Interbody Fusions in the Lumbar Spine: A Review
ConclusionsAll of the approaches to spinal fusion have plusses and minuses that must be considered when determining which to use, and newer-technology implants, such as PEEK with titanium coating, expandable, and 3D-printed cages, have tried to improve upon the limitations of existing grafts but require further study. (Source: HSS Journal)
Source: HSS Journal - January 13, 2020 Category: Orthopaedics Source Type: research

Symptoms of Burnout Among Surgeons Are Correlated with a Higher Incidence of Perceived Medical Errors
ConclusionIt is possible that symptoms of burnout cause surgeons to be more likely to perceive an imperfection as an error or that burnout distracts surgeons, contributing to a greater likelihood of a verifiable error. Additional studies are merited to investigate a potential causal relationship between symptoms of burnout and medical errors. (Source: HSS Journal)
Source: HSS Journal - January 6, 2020 Category: Orthopaedics Source Type: research

Time to Persevere
(Source: HSS Journal)
Source: HSS Journal - January 3, 2020 Category: Orthopaedics Source Type: research

Letter to the Editor, HSS Journal, Volume 15, Issue 3
(Source: HSS Journal)
Source: HSS Journal - January 2, 2020 Category: Orthopaedics Source Type: research

Correction to: Mechanically Induced Periprosthetic Osteolysis: A Systematic Review
Figure 2 and its caption were inadvertently omitted from the original article. The figure and caption are given below. (Source: HSS Journal)
Source: HSS Journal - December 17, 2019 Category: Orthopaedics Source Type: research

Correction to: the Scientific Basis for Modern Physical Therapy
The names of the guest editors of the issue on Rehabilitation and Musculoskeletal Health (October 2019) were omitted. Editor-in-Chief Charles N. Cornell, MD, wishes to acknowledge the contributions of Sherry Backus. (Source: HSS Journal)
Source: HSS Journal - December 17, 2019 Category: Orthopaedics Source Type: research

The Dome Technique, an Option for Massive Anterosuperior Medial Acetabular Bone Loss: A Retrospective Case Series
ConclusionsIn three patients, the dome technique allowed for the anterosuperior column to be recreated by piecing together two porous metal augments to fill the medial bony void and create a stable column for a jumbo cup to be press fit. By recreating the deficient anterosuperior medial bone, the acetabulum can be downsized in a stepwise manner (with further surgery) and reconstructed in a stable fashion. This novel procedure is a unique option for the treatment of this challenging problem. (Source: HSS Journal)
Source: HSS Journal - December 16, 2019 Category: Orthopaedics Source Type: research

Survivorship of a Medialized Glenoid and Lateralized Onlay Humerus Reverse Shoulder Arthroplasty Is High at Midterm Follow-up
ConclusionOverall, survivorship after RSA using a medialized glenoid and lateralized onlay-type humerus RSA is high, and prostheses implanted in native shoulders have lower rates of revision at midterm follow-up. Instability (1.9%) was the most common reason for revision. (Source: HSS Journal)
Source: HSS Journal - December 9, 2019 Category: Orthopaedics Source Type: research

Strategies to Achieve Spinal Fusion in Multilevel Anterior Cervical Spine Surgery: An Overview
ConclusionsMultilevel anterior cervical fusions offer a relatively safe and reliable treatment option for both single-level and multilevel pathology. (Source: HSS Journal)
Source: HSS Journal - December 9, 2019 Category: Orthopaedics Source Type: research

Interventional Efforts to Reduce Psychological Distress After Orthopedic Trauma: A Systematic Review
ConclusionInterventional strategies, including group interventions, brief individual interventions, longitudinal counseling, and consideration of early amputation in selected populations have proved effective in reducing negative psychological sequelae of major orthopedic trauma. Further research that determines the effects of interventions in this population is needed. (Source: HSS Journal)
Source: HSS Journal - December 4, 2019 Category: Orthopaedics Source Type: research

What Are the Benefits of Hip Resurfacing in Appropriate Patients? A Retrospective, Propensity Score-Matched Analysis
ConclusionHRA may provide a functional benefit in sports and recreation and greater satisfaction in patients who meet the current criteria for HRA. Because these benefits may be small, pre-operative counseling should focus on balancing the possible functional benefits against the longer-term risks associated with metal-on-metal bearings. (Source: HSS Journal)
Source: HSS Journal - December 4, 2019 Category: Orthopaedics Source Type: research

Technologies to Enhance Spinal Fusion: Bench to Bedside
(Source: HSS Journal)
Source: HSS Journal - December 4, 2019 Category: Orthopaedics Source Type: research

Correlation Between the PROMIS Pediatric Mobility Instrument and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS)
ConclusionThe study shows that although both PROM instruments provide valuable information about pediatric physical function, they are not redundant because they measure slightly different constructs. Future studies should further investigate the correlation between these questionnaires in specific subpopulations of pediatric patients with lower-extremity pathology. (Source: HSS Journal)
Source: HSS Journal - December 4, 2019 Category: Orthopaedics Source Type: research

Sagittal Tibiotalar Alignment May Not Affect Functional Outcomes in Fixed-Bearing Total Ankle Replacement: A Retrospective Cohort Study
ConclusionAt the 2-year follow-up, no correlation between the post-operative AP offset ratio and functional outcome scores was observed between the two fixed-bearing-implant groups. Further studies with longer follow-up are needed to determine whether the difference in sagittal alignment has an effect on functional outcomes in the long term. (Source: HSS Journal)
Source: HSS Journal - November 22, 2019 Category: Orthopaedics Source Type: research

Impact of Knee Injuries on Post-retirement Pain and Quality of Life: A Cross-Sectional Survey of Professional Basketball Players
ConclusionA majority of retired NBA athletes in our study had knee pain, and many needed operative management during and after their NBA careers. NBA players score lower on quality-of-life measures than average North American men of similar age. Further research is needed to elucidate the best strategies for recognizing and treating knee injuries in these athletes. (Source: HSS Journal)
Source: HSS Journal - November 8, 2019 Category: Orthopaedics Source Type: research

Etiology-Based Classification of Adjacent Segment Disease Following Lumbar Spine Fusion
ConclusionThis is the first study to propose an etiology-based classification scheme of ASDz following lumbar spine fusion. This simple classification system may allow for the grouping and standardization of patients with similar pathologies and thus for more specific pre-operative diagnoses, personalized treatments, and improved outcome analyses. (Source: HSS Journal)
Source: HSS Journal - October 30, 2019 Category: Orthopaedics Source Type: research

Surgical Strategies for the Treatment of Lumbar Pseudarthrosis in Degenerative Spine Surgery: A Literature Review and Case Study
ConclusionsThe management of lumbar pseudarthrosis requires careful planning, as well as intra-operative attention to detail, for revision surgery to be successful. Circumferential procedures have shown success in revision posterolateral and interbody fusion failures. (Source: HSS Journal)
Source: HSS Journal - October 30, 2019 Category: Orthopaedics Source Type: research

Posterior Fusion for the Subaxial Cervical Spine: A Review of the Major Techniques
This article is a narrative review of earlier and current concepts regarding the posterior fusion of the subaxial cervical spine, including wiring, translaminar screws, lateral mass screws, and pedicle screws, weighing the strengths and weakness of the different modalities that the surgeon should bear in mind in creating operative plans individualized to patient pathology. (Source: HSS Journal)
Source: HSS Journal - October 25, 2019 Category: Orthopaedics Source Type: research

Return to Sport After Coracoid Bone Block Transfer for Shoulder Instability: A Systematic Review
ConclusionCoracoid bone block transfer allows for a high rate of return to sport, although the rate of return to sport at athletes ’ pre-operative level is lower. The rate of return to sport after Latarjet procedure is higher in comparison with Bankart repair. Additionally, coracoid bone block transfer is associated with improvements in a number of clinical outcome measures. Common post-operative complications include non-uni on between bone block and glenoid, hematoma, and infection. (Source: HSS Journal)
Source: HSS Journal - October 18, 2019 Category: Orthopaedics Source Type: research

Use of Topical Tranexamic Acid Reduces Direct and Indirect Blood Loss and Transfusion Rates in Revision Total Hip Arthroplasty
ConclusionTopical TXA administration during revision THA effectively reduced direct and indirect blood loss, including hidden losses, without increasing the rates of thromboembolic events. This effect appeared to be enhanced when the  femoral component was revised. (Source: HSS Journal)
Source: HSS Journal - October 18, 2019 Category: Orthopaedics Source Type: research

Pre-operative Static Anterior Tibial Translation Assessed on MRI Does Not Influence Return to Sport or Satisfaction After Anterior Cruciate Ligament Reconstruction
ConclusionThe degree of pre-operative ATT in an ACL-deficient knee was not correlated with return to sport or satisfaction after ACL reconstruction. In this study cohort, only failed-ACL reconstruction patients undergoing revision ACL reconstruction were significantly less likely to return to their main sport. They were also less likely to return to sport at their pre-operative level, if they did return to sport. (Source: HSS Journal)
Source: HSS Journal - October 17, 2019 Category: Orthopaedics Source Type: research

The Scientific Basis for Modern Physical Therapy
(Source: HSS Journal)
Source: HSS Journal - September 3, 2019 Category: Orthopaedics Source Type: research

The Critical Role of Development of the Transversus Abdominis in the Prevention and Treatment of Low Back Pain
(Source: HSS Journal)
Source: HSS Journal - August 29, 2019 Category: Orthopaedics Source Type: research

Rehabilitation: Keeping Pace with Societal Needs
(Source: HSS Journal)
Source: HSS Journal - August 28, 2019 Category: Orthopaedics Source Type: research

Chloroprocaine Provides Safe, Effective, Short-Acting Spinal Anesthesia Ideal for Ambulatory Surgeries: A Retrospective  Review
ConclusionsIn 6  months of use at our institution, chloroprocaine provided safe and effective spinal anesthesia for short orthopedic procedures, with no incidence of transient neurologic symptoms, neuropraxia, or urinary retention. (Source: HSS Journal)
Source: HSS Journal - August 26, 2019 Category: Orthopaedics Source Type: research

HSS@Home, Physical Therapist-Led Telehealth Care Navigation for Arthroplasty Patients: A Retrospective Case Series
ConclusionHSS@Home was a promising alternative to live, in-home physical therapy that was effective in monitoring this series of patients after hip or knee arthroplasty. This preliminary data sets the stage for further research into the use of telehealth technology to provide rehabilitative care to arthroplasty patients. (Source: HSS Journal)
Source: HSS Journal - August 22, 2019 Category: Orthopaedics Source Type: research

Telerehabilitation for Total Hip and Knee Arthroplasty Patients: A Pilot Series with High Patient Satisfaction
ConclusionOur early experience demonstrates the feasibility of implementing a telerehabilitation program following primary total hip or knee arthroplasty without compromising clinical quality and with high patient satisfaction. (Source: HSS Journal)
Source: HSS Journal - August 21, 2019 Category: Orthopaedics Source Type: research

Trends in Ambulatory Laminectomy in the USA and Key Factors Associated with Successful Same-Day Discharge: A Retrospective Cohort Study
ConclusionsLaminectomy is increasingly being performed in the outpatient setting. Younger, healthier non-Hispanic male patients undergoing uncomplicated surgery have a higher likelihood of successful same-day discharge. (Source: HSS Journal)
Source: HSS Journal - August 19, 2019 Category: Orthopaedics Source Type: research

Incidence and Risk of Severe Ileus After Orthopedic Surgery: A Case-Control Study
ConclusionsIn this retrospective case –control study, patients undergoing elective orthopedic procedures who had not progressed to full diet by POD 2 and spine patients with longer operative times were most at risk for SPOI. These data can be used clinically by peri-operative physicians to stratify patients according to risk. (Source: HSS Journal)
Source: HSS Journal - August 16, 2019 Category: Orthopaedics Source Type: research

ACL Reconstruction Graft Angle and Outcomes: Transtibial vs Anteromedial Reconstruction
ConclusionAnatomic ACL angle was restored after reconstruction with both the TT and AM techniques, despite different FGAs. No significant differences in clinical outcome were noted between groups on physical exam or KOOS at 2  years after surgery. These results suggest that TT reconstruction results in a graft position similar to that seen in AM reconstruction and that the location of the intra-articular tunnel aperture matters more than the orientation of the tunnel. (Source: HSS Journal)
Source: HSS Journal - August 9, 2019 Category: Orthopaedics Source Type: research

Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study
ConclusionThis retrospective case –control study showed that the use of an MBLPM-TXA in patients with hemophilia A who underwent TKA was effective in reducing rates of transfusion. We recommend its use. (Source: HSS Journal)
Source: HSS Journal - August 9, 2019 Category: Orthopaedics Source Type: research

Questioning the Clinical Relevance of Positive Post-implantation Allergy Testing for Metal Hypersensitivity in Total Knee Arthroplasty: A Didactic Case Report
(Source: HSS Journal)
Source: HSS Journal - August 8, 2019 Category: Orthopaedics Source Type: research

Clinical Assessments of Hand Function in First Carpometacarpal Osteoarthritis Do Not Appear to Correlate with Radiographic Findings
ConclusionWhile only the DASH work score strongly correlated with radiographic grade of first CMC OA, several measures detected considerable differences in functional hand use between patients and control subjects. The findings of this pilot study suggest that hand function scores be considered in addition to radiographs when determining severity of first CMC OA. The findings can also inform the design of a larger, powered study. (Source: HSS Journal)
Source: HSS Journal - August 7, 2019 Category: Orthopaedics Source Type: research

A Protocol of Pose Avoidance in Place of Hip Precautions After Posterior-Approach Total Hip Arthroplasty May Not Increase Risk of Post-operative Dislocation
ConclusionA pose avoidance rehabilitation protocol in this P-THA population was found to be safe and was associated with accelerated functional recovery and high patient satisfaction without increased risk of early post-operative dislocation. (Source: HSS Journal)
Source: HSS Journal - August 5, 2019 Category: Orthopaedics Source Type: research

Chronic Subdural Hematoma as a Complication of Cerebrospinal Fluid Leak During Revision Lumbar Spine Surgery: A Case Report and Review of the Literature
(Source: HSS Journal)
Source: HSS Journal - August 5, 2019 Category: Orthopaedics Source Type: research

A Case Series That Supports the Application of the S2AI Technique for Fractures and Failures After Lumbosacral Fusion
ConclusionFractures and failures after lumbosacral fusion can be difficult to diagnose because of delayed presentation, nonspecific presenting symptoms, and a lack of identifiable mechanism. A high index of suspicion is required to detect these uncommon complications, and patients have responded well to both conservative and surgical treatments. (Source: HSS Journal)
Source: HSS Journal - July 29, 2019 Category: Orthopaedics Source Type: research

Certificate-of-Need Programs Are Associated with a Reduced Incidence, Expenditure, and Rate of Complications with Respect to Knee Arthroscopy in the Medicare Population
ConclusionsCON regulations appear to have achieved several of their intended goals for knee arthroscopy. Further research is needed to determine if CON regulations affect the quality and sustainability of care provided to patients undergoing knee arthroscopy. (Source: HSS Journal)
Source: HSS Journal - July 29, 2019 Category: Orthopaedics Source Type: research

Treatment of Recurrent Dislocation after Total Hip Arthroplasty Using Advanced Imaging and Three-Dimensional Modeling Techniques: A Case Series
ConclusionAdvanced modeling techniques may be useful for identifying the impingement mechanisms responsible for instability after THA. Once variables contributing to limited hip range of motion are identified, surgeons can develop treatment plans to improve patient outcomes. Resecting a hypertrophic AIIS may improve hip range of motion and may be an important consideration for hip surgeons when revising unstable THAs. (Source: HSS Journal)
Source: HSS Journal - July 25, 2019 Category: Orthopaedics Source Type: research

Posterior Malleolus Fracture Displacement Is Associated with Rotational Ankle Fracture Stability in Patients Without Medial Malleolar Fractures
ConclusionPM displacement on X-ray is a useful adjuvant along with external rotation stress radiography and MRI evaluation of deep deltoid integrity to distinguish between stable and unstable fracture patterns and thus helps facilitate treatment decisions. (Source: HSS Journal)
Source: HSS Journal - July 22, 2019 Category: Orthopaedics Source Type: research

Management of Failed SLAP Repair: A Systematic Review
ConclusionThe most common reason for failed SLAP repair is persistent post-operative mechanical symptoms. Revision surgery for failed SLAP repair has a high success rate. The rate of return to activity after biceps tenodesis was significantly higher than the rate after revision SLAP repair. Large high-quality randomized trials are required to provide definitive evidence to support the optimal treatment for failed SLAP repair. (Source: HSS Journal)
Source: HSS Journal - July 19, 2019 Category: Orthopaedics Source Type: research

Validation of Physical Performance Tests in Individuals with Advanced Knee Osteoarthritis
ConclusionThese results advance the understanding of the validity of the GS test, TUG test, and SPPB in demonstrating the impairments in physical performance that patients with advanced knee OA experience in walking, balancing, and rising from a chair. Future research should examine the reproducibility and responsiveness of the GS test, TUG test, and SPPB in patients with advanced knee OA, in order to facilitate the integration of these measures into clinical practice. (Source: HSS Journal)
Source: HSS Journal - July 19, 2019 Category: Orthopaedics Source Type: research

Factors Affecting Discharge Disposition After Primary Simultaneous Bilateral Joint Arthroplasty
ConclusionThese findings shed light on the variables that contribute to discharge destination after PSBTHA and PSBTKA. Such information allows for safe pre-operative discharge planning and assists with discharge to the appropriate level of patient care. Future studies might investigate the effect of surgeon experience, surgical technique, and pre-operative discussion with a physical therapist on the discharge disposition of patients undergoing bilateral total joint arthroplasty. (Source: HSS Journal)
Source: HSS Journal - July 17, 2019 Category: Orthopaedics Source Type: research

Pre-operative Two-Point Discrimination Predicts Response to Carpal Tunnel Release
ConclusionWe found that greater pre-operative 2PD scores predicted greater early post-operative 2PD scores but did not lead to worse functional outcome scores post-operatively. Patients with poor pre-operative 2PD scores were likely to demonstrate improvement in functional outcomes scores, while having less reliable improvement in 2PD after CTR. Patients with poor 2PD should be counseled that improvement of tactile perception is less predictable. (Source: HSS Journal)
Source: HSS Journal - July 5, 2019 Category: Orthopaedics Source Type: research

Quantifying the Impact of Patient-Specific Factors and Disease Severity on Clinical Decision Making in Cuff Tear Arthropathy: A Case-Based Survey
ConclusionWhen evaluating CTA, patient symptoms, radiographic grade, and patient age are the factors most strongly associated with the decision making of shoulder specialists. Additionally, the Seebauer and Hamada classifications had similar reliability and clinical utility. However, there was only fair agreement regarding treatment, which indicates that CTA management remains controversial. (Source: HSS Journal)
Source: HSS Journal - July 5, 2019 Category: Orthopaedics Source Type: research

Surgical Techniques, Outcomes, Indications, and Complications of Simultaneous High Tibial Osteotomy and Anterior Cruciate Ligament Revision Surgery: A Systematic Review
ConclusionThis systematic review found that the use of HTO for ACLR revision produces good post-operative functional outcomes, low complication rates, and no reported re-ruptures. The main indications for combined HTO with ACLR revision was a posterior slope of more than 12 ° or severe varus malalignment. Future studies with large sample sizes and long-term follow-up are required to corroborate these results. (Source: HSS Journal)
Source: HSS Journal - July 1, 2019 Category: Orthopaedics Source Type: research

Symptomatic Epidural Hematoma after Elective Posterior Lumbar Decompression: Incidence, Timing, Risk Factors, and Associated Complications
ConclusionsReadmission or reoperation for symptomatic PLEH following elective lumbar spine surgery is rare and can occur many days or weeks after a procedure. There are modifiable risk factors for PLEH and associated additional post-operative complications that physicians should be suspicious of following posterior lumbar decompression. (Source: HSS Journal)
Source: HSS Journal - July 1, 2019 Category: Orthopaedics Source Type: research

Extended Antibiotic Prophylaxis May Be Linked to Lower Peri-prosthetic Joint Infection Rates in High-Risk Patients: An Evidence-Based Review
AbstractIn 2018, Inabathula et al. published the results of a historical control study examining 90-day peri-prosthetic joint infection (PJI) rates at a single center before and after the institution of an extended post-operative oral antibiotic protocol for high-risk total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients. In the study, “Extended Oral Antibiotic Prophylaxis in High-Risk Patients Substantially Reduces Primary Total Hip and Knee Arthroplasty 90-Day Infection Rate” (J Bone Joint Surg Am. 2018;100[24]:2103 –2109), the authors considered any one of several patient-related crit...
Source: HSS Journal - June 19, 2019 Category: Orthopaedics Source Type: research

Return to Work After Shoulder Replacement for Glenohumeral Osteoarthritis Is Similar When Hemiarthroplasty Is Compared to Total Shoulder Arthroplasty
ConclusionPatients with shoulder OA undergoing aTSA have higher rates of return to work, function, and satisfaction than those undergoing HHA. (Source: HSS Journal)
Source: HSS Journal - June 17, 2019 Category: Orthopaedics Source Type: research

Clinical Outcomes and Quality of Literature Addressing Glenohumeral Internal Rotation Deficit: A Systematic Review
ConclusionCurrent trends in GIRD-related literature demonstrate limited focus on clinical, therapeutic, or patient-reported outcomes and mostly consist of low-level evidence. There is a lack of consensus in the literature on what clinically constitutes GIRD. (Source: HSS Journal)
Source: HSS Journal - June 17, 2019 Category: Orthopaedics Source Type: research

Is Post-discharge Rehabilitation Timing Associated with 90-Day Readmission in Primary Total Joint Arthroplasty?
ConclusionsTiming for initiating PT may be an important modifiable factor that can affect readmission in patients discharged home from acute care after TJA. Further exploration of the role of PT timing along with other factors such as dosage and frequency among such patients is needed. (Source: HSS Journal)
Source: HSS Journal - June 15, 2019 Category: Orthopaedics Source Type: research