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Background: We aimed to determine if Area Deprivation Index (ADI) is associated with self-reported metrics socioeconomic status (SES), and to assess the relationship between ADI and preoperative score on common patient reported outcome scores (PROS)., Methods: Patients presenting for outpatient orthopaedic surgery completed Patient-Reported Outcome Metric Information System (PROMIS) and joint-specific PROS. ADI was determined from geocoded home address. Sociodemographic data was collected from self-reported survey. Tests of association were used to describe the relationship between ADI and sociodemographic factors as well as the correlation between ADI and PROS. Extreme group analysis was used to examine which PROS may be subject to clinically meaningful variation., Results: ADI was associated with self-reported SES. ADI was correlated with score on all baseline PROS. Extreme group analysis showed that low SES was associated with clinically meaningful differences in some, but not all, PROS., Conclusion: ADI is associated with self-reported measures of SES in an orthopaedic outpatient surgical population. Lower SES correlates with worse function to a clinically significant degree for some PROS. SES should be considered in the context of preoperative symptom severity in outpatient orthopaedic surgery patients. ADI may be a useful adjunct to self-reported measures of SES for this purpose., Competing Interests: N. N. O'Hara receives stock or stock options from Arbutus Medical, Inc. unrelated to this research. C. G. Langhammer is a paid consultant for DePuy Synthes unrelated to this research. The remaining authors report no conflicts., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Aims & Objectives: Meaningful clinical interpretation of orthopaedic patient-reported outcome scores remains challenging. Grouping scores may be more meaningful than individual score analysis. The purpose of this study was to determine if grouping knee surgery patients into four preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) clusters would have prognostic value for two-year postoperative outcomes., Materials & Methods: 488 of 697 (70%) patients undergoing elective knee surgery at a single urban institution were enrolled in an orthopaedic registry and completed two-year follow up. Patients were administered questionnaires for PROMIS, International Knee Documentation Committee Score (IKDC), Marx Activity Rating Scale (MARS), and Surgical Satisfaction (SSQ-8). A k-means cluster analysis was performed to identify preoperative PROMIS clusters. Chi-square or Kruskal-Wallis tests were conducted for bivariate analyses. Least-squares multiple linear regression models were performed to identify if cluster group was an independent predictor., Results: Cluster analysis revealed four clusters of patients. Psychological distress was most significant in determining classification. More impaired clusters were associated with higher rates of arthroplasty, African American race, preoperative opioid use, lower income, higher comorbidity index, and other sociodemographic and operative factors. Worse preoperative cluster status was associated with higher chance of achieving minimally clinically important change (MCID) on all metrics except PROMIS Pain Interference (PI), IKDC, and MARS. Multivariable analysis confirmed better preoperative cluster as predictive of better PROMIS Physical Function (PF), PI, IKDC scores, and satisfaction. Worse preoperative cluster was predictive of greater improvement on PF and PI but not IKDC., Conclusion: Preoperative PROMIS clusters have prognostic value in predicting outcomes for knee surgery patients. Better preoperative cluster function predicts superior outcomes. While worse preoperative cluster predicts worse outcome, all clusters still significantly improve, so worse preoperative cluster is not a contraindication to surgery., Competing Interests: All authors certify that they have no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. On the Disclosure of Potential Conflicts of Interest forms, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work., (© 2023 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)

Introduction: The aim of this study was to systematically review the literature regarding accurate shoulder prosthetic joint infection (PJI) diagnosis., Methods: Using PRISMA guidelines, we analyzed 25 studies reporting on 5535 patients and 646 infections., Results: Cutibacterium acnes (C. acnes) cultures were positive in 60% of patients. Serum markers WBC, CRP, ESR, and IL-6 appear to lack diagnostic reliability. Synovial IL-6 and alpha-defensin may be more accurate in detecting infections., Conclusion: Synovial IL-6 and alpha-defensin appear to have greater utility than serum markers. These may be incorporated into new criteria to accurately diagnose shoulder PJI., Level of Evidence: IV., (© 2021 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)