Demographic, Comorbidity, and Episode of Care Trends in Primary Hip Arthroplasty: 2008 to 2018

2021 ◽  
Author(s):  
Ahmed Siddiqi ◽  
Jared A. Warren ◽  
Wael K. Barsoum ◽  
Carlos A. Higuera ◽  
Michael A. Mont ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Improvement Program ◽  
Level Of Evidence ◽  
Patient Demographics ◽  
Lengths Of Stay ◽  
Episode Of Care ◽  
Episodes Of Care ◽  
Patient Optimization

Abstract Background While previous studies have provided insight into time-trends in age and comorbidities of total hip arthroplasty (THA) patients, there is limited recent literature from within the past decade. The implication of these findings is relevant due to the projected THA volume increase and continued emphasis on healthcare system cost-containment policies. Therefore, the purpose of this study was to identify trends in THA patient demographics, comorbidities, and episode of care from 2008 to 2018. Methods The National Surgical Quality Improvement Program (NSQIP) was queried to identify patient demographics, comorbidities, and episodes of care outcomes in patients undergoing primary THA from 2008 to 2018 (n = 216,524). Trends were analyzed using analysis of variances for continuous variables, while categorical variables were analyzed using chi-squared or Monte Carlo tests, where applicable. Results From 2008 to 2018, there were no clinically significant differences in age and body mass index (BMI) in patients with BMI over 40 kg/m2. However, modifiable comorbidities including patients with hypertension (60.2% in 2008, 54.3 in 2018%, p < 0.001) and anemia (19% in 2008, 11.2%, in 2016, p < 0.001) improved. Functional status and the overall morbidity probability have improved with a decrease in hospital lengths of stay (4.0 ± 2.8 days in 2008, 2.1 ± 2.2 days in 2018, p < 0.001), 30-day readmissions (4.2% in 2009, 3.3% in 2018, p < 0.001), and significant increase in home-discharges (70.1% in 2008, 87.3% in 2018, p < 0.001). Conclusion Patient overall health status improved from 2008 to 2018. While conjectural, our findings may be a reflection of a global shift toward value-based comprehensive care centering on patient optimization prior to arthroplasty, quality-of-care, and curtailing costs by mitigating perioperative adverse events.This study's level of evidence is III.

scholarly journals Clinical and functional outcomes of tarsal coalition resection to correct rigid flat foot

2021 ◽  
Vol 15 (2) ◽  
pp. 115-119
Author(s):  
Rodrigo Guimarães Huyer ◽  
Mário Sérgio Paulillo Cillo ◽  
Carlos Daniel Cândido Castro Filho ◽  
Hallan Douglas Bertelli ◽  
Marcelo Morelli Girondo ◽  
...  
Keyword(s):  
Case Series ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Tarsal Coalition ◽  
Retrospective Case ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Flat Foot ◽  
Flat Feet ◽  
The Mean

Objective: This study used the AOFAS score to assess the clinical functional results of patients who underwent tarsal coalition resection. Methods: This was a retrospective case series of patients who underwent tarsal coalition resection to correct rigid flat foot. Clinical and functional assessment was performed with the AOFAS score before and 6 months after surgical treatment. Descriptive analysis was performed for 7 patients (11 operated feet) using measurements of position and dispersion (mean, standard deviation, minimum, median and maximum value) for continuous variables and frequency tables (absolute and relative) for categorical variables. Results: The mean patient age was 10 years, 7 months, and the majority (71.43%) were male. The most affected joint was the calcaneonavicular. The right side was affected in 54.55% of the cases. The most frequent type of coalition was osseous (81.82% of the cases). The mean pre- and postoperative AOFAS scores were 32.7 and 70.2 points, respectively, which was a significant increase. Conclusion: The increased scores after coalition resection was considered the main change between the two assessments. Thus, it can be concluded that in rigid flat feet without severe hind- or forefoot deformities for which conservative treatment failed, bar resection should be the surgical procedure of choice. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Incidence of Venous Thromboembolism in Orthopaedic Foot and Ankle Surgeries

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0010
Author(s):  
Ashish Shah ◽  
Samuel Huntley ◽  
Harshadkumar Patel ◽  
Eildar Abyar ◽  
Eva Lehtonen ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Foot And Ankle ◽  
Improvement Program ◽  
Female Sex ◽  
Increased Risk ◽  
Ankle Surgery

Category: Other Introduction/Purpose: Venous thromboembolism (VTE) is a rare but potentially lethal complication following orthopaedic foot and ankle surgery. Surgeons continue to debate the types of patients and procedures in which it is appropriate to use chemical thromboprophylaxis. A recent meta-analysis concluded that patients at high risk for VTE after foot and ankle surgery should receive prophylaxis, but there remains a paucity of data to elucidate which demographic or comorbidity variables are most strongly associated with development of VTE. The incidence of VTE after orthopaedic foot and ankle surgery stratified by specific procedure has yet to be examined. The purpose of this study is to report the incidence of and identify risk factors for VTE in a large sample of patients receiving orthopaedic foot and ankle surgery. Methods: In this study, we retrospectively analyzed prospectively-collected data from the National Surgical Quality Improvement Program (NSQIP) 2006 to 2015 data files. The incidence of VTE was calculated for 30 specific orthopaedic foot and ankle surgeries and for four broad types of foot and ankle surgery. A total of 23,212 patients were identified and grouped by current procedures terminology (CPT) codes. Demographic, comorbidity, and complication variables were analyzed to determine associations with development of VTE. Pearson’s chi-squared test was used to compare categorical variables and Student t test was used to compare continuous variables. P-values of p<0.05 were considered statistically significant. Multivariable modelling was not possible due to the very low number of VTE cases relative to non-VTE cases. Results: The mean age at the time of surgery was 52.7±17.8 years. VTE events were documented 142 times in our sample, yielding an overall sample VTE incidence of 0.6%. The types of procedures with the highest frequency of VTE were ankle fractures (105/15,302 cases, 0.7%), foot pathologies (28/5,466, 0.6%), and arthroscopy (2/398, 0.5%). Female sex, increasing age, obesity level, inpatient status, and non-elective surgery were all significantly associated with VTE events. Postoperative pneumonia was significantly associated with VTE development. Patients who developed a VTE stayed at the hospital after surgery significantly longer than patients without VTE (6.2 vs. 3.1 days). Patients who developed VTE also had significantly higher estimated probability of morbidity (8.0% vs. 6.0%) and mortality (2.0% vs. 1.0%) when compared to patients without VTE. Conclusion: The present study confirms that VTE events after foot and ankle procedures are rare. The data presented suggest that female sex, increasing age, higher BMI, inpatient status, and non-elective procedures are associated with increased risk for VTE after orthopaedic foot and ankle surgery. Prospective, randomized, controlled trials are necessary to definitively determine the efficacy of chemoprophylaxis and to develop evidence-based clinical practice guidelines to minimize VTE after foot and ankle procedures.

Does Incidental Appendectomy Increase the Risk of Complications after Abdominal Procedures?

2016 ◽  
Vol 82 (10) ◽  
pp. 885-889 ◽  
Author(s):  
Mohammed Al-Temimi ◽  
Charles Trujillo ◽  
John Agapian ◽  
Hanna Park ◽  
Ahmad Dehal ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Multivariate Logistic Regression Analysis ◽  
Patient Characteristics ◽  
Categorical Variables ◽  
Wound Complications ◽  
Continuous Variables ◽  
Improvement Program ◽  
Increased Risk ◽  
Chi Squared ◽  
Incidental Appendectomy

Incidental appendectomy (IA) could potentially increase the risk of morbidity after abdominal procedures; however, such effect is not clearly established. The aim of our study is to test the association of IA with morbidity after abdominal procedures. We identified 743 (0.37%) IA among 199,233 abdominal procedures in the National Surgical Quality Improvement Program database (2005–2009). Cases with and without IA were matched on the index current procedural terminology code. Patient characteristics were compared using chi-squared test for categorical variables and Student t test for continuous variables. Multivariate logistic regression analysis was performed. Emergency and open surgeries were associated with performing IA. Multivariate analysis showed no association of IA with mortality [odds ratio (OR) = 0.51, 95% confidence interval (CI) = 0.26–1.02], overall morbidity (OR = 1.16, 95% CI = 0.92–1.47), or major morbidity (OR = 1.20, 95% CI = 0.99–1.48). However, IA increased overall morbidity among patients undergoing elective surgery (OR = 1.31,95% CI = 1.03–1.68) or those ≥30 years old (OR = 1.23, 95% CI = 1.00–1.51). IA was also associated with higher wound complications (OR = 1.46,95% CI = 1.05–2.03). In conclusion, IA is an uncommonly performed procedure that is associated with increased risk of postoperative wound complications and increased risk of overall morbidity in a selected patient population.

Surgical Duration Impacts Venous Thromboembolism Risk in Microsurgical Breast Reconstruction

2017 ◽  
Vol 34 (01) ◽  
pp. 047-058 ◽  
Author(s):  
Cecil Qiu ◽  
Sumanas Jordan ◽  
Robert Dorfman ◽  
Michael Vu ◽  
Mohammed Alghoul ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Breast Reconstruction ◽  
Free Flaps ◽  
Improvement Program ◽  
Level Of Evidence ◽  
Adjusted Risk ◽  
Patient Demographics ◽  
Operative Duration ◽  
Surgical Duration ◽  
The Relationship

Background Increased surgical duration can impact patient outcomes and operative efficiency metrics. In particular, there are studies suggesting that increased surgical duration can increase the risk of venous thromboembolism (VTE). One of the longer duration plastic surgery procedures commonly performed is microsurgical breast reconstruction. With the widening indications for multiple and “stacked” free flaps to reconstruct breasts, we endeavored to assess (1) the relationship between duration of microsurgical breast reconstruction and VTE; and (2) determine if a threshold operative time exists that connotes VTE higher risk. Methods Patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) between 2005 and 2014 who underwent microsurgical breast reconstruction were identified by Current Procedural Terminology code. Three models of multivariate logistic regression were used to characterize the adjusted risk for VTE by operative duration, bilaterality, the length of stay, and patient demographics. Results A total of 4,782 patients who underwent microsurgical breast reconstruction were identified. Overall VTE incidence was 1.13%. The mean operative duration was 8:31 hours:minutes (standard deviation: 2:59). Operative duration was statistically associated with VTE in continuous, quintile, and dichotomized risk models. Beyond an operative duration of 11 hours, adjusted VTE risk increases fourfold corresponding to a number needed to harm of 45.8. Conclusions Increasing surgical duration heightens the risk of VTE in microsurgical breast reconstruction. Increasing body mass index and age enhances this VTE risk. Moreover, limiting surgical duration to 11 hours or less can decrease VTE risk by fourfold vis-à-vis baseline. Level of Evidence Risk, II.

scholarly journals Safety and Outcomes of Inpatient Compared with Outpatient Procedures for Elective Orthopaedic Foot and Ankle Surgery

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0042
Author(s):  
Ashish Shah ◽  
Samuel Huntley ◽  
Harshadkumar Patel ◽  
Sameer Naranje ◽  
Sung Lee ◽  
...  
Keyword(s):  
Ankle Fractures ◽  
National Database ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Foot And Ankle ◽  
Improvement Program ◽  
Outpatient Procedures ◽  
Ankle Surgery ◽  
Transmetatarsal Amputation ◽  
Tract Infections

Category: Ankle Introduction/Purpose: With increasing implementation of the bundled payment model and meteoric rise in healthcare prices over the past decade, efforts to minimize unnecessary costs are highly warranted. One potential method to do this is by performing foot and ankle surgery on patients either in an appropriate inpatient or outpatient setting. There is evidence suggesting that outpatient orthopaedic foot and ankle surgery for ankle fractures leads to lower risk of 30-day medical morbidities, reoperation, and admissions as compared to inpatient surgeries. The purpose of this study is to compare the inpatient versus outpatient outcomes of patients undergoing elective orthopaedic foot and ankle surgery using a large national database. Methods: Data from the National Surgical Quality Improvement Program (NSQIP) years 2005-2015 were used in this study. There were 216 CPT codes specific to orthopaedic foot and ankle surgery queried for inclusion in the analysis, 36 of which were identified in the database. CPT codes representing ORIF of ankle fractures were excluded. These codes were manually reviewed by a licensed orthopaedic foot and ankle surgeon to confirm their elective nature, reducing the number of codes to 30. Demographic, comorbidity, and outcome variables were calculated and stratified by inpatient versus outpatient status. Significant differences in these variables were evaluated using ANOVA for continuous variables and Pearson’s Chi-Square for categorical variables. There was a total of 7,672 cases identified. Results: The most common elective inpatient procedures were transmetatarsal amputation (57.9%), total ankle arthroplasty (13.0%), and midtarsal amputation (5.2%). The most common elective outpatient procedures were collateral ligamentous repair (15.8%), transmetatarsal amputation (10.7%), and extensor tendon repair (8.7%). As compared to patients receiving outpatient treatment, patients who received inpatient treatment for elective foot and ankle surgeries were significantly older, male, had lower BMI, and were more likely to smoke. Inpatients were also more likely to receive general anesthesia, have shorter operative times, and have functional limitations (p<0.05). Inpatients were more likely to suffer from various complications, including surgical site infection, pneumonia, unplanned intubation, renal insufficiency, acute renal failure, urinary tract infections, myocardial infarction, cardiac arrest, stroke, transfusions, sepsis, and reoperation (p<0.05). Conclusion: Our results show that outpatient procedures for elective foot and ankle surgery were significantly safer than inpatient procedures in regard to complication profiles. However, the inpatients who received surgery were significantly older than the outpatients, which may explain the described findings. Additional advanced regression modeling is currently underway to examine the multivariable associations between inpatient status and total hospital costs.

scholarly journals Postoperative infection in foot & ankle surgery

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0042
Author(s):  
Ashish Shah ◽  
Samuel Huntley ◽  
Eildar Abyar ◽  
Eva Lehtonen ◽  
Sameer Naranje ◽  
...  
Keyword(s):  
Surgical Site Infections ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Foot And Ankle ◽  
Improvement Program ◽  
Chi Square ◽  
Surgical Incision ◽  
Prosthetic Implants ◽  
Ankle Surgery ◽  
Orthopaedic Literature

Category: Other Introduction/Purpose: Surgical site infections (SSI) are infections of the incision site, organ, or space at or near the surgical incision within 30 days of the procedure or within 90 days for prosthetic implants. Being the most common nosocomial infection, SSI’s are a burden to the healthcare system as they increase costs, duration of stay, antimicrobial resistance, morbidity, and mortality. While there is limited evidence in the orthopaedic literature suggesting that the incidence of SSI increases during the summer months, this association has not been examined in the setting of foot and ankle surgery. The purpose of this study was to determine whether seasonal variation plays a role in developing SSI’s after orthopaedic foot and ankle surgery. Methods: Data from the National Surgical Quality Improvement Program (NSQIP) years 2011-2015 were used in this study. The pooled and individual incidences of superficial incisional SSI, deep SSI, and organ space SSI were calculated and stratified by quarter of admission. The quarters of admission represent the various seasons (1=winter, 2=spring, 3=summer, 4=fall). Differences in the incidence of SSI as well as various demographic, comorbidity, and complication variables were evaluated using ANOVA for continuous variables and Pearson’s Chi-Square for categorical variables. Results: A total of 17,939 patients were identified. After pooling the superficial, deep, and organ space infections, the overall SSI rate was highest in the summer months (July-September, 3rd quarter) at 2.68% as compared to 2.20%, 2.33%, and 2.14% in the other respective quarters (p=0.338). There was a total of 218 cases of superficial incisional SSI. The summer months had the highest incidence of superficial SSI at 1.38% compared to 1.14%, 1.13%, and 1.21% for 1st, 2nd, and 4th quarters, respectively (p=0.677). There were 145 cases of deep incisional SSI. The third quarter again had the highest rate at 1.02% compared to 0.72%, 0.93%, and 0.60% for 1st, 2nd, and 4th quarter respectively (p=0.105). Conclusion: Our results show that superficial incisional SSI, deep incisional SSI, and open wound infections have increased likelihood during the summer months in the setting of orthopaedic foot and ankle surgery. Some studies have associated the increased temperature and humidity during the summer months with increased rates of infections and our results show similar trends. Additional evidence with larger sample sizes is needed to determine which specific procedures are at highest risk of infection during the summer months.

The Effects of Rheumatoid Arthritis on In-Hospital Lengths of Stay, Complications, and Costs following Primary Total Hip Arthroplasty: A Matched-Control Study

2020 ◽  
Vol 4 (03) ◽  
pp. 110-116
Author(s):  
Rushabh M. Vakharia ◽  
Chukuweike Gwam ◽  
T. David Luo ◽  
Angelo Mannino ◽  
Afshin A. Anoushiravani ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
P Value ◽  
Administrative Claims ◽  
Total Hip ◽  
Lengths Of Stay ◽  
Episode Of Care ◽  
Relationship Of ◽  
Primary Total Hip Arthroplasty

AbstractStudies investigating the relationship of rheumatoid arthritis (RA) in patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to analyze whether RA patients undergoing primary THA have higher rates of: (1) in-hospital lengths of stay (LOS), (2) medical complications, (3) implant-related complications, and (4) costs of care. A query using an administrative claims database was performed identifying patients who underwent primary THA with RA, whereas patients without RA served as controls. Study group patients were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 518,927 patients with (n = 86,507) and without (n = 432,420) RA undergoing primary THA. A p-value of less than 0.002 was considered statistically significant. Patients with RA were found to have significantly longer in-hospital LOS (4 vs. 3 days, p < 0.0001). Additionally, RA patients had significantly higher incidence and odds (odds ratio [OR]) of medical (6.39 vs. 1.18%; OR: 5.71, p < 0.0001) and implant-related complications (7.45 vs. 3.35%; OR: 2.32, p < 0.0001) compared with patients without RA. Furthermore, RA patients were found to have significantly higher day of surgery ($12,422.19 vs. $12,103.08, p < 0.0001) and total global 90-day episode of care costs ($16,560.40 vs. $15,167.67, p < 0.0001). This study of 518,927 patients demonstrates patients with RA undergoing primary THA have significantly longer in-hospital LOS, in addition to higher rates of complications and costs. The study is informative as orthopaedists can adequately counsel and educate RA patients of the potential complications which may occur following their procedure.

Not all hip arthroplasties are created equal

2019 ◽  
Vol 101-B (6_Supple_B) ◽  
pp. 84-90 ◽  
Author(s):  
R. S. Charette ◽  
M. Sloan ◽  
G-C. Lee
Keyword(s):  
Operative Time ◽  
Categorical Variables ◽  
Complication Rates ◽  
Continuous Variables ◽  
Improvement Program ◽  
Major Morbidity ◽  
Fracture Care ◽  
Displaced Femoral Neck Fractures ◽  
Chi Squared ◽  
Student’S T

Aims Total hip arthroplasty (THA) is gaining popularity as a treatment for displaced femoral neck fractures (FNFs), especially in physiologically younger patients. While THA for osteoarthritis (OA) has demonstrated low complication rates and increased quality of life, results of THA for acute FNF are not as clear. Currently, a THA performed for FNF is included in an institutional arthroplasty bundle without adequate risk adjustment, potentially placing centres participating in fracture care at financial disadvantage. The purpose of this study is to report on perioperative complication rates after THA for FNF compared with elective THA performed for OA of the hip. Patients and Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database between 2008 and 2016 was queried. Patients were identified using the THA Current Procedural Terminology (CPT) code and divided into groups by diagnosis: OA in one and FNF in another. Univariate statistics were performed. Continuous variables were compared between groups using Student’s t-test, and the chi-squared test was used to compare categorical variables. Multivariate and propensity-matched logistic regression analyses were performed to control for risk factors of interest. Results Analyses included 139 635 patients undergoing THA. OA was the indication in 135 013 cases and FNF in 4622 cases. After propensity matching, mortality within 30 days (1.8% vs 0.3%; p < 0.001) and major morbidity (24.2% vs 19%; p < 0.001) were significantly higher among FNF patients. Re-operation (3.7% vs 2.7%; p = 0.014) and re-admission (7.3% vs 5.5%; p = 0.002) were significantly higher among FNF patients. Hip fracture patients had significantly longer operative time and length of stay (LOS), and were significantly less likely to be discharged to their home. Multivariate analyses gave similar results. Conclusion This large database study showed a higher risk of postoperative complications including mortality, major morbidity, re-operation, re-admission, prolonged operative time, increased LOS, and decreased likelihood of discharge home in patients undergoing THA for FNF compared with OA. While THA is a good option for FNF patients, there are increased costs and financial risks to centres with a joint arthroplasty bundle programme participating in fracture care. Cite this article: Bone Joint J 2019;101-B(6 Supple B):84–90.

scholarly journals Emergency room closed reductionversus in situsplinting in the treatment of paediatric supracondylar humerus fractures

2019 ◽  
Vol 13 (3) ◽  
pp. 334-339 ◽  
Author(s):  
S. M. Sylvia ◽  
K. J. Maguire ◽  
D. A. Molho ◽  
B. J. Levens ◽  
M. E. Jr. Stone ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Hospital Length Of Stay ◽  
Categorical Variables ◽  
Type Ii ◽  
Continuous Variables ◽  
Level Of Evidence ◽  
Supracondylar Humerus Fractures ◽  
Significant Difference ◽  
Humerus Fractures

PurposeDisplaced supracondylar humerus fractures are treated with open or closed reduction and percutaneous pinning. In 2012, our management of patients with a displaced fracture changed from closed reduction in the emergency department (ED) to in situ splinting prior to closed reduction and pinning in the operating room (OR). The purpose of this study was to investigate if outcomes or complications differ between these two management methods.MethodsPatients less than ten years old with a Gartland type II or III supracondylar humerus fracture between 2008 and 2016 were included. Cases of polytrauma were excluded. Radiographic outcomes were assessed at follow-up. The Fisher’s exact test was used for categorical variables and the Wilcoxon rank sums tests for continuous variables.ResultsIn all, 157 patients were included, 89 with reduction in the ED and 68 without. There was no significant difference between the groups related to demographic factors or fracture characteristics. Patients managed without reduction in the ED had a lower average delay from ED to OR compared with those treated with reduction (16 hours versus 22 hours, p < 0.005) and a shorter hospital length of stay (34 hours versus 40 hours, p < 0.005).ConclusionNo difference in complications or outcomes was found between patients with Type II or III supracondylar fractures treated initially with or without closed reduction in the ED. Patients treated without ED reduction were taken to the OR sooner and remained in the hospital for a shorter period of time. Splinting in situ reduces anaesthesia exposure without increasing postoperative complications or suboptimal outcomes.Level of EvidenceLevel III, retrospective comparative study

scholarly journals Patient-Reported Outcomes After a Modified Albee Procedure

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110281
Author(s):  
Patrick J. Bevan ◽  
Lutul D. Farrow ◽  
Jared Warren ◽  
Perry O. Hooper ◽  
Elisabeth Kroneberger ◽  
...  
Keyword(s):  
Trochlear Dysplasia ◽  
Case Series ◽  
Patellofemoral Instability ◽  
Lateral Wall ◽  
International Knee Documentation Committee ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Level Of Evidence ◽  
Patient Reported

Background: Trochlear dysplasia (TD) is a recognized condition that can become a risk factor for patellofemoral instability. A modified Albee osteotomy procedure using a trapezoidal-shaped wedge to elevate the lateral wall of the trochlea can be used with the goal of preventing further dislocation. However, outcomes studies are lacking, and scores on patient-reported outcome measures (PROMs) are largely unknown. Purpose/Hypothesis: The purpose of this study was to identify PROM scores for the Kujala Anterior Knee Pain Scale (AKPS), International Knee Documentation Committee (IKDC), Activity Rating System (ARS), and 100-point pain visual analog scale (VAS) for patients having undergone the modified Albee osteotomy. The hypothesis was that patients will have acceptable pain and function at mid- to long-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: From 1999 to 2017, a total of 46 consecutive patients (49 knees) underwent a modified Albee procedure by a single surgeon at a single health care system. These 46 patients were contacted and asked to complete the AKPS, IKDC, ARS, and pain VAS. Additional demographic information was obtained via chart review. Frequencies and rates for categorical variables and means and standard deviations for continuous variables of the demographics and PROM scores were calculated. Results: PROM scores were obtained in 28 (30 knees; 61%) of the 46 patients. At minimum follow-up of 82 months, the mean scores were 78.5 ± 18.2 for AKPS, 61.2 ± 11.4 for IKDC, 5.2 ± 5.3 for ARS, and 24.4 ± 28.7 for VAS pain. Notably, only 1 of the 28 patients reported a patellofemoral dislocation since surgery, and this was an isolated incident without further instability. Conclusion: A modified Albee trochlear osteotomy can be a successful adjunctive procedure to prevent recurrent patellar dislocations in patients with mild TD. However, owing to the loss of one-third of patient follow-up scores and the absence of baseline function scores in this study, the procedure deserves further investigation as a way to address a particularly difficult dilemma for a select subset of patients with patellofemoral instability.

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