A Systematic Review of the Histological and Molecular Changes in the Subacromial Bursa in Rotator Cuff Disease.
Authors: HajAssaad A, Willacy R, Wilson R Abstract To evaluate the involvement of the subacromial bursa in the pathologic development of rotator cuff disease (RCD), a systematic review of the literature was undertaken to assess the cellular, biochemical and metabolic changes in the bursa. A systematic review was performed to identify all studies that reported histological and molecular changes in the subacromial bursa pertaining to RCD. The molecular biomarkers found to be altered in RCD included extracellular matrix enzymes, cytokines, growth factors and neuronal signals. Previous reports show an increase in IL1, ...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Opioid Prescribing and Patient Satisfaction Scores Across Practice Types.
Authors: Secrist E, Wally MK, McKnight R, Van Demark R, Seymour RB, Karunakar M, Hsu JR, PRIMUM Group, Beuhler M, Gibbs M, Griggs C, Jarrett S, Leas D, Runyon M, Saha A, Watling B, Wyatt S Abstract US physicians prescribe opioids at a high rate relative to other countries. Of the US physicians surveyed, almost half report having prescribed an inappropriate opioid due to concerns about patient satisfaction scores. We investigated patterns in controlled substance prescribing practices, patient risk factors, and associated Press Ganey patient satisfaction scores at a sample of orthopaedic surgery and primary care clin...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

The Effect of Obesity on Revision Discectomy After Singlelevel Lumbar Discectomy.
Authors: Smith EJ, Inkrott BP, Kim CY, Du JY, Ahn UM, Ahn NU Abstract The prevalence of obesity has been rising, creating a major public health concern. While several studies have shown obesity to increase the risk of surgical complications, few have analyzed its effects on reoperation, specifically after singlelevel lumbar discectomy. Data was obtained using the commercially available Explorys software that houses deidentified data for several major healthcare systems. A database search was used to find all patients who had undergone a lumbar discectomy. Scoliosis, spondylolisthesis, smoking history and depression...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Opioid Use Patterns After Total Joint Arthroplasty.
Authors: King P, Stone A, Arentz E, MacDonald J Abstract The incidence of new persistent opioid use following elective total joint arthroplasty (TJA) hasnt been well documented; with this study we aim to further characterize opioid use following TJA, specifically focusing on those patients still requiring opioid prescriptions 6 months postoperatively. Retrospective review of a consecutive series of 977 primary TJA performed from June 2016May 2017. Opioid prescriptions verified in Surescripts database; 3.7% (29) opioid nave patients and 18.0% (35) opioid nonnave patients received fills at 6 months. Opioid nave patie...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Biomechanical Evaluation of a Minimally Invasive Fixation Method for Length Unstable Limb Injuries.
This study and case report demonstrate the biomechanical feasibility of using INFIX to treat limb injuries. (Journal of Surgical Orthopaedic Advances 29(1):1825, 2020). PMID: 32223861 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

A Systematic Review and Meta-analysis of Injury in Crossfit.
This study used a database search of Crossfit AND Injury for systematic review and metaanalysis. Crossfit seems to be an effective exercise method to decrease weight and BMI while improving function. High intensity interval training improves blood pressure, body fat percentage, lung capacity and pancreas function. Articles meeting inclusion showed that shoulder, back and then knee injuries were the most commonly selfreported in surveys. Incidence of injury is similar to that of other common recreational sports. Some Crossfit movements and participant characteristics may lead to higher incidences of specific injuries and in...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Rotator Cuff Dysfunction after Anatomic Total Shoulder Arthroplasty: Who is at Risk?
Authors: Ikard ST, Farmer KW, Struk AM, Garvan CS, Gillespy A, Wright TW Abstract We compare posttotal shoulder arthroplasty (TSA) patients with suspected cuff dysfunction to a successfulTSA control group. Thirtynine patients met suspectedcuffdysfunction criteria. Forty matched controls were selected. Radiographic and functional outcomes and demographics were compared preoperatively and postoperatively. Humeral head height above the greater tuberosity and postoperative humeral head translations were significantly greater in the dysfunction group. The dysfunction group demonstrated a significant correlation between ...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Patient Age Is Inversely Associated with Injury Counts Caused by Motor Vehicle Crashes.
Authors: Miller AN, Tilan J, Wellman A, Talton J, Usoro A, Sun K, Wuertzer S, Lenchik L, Stitzel J, Weaver A Abstract Associations between age and fracture incidence, total number of fractures, and total number of injuries per occupant occurring in motor vehicle crashes were evaluated. An observational study of the Crash Injury Research and Engineering Network was conducted. Multivariable logistic regression and negative binomial models were used to relate age (2064, 65+ years) to fracture incidence, total number of fractures per occupant, and total number of injuries, adjusting for sex and change in vehicle veloci...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Accuracy of the Spinal Pain Diagram Is Influenced by Patient Health Literacy in Completion of the Scoliosis Research Society30 Questionnaire.
Authors: Hadden K, Gan JM, McClure S, McCarthy RE, Bumpass DB Abstract The Scoliosis Research Society Questionnaire (SRS30) was designed to measure healthrelated quality of life in scoliosis patients. Patients with low health literacy may need specific guidance when providing feedback on the SRS30 so that reliable and valid results are collected for clinical decision making. The purpose of this research study was to investigate the health literacy demands of the Scoliosis Research Society Questionnaire (SRS30) and to determine if health literacy best practices mitigate errors for patients with low health literacy. ...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

The Dislocated Hip on CT Scan: An Argument for the Initial Pelvic Radiograph in Trauma Patients.
This study evaluated the frequency in which a hip dislocation is first diagnosed by computed tomography (CT) scan. A retrospective review was conducted of orthopaedic trauma patients presenting with hip dislocation to a Level 1 trauma center over three years. We recorded whether the patient first received pelvic radiograph (PXR) or CT scan of the pelvis, if the patient underwent closed reduction of the hip prior to CT scan, and if repeat pelvis CT scan was done. Of 83 hip dislocations, 64 patients were sent to CT scanner dislocated; 19 patients first had PXR and underwent closed reduction of the hip prior to CT scan. By ob...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Reversed Palmaris Longus MuscleA Normal Anatomic Variant: A Case Report.
We report a case of a 15yearold male with complaints of a mass in his right wrist; workup of the mass revealed a reversed palmaris longus muscle. (Journal of Surgical Orthopaedic Advances 29(1):4647, 2020). PMID: 32223867 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Recurrent Pain in a Patient with Bilateral Scaphotrapezial Coalition and Radiocarpal Arthritis.
Authors: McDowell A, Jeong A, Willacy R, Wilson R Abstract Carpal coalition is an uncommon and rarely reported anomaly, characterized by the union of two or more carpal bones. It is usually found incidentally during radiographic evaluation for trauma or other unassociated pathology. While lunotriquetral and capitohamate coalitions are the most common forms of carpal coalition, there are very few reports of scaphotrapezial coalitions described in the literature. This a novel case report, in which we present a case of bilateral scaphotrapezial coalition in a patient with radiocarpal arthritis and persistent wrist pai...
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Antegrade Screw Fixation of Medial Malleolus Fractures: A Technique Tip.
We present an alternative strategy for fixing medial malleolus fractures, in which a screw is placed antegrade across the fracture line. (Journal of Surgical Orthopaedic Advances 29(1):5052, 2020). PMID: 32223869 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - April 2, 2020 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Cost Analysis and Bundled Care of Hip and Knee Replacement.
This article inspects the basics of reimbursement under Medicare's bundled care programs as well as some common investigative tools used in the literature to measure cost. Additionally, the effects of standardized enhanced recovery clinical pathways on costs are reviewed. Finally, drivers of implant costs and several proven measures for implant cost-reduction are evaluated. This review provides surgeons and hospitals successful measures to reduce the cost of TJA via enhanced recovery pathways and reduced implant pricing. (Journal of Surgical Orthopaedic Advances 28(4):241-249, 2019). PMID: 31886758 [PubMed - in process...
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Predictive Accuracy of the ACS-NSQIP Surgical Risk Calculator for Pathologic Humerus Fracture Fixation.
This article investigated the prevalence of underestimation of risk by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Surgical Risk Calculator (SRC) in patients with pathologic humerus fractures. Two hundred seven (207) patients were identified and analyzed using the ACS-NSQIP SRC. Predicted and actual outcomes were then compared. Average hospitalization was 6 ± 10 days. Ten patients (5%) had a mild adverse event (AE), and 15 (7%) had a serious AE. The ACS-NSQIP SRC underestimated hospitalizations (p
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Pediatric Patients with Spondylolysis Have High Rates of Vitamin-D Deficiency.
The objective of this study was to document the 25-hydroxyvitamin D status of patients with a confirmed diagnosis of spondylolysis to determine if these patients have increased rates of vitamin D deficiency. After confirming the diagnosis of spondylolysis, patients were prospectively enrolled in this study. A total of 39 patients (30 male, 9 female) with a mean age of 14.9 years and a mean BMI of 22.9 had vitamin D levels drawn after imaging confirmed the diagnosis of spondylolysis. The mean 25-hydroxyvitamin D level was 26 ng/ml. Only 9 patients (23.1%) were considered to have normal vitamin D levels> 32 ng/ml. An addi...
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Rater Variation in Ultrasound Detection of Dorsal Cortex Screw Protrusion in Fixed-Angle Volar Plating of the Distal Radius.
This study evaluates rater accuracy and variation for the purpose of using intraoperative ultrasound (US) imaging to detect dorsal screw protrusion during fixed-angle volar plating of distal radius fractures. Stabilizing volar plates and screws with varying lengths of dorsal protrusion were applied to 10 cadaver wrist pairs. After a brief training session, seven surgeons without prior ultrasound experience assessed screw protrusion on two separate occasions using a diagnostic ultrasound machine. Screw protrusions were visually confirmed after data collection was completed. Statistical analyses included percent agreement an...
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

The Saline Load Test is Effective at Diagnosing Traumatic Arthrotomies of the Shoulder.
Authors: Gittings D, Dattilo J, Fryhofer G, Martin A, Hast M, Mehta S Abstract The purpose of this study is to evaluate the fluid volume required for a saline load test to detect intra-articular involvement of the glenohumeral joint after penetrating trauma. A human cadaver study was conducted with 22 thawed, fresh-frozen forequarter amputations. A standard posterior shoulder portal was made with an 11-blade scalpel. A 19-gauge needle was inserted into the anterior portal site, and intra-articular position of both the blade and needle was confirmed with fluoroscopy. The blade was removed and normal saline was injec...
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Smoking as a Risk Factor for Readmission in Arthroscopic Surgery: A Propensity Matched Analysis.
This study suggests that smoking increases chances of readmission in all arthroscopic surgery. (Journal of Surgical Orthopaedic Advances 28(4):272-276, 2019). PMID: 31886763 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Incidence of Periprosthetic Femur Fractures Utilizing the Posterior Approach with a Single Wedge Tapered Stem.
Authors: Formby P, Hong CS, Ryan S, Wellman S, Bolognesi M Abstract We sought to determine early periprosthetic femur fracture rate and stem-related failures in primary total hip arthroplasty (THA) performed through a posterior approach with a cementless wedge stem. We reviewed 818 primary THAs in 713 patients with a single wedge tapered titanium component. We used multivariate logistic regression to determine predisposing factors to stem failure. The mean radiographic follow up was 1.6 years. Overall there were eight perioperative femur fractures (0.98%). There were two intraoperative fractures (0.24%), six postop...
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

In Hospital Outcomes of Total Hip Arthroplasty in the Medicaid Population.
This study's purpose was to evaluate national trends, patient demographics and hospital outcomes for Medicaid patients who underwent a primary THA. The National Hospital Discharge Survey (NHDS) database was queried for patients undergoing THA from 2001-2010. Patients were stratified into two groups based on insurance. We found from 2001-2005, Medicaid accounted for 2.38% of all THA performed, increasing insignificantly to 2.61% between 2006-2010. The Medicaid group was younger (50.3 vs. 65.6 years, p
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

New NCAA Bat Standard, BBCOR, is Associated with an Increased Incidence of Hamate Fractures.
This study shows that there was more than a 200% increased risk of hamate fracture with implementation of the 2011 collegiate baseball batting standards. The most common injury mechanism was batting with the down hand (79%). We suggest that a national injury database be considered for collegiate athletics so that injury rates, risk factors and results of interventions could be studied to improve the health of our nations' athletes. (Journal of Surgical Orthopaedic Advances 28(4):285-289, 2019). PMID: 31886766 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

The Quality and Accuracy of Online Resources for Total and Reverse Shoulder Replacement.
Authors: Monroe EJ, Selley RS, Gombera MM, Nair R, Martusiewicz A, Christian RA, Marra G, Saltzman MD Abstract Recent literature suggests that many online patient resources are poor in quality and lack important clinical information. The purpose of this study was to investigate the value of online resources available to patients considering shoulder arthroplasty. A total of 84 websites were discovered with the terms "total shoulder replacement" (TSR) and "reverse shoulder replacement" (RSR), they were reviewed and graded for quality and accuracy. Overall quality scores were low for TSR and RSR w...
Source: Journal of surgical orthopaedic advances - December 31, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Medial Patellofemoral Ligament Reconstruction Technique Utilizing Patellar Suture Anchors and a Peroneus Longus Tendon Allograft.
This article presents a technique of MPFL reconstruction utilizing patellar suture anchors and a peroneus longus tendon allograft that avoids the need to drill tunnels that completely traverse the patella. (Journal of Surgical Orthopaedic Advances 28(3):166-174, 2019). PMID: 31675292 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Orthopaedic Residency Training Structure: Implications on Quantity and Quality of Scholarship.
The objective of this analysis was to compare the efficiency of scholarly activity withinmilitary orthopaedic training programs. The authors obtained the lists of abstracts accepted for presentation at the 2009 through 2014 Society of Military Orthopaedic Surgeons (SOMOS) annual meetings. Data were extracted for each individual presentation. Three primary groups were compared: a traditional program, a research program, and a hybrid program. The hybrid program produced the highest percentage of the presentations (28.6%). The traditional program contributed the most presentations (3.32) and publications (2.16) per resident a...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Trends and Characteristics of Highly Cited Articles in Proximal Humerus Fracture Research.
This study compiles a collection of articles investigating proximal humerus fractures for future review and demonstrates citation count to be an acceptable measure of an article's contemporary academic influence. (Journal of Surgical Orthopaedic Advances 28(3):180-188, 2019). PMID: 31675294 [PubMed - in process] (Source: Journal of surgical orthopaedic advances)
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Outcomes of Revision Arthroscopic Anterior Shoulder Stabilization in a Military Population: A Prospective Cohort Study.
Authors: Balazs LGC, Donohue MMA, Brelin CAM, Wolfe CJA, Grimm CPD, Dworak LTC, Rue CJH Abstract The purpose of the study was to determine the outcomes of revision arthroscopic anterior shoulder stabilization in a young, military population. The hypothesis was that this subgroup functions well in a high-demand environment without increased rates of failure. Patients were enrolled in an institutional database and followed prospectively. The primary outcomes were scores on the semiannual Physical Readiness Test (PRT), as compared to prior to reinjury. Secondary outcomes included the Single Assessment Numeric Evaluati...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Dreaded Ulnar Wrist Pain: Long-Term Results of Pisiformectomy for Painful Pisotriquetral Arthrosis.
This study reviews the long-term outcomes of patients treated with pisiformectomy. A retrospective study approved by the institutional review board was performed over a 27-year period of patients undergoing pisiformectomy. Range of motion, grip strength, complications, and need for revision surgery were recorded. The series includes 61 wrists (60 patients) with an average age at surgery of 46 years. Two complications were noted (3%): a postoperative ulnar nerve palsy and symptomatic retained suture. At final follow-up, average flexion-extension arc was 81% (expressed as percent of contralateral), radioulnar deviation arc w...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Hip Range of Motion: Which Plane of Motion Is More Predictive of Lower Extremity Injury in Elite Soccer Players? A Prospective Study.
The objective of this study was to determine which plane of hip motion (rotational or sagittal) is more predictive of lower extremity (LE) injury in elite soccer players. A total of 69 athletes (43 professional and 26 collegiate) were examined (mean age, 22.6 years). Bilateral hip internal rotation (IR), external rotation, extension, and flexion measurements were taken along with the modified Thomas test during preseason physicals. There were 42 LE injuries (injury rate 3.74/1000 athlete exposures). Mean IR was 25.2. and 29.9° for injured versus noninjured extremities, respectively (p = .009). There was a significant a...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Evaluating the Readability of Online Patient Education Materials Regarding Shoulder Surgery: How Do Medical Institution Web Sites Rate?
This study evaluated the readability of online patient education materials on shoulder surgery. Medical and nonmedical institution web sites were compared and it was hypothesized that medical institution materials are written at lower grade levels than nonmedical institution materials, because medical institutions understand physician-patient interactions. Eighty-six articles were scored according to 10 readability tests: cumulative combined average grade level was 12.5 ± 2.8 and average Flesch reading score was 43.5 ± 12.6 (college level). The average composite grade level readability for medical institution...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Gait and Functional Outcomes Between Cruciate-Retaining and Cruciate-Substituting Implants in Total Knee Arthroplasty: A Prospective, Randomized Study.
This study sought to test the hypothesis that CR TKA will facilitate improved early functional outcomes in gait compared with PS TKA. Patients were randomized to either the CR or PS implant. Various patient-reported and surgeon-reported outcomes as well as gait analyses were obtained pre- and postoperatively. Patients undergoing PS TKA had higher University of California, Los Angeles activity scores at 12 months. No significant difference in spatiotemporal, kinematic, or kinetic parameters between groups was detected, but there was a trend toward quadriceps overuse gait pattern in the CR group. Patients undergoing TKA with...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Epidural Abscess in the Lumbar Spine: A Single Institution's Experience With Nonsurgical and Surgical Management.
Authors: Berwick BW, Luo TD, Sun KW, Sharp RA, Birkedal JP, O'Gara TJ Abstract The purpose of this study was to compare patient factors and outcomes in conservatively and surgically treated patients with spinal epidural abscess (SEA). This was a single-center retrospective review of adult patients treated for SEA of the lumbar spine. Primary treatment outcome was readmission for recurrent abscess. Sixty-one patients met inclusion criteria: 59% male, mean age 56.9 years, and body mass index 30.8 kg/m2. Initially 47.5% of patients were treated with conservative measures and 52.5% were treated with surgery. In the con...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Health Literacy Evaluation of Opioid Patient Education Materials for Orthopaedic Surgery.
Authors: Prince LY, Mears SC, Watson JC, Hadden KB Abstract Increased opioid use in the United States has resulted in greater incidence of misuse. Orthopaedic patients are more likely to be prescribed opioids for pain. Low health literacy is related to opioid misuse; therefore, orthopaedic patient education tools on use of opioids must be easy to read, understand, and use for patients of all skill levels to be effective. This project aimed to review a broad array of opioid patient education tools and evaluate them from a health literacy perspective. Content evaluation revealed that not all tools expressed the same ...
Source: Journal of surgical orthopaedic advances - November 3, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Keeping Up With the Orthopaedic In-Training Examination: National Survey on Orthopaedic Residency Training in Practice Management.
This study surveyed 500 orthopaedic residents nationwide in 2016. Resident participation was online, anonymous, and voluntary. Only complete survey responses were included, yielding a 49.2% (246/500) response rate. The majority of orthopaedic residents (72.4%, 178/246) reported no formal education in PM topics, and 86.2% (212/246) responded that they do not receive direct feedback on individual accuracy of Current Procedural Terminology (CPT) code case logging. Of the residents without formal education in PM, 87.1% (155/178) desire its implementation. The evolving health care system is becoming increasingly reliant on phys...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

A Legacy Revisited: Needle Holders.
Authors: Agarwal A, Arkesh M, Jandial G Abstract A needle holder is one of the crucial surgical instruments for surgeons. Its prime function is to steadily hold the needle while applying sutures, thus avoiding injury to the surrounding tissues and to the surgeon's hand. Wide varieties of needle holders are available for use in orthopaedic practice. This review article briefly describes the biomechanics and other characteristics of some of the commonly used needle holders. The care aspects and wear features of needle holders are also discussed. A surgeon should be aware of the different types of needle holders, thei...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Preoperative Risk Factor Score Predicts Malnutrition in Total Joint Arthroplasty Patients.
Authors: Rudasill S, Gittings DJ, Elkassabany NM, Liu J, Nelson CL, Kamath AF Abstract Malnutrition is a modifiable risk factor for poor outcomes in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). The purpose of this study is to highlight risk factors for hypoalbuminemia and develop a predictive model that identifies patients at risk for this condition before THA or TKA. The study retrospectively reviewed the National Surgical Quality Improvement Program database to analyze preoperative independent risk factors for a diagnosis of hypoalbuminemia in adult patients who underwent THA...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Generating Differential Ligamentotaxis Across the Radiocarpal Joint.
This study sought to determine if traction through the index or long finger metacarpal provided a selective distraction force through either the distal radius' radial or ulnar column. In eight specimens, the radius was cut transversely 1 cm proximal to the Lister tubercle. Index and long finger metacarpals were cut and two-hole plates were fixed to metacarpals. Traction forces were alternately applied to index, then long finger metacarpals, sequentially through each metacarpal from 4.5N to 89N. Traction loading through the index finger metacarpal resulted in significantly more distraction force transmitted through the dist...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Early to Midterm Clinical and Radiographic Survivorship of the All-Polyethylene Versus Modular Metal-Backed Tibia Component in Primary Total Knee Replacement.
Authors: Herschmiller T, Bradley KE, Wellman SS, Attarian DE Abstract The purpose of this study was to compare the all-polyethylene tibial component with the modular metal-backed component in primary total knee arthroplasty. A retrospective review of 1064 patients recorded clinical failure, as determined by need for revision surgery, range of motion, and impending radiographic loosening, as evaluated by the presence of radiolucent lines. Mean follow-up was 1.2 and 3 years, respectively. Survival in the all-polyethylene group was 100%, with 95.5% (95% CI: 85.8-98.6) survival in the metal-backed component group at 4.3 years. Thin (
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Radiographic Predictors of Screw Cutout for Intertrochanteric Fractures Treated With Cephalomedullary Nails.
The objective of this study was to determine the predictive value of tip-apex distance (TAD) and Parker's ratio for screw cutout after treatment of intertrochanteric hip fractures with a long cephalomedullary nail. A total of 97 patients with AO/OTA 31-A1-A3 intertrochanteric fractures and a minimum follow-up of 8 weeks were included. Increased Parker's ratio on the anteroposterior radiograph (OR = 1.386, p
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Adoption of Intramedullary Nail Fixation for Proximal Humerus Fractures: Assessment of Surgical Efficiency and Complications.
Authors: Ponce BA, Williams JF, Watson SL, Perez JL, Hudson PW, Scott JH, Petkovic D, Jobe CM, Rowan PD, Phipatanakul WP Abstract Fixation of proximal humerus fractures (PHFs) with intramedullary (IM) nails potentially is a newer, less invasive technique. The purpose of this study was to report on the early adoption results of IM nail use for PHF. Retrospective chart reviews were performed on the first 60 patients treated with IM nails for acute PHFs by two shoulder surgeons. The first 15 patients treated by each surgeon were compared with the subsequent 15 patients. Surgical and fluoroscopic times, fracture type, ...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Diabetes and Total Joint Arthroplasty: Infection Risk May Not Be Predictable by Markers of Glycemic Control.
This study sought to determine if perioperative markers of diabetic control were associated with infection and to further characterize diabetic periprosthetic joint infections (PJI). A retrospective analysis of 506 diabetic patients and 900 nondiabetic patients who underwent primary total hip and knee arthroplasty was performed. In this cohort, an infection rate of 4.7% and 2.0% for diabetic and nondiabetic patients, respectively, was observed. There was no association between infection at 1 year and preoperative hemoglobin A1C or postoperative blood glucose; however, diabetic infections were significantly more likely to b...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Isolated Subtalar Arthrodesis for Avascular Necrosis of the Talus.
This article reports the efficacy of isolated subtalar arthrodesis in the setting of AVN. A retrospective review of subtalar arthrodeses was performed on a cohort of 12 patients with talar AVN who underwent subtalar arthrodesis. The primary outcome was radiographic fusion with secondary outcomes of subsequent procedures, recurrent pain, and perioperative complications. Radiographic fusion of subtalar arthrodesis occurred in 12 of 12 patients. Five of six patients with traumatic etiology went on to have secondary procedures. One of six patients with atraumatic etiology underwent a secondary procedure for advancement of tibi...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Early Stabilization of Femur Fractures in the Setting of Polytrauma Is Associated With Decreased Risk of Pulmonary Complications and Mortality.
Authors: Blair JA, Kusnezov N, Fisher T, Prabhakar G, Bader JO, Belmont PJ Abstract Timing of definitive fixation of femoral shaft fractures is a subject of continued controversy. The purpose of this study was to determine if early definitive fixation of femoral shaft fractures in the setting of polytrauma decreased the risk of pulmonary complications and mortality. The 2009-2012 National Sample Program of the National Trauma Data Bank was queried for all patients 18 to 65 years with Injury Severity Scores (ISS)>15 who underwent definitive fixation of femoral shaft fractures. Mortality, perioperative complicatio...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Musculoskeletal Health Literacy, Pain Catastrophization, and Sleep Quality: Effect on Functional Disability Scores.
Authors: Noback PC, Seetharaman M, Tantigate D, Strauch RJ, Rosenwasser MP, Vosseller JT Abstract Limited musculoskeletal health literacy, catastrophic pain thinking, and poor sleep quality may be associated with adverse long-term health outcomes, but are sparsely studied concomitantly in orthopedics. The purpose of this study was to assess how these factors influence baseline functional disability. Hand and wrist and foot and ankle patients presenting with a previously untreated complaint were enrolled and completed the Literacy in Musculoskeletal Problems questionnaire, Pain Catastrophization Scale (PCS), and Pit...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Acute Pectoralis Major Tears in Forward Deployed Active Duty U.S. Military Personnel: A Population at Risk?
Authors: Salazar D, Shakir I, Joe K, Choate WS Abstract The purpose of this study is to report on the causes of a series of acute pectoralis major tears in active duty deployed military personnel. Nine cases of acute pectoralis major tears evaluated at one expeditionary military treatment facility over a 4-month deployment cycle were analyzed. Nine male patients were diagnosed with tears: seven complete tears at the tendinous insertion, one complete tear at the musculotendinous junction, and one incomplete tear, with a mean age of 32 years (range, 23-52 years). All injuries occurred during bench press, with the dom...
Source: Journal of surgical orthopaedic advances - August 15, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Accuracy and Interobserver and Intraobserver Reliability of Ultrasound in the Early Diagnosis of Occult Scaphoid Fractures: Diagnostic Criteria and a Way of Interpretation.
Authors: Malahias MA, Nikolaou VS, Chytas D, Kaseta MK, Babis GC Abstract The purpose of this study was to illustrate the usefulness of ultrasound in the early diagnosis of occult scaphoid fractures. Forty-eight patients with clinical symptoms of scaphoid fracture and negative initial X-rays were examined. All patients underwent ultrasonography in the emergency room (ER). After 14 days, a computed tomography (CT) scan was performed, which confirmed or not the initial suspicion of fracture. Twenty-two patients were found with subperiosteal hematoma, while six also had cortical discontinuity. The sensitivity of ultra...
Source: Journal of surgical orthopaedic advances - May 12, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Trends and Characteristics of Highly Cited Articles in Shoulder Arthroplasty.
This study sought to analyze highly cited shoulder arthroplasty articles and determine the best measure to assess their impact. Scopus identified the 50 most cited articles, and each was analyzed for citation number, authors, institution, country of origin, and journal of publication. SPSS 23 was used for descriptive statistics, and a Pearson correlation coefficient assessed the relationship between citation measures. The results revealed an average citation count of 259 ± 108 and a citation density (citation count/years since publication) of 18 ± 10 annually. Most articles originated in the United States (31...
Source: Journal of surgical orthopaedic advances - May 12, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Comparison of Scapular Mechanics After Activity With and Without a Targeted Compression Garment.
This study evaluated the ability of a compression shirt to maintain scapular alignment after fatiguing of periscapular musculature. Subjects' scapular movements were monitored before and after a periscapular muscle- fatiguing exercise program. In the anterior and posterior tilt and medial and lateral rotation dimensions, control and shirt subjects both exhibited differences between the prefatigue and postfatigue measurements throughout humeral elevation. In the retraction and protraction dimension, control subjects exhibited differences between prefatigue and postfatigue measurements for a large portion of elevation, while...
Source: Journal of surgical orthopaedic advances - May 12, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

High-Energy Midfoot Fracture-Dislocations: Staged Treatment With an External Fixator.
Authors: Arvesen JE, Burnett Z, Israel H, Watson JT, Cannada LK Abstract The purpose of this study was to analyze the clinical outcomes of patients treated for high-energy midfoot (Lisfranc) injuries with initial temporization of an external fixator before definitive fixation. A retrospective chart review at two level 1 trauma centers was completed. Clinical parameters including demographics and comorbidities were evaluated in addition to hospital and clinical data. Time to full weight bearing took an average of 4.4 months, and with the numbers available no significant difference (p
Source: Journal of surgical orthopaedic advances - May 12, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Survival of a Second-Generation Porous Plasma-Sprayed Acetabular Component at Minimum 15-Year Follow-up.
This study assessed the 15-year minimum outcomes of the RingLoc cup (Zimmer Biomet, Warsaw, Indiana), a second-generation cementless porous plasma-coated acetabular component. The study identified 2438 patients (2905 hips) who underwent total hip arthroplasty using the RingLoc acetabular component between 1992 and 2000. Fifteen-year minimum follow-up data were available on 431 consented patients (511 hips). Clinical outcomes included the Harris hip score. Follow-up radiographs, complications, and revisions were reviewed. Mean follow-up was 18.2 years (range, 15-24.7). Harris hip scores improved from 46.9 preoperatively to ...
Source: Journal of surgical orthopaedic advances - May 12, 2019 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research