of $50,000 if the rate of failure of nonoperative treatment rose to 14.6%. Similarly, at the $100,000 threshold, allograft became dominant if the probability of failure of nonoperative treatment rose to 22.8%.

The cost-effectiveness of nonoperative treatment is fueled by its notably lower costs and overall high rates of success in Grade-III separations. It is important to note that, in our analysis, the societal cost (measured in lost productivity) of nonoperative treatment neared that of surgical treatment, but the cost from the health-care system perspective was minimal. Physicians should bear in mind the sensitivity of these conclusions and should consider cost-effectiveness analyses in their decision-making guidelines.

Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.

Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.

Despite new 3-dimensional imaging modalities, 2-dimensional fluoroscopy remains the standard intraoperative imaging modality. The elbow has complex anatomy, and defined standard fluoroscopic projections are lacking. Therefore, the aim of this study was to define standard projections of the elbow for intraoperative fluoroscopy.

This study consisted of 2 parts. In part I, dissected cadaveric elbows were examined under fluoroscopy, and their radiographic anatomical features were assessed, with focus on projections showing defined anatomical landmarks. In part II, projections from part I were verified on entire cadavers to simulate intraoperative imaging. Standard projections for anteroposterior (AP) and lateral views as well as oblique and axial views were recorded.

Eight standardized projections could be defined and included 3 AP, 1 lateral, 2 oblique, and 2 axial views. By applying these specific projections, we could visualize the epicondyles, the trochlea with its medial and lateral borders, the capitellum, the olecranon, the greater sigmoid notch, the coronoid process including its anteromedial facet, the proximal radioulnar joint with the radial tuberosity, and the anterior and posterior joint lines of the distal part of the humerus. These standard projections were reliably obtained using a specific sequence.

Knowledge about radiographic anatomy and standard projections is essential for visualizing important landmarks. With the presented standard projections of the elbow, important anatomical landmarks can be clearly examined. Thus, fluoroscopic visualization of anatomical fracture reduction and correct implant placement should be facilitated.

This basic science cadaveric study defines fluoroscopic standard projections of the elbow essential for visualization of anatomical landmarks during surgery.

This basic science cadaveric study defines fluoroscopic standard projections of the elbow essential for visualization of anatomical landmarks during surgery.

A better understanding of early pain trajectories (patterns) following scoliosis surgery and how they relate to baseline patient characteristics and functional outcomes may allow for the development of mitigating strategies to improve patient outcomes.

This was a prospective cohort study. Adolescents with idiopathic scoliosis were recruited across multiple centers. Latent growth mixture modeling techniques were used to determine pain trajectories over the first postoperative year.

The median numerical rating scale for pain in the hospital following surgery for adolescent idiopathic scoliosis was 5.0. It improved to 1.0 by 6 weeks, and was maintained at <1 by 3 to 12 months postoperatively. Three trajectories were identified, 2 of which involved moderate acute postoperative pain 1 with good resolution and 1 with incomplete resolution by 1 year. The third trajectory involved mild acute postoperative pain with good resolution by 1 year. Membership in the “moderate pain with incomplete resolution” trajectory was predicted by higher baseline pain and anxiety, and patients in this trajectory reported worse quality of life than those in the trajectories with good resolution.

Pain recovery following surgery for idiopathic scoliosis was found to be substantial during the first 6 weeks and continued up to 1 year. We identified 3 main trajectories, 2 with favorable outcomes and 1 with persistent pain and worse quality of life at 1 year postoperatively. The risk factors most associated with the latter trajectory included increased baseline pain and anxiety.

Prognostic Level II. MEK inhibitor See Instructions for Authors for a complete description of levels of evidence.

Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Antiretroviral therapy (ART) remains the cornerstone of decreasing morbidity and mortality in patients with human immunodeficiency virus (HIV), but additional information on its impact on total hip arthroplasty (THA) complication rates is needed to mitigate risks postoperatively. Therefore, we sought to examine patients with HIV who were and were not taking ART compared with a cohort without HIV in the setting of primary THA with respect to the following outcomes length of stay, readmissions, and postoperative infection.

A retrospective database review was performed with PearlDiver for patients who underwent THA from 2010 to 2019 (n = 729,101). Patients with HIV who were and were not taking ART were then identified and were matched with patients without HIV at a 111 ratio based on age, sex, Charlson Comorbidity Index, diabetes, obesity, and tobacco use, resulting in 601 patients in each cohort. Length of stay, 30-day readmissions, and complications at 90 days and 1 year were analyzed. Continuous outcomes een mitigated by modern therapy, extreme care should be taken while clinically evaluating these patients prior to the surgical procedure given the complexity of their clinical status. The findings of this study underscore the utility of ART and patient optimization to reduce risk in this patient population.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.