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In recent decades, the trend toward early same-day discharge (SDD) after surgery has dramatically increased. Efforts to develop adequate risk stratification tools to guide decision-making regarding SDD versus prolonged hospitalization after total hip arthroplasty (THA) remain largely incomplete. The purpose of this report is to identify the most frequent causes and risk factors associated with SDD failure in patients undergoing THA and total knee arthroplasty (TKA). A systematic search following PRISMA guidelines of four bibliographic databases was conducted for comparative studies between patients who were successfully discharged on the same day and those who failed. Outcomes of interests were causes and risk factors associated with same-day discharge failure. Odds ratios (OR) were calculated for dichotomous variables, whereas mean differences (MD) were calculated for continuous variables. Meta-analysis was performed using RevMan software. Random effects were used if there was evidence of heterogeneity. Eight studies with 3492 patients were included. The most common cause of SDD failure was orthostatic hypotension, followed by inadequate physical condition, nausea/vomiting, pain, and urinary retention. Female sex was a risk factor for failure (OR 0.77, 95% CI 0.63–0.93), especially in the THA subgroup. ASA score IV (OR 0.33, 95% CI 0.14–0.76) and III (OR 0.72, 95% CI 0.52–0.99) were risk factors, as were having > 2 allergies and smoking patients. General anesthesia increased failure risk (OR 0.58, 95% CI 0.42–0.80), while spinal anesthesia was protective (OR 1.62, 95% CI 1.17–2.24). The direct anterior and posterior approaches showed no significant differences. In conclusion, orthostatic hypotension was the primary cause of SDD failure. Risk factors identified for SDD failure in orthopedic surgery include female sex, ASA III and IV classifications, a higher number of allergies, smoking patients and the use of general anesthesia. These factors can be addressed to enhance SDD outcomes. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency has been linked to numerous health issues, including an increased risk of hip fractures. This meta‐analysis aimed to investigate the relationship between vitamin D deficiency and mortality in patients with hip fracture. To assess the impact of different levels of vitamin D deficiency on mortality in patients with hip fractures and examine the influence of potential confounding factors. Methods: A systematic search of PubMed, EMBASE, Scopus, and Cochrane Collaboration Library was conducted, resulting in nine eligible cohort studies (n = 4409). Patients with hip fractures were categorized based on their vitamin D levels as severe, moderate, or insufficient. Mortality was the primary outcome measure in this study. Subgroup analyses were performed according to the follow‐up time. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random‐effects model in Review Manager 5.4. Results: Nine studies, with a pool of 4409 patients, were included. Vitamin D insufficiency was significantly associated with increased mortality (OR 1.24, 95% CI 1.05–1.46; I2 = 4%). Severe deficiency also led to a significant increase in mortality (OR 2.08, 95% CI 1.09–3.97; I2 = 42%), whereas moderate deficiency did not show a significant effect (OR 1.06, 95% CI 0.79–1.44; I2 = 0%). Subgroup analysis revealed significant associations between vitamin D insufficiency and increased mortality at 1‐year (OR 1.37, 95% CI 1.06–1.77) and 2‐year follow‐ups (OR 1.78, 95% CI 1.01–3.15). After adjusting for potential confounders, no significant increase in the mortality rate was observed. Conclusions: This meta‐analysis suggests that vitamin D insufficiency and severe deficiency are associated with increased mortality in patients with hip fracture. However, after adjusting for confounding factors, this association was not statistically significant. Further research is necessary to understand the role of vitamin D deficiency in this population. [ABSTRACT FROM AUTHOR]

The article focuses on the retraction of the study "Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome," due to data errors and incorrect statistical modeling that compromised the reliability of its conclusions.

Background: Introduction: Robotic surgery in total hip arthroplasty (THA) has emerged as a promising approach for improving precision and reducing errors. This meta-analysis aimed to compare the efficacy and safety of robot-assisted MAKO total hip arthroplasty., Methods: Studies were searched using four databases. Meta-analysis was performed using Review Manager 5.4. Efficacy was assessed radiologically, and functional scores and complications were recorded., Results: Twelve studies (1224 hips) were analyzed. The MAKO group achieved greater cup anteversion (MD 1.53, 95%CI 1.04-2.03) and a higher percentage of components within safe inclination and anteversion ranges (p > 0.05). Harris Hip Scores did not differ significantly (MD 0.61, 95%CI -0.22-1.45) but the forgotten joint scores favored MAKO (MD 5.99, 95% CI 4.10-7.88), although not exceeding the minimally clinically significant difference. No differences in intraoperative complications emerged (OR 0.96, 95%CI 0.51-1.79) but preoperative plans significantly mismatched the final cup placement after MAKO (p < 0.05)., Conclusions: The use of the MAKO robot in THA improves radiological outcomes by enhancing safe prosthesis placement. However, no significant differences were observed in terms of complications. Longer follow-up studies are required to assess the clinical impact of improved radiological results., Level of Evidence: Level IV metaanalysis of nonrandomized clinical trials., Registration: CRD42023433733., (© 2024. The Author(s).)

Introduction: The primary objective of this meta-analysis was to evaluate and compare the functional outcomes, postoperative reinfection rates, and complication rates in patients undergoing one-stage versus two-stage surgical revision for periprosthetic hip infection., Methods: The study population included adult patients who had undergone revision hip arthroplasty. Comparative studies have compared two-stage and one-stage revision strategies. Searches were conducted using the major databases. Review Manager software was used to estimate the effects. A sensitivity analysis was also conducted., Results: Nine cohort studies including 2,502 hips were included. The success rate did not show significant differences between the groups (odds ratio [OR] 0.42, 95% confidence interval 0.05 to 3.37). No difference was noted in reinfection (OR 0.81, 95% CI 0.56-1.19). Life quality per Harris Hip Score was higher for one-stage revision strategies (mean difference [MD] 9.00, 95% CI 2.23-15.78). No differences were noted in mortality, aseptic loosening, or revision rates. Age (MD 2.32, 95% CI 1.34-3.29) and body mass index (BMI) (MD 1.88, 95% CI 0.38-3.38) were lower in the two-stage group. Sinus tract presence was higher in the one-stage group (OR 1.44, 95% CI 1.05-1.95). Paprosky I acetabulum was higher in the one-stage group, and Paprosky III was higher in the two-stage group., Conclusions: The results did not demonstrate notable clinical differences between one-stage and two-stage hip arthroplasties, regardless of the treated microorganism. However, the quality of life may be somewhat better in the one-stage group. Age, body mass index, and Paprosky classification are factors that influence procedure selection., (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.)