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Yvet Mooiweer Department of Health Services Research, Carl von Ossietzky University, Oldenburg, Germany
Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

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Lina Roling School of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany

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Margaret Vugrin Preston Smith Library, Texas Tech University Health Sciences Center, Lobbock, Texas, USA

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Lena Ansmann Department of Health Services Research, Carl von Ossietzky University, Oldenburg, Germany
Chair of Medical Sociology, Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR) Faculty of Medicine, University of Cologne, Oldenburg, Germany

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Martin Stevens Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

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Gesine H Seeber Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
University Hospital of Orthopedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany

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, with a generally good outcome and cost-effectiveness ( 6 ). However, 10–30% of patients are dissatisfied with their surgical outcome ( 7 ). Patient’s preoperative level of expectations seems to play a role in postoperative outcomes ( 8 , 9

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SaTia T. Sinclair Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Ahmed K. Emara Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Melissa N. Orr Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Kara M. McConaghy Case Western Reserve University School of Medicine, Cleveland, Ohio, United States

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Alison K. Klika Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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Nicolas S. Piuzzi Cleveland Clinic Foundation, Department of Orthopedic Surgery, Cleveland, Ohio, United States

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postoperative outcomes. 15 , 18 Upon its development, Dripps et al 19 revised the classification system, giving rise to the current model comprising six classes and a separate designation for emergency procedures ( Table 2 ). 17 , 19 Currently

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Dieter Wirtz Department of Orthopaedic Surgery and Traumatology, University Hospital of Bonn, Germany

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Hendrik Kohlhof Department of Orthopaedic Surgery and Traumatology, University Hospital of Bonn, Germany

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hospitalized have high rates of malnutrition (up to 38.7%). Several studies have also highlighted the association of post-operative malnutrition markers with adverse outcomes such as pulmonary infections, SSI and length of stay. 5 , 8 Several studies and

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Stavros Tsotsolis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece
Trauma and Orthopaedics Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

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Eustathios Kenanidis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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Vasileios F Pegios Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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Michael Potoupnis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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Eleftherios Tsiridis Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Ring Road Efkarpia, Thessaloniki, Greece
Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Balkan Center, Buildings A & B, Thessaloniki, Greece

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population ( 10 ). However, the evaluation of thyroid dysfunction influence on primary TJA outcomes is limited. Recent data demonstrated an increased risk of multiple postoperative complications and higher care costs among patients with hypothyroidism

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Maria Anna Smolle Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Lukas Leitner Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Nikolaus Böhler Department for Orthopedics and Traumatology, Kepler University Hospital GmbH, Linz, Austria

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Franz-Josef Seibert Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Mathias Glehr Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Andreas Leithner Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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negative impact of smoking regarding various outcome parameters in orthopaedics and trauma, including incidence of fracture, risk for lateral epicondylitis, fracture nonunion and postoperative complication rate. 15 – 18 The aim of the current systematic

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İlker Eren Koç University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey

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Cemil Cihad Gedik Koç University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey

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Uğur Kılıç Koç University, School of Medicine, Istanbul, Turkey

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Berk Abay Koç University, School of Medicine, Istanbul, Turkey

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Olgar Birsel Koç University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey

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Mehmet Demirhan Koç University, School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey

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extremity disability better than others, but it still has similar drawbacks. There is clearly a need for an STA-specific QoL outcome score. Figure 8 (A) Preoperative elevation; (B) postoperative elevation. Table 3 A summary of clinical

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Anna Bogdanova-Bennett Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, UK

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Amit Sagi Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, UK

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Vipin Asopa Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, UK

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Richard E. Field Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, UK

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David H. Sochart Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, UK

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respectively. 4 Since these metals are commonly used in THR implants, it has been suggested that patients who are hypersensitive to them may develop a hypersensitivity reaction post-operatively. 5 Metal hypersensitivity reactions in orthopaedic patients have

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Xiangji Dang Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, P.R. China
Department of Pharmaceutical, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Mei Liu The First Clinical Medical School, Gansu University of Chinese Medicine, Gansu, P.R. China

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Qiang Yang Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Jin Jiang Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Yan Liu Gansu High Throughput Screening and Creation Center for Health Products, School of Pharmacy, Lanzhou University, Lanzhou, P.R. China

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Hui Sun Cuiying Biomedical Research Center, Lanzhou University Second Hospital, Lanzhou, Gansu province, P.R. China

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Jinhui Tian Evidence-based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, P.R. China

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use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety . BMJ 2014 349 g4829 . ( https://doi.org/10.1136/bmj.g4829 ) 27 Gillette BP DeSimone LJ

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Anne Lübbeke Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Switzerland; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK

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Commonly assessed outcomes in orthopaedic and trauma surgery include: (1) mortality; (2) post-operative medical complications (e.g. deep vein thrombosis, pulmonary embolism, cardiovascular and gastrointestinal complications, anaemia, delirium); (3

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Yu Ren Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Hui Yu Department of Hematology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
Department of Hematology, Enze Hospital, Taizhou Enze Medical Center (Group), Taizhou, Zhejiang, China

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Zhangfu Wang Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Wenjun Pan Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Lin Chen Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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Hua Luo Department of Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China

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delayed postoperative bathing groups (OR: 0.25; 95% CI: 0.09–0.73, P  = 0.01; Fig. 5 ); for the other wound complications, no significant difference was found. Figure 5 Forest plot of comparison: earlier bathing versus delayed bathing; outcome

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