Background: Proposed benefits of modularity for femoral revisions in total hip arthroplasty (THA) include more precise biomechanical restoration and improved stability, but this has not been proven with use of a splined, tapered design. This study's purpose is to compare (1) complication rates, (2) functional outcomes, and (3) radiographic measures of subsidence, offset, and leg length discrepancy with the use of modular vs monoblock splined, tapered titanium stems in revision THA. Methods: We retrospectively reviewed 145 femoral revisions with minimum 2-year follow-up (mean, 5.12 years; range, 2-17.3 years). Patients receiving a modular (67) or monoblock (78) splined, tapered titanium stem for femoral revision were included. Results: There were no statistically significant differences in rates of reoperation (22.3% vs 17.9%; P ¼ .66), intraoperative fracture (9.0% vs 3.8%; P ¼ .30), postoperative fracture (3.0% vs 1.3%; P ¼ .47), dislocation (11.9% vs 5.1%; P ¼ .23), or aseptic loosening (4.5% vs 6.4%; P ¼ .73) between the modular and monoblock cohorts, respectively. There were similar results regarding subsidence >5 mm (10.4% vs 12.8%; P ¼ .22), LLD >1 cm (35.8% vs 38.5%; P ¼ .74), restoration of hip offset (À5.88 ± 10.1 mm vs À5.07 ± 12.1 mm; P ¼ .67), and Harris Hip Score (70.7 ± 17.9 vs 73.9 ± 19.7; P ¼ .36) between groups. Multivariate regression showed no differences in complications (P ¼ .44) or reoperations (P ¼ .20) between groups. Conclusion: Modular and monoblock splined, tapered titanium stems demonstrated comparable complication rates, functional outcomes, and radiographic parameters for femoral revisions. However, a limited number of patients with grade IIIB or IV femoral bone loss received a monoblock stem. Future investigations are required to determine whether modularity is beneficial for more complex femoral defects.

Background: In the United States, the COVID-19 pandemic led to a nationwide quarantine that forced individuals to adjust their daily activities, potentially impacting the burden of foot and ankle disease. The purpose of this study was to compare diagnoses made in an orthopaedic foot and ankle clinic during the shelter-in-place period of the COVID-19 pandemic to diagnoses made during the same months of the previous year. Methods: A retrospective review of new patients presenting to the clinics of 4 fellowship-trained orthopaedic foot and ankle surgeons in a major United States city was performed. Patients in the COVID-19 group presented between March 22 and July 1, 2020, during the peak of the quarantine for this city. Patients in the control group presented during the same period of 2019. Final diagnosis, chronicity of symptoms (acute: ≤1 month), and mechanism of disease were compared between groups. Results: A total of 1409 new patient visits were reviewed with 449 visits in the COVID-19 group and 960 visits in the control group. The COVID-19 group had a significantly higher proportion of ankle fractures (8.7% vs 5.4%, P = .020) and stress fractures (4.2% vs 2.2%, P = .031), but a smaller proportion of Achilles tendon ruptures (0.7% vs 2.5%, P = .019). The COVID-19 group had a higher proportion of acute injuries (35.4% vs 23.5%, P < .001). Conclusion: There was a shift in prevalence of pathology seen in the foot and ankle clinic during the COVID-19 pandemic, which may reflect the adoption of different activities during the quarantine period and reluctance to present for evaluation of non-urgent injuries. Level of Evidence: Level III, retrospective cohort study.

per week and 91 were in the top 90th percentile (High ASB), consuming >21 ounces per week. Sixty percent of the cohort consumed no ASB. Demographic characteristics were similar between groups. No significant differences were found for primary or secondary outcomes after adjusting for potential confounding variables. CONCLUSION: Most patients consumed some SSB, no ASB, and there were no differences in pregnancy outcomes between the highest consumers in both groups. Beverage consumption is an important aspect of maternal dietary quality and evidence-based recommendations are needed to guide consumption in pregnancy.

A cyanide-bridged anionic three-dimensional network solid is described, with mol­ecular formula {Cu2(CN)3}−. Charge neutrality is provided by guest N-protonated N,N-di­ethyl­ethano­lamine mol­ecules.

In the title complex, [CuICuII(CN)3(C4H12N2)2], the CuI and CuII ions and a bridging cyanide group lie on a twofold rotation axis. The CuII ion is in a slightly-distorted square-pyramidal coordination environment, with the N atoms of the two symmetry-related N-ethyl­ethylenedi­amine ligands occupying the basal positions and an N-bonded cyanide group in the apical position. The CuI ion is in a trigonal-planar coordination environment, bonded to the C atom of the bridging cyanide group and to two terminal cyanide groups. In the crystal, N—H⋯N hydrogen bonds involving two of the symmetry-unique N—H groups of the N-ethyl­ethylenedi­amine ligands and the N atoms of the terminal cyanide ligands link the mol­ecules into strands along [010].

Study Design: Retrospective cohort study. Objective: To assess the effect of diabetes mellitus (DM) on clinical and radiographic outcomes in patient with degenerative spondylolisthesis undergoing posterior lumbar spinal fusion. Methods: Analysis of patients who underwent open posterior lumbar spinal fusion from 2011 to 2018. Patients being medically treated for DM were identified and separated from nondiabetic patients. Visual analogue scale Back/Leg pain and Oswestry Disability Index (ODI) were collected, and achievement of minimal clinically important difference was evaluated. Lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and PI-LL difference were measured on radiographs. Rates of postoperative complications were also collected. Results: A total of 850 patients were included; 78 (9.20%) diabetic patients and 772 (90.80%) nondiabetic patients. Final PI-LL difference was significantly larger ( P = .032) for patients with diabetes compared to no diabetes, but there were no other significant differences between radiographic measurements, operative time, or postoperative length of stay. There were no differences in clinical outcomes between the 2 groups. Diabetic patients were found to have a higher rate of discharge to a facility following surgery ( P = .018). No differences were observed in reoperation or postoperative complication. Conclusions: While diabetic patients had more associated comorbidities compared with nondiabetic patients, they had similar patient-reported and radiographic outcomes. Similarly, there are no differences in rates of reoperation or postoperative complications. This study indicates that diabetic patients who have undergone thorough preoperative screening of related comorbidities and appropriate selection should be considered for lumbar spinal fusion.

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