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Editorial Board
Professor, Department of Orthopaedic Surgery& Biomedical Engineering, University of Tennessee-Campbell Clinic; Chief-of-Staff, Campbell Clinic, Inc, Memphis, Tennessee (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 17, 2021 Category: Orthopaedics Source Type: research

Contributors
FREDERICK M. AZAR, MD (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 17, 2021 Category: Orthopaedics Source Type: research

Contents
Frederick M. Azar (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 17, 2021 Category: Orthopaedics Source Type: research

Forthcoming Issues
January 2022 (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - September 17, 2021 Category: Orthopaedics Source Type: research

Treatment of B1 Distal Periprosthetic Femur Fractures
The burden of periprosthetic distal femoral fractures is projected to increase accordingly with the increase in total knee arthroplasties (TKAs) performed globally in the future. Less invasive plating and intramedullary (IM) nailing techniques still seem to provide similar outcomes based on current literature. Double-plating and combination techniques may prove to be beneficial in the future pending further large-scale studies but currently have not demonstrated superiority over single plating and IM nailing based on current evidence. Distal femoral replacement may provide a useful option for future treatment, provided it ...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Gerard A. Sheridan, Aresh Sepehri, Karl Stoffel, Bassam A. Masri Source Type: research

Classification and Management of Periprosthetic Patella Fractures
Complications related to the extensor mechanism and patellofemoral joint continue to be the most common cause of pain and indication for surgical revision following total knee arthroplasty. Numerous risk factors related to the patient, implant, and technical performance of the procedure have been identified. The Ortiguera and Berry classification system is widely used for the systematic classification and management of these fractures. Because of the difficult nature of revision surgery for fracture and the high risk of complication, a careful assessment of the fracture and implants is vital to determining the best course ...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Justin Deans, Giles R. Scuderi Source Type: research

Modular or Monolithic Tapered Fluted Prostheses for Periprosthetic Fractures
We present an overview of revision total hip arthroplasty in the setting of periprosthetic fracture, focusing on comparing the 2 most popular femoral component revision models, the modular and monolithic tapered fluted conical prostheses. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Steven Yacovelli, William Hozack Source Type: research

Ten-Year Survivorship and Risk of Periprosthetic Fracture of a Cementless Tapered Stem
This article is a retrospective review of a consecutive series of 401 primary total hip arthroplasties with the use of cementless, ream and broach Synergy stem (Smith& Nephew, Memphis, TN, USA) with minimal 10-year follow-up. We report an overall 10-year survivorship of 99.6% with a total of 15 fractures during the study period. Six of these fractures occurred intraoperatively. This is the largest series to our knowledge reporting greater than 10-year follow-up. This stem has excellent survivorship with overall low risk of periprosthetic fracture (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Mathew H. Freeman, Beau J. Kildow, Tyler J. Larson, Zachary C. Bailey, Elizabeth R. Lyden, Kevin L. Garvin Source Type: research

A Review of Periprosthetic Tibial Fractures
Periprosthetic fracture occurring during or after total knee arthroplasty is a rare injury. Literature concerning periprosthetic tibial factures is sparse, and there is limited guidance for evidence-based management. This review aims to provide readers with an overview of the epidemiology, risk factors, and classification of these fractures. Management includes nonoperative treatment of nondisplaced fractures, fixation for those with stable implants, and revision for those with loose implants. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Samantha A. Mohler, Jeffery B. Stambough, Simon C. Mears, Charles Lowry Barnes, Benjamin M. Stronach Source Type: research

Treatment of Geriatric Acetabular Fractures —A Concise Review of the Literature
Optimal management of acetabular fractures (AF) in the elderly has not been defined clearly. The incidence of such fractures is rising in the aging population. Advancements in implant technology have improved the longevity of combined or staggered total hip arthroplasty procedures for this patient population, thus allowing earlier weight bearing and continued functional independence. Perioperative/postoperative complication rates remain significantly high in all treatment arms. Overall, the best outcomes with the lowest complication rates are achieved when AF are treated by a surgeon or a team of surgeons who specialize in...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Daniel A. Cohen, Spencer J. Montgomery, Alexandra Stavrakis, Simon C. Mears, Amit Atrey, Amir Khoshbin Source Type: research

Management of Geriatric Elbow Injury
Approximately 4.1% of all fractures in the elderly involve the elbow. Most elbow injuries in geriatric patients occur as the result of low-energy mechanisms such as falls from standing height. Elbow injuries in elderly patients present complex challenges because of insufficient bone quality, comminution, articular fragmentation, and preexisting conditions, such as arthritis. Medical comorbidities and baseline level of function must be heavily considered in surgical decision making. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Naoko Onizuka, Julie Switzer, Chad Myeroff Source Type: research

The Syndesmosis, Part I
Ankle fractures are common injuries to the lower extremity with approximately 20% sustaining a concomitant injury to the syndesmosis. Although the deltoid ligament is not formally included in the syndesmotic complex, it plays an important role in the mortise stability. Therefore, its integrity should be always evaluated when syndesmotic injury is suspected. Given the anatomic variability of the syndesmosis between individuals, bilateral ankle imaging is recommended, especially in cases of subtle instability. Diagnostic tests that allow dynamic assessment of the distal tibiofibular joint in the 3 planes are the most reliabl...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Lorena Bejarano-Pineda, Daniel Guss, Gregory Waryasz, Christopher W. DiGiovanni, John Y. Kwon Source Type: research

The Syndesmosis, Part II
Syndesmotic injuries in the setting of ankle fracture are critically important to diagnosis and treat to restore an anatomic tibiotalar relationship. Physical examination and clinical suspicion remain critically important for diagnosis. Ultrasound examination and weight-bearing computed tomography scans are evolving to help diagnosis more subtle injuries. Although flexible syndesmotic fixation may decrease malreduction rates, the benefits over rigid fixation is the subject of ongoing study. Anatomic reduction remains critical regardless of fixation choice. Routine removal of rigid syndesmotic hardware does not seem to offe...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Philip B. Kaiser, Lorena Bejarano-Pineda, John Y. Kwon, Christopher W. DiGiovanni, Daniel Guss Source Type: research

Calcaneal Fractures —Which Approach for Which Fracture?
Treatment of calcaneal fractures has to be tailored to the individual pathoanatomy. If operative treatment is chosen, anatomic reconstruction of the calcaneal shape and joint surfaces is mandatory. For most of the displaced, intraarticular fractures, this can be achieved by less invasive reduction and fixation via a sinus tarsi approach, which may be extended along the “lateral utility” line for calcaneocuboid joint involvement or calcaneal fracture-dislocations. Purely percutaneous fixation is the treatment of choice for displaced extraarticular fractures and simple intraarticular fractures with adequate control of jo...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Stefan Rammelt, Michael P. Swords Source Type: research

Upper Cervical Trauma
Craniocervical injuries (CCJs) account for 10% to 30% of all cervical spine trauma. An increasing number of patients are surviving these injuries due to advancements in automobile technology, resuscitation techniques, and diagnostic modalities. The leading injury mechanisms are motor vehicle crashes, falls from height, and sports-related events. Current treatment with urgent rigid posterior fixation of the occiput to the cervical spine has resulted in a substantial reduction in management delays expedites treatment of CCJ injuries. Within CCJ injuries, there is a spectrum of instability, ranging from isolated nondisplaced ...
Source: Orthopedic Clinics of North America - July 30, 2021 Category: Orthopaedics Authors: Catherine Olinger, Richard Bransford Source Type: research