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Opioid Use Patterns After Primary Total Knee Replacement
Orthopedic surgeries are associated with the prescription of more narcotics than any other surgical specialty, particularly for total knee replacement (TKR) surgery. The authors examined controlled substance prescriptions following TKR surgery in a sample of 560 TKR patients. Results indicated that of all the 5164 prescriptions documented on the controlled substance monitoring database, 64% were for opioid medications. More than half of the patients received controlled substances from both the surgery site provider and a nonsurgery site provider in the year following surgery. The authors recommend that providers consider t...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Karen J. Derefinko, Zhenghua Gong, Zoran Bursac, Sarah B. Hand, Karen C. Johnson, William M. Mihalko Source Type: research

Contemporary Robotic Systems in Total Knee Arthroplasty
The success of total knee arthroplasty (TKA) depends on restoration of the stability and biomechanical efficiency of the native knee. The emergence of robotic surgical technologies has greatly increased the precision and reproducibility. We discuss contemporary robotic TKA systems by reviewing the features of the individual platforms, their accuracy, and the clinical outcomes. While early results suggest significant gains in patient outcomes, long-term evidence is still awaited from multicenter prospective clinical trials. Moreover, advances in this technology are needed to address knee laxity while individualizing the fun...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Shuyang Han, David Rodriguez-Quintana, Adam M. Freedhand, Kenneth B. Mathis, Alexander V. Boiwka, Philip C. Noble Source Type: research

Clinical Evidence of Current Irrigation Practices and the Use of Oral Antibiotics to Prevent and Treat Periprosthetic Joint Infection
During total joint arthroplasty, the contamination of the operative field with bacteria has historically been thought to be the major cause of early, acute periprosthetic joint infection (PJI).1 Aimed at reducing this bacterial load, surgeons have engaged in the use of irrigation and other adjuvants during surgery and before wound closure. These additives have varied in type, concentration, and mechanism for disrupting bacterial colonization. Antiseptics, antibiotic-infused irrigation, or soap-like surfactants are three main classifications for irrigation solutions. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Jason Zlotnicki, Alexandra Grabrielli, Kenneth L. Urish, Kimberly M. Brothers Source Type: research

Opioid Use Patterns After Primary TKR
Orthopedic surgeries are associated with the prescription of more narcotics than any other surgical specialty, particularly for total knee replacement (TKR) surgery. The authors examined controlled substance prescriptions following TKR surgery in a sample of 560 TKR patients. Results indicated that of all the 5164 prescriptions documented on the controlled substance monitoring database, 64% were for opioid medications. More than half of the patients received controlled substances from both the surgery site provider and a nonsurgery site provider in the year following surgery. The authors recommend that providers consider t...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Karen J. Derefinko, Zhenghua Gong, Zoran Bursac, Sarah B. Hand, Karen C. Johnson, William M. Mihalko Source Type: research

Orthopedic Versus Podiatric Care of the Foot and Ankle
As the scope of podiatric surgery expands, the relative roles and outcomes of orthopedic surgeons and podiatrists need to be defined. With growing demand for foot and ankle services, the roles of podiatrists and orthopedic surgeons are increasingly overlapping. Few studies have examined the overlapping scope of practice of each of the groups or compared the relative costs and outcomes associated with each. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Charlotte Allen, Alastair Younger, Andrea Veljkovic, Mark Glazebrook Source Type: research

Converting Ankle Arthrodesis to a Total Ankle Arthroplasty
Several articles in the literature discuss the positive results of converting a painful ankle fusion to an ankle replacement. Our results confirm that in well-selected cases a conversion to a total ankle replacement is not only possible, but also significantly improves quality of life and reduces pain. The outcome of a total ankle replacement after an ankle fusion depends to a degree on the method of fusion. Less destructive fusion that is arthroscopic has better results than conventional transfibular open fusions. Absence of a fibula should be an absolute contraindication for a conversion. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: J. Chris Coetzee, Fernando Raduan, Rebecca Stone McGaver Source Type: research

Factors Influencing Appropriate Implant Selection and Position in Reverse Total Shoulder Arthroplasty
Reverse shoulder arthroplasty has increased in popularity and has provided improved but somewhat variable results. These variable outcomes may be related to many factors, including implant design, component positioning, specific indication, and patient anatomy. The original Grammont design provided a solution to the high failure rate at the time but was found to have a high rate of scapular notching and poor restoration of rotation. Modern lateralized designs are more consistent in reducing scapular notching while improving range of motion, especially in regards to external rotation. This review article summarizes the effe...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Jonathan Callegari, Georges Haidamous, Alexandre L ädermann, Cameron Phillips, Shane Tracy, Patrick Denard Source Type: research

Pediatric Orthopedics
Dual-fellowship –trained surgeons specializing in both pediatric and sport medicine are treating an increasing number of pediatric orthopedic injuries, making pediatric orthopedic sports medicine a potential new emerging subspecialty. With fellowship training now being the norm rather than the exception across or thopedics, it is possible that dual-fellowship training may become a prerequisite for treatment of pediatric sports medicine patients. This may impact the practices of surgeons trained in either pediatric or sports medicine alone. As the trend toward dual-fellowship training is likely to continue, f uture studie...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Maksim A. Shlykov, Pooya Hosseinzadeh Source Type: research

Implant Selection for Proximal Humerus Fractures
Proximal humerus fractures (PHF) are a common orthopedic injury; however, their treatment remains largely controversial with evidence supporting a wide array of treatments. Although many injuries can be treated nonoperatively, there has been much debate about surgical management of PHF. A detailed review of the literature was performed relative to operative management options specifically related to implant choices. Although no definitive answers are available regarding best practice, there is literature to guide operative decision-making and implant selection based on both patient- and surgeon-specific factors. (Source: O...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Adeshina Adeyemo, Nicholas Bertha, Kevin J. Perry, Gary Updegrove Source Type: research

Nontraditional Methods of Fibula Fixation
This article explores different nontraditional methods that could be adopted in clinical settings as alternatives to the traditional fibular fixation. Less invasive methods, such as intramedullary nail and screw fixation, might be viable alternatives for managing ankle fractures. These methods might especially benefit patients with poor soft tissue envelopes, low immunity, and poor bone quality. There is minimal soft tissue coverage for most orthopedic implants around the ankle. Various authors have highlighted the importance of minimally invasive surgery as an effective modality for ensuring superior prognosis for ankle f...
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Casey M. Beleckas, Jan P. Szatkowski Source Type: research

Extreme Nailing or Less Invasive Plating of Lower Extremity Periarticular Fractures
Periarticular fractures of the lower extremity can be difficult injuries to stabilize effectively. Modern advances in technique and implant design now allow many of these fractures to be fixed with an extreme intramedullary nail. When nailing is not possible, less invasive plating through percutaneous incisions is a reliable option. The decision to perform extreme nailing is multifactorial and is based on the fracture pattern, the condition of the soft tissues, the medical condition of the patient, and the importance of earlier or immediate weightbearing. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - February 10, 2021 Category: Orthopaedics Authors: Peter R. Wasky, Michael J. Beltran Source Type: research

Augmented Reality in Orthopedic Practice and Education
This article evaluates AR applications specific to total knee arthroplasty, total hip arthroplasty, and the opportunities for AR to enhance arthroplasty education and professional development. (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 20, 2020 Category: Orthopaedics Authors: Timothy C. Keating, Joshua J. Jacobs Source Type: research

Orthopedic Clinics of North America
www.orthopedic.theclinics.com (Source: Orthopedic Clinics of North America)
Source: Orthopedic Clinics of North America - November 20, 2020 Category: Orthopaedics Source Type: research

Copyright
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Source: Orthopedic Clinics of North America - November 20, 2020 Category: Orthopaedics Source Type: research

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 - November 20, 2020 Category: Orthopaedics Source Type: research