Changes in Severity of Pelvic Floor Dysfunction after Hip Surgery

Introduction: Despite growing evidence that suggests an association between hip pathology and pelvic floor disorder (PFD), the comprehensive effects of hip surgery on PFD symptoms are not well understood. The primary purpose of this study was to report the role of surgical hip procedures on the severity of PFD symptoms. Methods: A prospective database of demographic and outcome data for all female patients that were operated on between 2019-2020 at a single institution was queried. The PDFI-20 was used to assess symptom severity, and cases with both pre and postoperative surveys were included (n=62). MCID was used to determine significance of change in PDFI-20 score. Results: All patients were female and mean age was 50.1 years. 40 patients had a THA, 10 had a PAO, 9 had a hip arthroscopy, 2 had a surgical hip dislocation, and one had abductor repair and reconstruction. The pre- and postoperative PFDI-20 scores for patients who underwent THA were 40.4±40.1 and 31.5±35.8. The pre- and post-operative PFDI-20 scores for patients who underwent PAO were 10.6±16.9 and 5.3±12.4. The pre- and post-operative PFDI-20 scores for patients who underwent hip arthroscopy were 7.2±12 and 15.2±25.9. The pre- and post-operative PFDI-20 scores for patients who underwent surgical hip dislocation were 41.7±58.9 and 39.1±55.2. The pre- and post-operative PFDI-20 scores for patients who underwent abductor repair and reconstruction were 33.3±0 and 113.5±0. Conclusion: A subset of patients undergoing hip surgery do have baseline pelvic floor dysfunction. We did not find a significant improvement from pre and post op in our patient population. Mean PFDI-20 scores improved in patients who underwent THA, PAO, and surgical hip dislocation. This study demonstrates that the impact of hip surgery on PFD symptoms in patients with hip pathology should be considered, with further research required to fully characterize this relationship

Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database

Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that has investigated complications following total shoulder arthroplasty (TSA) in wheelchair users. Utilizing the PearlDiver Mariner national administrative database, 72,108 patients were identified who underwent TSA with a concurrent diagnosis of a rotator cuff tear. Two matched cohorts, one of wheelchair users and one of non-wheelchair users, were created. Due to limitations within PearlDiver, one-year outcomes, including comorbidity and complication rates and readmission statistics, were compared between the two cohorts. Each matched cohort of 869 patients underwent TSA with a concurrent diagnosis of a rotator cuff tear. The rate of readmission in wheelchair users was greater than in non-wheelchair users (24.05% vs. 9.55%, OR: 3.00, CI: 2.279, 3.946). Patients in the wheelchair cohort exhibited higher rates of complications and comorbidities (p p < 0.05). Significant differences in surgical outcomes existed between wheelchair and non-wheelchair users in terms of preoperative comorbidities, postoperative complications, and readmission rates