Introduction: Hospital readmissions after elective shoulder arthroplasty represent a costly burden to the health-care system due to the rising demand for this procedure. Nevertheless, the reasons for readmissions remain inconclusive. Therefore, the main purposes of the current investigation were to determine (1) the readmission rates within 90 days after shoulder arthroplasty, (2) the reasons behind those readmissions, and (3) the characteristics of readmitted patients. Methods: A retrospective review was performed on 184 patients who underwent total shoulder arthroplasty (TSA) or reverse shoulder arthroplasty (RSA) performed by a single surgeon at a single institution between 2010 and 2016. The readmissions that occurred within 90 days after surgery and their reasons were noted. Patient characteristics were compared between readmitted and non-readmitted patients. Results: Overall, 7.1% of patients were readmitted within 90 days after shoulder arthroplasty. However, patients with a previous surgery on the same shoulder of the TSA or RSA had a higher rate (13.5%) than patients without a previous surgery (5.4%). Readmission rates for TSA and RSA were virtually identical. Most readmissions were due to surgical (69.2%) rather than medical complications (30.8%). The most common reasons for readmission were surgical-site infection and deep vein thrombosis. There were no statistically significant differences between the baseline patient characteristics of readmitted and non-readmitted patients. However, the proportion of males (69.2%) was more than twice the one of females (30.8%) among readmitted patients. Conclusion: The readmission rate within 90 days after surgery was relatively low among patients who underwent either a TSA or RSA at our institution. Surgically related causes were largely responsible for readmissions.
Introduction: Eminectomy is the physical removal of the articular eminence to enable free movement of the condyle. The primary indication is to treat recurrent dislocation, although in the past it has been used for non-reducing disc displacement without reduction (NDDR). The established contraindication to the procedure is pneumatisation of the articular eminence or tubercle. Determining the success rates of eminectomies from previous papers are hampered by the lack of baseline objective measures needed to improve assessment of treatment outcomes. Methodology: A retrospective case series was conducted, in which written and computerised hospital records and images were analysed from 2007 to 2014, using a minimum data set developed by our unit to assess outcomes. These included indication for procedure, frequency of dislocation, interincisal distance, pre-operative imaging and objective pain scoring. Results: Twenty of twenty-eight (71%) patients receiving an eminectomy conformed to the minimum data set. Pain improvement was demonstrated in 60% of patients with both recurrent dislocation and NDDR. Complications occurred in 24% of eminectomies, all of which were temporary. Conclusions: Eminectomy is a safe and effective procedure for management of chronic temporomandibular joint dislocation in wellselected cases. However, the results were less predictable with NDDR. The recording of specific clinical information is required to improve comparing outcomes and we would recommend the use of a proforma such as one utilised in our study. There was no evidence that pneumatisation of the eminence was related to an adverse clinical outcome but further evidence is required to question this as a contraindication to eminectomy.
A previous concussion history does not appear to significantly influence postconcussive recovery time in young athletes, although it does increase the probability of neuropsychological referral. Without regard to a previous concussion history, young female athletes recover slower than males from concussion and are also more likely to require neuropsychological referral.
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