Impact of Frailty on 30-Day Morbidity and Mortality of Patients With Intertrochanteric Femur Fractures.
Abstract The aim of this study was to evaluate the association between frailty and 30-day morbidity and mortality in patients with intertrochanteric femur fractures. Furthermore, the authors sought to identify a specific frailty index score that would help identify high-risk patients. This retrospective study evaluated 229 consecutive patients 50 years or older who presented to a single level I trauma center for surgical fixation of an intertrochanteric femur fracture. Frailty was determined using a previously validated 11-point modified frailty index (mFI) scale. Primary outcome variables included 30-day morbidit...
Source: Orthopedics - October 4, 2019 Category: Orthopaedics Authors: Boissonneault A, Mener A, Schwartz A, Wilson J, Staley C, Schenker M Tags: Orthopedics Source Type: research
Exclusive Posterolateral Arthroscopic and Endoscopic Approaches Used in the Treatment of Lateral Epicondylitis.
Abstract Complications following arthroscopy of the elbow for the treatment of lateral epicondylitis are essentially related to the anterior arthroscopic approach. The principal aims of this study were to describe and evaluate the mixed arthroscopic and endoscopic surgical technique using posterolateral approaches exclusively. This was a retrospective study of consecutive patients operated on between 2005 and 2014 for lateral epicondylitis following more than 6 months of ineffective medical treatment. The exploration was arthroscopic via a distal posterolateral portal. The extensor carpi radialis brevis was disins...
Source: Orthopedics - October 4, 2019 Category: Orthopaedics Authors: Colombi R, Bevand A, Devillier A, Baulot E, Ezzahoui A, Martz P Tags: Orthopedics Source Type: research
Day of the Week of Surgery Affects Time to Discharge for Patients With Adolescent Idiopathic Scoliosis.
This study examined the effect of this traditional staffing model on time to discharge for patients undergoing posterior spinal instrumentation and fusion for adolescent idiopathic scoliosis. Patients undergoing surgery later in the week had a significantly longer hospital stay compared with patients undergoing surgery early in the week (5.5 days vs 4.9 days, respectively; P=.003). This discrepancy resulted in a mean cost increase of $7749.50 for patients undergoing surgery later in the week. A subsequent quality, safety, value initiative (QSVI) was undertaken to balance physical therapy resources alone. Following the QSVI...
Source: Orthopedics - October 4, 2019 Category: Orthopaedics Authors: Tileston KR, Uzosike M, Segovia N, Rinsky LA, Imrie MN Tags: Orthopedics Source Type: research
Positive "Surprise" Broth Cultures in Nonunion Surgery Do Not Require Antibiotic Treatment.
The objective of this study was to review the efficacy of a treatment approach for patients with positive intraoperative cultures during fracture nonunion surgery. The authors performed a retrospective case series at a level I trauma center. In this series, 60 patients without preoperative concern for infection were surgically treated for fracture nonunion. The treatment course of patients after fracture nonunion surgery, including culture results, antibiotic administration, and the presence of clinical infection and radiographic union, was studied. Sixty patients underwent fracture nonunion surgery. Twenty-four patients h...
Source: Orthopedics - October 4, 2019 Category: Orthopaedics Authors: Cantrell WA, Lawrenz JM, Vallier HA Tags: Orthopedics Source Type: research
Risk Factors for Readmission After Surgical Treatment of Slipped Capital Femoral Epiphysis.
This study sought to evaluate postoperative complications and factors associated with hospital readmission using a nationally representative database. The 2013 Healthcare Cost and Utilization Project's Nationwide Readmissions Database was queried to analyze the incidence of acute readmission and complications for all patients with SCFE. Patients were separated based on 3 different operative approaches (open procedures, closed procedures, or both) and were compared based on choice of procedure, clinical characteristics, patient demographics, comorbidities, and complications. Univariate and multivariate techniques were used ...
Source: Orthopedics - October 4, 2019 Category: Orthopaedics Authors: Gutman IM, Niemeier TE, Gilbert SR Tags: Orthopedics Source Type: research
Survival, Tumor Recurrence, and Function Following Shoulder Girdle Limb Salvage at 24 to 35 Years of Follow-up.
Abstract Limb salvage is the treatment of choice for malignant shoulder girdle tumors; however, there is a paucity of data examining the long-term outcome. The authors have previously reported on a cohort of patients at short- and mid-term follow-up. The purpose of this study was to report the long-term outcome of shoulder reconstruction in terms of oncological and functional outcome. The authors reviewed 53 patients who underwent a limb salvage procedure for treatment of a tumor of the shoulder girdle. At a mean of 28 years following the resection, 76% of surviving patients were contacted and administered functio...
Source: Orthopedics - October 4, 2019 Category: Orthopaedics Authors: Scorianz M, Houdek MT, Sherman CE, Sim FH, O'Connor MI Tags: Orthopedics Source Type: research
Anticoagulation in Revision Total Joint Arthroplasty: A Retrospective Review of 1917 Cases.
Abstract Although several studies now support the use of aspirin for venous thromboembolism (VTE) prophylaxis in primary total hip arthroplasty (THA) and total knee arthroplasty (TKA), the optimal chemoprophylactic agent in revision THA and TKA is not clear. The purpose of this study was to determine if the type of chemoprophylaxis has an effect on the VTE rate in patients undergoing revision total joint arthroplasty (TJA). The second aim was to compare differences in rates of wound drainage in primary and revision TJA stratified by the postoperative chemoprophylaxis used. The authors retrospectively reviewed 1917...
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Manista GC, Batko BD, Sexton AC, Edmiston TA, Courtney PM, Hannon CP, Levine BR Tags: Orthopedics Source Type: research
Negative Pressure Incisional Therapy and Infection After Direct Anterior Approach Primary Total Hip Arthroplasty.
This study's findings suggest that the SSI rate in this group did not differ from that in the standard dressing group, such that the prophylactic use of a negative pressure wound therapy device is not indicated for either standard or high-risk patients undergoing primary anterior approach THA. [Orthopedics. 201x; xx(x):xx-xx.]. PMID: 31505014 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Tyagi V, Kahan J, Huang P, Leslie MP, Rubin LE, Gibson DH Tags: Orthopedics Source Type: research
Early Results of a Modern Uncemented Total Knee Arthroplasty System.
Abstract Historically, cementless total knees were associated with early failure, which made cemented total knee arthroplasty the gold standard. Manufacturers have introduced newer uncemented technologies that provide good initial stability and use highly porous substrates for bony in-growth. The authors hypothesized that the implants would have equivalent 90-day clinical and economic outcomes. Prospectively collected data on 252 uncemented knees in the Michigan Arthroplasty Registry Collaborative Quality Initiative database were reviewed. Ninety-day outcomes, demographics, length of stay, complications, emergency...
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Manoli A, Markel JF, Pizzimenti NM, Markel DC Tags: Orthopedics Source Type: research
Two-Stage Treatment for Ankylosing Spondylitis With Severe Hip Contracture.
Abstract Ankylosing spondylitis is a progressive inflammatory disease that often involves the hip, causing deformities and dysfunction. Total hip arthroplasty (THA) may be used, but contracture of the hip joint in ankylosing spondylitis makes THA technically difficult and leads to poor efficacy. This retrospective study describes a novel 2-stage surgical treatment for ankylosing spondylitis of the hip and evaluates its efficacy relative to THA alone. Patients with ankylosing spondylitis and severe hip flexion contracture treated between 2011 and 2017 were assigned to either an experimental group or an age-matched ...
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Zeng Y, Huang Q, Ma H, Xu B Tags: Orthopedics Source Type: research
Self-Reported Metal Allergy and Early Outcomes After Total Knee Arthroplasty.
The objective of this study was to determine the effect of SRMA on early outcomes after TKA. Between 2010 and 2014, 168 patients with SRMA underwent TKA; 150 (89%) received nickel-free implants, and 18 (11%) received cobalt-chrome implants that contained nickel. Mean age was 67 years, and 95% were female. A cohort of 858 TKA patients (mean age, 68 years) without SRMA matched by sex served as the control group. Outcomes included Knee Society Score (function [KSS-F] and knee [KSS-K]), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, knee flexion, further surgery, and complications. No difference...
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Schmidt KJ, Huang PS, Colwell CW, McCauley JC, Pulido PA, Bugbee WD Tags: Orthopedics Source Type: research
Advanced Baseball Metrics Indicate Significant Decline in MLB Pitcher Value After Tommy John Surgery.
Abstract There are conflicting reports regarding the efficacy of Major League Baseball (MLB) pitchers following medial ulnar collateral ligament reconstruction (UCLR). As advanced baseball metrics have revolutionized the way general managers define pitchers' value, the authors believe that these should be used to measure clinical outcomes after UCLR. All MLB pitchers who underwent UCLR from April 1, 1991, through July 1, 2016, were compiled (N=253). Pitcher demographics and statistics were collected for up to 3 full seasons preceding and following surgery. Data for pitching controls (all MLB [AMLB] pitchers) were ...
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Selley RS, Portney DA, Lawton CD, Shockley MD, Christian RA, Saltzman MD, Hsu WK Tags: Orthopedics Source Type: research
The Effect of Femoral Cutting Jig Design on Restoration of Femoral Offset in Posterior-Referenced Total Knee Arthroplasty.
Abstract Femoral component sizing and rotation in total knee arthroplasty (TKA) affects patellofemoral tracking and tibiofemoral mechanics. Posterior referencing is said to optimize restoration of posterior condylar offset. However, it typically allows the surgeon to select 3° to 5° of external rotation to the posterior condylar axis, inevitably changing the offset of one or both condyles. The axis about which external rotation occurs varies between the jigs of various TKA systems. The location of this axis can result in a medial, central, or lateral reference point for posterior offset restoration. Variat...
Source: Orthopedics - September 10, 2019 Category: Orthopaedics Authors: Coyle RM, Bas MA, Rodriguez JA, Hepinstall MS Tags: Orthopedics Source Type: research
Use of a Suture Button Device to Correct Syndesmotic Malreduction Caused by a Trans-Syndesmotic Screw.
This report describes the replacement of a rigid syndesmotic screw with a flexible suture button fixation device to correct fibular translation and tibiotalar malalignment related to screw contact with other tibial implants. Suture button devices, although more expensive, can result in less postoperative malreduction and lead to better functional outcomes. As seen in these cases, careful attention should be given to syndesmotic or tibiotalar reduction after screw placement around other tibial implants, and the screw can be exchanged to a suture button device to address malreduction, if needed. [Orthopedics. 201x; xx(x):xx-...
Source: Orthopedics - August 13, 2019 Category: Orthopaedics Authors: Hadeed MM, Hunold T, Yarboro SR Tags: Orthopedics Source Type: research
Electromyographic Analysis of Grip.
Abstract This prospective cohort study used video electromyography synchronized analysis to determine the dynamic use of extrinsic and intrinsic finger flexion during grasp. Light fist formation primarily involved the flexor digitorum profundus with either the flexor digitorum superficialis or intrinsics. In contrast, both the flexor digitorum superficialis and intrinsics were recruited in all tight fist video electromyography. However, the sequence of recruitment differed between patients in tight fist formation. Injured patients demonstrated a unique pattern of recruitment based on injury. The authors conclude t...
Source: Orthopedics - August 13, 2019 Category: Orthopaedics Authors: Fox PM, Oliver JD, Nguyen V, Hentz VR, Curtin CM Tags: Orthopedics Source Type: research
Biomechanical Comparison of Suture Techniques in Radial Meniscal Tears Using Gap Configuration Analysis.
This study compared suture strength among these 3 techniques using gap configuration analysis. Biomechanical testing was performed on 60 matched and paired porcine menisci that were repaired with 2 stitches of vertical, horizontal, and cross sutures. The specimens were cyclically loaded 500 times at 5 to 30 N, and central, peripheral, and total gap distance were measured. After completing cyclic load testing, the specimens were loaded to failure. Double vertical sutures demonstrated significantly lower total and central gap displacement than cross and double horizontal sutures (P
Source: Orthopedics - August 13, 2019 Category: Orthopaedics Authors: Lee SS, Lee MC, Lee JH, Kim TW Tags: Orthopedics Source Type: research
Frailty Index Is Associated With Periprosthetic Fracture and Mortality After Total Knee Arthroplasty.
Abstract This cohort study of adult (≥50 years) patients aimed to calculate a validated, preoperative frailty deficit index (FI) and used it to compare outcomes following total knee arthroplasty (TKA), primary and revision, from 2005 through 2016. Using multivariable logistic and Cox regression, the authors analyzed whether FI, adjusted for age, predicts outcomes prior to hospital discharge, within 90 days, and within 365 days. They classified 9818 patients undergoing TKA (7920 primary and 1898 revision; median age, 69 years) as frail (21%), vulnerable (39%), and non-frail (40%). Frail, relative to non-frail, p...
Source: Orthopedics - August 13, 2019 Category: Orthopaedics Authors: Johnson RL, Abdel MP, Frank RD, Chamberlain AM, Habermann EB, Mantilla CB Tags: Orthopedics Source Type: research
Understanding Nail Gun Injuries in Orthopedics: Mechanisms and Treatment.
Abstract Nail gun injuries are common among users, and most frequently involve the hands and lower extremities. A wide variation in costs and time are missed from work due to these injuries, and training on the proper use of nail guns has been shown to decrease workplace-related injuries. Minimal long-term disability can be expected, and orthopedic evaluations provide an opportunity to inform patients on proper use of these devices. In this article, management of nail gun injuries is discussed, including the necessity for a high suspicion for wound contamination because foreign material is often deposited with the...
Source: Orthopedics - August 13, 2019 Category: Orthopaedics Authors: Spanyer JM, Lands HM, Kelly SC, Page PS, Yakkanti MR Tags: Orthopedics Source Type: research
Effect of Acetylsalicylic Acid Dose and Time Discontinued Preoperatively on Outcomes After Total Knee and Hip Arthroplasty.
Abstract The purpose of this study was to determine if acetylsalicylic acid (ASA) dose or time discontinued preoperatively affected surgical outcomes in total joint arthroplasty (TJA). The authors hypothesized that ASA worsens surgical outcomes in patients receiving higher doses and in those who discontinue ASA closer to the operative date. A total of 2853 TJAs (1802 primary total knee arthroplasties and 1051 total hip arthroplasties) performed at a tertiary medical center were reviewed. Postoperative outcomes of patients receiving ASA prior to TJA, dosing of ASA (81 mg or 325 mg) preoperatively and postoperativel...
Source: Orthopedics - August 13, 2019 Category: Orthopaedics Authors: Shaw JH, Kadri OM, Les CM, Charters M Tags: Orthopedics Source Type: research
A New Technique for Radiographic Visualization of the Scaphotrapeziotrapezoid Joint.
Abstract Standard radiographs of the wrist do not provide adequate visualization of the scaphotrapeziotrapezoid joint. A radiographic technique that provides an improved and more complete visualization of the joint compared with routine views is described. [Orthopedics. 201x; xx(x):xx-xx.]. PMID: 31355899 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Brown AM, Winfield SM, Kuschner SH Tags: Orthopedics Source Type: research
Diagnosis and Management Strategies for Distal Biceps Rupture.
Abstract Rupture of the distal biceps tendon most commonly is secondary to mechanical overload during eccentric muscle contraction. Due to deficits of strength and endurance, surgical repair usually is recommended. Although both single- and double-incision approaches have been described, double-incision techniques have been shown to better re-create the native anatomic insertion. However, excellent and comparable clinical outcomes have been demonstrated with both techniques. Fixation with a cortical button and interference screw has been shown to be the strongest construct biomechanically; however, several modern ...
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Holt J, Preston G, Heindel K, Preston H, Hill G Tags: Orthopedics Source Type: research
Hemiepiphysiodesis for Idiopathic Genu Valgum Using Physeal Staples Versus Tension-Band Plating: A Systematic Review.
Abstract This review assesses the outcomes of hemiepiphysiodesis in patients with idiopathic genu valgum (IGV) treated with physeal staples vs tension-band plating (TBP). A systematic review of the literature was conducted to identify articles examining the use of physeal staples vs TBP for the treatment of IGV in skeletally immature patients. No significant difference in overall mean deformity correction (P=.92) or correction per month (P=.61) was observed between groups. Repeat hemiepiphysiodesis was more common in patients who underwent TBP vs physeal staples (P=.05). Tension-band plating did not yield signific...
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Knapik DM, Buschbach J, Sabharwal S, Liu RW Tags: Orthopedics Source Type: research
Repair of Combined Insertional and Midsubstance Achilles Tendon Ruptures.
Abstract Complex combined tears of the insertion and midsubstance of the Achilles tendon are rare injuries that are challenging to diagnose and treat. The author describes a novel technique for combined insertional and midsubstance Achilles repair that decreases proximal soft tissue dissection, restores musculotendinous length, and directly fixes tendon to bone in a strong, knotless fashion to allow for early mobilization and functional recovery. [Orthopedics. 201x; xx(x):xx-xx.]. PMID: 31355902 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Hsu AR Tags: Orthopedics Source Type: research
The Effects of Timing of Soft Tissue Coverage on Outcomes After Reconstruction of Type IIIB Open Tibia Fractures.
This study provides guidance on treating a heterogeneous patient population with severe open tibia fractures typically seen in a large tertiary hospital orthopedic trauma service. [Orthopedics. 201x; xx(x):xx-xx.]. PMID: 31355903 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Clegg DJ, Rosenbaum PF, Harley BJ Tags: Orthopedics Source Type: research
Postdischarge Opiate-Prescribing Habits for Primary THA and TKA: A Survey of American Association of Hip and Knee Surgeons Members.
Abstract Abuse of opiate medications has reached epidemic proportions, and elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) typically require outpatient use of narcotic medications. This survey sought to determine opiate-prescribing habits of members of the American Association of Hip and Knee Surgeons (AAHKS) for patients undergoing primary THA and TKA. An 11-question online survey was developed to evaluate current prescribing habits for opiate and nonopiate medications prescribed after primary THA and TKA. An invitation to complete the survey was e-mailed to 2698 orthopedic surgeons using ...
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Lipof JS, Thirukumaran CP, Greenstein AS, Zmich Z, Lander A, Ricciardi BF Tags: Orthopedics Source Type: research
Femoral Head Vascularity: Implications Following Trauma and Surgery About the Hip.
Abstract Traumatic injury and surgical intervention about the hip joint place the arterial supply to the femoral head (FH) at risk. Compromised perfusion may lead to FH ischemia, cell death, and osteonecrosis. Progression to FH collapse may lead to pain, functional impairment, and decreased quality of life, especially in younger patients. This review describes the arterial supply to the FH, analyzes the impact of femoral neck fractures on FH vascularity, and explores the vascular implications of various surgical interventions about the hip, offering specific techniques to minimize iatrogenic damage to the vessels ...
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Gadinsky NE, Klinger CE, Sculco PK, Helfet DL, Lorich DG, Lazaro LE Tags: Orthopedics Source Type: research
The Safety of Continuing Antiplatelet Medication Among Elderly Patients Undergoing Urgent Hip Fracture Surgery.
This study sought to elucidate the safety of urgent hip surgery without termination of antiplatelet medication among patients taking a combination of aspirin and dipyridamole, aspirin alone, or dipyridamole alone. This retrospective cohort study included 176 patients 55 years or older who had uncomplicated hip fractures and underwent surgery within 48 hours after admission. On the basis of the preoperative medication regimen, the patients were divided into the following 4 groups: those receiving aspirin and dipyridamole combined (n=29); those receiving aspirin alone (n=63); those receiving dipyridamole alone (n=28); and th...
Source: Orthopedics - July 26, 2019 Category: Orthopaedics Authors: Lin SY, Huang HT, Chou SH, Ho CJ, Liu ZM, Chen CH, Lu CC Tags: Orthopedics Source Type: research
Patellar Osteonecrosis Following Knee Arthroscopy.
Abstract Patellar osteonecrosis is a rare condition, although knee osteonecrosis has been described in the arthroplasty literature. This is the first case describing knee arthroscopy as the cause of osteonecrosis. A 50-year-old woman who was experiencing knee pain during her marathon training and singles tennis underwent knee arthroscopy for a torn medial meniscus. The result of her partial medial meniscectomy led to patellar osteonecrosis 3 months following the index procedure. Osteonecrosis of the knee has been reported in the arthroplasty and sports medicine literature following surgical intervention, usually i...
Source: Orthopedics - July 2, 2019 Category: Orthopaedics Authors: Carstensen SE, Domson GF Tags: Orthopedics Source Type: research
A Case of Tularemia in a Prosthetic Joint Infection.
Abstract Periprosthetic infections occur in approximately 0.8% to 1.9% of all total knee arthroplasties (TKAs). Even with these low rates, it is rare to find a zoonotic bacterium causing a periprosthetic infection. In this case report, the authors identify the second documented case of a total joint infection with Francisella tularensis in the world and the first in the United States. A 58-year-old man underwent a left TKA in 1994 and a right TKA in 1997 for severe primary bilateral knee osteoarthrosis. In 2015, he underwent polyethylene exchange for polyethylene wear. Subsequently, he developed repeated effusion ...
Source: Orthopedics - July 2, 2019 Category: Orthopaedics Authors: Azua EN, Voss LA Tags: Orthopedics Source Type: research
Return to Sport Following Hemiarthroplasty With Concentric Reaming Versus Total Shoulder Arthroplasty: A Matched Pair Analysis.
Abstract The purpose of this study was to establish functional outcomes regarding return to sport activity for patients receiving anatomical total shoulder arthroplasty (aTSA) vs the ream and run procedure (hemi RR). Patients who underwent hemi RR and who underwent aTSA with a polyethylene glenoid component for end-stage glenohumeral arthritis were retrospectively identified from 2000 to 2014. Patients were matched regarding age, body mass index, sex, and hand dominance. Patients were surveyed to determine their level of sport and satisfaction after surgery. At a mean follow-up of 69.1±24.8 months, a total ...
Source: Orthopedics - July 2, 2019 Category: Orthopaedics Authors: Garcia GH, Gowd AK, Liu JN, Malaret MR, Cabarcas BC, Romeo AA Tags: Orthopedics Source Type: research
Orthopedic Surgeons Have Inadequate Knowledge of the Cost of Trauma-Related Imaging Studies.
This study evaluated whether orthopedic residents and faculty could accurately estimate charges of imaging modalities at their respective institutions. A survey with 10 common imaging studies was sent to 8 academic level I trauma centers. Participants estimated the total charge of each imaging modality. This was compared with the actual charge at their institution. Seven centers produced 162 responders: 74 faculty and 88 residents. The differences between the estimated cost and the billing charge were calculated and broken down by training level and imaging modality. Overall, imaging charges were underestimated by 31% (P
Source: Orthopedics - July 2, 2019 Category: Orthopaedics Authors: Schultz B, Fogel N, Finlay A, Collinge C, Githens MF, Higgins T, Mehta S, O'Toole RV, Summers H, Bishop JA, Gardner MJ Tags: Orthopedics Source Type: research
Bilateral Total Hip Replacement in Dwarfism With a Custom Laser-Printed Trabecular Acetabular Shell.
Abstract Total hip arthroplasty in cases of dwarfism may be a demanding procedure, as the small-sized joints are difficult to replace with standard prostheses, even more so in the presence of dysplastic hips. The authors report a case of bilateral customized total hip arthroplasty performed in a young patient with proportionated dwarfism with bilateral hip dysplasia. To ensure sufficient stabilization of the cup, roof bone grafting was performed. The custom-made acetabular component was a trabecular acetabular shell manufactured using selective laser melting technology to ensure an optimal porous structure to enha...
Source: Orthopedics - July 2, 2019 Category: Orthopaedics Authors: Memminger M, Banci L, Meoli A Tags: Orthopedics Source Type: research
Metallic Press-fit Radial Head Replacement for Radial Head Fractures.
This study evaluated the clinical and radiographic results of patients who sustained nonreconstructible radial head fractures that subsequently were treated with a metallic press-fit radial head prosthesis (RHP). Nine patients with comminuted radial head fractures were treated with a metallic press-fit RHP; mean follow-up was 38.7 months. The radial head fracture was acute in 6 patients (group A) and chronic in 3 patients (group B). Functional evaluation was assessed using the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. Radiographs were assessed for loosening, ra...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Jung KJ, Nho JH, Wang SD, Hong YC, Kim BS Tags: Orthopedics Source Type: research
Early Clinical Outcome of Lumbar Spinal Fixation With Cortical Bone Trajectory Pedicle Screws in Patients With Osteoporosis With Degenerative Disease.
Abstract This cohort study aimed to elucidate early surgical outcomes after midline lumbar fusion (MidLIF) with cortical bone trajectory (CBT) screw fixation compared with transforaminal lumbar interbody fusion (TLIF) using traditional pedicle screw (TPS) fixation for lumbar degenerative disease (LDD) in patients with osteoporosis. The authors randomly assigned 70 patients with osteoporosis who had LDD at 1 or 2 adjacent vertebral levels to undergo either MidLIF with CBT (CBT group) or TLIF with TPS fixation (TPS group) from February 2015 to March 2016. Pre- and postoperative lumbar Japanese Orthopaedic Associatio...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Liu L, Zhang S, Liu G, Yang B, Wu X Tags: Orthopedics Source Type: research
Survivorship of the Modular Femoral Revision Stem.
This study showed excellent component survivorship of the specific modular femoral revision system in revision THA. [Orthopedics. 201x; xx(x):xx-xx.]. PMID: 31185119 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Shah RR, Cipparrone NE, Parilla FW, Robinson MG, Gordon AC, Goldstein WM Tags: Orthopedics Source Type: research
Ultrasonography Provides a Diagnosis Similar to That of Nerve Conduction Studies for Carpal Tunnel Syndrome.
In this study, the authors compared ultrasonography with neurophysiological findings for the diagnosis of CTS in 96 patients/hands with clinical symptoms of CTS. The latency, amplitude, distance, and velocity of the median and ulnar nerves were measured. Needle electromyography was performed in the abductor pollicis brevis, in addition to muscles of the arm and forearm, to exclude proximal median nerve, brachial plexus, or radicular abnormalities. Ultrasonography was based on the morphologic/anatomic changes of the median nerve cross-sectional area in the sagittal plane of the wrist at the level of the pisiform bone, the c...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Drakopoulos D, Mitsiokapa E, Karamanis E, Kontogeorgakos V, Mavrogenis AF Tags: Orthopedics Source Type: research
Prevalence of Ulnar Artery Thrombosis in Orthopedic Surgeons.
This study sought to determine the prevalence of UAT among orthopedic surgeons and to identify risk factors for developing UAT. Eighty orthopedic surgeons and residents were included in the study. Participants completed a demographic questionnaire, and a timed Allen test was performed on each hand with the radial artery occluded. A reperfusion result greater than 6 seconds was considered abnormal. Participants with a positive Allen test and UAT-associated symptoms were deemed to have UAT. Statistical analysis was performed using the Fisher exact and Wilcox-on rank-sum tests. The prevalence of UAT was 11% (9 of 80) in the s...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Mathews CS, Dua K, Cole A, Siegel E, Abzug J, Wyrick TO Tags: Orthopedics Source Type: research
Preoperative Morphology of the Proximal Femoral Canal Did Not Affect the Postoperative Bone Mineral Density Change Around the Zweym üller-Type Stem.
Preoperative Morphology of the Proximal Femoral Canal Did Not Affect the Postoperative Bone Mineral Density Change Around the Zweymüller-Type Stem. Orthopedics. 2019 Jun 11;:1-5 Authors: Nakamura S, Minoda Y, Ohta Y, Sugama R, Yamamura K, Ueyama H, Nakamura H Abstract The bone mineral density (BMD) around a femoral component changes after total hip arthroplasty (THA). The aim of this study was to investigate the influence of the morphology of the preoperative proximal femoral canal on the postoperative BMD change of the femur around a Zweymüller-type stem. The authors performed a retrospecti...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Nakamura S, Minoda Y, Ohta Y, Sugama R, Yamamura K, Ueyama H, Nakamura H Tags: Orthopedics Source Type: research
Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis.
This study examined whether order of surgery (TKA or THA first) affects length of stay (LOS) and discharge disposition among patients with coexisting knee and hip arthritis. A total joint arthroplasty database review was performed to collect all available data for arthroplasties performed at 2 campuses of a single institution between July 2013 and April 2017. Inclusion criteria were patients who underwent both primary THA and TKA within 18 months and were age 18 years or older. Patients were divided into 2 groups based on whether THA or TKA was performed first. For all procedures, the following data were collected: age, bo...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Siljander MP, Cross J, Koueiter DM, Sobh A, Moore D, Karadsheh MS Tags: Orthopedics Source Type: research
Success Rates of Revision Knee Arthroplasty for Periprosthetic Joint Infection in Rheumatoid and Non-Rheumatoid Arthritis Patients.
This study evaluated the success and failure rates as well as the final results following 2-stage revision total knee arthroplasty (TKA) for periprosthetic joint infection (PJI). Particular emphasis was placed on comparing patients with rheumatoid arthritis (RA) and non-RA patients. A total of 140 knees that required 2-stage revision for PJI after TKA were analyzed. Mean patient age at first revision TKA was 67.9 years (range, 43 to 89 years), and mean time from second-stage revision to final follow-up was 53.3 months (range, 26 to 127 months). Thirty-eight of the 140 knees (27.1%) demonstrated recurrence of infection afte...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Grzelecki D, Dudek P, Marczak D, Sibinski M, Olewnik Ł, Kowalczewski J Tags: Orthopedics Source Type: research
Despite the Safety of Preoperative Cefazolin for Patients With Non-anaphylactic Penicillin Allergy, 20% of Practitioners Avoid Its Use.
Abstract Cefazolin is commonly used for surgical site infection prophylaxis due to its low cost and effective coverage. However, it is controversial to use cefazolin in patients with a penicillin allergy despite the cross-reactivity between cefazolin and penicillin being only 1%. Ample literature shows that it is safe to use cefazolin in patients with non-anaphylactic penicillin allergies. However, there is often hesitation by anesthesiologists or orthopedists when prescribing this medication in this population. The current authors sent a 16-question survey to all the residency programs in the United States in ane...
Source: Orthopedics - June 11, 2019 Category: Orthopaedics Authors: Pettett BJ, Eskildsen SM, Huang KX, Ostrum RF Tags: Orthopedics Source Type: research
Total Talectomy and Reconstruction Using a 3-dimensional Printed Talus Prosthesis for Ewing's Sarcoma: A 3.5-Year Follow-up.
Abstract Ewing's sarcoma is extremely rare in the foot. Below the knee amputation is indicated for most primary malignant bone tumors of the hindfoot, with few cases of successful limb salvage surgery having been reported. The use of 3-dimensional printed implants may successfully address reconstruction challenges after tumor resection. The authors present a case of a 30-year-old woman with a Ewing's sarcoma of the talus who underwent total talectomy and replacement of the entire talus with a custom-made 3-dimensional printed talar prosthesis. [Orthopedics. 201x; xx(x):xx-xx.]. PMID: 31136673 [PubMed - as sup...
Source: Orthopedics - May 28, 2019 Category: Orthopaedics Authors: Papagelopoulos PJ, Sarlikiotis T, Vottis CT, Agrogiannis G, Kontogeorgakos VA, Savvidou OD Tags: Orthopedics Source Type: research
Acute Carpal Tunnel Syndrome in Inpatients With Operative Distal Radius Fracture.
Abstract Acute carpal tunnel syndrome (CTS) may occur concomitantly with distal radius fracture (DRF) and is often managed with carpal tunnel release (CTR). Carpal tunnel syndrome may also develop postoperatively after DRF fixation. The authors sought to determine the rate of CTS with DRF, prophylactic CTR, and postoperative development of CTS. Furthermore, they also sought to identify predictors of these. The Nationwide Inpatient Sample database was queried (2002 to 2014) to identify adult inpatients undergoing surgical fixation of DRFs. They were segregated by the presence of CTS and further stratified by the ti...
Source: Orthopedics - May 28, 2019 Category: Orthopaedics Authors: Shah KN, Goodman AD, Durand W, Daniels AH, Weiss AC Tags: Orthopedics Source Type: research
Secondary Surgery Rates After Primary Fusion for Adolescent Idiopathic Scoliosis.
Abstract Instrumented spinal fusion is the gold standard treatment for surgical magnitude adolescent idiopathic scoliosis (AIS), with the goal being stable fusion without the need for additional procedures. The purpose of this study was to define the surgical return rates of AIS at a single center with respect to various instrumentation constructs used during initial spinal fusion. A retrospective chart review was performed of all patients with AIS who underwent instrumented fusion with a minimum of 2-year follow-up. Demographic information, implant type, and surgical approach for the primary surgery and all subse...
Source: Orthopedics - May 28, 2019 Category: Orthopaedics Authors: Dannenbaum JH, Tompkins BJ, Bronson WB, McMulkin ML, Caskey PM Tags: Orthopedics Source Type: research
Figure-of-eight Reconstruction of the Sternoclavicular Joint: Outcomes of Sport and Work.
Abstract Instability of the sternoclavicular joint is a challenging condition given the proximity of neurovascular structures and minimal osseous constraint, and little is known regarding return to activity. A prospectively maintained institutional registry was retrospectively queried for all sternoclavicular joint reconstructions performed from 2005 to 2016. All included patients were asked to answer questions from a previously established survey to assess return to sport, work, and satisfaction following surgery. Ten patients (12 shoulders) were available for long-term follow-up (71.4%; range, 26-145 months). Th...
Source: Orthopedics - May 28, 2019 Category: Orthopaedics Authors: Gowd AK, Liu JN, Garcia GH, Cabarcas BC, Agarwalla A, Nicholson GP, Romeo AA Tags: Orthopedics Source Type: research
Rates of Perioperative Complications Among Patients Undergoing Orthopedic Trauma Surgery Despite Having Positive Results for Methamphetamine.
This study sought to determine the rate of cardiovascular complications in these patients. The authors reviewed the medical records of all patients between 2013 and 2018 who underwent orthopedic trauma surgery at two level I trauma centers in the setting of a methamphetamine-positive urine toxicology screening prior to surgery. Information on demographics, injury, type of surgical intervention, and incidence of perioperative cardiovascular and overall medical complications prior to discharge was recorded. Ninety-four patients were included in the study (mean age, 44 years; range, 16-78 years). Twenty-six (28%) patients had...
Source: Orthopedics - May 28, 2019 Category: Orthopaedics Authors: Githens T, DeBaun MR, Campbell ST, Wu EJ, Goodnough LH, Lichstein P, Painter C, Krygier JE, Bishop J, Gardner MJ Tags: Orthopedics Source Type: research
Failure of Fixation With Nickel-Titanium Staples in First Metatarsophalangeal Arthrodesis With Hallux Valgus Deformity.
Abstract First metatarsophalangeal (MTP) joint arthrodesis is a treatment option for patients with arthritic hallux valgus (HV). Nickel-titanium staples allow continuous compression throughout the fusion site and have been shown to achieve successful union in many procedures. However, their efficacy has not been tested in patients with underlying HV deformity. Three cases of severe HV deformity that underwent first MTP arthrodesis with 2 nickel-titanium staples placed 60° from each other and had failure are reported. The authors believe this construct does not provide adequate rotational control for first MTP ...
Source: Orthopedics - May 28, 2019 Category: Orthopaedics Authors: Chan JJ, Sarkar SS, Nordio A, Guzman JZ, Hasija R, Vulcano E Tags: Orthopedics Source Type: research
The Resident Work Hour Restriction: Good, Bad, or Indifferent?
PMID: 31099876 [PubMed - in process] (Source: Orthopedics)
Source: Orthopedics - May 1, 2019 Category: Orthopaedics Authors: Lubicky JP Tags: Orthopedics Source Type: research
Calipered Kinematically Aligned Total Knee Arthroplasty: An Accurate Technique That Improves Patient Outcomes and Implant Survival.
Abstract Kinematic alignment performed with caliper measurements and verification checks accurately co-align the femoral and tibial components with the 3 axes and joint lines of the native knee without ligament release and without restrictions on the degree of preoperative varus, valgus, flexion, and extension deformities and the degree of postoperative correction. [Orthopedics. 2019; 42(3):126-135.]. PMID: 31099877 [PubMed - in process] (Source: Orthopedics)
Source: Orthopedics - May 1, 2019 Category: Orthopaedics Authors: Howell SM Tags: Orthopedics Source Type: research
Industry Consulting Payments to Orthopedic Surgeons Are Associated With Increased Publications.
This study sought to investigate the relationship between consulting fees paid to orthopedic surgeons and academic productivity. Using the Centers for Medicare & Medicaid Services Open Payments Database, this study identified 2555 orthopedic surgeons who received at least one industry consulting fee in 2015. Physicians who received total consulting fees of at least $20,000 (US) were stratified into the high payment group. The number of publications and the h-index for each physician were used as metrics of scholarly impact. Mean publication number and h-index for the high payment group were compared with all other phys...
Source: Orthopedics - May 1, 2019 Category: Orthopaedics Authors: Lieber AM, Kirchner GJ, Zavras AG, Kerbel YE, Khalsa AS Tags: Orthopedics Source Type: research