Custom partial constrained scapula total humerus and total elbow arthroplasty as a salvage procedure in a patient with rheumatoid arthritis
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Case Report Source Type: research

Treatment of a symptomatic triquetral nonunion
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Case Report Source Type: research

Occurrence of hereditary multiple osteochondromatosis with multiple exostoses in a patient from Bahia, Brazil
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Case Report Source Type: research

The use of sublaminar bands in treatment of spinal deformity: an operative technique
Conclusions: This novel surgical technique of sublaminar band utilization offers a user-friendly procedure with a short learning curve. This technique, if applied in the correct surgical candidates, has been proven to be a successful method of spinal deformity correction in pediatric spinal fusions. Level of Evidence: Level IV. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Innovations in Practice Source Type: research

Characterization of compliance to weight-bearing protocols and patient weight-bearing behavior during the recovery period in lower extremity fractures: a pilot study
Conclusions: Continuous compliance data from this study indicate that patients do not comply with weight-bearing protocols. Additionally, the variety of weight-bearing progressions, with limited complications, may suggest that patients are able to self-regulate their weight bearing without compromising healing outcomes. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Innovations in Practice Source Type: research

Hip fractures: current review of treatment and management
Hip fractures are one of the most common major orthopaedic injuries in the United States, with an incidence that is growing with the aging population. These fractures vary significantly in anatomy, pathogenesis, and treatment. Orthopaedists must be able to carefully distinguish between femoral neck, intertrochanteric, and subtrochanteric femoral fractures because diagnosis is essential in guiding treatment. The extent of complex decision-making and management is often underappreciated in this diverse group of fractures. In this review, the relevant background, anatomy, and current treatment considerations essential to opti...
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Review Article Source Type: research

A systematic review of treatment of frozen shoulder by hydrodistension with or without steroid or intraarticular steroid injection
Conclusions: Our systematic review demonstrated that patients treated by any of the three modalities improved with no significant difference among them over a period of 6 to 12 mo. However, at 3 mo distension with steroids and steroid injection alone were superior to distension alone. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Intrafocal joystick technique for closed reduction and percutaneous fixation of late-presenting supracondylar fractures of the humerus
Conclusions: The intrafocal joystick technique for closed reduction and percutaneous fixation of irreducible supracondylar fractures of the humerus in certain difficult situations can effectively and safely achieve satisfactory radiographic and functional outcomes and decrease the need for conversion to an open reduction. Open reduction and internal fixation are essential in some patients but should only be used after all techniques of closed reduction and percutaneous fixation have failed. Level of Evidence: Level III retrospective. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Posterior vertebral column resection for congenital rigid spinal deformities
Conclusions: Single-stage PVCR is a highly effective option in the management of rigid spinal deformities with satisfactory clinical and radiographic outcomes. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Changing practice patterns: flexed versus semi-extended positioning for tibial nailing
Background: Recent studies have demonstrated several benefits to semi-extended leg position for intramedullary nailing (IMN) without increased complications. The purpose of this study was to evaluate how surgeon preference for flexed versus semi-extended positioning has changed over time. Methods: We distributed an anonymous online survey to orthopaedic surgeons via the Orthopaedic Trauma Association (OTA) website. We compared surgeon demographics and preferred leg positioning for tibial nailing. Results: Twenty-seven percent of surgeons reported substantial experience (>50% of cases) with semi-extended position...
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Geriatric olecranon fractures treated with plate fixation have low complication rates
Conclusions: The complication and reoperation rates after plate fixation of geriatric olecranon fractures were low. Loss of reduction was uncommon, and most patients went on to uneventful fracture union. These results support plate fixation of olecranon fractures in geriatric patients as a viable alternative to nonoperative management. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Rates and treatments of CrossFit-related injuries at a single hospital system
Conclusions: CrossFit injury volumes at our center have steadily increased as participation rates have increased. Physical therapy was frequently utilized. Surgery rates for MSK injuries varied considerably by anatomic region. Men were more likely to require surgery. The percentage of injuries requiring surgery increased throughout the study period. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Lever sign test: is it sensitive for the diagnosis of anterior cruciate ligament disruption?
Background: Anterior cruciate ligament (ACL) tear is a common knee injury with various manual tests used for clinical diagnosis. The aim of this prospective study was to evaluate the lever sign test sensitivity as a new clinical test for diagnosis of ACL disruptions compared to other manual diagnostic tests. Methods: One hundred patients with chronic ACL tears were included in this study between January 2017 and March 2018. The mean age was 29.1±8.2 yr. Four clinical tests (anterior drawer, Lachman test, pivot shift, and lever sign) were obtained in all patients by two different clinicians. The contralat...
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Intraoperative bone tunnel laceration affects integrity of arthroscopic transosseous rotator cuff repair with a tunneling device
Background: We aimed to evaluate the functional outcomes, incidence of bone tunnel laceration, and bone tunnel morphology of transosseous arthroscopic rotator cuff repair (ARCR) with the Arthro-TunnelerTM. Methods: Between May 2012 and April 2013, patients with full-thickness tears who underwent transosseous ARCR with the Arthro-TunnelerTM and could be followed for a minimum of 2 yr were included in this retrospective study. Functional outcomes, cuff repair integrity, intraoperative bone tunnel laceration, and postoperative bone tunnel morphology were analyzed. Results: We retrospectively evaluated 42 consec...
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Opioid use after ankle fracture surgery: current trends in the United States
Conclusions: The percentage of patients utilizing opioid prescriptions after ankle fracture surgery is much lower than expected, suggesting that routine prescriptions given after ankle fracture surgery and other smaller orthopaedic procedures are not likely to be contributing to the epidemic. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Parameters identifying the risk of treatment failure after cartilage repair: a proposed treatment algorithm and pilot study
Conclusions: Microfracture as the primary technique led to the most failures, but because of its simplicity and balanced clinical results, it should be used as the gold standard, especially in younger patients. Open techniques, AMIC, and periosteal transplantation should be reserved as second choice treatments after failure and as a first choice treatment for multiple lesions, larger defects, older patients, and for defects such as osteochondritis dissecans where there is a need for autologous cancellous bone transplantation. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

Lisfranc open reduction and internal fixation in an athletic population: screw versus suture button fixation
Conclusions: Our results demonstrate that suture button fixation serves as a viable alternative to screw fixation in an athletic population. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

Challenges encountered using Fassier-Duval rods in osteogenesis imperfect
Conclusions: In OI long bone deformities, the goal of the Fassier-Duval rod is to provide realignment with intramedullary stabilization, reduce the number of fractures, and limit reoperations due to the expansion of the telescoping devices. Although the FD rod has the potential to accomplish these goals, challenges remain in this condition. Level of Evidence: Therapeutic level IV. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

Biomechanical analysis of pedicle screw density in posterior spine instrumentation
Conclusions: Decreasing pedicle screw density in biomechanical testing of nondeformed porcine thoracic spines does not result in any significant changes to ROM when comparing constructs with greater than 60% density. The addition of crosslinks may confer added stability to AR in patients with decreased density constructs. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

Total hip templating using a marker ball (vs. 21% magnification): no difference in accuracy but increase in potential harm
Conclusions: Digital templating using 21% magnification or MB were equally accurate. However, when finer discriminations were made between templating estimates and the final actual size, 21% magnification had better directional accuracy and the advantage of improved clinic efficiency. Using MB, the components tended to be over-estimated, particularly femoral components, which could have a substantial negative impact, especially if the surgeon is trying to match implant with template size. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

Third Place Award: Characterization and incidence of occult posterior malleolar fractures
Conclusions: With a 15% incidence of occult posterior malleolar fractures, a CT scan or multiple orthogonal views can be helpful to avoid missed fractures. Given the wide variability of fracture angle, a single external rotation view is unlikely to prevent all missed fractures on initial radiographic interpretations. Level of Evidence: Level III, retrospective cohort study. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

Second Place Award: Residents or hip surgeons for the treatment of displaced femoral neck fractures? A 10-year survivorship rate analysis
Conclusions: In this series we found that patients treated surgically by orthopaedic residents were more than two times more likely to die compared to the ones treated by hip surgeons with no other association found between complications and performing surgeon. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

First Place Award: A radiographic analysis of closed reduction and casting of distal radial fractures with consideration of candidacy
This study sought to identify patients who presented with DRF and received treatment with CRC and determine if the process of selecting CRC-managed patients had improved by analyzing radiographic maintenance of reduction through final bone union. Methods: Retrospective review of a single-site database from 2012-2015 identified CRC-managed DRF with pre-CRC, post-CRC, and final-union radiographs. Outcomes compared included radial height (RH), radial inclination (RI), volar tilt (VT), teardrop angle (TDA), and ulnar variance (UV). Results: Post-CRC RH increased (7.5 to 10.4 mm, P (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - June 25, 2019 Category: Orthopaedics Tags: Special Focus: Resident Research Award Source Type: research

A lesson worth remembering
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Editorial Source Type: research

Physician hourly wages by specialty: how do orthopaedists stack up?
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Editorial Source Type: research

Osteochondral allograft for failed mosaicplasty in adolescent female with large patellar defect
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Case Report Source Type: research

A goalkeeper’s hip during kickboxing: pathophysiology of acute hematogenous osteomyelitis in adolescents
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Case Report Source Type: research

An ethical dilemma: how to treat a symptomatic pediatric vertebral hemangioma?
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Case Report Source Type: research

Pediatric femoral osteotomy: a review
The aim of proximal femoral osteotomies in pediatrics is to restore normal anatomy and obtain joint congruency to prevent long-term degenerative hip problems. These osteotomies play an important role in the management of hip dislocations or subluxations due to neurological and other conditions that affect the hip. Femoral derotational osteotomy is an effective treatment in decreasing femoral anteversion. Derotational osteotomy may be indicated in patients with hip pain, gait disturbances, or cosmetic deformity. Distal femoral osteotomies are used for the correction of deformities in all directions of the distal femur: mala...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Review Article Source Type: research

Incidence of graft failure with Achilles tendon allograft combined with RetroScrewTM tibial fixation in primary anterior cruciate ligament reconstruction
Conclusions: The results of our study showed an unacceptably high rate of failure of irradiated fresh frozen Achilles allograft for primary ACL reconstruction using tibial Retroscrew fixation. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Middle third clavicular fractures fixed with precontoured locking compression plate or reconstruction plate: comparison of outcomes and complications
Conclusions: The treatment of displaced midshaft clavicular fractures with either reconstruction plates or precontoured plates offers a return to excellent shoulder function. However, a significant decrease in duration of surgery, hardware prominence, and reoperation rate was seen with precontoured plates. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Mood disorders do not predict a more difficult course after primary anatomic total shoulder arthroplasty
Conclusions: Patients with a mood disorder can expect a postoperative course similar to patients without depression or anxiety. A mood disorder does not appear to be a significant risk factor for bundled payment plans to consider when developing predictive modeling for primary anatomic TSA. Level of Evidence: Level III, retrospective case-control prognostic study (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Vitamin D hypovitaminosis and efficacy of supplementation in spine surgery patients
Background: Although there is evidence that hypovitaminosis D is present in many otherwise healthy adults, there is little information on supplementation in patients undergoing spine surgery. Thus, the purpose of this study was to determine the prevalence of preoperative hypovitaminosis D in spine surgery patients and evaluate the efficacy of postoperative vitamin D supplement regimens. Methods: Per standard of care, serum 25-hydroxyvitamin D levels were regularly drawn preoperatively and at 6 mo postoperatively; patients with hypovitaminosis D were prescribed a 3-month supplementation regimen based on their le...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Total joint arthroplasty in immunocompromised patients: a matched pair analysis for comorbidities
Conclusions: IC patients were not at a significant increased risk for perioperative complications, postoperative infections, or readmissions, but they were at higher risk of reoperation. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Does postoperative alignment affect union in distal femoral fractures?
Background: Distal femoral shaft fractures can be hard to treat. Recently, a meta-analysis concluded that healing rates of distal femoral fractures are suboptimal, and further research is needed. The purpose of our study was to evaluate if postoperative alignment affected union rates of distal femoral fractures. Methods: Eighty-nine distal femoral fractures from the University of Louisville met inclusion and exclusion criteria. We used the Fracture and Dislocation Classification Compendium-2018 to classify fractures. Radiographs were evaluated for fracture location, alignment, and for healing. All statistical tests ha...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Use of technetium bone scans to help predict whether patellar resurfacing will be successful in treating pain after primary total knee arthroplasty
Conclusions: In patients who develop pain after primary total knee arthroplasty, a technetium bone scan may help to predict which patients will benefit from a subsequent patellar resurfacing procedure (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Seasonal changes in body composition in collegiate baseball players
Conclusions: Body composition does change during the course of a baseball season, and these changes have the potential to impact performance and outcome measures as it relates to baseball. Principles of kinesiology suggest that it could significantly influence power, speed, agility, and quickness, but further study is needed to determine the practical on-field implications of the seasonal changes in body composition observed in baseball players. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Effect of chronic narcotic use on episode-of-care outcomes following primary anatomic total shoulder arthroplasty
Background: Bundled-care payments for total shoulder arthroplasty (TSA) make early outcomes relevant because they typically are tied to a 90-day episode-of-care. The purpose of this study was to determine the effect of chronic preoperative narcotic use on early postoperative pain relief, narcotic use, length of hospital stay, readmissions, and complications in patients with primary TSA. Methods: Chronic narcotic use was defined as use of narcotic pain medication for at least 3 mo before surgery. Narcotic use was converted to oral morphine equivalents (OME) for in-hospital use, discharge medications, and prescri...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Smartphone applications in orthopaedic surgery: a review of the literature and application analysis
Conclusions: As more advanced applications are developed, it is likely that smartphones will gain an ever greater presence both in the operative room and clinical settings. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Original Research Source Type: research

Proximal humeral endoprosthesis after tumor resection: does synthetic mesh improve stability? A radiographic review
Conclusions: Historically, proximal humeral endoprostheses have a poor track record regarding stability. Although the aortograft group trended toward longer time to proximal humeral migration, it did not significantly improve functional range of motion. The role of modular reverse total shoulder arthroplasty should be further investigated to determine if there is improvement in stability and functional range of motion. Level of Evidence: IV. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Special Focus: Upper Extremity Rotation Source Type: research

Shoulder replacement surgery: computer-assisted preoperative planning and navigation
With the increasing use of shoulder arthroplasty, surgeons encounter a greater number of primary and revision cases with glenoid deformity, presenting the challenge of avoiding glenoid component malpositioning that can impact patient function and implant longevity. Surgeons can now use preoperative three-dimensional imaging and templating to better understand each patient’s pathology and arrive at the operating room with a clear surgical strategy for implant type, size, and position. With the advent of intraoperative patient-specific instrumentation and navigation, the surgeon also has the means to translate the preo...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Special Focus: Upper Extremity Rotation Source Type: research

Lateral versus medial offset design for reverse shoulder replacement
Reverse total shoulder arthroplasty (RTSA) has become significantly more popular in recent years due to expanding indications and successful long-term outcomes being reported. RTSA has undergone several iterations throughout history that has led to modern-day designs. What initially started as a salvage procedure for cuff-deficient shoulders is now commonly used for a variety of reconstructive shoulder problems not limited just to those without a functioning rotator cuff. The goal of this article was to compare and contrast lateral and medial offset designs for RTSA. Details of both glenoid and humeral-sided design charact...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Special Focus: Upper Extremity Rotation Source Type: research

Tendon transfers for rotator cuff pathologies
Irreparable rotator cuff tears remain one of the most challenging pathologies faced by shoulder surgeons. In both irreparable anterior (subscapularis) and posterosuperior (supraspinatus and infraspinatus) tears, patients experience marked shoulder dysfunction and pain. In this article, we review the surgical considerations for treating patients with these tears, as well as the tendon transfer options. Irreparable rotator cuff tears are associated with advanced fatty infiltration, tendon retraction, and loss of tendon length. Although there are multiple reconstructive options, most are limited to small series with short-ter...
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Special Focus: Upper Extremity Rotation Source Type: research

Top classic articles to read for elbow training
This article reviews a number of these articles that the author believes are important in the education of residents on an upper extremity rotation. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Special Focus: Upper Extremity Rotation Source Type: research

Top classic articles to read for shoulder training
We attempted to identify several articles spanning the areas of shoulder surgery that would be particularly relevant to those in training. We identified articles highly cited by peer-reviewed literature, still applicable to today’s practice, and well-written with good science. We focused on articles that were highly referenced during training, board examinations, and lectures, and separated them into the following categories: clavicular and proximal humeral fractures; the rotator cuff: instability, the labrum, and capsular disease; shoulder arthroplasty; and basic science and anatomy. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - April 20, 2019 Category: Orthopaedics Tags: Special Focus: Upper Extremity Rotation Source Type: research

Situational ethics of study designs for orthopaedic surgery interventions in children with cerebral palsy
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - February 26, 2019 Category: Orthopaedics Tags: EDITORIAL Source Type: research

Ultrasound-guided platelet-rich plasma injection for a high-grade sternocleidomastoid tear in a professional football player
No abstract available (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - February 26, 2019 Category: Orthopaedics Tags: CASE REPORT Source Type: research

A novel technique to prevent distal anterior femoral cortical perforation
Conclusions: By surgically redirecting the guidewire posteriorly before placing the nail in its desired position, our surgical technique prevents the anterior intramedullary nail abutment against the femoral cortex and the risk of anterior femoral cortical perforation. Level of Evidence: V. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - February 26, 2019 Category: Orthopaedics Tags: INNOVATIONS IN PRACTICE Source Type: research

90/90 Bicortical, double-loop, interosseous wiring for fixation of transverse and short oblique metacarpal shaft fractures
Conclusions: The interosseous wiring technique is an effective method of fixation that can be used alone for transverse or short oblique fractures of the metacarpal and can permit early hand mobilization postoperatively without loss of reduction. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - February 26, 2019 Category: Orthopaedics Tags: ORIGINAL RESEARCH Source Type: research

Effect of dose of the corticosteroid injected locally on inflammatory diseases
Conclusions: A 20-mg injection of methylprednisolone acetate locally was sufficient for improvement of symptoms in patients with de Quervain disease, lateral epicondylitis, and plantar fasciitis. More doses of the steroid had no more beneficial effect. (Source: Current Orthopaedic Practice)
Source: Current Orthopaedic Practice - February 26, 2019 Category: Orthopaedics Tags: ORIGINAL RESEARCH Source Type: research