Background: Unicompartmental knee arthroplasty (UKA) is increasingly used for knee osteoarthritis due to faster recovery, better range of motion, and lower costs compared to total knee arthroplasty (TKA). While TKA may offer longer-lasting results with lower revision rates, this study compares the relative benefits and limitations of UKA and TKA using the National Inpatient Sample (NIS) database. Methods: This retrospective analysis examined outcomes of elective UKA and TKA procedures from 2016 to 2019, identifying 2,606,925 patients via ICD-10 codes. Propensity score matching based on demographics, hospital characteristics, and comorbidities resulted in a balanced cohort of 136,890 patients. The present study compared in-hospital mortality, length of stay, postoperative complications, and hospitalization costs. Results: The results showed that UKA procedures increased significantly over the study period. Patients undergoing UKA were generally younger with fewer comorbidities. After matching, both groups had low in-hospital mortality (0.015%). UKA patients had shorter hospital stays (1.53 vs. 2.47 days) and lower costs (USD 55,976 vs. USD 61,513) compared to TKA patients. UKA patients had slightly higher rates of intraoperative fracture and pulmonary edema, while TKA patients had higher risks of blood transfusion, anemia, coronary artery disease, pulmonary embolism, pneumonia, and acute kidney injury. Conclusions: UKA appears to be a less-invasive, cost-effective option for younger patients with localized knee osteoarthritis.

Introduction: Unicompartmental knee arthroplasty (UKA) is gaining traction as a treatment for knee osteoarthritis due to faster recovery, better range of motion, and reduced healthcare costs compared to total knee arthroplasty (TKA). UKA preserves healthy parts of the knee, leading to a quicker return to function and less pain. However, TKA offers potentially longer-lasting results with lower revision rates. This study investigates the National Inpatient Sample (NIS) database for UKA and TKA patients to understand their relative benefits and limitations, aiming to inform patient care and resource allocation. Methods: This retrospective analysis examined outcomes following UKA and TKA using the Nationwide Inpatient Sample (NIS) database (2016-2019). Patients undergoing elective UKA or TKA (n=2,606,925) were identified using ICD-10 codes (Appendix). To minimize confounding factors, propensity score matching was performed using patient demographics, hospital characteristics, and comorbidities, resulting in a balanced cohort of 136,890 patients. In-hospital mortality, length of stay, postoperative complications, and hospitalization costs were compared (p < 0.05). This study received exempt IRB approval due to de-identified data. Results: The prevalence of UKA procedures significantly increased over the study period, with primary osteoarthritis being the leading cause for both UKA and TKA. Patients undergoing UKA were younger and had less comorbidities compared to those undergoing TKA. Propensity score matching effectively balanced these baseline characteristics between the two groups. Examining hospitalization outcomes in propensity-matched cohorts revealed low in-hospital mortality for both groups (0.015%). However, UKA demonstrated a clear advantage in terms of shorter length of stay (1.53 days vs. 2.47 days) and lower total hospitalization charges ($55,976 vs. $61,513). While UKA had slightly higher rates of intraoperative fracture and pulmonary edema compared to TKA, TKA was associated with a significantly increased risk of various complications. These included blood transfusion, blood loss anemia, acute coronary artery disease, pulmonary embolism, pneumonia, and acute kidney injury. Conclusion: UKA shows promise as a less-invasive option for younger patients with one-sided knee osteoarthritis, potentially offering shorter hospital stays, lower costs, and potentially fewer complications.

Background: Chronic wrist pain is becoming increasingly recognized among athletes engaging in wrist-loading activities such as handstands. However, its prevalence and associated risk factors in handstand practitioners have not been systematically studied. This study aimed to investigate the prevalence of chronic wrist pain and to explore associated factors such as discipline, training habits, and pain management strategies. Methods: This cross-sectional study aimed to investigate the prevalence and associated factors of chronic wrist pain among handstand practitioners. Eligible participants were individuals aged 18 years or older, of any gender, who practiced handstands regularly (defined as at least once per week). Participants were recruited via a combination of open invitations on social media (Facebook, WhatsApp, Instagram) and direct outreach to movement studios and training communities. The survey was administered online using Google Forms and remained open for two months. Participation was voluntary and anonymous. Descriptive statistics were used to present sociodemographic characteristics, including age group, gender, sport discipline, and weekly training hours. Participants reported training habits, equipment use, pain history, and management strategies via a self-developed questionnaire designed for this study. Chronic pain was defined as recurring or persistent wrist pain. Descriptive statistics were used to summarize responses. Associations between chronic wrist pain and survey variables were analyzed using Chi-square or Fisher’s exact tests for nominal data, and Chi-square test for trend for ordinal data. A p-value < 0.05 was considered statistically significant. Results: A total of 321 participants were included in the study. The most represented age group was 25–34 years, comprising 123 (38.3%) of the participants. Gender distribution was 174 (54.2%) males and 147 (45.8%) females. The most common sport disciplines were Yoga (88, 27.4%), Capoeira (60, 18.7%), and Movement (52, 16.2%). Chronic wrist pain was reported by 182 (56.7%) of participants. Younger age was significantly associated with higher pain prevalence (p = 0.042). No significant associations were observed between chronic pain and weekly training hours, warm-up routines, brace use, or grip device use. Female participants demonstrated more proactive pain management behaviors (p = 0.016). Sport discipline and training practices showed non-significant trends toward pain differences. Conclusions: Chronic wrist pain is common among handstand practitioners, particularly among younger athletes. These findings suggest that injury risk may relate more to training intensity and biomechanics than to simple training volume. Further research incorporating objective diagnostics and standardized intervention protocols is warranted.

Introduction: Femoral neck fractures pose significant health risks, particularly in the elderly population, leading to mortality, morbidity, and decreased quality of life. Surgery is the preferred treatment to restore function and alleviate pain, with options including total hip arthroplasty (THA) and hemiarthroplasty (HA). However, clinical guidelines for selecting surgical procedures remain heterogeneous, prompting the need for further investigation into treatment trends and influencing factors. Methods: Data from the NIS database spanning 2016–2019 were analyzed, focusing on patients diagnosed with intracapsular femoral neck fractures and undergoing THA or HA as primary in-hospital surgeries. Advanced statistical analyses using SPSS and MATLAB were conducted to identify trends and factors influencing surgical choices. Results: Comorbidity profiles varied significantly between HA and THA patients, with specific conditions such as Alzheimer’s disease showing higher prevalence in HA patients. Demographic differences included a higher proportion of females and Medicare-insured individuals in the HA group. Racial disparities were observed, with differences in surgical preferences among various ethnic groups. THA adoption gradually increased over the study period, indicating a shift in surgical priorities. Additionally, THA patients tended to be younger on average compared with HA patients. Conclusions: This study highlights evolving trends in surgical management for femoral neck fractures and identifies factors influencing treatment decisions in our cohort. Understanding these trends and disparities is crucial for optimizing patient care and informing future clinical guidelines. Further research should focus on assessing different surgical approaches’ long-term outcomes and cost-effectiveness.

The integration of navigation technologies into spine surgery has improved precision and safety, yet traditional free-hand techniques are still widely used in anterior cervical discectomy and fusion (ACDF). This study uses the National Inpatient Sample (NIS) database to compare free-hand ver-sus navigation-guided ACDF, analyzing complications, costs, mortality, and hospital stay. Data from 2016 to 2019 identified 85,085 ACDF patients, including 560 navigation-guided surgeries. Propensity score matching balanced the cohorts for demographics and comorbidities. Navigation-guided surgeries showed higher total costs (p

Introduction: Older patients with distal humerus fractures die more often after conservative than after operative treatment in unadjusted comparisons; whether this reflects treatment or the selection of healthier patients for surgery is unresolved. We estimated the association between operative versus conservative management and five-year all-cause mortality in patients aged ≥ 65 years. Materials and methods: Retrospective comparative cohort study at two tertiary trauma centres (2012–2025). Cases were ascertained by automated screening of codes and free text, then adjudication of all uncertain records against source notes and injury radiographs, masked to treatment and vital status. Patients were classified by management initiated within 14 days as operative ( n = 75) or conservative ( n = 78); vital status was registry-linked. The primary estimand was the five-year restricted mean survival time (RMST) difference; principal adjusted estimates were inverse-probability-weighted (IPW) RMST and survival differences, requiring no proportional-hazards assumption. Cox, window and landmark analyses are supportive. Results: Among 153 patients (52 deaths), conservatively managed patients were older (median 83 vs. 73 years, p < 0.001). Unadjusted five-year mortality was 41.9% versus 18.4%: RMST difference + 11.2 months (95% CI + 5.6 to + 16.8), log-rank p = 0.006. After weighting for age, sex, comorbidity and centre this shrank to + 3.4 months (95% CI − 1.5 to + 8.6; adjusted five-year survival difference + 1.4%, − 14.7 to + 18.5), and to + 1.0 month (− 2.9 to + 5.5) within the covariate-overlap cohort (65–84 years). Comorbidity (HR 1.35 per Charlson point) and age (HR 1.72 per decade) predicted mortality in both arms. Sensitivity analyses were concordant. Conclusions: The large unadjusted survival advantage of operative fixation shrank substantially after adjustment, and the remaining estimates are too imprecise to support any claim of survival benefit or harm. Because functional outcomes, the principal indication for surgery, were not measured, the study cannot inform individual treatment choice. Crude survival differences here should not be read as treatment effects. Level of evidence: Level III, Retrospective comparative cohort study.