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Villa JM, Pannu TS, Ozery M, Jin Y, Piuzzi NS, Patel PD, Higuera CA. Does Time to Aseptic Failure After Primary Total Hip Arthroplasty Affect Clinical and Patient-Reported Outcomes? J Arthroplasty 2024; 39:180-186. [PMID: 37531980 DOI: 10.1016/j.arth.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/12/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Evidence on the effects of time-to-failure from primary total hip arthroplasty (THA) to aseptic first-revision on clinical results and patient-reported outcome measures (PROMs) is scarce. Therefore, we sought to compare demographics, operative times, lengths of stay, discharge dispositions, 90-day readmissions, re-revision rates, mortalities, and PROMs between early and late aseptic THA revisions. METHODS This study is a retrospective review of a prospectively collected institutional database of all elective hip procedures. In total, 572 patients who underwent aseptic revision after primary THA from August 2015 to December 2018 were analyzed. Patients were stratified into either early revision (<3-years; n = 176) or late revision (≥3-years; n = 396) cohorts. RESULTS Significantly more patients were revised earlier for bone-related (ie, periprosthetic fractures) (22.7% versus 8.3%) or other various complications (19.9% versus 5.8%), whereas more late revisions were performed to treat implant-related failures (6.8% versus 37.1%), respectively. Operative time was significantly shorter in early versus late revisions (133 versus 157 minutes). A significantly higher delta-change/improvement from baseline/preoperative to 1-year postoperative was found for hip disability and osteoarthritis outcome score physical function (HOOS-PS), veterans-RAND-12 physical and mental components (VR-12-PCS and MCS, respectively) of early revisions. However, HOOS-PS and HOOS-Pain at 1-year of follow-up were significantly worse in early revisions. CONCLUSION With exception of operative time, time-to-failure had no significant influence on clinical results. Despite greater improvements on PROMs from preoperative to postoperative, patients undergoing early revisions after primary THA perceive significantly higher levels of pain and worse physical functionality at 1-year of follow-up.
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Affiliation(s)
- Jesus M Villa
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
| | - Tejbir S Pannu
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
| | - Matan Ozery
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
| | - Yuxuan Jin
- Department of Orthopaedic Surgery, Cleveland Clinic Main Campus, Cleveland, Ohio
| | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic Main Campus, Cleveland, Ohio
| | - Preetesh D Patel
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
| | - Carlos A Higuera
- Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
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Lapica H, Ozery M, Raju H, Castro G, Rodriguez de la Vega P, Barengo NC. The Associations between Racial Disparities, Health Insurance, and the Use of Amputation as Treatment for Malignant Primary Bone Neoplasms in the US: A Retrospective Analysis from 1998 to 2016. Int J Environ Res Public Health 2022; 19:6289. [PMID: 35627824 PMCID: PMC9140582 DOI: 10.3390/ijerph19106289] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Primary bone neoplasms (PBNs) represent less than 1% of diagnosed cancers each year. Significant treatment disparities exist between racial and ethnic groups. We investigated patients with PBNs to determine an association between race/ethnicity and procedure-type selection. A non-concurrent cohort study was conducted using the SEER database. Patients diagnosed with PBNs between 1998 and 2016 were included (n = 5091). Patients were classified into three racial groups (Black, White and Asian Pacific Islanders) and were assessed by procedure-type received. The outcome was amputation. Race was not associated with increased amputation incidence. Hispanic patients had a 40% increased likelihood of amputation (OR 1.4; 95% CI 1.2-1.6). Insurance status was an independent predictor of procedure selection. Uninsured patients were 70% more likely to receive amputation than insured patients (OR 1.7; 95% CI 1.1-2.8). We recommend provider awareness of patients less likely to seek regular healthcare in the context of PBNs.
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Affiliation(s)
- Hans Lapica
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Matan Ozery
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Harsha Raju
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Pura Rodriguez de la Vega
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
| | - Noël C. Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; (H.L.); (M.O.); (H.R.); (G.C.); (P.R.d.l.V.)
- Department of Health Policy & Management, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
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Vassilakos G, Lei H, Yang Y, Puglise J, Matheny M, Durzynska J, Ozery M, Bennett K, Spradlin R, Bonanno H, Park S, Ahima RS, Barton ER. Deletion of muscle IGF-I transiently impairs growth and progressively disrupts glucose homeostasis in male mice. FASEB J 2018; 33:181-194. [PMID: 29932867 DOI: 10.1096/fj.201800459r] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Insulin-like growth factors (IGFs) are essential for local skeletal muscle growth and organismal physiology, but these actions are entwined with glucose homeostasis through convergence with insulin signaling. The objective of this work was to determine whether the effects of IGF-I on growth and metabolism could be separated. We generated muscle-specific IGF-I-deficient (MID) mice that afford inducible deletion of Igf1 at any age. After Igf1 deletion at birth or in young adult mice, evaluations of muscle physiology and glucose homeostasis were performed up to 16 wk of age. MID mice generated at birth had lower muscle and circulating IGF-I, decreased muscle and body mass, and impaired muscle force production. Eight-wk-old male MID had heightened insulin levels with trends of elevated fasting glucose. This phenotype progressed to impaired glucose handling and increased fat deposition without significant muscle mass loss at 16 wk of age. The same phenotype emerged in 16-wk-old MID mice induced at 12 wk of age, compounded with heightened muscle fatigability and exercise intolerance. We assert that muscle IGF-I independently modulates anabolism and metabolism in an age-dependent manner, thus positioning muscle IGF-I maintenance to be critical for both muscle growth and metabolic homeostasis.-Vassilakos, G., Lei, H., Yang, Y., Puglise, J., Matheny, M., Durzynska, J., Ozery, M., Bennett, K., Spradlin, R., Bonanno, H., Park, S., Ahima, R. S., Barton, E. R. Deletion of muscle IGF-I transiently impairs growth and progressively disrupts glucose homeostasis in male mice.
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Affiliation(s)
- Georgios Vassilakos
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Hanqin Lei
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Yun Yang
- Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, Florida, USA.,Gastrointestinal Surgery, West China School of Medicine, Sichuan University-West China Hospital, Chengdu, China
| | - Jason Puglise
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Michael Matheny
- Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Julia Durzynska
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA.,Molecular Virology, Institute of Experimental Biology, A. Mickiewicz University, Poznań, Poland
| | - Matan Ozery
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Katherine Bennett
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Ray Spradlin
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Heather Bonanno
- Animal Care Services, Cancer and Genetics Research Complex, University of Florida, Gainesville, Florida, USA
| | - Soohyun Park
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rexford S Ahima
- Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elisabeth R Barton
- Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA.,Pharmacology and Therapeutics, College of Medicine, University of Florida, Gainesville, Florida, USA
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