Running Following Hip Arthroplasty: A Systematic Review.

With improved implants and younger patients undergoing total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA), there are increased expectations to return to high-impact activities. Recommendations regarding return to running following hip arthroplasty remain unclear. A search of the PubMed database was conducted, and all publications referencing running following THA or HRA published between January 1, 2000, and September 1, 2020, were included in the systematic review. Patient demographics, surgical variables, activity measures, and revision rates were recorded for each study. A total of 225 unique citations were identified, of which four manuscripts met the eligibility criteria. Eighty-nine of 121 (73.6%) preoperative runners returned to running postoperatively. All four studies reported mean postoperative UCLA activity scores of at least nine. More patients returned to running following HRA than THA with lower rates of revision. Further research with longer postoperative follow-up is necessary to provide definitive recommendations for running following arthroplasty procedures. (Journal of Surgical Orthopaedic Advances 32(1):001-004, 2023).

Risk Factors for Deep Vein Thrombosis or Pulmonary Embolus Following Anterior Cruciate Ligament Reconstruction.

BACKGROUND: Nearly 350,000 Americans develop a deep venous thromboembolism (DVT) or pulmonary embolism (PE) annually, and nearly 100,000 Americans die from these events. To date, little research has investigated patient-specific risk factors that increase the rate of DVT/PE following anterior cruciate ligament reconstruction (ACLR). PURPOSE: To determine relevant patient risk factors for the development of DVT/PE following ACLR. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: All instances of ACLR from 2005 to 2014 within the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine which patient demographics and surgical factors were associated with DVT or PE following surgery. RESULTS: Of the 9146 patients who underwent ACLR, 46 (0.5%) developed postoperative DVT, 8 (0.1%) developed PE, and 5 (0.05%) developed both. The following variables were associated with the development of DVT or PE on univariate analysis: increased age, a high tibial osteotomy (HTO) performed at the time of ACLR, microfracture performed, the presence of hypertension requiring medical therapy, and the presence of an active wound infection. Independent predictors of DVT or PE on multivariate analysis included HTO (odds ratio [OR], 22.7), the presence of an active wound infection (OR, 11.0), or hypertension requiring medication (OR, 2.2). Meniscal repair was not a risk factor for DVT or PE on univariate or multivariate analysis. CONCLUSION: In a review of 9146 patients undergoing ACLR, 46 (0.5%) developed DVT in the 30-day postoperative period. Increasing age over 30 years, concomitant HTO or microfracture, hypertension requiring medication, and presence of wound infection were all associated with an increased risk of DVT. The annual incidence of DVT/PE following ACLR reconstruction is low (<1%) and has not changed over time.