Orthopedics Commons^™

Changes In Opioid Prescribing Patterns In Opioid Naive Patients Can Translate To Improved Outcomes In The Opioid Non-Naive Patients With Anterior Cervical Surgery: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Bhargav Ayloo, Trevor Ruesch, Adam Junn, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tang, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Though often necessary for adequate analgesia after spine surgery, continued opioid use can lead to chronic dependency. The Michigan Spine Surgery Improvement Collaborative (MSSIC) has demonstrated in prior work the promise of utilizing a multi-institutional morphine milliequivalent (MME) cutoff for elective anterior cervical surgery in the opioid naıve population. However, the effect of this cutoff in patients who were already on opioids pre-operatively have not previously been studied. The goal of this study was to evaluate whether changes in prescribing patterns in the opioid naıve population would also translate to the non-naıve populations, and whether the non-naıve population would …

Implementation Of A Multi-Institutional Enhanced Recovery After Surgery (Eras) For Elective Spine Surgery: Two-Year Michigan Spine Surgery Improvement Collaborative (Mssic) Experience, Anisse Chaker, Kylie Springer, Kari Jarabek, Michael Melhem, Heegook Yeo, Jian-Hui Hu, Jad Khalil, Kenneth Easton, Richard Easton, Doris Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, Victor Chang

Conference Presentation Abstracts

Introduction: Enhanced Recovery After Surgery (ERAS) protocols have been introduced to several surgical specialties with the intention to reduce peri-operative adverse events and improve various health-system quality metrics including length of stay and patient satisfaction. Though this has been studied in the setting of spine surgery, the vast majority are single institution protocols biased toward academic teaching hospitals. There is a paucity of literature studying the utilization of a multi-institutional ERAS protocols that is applicable to community hospitals without associated training programs. We present the Michigan Spine Surgery Improvement Collaborative (MSSIC) two-year experience implementing a multi-institutional ERAS protocol for elective …

The Impact Of Covid-19 On Spine Surgery: Temporal Trends In Complications And Patient-Reported Outcomes Across A Statewide Cohort, Ali Mehaidli, Richard Easton, Ahmad Almaat, Gary George, Alqasim Elnaggar, Victor Chang, Doris Tong, Jad Khalil, Kevin Taliaferro

Conference Presentation Abstracts

Introduction: The COVID-19 pandemic caused major disruptions in elective surgical care, including spine surgery, due to widespread hospital restructuring and resource limitations. Although previous studies have examined surgical volumes and safety during the pandemic, limited data exist on how outcomes varied across multiple phases of the pandemic, especially in real-world, multicenter spine surgery populations. Material and Methods: This retrospective cohort study used data from the Michigan Spine Surgery Improvement Collaborative (MSSIC) to compare outcomes in patients undergoing lumbar or cervical spine surgery across four COVID-19 timeframes: pre-COVID (1/2019-2/2020), onset-COVID (3/2020-9/2020), active-COVID (10/2020-2/2022), and post-COVID (3/2022- 12/2022). Patient demographics, surgical characteristics, …

Halo Effect Of Prescribing Guidelines For Opioid Naive Patients Translates To Opioid Non-Naive Patients Undergoing Lumbar Decompression: A Michigan Spine Surgery Improvement Collaborative (Mssic) Study, Anisse Chaker, Geoff Kahn, Michael Melhem, Jian-Hui Hu, Kari Jarabek, Heegook Yeo, Jawad Saad, Abdullah Al-Tekreeti, Kenneth Easton, Jad Khalil, Richard Easton, Doirs Tong, Miguelangelo Perez-Cruet, Noojan Kazemi, Ilyas Aleem, Muwaffak Abulhak, David Nerenz, Victor Chang

Conference Presentation Abstracts

Introduction: Chronic opioid dependency in spine surgery is an ongoing concern given the ongoing opioid epidemic. We have previously reported on our cohort of opioid-naıve patients, however the literature has shown that patients with opioid use at baseline are at higher risk of less favorable outcomes. Starting in 2022, MSSIC instituted state-wide prescribing guidelines for opioid naıve patients undergoing one- or two-level lumbar decompression surgery (laminectomy, laminotomy, foraminotomy, microdiscectomy) with performance goals of 80% compliance. The goal of this study was to evaluate whether there would be a form of a “halo” effect on prescribing patterns for patients with baseline …

Postoperative Ileus After Lumbar Spine Surgery: Modifiable Risk Factors And Impact On Outcomes, Ali Mehaidli, Richard Easton, Alqasim Elnaggar, Gary George, Ahmad Almaat, Victor Chang, Jad Khalil, Kevin Taliaferro

Conference Presentation Abstracts

Introduction: Postoperative ileus (POI) is an infrequent but impactful complication following lumbar spine procedures. While well-characterized in abdominal surgery, spine-specific data remain limited, particularly regarding modifiable risk factors. Materials and Methods: We analyzed 41,164 patients who underwent elective lumbar spine surgery between 2018 and 2023 using the Michigan Spine Surgery Improvement Collaborative (MSSIC) registry. Multivariable generalized estimating equation models were used to identify independent risk factors for POI. We also evaluated the association between POI and postoperative outcomes, including patient-reported outcome measures (PROMs). Results: POI occurred in 1.1% of patients (n = 447). Independent risk factors included older age (RR …

Clinical Factors Associated With Same Day Discharge After Primary Total Shoulder Arthroplasty, Ryan Mcnassor, Lucas Haase, Brandon Fisher, Kaleb R. Howard, Justin T. Deslaurier, Elijah C. Auch, Alexander Martusiewicz, J Michael Wiater

Conference Presentation Abstracts

OBJECTIVE: Cost conservation and value are major components of orthopedic surgery and health economics. A frequent measure used to mitigate cost is the utilization of same day discharge (SDD) after total shoulder arthroplasty (TSA). The purpose of this study was to investigate if patient travel distance is associated with safe SDD. Secondarily, we aimed to identify other patient factors associated with safe SDD. Our hypothesis was that increased travel distance would be associated with decreased SDD. METHODS: This retrospective review included all patients undergoing primary anatomic or reverse total shoulder arthroplasty by at a single institution between January 2021 to …

Which Repair Technique, Bone Tunneling Or Suture Anchors, Is Superior When Performing Lesser Tuberosity Osteotomy At The Time Of Stemless Total Shoulder Arthroplasty?, Jared M. Mahylis, Stephaine J. Muh, Mahdi Mazeh, Emil Espinal Nunez, Daniel Oravec, Johnny Kasto, Chimdindu Obinero, Kai Zhu, Yener N. Yeni, Shariff K. Bishai

Conference Presentation Abstracts

INTRODUCTION: Total shoulder arthroplasty (TSA) has evolved as a treatment for advanced shoulder osteoarthrosis, with stemless implants gaining popularity due to reduced risks of stress shielding and complications associated with stemmed designs. However, the optimal technique for repairing the subscapularis during TSA remains under investigation. This study evaluates the biomechanical performance of two repair techniques—bone tunneling and suture anchors—used for Lesser Tuberosity Osteotomy (LTO) in the context of stemless TSA.  
METHODS: Ten shoulders from six cadaveric specimens (3 male, 3 female; aged 58–93) were prepared and allocated to bone tunneling or suture anchor repair groups. Cyclic loading tests were performed, …

Medial Meniscus Root Repair Demonstrates Superior Radiographic And Clinical Outcomes At Long-Term Follow-Up Compared To Partial Medial Meniscetomy, Robert Dean, Ryan Mcnassor, Aaron John Krych, Brian R. Waterman

Conference Presentation Abstracts

INTRODUCTION: Posterior medial meniscus root tears (PMMRTs) are frequently observed injuries that lead to alterations in tibiofemoral biomechanics. Few long-term reviews have considered the long term clinical and radiographic outcomes of management of these injuries. This study sought to perform a systematic review and meta-analysis of the current literature on long term clinical and radiographic outcomes of PMMRTs. METHODS: Using PRISMA guidelines, a systematic review was performed with inclusion criteria of English language studies, diagnosis of PMMRT on MRI with confirmation on arthroscopy if managed operatively, studies with minimum 5-year radiographic or patient reported outcome metrics. Data including management strategy, …

Evaluation Of Heterotopic Ossification Following Two-Level Cervical Disc Arthroplasty With A Peek-On-Ceramic Artificial Disc, Jad Khalil, Hyan Bae, Pierce Nunley, K Brandon Strenge, Ashvin Patel, Armen Khachatryan, Rick Sasso, Andrew Park, Christopher Good, James Yue, Paul Kim, Richard Guyer

Conference Presentation Abstracts

Introduction: While favorable outcomes have consistently been reported following treatment of disc degeneration with cervical total disc replacement (cTDR), the development of heterotopic ossification (HO) at the index level has been reported. This study evaluated baseline characteristics potentially associated with the development of HO, as well as the impact of HO on 5-year clinical outcomes Materials and Methods: Baseline characteristics and 5-year outcomes of two-level polyetheretherketone (PEEK)-on-ceramic cTDR patients were stratified by worst HO grade at either index level through 5 years (defined as grade 1, 2, 3 or 4 on the McAfee/Mehren scale). Baseline index-level radiographic variables were stratified …

The Effect Of Covid-19 On Total Joint Arthroplasty, Hailey Worstman, James E. Feng, Alex Miller, Drew Moore

Posters

• Arthritis is debilitating disease that is common throughout the U.S. For patients with refractory disease, total hip and knee arthroplasty, collectively known as total joint arthroplasty, are used for definitive management.1 •

Total joint arthroplasty, TJA, is one of the most common procedures in the U.S. and is typically inpatient in order to start physical therapy and promote joint mobility as soon as possible.

• Elective procedures, including total joint arthroplasties, were halted in March 2020 due to the pandemic.2,3

• When TJAs resumed they shifted towards outpatient procedures and at home physical therapy.4

• The impact of the …

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty, Daniel Nikolaidis, Devin Young, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infections (PJI) can arise anytime in the lifetime of a patient. Therefore, patients who have multiple prosthetic joints are at risk for developing multiple PJIs. Polyarticular PJI can be classified as either synchronous or metachronous. Synchronous PJIs present simultaneously in two or more joints. Metachronous PJIs (MPJI) occur in two or more joints after a disease-free period. Incidence of MPJI varies in the literature from 8-20%.1

Known risk factors associated with MPJI include Rheumatoid Arthritis, sepsis or SIRS, infection with MRSA, ≥3 revision arthroplasties, longer length of stay in the hospital, and an index TKA PJI.2

Only a …

A Review Of Risk Factors For Postoperative Failure After Isolated Primary Medial Patellofemoral Ligament Reconstruction, Bilal Tarar, Ameen Suhrawardy, Clark Yin, Leonardo Cavinatto, Elizabeth Dennis, Jeffrey Fischgrund, Betina B. Hinckel

Posters

• Medial patellofemoral ligament reconstruction (MPFL-R) is a surgical treatment for patellar instability [1].

• Cases of post-operative recurrent dislocation and persistent instability may occur due to preexisting anatomic risk factors and technical errors in the procedure.

• Current rates of recurrent dislocation are reported to be up to 20% [2].

• Research Question: What anatomic and technical risk factors are associated with increased rates of recurrent dislocation after primary MPFL-R?

Metachronous Periprosthetic Joint Infection In Patients With Multiple Arthroplasties At Index Infection, Devin Young, Daniel Nikolaidis, Andrew Steffensmeier, Robert Runner, Mark Karadsheh

Posters

Periprosthetic joint infection (PJI) is a devastating complication of one of the most successful surgeries in medicine. About 1% to 2% of patients will develop PJI after primary total hip arthroplasty (THA) or primary total knee arthroplasty (TKA) [1]. The 5-year patient survival rate of THA PJI is estimated to be worse than that of common cancers, such as breast cancer [2]. The burden of this disease is likely to increase exponentially as the population ages and the number of patients undergoing total joint arthroplasties increases in the future [3].

Most devastating is what Murray et al deem as metachronous …

Gender And Racial Disparities In Pediatric Orthopaedic Surgery Fellows: A Decade-Long Analysis, Naomi Haque, Mazen Zamzam, Imran Bitar, Ehab Saleh

Posters

• The Association of American Medical Colleges (AAMC) has highlighted the increasing gender, racial, and ethnic diversity among medical student applicants, noting a significant rise in the number of underrepresented students.
• In the 2021-2022 academic year, there was an 18% increase in total applicants. The number of Black or African American applicants rose by 21%, with Black or African American students comprising 11.3% of matriculants in 2021, up from 9.5% the previous year. First-year students of Hispanic, Latino, or Spanish origin saw a 7.1% increase, making up 12.7% of matriculants. Additionally, women constituted 56.8% of applicants, 55.5% of matriculants, and 52.7% …

Influence Of Medicaid And Medicare On Total Joint Arthroplasty Outcomes: 10-Year Report Of Michigan Hospitals, Madeleine Declercq, Jacob Keeley, Robert Runner, Kevin Weisz, Leonardo Cavinatto, Drew Moore

Posters

Access to healthcare significantly varies by medical insurance type, particularly for individuals for low socioeconomic status.

• Medicaid often covers these individuals (a government-funded program for low-income adults and children).

• Only 45% of primary care providers accept new Medicaid patients, versus 94% for private insurance.1

• Large non-profit medical centers accept Medicaid but still present considerable access challenges for patients.

• Lower reimbursement rates, complex medical needs, and extensive administrative requirements are key barriers for providers accepting Medicaid.

• Studies, such as those by Deans et al., highlight greater travel burdens for Medicaid patients needing revision hip or knee …

Operative Vs. Non-Operative Treatment Of Z-Type Clavicle Shaft Fractures In Adolescents: A Retrospective Study, Iulio Dobrin, Colin Van Wagoner, Ehab Saleh

Conference Presentation Abstracts

OBJECTIVE: Clavicle fractures are common in both adult and pediatric populations.1 Yet, the literature describes differences regarding treatment in such fractures between these populations, favoring operative treatment for adults and nonoperative treatment for pediatric patients.2 There is particular uncertainty for treating a subgroup of adolescent clavicle fractures known as the Z-type comminuted fracture which, being a completely displaced and complex fracture pattern, can prove to have different healing rates than other midshaft clavicle fractures. Because of concerns about healing and bony prominences, these types of fractures are commonly treated surgically, despite an increasing body of literature indicating equivalent outcomes in …

Associated Urogenital Injuries Following Pelvic Trauma In Pediatrics, A 15-Year Single-Center Retrospective Studey, Colin Van Wagoner, Ehab Saleh, Sazid Hasan

Conference Presentation Abstracts

OBJECTIVE: The association between pelvic trauma and urogenital injuries in adult patients is well established, whereas literature concerning pediatric patients is sparse. The purpose of this study was to determine the association between pelvic trauma and urogenital injuries in the pediatric population including incidence, and trends in injury modality, treatment patterns, imaging, and outcome. METHODS: This was a single-center, retrospective chart review. Patients aged 0-16 years admitted for pelvic fracture, pelvic dislocation, proximal femur fracture, and injury of urinary and pelvic organs over a 15-year period were included. Primary outcomes included fracture diagnosis, urogenital injury diagnosis, treatment modalities, and mechanism …

Polymicrobial Prosthetic Joint Infection Including Mycobacterium Tuberculosis: A Case Report, Hernan Andres Yunis, Zachary J. Walker, Matthew E. Charlick, Daniel P. Mccall

Posters

• Usual culprits of PJI affecting total hip and knee arthroplasty are Staphylococcus aureus and streptococcus epidermidis in the acute phase.

• During the chronic presentation, microbes become much more diverse as they may seed due to hematogenous spread from other body sites.

• The purpose of this case study was to illustrate an instance when polymicrobial total hip arthroplasty PJI included Mycobacterium Tuberculosis.

Subclinical Presentation Of Cutibacterium Acnesinfection Following Revision Rotator Cuff Repair: A Case Report, Zachary Walker, David Shuster, David Sosnoski, Ali Hamade, Hussein Saad, Marc Milia

Posters

Cutibacterium acnesis a gram-positive anaerobic bacillus which is commonly found in the sebaceous glands of the skin generally in the axilla, chest and back regions1,2.

Shoulder infections have been reported to occur at 3.4% following arthroscopic or open shoulder surgeries, where they are most commonly due to C. acnes3,4.

This case report demonstrates a unique case and management of a subclinical presentation of confirmed C. acnes infection.

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosisand candidiasis from the fungus Candida albicansare both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Second-Site Periprosthetic Joint Infection After Subsequent Primary Hip Or Knee Arthroplasty: Risk Factor Assessment, Daniel Aris Nikolaidis, Devin Young, Robert Runner, Mark S. Karadsheh, Andrew Steffensmeier

Conference Presentation Abstracts

INTRODUCTION: The risk factors for developing a periprosthetic joint infection (PJI) are well described. However, those associated with developing a second-site or metachronous PJI (MPJI) following a subsequent primary arthroplasty are poorly understood. The purpose of our study is to determine (1) prevalence and (2) risk factors associated with developing a second-site PJI in patients with a prior history of PJI who undergo a subsequent THA or TKA. METHODS: A retrospective, single-center case-control study identified 77 patients treated for an index PJI (hip or knee) between 2013-2022, and who also underwent another primary arthroplasty after completing treatment for their first …

Increasing Patient Age And General Anesthesia Are Risk Factors For Failure Of Same-Day Discharge Total Hip Arthroplasty, Kevin Xavier Farley, Robert Dean, Mark S. Karadsheh, Drew Douglas Moore

Conference Presentation Abstracts

INTRODUCTION: As cost containment efforts in orthopedic surgery increase, there has been a rise in same-day discharge total hip arthroplasty (THA). Same-day discharge THA has been further accelerated by the COVID-19 pandemic and the removal of THA from the Medicare inpatient only list. This study sought to evaluate risk factors for readmission following same-day discharge THA. METHODS: From 2012-2021, the National Surgical Quality Improvement Project database was used to identify all patients undergoing elective THA discharged the day of surgery to their home. Demographic, comorbid, and operative variables were collected, as displayed in Table 1. Readmission within 30-days of surgery …

Neuraxial Vs. General Anesthesia In Total Hip Arthroplasty For Femoral Neck Fracture: A Comparison Of Post-Operative Complications, Kevin Xavier Farley, Robert Dean, Mark S. Karadsheh, Drew Douglas Moore

Conference Presentation Abstracts

INTRODUCTION: Rates of complications with differing anesthetic choices has not been directly compared for patients undergoing total hip arthroplasty (THA) for femoral neck fractures. This study sought to directly compare neuraxial vs. general anesthetic use and compare post-operative outcomes for patients undergoing THA for a femoral neck fracture. METHODS: From 2012-2021, the National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing THA for a femoral neck fracture. Anesthetic type was identified and categorized as neuraxial (spinal, epidural) or general. Demographic and comorbid variables were collected. Days from admission to surgery was also identified. Postoperative complications …

Are Pre-Operative Falls Associated With Post-Operative Complications In Patients Undergoing Aseptic Revision Hip Or Knee Arthroplasty?, Kevin Xavier Farley, Robert Dean, Mark S. Karadsheh, Drew Douglas Moore

Conference Presentation Abstracts

INTRODUCTION: Pre-operative falls are common in patients undergoing primary hip or knee arthroplasty and pre-dispose patients to poor outcomes. However, this relationship in those undergoing revision hip and knee arthroplasty (rTHA, rTKA) is unclear. This study sought to study the relationship between a pre-operative fall history and post-operative patient complications in patients undergoing rTKA or rTHA. METHODS: The National Surgical Quality Improvement Project (NSQIP) database was used to identify all patients undergoing aseptic rTKA or rTHA. The variable for a fall history was available in 2021. Fall history was defined as a patient with a fall in the 6- months …

New-Onset Depression Following Total Shoulder Arthroplasty: The Impact Of Preoperative Patient Factors And Postoperative Complications, Kevin Xavier Farley, Robert Dean, J Michael Wiater

Conference Presentation Abstracts

INTRODUCTION: Depression has been well studied as a risk factor for postoperative complications following total shoulder arthroplasty (TSA). However, little is known about new-onset depression (NOD) following TSA. The purpose of this study is to determine the incidence of NOD following TSA and identify risk factors for its occurrence. METHODS: This was a retrospective review of patients undergoing TSA in the Truven Health MarketScan database. NOD was identified. Patients with pre-operative depression were excluded from analysis. Post-operative complications were identified, including the development of a prosthetic joint infection (PJI), need for revision surgery, and postoperative dislocation. If a complication occurred …

Comparing Outcomes After Cemented And Cementless Total Knee Arthroplasty, Phillip Vartanyan, James Feng, Ali Omari, Elijah Christian Auch, Alex Miller, Drew Douglas Moore, Hasson Alosh, Mark S. Karadsheh

Conference Presentation Abstracts

INTRODUCTION: The optimal method of fixation for primary total knee arthroplasties (TKAs) has been subject to debate. Here we compare patients who received cemented and cementless TKAs for arthritis and compared clinical outcome measures. METHODS: All primary TKAs between January 2016 and December 2022 were obtained retrospectively from a prospective institutional database utilized for contribution to a state-wide joint arthroplasty database. Prospective data includes baseline demographics, select medical comorbidities, intraoperative variables, and postoperative course/complications. Patients were split into two cohorts based on the use of cemented vs cementless TKA implants. Hybrid fixation was excluded. Groups were compared utilizing Student’s unpaired …

Serum Metal Ion Levels In Patients Undergoing Revision Should Arthroplasty, Rishi Chatterji, Brandon Fisher, Avianna Elizabeth Arapovic, Yuying Xing, J Michael Wiater

Conference Presentation Abstracts

INTRODUCTION: Shoulder arthroplasty systems are transitioning towards more modular prosthesis options with the goal of reducing complication profiles and increasing range of motion. Modularity may increase the potential for fretting, corrosion, and subsequent release of metal ions. These events have been associated with adverse reactions in hip and knee arthroplasty, but not in the setting of revision shoulder arthroplasty. The purpose of this study was to identify associations between implant designs, metallurgy, patient characteristics, and serum metal ion levels in patients undergoing revision shoulder arthroplasty. METHODS: 51 patients that underwent revision shoulder arthroplasty were retrospectively reviewed based on prospectively collected …

Two-Year Follow-Up Of Additive Manufactured, Fully 3d Printed Humeral Prosthesis, Jie Jonathan Yao, Andrew Jawa, J Michael Wiater, Anand M. Murthi, Matthew J. Smith, Derek J. Cuff, Samantha Anne Riebesell, Dennis Debernardis, Luke Stanford Austin

Conference Presentation Abstracts

INTRODUCTION: A fully 3D printed prosthetic may offer numerous potential advantages including improved pore precision, overall porosity, topology optimization, spatial variability in stiffness, communication between pores, and strut size. However, there are numerous theoretical concerns surrounding inferior mechanical performance with fully 3D printed implants (e.g. potentially higher rates of fatigue, increased in vivo particle release, etc.) compared to conventionally fabricated ones. We are aware of no reports on the clinical performance of fully 3D printed, off-the-shelf, humeral prostheses. To validate fully 3D printed humeral designs, the purpose of this study was to provide minimum 2-year postoperative clinical outcomes and survivorship …

Outcomes After Total Hip Arthroplasty: Comparison Between Posterior And Anterior Approaches, Phillip Vartanyan, James Feng, Alex Miller, Ali Omari, Elijah Christian Auch, Hasson Alosh, Drew Douglas Moore, Mark S. Karadsheh

Conference Presentation Abstracts

INTRODUCTION: The effects of surgical approach in total hip arthroplasty (THA) are often debated. Here we compare patients who underwent THA through a posterior versus anterior approach and compared clinical outcomes and patient reported outcome measures (PROMs). METHODS: All primary THAs between January 2016 and December 2022 were obtained retrospectively from a prospective institutional database utilized for contribution to a state-wide joint arthroplasty database. Prospective data was abstracted including baseline demographics, select medical comorbidities, intraoperative variables, postoperative course/complications and patient reported outcomes. Two cohorts were developed based on approach: anterior (aTHA) and posterior (pTHA) THA. Cohort groups were compared utilizing …

Polyethylene Wear: An Under-Recognized Cause Of Failed Shoulder Arthroplasty, Brandon Fisher, Matthew Astolfi, Justin Taylor Deslaurier, Karen Childers, James Youngjin Lee, Marisa Samani, J Michael Wiater

Conference Presentation Abstracts

INTRODUCTION: Particle-induced osteolytic and chronic inflammatory effects of polyethylene (PE) wear are a source of failure after both anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA). Historically, PE wear has rarely been reported as a cause of revision in the setting of prior shoulder arthroplasty, unlike hip and knee counterparts. The goal of this study was to analyze and present the clinical, radiographic, and intra-operative findings in a consecutive series of patients who presented after shoulder arthroplasty with evidence of PE wear. METHODS: This was a retrospective review of prospectively collected data on a consecutive series of …