What Method of Fixation Is Superior for Biceps Tenodesis?
PMID: 32674171 [PubMed - in process] (Source: Orthopedics)
Source: Orthopedics - July 1, 2020 Category: Orthopaedics Authors: Zhong M, Zhu W, Lu W Tags: Orthopedics Source Type: research

Patient Advocacy During COVID-19.
PMID: 32674172 [PubMed - in process] (Source: Orthopedics)
Source: Orthopedics - July 1, 2020 Category: Orthopaedics Authors: Lockey SD, Postma WF Tags: Orthopedics Source Type: research

The Early Effect of COVID-19 Restrictions on an Academic Orthopedic Surgery Department.
Abstract The SARS-CoV-2 (COVID-19) pandemic has had a global influence on health care. The authors examined the early effect of hospital- and state-mandated restrictions on an orthopedic surgery department and hypothesized that the volume of ambulatory clinic encounters, office and surgical procedures, and cases would dramatically decrease. A retrospective review was performed of all encounters in an orthopedic surgery department at a level I academic trauma center during a 4-week period, from March 16, 2020, to April 12, 2020. The results were compared with two control 4-week periods, February 17, 2020, to March ...
Source: Orthopedics - July 1, 2020 Category: Orthopaedics Authors: Earp BE, Zhang D, Benavent KA, Byrne L, Blazar PE Tags: Orthopedics Source Type: research

Coagulopathies Are a Risk Factor for Adverse Events Following Total Hip and Total Knee Arthroplasty.
Abstract Current literature suggests a correlation between preoperative coagulopathies and postsurgical adverse events (AEs). However, this correlation has not been specifically assessed in the total hip arthroplasty (THA) and the total knee arthroplasty (TKA) populations. Patients who underwent primary THA and TKA with coagulopathy data were identified from the 2011-2015 American College of Surgeons National Surgical Quality Improvement Program database. Coagulopathies studied were low platelets, high partial thromboplastin time (PTT), high international normalized ratio (INR), and other hematological conditions....
Source: Orthopedics - July 1, 2020 Category: Orthopaedics Authors: Malpani R, Mclynn RP, Bovonratwet P, Bagi PS, Yurter A, Mercier MR, Rubin LE, Grauer JN Tags: Orthopedics Source Type: research

The Effect of the COVID-19 Pandemic on Orthopedic Practices in New York.
Abstract The SARS-CoV-2 (COVID-19) crisis has strained hospitals and health systems across the world. In the United States, New York City has faced a surge of cases as the epicenter of the North American outbreak. Northwell Health, as the largest regional health system in New York City, has implemented various practices and policies to adapt to the evolving situation and prepare for future global events. [Orthopedics. 2020;43(4):245-249.]. PMID: 32674175 [PubMed - in process] (Source: Orthopedics)
Source: Orthopedics - July 1, 2020 Category: Orthopaedics Authors: Mo AZ, Mont MA, Grossman EL, Rahman OF, Murray DP, Hershman EB, Sgaglione NA Tags: Orthopedics Source Type: research

Cost Analysis of Dual-Mobility Constructs in Revision Total Hip Arthroplasty: A European Payer Perspective.
Abstract Dual-mobility constructs have been shown to significantly and substantially decrease dislocations after revision total hip arthroplasty (THA). The authors have previously shown that dual-mobility (DM) constructs are cost-effective given their ability to decrease dislocations and re-revision for dislocation. The goal was to report the costs of DM and large femoral head (LFH) constructs in revision THAs from a European health care payer perspective. A Markov model was constructed to analyze the costs incurred by payers in the United Kingdom, Germany, Italy, and Spain over 3 years in revision THAs with DM or...
Source: Orthopedics - July 1, 2020 Category: Orthopaedics Authors: Abdel MP, Miller LE, Hull SA, Coppolecchia AB, Hanssen AD, Pagnano MW Tags: Orthopedics Source Type: research

Intramedullary Nail Fixation for the Treatment of Pathologic Humeral Shaft Fractures.
Abstract The goal of this study was to report the clinical outcomes of pathologic humeral shaft fractures treated with reamed or unreamed intramedullary nail fixation in an era of longer patient survival. A retrospective review was conducted of all patients who underwent intramedullary nail fixation performed by a single surgeon for pathologic humeral shaft fractures at a Level I trauma center from 2009 to 2017. Of the 25 patients who were identified, 9 were excluded. Groups were categorized according to whether they underwent reamed or unreamed fixation, and they were evaluated for evidence of union, complication...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Colello MJ, Hunter MD, Tanner SL, Porter SE Tags: Orthopedics Source Type: research

Unmet Patient Expectations for Interventions Decrease Provider Satisfaction Scores.
Abstract As health care reimbursement evolves, physicians will continue to be evaluated based on the quality of care that they provide. One measure of quality is based on patient satisfaction as reported through the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS). Although previous studies have explored expectations and their role in patient satisfaction, no studies have investigated the role of patient expectations for interventions in surgical specialty clinics. Patients (N=126) were given 2 surveys, a pre-visit and a post-visit questionnaire, with options based on the CAHPS survey. Patien...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Brancazio S, Eskildsen SM, Abimbola F, Olcott CW, Kamath GV, Del Gaizo DJ Tags: Orthopedics Source Type: research

Effect of Nicotine Dependence and Smoking on Revision Diskectomy After Single-Level Lumbar Diskectomy.
Abstract Removal of a herniated disk that is causing neural compression is among the most common indications for spinal surgery. Previous population database studies of risk factors for reoperation after this procedure analyzed small to medium numbers of patients. To date, no study has concurrently assessed the effect of modifiable risk factors, such as smoking and nicotine dependence, with a large number of patients. Data were obtained with commercially available software that houses de-identified data for several major US health care systems. A database search was conducted to find all patients who had undergone...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Smith EJ, Inkrott BP, Du JY, Ahn UM, Ahn NU Tags: Orthopedics Source Type: research

Transcription Error Rates in Retrospective Chart Reviews.
Abstract Electronic health record (EHR) technologies have improved the ease of access to structured clinical data. The standard means by which data are collected continues to be manual chart review. The authors compared the accuracy of manual chart review against modern electronic data warehouse queries. A manual chart review of the EHR was performed with medical record numbers and surgical admission dates for the 100 most recent inpatient venous thromboembolic events after total joint arthroplasty. A separate data query was performed with the authors' electronic data warehouse. Data sets were then algorithmically...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Feng JE, Anoushiravani AA, Tesoriero PJ, Ani L, Meftah M, Schwarzkopf R, Leucht P Tags: Orthopedics Source Type: research

Arthroplasty Surgeons Do Not Improve Acute Outcomes for Patients With Hip Fracture Relative to Other Subspecialists.
This study showed that the acute outcomes used to assess the value of care for patients undergoing THA were not significantly different when the surgery was performed by an adult reconstruction specialist compared with other orthopedic surgeons at 2 high-volume academic centers with perioperative care pathways. Alternative modalities to significantly improve acute postoperative outcomes in a bundled reimbursement model must be investigated. [Orthopedics. 2020;43(x):xx-xx.]. PMID: 32602917 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Ryan SP, Padilla JA, Schwarzkopf R, Gage MJ, Bolognesi MP, Seyler TM Tags: Orthopedics Source Type: research

Return to Work After Total Joint Arthroplasty: A Predictive Model.
Abstract Returning to work after surgery is a primary concern of patients who are contemplating total joint arthroplasty (TJA). The ability to return to work has enormous influence on the patient's independence, financial well-being, and daily activities. The goal of this study was to determine the independent patient variables that predict return to work as well as to create a predictive model. From June 2017 to December 2017, a total of 391 patients who underwent primary TJA (243 hips, 148 knees) were prospectively enrolled in the study to obtain information on return to work after surgery. Patients were sent a ...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Rondon AJ, Tan TL, Greenky MR, Kheir MM, Foltz C, Purtill JJ Tags: Orthopedics Source Type: research

Identifying the Safe Zone in Arthroscopic Anterior Elbow Capsulectomy: A Cadaveric Study.
Abstract The authors assessed the effects of forearm rotation on the proximity of the radial nerve and medial collateral ligament (MCL) to a proximal and a more distal arthroscopic anterior elbow capsulectomy. Arthroscopy was performed on 10 cadaveric specimens. Sutures were passed lateral to medial at the level of the radiocapitellar joint and at the proximal edge of the annular ligament. Dissection measured the distance to the radial nerve from the lateral starting point and to the MCL from the medial exit point in varying degrees of forearm rotation. The extent of brachialis muscle coverage of the radial nerve ...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Chin KM, Gilotra MN, Horton S, Hasan SA Tags: Orthopedics Source Type: research

Peri-implant Fractures Following Hook Plate Fixation for Unstable Distal Clavicle Fractures.
Abstract Clavicle hook plate is a common implant for treating distal clavicle fracture. Although high bone union rate and good functional outcome have been reported, so have several complications, such as osteolysis and fracture of the acromion, loss reduction, hook impingement, and rotator cuff tear. Peri-implant fracture over the medial side of the hook plate is a rare complication. Sporadic cases have been reported, and most of them have had no history of trauma. Between June 2015 and August 2018, 7 patients treated for distal clavicle fracture with a 3.5-mm locking compression hook plate with no history of tra...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Ni PL, Lin KC, Chen CY, Tarng YW, Chang WN, Renn JH Tags: Orthopedics Source Type: research

Hip Arthroscopy for Diffuse Idiopathic Skeletal Hyperostosis Using a Capsulotomy-First Approach.
Abstract Diffuse idiopathic skeletal hyperostosis (DISH) is a systematic disease of unknown etiology characterized by ossification at the site of spine and major joints entheses, including the hip. Ossified connective tissue may cause pain and joint stiffness, which may require surgical intervention. The purpose of this study was to investigate the clinical, radiographic, and arthroscopic presentation and surgical outcomes of patients with DISH involving the hips. Fourteen hips in 9 patients (mean±SD age, 63±14 years; range, 35-76 years) with overcoverage of the femoral head by DISH were retrospectiv...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Yukizawa Y, Matsuda DK, Sakai A, Uchida S Tags: Orthopedics Source Type: research

Analysis of the Sports Medicine Section of the Orthopaedic In-Training Examination: Improvements in Levels of Evidence and Question Taxonomy Over a 12-Year Period.
This study indicated that sports medicine questions on recent OITEs cite references of higher levels of evidence and contain higher taxonomic question structure than examinations 10 to 12 years ago. However, the majority of questions still cite articles with low levels of evidence or nonprimary sources. These findings can be used to guide resident education and continue improvements in the selection of references for questions on the Sports Medicine section of the OITE. [Orthopedics. 2020;43(x):xx-xx.]. PMID: 32602922 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Luginbuhl JC, Sobel AD, Mulcahey MK Tags: Orthopedics Source Type: research

Displaced Supracondylar Humerus Fractures in Toddlers.
Abstract Gartland type III fracture is the most troublesome type of supracondylar humerus fracture. These injuries most often occur in school age children, but they are seen in pediatric patients of all ages. The goal of this study was to analyze toddlers with Gartland type III fractures to identify clinically significant differences compared with older children. A retrospective cohort study was conducted with 94 toddlers (
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Striano BM, De Mattos C, Ramski DE, Flynn KR, Horn BD Tags: Orthopedics Source Type: research

Patient-Reported Outcomes of Shoulder Surgery in a Community Orthopedic Practice: A 5-Year Quality Improvement Project Using the QuickDASH Questionnaire.
Abstract There has been a shift in US health care to a system that emphasizes value. Patient-reported outcomes have become a critical component of that valuation. A 5-year quality improvement project at the community private practice level was undertaken to assess the authors' delivery of care and practice processes for shoulder surgery as compared with established standards. QuickDASH questionnaires were collected from 1304 consecutive shoulder surgery patients, and data were collected at 4 time points. Mean QuickDASH scores for each procedure and scores assessing biceps tenodesis, distal clavicle excision, worke...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Shubert DJ, Shubert SB Tags: Orthopedics Source Type: research

National Trends in the Surgical Treatment of Chronic Rotator Cuff Tear in Patients Without Arthritis.
Abstract Both rotator cuff repair (RCR) and reverse total shoulder arthroplasty (RTSA) are effective treatment options for chronic large degenerative rotator cuff tear (RCT) in the elderly. The goal of this study was to evaluate national trends for surgical management of chronic RCT among patients without glenohumeral arthritis. The authors conducted a retrospective review from 2007 to 2015 using the PearlDiver database. The study included patients who had the International Classification of Diseases, Ninth Revision, diagnosis of chronic RCT without shoulder arthritis. Procedural codes from the Current Procedural ...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Vora M, Sing DC, Curry EJ, Kamal RN, Li X Tags: Orthopedics Source Type: research

Preoperative Exercise Participation Reflects Patient Engagement and Predicts Earlier Patient Discharge and Less Gait Aid Dependence After Total Joint Arthroplasty.
Abstract Whether preoperative physical therapy actually leads to improved clinical outcomes after total joint arthroplasty (TJA) remains unclear. The authors sought to use participation in a preoperative online exercise and education program as a marker for patient engagement. They hypothesized that increased preoperative participation with the program would predict shorter length of stay (LOS) and gait independence. Forty consecutive patients undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) by a single surgeon were given access to the PrimePrehab Prehabilitation Exercise Program (N...
Source: Orthopedics - June 30, 2020 Category: Orthopaedics Authors: Denduluri SK, Huddleston JI, Amanatullah DF Tags: Orthopedics Source Type: research

Reasons for Failure of Primary Total Hip Arthroplasty Performed Through a Direct Anterior Approach.
Abstract The direct anterior approach (DAA) for total hip arthroplasty (THA) is a technique popular among some arthroplasty surgeons. There is currently a paucity of data regarding reasons for failure of THA using the DAA. The authors conducted a retrospective review of prospectively collected data on 56 patients who underwent revision THA at their institution after failing primary THA that was performed through a DAA either at their institution (n=8) or elsewhere (n=48) from January 1, 2010, to June 1, 2017. Patients were grouped by modes of failure and compared using patient characteristics, surgical factors, an...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Duethman NC, Statz JM, Trousdale RT, Taunton MJ Tags: Orthopedics Source Type: research

Surgical Outcomes in Selective Laminectomy and Conventional Double-Door Laminoplasty for Cervical Spondylotic Myelopathy.
In this study, the authors prospectively compared neurological outcomes and radiological parameters in C-LAMP and S-LAM for the treatment of cervical spondylotic myelopathy. Fifty-three patients were enrolled, with 25 patients receiving conventional double-door C-LAMP and 28 patients receiving S-LAM. Measured outcomes included operative time, intraoperative blood loss, Japanese Orthopaedic Association score for neurological recovery, cervical sagittal alignment at C2-7, cervical sagittal vertical axis from occiput to C7, C7 slope, and cervical ROM at C2-7. No difference was found in operative time, whereas intraoperative b...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Yoshii T, Tomizawa S, Hirai T, Inose H, Yamada T, Sakai K, Ushio S, Egawa S, Yuasa M, Kato T, Kawabata S, Arai Y, Okawa A Tags: Orthopedics Source Type: research

Characteristics of Pyogenic Musculoskeletal Infections in Older Children and Adolescents.
This study evaluated the presentation and complications of musculoskeletal infections involving the pelvis and extremities in children older than 10 years. Thirty patients 10 to 17 years old (mean, 12.7 years old) were treated for musculoskeletal infections. Mean time to diagnosis was 9.2 days. Prior to correct diagnosis, 83% were assessed by at least 1 outpatient provider. At the time of admission, 55% were weight bearing and 93% were afebrile. Twenty-eight percent had a multifocal infection. More than one-third had serious medical complications or orthopedic sequelae; compared with patients without complications, this gr...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Pierrie SN, Scannell BP, Brighton BK, Vanderhave KL Tags: Orthopedics Source Type: research

Clinical Significance of Radiologic Improvement Following Single-Level Oblique Lateral Interbody Fusion With Percutaneous Pedicle Screw Fixation.
Abstract Indirect decompression using oblique lateral interbody fusion (OLIF) improves spinal canal dimensions by reducing spondylolisthesis and restoring intervertebral disk height in patients with degenerative lumbar diseases. However, the clinical significance of these radiological improvements has not been fully evaluated in the literature. To examine the relationship between the clinical and radiological outcomes following OLIF, the authors prospectively studied 41 patients who underwent single-level OLIF with percutaneous pedicle screw fixation for lumbar degenerative disease, including degenerative and spon...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Chang SY, Nam Y, Lee J, Chang BS, Lee CK, Kim H Tags: Orthopedics Source Type: research

Return to Sport Following Adolescent Concussion: Epidemiologic Findings From a High School Population.
Abstract High school athletes sustaining a concussion require careful attention when determining return-to-sport (RTS) readiness. The purpose of this study was to determine epidemiological and RTS data of a large cohort of high school athletes who sustained 1 or more concussions. Records of 357 consecutive youth patients who sustained concussions and presented to a single health care system between September 2013 and December 2016 were reviewed. Demographic data, RTS, and concussion-related variables were obtained via chart review. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores at basel...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Jildeh TR, Okoroha KR, Denha E, Eyers C, Johnson A, Shehab R, Moutzouros V Tags: Orthopedics Source Type: research

Tibial Fracture Healing Score: A Novel Tool to Predict Tibial Nonunion.
Abstract The aim of the study was to investigate the utility of a simple office-based tool in predicting the need for secondary intervention to obtain union in patients with tibial fractures. All patients 18 years and older with isolated tibial shaft fractures (OTA 41A, 42A-C, and 43A) treated with intramedullary nailing from 2013 to 2017 were screened. Eighty-seven patients met enrollment criteria. Surgeon assessment of the following 3 clinical parameters was performed at routine office visits and scored as follows: (1) pain (none/mild/decreased=1, no change/increased=0); (2) function (minimal limp/able to perfor...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Jang Y, Gaski G, Natoli R, Virkus W, Mckinley T Tags: Orthopedics Source Type: research

Gluteus Maximus Transfer as an Augmentation Technique for Patients With Severe Abductor Deficiency of the Hip.
Abstract Impaired abductor function of the hip following severe abductor deficiencies can be devastating for functionality and quality of life. Recently, gluteus maximus transfer has been proposed as a solution to these difficult problems. However, outcome results are sparse. The aim of this study was to evaluate the effects of gluteus maximus transfer on improvement of pain, disability, and quality of life in patients with severe hip abductor deficiencies. Gluteus maximus transfer was performed in 16 patients with severe disruption of the abductor muscles of the hip. Data were collected preoperatively and at 6 we...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Quisquater L, Timmermans A, Vandenabeele F, Driesen R, Corten K Tags: Orthopedics Source Type: research

Nutritional Counseling Program for Morbidly Obese Patients Enables Weight Optimization for Safe Total Joint Arthroplasty.
Abstract Obesity affects one-third of total joint arthroplasty (TJA) patients and is the most common modifiable risk factor for increased complications in the TJA population. The authors' institution implemented a body mass index (BMI) cutoff of 40 kg/m2 to define appropriate TJA candidates. Patients above the cutoff were referred for nutritional counseling. The study objective was to evaluate the efficacy of this protocol in optimizing patient BMI for safe and successful TJA. Between 2016 and 2018, the authors examined 133 patients (mean age, 62.6 years) with a BMI greater than 40 kg/m2 seeking TJA (94 knee, 39 h...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Lingamfelter M, Orozco FR, Beck CN, Harrer MF, Post ZD, Ong AC, Ponzio DY Tags: Orthopedics Source Type: research

Effect of Global Fracture Care Billing on Distal Radius Fractures.
This study demonstrates that patients billed via global fracture care have less frequent follow-up and fewer office visits during the 90-day global period than patients billed in itemized fashion. [Orthopedics. 2020;43(x);xx-xx.]. PMID: 32501523 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Curtis DM, Lee CS, Boyajian HH, Lee MJ, Conti Mica M, Shi LL Tags: Orthopedics Source Type: research

A Dual-Motor Drill Reduces Plunge, Simultaneously Gauges Depth, and Saves Time When Placing Orthopedic Screws.
Abstract The technique for placement of orthopedic hardware remains unchanged despite technological advances. The surgeon controls drill bit speed and advancement, which risks drill bit overpenetration, or plunge. Measurement is performed as an additional step, introducing measurement error and increasing operative time. A dual-motor drill was created to control drill variables and combine drilling and measurement into a single step. The purpose of this study was to determine whether a dual-motor drill could reduce drilling and measurement errors while increasing the speed of placement of orthopedic hardware. Five...
Source: Orthopedics - June 4, 2020 Category: Orthopaedics Authors: Lang SD, Gilmer BB Tags: Orthopedics Source Type: research

Effect of Postoperative Nonsteroidal Anti-inflammatory Drugs on Nonunion Rates in Long Bone Fractures.
Abstract The association of nonsteroidal anti-inflammatory drugs (NSAIDs) with non-union in long bone fractures has been controversial. The purpose of this study was to evaluate whether NSAID exposure results in increased risk of non-union in operatively treated long bone fractures. The authors used International Classification of Diseases and Current Procedural Terminology codes to identify patients under a single-payer private insurance with operatively treated humeral shaft, tibial shaft, and subtrochanteric femur fractures from a large database. Patients were divided into cohorts based on NSAID use in the imme...
Source: Orthopedics - May 5, 2020 Category: Orthopaedics Authors: Tucker WA, Birt MC, Heddings AA, Horton GA Tags: Orthopedics Source Type: research

Treatment of Periprosthetic Nonunions of the Lower Extremity.
Abstract Multiple studies have reported nonunion rates of 3% to 17% following peri-prosthetic fractures. Determining management strategies based on the available literature is difficult because existing studies are small and involve heterogeneous treatments and multiple surgeons. The purpose of this study was to describe a consecutive series of patients who presented to the authors' clinic with a periprosthetic nonunion of the lower extremity and to report the methods used to achieve limb salvage and the associated complications. Patients were included if they were indicated for surgery for a nonunion of a peripro...
Source: Orthopedics - May 5, 2020 Category: Orthopaedics Authors: Vemulapalli KC, Davis SL, Mathews V, Goytia RN, Stocks GW, Dunn WR, Laughlin MS, Brinker MR Tags: Orthopedics Source Type: research

Opioid Consumption and Time to Return to Work After Percutaneous Osteotomy in Foot Surgery.
Abstract Surgeries involving the foot and ankle are painful procedures, with many patients unwilling to discontinue prescribed narcotics at 3 months postoperatively. Percutaneous techniques allow for smaller incisions and minimal soft tissue disruption. Fifty consecutive patients underwent outpatient percutaneous foot surgery. Data were collected on pain medication taken and time to return to work. A mean of 3.3 tablets of oxycodone were consumed during the first 2 weeks. No patient was taking narcotics after 2 weeks. Mean time to return to work was 18.9 days. Percutaneous foot and ankle surgery led to a significa...
Source: Orthopedics - May 5, 2020 Category: Orthopaedics Authors: Chan JJ, Guzman JZ, Nordio A, Chan JC, Cirino CM, Vulcano E Tags: Orthopedics Source Type: research

Combined Procedure Allowing Atlantoaxial and Atlanto-Occipital Joint Motion for Complex Injuries in the Upper Cervical Spine.
This study was performed to explore an ideal limited fixation method for the treatment of unstable atlantoaxial fractures that can preserve the range of motion of the occipital and atlantoaxial joints and restore the stability of the upper cervical spine. A 64-year-old man was diagnosed with a complicated injury of the upper cervical spine. The anterior and posterior approach was used to reconstruct the stability of the upper cervical spine while preserving the range of motion of the occipital and atlantoaxial joints. Preoperative imaging and neurologic examinations were performed. Follow-up lasted 24 months. The patient c...
Source: Orthopedics - May 5, 2020 Category: Orthopaedics Authors: Zhao W, Sun Y, Xu G, Yan J Tags: Orthopedics Source Type: research

Same-Day Discharge Following Total Joint Arthroplasty: Examining Trends, Discharge Dispositions, and Complications Over Time.
Abstract Administrative database studies have reported on the safety of same-day discharge (SDD) following total joint arthroplasty (TJA); however, most patient cohorts have been defined by length of stay (LOS), and the proportion discharged directly home remains unknown. The purpose of this investigation was to (1) determine common dispositions for patients undergoing SDD TJA; (2) understand changes in discharge disposition over time; and (3) determine the safety of SDD TJA, stratified by discharge disposition. The PearlDiver Database was reviewed for patients who underwent SDD TJA (LOS of 0 days) from 2011 to 20...
Source: Orthopedics - May 5, 2020 Category: Orthopaedics Authors: Clouette J, Agarwalla A, Ravi B, Gandhi R, Maldonado-Rodriguez N, Saltzman BM, Romeo AA, Leroux TS Tags: Orthopedics Source Type: research

Arthroscopic Superior Capsular Reconstruction of the Shoulder Using Dermal Allograft.
Abstract Irreparable massive cuff tears in young patients pose a difficult problem for shoulder surgeons. Arthroscopic superior capsular reconstruction has shown promise in recent years in the treatment of this challenging patient population. The majority of the literature is limited to surgical techniques. The authors present the 2-year clinical outcomes of 25 patients undergoing arthroscopic superior capsular reconstruction with dermal allograft from a single center. The Oxford Shoulder Score and range of motion were assessed preoperatively and then at 3 to 6 months, 1 year, and 2 years following surgery. Patien...
Source: Orthopedics - May 5, 2020 Category: Orthopaedics Authors: Makki D, Tang QO, Sandher D, Morgan BW, Ravenscroft M Tags: Orthopedics Source Type: research

Long-term Comparison of Retrograde and Antegrade Femoral Nailing.
Abstract Antegrade or retrograde nailing for femoral shaft fractures remains the gold standard, but long-term data on functional outcomes after intramedullary nailing are lacking. In a retrospective review of prospectively collected patient registry data, patients with an isolated femoral shaft fracture treated with antegrade or retrograde femoral nailing from 1997 to 2012 were interviewed and their medical records analyzed. Functional reported outcome data were obtained via the visual analog scale (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 5 to 17 years postop...
Source: Orthopedics - April 20, 2020 Category: Orthopaedics Authors: Brewster J, Grenier G, Taylor BC, Carter C, Degenova D, Ebaugh MP, Halverson A Tags: Orthopedics Source Type: research

Orthopedic Manifestations of Lead Toxicity.
Abstract Given the recent news regarding the water supply in Flint, Michigan, lead toxicity has become an increasingly important topic in health care. Lead toxicity can have a widespread effect on the human body. Because lead has a significant effect on mineralized tissue such as bone, the purpose of this review was to identify and analyze the orthopedic manifestations of lead poisoning. The effects of lead at the cellular level, on the hematopoietic system, in osteoporosis, and in pediatric patients are discussed. Possible treatment options and recommendations for further monitoring are presented. [Orthopedics. 2...
Source: Orthopedics - April 20, 2020 Category: Orthopaedics Authors: Meyers AL, Woodbury MP, Nelson RA Tags: Orthopedics Source Type: research

Hospital Stays and Medical Expenses Increase Nationwide Among Patients With Septic Arthritis of the Shoulder Who Inject Drugs.
Abstract The authors determined the proportion of patients nationwide with septic arthritis of the shoulder who inject drugs, evaluated differences in hospitalization outcomes and charges between patients with and without injection drug use (IDU), and quantified demographic trends among patients with IDU from 2000 to 2013. Nationally representative data of patients with a principal discharge diagnosis of shoulder septic arthritis were obtained from the Nationwide Inpatient Sample 2000-2013. Using published algorithms, the authors classified septic arthritis of the shoulder as related or unrelated to IDU. They comp...
Source: Orthopedics - April 20, 2020 Category: Orthopaedics Authors: Toppo AJ, Oh DHW, Tybor DJ, Wurcel AG, Menendez ME, Ryan SP, Salzler MJ Tags: Orthopedics Source Type: research

Surgical Management of Glenohumeral Osteoarthritis With Glenoid Erosion and Static Posterior Subluxation (Walch B2): Techniques, Outcomes, and Survivorship Rates.
Abstract The purpose of this study was to systematically assess the surgical techniques and outcomes related to the management of Walch B2 glenoids. PubMed, Medline, and Embase were searched from inception to July 2018. Overall, 24 studies (787 B2 glenoids) were identified. Revision-free survivorship was highest for reverse total shoulder arthroplasty (98.6%) and anatomic total shoulder arthroplasty with asymmetric reaming and a non-augmented glenoid implant (95.6%). Walch B2 glenoids are most commonly managed by asymmetric reaming in the context of anatomic total shoulder arthroplasty, and by the ream-and-run tec...
Source: Orthopedics - April 20, 2020 Category: Orthopaedics Authors: Shanmugaraj A, Sarraj M, Coughlin RP, Guerrero EM, Ekhtiari S, Ayeni OR, Garrigues GE Tags: Orthopedics Source Type: research

The Proportion of Abstracts Presented at the 2010 American Academy of Orthopaedic Surgeons Annual Meeting Ultimately Published.
Abstract As attendees of orthopedic meetings consider how to integrate presented information into their practice, it is helpful to consider the quality of the data presented. One surrogate metric is the proportion of and changes to presented abstracts that become journal publications. With this study, using the 2010 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting abstracts, the authors sought to answer the following questions: Did the publications following abstract presentations differ in terms of the conclusions, study subjects, or coauthors? What proportion of abstracts was published? What are th...
Source: Orthopedics - April 20, 2020 Category: Orthopaedics Authors: Williams BR, Freking WG, Ridley TJ, Agel J, Swiontkowski MF Tags: Orthopedics Source Type: research

Risk Factors for Wound Complications After Periprosthetic Fractures.
This study evaluated risk factors for wound healing complications in patients undergoing surgical management of periprosthetic fractures around the hip and knee. This was a retrospective analysis of 67 consecutive lower-extremity periprosthetic hip and knee fracture surgeries. Descriptive data, comorbidities, dressing type, and rates of wound complications treated nonoperatively and operatively were collected. Logistic regression analysis was performed to calculate odds ratios (ORs) of having a wound complication. There was an overall wound complication rate of 22%; the majority of these complications (16%) were treated op...
Source: Orthopedics - April 20, 2020 Category: Orthopaedics Authors: Kamara E, Berliner ZP, Cooper HJ Tags: Orthopedics Source Type: research

Agonizing and Expensive: A Review of Institutional Costs of Ankle Fusion Nonunions.
This study sought to summarize all institutional expenditures related to the revision of an ankle fusion nonunion, presuming that cost and skin-to-skin time would exceed those of the index surgery. The electronic records from 2 foot and ankle centers were reviewed, leading to a list of patients with 2 or more entries for tibiotalar fusions being generated. A total of 24 cases were found to match the criteria. Demographic factors and skin-to-skin time of the remaining patients were compiled. This cohort included 24 patients (6 female and 18 male) with a mean age of 64 years and body mass index of 30.4 kg/m2. Supplemental cl...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Gagne OJ, Veljkovic AN, Glazebrook M, Penner M, Wing K, Younger ASE Tags: Orthopedics Source Type: research

Single-Incision 4-Compartment Fasciotomy of the Lower Leg: Safe, Effective, and Advantageous.
Abstract The optimal surgical approach for acute compartment syndrome (ACS) of the lower leg remains debatable. Although a majority of surgeons tend to use a 2-incision approach to 4-compartment fasciotomies, the authors have used a single-incision technique followed by protocolized, staged skin closure. The purpose of this study was to determine the safety, efficacy, and complication rate of this strategy. This retrospective study included all patients treated for ACS by a single surgeon during a 3-year period. A protocol was used including a single-incision technique followed by vacuum-assisted wound-closure dre...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Chang G, Fram B, Krieg JC Tags: Orthopedics Source Type: research

Needle Length Requirement for Glenohumeral Joint Injection Using the Neviaser Approach.
Abstract Intra-articular glenohumeral joint injections are commonly performed in the clinical setting for diagnostic and therapeutic purposes. Multiple approaches are described, including the anterior and posterior approaches and the less studied superomedial (Neviaser) approach. The purpose of this study was to determine the length of needle required to enter the shoulder joint via the Neviaser approach by radiography and magnetic resonance imaging (MRI) measurements. Additionally, the authors sought to identify any correlation between needle length and body mass index (BMI). They performed a retrospective review...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Teske L, Al'Khafaji I, Graves BR Tags: Orthopedics Source Type: research

Long-term Anticoagulation Prevents Progression of Stages I and II Primary Osteonecrosis of the Hip in Patients With Familial Thrombophilia.
Abstract The authors prospectively assessed long-term anticoagulation outcomes (≥3 years) for 9 patients meeting 4 inclusion criteria: pretreatment Ficat stage I or II primary hip osteonecrosis (ON), factor V Leiden or prothrombin G20210A heterozygosity, no contraindication to anticoagulation, and 90-day participation in an initial enoxaparin 60 mg/d protocol. The primary endpoint was prevention of hip collapse (Ficat stage III or IV). The secondary endpoint was pain relief. After 90 days of enoxaparin 60 mg/d, anticoagulation was continued for 8 patients: 4 receiving warfarin (international normalized ratio ta...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Glueck CJ, Freiberg RA, Wang P Tags: Orthopedics Source Type: research

Preservation of the Tibial Remnant in Anterior Cruciate Ligament Reconstruction May Improve Postoperative Proprioceptive Function.
Abstract The purpose of this study was to retrospectively compare clinical results, including proprioceptive function, after anterior cruciate ligament (ACL) reconstruction between 2 groups using techniques that preserve and eliminate the tibial remnant. Forty-eight patients who were followed for at least 24 months after ACL reconstruction with 4-strand hamstring tendon autografts were enrolled in this study. They were then divided into 2 groups: the remnant-preserving group (group A, 26 patients), in whom more than 7 mm of the remnant tibial stump (approximately 20% of the mean length of the ACL) was preserved; a...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Lee BI, Kim CH, Jang BW, Hong YC, Kwon SW Tags: Orthopedics Source Type: research

Recognition and Management of Emergent Spinal Pathology Among First-Line Providers.
The objective of this study was to understand the proficiency with which first-line providers can recognize and manage spinal conditions, particularly spinal emergencies. This was a cross-sectional analysis of 143 internal medicine, family medicine, emergency care, and neurology questionnaires collected at a single-site academic center. Participants were predominantly physicians (88.1%, n=126), with a smaller percentage of midlevel providers (11.9%, n=17). Only 35.0% (n=50) of respondents felt "very prepared" to handle spinal emergencies. Bivariate analyses revealed interdepartmental differences in clinical knowl...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Johnson JR, Babu JM, Durand WM, Eltorai AEM, Patel SA, Daniels AH Tags: Orthopedics Source Type: research

Unintended Retention of Temporary Articulating Spacers in the Treatment of Periprosthetic Hip Joint Infection.
Abstract A considerable number of patients who underwent a 2-stage exchange protocol for periprosthetic hip joint infection could not complete the second-stage reimplantation. The aim of this study was to evaluate the results of unintended retention of temporary articulating spacers for the treatment of periprosthetic hip joint infection. Ninety-four patients with infection after total hip arthroplasty were treated by using a 2-stage exchange protocol with temporary articulating spacers. Of the 94 patients, 35 did not complete the 2-stage exchange protocol and retained spacers for more than 12 months. The authors ...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Lee KJ, Min BW, Bae KC, Cho CH, Son ES, Lee SW, Lee SJ, Kang MK Tags: Orthopedics Source Type: research

Learning Curve for the Direct Superior Approach to Total Hip Arthroplasty.
In this study, the authors present the learning curve for the direct superior (DS) approach to total hip arthroplasty, which is a muscle-sparing modification to the mini-posterior technique. This was a retrospective analysis of the first 40 primary DS cases done by a single surgeon. These cases were divided into 2 groups of 20 and compared for intra- and postoperative complications, acetabular component positioning, and Harris Hip Score at 90 days after surgery. As a control, the first 20 primary mini-posterior cases were analyzed as the baseline performance of the surgeon and the DS approach. There was no statistically si...
Source: Orthopedics - April 9, 2020 Category: Orthopaedics Authors: Ezzibdeh RM, Barrett AA, Arora P, Amanatullah DF Tags: Orthopedics Source Type: research