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2. Mortality, perioperative complications and surgical timelines in hip fracture patients: Comparison of the Spanish with the non-Spanish Cohort of the HIP ATTACK-1 trial

Author

Veevaete, Laurent, Waroux, Bernard le Polain de, Lavand'homme, Patricia, Cornu, Olivier, Tribak, Karim, Yombi, Jean C, Touil, Nassim, Bhutia, Jigme T, Clinckaert, Carol, Clippeleir, Dirk De, Reul, Maike, Patel, Ameen, Tandon, Vikas, Gauthier, Leslie P, Avram, Victoria R.A., Winemaker, Mitchell, de Beer, Justin, Simpson, Diane L, Worster, Andrew, Alvarado, Kim A, Gregus, Krysten K, Lawrence, Kelly H, Leong, Darryl P, Joseph, Philip G, Magloire, Patrick, Deheshi, Benjamin, Bisland, Stuart, Wood, Thomas J, Tushinski, Daniel M., Wilson, David A.J., Haider, Shariq, Bali, Kamal, Kearon, Clive, Manach, Yannick Le, Adili, Anthony, Tiboni, Maria E, Neary, John D, Cowan, David D, Khanna, Vickas, Zaki, Amna, Farrell, Janet C, MacDonald, Anne Marie, Conen, David, Wong, Steven C.W., Karbassi, Arsha, Wright, Douglas S, Shanthanna, Harsha, Coughlin, Ryan, Khan, Moin, Wikkerink, Spencer, Quraishi, Faraaz A, Lawendy, Abdel-Rahman, Kishta, Waleed, Schemitsch, Emil, Carey, Timothy, Macleod, Mark D, Sanders, David W, Vasarhelyi, Edward, Bartley, Debra, Dresser, George K, Tieszer, Christina, Jenkinson, Richard J, Shadowitz, Steven, Lee, Jacques S, Choi, Stephen, Kreder, Hans J, Nousiainen, Markku, Kunz, Monica R, Tuazon, Ravianne, Shrikumar, Mopina, Ravi, Bheeshma, Wasserstein, David, Stephen, David J.G., Nam, Diane, Henry, Patrick D.G., Wood, Gavin C.A., Mann, Stephen M., Jaeger, Melanie T., Sivilotti, Marco L.A., Smith, Christopher A., Frank, Christopher C., Grant, Heather, Ploeg, Leone, Yach, Jeff D., Harrison, Mark M., Campbell, Aaron R., Bicknell, Ryan T., Bardana, Davide D., Feibel, Robert J., McIlquham, Katie, Gallant, Catherine, Halman, Samantha, Thiruganasambandamoorth, Venkatesh, Ruggiero, Sara, Hadden, William J., Chen, Brian P.J., Coupal, Stephanie A., McMahon, Stephen J., McLean, Lisa M., Shirali, Hemant R., Haider, Syed Y., Smith, Crystal A., Watts, Evan, Santone, David J., Koo, Kevin, Yee, Allan J., Oyenubi, Ademilola N., Nauth, Aaron, Schemitsch, Emil H., Daniels, Timothy R., Ward, Sarah E., Hall, Jeremy A., Ahn, Henry, Whelan, Daniel B., Atrey, Amit, Khoshbin, Amir, Puskas, David, Droll, Kurt, Cullinan, Claude, Payendeh, Jubin, Lefrancois, Tina, Mozzon, Lise, Marion, Travis, Jacka, Michael J., Greene, James, Menon, Matthew, Stiegelmahr, Robert, Dillane, Derek, Irwin, Marleen, Beaupre, Lauren, Coles, Chad P., Trask, Kelly, MacDonald, Shelley, Trenholm, J.A.I., Oxner, William, Richardson, C.G., Dehghan, Niloofar, Sadoughi, Mehdi, Sharma, Achal, White, Neil J., Olivieri, Loretta, Hunt, Stephen B., Turgeon, Thomas R., Bohm, Eric R., Tran, Sarah, Giilck, Stephen M., Hupel, Tom, Guy, Pierre, O'Brien, Peter J., Duncan, Andrew W., Crawford, Gordon A., hou, Junlin, Zhao, Yanrui, Liu, Yang, Shan, Lei, Wu, Anshi, Muñoz, Juan M., Chaudier, Philippe, Douplat, Marion, Fessy, Michel Henri, Piriou, Vincent, Louboutin, Lucie, David, Jean Stephane, Friggeri, Arnaud, Beroud, Sebastien, Fayet, Jean Marie, Landais, Paul, Leung, Frankie Ka Li, Fang, Christian Xinshuo, Yee, Dennis King Hang, Sancheti, Parag K., Pradhan, Chetan V., Patil, Atul A., Puram, Chetan P., Borate, Madhav P., Kudrimoti, Kiran B., Adhye, Bharati A., Dongre, Himanshu V., John, Bobby, Abraham, Valsamma, Pandey, Ritesh A., Rajkumar, Arti, George, Preetha E., Sigamani, Alen, Stephen, Manesh, Chandran, Nitheesh, Ashraf, Mohammed, Georgekutty, A.M., Sulthan, Ahamad S., Adinarayanan, S., Sharma, Deep, Barnawal, Satish P., Swaminathan, Srinivasan, Bidkar, Prasanna U., Mishra, Sandeep K., Menon, Jagdish, M, Niranjan, Zk, Varghese, Hiremath, Santosh A., Nc, Madhusudhan, Jawali, Abhijit, Gnanadurai, Kingsly R., George, Carolin E., Maddipati, Atarao, Kp, Mary, Sharma, Vijay, Farooque, Kamran, Malhotra, Rajesh, Mittal, Samarth, Sawhney, Chavi, Gupta, Babita, Mathur, Purva, Gamangati, Shivanand, Tripathy, Vijaylaxmi, Menon, Prem H., Dhillon, Mandeep S., Chouhan, Devendra K., Patil, Sharanu, Narayan, Ravi, Lal, Purushotham, Bilchod, Prashanth N., Singh, Surya U., Gattu, Uttam V., Dashputra, Ravi P., Rahate, Prashant V., Turiel, Maurizio, Blasio, Giuseppe De, Accetta, Riccardo, Perazzo, Paolo, Stella, Daniele, Bonadies, Marika, Colombo, Chiara, Fozzato, Stefania, Pino, Fabio, Morelli, Ilaria, Colnaghi, Eleonora, Salini, Vincenzo, Denaro, Giuseppe, Beretta, Luigi, Placella, Giacomo, Giardina, Giuseppe, Binda, Mirko, Marcato, Anna, Guzzetti, Luca, Piccirillo, Fabio, Cecconi, Maurizio, Khor, H.M., Lai, Hou Yee, Kumar, C.S., Chee, K.H., Loh, P.S., Tan, Kit Mun, Singh, Simmrat, Foo, Li Lian, Prakasam, Komella, Chaw, Sook Hui, Lee, Meng-Li, Ngim, Joanne H.L., Boon, Huck Wee, Chin, Im Im, Kleinlugtenbelt, Ydo V., Landman, Ellie B.M., Flikweert, Elvira R., Roerdink, Herbert W., Brokelman, Roy B.G., Elskamp-Meijerman, Hannie F., Horst, Maarten R., Cobben, Jan-Hein M.G., Umer, Masood, Begum, Dilshad, Anjum, Anila, Hashmi, Pervaiz M., Ahmed, Tashfeen, Rashid, Haroon U., Khattak, Mujahid J., Rashid, Rizwan H., Lakdawala, Riaz H., Noordin, Shahryar, Juman, Naveed M., Khan, Robyna I., Riaz, Muhammad M., Bokhari, Syedah S., Almas, Ayesha, Wahab, Hussain, Ali, Arif, Khan, Hammad N., Khan, Eraj K., Nur, Aamer Nabi, Janjua, Kholood A., Orakzai, Sajjad H., Khan, Abdus S., Mustafa, Khawaja J., Sohail, Mian A., Umar, Muhammad, Khan, Siddra A., Ashraf, Muhammad, Khan, Muhammad K., Shiraz, Muhammad, Furgan, Ahmad, Ślęczka, Paweł, Dąbek, Piotr, Kumoń, Adam, Satora, Wojciech, Ambroży, Wojciech, Święch, Mariusz, Rycombel, Jacek, Grzelak, Adrian, Nowak- Kózka, Ilona, Gucwa, Jaroslaw, Machala, Waldemar, Ramokgopa, Mmampapatla T., Firth, Gregory B., Karera, Mwalimu, Fourtounas, Maria, Singh, Virsen, Biscardi, Anna, Iqbal, Muhammad N., Campbell, Ryan J., Maluleke, Matimba L., Moller, Carien, Nhlapo, Lerato, Maqungo, Sithombo, Flint, Margot, Nejthardt, Marcin B., Chetty, Sean, Naidoo, Rubendren, Guerra-Farfan, Ernesto, Tomas-Hernandez, Jordi, Garcia-Sanchez, Yaiza, Clua, Miriam Garrido, Molero-Garcia, Vicente, Minguell-Monyart, Joan, Teixidor-Serra, Jordi, Villar-Casares, Maria del Mar, Marsa, Jordi Selga, Porcel-Vazquez, Juan A., Andres-Peiro, Jose-Vicente, Aguilar, Marc, Mestre-Torres, Jaume, Colomina, Maria J., Guilabert, Patricia, Gozalo, M Luisa Paños, Abarca, Luis, Martin, Nuria, Usua, Gemma, Martinez-Ripol, Pedro, Posada, M.A. Gonzalez, Lalueza-Broto, Pilar, Sanchez-Raya, Judith, Camarena, Jorge Nuñez, Fraguas-Castany, Antoni, Balaguer-Castro, Mariano, Torner, Pere, Jornet-Gibert, Montsant, Serrano-Sanz, Jorge, Cámara-Cabrera, Jaume, Salomó-Domènech, Mònica, Yela-Verdú, Christian, Peig-Font, Anna, Ricol, Laura, Carreras-Castañer, Anna, Martínez-Sañudo, Luis, Herranz, Susana, Feijoo-Massó, Carlos, Sianes-Gallén, Mònica, Castillόn, Pablo, Bernaus, Martí, Quintas, Saioa, Gόmez, Olga, Salvador, Jordi, Abarca, Javier, Estrada, Cristina, Novellas, Marga, Torra, Mercè, Dealbert, Alfred, Macho, Oscar, Ivanov, Alexia, Valldosera, Esther, Arroyo, Marta, Pey, Borja, Yuste, Antoni, Mateo, Llorenç, Caso, Julio De, Anaya, Rafael, Higa-Sansone, J.L., Millan, Angelica, Baños, Victoria, Herrera-Mateo, Sergio, Aguado, Hector, Martinez-Municio, Gonzalo, León, Ricardo, Santiago-Maniega, Silvia, Zabalza, Ana, Labrador, Gregorio, Guerado, Enrique, Ramirez-Roldan, Alicia, Cruz, Encarnacion, Cano, Juan R, Bogallo, Jose M, Sangasoongsong, Paphon, Kulachote, Noratep, Sirisreetreerux, Norachart, Pengrung, Nachapan, Chalacheewa, Theerawat, Arnuntasupakul, Vanlapa, Yingchoncharoen, Teerapat, Naratreekoon, Bundit, Kadry, Miriam A, Thayaparan, Surendini, Abdlaziz, Ihab, Aframian, Arash, Imbuldeniya, Arjuna, Movahedi, Roya, Omran, Sherif, Vizcaychipi, Marcela P, Correia, Patricia, Patil, Shashank, Haire, Kevin, Mayor, Amy S.E., Dillingham, Sally, Nicholson, Laura, Elnaggar, Mohamed, John, Joby, Nanjayan, Shashi K, Parker, Martyn J, O'Sullivan, Susan, Marmor, Meir T, Matityahu, Amir, McClellan, Robert T, Comstock, Curt, Ding, Anthony, Toogood, Paul, Slobogean, Gerard, Joseph, Katherine, O'Toole, Robert, Sciadini, Marcus, Ryan, Scott P, Clark, Molly E, Cassidy, Charles, Balonov, Konstantin, Bergese, Sergio D, Phieffer, Laura S, Gonzalez-Zacarias, Alicia A, Marcantonio, Andrew J, Borges, Flavia K., Bhandari, Mohit, Nuñez, Jorge H., Castillon, Pablo, De Caso Rodriguez, Julio, Aguado, Hector J., Popova, Ekaterine, Tonelli, Ana Claudia, Balasubramanian, Kumar, Vincent, Jessica, Harvey, Valerie, Kocaqi, Etri, and Devereaux, P.J.

Published
2024
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7. Orthogeriatric Multidisciplinary Co-Management Across Acute and Rehabilitation Care Improves Length of Stay, Functional Outcomes and Complications in Geriatric Hip Fracture Patients.

Author

Yee, Dennis King Hang, Lau, Tak-Wing, Fang, Christian, Ching, Kathine, Cheung, Jake, and Leung, Frankie

Subjects
LENGTH of stay in hospitals, SPECIALTY hospitals, REHABILITATION centers, FUNCTIONAL status, HIP fractures, OSTEOPOROSIS, LONGITUDINAL method, OLD age
Abstract

Introduction: As the global number of geriatric hip fracture cases continues to proliferate, a newly developed orthogeriatric co-management multidisciplinary care model has been implemented since November 2018 to meet further increases in demand. Our objective was to evaluate the effectiveness of the new pathway in improving the clinical outcomes of fragility hip fractures. Methods: The data of geriatric hip fracture patients from 1 April 2018 till 30 October 2018 was collected as the conventional orthopaedic care model (pre-orthogeriatric care model) to compare with data from the orthogeriatric co-management model, 1 Feb 2019 till 31 August 2019. Clinical outcomes were analyzed between the groups, with the efficiency of the programme reflected in the total length of stay in acute and convalescent hospitals. Results: 194 patients were recruited to the conventional group and 207 were recruited to the orthogeriatric group, 290 patients (72.3%) were female. The mean (SD) patient age was 84.2 (7.9) years. The median length of stay in the acute and rehabilitation hospitals decreased by 1 day and 2 days, respectively (P=.001). The orthogeriatric group was associated with a higher Modified Barthel Index score on discharge from the rehabilitation hospital and more patients in the orthogeriatric collaboration group received osteoporosis medication prescription within one year after the index fracture. There was no difference in the 28-days unplanned readmission rate, complication rate, mortality rate or Elderly Mobility Scale scores on discharge from the rehabilitation hospital between the two groups. Conclusion: Orthogeriatric collaboration has been proven to be effective in terms of a decreased length of stay in both the acute and the rehabilitation hospitals. [ABSTRACT FROM AUTHOR]

Published
2022
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8. Topical administration of tranexamic acid in elderly patients undergoing short femoral nailing for intertrochanteric fracture: A randomised controlled trial.

Author

Yee, Dennis King-Hang, Wong, Janus Siu Him, Fang, Evan, Wong, Tak-Man, Fang, Christian, and Leung, Frankie

Subjects
*INTRAMEDULLARY fracture fixation, *HIP fractures, *TOPICAL drug administration, *OLDER patients, *RANDOMIZED controlled trials, *TRANEXAMIC acid, *HEMORRHAGE prevention, *SURGICAL blood loss, *RESEARCH, *SURGICAL complications, *EVALUATION research, *COMPARATIVE studies, *FRACTURE fixation, *ANTIFIBRINOLYTIC agents, *CUTANEOUS therapeutics, *HEMORRHAGE, PREVENTION of surgical complications
Abstract

Introduction: Topical application of tranexamic acid (TXA) has been proposed as an alternative to intravenous administration to reduce perioperative bleeding in orthopaedic surgery. The purpose of this randomised controlled trial was to evaluate the efficacy and safety of 1 g topically applied TXA in patients undergoing fixation of intertrochanteric hip fractures by short femoral nailing.Methods: A total of 121 patients were enrolled between May 2018 and January 2020. Patients were randomly allocated (1:1) to receive either 10 mL (1 g) of TXA or 10 mL of normal saline (NS) injected through the subfascial drain following wound closure. Total blood loss, total drain output and blood transfusion requirements up to postoperative day 3 were recorded. Rates of thromboembolic complications and mortality up to 90 days postoperatively were also compared.Results: There was no statistically significant difference in total blood loss, total drain output or proportion of patients requiring transfusions. Median total blood loss was 1.088 L (IQR: 0.760-1.795) in the TXA group and 1.078 L (IQR: 0.797-1.722) in the NS group (P = .703). Median total drain output was 60 mL (IQR: 40-140) in the TXA group and 70 mL (IQR: 30-168) in the NS group (P = .696). Blood transfusions were administered in 29 patients (47.5%) in the TXA group and 27 patients (45.0%) in the NS group (P = .782). There was also no difference in frequency of thrombotic complications or mortality within 90 days. There were five thrombotic events in the TXA group and four in the NS group (P = .751). The 90-day mortality rate was 6.6% (4 patients) in the TXA group and 3.3% (2 patients) in the NS group (P = .680).Conclusion: A 1 g dose of topically administered TXA did not produce any difference in blood loss, transfusion requirements, thromboembolic complications, or 90-day mortality. Future trials may consider the effect of larger doses in patients undergoing hip fracture fixation surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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9. Surgical accuracy of image-free versus image-based robotic-assisted total knee arthroplasty.

Author

Yee DK, Ng JP, Lau CT, Ho KK, Man GC, Chu VW, Choi TL, Lam GYT, Ong MT, and Yung PS

Abstract

Background: This study investigated the accuracy in achieving proper lower limb alignment and component positions after total knee replacement (TKR) with image-free and image-based robotic-assisted TKR., Methods: A total of 129 patients (166 knees) suffering from end-stage knee arthritis who underwent TKA operated by robotic-assisted surgery between the years 2018 and mid-2021 were recruited. Radiological outcomes were compared between image-free and image-based robotic-assisted surgical systems., Results: There were significant differences between the two robotic systems when comparing the mean planned component alignment and the mean measured alignment on radiographs, in which the image-free robotic-assisted system was more varus, whereas the image-based robotic-assisted system was more valgus for both the mean femoral and tibial component coronal alignment (p < 0.001). For tibial component sagittal alignment, the image-based group had a larger deviation from the planned posterior slope (p < 0.001)., Conclusion: Image-free and image-based robotic assisted TKR had differing accuracy in femoral and tibial alignment., (© 2023 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.)

Published
2023
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10. Comparing 3 Different Techniques of Patella Fracture Fixation and Their Complications.

Author

Shea GK, Hoi-Ting So K, Tam KW, Yee DK, Fang C, and Leung F

Abstract

Introduction: Patella fractures managed by fixation with metal implants often cause local soft tissue irritation and necessitate implant removal. An alternative is to utilize suture-based fixation methods. We have adopted suture and hybrid fixation in the routine management of patella fractures. Here, we compare the results of 3 fixation techniques., Materials and Methods: Eighty-seven eligible patients underwent patella fracture fixation over a 3-year period. As determined by fracture configuration, patients received (1) suture fixation (transosseous sutures and figure-of-eight tension banding with FiberWire), (2) hybrid fixation (transosseous FiberWire sutures and metal tension banding), or (3) metal fixation. Primary outcome measures included reoperation rate and soft tissue irritation. Secondary outcomes included surgical complications, radiological, and functional parameters., Results: Reoperation rate was highest for metal fixation (25/57, 43.9%) and lowest for suture fixation (2/13, 15.4%). Soft tissue irritation necessitating implant removal was the predominant reason for reoperation and was significantly less prevalent following suture fixation (1/13, 7.7%, P < .01). Hybrid fixation resulted in similar rates of soft tissue irritation (6/17, 35.3%) and implant removal (7/17, 41.2%) as compared to metal fixation. There was a significant increase in patella baja (13/17, 76.5%) and reduction in Insall-Salvati ratio (0.742; 95% confidence interval: 0.682-0.802) following hybrid fixation as compared to the other 2 fixation methods ( P < .05)., Discussion: Suture fixation results in the least amount of soft tissue irritation and lowest reoperation rate, but these advantages are negated with the addition of a metal tension band wire. Hybrid fixation also unbalances the extensor mechanism., Conclusion: Patients should be counseled as to the expected sequelae of their fixation method. Suture fixation is the favored means to fix distal pole fractures of the patella. An additional metal tension band loop may confer additional stability but should be applied with caution., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2019
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