Background: Female surgeons, representing 6.5% of the American Academy of Orthopaedic Surgeons, are particularly vulnerable to work-family conflict. This conflict may deter women from considering orthopaedic surgery as a specialty. The study objective was to identify differences in work-family integration between female and male orthopaedic surgeons in the United States.Methods: An anonymous survey collecting data within the domains of work, family, and satisfaction was completed by 347 orthopaedic surgeons (153 female, 194 male). Differences in responses between males and females were identified.Results: Female surgeons were younger than males (mean, 41.1 versus 50.1 years; p < 0.001) and earlier in their careers, with 60.3% of males in practice >10 years compared with 26.1% of females (p < 0.001). Consulting (7.8% versus 31.4%; p < 0.001), course faculty positions (19.0% versus 39.2%; p < 0.001), and academic and leadership titles (30.7% versus 47.4%; p = 0.002) were significantly less common among females. There was a significant income disparity between females

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Meiosis-specific chromatin structures, guided by histone modifications, are critical mediators of a meiotic transient transcription program and progression through prophase I. Histone H3K4 can be methylated up to three times by the Set1-containing COMPASS complex and each methylation mark corresponds to a different chromatin conformation. The level of H3K4 modification is directed by the activity of additional COMPASS components. In this study, we characterized the role of the COMPASS subunits during meiosis in S. cerevisiae. In vegetative cells, previous studies revealed a role for subunits Swd2, Sdc1, and Bre2 for H3K4me2 while Spp1 supported trimethylation. However, we found that Bre2 and Sdc1 are required for H3K4me3 as yeast prepare to enter meiosis while Spp1 is not. Interestingly, we identified distinct meiotic functions for the core COMPASS complex members that required for all H3K4me, Set1, Swd1, and Swd3. While Set1 and Swd1 are required for progression through early meiosis, Swd3 is critical for late meiosis and spore morphogenesis. Furthermore, the meiotic requirement for Set1 is independent of H3K4 methylation, suggesting the presence of non-histone substrates. Finally, checkpoint suppression analyses indicate that Set1 and Swd1 are required for both homologous recombination and chromosome segregation. These data suggest that COMPASS has important new roles for meiosis that are independent of its well-characterized functions during mitotic divisions.

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Outpatient total joint arthroplasty (TJA) gained favor during the COVID-19 pandemic. Our objective was to critically evaluate the safety and short-term outcomes of outpatient total hip arthroplasty (THA) and total knee arthroplasty (TKA) throughout the pandemic compared with pre-pandemic given their increased use. This was a retrospective review of 941 patients who underwent elective, outpatient TKA and THA at a single institution. Patients were divided into two cohorts: pre-pandemic (N=611) and pandemic (N=330). Data points included demographics, comorbidities, failure of same calendar day discharge (SCDD), and 90-day readmissions and re-operations. The pandemic cohort was older (61.0 vs 59.0 years; P =.001) and had a higher Charlson Comorbidity Index (2 vs 1; P =.004). There were no differences between the pandemic and pre-pandemic cohorts regarding SCDD failures (23.3% vs 21.9%; P =.623) and reoperations (4.2% vs 6.2%; P =.205). The pandemic cohort had a lower readmission rate (4.8% vs 8.2%; P =.056). Overall, patients who had failure of SCDD more commonly underwent TKA than THA (63.5% vs 36.5%; P <.001), were older (63.0 vs 58.5 years; P <.001), had a higher body mass index (30.8 vs 29.9 kg/m 2 ; P =.006) and Charlson Comorbidity Index (2 vs 1; P <.001), had an American Society of Anesthesiologists class greater than 2 (51.2% vs 31.6%; P <.001), received physical therapy later postoperatively (4.15 vs 3.12 hours; P <.001), and had a history significant for myocardial infarction ( P =.025), chronic kidney disease ( P =.004), or diabetes ( P =.003). This study supports broadening indications for outpatient TJA because we found a shift toward older patients with more comorbidities successfully undergoing the procedure. [ Orthopedics . 202x;4x(x):xx–xx.]

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Background: Selective genicular artery embolization (GAE) has shown promise as a minimally invasive treatment option for persistent symptomatic recurrent effusions (REs) following total knee arthroplasty (TKA). Purpose: We sought to investigate the radiographic and clinical success of GAE for RE after TKA. Methods: We performed a retrospective review of prospectively collected data on primary and revision TKA patients with RE, both hemorrhagic and non-hemorrhagic, who underwent GAE between 2019 and 2021 with a minimum of 6-month follow-up. All embolization procedures were performed by a single interventional radiologist. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores were collected prior to GAE and at 1, 3, and 6 months post-procedure. Recurrence of effusion following GAE was assessed at 6 months using ultrasound. Results: Seventeen patients, 10 female and 7 male, with 18 TKAs and a mean (SD) age of 63.1 (8.6) years were included. We saw a mean (SD) of 36.1 (24.4) and 3.3 (3.0) point improvement in WOMAC and VAS scores, respectively. In addition, 14 of the 18 TKAs (77.8%) seen at final follow-up had complete resolution of effusion confirmed by ultrasound. Conclusion: Our retrospective review found that a majority of patients showed significant clinical improvement and resolution of effusion following GAE. These findings suggest that GAE may be an effective minimally invasive treatment option for RE following TKA and should be further investigated.

Salvage conversion hip arthroplasty is a viable solution to restore function and reduce pain after failed intertrochanteric hip fracture fixation. Our primary objective was to assess early outcomes achieved with primary cementless metaphyseal-engaging femoral stems for conversion hip arthroplasty compared with revision diaphyseal-engaging stems. This was a retrospective review of 70 patients with failed intertrochanteric hip fractures subsequently managed with conversion total hip arthroplasty or hemiarthroplasty. Thirty-five patients who underwent conversion using a primary cementless stem were compared with 35 patients who underwent conversion using a revision stem. The groups were similar regarding sex, body mass index, American Society of Anesthesiologists classification, preoperative diagnosis, and implants removed. Clinical and radiographic outcomes and complications were compared over a mean follow-up of 6 years. The primary stem cohort had a shorter mean hospital stay (3.03 vs 4.34 days, P =.028). There were no significant differences between the primary and revision cohorts regarding mean time to conversion (2.26 vs 1.75 years, P =.671), operative time (127 vs 131 minutes, P =.611), incidence of discharge to home (54.3% vs 37.1%, P =.23), postoperative complications (5.71% vs 5.71%, P =1.0), reoperations (5.71% vs 11.4%, P =.669), leg length discrepancy (5.33 vs 7.38 mm, P =.210), subsidence (20.0% vs 23.3%, P =.981), and Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement (78.6 vs 81.9, P =.723). We report comparable outcomes of conversion hip arthroplasty with the use of primary cementless and revision stems. Current primary cementless femoral stems may be considered for conversion hip arthroplasty for failed intertrochanteric fracture fixation. [ Orthopedics . 202x;4x(x):xx–xx.]