A call to "own the bone": osteoporosis is a predictor for adverse two-year outcomes following total hip and knee arthroplasty.

PURPOSE: While bone health is instrumental in orthopedic surgery, few studies have described the long-term outcomes of osteoporosis (OP) in patients undergoing total hip (THA) or knee (TKA) arthroplasties. METHODS: Using the New York State statewide planning and research cooperative system database, all patients who underwent primary TKA or THA for osteoarthritis from 2009 to 2011 with minimum 2-year follow-up were identified. They were divided based on their OP status (OP and non-OP) and 1:1 propensity score matched for age, sex, race, and Charlson/Deyo index. Cohorts were compared for demographics, hospital-related parameters, and 2-year postoperative complications and reoperations. Multivariate binary logistic regression was utilized to identify significant independent associations with 2-year medical and surgical complications and revisions. RESULTS: A total of 11,288 TKA and 8248 THA patients were identified. OP and non-OP TKA patients incurred comparable overall hospital charges for their surgical visit and hospital length of stay (LOS) (both, p ≥ 0.125). Though OP and non-OP THA patients incurred similar mean hospital charges for their surgical visit, they experienced longer hospital LOS (4.3 vs. 4.1 days, p = 0.035). For both TKA and THA, OP patients had higher rates of overall and individual medical and surgical complications (all, p < 0.05). OP was independently associated with the 2-year occurrence of any overall, surgical, and medical complications, and any revision in TKA and THA patients (all, OR ≥ 1.42, p < 0.001). CONCLUSION: Our study found OP was associated with a greater risk of 2-year adverse outcomes following TKA or THA, including medical, surgical, and overall complications as well as revision operations compared to non-OP patients.

Functional requirement for a highly conserved charged residue at position 75 in the gap junction protein connexin 32.

Charcot Marie Tooth disease (CMT) is a group of inherited disorders characterized clinically by exclusively or predominantly peripheral nerve dysfunction. CMT1X, the most common form of X-linked CMT is caused by mutations in connexin 32 (Cx32). In this work, we used dual whole cell patch clamp recording to examine the functional effects of mutations at the Arg(75) position. This residue is highly conserved among members of the connexin family, and disease-causing mutations have been identified at this (or the corresponding) position in Cx26, Cx43, and Cx46. Thus, a better understanding of the effects of mutations of this position in Cx32 may have relevance to pathogenesis of a number of different human diseases. All three mutants associated with CMT1X (R75P, R75Q, and R75W) showed very low levels of coupling similar to those of the cells transfected with vector alone. Heterotypic pairing with Cx32 WT showed that the absence of coupling for these mutants in the homotypic configuration could be explained by shifts in their hemichannel G(j)-V(j) relations. Examination of the expression levels and gating characteristics of seven additional mutants (R75A, R75D, R75E, R75H, R75K, R75L, and R75V) at this position suggest that the positive charge at position 75 in Cx32 is required for normal channel function but not for gap junction assembly. Our studies also suggest that disease treatment strategies for CMT1X, which correct trafficking abnormalities in Cx32, may be ineffective for the group of mutations also conferring changes in gating properties of Cx32 channels.

Association of Scholarly Impact to Industrial Contributions Among Academic Interventional Radiologists.

OBJECTIVE: The Physician Sunshine Act of 2010 aimed to increase public awareness of physician-industry relationships. Our objective was to evaluate whether there is an association between scholarly impact and industry funding among academic interventional radiologists. METHODS: A database from a prior study with our group was used in which we had investigated H-indices among US interventional radiologists; academic rank, gender, institution, and geographic location were obtained. The Scopus database was queried to determine all physicians' H-index. The CMS Open Payments database was used to determine industry payments from 2015 to 2021 for each interventional radiologist. RESULTS: H-index and professor rank positively and significantly correlated with industrial funding (H-index coefficient = $6,977, P < .001 and professor rank coefficient = $183,902, P = .003). Industry funding was found to be significantly different between all ranks. Among 830 academic interventional radiologists, the mean industrial funding of male physicians was $130,034, which was significantly higher than female physicians' $28,166 (P = .00013). By academic rank, male primary investigators of associate professor and unranked position had higher industrial funding than female primary investigators (Wilcoxon test, P = .029 and P= .039, respectively). Professor and assistant professor ranks had no significant difference in industrial funding between male and female physicians (Wilcoxon's test, P = .080 and P = .053, respectively). CONCLUSION: Scholarly activity as defined by the H-index and academic rank seem to have a positive association with industry funding of academic interventional radiologists.