Perioperative Outcomes in Orthopedic Surgery

With millions of surgical procedures being performed worldwide annually, clinicians, researchers, patients, and administrators increasingly pursue understanding factors, which affect and determine perioperative outcomes. The last decades have been associated with extensive research and subsequent increased number of publications in the field of perioperative outcomes in orthopaedic surgery. The population is progressively involved in recreational and athletic activities increasing thus the prevalence of sport-related soft-tissue and bone injuries. Furthermore, the population is aging and the demand for joint replacement and spine surgery is increasing annually, raising inevitably the absolute numbers of surgery related complications such as infection, mechanical failure, and delayed union. Finally, the adoption of new technology and the introduction of minimally invasive surgical techniques still remain a controversial topic on whether evidence-based medicine has justified the risk of their use. Hence, it is important to critically evaluate the perioperative outcomes of modern orthopaedic surgery and further investigate whether a change in the perioper-ative management of the orthopaedic patient is warranted. Although the selected papers for this special issue are not an exhaustive representation of the area of perioperative outcomes in orthopaedic surgery, they represent an excellent panel for approaching and addressing this challenge. Without doubt they will provide significant knowledge to the readers, simulating further investigation and research and possible improvement of the current surgical technique and overall perioperative management of the orthopaedic patient. The special issue contains six papers; of these, three papers are related to spine surgery and more specifically to fusion rates of various disc substitutes and outcomes and complications of minimally invasive surgery. One paper presents short-term outcomes of surgical reconstruction of chronic functional ankle instability. Another experimental study provides data that support the combined use of flexible intramedullary nailing and Ilizarov external fixation for bone repair enhancement. Finally, the last paper covers criteria for patient risk stratification with regard to the development of surgical site infection following total hip arthroplasty. In the paper entitled " PEEK Cages versus PMMA Spacers in Anterior Cervical Discectomy: Comparison of Fusion, Subsidence, Sagittal Alignment, and Clinical Outcome with a Minimum 1-Year Follow-Up, " authors compared radio-graphic and clinical outcomes after anterior cervical dis-cectomy in patients with cervical degenerative disc disease using PEEK cages or PMMA spacers with a minimum 1-year follow-up. They found that the substitute groups showed differing fusion rates. However, clinical outcomes appeared to be generally not correlated with fusion status or subsidence. Authors concluded …