BACKGROUND The purpose of this study was to investigate whether opioid use disorder (OUD) patients are at greater odds than non-opioid use disorder (NUD) patients in developing (1) thromboembolic complications; (2) readmission rates; and (3) costs of care. METHODS All patients with a 90-day history of OUD before total hip arthroplasty (THA) were identified from a national database. Patients were matched 15 to controls by age, gender, Elixhauser Comorbidity Index scores, and high-risk medical comorbidities, yielding 38,821 patients with (n = 6398) and without (n = 31,883) OUD. Multivariate logistic regression analyses were performed to compare the risks of developing venous thromboembolism (deep vein thrombosis and/or pulmonary embolism) 90 days after the index procedure, 90-day readmission rates, and total global 90-day episode of care costs. RESULTS Patients with a history of OUD were found to be at greater risk for 90-day venous thromboembolisms (2.38 vs. 1.07%; OR 2.25, 95% CI 1.86-2.73, P less then .0001) compared with matched NUD patients. Specifically, OUD patients were at greater risk for both deep vein thromboses (2.13 vs. 0.87%; OR 2.46, 95% CI 2.00-3.03, P less then .001) and pulmonary embolism (0.61 vs. 0.27%; OR 2.24, 95% CI 1.53-3.27, P less then .0001). In addition, patients with OUD were at an increased risk for 90-day readmission (28.68 vs. 22.62%; OR 1.37, 95% CI 1.29-1.46, P less then .0001) compared with controls. Primary THA patients with OUD incurred a 14.72% higher cost of care ($20,610.65 vs. $17,964.58) compared with NUD patients. CONCLUSION These findings demonstrate that primary THA patients with a history of OUD are at greater risks for thromboembolic complications, readmissions, and higher costs of care in the 90-day postoperative period. BACKGROUND Modular dual-mobility (MDM) total hip arthroplasty (THA) is designed with a cobalt-chromium liner inserted into a titanium acetabular component. The purpose of this study is to investigate the potential risks for fretting corrosion at this junction, by measuring serum metal ions, after MDM acetabular revision. METHODS Thirty-seven patients with well-functioning revision THAs participated in a cross-sectional study at mean 5.1 (2-10) years after surgery. All received a trabecular titanium MDM acetabular component. The serum levels of cobalt and chromium were measured using mass spectrometry. RESULTS The mean values of chromium and cobalt were 2.08 μg/L (95% confidence interval 0.9-3.2, range 0.02-11.8) and 1.99 μg/L (95% confidence interval 0.81-3.17, range 0.07-16.05), respectively.Eleven patients (29, 7%) had ion levels above the normal range, with 6 (16.2%) above 5 μg/L and 5 (13.5%) between 1 and 5 μg/L. A significant correlation was found between an elevated serum metal ion level and University of California Los Angeles score (P = .016). CONCLUSION We conclude that serum metal level elevation may occur secondary to metal debris resulting from corrosion of the index MDM THA. This potential risk should be included in the decision-making process when dealing with revision arthroplasty in young and active patients. BACKGROUND Hip arthroplasty is increasing in Australia. The number of procedures for fractured neck of femur was 7500 in 2017. Best practices for fixation method and procedure type require scrutiny. This paper is about the costs and health outcomes of cemented and uncemented hemiarthroplasty and total hip arthroplasty at a national level. METHODS We created a Markov model for patients less then 75, aged 75-85, and over 85. Expected costs and health outcomes over 5 years from a decision to change from existing practice to a best practice policy in which all patients with fractured neck of femur received the same fixation method based on age and type of arthroplasty are estimated. The model was populated using prevalence and incidence data from the Australian Orthopedic Association National Joint Replacement Registry, costs from Metro North Hospital and Health Service in Queensland, and probabilities and utilities from the literature. We simulated the uncertainties in outcomes with probabilistic sensitivity analysis. RESULTS We found that uncemented stem procedures were more costly and provided worse health outcomes compared to cemented stem fixation for hemiarthroplasty and total hip arthroplasty for all age groups. Moving from existing practice to cemented stem arthroplasty could save the Australian health system $2.0 million over 5 years with a gain of 203 quality-adjusted life years. CONCLUSION We suggest that consideration be given to cemented fixation of the femoral stem for patients receiving both hemiarthroplasty and total hip arthroplasty for fractured neck of femur. https://www.selleckchem.com/products/eras-0015.html Best practice guidelines focused on cost-effectiveness should recommend cemented stem fixation to both save costs and improve patient quality of life. BACKGROUND Although intermittent catheters are immediately removed, indwelling catheterization may lead to decreased ambulation and participation in physical therapy, critical components to post-total knee arthroplasty (TKA) management. Therefore, this study aimed to compare the effect of catheterization treatments on (1) postoperative ambulation distances, (2) deep vein thromboses (DVTs), and (3) pulmonary emboli (PEs) following TKA. METHODS A total of 9123 prospectively collected primary TKA patients were assessed based on postoperative catheter status. Patient demographics, Charlson Comorbidity Indices, body mass indices, DVT prophylaxes, first ambulation distances, DVTs, and PEs were collected at approximately mean 12 months of follow-up. Univariate and multivariate analyses were performed with independent t-tests and multiple linear regression models in order to compare catheterization techniques. RESULTS There were 1193 patients who had urinary retention and treated with either indwelling only (62%, n = 734), both indwelling and intermittent catheterizations (13%, n = 160), or intermittent only (25%, n = 299). Multivariate analyses found that indwelling catheter-only use had an 11% decrease in ambulation distance (P less then .001). Additionally, the indwelling catheterization-only group was found to be at increased risk of DVTs (odds ratio 2.605, P less then .001), even after controlling for DVT prophylaxes (odds ratio 2.807, P less then .001). CONCLUSION This study showed that the use of an indwelling catheter for treatment of urinary retention significantly decreased TKA patient ambulation distance and subsequently increased the risk for DVTs. This information is important as we would recommend the treatment with intermittent catheterization rather than indwelling catheters to decrease the risk of immobilization and postoperative DVTs.