology most often affecting the pediatric population, although adults can also be affected. Few studies exist of adults undergoing repair of this defect. Using a national database, we sought to determine demographics and outcomes of this population. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015-2018) was performed, capturing patients with postoperative diagnosis of CDH, distinct from ventral hernia. Two groups were created based upon surgical approach of open or minimally invasive (MIS) repair. Baseline demographics and outcomes were compared. Results 110 patients undergoing surgical correction of CDH were captured in the database. We found rates of return to the operating room (4.55%), postoperative respiratory failure (5.45%), and reintubation (3.64%) with no difference between groups. There was no mortality and no difference between groups in length of operation, discharge to home, or postoperative complications. Patients undergoing open repair had a longer length of stay than patients in the MIS group (6.47 ± 10.76 days vs. 3.68 ± 3.74 days, P = .0471). Mesh was used in MIS more often than the open group (47.30% vs. 5.56%, P < .0001). Discussion This study describes rates of postoperative complications in patients undergoing repair of CDH, and suggests outcomes those are equivalent between patients receiving open or MIS approaches. Further case series or retrospective studies are needed to further describe this population of patients.

scholarly journals Open versus arthroscopic release for lateral patellar compression syndrome: a randomized-controlled trial

2021 ◽  
Author(s):  
Sherwan A. Hamawandi ◽  
Hazhar I. Amin ◽  
Ameer Kadhim Al-Humairi
Keyword(s):  
Functional Outcome ◽  
Patellar Instability ◽  
Controlled Trial ◽  
Lateral Release ◽  
Open Release ◽  
Arthroscopic Release ◽  
Compression Syndrome ◽  
Significant Difference ◽  
Lateral Patellar Compression Syndrome

Abstract Introduction Lateral patellar compression syndrome is one of the causes of anterior knee pain in young adults and resulted from tight lateral patellar retinaculum. The aim of our study is to compare between open and arthroscopic release of lateral patellar compression syndrome in relation of functional outcome, time of surgical procedure, length of hospital stays, intraoperative and postoperative complications as bleeding, infection, recurrence, and patellar instability with 2 years of follow-up. Materials and methods 80 patients, age (21–49 years), were divided randomly into 2 groups (A and B). Group A (40 patients) were treated with open release. Group B (40 patients) were treated by arthroscopic release. All these patients are diagnosed as lateral patellar compression syndrome depending on clinical features and MRI. All patients were assessed by Lysholm knee scoring scale before surgery and at periods of 2, 6 weeks, 6, 12, and 24 months after surgery. Results There is significant difference in functional outcome, measured by Lysholm knee scoring scale, between preoperative and postoperative assessment periods in both groups (P < 0.001). There is significantly better functional outcome at 2 years of follow-up with arthroscopic release (P = 0.018). There is no recurrence in both groups, but there were 4 patients develop medial patellar instability in the group of open release. Conclusion Both open and arthroscopic lateral release for patients with isolated lateral patellar compression syndrome can be effective surgical procedures, but arthroscopic release can achieve better functional outcome. Trial registration: NCT, NCT04130412. Retrospectively registered on 3rd of June, 2020 at ClinicalTrials.gov.

scholarly journals Adverse drug events identified in hospitalized patients in Brazil by International Classification of Diseases (ICD-10) code listings

2018 ◽  
Vol 34 (12) ◽  
Author(s):  
Ana Cristina Martins ◽  
Fabíola Giordani ◽  
Lusiele Guaraldo ◽  
Gianni Tognoni ◽  
Suely Rozenfeld
Keyword(s):  
Public Health ◽  
Adverse Drug Events ◽  
International Classification Of Diseases ◽  
Hospitalized Patients ◽  
International Classification ◽  
Administrative Databases ◽  
National Database ◽  
Classification Of Diseases ◽  
Icd 10

Studies of adverse drug events (ADEs) are important in order not to jeopardize the positive impact of pharmacotherapy. These events have substantial impact on the population morbidity profiles, and increasing health system operating costs. Administrative databases are an important source of information for public health purposes and for identifying ADEs. In order to contribute to learning about ADE in hospitalized patients, this study examined the potential of applying ICD-10 (10th revision of the International Classification of Diseases) codes to a national database of the public health care system (SIH-SUS). The study comprised retrospective assessment of ADEs in the SIH-SUS administrative database, from 2008 to 2012. For this, a list of ICD-10 codes relating to ADEs was built. This list was built up by examining lists drawn up by other authors identified by bibliographic search in the MEDLINE and LILACS and consultations with experts. In Brazil, 55,604,537 hospital admissions were recorded in the SIH-SUS, between 2008 and 2012, of which 273,440 (0.49%) were related to at least one ADE. The proportions and rates seem to hold constant over the study period. Fourteen out of 20 most frequent ADEs were identified in codes relating to mental disorders. Intoxications figure as the second most frequently recorded group of ADEs in the SIH-SUS, comprising 76,866 hospitalizations. Monitoring of ADEs in administrative databases using ICD-10 codes is feasible, even in countries with information systems under construction, and can be an innovative tool to complement drug surveillance strategies in place in Brazil, as well as in others countries.

Increasing hospital admissions for patellar instability: a national database study from 2004 to 2017

2019 ◽  
Vol 48 (2) ◽  
pp. 215-221
Author(s):  
Matthew J Poorman ◽  
Divya Talwar ◽  
Justin Sanjuan ◽  
Keith D Baldwin ◽  
Nikki Sutliff ◽  
...  
Keyword(s):  
Patellar Instability ◽  
Hospital Admissions ◽  
National Database ◽  
Database Study

scholarly journals Frequency and predictors of complications in neurological surgery: national trends from 2006 to 2011

2014 ◽  
Vol 120 (3) ◽  
pp. 736-745 ◽  
Author(s):  
John D. Rolston ◽  
Seunggu J. Han ◽  
Catherine Y. Lau ◽  
Mitchel S. Berger ◽  
Andrew T. Parsa
Keyword(s):  
Univariate Analysis ◽  
Binary Logistic Regression ◽  
National Database ◽  
Improvement Program ◽  
Chi Square ◽  
Surgical Specialty ◽  
Starting Point ◽  
Neurosurgical Patients ◽  
Us Government ◽  
Neurological Surgery

Object Surgical complications increase the cost of health care worldwide and directly contribute to patient morbidity and mortality. In an effort to mitigate morbidity and incentivize best practices, stakeholders such as health insurers and the US government are linking reimbursement to patient outcomes. In this study the authors analyzed a national database to determine basic metrics of how comorbidities specifically affect the subspecialty of neurosurgery. Methods Data on 1,777,035 patients for the years 2006–2011 were acquired from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. Neurosurgical cases were extracted by querying the data for which the surgical specialty was listed as “neurological surgery.” Univariate statistics were calculated using the chi-square test, and 95% confidence intervals were determined for the resultant risk ratios. A multivariate model was constructed using significant variables from the univariate analysis (p < 0.05) with binary logistic regression. Results Over 38,000 neurosurgical cases were analyzed, with complications occurring in 14.3%. Cranial cases were 2.6 times more likely to have complications than spine cases, and African Americans and Asians/Pacific Islanders were also at higher risk. The most frequent complications were bleeding requiring transfusion (4.5% of patients) and reoperation within 30 days of the initial operation (4.3% of patients), followed by failure to wean from mechanical ventilation postoperatively (2.5%). Significant predictors of complications included preoperative stroke, sepsis, blood transfusion, and chronic steroid use. Conclusions Understanding the landscape of neurosurgical complications will allow better targeting of the most costly and harmful complications of preventive measures. Data from the ACS NSQIP database provide a starting point for developing paradigms of improved care of neurosurgical patients.

scholarly journals Arthroscopic Lateral Retinacular Ligament Release in Patellofemoral Pain Syndrome

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Teoman Başaran ◽  
Ahmet Ozgur Atay ◽  
Mahmut Nedim Doral ◽  
Pınar Özge Başaran
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Bleeding Time ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Lateral Release ◽  
Lateral Retinacular Release ◽  
Anterior Knee ◽  
Surgery Duration

Objectives: Arthroscopic lateral retinacular release in patellofemoral pain syndrome Comparing the amount of hemorrhage and times of release between electrocautery and a new techniques for arthroscopic lateral release with scissors Methods: 77 patients included in this prospective randomized controlled study. Inclusion Criteria: 1. Over the age of fourteen and have anterior knee pain syndrome 2. Tightness in lateral part of knee 3. Despite receiving conservative treatment for 6 months, patients who have anterior knee pain complaints Exclusion Criteria: 1. Diseases that prolong bleeding time 2. Drugs that prolong bleeding time 3. Abnormal APTT-INR levels 4. Patients underwent anterior cruciate reconstruction surgery 5. Patients underwent microfracture surgery 6. Patients underwent meniscus repair surgery 7. Patients underwent synovectomy -- Due to inflammatory diseases and synovial chondromatosis is excluded from the study. In this study 77 (25M 52W med age 50,14 ± 14,17 ) patients divided into three groups which was similar in age and sex. All patients underwent standard arthroscopic surgery for patellofemoral knee sydrome and meniscal debridement 1. Group 1 (Control) (n:10) LRL was preserved 2. Group 2 (Scissors) (n:33) LRL was released with Scissors 3. Group 3 (Electrocautery) (n:34) LRL was released with Electrocautery Results: There was no difference between the groups in terms of socio-demographic characteristics. All lateral ligaments releases were performed under tourniquet . The release is not considered to be complete unless the patella can be stood on its medial edge without difficulty . In all patients, surgery duration was recorded. To calculate the amount of bleeding the blood in the drainage tube was recorded for 24 hours after surgery. For 67 patients based on clinical examination at surgery and in the immediate postoperative period, all releases were felt to be adequate. For all groups total bleeding at 24 h postoperatively is the statistically same (p:0.850) . In first 8 hours the amount of bleeding is more in scissors group (p:0.002). Lateral release time is longer in electrocautery group (380 seconds) than in scissors group (24 seconds). In release with electrocautery sometimes we used additional techniques scissors and scalpel for enough release. There was no difference between groups in terms of complications such as deep vein thrombosis , hemarthrosis or severe complications. Conclusion: In this study the amount of bleeding was the same in the groups but surgery duration was longer in electrocautery group. Our new technique for intraarticular arthroscopy guided lateral retinacular release uses with scissors which is simple, effective, rapid, and have resulted a few surgical complications such as superficial skin infection which responds oral antibiotics. Electrocautery is difficult and needs experience.

Burden of acute myeloid leukemia (AML) in a U.S. commercially insured population.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18330-e18330 ◽  
Author(s):  
May Hagiwara ◽  
Arati Sharma ◽  
Karen C Chung ◽  
Thomas E. Delea
Keyword(s):  
Economic Burden ◽  
Newly Diagnosed ◽  
Acute Leukemias ◽  
The Us ◽  
Icd 10 ◽  
Health Insurance Claims ◽  
And Gender ◽  
Insured Patients ◽  
Care Costs ◽  
Rule Out

e18330 Background: AML accounts for 25% of acute leukemias in adults worldwide, with an estimated 5-year survival of 26% in the US. Up-to-date information on the clinical and economic burden of AML among US commercially insured patients (pts) is needed to inform reimbursement decisions. Methods: This retrospective study of the burden of AML in a US commercially insured population used the IMS PharMetrics Plus health insurance claims database. Adults with ≥1 claim with a diagnosis (Dx) of AML (ICD-9-CM 205.00, 205.01, or 205.02 or ICD-10-CM C92.00, C92.40, C92.50, C92.01, C92.41, C92.51, C92.02, C92.42, C92.52) during the study period (Jan 2008 through Dec 2015) were identified. To avoid rule-out diagnoses, pts with only 1 outpatient claim (or >1 claim on a single day) with a Dx of AML not in relapse or remission were excluded. Annual incidence and total and AML-related inpatient and outpatient healthcare costs per person year (PY) were calculated by age and gender. For cost analyses, pts with newly diagnosed AML were assessed. To ensure adequate claims history to identify all prevalent cases, prevalence was calculated for the last year of the study period. Results: 26,344 adults with AML were identified during the study period, which covered 228.3 million PY of enrollment. The incidence rate was 4.9 per 100,000 PY. Incidence was greatest in men and pts aged 60+ years. Prevalence was 12.2 per 100,000 persons. Among 11,170 newly diagnosed AML pts, total average costs were $352,138 per PY. 63% of costs were for AML-related care. 70% of AML-related costs were for inpatient care. Costs were greatest for men, pts aged 45-59 years, and during the first 6 months post-diagnosis. Conclusions: Although AML is relatively rare, its economic burden to US commercial insurers is substantial. [Table: see text]

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