Bjerre Stallings (repairbrain14)

The purpose of this multicenter study was to investigate the clinical outcomes after hip arthroscopy in a series of patients 65 years and older with labral tears with a minimum 2-year follow-up. Outcome data were prospectively collected and retrospectively reviewed for patients 65 years and older who underwent hip arthroscopy. Outcomes at minimum 2-year follow-up were analyzed using prospectively collected Hip Outcome Score (HOS) and modified Harris Hip Score (mHHS). A paired Student's t test was performed to determine significant differences between pre- and postoperative patient-reported outcome scores. Twenty-six patients were included, with a mean age of 67.7 years (range, 65-75 years) and mean follow-up of 50.5 months. The short-term survivorship rate was 65%, with 9 patients requiring total hip arthroplasty (THA) by latest follow-up. At minimum 2-year follow-up, mean mHHS, HOS-Activities of Daily Living, and HOS-Sports-Specific Subscale for surviving hips were 78.97 (range, 25-100), 78.56 (range, 21.7-100), and 65.93 (range, 2.78-100), respectively. The mean improvements for patients with pre- and postoperative mHHS and HOS-Sports-Specific Subscale were 28 and 36.6 (P=.0005 and P=.003, respectively). The average patient satisfaction was 7.7 on a scale of 10. There were no complications noted in this cohort. This study demonstrated that patients older than 65 years with labral pathology who have failed nonoperative measures obtain modest clinical improvement from hip arthroscopy. This clinical improvement yielded a high patient satisfaction, but due to the potential for subsequent THA in a subset of this population, surgeons should use a rigorous selection criteria and counsel patients appropriately. [Orthopedics. 2020;43(6)e579-e584.].Shoulder arthroplasty is an effective treatment option for patients with symptomatic shoulder arthritis and rotator cuff arthropathy. Although there have been reports of variations in complication rates according to insurance type, few studies have examined the effect of payer status on functional outcomes. Patients who underwent elective shoulder arthroplasty performed by a single fellowship-trained surgeon and had a minimum of 1 year of follow-up were queried. Patient characteristics were compared across insurance types. selleck chemical Each patient completed the American Shoulder and Elbow Surgeons (ASES) questionnaire preoperatively and postoperatively. A generalized linear mixed model was specified to predict ASES score at 1 year and included preoperative ASES score as an adjustment variable. A total of 84 patients underwent 91 procedures. Before surgery, ASES score differed by insurance type (P=.014), with lower scores in the Medicaid cohort compared with the private insurance cohort (20.4 vs 38.8, P=.009). After controlling for baseline ASES score, postoperative ASES score at 1-year follow-up differed by insurance type (P less then .001). Patients with private insurance had better ASES scores (85.6) than patients with Medicaid (55.2) (P less then .001) and workers' compensation (57.1) (P=.028). Patients with Medicare (80.6) had better ASES scores at follow-up compared with those with Medicaid (P less then .001). Patients with Medicaid are at risk for significantly lower postoperative functional outcome scores after shoulder arthroplasty compared with patients with private insurance and Medicare. In this study, patients with Medicaid had lower preoperative ASES scores compared with other groups. These observed differences are likely multifactorial and should be acknowledged when counseling patients. [Orthopedics. 2020;43(6)e523-e528.].An enzyme, Cut190, from a thermophilic isolate, Saccharomonospora viridis AHK190 could depolymerize polyethylene terephthalate (PET). The catalytic activity and stability of Cut190 and its S226P/R228S mutant, Cut190*, are regulated by Ca2+ binding. We previously determined the crystal structures of the inactive mutant of Cut190*, Cut190*S176A, in co