Nonoperative Treatment of Periprosthetic Humeral Shaft Fractures After Reverse Total Shoulder Arthroplasty.
Abstract Few studies report on periprosthetic humeral shaft fractures after reverse total shoulder arthroplasty (RTSA). The authors evaluated outcomes of 5 patients with this complication who were initially treated nonoperatively. Of 152 patients who underwent RTSA at the authors' institution from 2012 to 2017, 4 experienced periprosthetic humeral shaft fractures. One patient was referred to the authors for fracture treatment. All 5 patients were initially treated nonoperatively. The mean duration of follow-up was 11.5 months (range, 1.5-26 months). The authors analyzed time to fracture union, Single Assessment Nu...
Source: Orthopedics - September 21, 2020 Category: Orthopaedics Authors: Ragusa PS, Vadhera A, Jang JM, Ali I, McFarland EG, Srikumaran U Tags: Orthopedics Source Type: research
Effect of Length of Hospital Stay and Patient Factors on Patient Satisfaction in an Academic Hospital.
Abstract The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a metric for patient satisfaction consisting of 19 questions divided into 10 domains. Scores affect hospital reimbursements and accreditation and may play a role in patient outcomes. It is unclear how length of stay and other factors affect each of the 10 domains. This retrospective review gathered data of 600 patients between December 2008 and January 2017 who completed the HCAHPS survey. The odds of complete satisfaction in each of the 10 domains was evaluated. The results suggest increased length of stay is associated with...
Source: Orthopedics - September 21, 2020 Category: Orthopaedics Authors: Diwan W, Nakonezny PA, Wells J Tags: Orthopedics Source Type: research
Early-Onset Scoliosis Treated With Magnetically Controlled Growing Rods.
Abstract The recently developed magnetically controlled growing rod (MCGR) system has gained popularity because it limits additional surgical lengthening procedures and promises reduction of the complication rate previously reported for the traditional growing rods. A retrospective single-center study was performed. Demographic and complications data were recorded. A statistical analysis was conducted to quantify the effect of MCGR placement and of subsequent lengthening on the Cobb angle, T1-T12 kyphosis, and the distances from T1-T12 and T1-S1. Twenty-four patients met the inclusion criteria. Six had idiopathic ...
Source: Orthopedics - September 21, 2020 Category: Orthopaedics Authors: Calderaro C, Labianca L, Dolan LA, Yamashita K, Weinstein SL Tags: Orthopedics Source Type: research
Simultaneous Bilateral Carpal and Cubital Tunnel Releases: Quadruple Tunnel Release.
Abstract The authors retrospectively reviewed the first 30 patients who underwent bilateral simultaneous carpal and cubital releases (quadruple tunnel release). Patients were asked to complete a questionnaire over the phone regarding their satisfaction with the procedures and willingness to make the same choice of bilateral carpal and cubital releases simultaneously, as well as the time to return to unrestricted use. Of 24 patients who responded to the questionnaire, 23 (95.8%) were satisfied or highly satisfied with their care, and 23 (95.8%) would again choose to have release of the 4 tunnels simultaneously. Tim...
Source: Orthopedics - September 21, 2020 Category: Orthopaedics Authors: Prud'homme BJ, Sraj S Tags: Orthopedics Source Type: research
The Effect of Total Hip Arthroplasty Surgical Technique on Postoperative Muscle Atrophy.
Abstract A variety of surgical approaches are used for total hip arthroplasty (THA). Controversy still exists regarding whether the direct anterior approach truly minimizes muscle damage. The purpose of this study was to determine the effect of surgical approach for THA on muscle atrophy quantified through magnetic resonance imaging (MRI). The study included 25 hips in patients with a mean age of 64.72±8.35 years who underwent a primary unilateral THA for severe osteoarthritis. Patients were grouped according to surgical approach: direct anterior (n=9), direct lateral (n=9), and posterior (n=7). Magnetic re...
Source: Orthopedics - September 21, 2020 Category: Orthopaedics Authors: Vasarhelyi EM, Williams HA, Howard JL, Petis S, Barfett J, Lanting BA Tags: Orthopedics Source Type: research
An Analysis of Trends in National Residency Matching Program Match Data for Orthopedic Surgery.
Abstract Due to electronic residency applications, US Medical Licensing Examination Step 1 scores are frequently used by orthopedic surgery program directors to screen applicants. Prospective applicants therefore often use Step 1 scores as a proxy for specialty competitiveness. The goal of this investigation was two-fold: (1) to determine whether trends in Step 1 scores are indicative of trends in competitiveness of orthopedic surgery and (2) to report the characteristics that optimize a US medical student's match success. A retrospective review of published National Resident Matching Program data from 2009 to 201...
Source: Orthopedics - September 21, 2020 Category: Orthopaedics Authors: Rynecki N, Para A, Gantz O, Coban D, Gala Z, Gupta R, Adeeb N, Ippolito JA, Ruskin J, Beebe KS Tags: Orthopedics Source Type: research
Effect of Insurance Status on Clinical Outcomes After Shoulder Arthroplasty.
Abstract Shoulder arthroplasty is an effective treatment option for patients with symptomatic shoulder arthritis and rotator cuff arthropathy. Although there have been reports of variations in complication rates according to insurance type, few studies have examined the effect of payer status on functional outcomes. Patients who underwent elective shoulder arthroplasty performed by a single fellowship-trained surgeon and had a minimum of 1 year of follow-up were queried. Patient characteristics were compared across insurance types. Each patient completed the American Shoulder and Elbow Surgeons (ASES) questionnair...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Strotman P, Perry M, LeDuc R, Joyce C, Garbis N Tags: Orthopedics Source Type: research
Arthroscopic Treatment of Labral Tears in Patients 65 Years and Older.
This study demonstrated that patients older than 65 years with labral pathology who have failed nonoperative measures obtain modest clinical improvement from hip arthroscopy. This clinical improvement yielded a high patient satisfaction, but due to the potential for subsequent THA in a subset of this population, surgeons should use a rigorous selection criteria and counsel patients appropriately. [Orthopedics. 202x;4x(x):xx-xx.]. PMID: 32882046 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Hartigan DE, Wojnowski N, Krych AJ, Levy BA, Domb BG Tags: Orthopedics Source Type: research
Use of a Modified Rep Model in Primary Joint Arthroplasty: Lessons Learned.
Abstract Orthopedic implant device sales representatives ("reps") can provide intraoperative guidance based on their product knowledge, as part of their many responsibilities. However, for experienced high-volume arthroplasty surgeons, a representative may not be required in the room for most primary total knee arthroplasty (TKA) procedures. The goal of this study was to describe the authors' experience with a modified rep model for primary TKA. Between January and December 2017, a total of 100 unilateral primary TKAs were performed with a modified rep model and compared with 100 primary TKAs that were p...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Meftah M, Siddappa VH, Johnson N, White PB, Mack A, Skoller M, Kirschenbaum IH Tags: Orthopedics Source Type: research
Coding Education in Residency and in Practice Improves Accuracy of Coding in Orthopedic Surgery.
Abstract The goal of training in orthopedic residency is to produce surgeons who are proficient in all aspects of the practice of orthopedic surgery; however, most residents receive either inadequate or no training in medical coding. The purpose of this study was to determine how well orthopedic residents code when compared with practicing surgeons and to identify whether coding education improves accuracy in medical coding. A mock coding survey was developed using commonly encountered orthopedic clinical scenarios. The survey was distributed to orthopedic trainees post-graduate years (PGY) 1 to 6 at 2 training pr...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Greenky MR, Winters BS, Bishop ME, McDonald EL, Rogero RG, Shakked RJ, Raikin SM, Daniel JN, Pedowitz DI Tags: Orthopedics Source Type: research
Wide-Awake Surgery With Local Anesthesia and Epinephrine Is Safe.
Abstract Hand and upper extremity surgery performed with the patient wide awake involves the use of a local anesthetic and epinephrine. Controversy persists as to whether epinephrine is safe for use in the hand. The goal of this study was to evaluate the safety of epinephrine in hand and upper extremity surgery. The hypothesis was that epinephrine is safe and can be used for a wide breadth of surgical procedures of the hand and upper extremity. A 4-year retrospective chart review was conducted of consecutive patients undergoing wide-awake surgery performed by 2 surgeons at a single institution. All procedures were...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Ilyas AM, Jennings JD, Banner L, Matzon JL Tags: Orthopedics Source Type: research
The Role of High School Football Coverage in Resident Education.
Abstract Athletic team coverage experience varies widely across orthopedic surgery residency programs in the United States. There is a paucity of literature regarding whether serving as a team physician contributes to resident education and whether it can be performed within the bounds of current work-hour restrictions. Residents consider coverage of high school football games a valuable educational experience that does not adversely affect their 80-hour work week. Sixty-one orthopedic residents who served as high school football team physicians as part of their residency curriculum completed an 11-question survey...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Salzler MJ, Stoker GE, Lunardini DJ, Harner CD Tags: Orthopedics Source Type: research
Posterior Tibial Tendon Integrity Can Be Screened With Plain Anteroposterior Foot Radiography.
Abstract Posterior tibial tendon integrity is an important consideration when treating adult-acquired flatfoot caused by posterior tibial tendon dysfunction. The condition of this tendon traditionally has been evaluated with ultrasonography or magnetic resonance imaging, but recent advances in radiography have increased the resolution of radiographic soft tissue images. The authors examined whether the posterior tibial tendon could be screened with anteroposterior foot radiographs, based on interobserver agreement and accuracy. The authors retrospectively evaluated consecutive patients who underwent weight-bearing...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Kwon KB, Lee SY, Chung CY, Park MS, Choi JH, Koo S, Lee KM Tags: Orthopedics Source Type: research
Allergic Contact Dermatitis to Dermabond Prineo After Elective Orthopedic Surgery.
Abstract The Dermabond Prineo skin closure system (Ethicon, Somerville, New Jersey) is a wound closure device that combines a 2-octyl cyanoacrylate liquid adhesive and a self-adhesive polyester mesh. Although cyanoacrylates traditionally have been associated with low rates of sensitization, allergic contact dermatitis (ACD) to Dermabond products is being increasingly reported after orthopedic surgery. The authors describe the first case series of ACD to Dermabond Prineo where patch testing confirmed the diagnosis in all patients. Six patients who had suspected Dermabond Prineo ACD after lower limb orthopedic surge...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Ricciardo BM, Nixon RL, Tam MM, Radic RR, Ricciardo BJ Tags: Orthopedics Source Type: research
Locking Plate Combined With Endosteal Fibular Allograft Augmentation for Medial Column Comminuted Proximal Humeral Fracture.
Abstract The goal of this study was to evaluate the role of endosteal fibular allografts in the treatment of medial column comminuted proximal humerus fractures with a locking plate. The authors retrospectively analyzed the clinical outcomes of 63 patients (21 men and 42 women) who had proximal humerus fractures with a comminuted medial column and were treated at Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, with a locking plate, either alone or in combination with a fibular strut allograft, between January 2013 and May 2017. Patients were divided into 2 groups: locking plate c...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Tuerxun M, Tuxun A, Zeng L, Wang Q, Chen Y Tags: Orthopedics Source Type: research
Bone Scans Have Little Utility in the Evaluation of Well-Differentiated Cartilaginous Lesions of the Humerus.
Abstract In the humerus, pain is a poor guide for differentiating between benign enchondromas and malignant well-differentiated chondrosarcomas. Radionuclide bone scans often are used, and chondrosarcomas reliably show increased uptake. However, it remains to be seen whether enchondromas consistently have negative findings on bone scans, which would provide reliable differentiation from malignant lesions. Imaging and medical records were reviewed for patients who underwent radionuclide bone scans for enchondroma of the humerus at one academic medical center over a period of 7 years. Bivariate logistic regression w...
Source: Orthopedics - September 2, 2020 Category: Orthopaedics Authors: Samuel AM, Munger AM, Lee FY, Friedlaender GE, Ibe IK, Lindskog DM Tags: Orthopedics Source Type: research
Association Between Delays in Radiography and Surgery With Hip Fracture Outcomes in Elderly Patients.
Abstract Appropriate waiting time for hip fracture surgery is disputed. The American Academy of Orthopaedic Surgeons recommends surgery within 48 hours of presentation, although evidence suggests that earlier surgery (within 24 hours) reduces the risks of complications and death. The authors asked: (1) Do patients who receive earlier radiographic evaluation of hip fracture undergo surgery earlier? and (2) Is "surgery delay" (time from presentation to surgery) associated with postoperative opioid use, duration of hospital stay, and 30-day and 1-year mortality rates? The authors identified 511 adults 60 ye...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Shi BY, Hannan CV, Jang JM, Ali I, Srikumaran U Tags: Orthopedics Source Type: research
Clinical Outcome of Transtendon Repair of Partial Articular Supraspinatus Tendon Avulsion Tear.
Abstract Partial articular supraspinatus tendon avulsion (PASTA) tears are common. However, there is no consensus on the optimal surgical technique for the management of grade 3 tears (>50%). The authors report a retrospective consecutive case series of 64 patients with grade 3 PASTA lesions. The patients were treated by 2 surgeons from 2 centers with the same transtendon repair technique and implant system. The preoperative Oxford Shoulder Score (OSS) was compared with the postoperative OSS at final follow-up (mean, 28 months). Significant improvement in mean OSS occurred from 19.2 (SD, 7.5) preoperatively to ...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Makki D, Cooke RA, Tang QO, Peach CA, Morgan BW Tags: Orthopedics Source Type: research
Patient Satisfaction After Total Shoulder Arthroplasty.
This study included 47 articles. The most commonly used method for assessing satisfaction was an ordinal scale (27 studies, 57.4%). Of the studies, 27 (57.5%) differentiated between patient satisfaction with the care provided and with the outcome achieved. Reported satisfaction rates after anatomic total shoulder arthroplasty ranged from 75% to 100%. For the included studies, increasing age, workers' compensation status, depression, opioid use, and visual analog scale pain score were the only preoperative factors that were significantly associated with worse postoperative satisfaction. Postoperative American Shoulder and E...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Puzzitiello RN, Nwachukwu BU, Agarwalla A, Cvetanovich GL, Chahla J, Romeo AA, Verma NN, Forsythe B Tags: Orthopedics Source Type: research
Talectomy by Medial Surgical Approach for Congenital Vertical Talus in Arthrogryposis Multiplex Congenita.
Abstract Arthrogryposis multiplex congenita involves stiff contracture of joints and weak atrophic muscles presenting at birth. The two most common forms are amyoplasia and distal arthrogryposis. Amyoplasia affects all 4 extremities: internally rotated shoulders, extended fixed elbows, flexed fixed wrists, extended fixed knees, clubfeet, and decreased muscle volume. Distal arthrogryposis is a group of syndromes with a genetic basis. The distal joints are contracted. Clubfeet and congenital vertical talus are the most common foot deformities. A 10-year-old boy presented with distal arthrogryposis with bilateral con...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Abraham E, Quan Soon CH, Murphy A, Toby D Tags: Orthopedics Source Type: research
Safety and Efficacy of Same-Day Hip Resurfacing.
This study compared the safety and efficacy of non-SDD HRA and SDD HRA for specific postoperative outcomes. An electronic data warehouse query was performed for procedures labeled "hip resurfacing." Data collected included demographics, surgical factors, and quality metrics. Statistical analyses were evaluated using a graphing and statistics software program. Categorical variables were analyzed with chi-square tests and continuous variables with Student's t tests, with P
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Ani L, Anoushiravani AA, Feng JE, Collins M, Schwarzkopf R, Slover J, Macaulay W, Marwin S Tags: Orthopedics Source Type: research
Relationship Between Paralysis and the Epidural Spinal Cord Compression Scale in Spinal Metastasis.
This study is the first to examine the relationship between the epidural spinal cord compression (ESCC) scale, which measures circumferential compression, and the functional outcomes of treatment, which were assessed at regular intervals after treatment until death. A total of 191 patients who had grade D or worse paralysis on the American Spinal Injury Association (ASIA) classification scale and a grade 1b or more severe cord compression on the ESCC scale were included in the study. Patients had been treated with surgery combined with radiotherapy (n=146) or radiotherapy alone (n=45). Three spinal surgeons assessed the ES...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Uei H, Tokuhashi Y, Maseda M Tags: Orthopedics Source Type: research
Effect of Reverse Shoulder Arthroplasty Lateralization Design on Scapular Notching: A Single-Surgeon Experience.
Abstract Scapular notching remains a concern with both medialized and lateralized reverse shoulder arthroplasty (RSA) designs. Few studies have directly compared the rate of notching among various designs. The purpose of this study was to compare a single surgeon's rate of scapular notching in relation to RSA design. A total of 156 primary RSAs were performed for cuff tear arthropathy or osteo-arthritis with rotator cuff insufficiency by a single surgeon. Follow-up was controlled to between 3 and 5 years. Shoulders were grouped according to implant design: medialized center of rotation (CoR; n=17), lateralized CoR...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Schoch BS, Taba H, Aibinder W, King JJ, Wright TW Tags: Orthopedics Source Type: research
Comparison Between the Attune and PFC Sigma in Total Knee Arthroplasty: No Difference in Patellar Clunk and Crepitus or Anterior Knee Pain.
This study compared the incidence of PCC between a historical and modern TKA design. A single-surgeon retrospective review of primary PFC Sigma (DePuy Synthes, Warsaw, Indiana) or Attune TKA (DePuy Synthes) was performed. A total of 114 PFC Sigma and 103 Attune implants were analyzed at a mean 3.2 years follow-up for overall PCC, painful PCC, anterior knee pain (regardless of crepitus), and PCC necessitating revision. Similar rates of overall PCC (14.6% vs 20.2%, P=.803), painful PCC (8.7% vs 6.1%, P=.605), and anterior knee pain (15.5% vs 9.7%, P=.219) were observed in the Attune and PFC Sigma groups, respectively. No cli...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Bateman DK, Preston JS, Mennona S, Gui E, Kayiaros S Tags: Orthopedics Source Type: research
The July Effect for Total Joint Arthroplasty Procedures.
Abstract The "July effect" refers to the assumed increased risk of complications during the months when medical school graduates transition to residency programs. The actual existence of a July effect is controversial. With this study, the authors sought to determine whether evidence exists for the presence of a July effect among total joint arthroplasty (TJA) procedures. The 2013 and 2014 Nationwide Readmission Databases were combined and all index primary and revision arthroplasty procedures were identified, and then patients from December were excluded. Thirty-day readmission rates, time to readmissio...
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Rockov ZA, Etzioni DA, Schwartz AJ Tags: Orthopedics Source Type: research
Proximal Fibular Osteotomy: Biomechanics, Indications, Technique, and Results.
Abstract The evidence base is growing regarding proximal fibular osteotomy. Most studies show that the pain relief and improvement in terms of radiology is statistically significant. More understandable biomechanical theories explaining this improvement are appearing. Because it has a low complication rate and is relatively easy to execute, proximal fibular osteotomy should definitely be considered in any algorithm for the treatment of medial compartment osteoarthritis of the knee. [Orthopedics. 2020;43(x):xx-xx.]. PMID: 32818289 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - August 19, 2020 Category: Orthopaedics Authors: Prakash L, Dhar SA Tags: Orthopedics Source Type: research
Effect of a Clean Surgical Airflow Layer on the Incidence of Infection in Total Hip Arthroplasty.
Abstract The Center for Health Design estimates that more than 30% of surgical site infections are caused by airborne pathogens. A device that creates a localized clean air field directly adjacent to and surrounding the incision site is meant to shield a surgical site from particulate in the operating room. The purpose of this study was to determine whether the routine use of this device would reduce the rate of infection following total hip arthroplasty (THA). The authors conducted a retrospective review of primary THA cases performed with and without the airflow device. Since July 2013, a total of 1093 primary T...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Routh LK, Parks NL, Gargiulo JM, Hamilton WG Tags: Orthopedics Source Type: research
Risk Factors for Preoperative Opioid Use in Patients Undergoing Primary Anatomic Total Shoulder Arthroplasty.
Abstract The effect of preoperative opioid use in orthopedic patients has been highlighted. Numerous studies have identified worse patient outcomes with pre-operative opioid use; however, there is currently no information identifying risk factors for preoperative opioid use in the total shoulder arthroplasty (TSA) population. The purpose of this study was to determine risk factors for preoperative opioid use in patients undergoing primary anatomic TSA for primary osteoarthritis (OA) and to determine baseline preoperative patient-reported outcomes (PROs) in preoperative opioid users compared with nonopioid users. T...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Morris BJ, Sheth MM, Laughlin MS, Elkousy HA, Edwards TB Tags: Orthopedics Source Type: research
Improvement in Postoperative Pain Control and Length of Stay With Peripheral Nerve Block Prior to Distal Radius Repair.
In this study, the authors evaluated patients who underwent distal radius open reduction and internal fixation (ORIF) in an outpatient surgery center setting. Comparisons between 2 surgical groups, peripheral nerve block without general anesthesia vs general anesthesia only, were recorded in terms of postoperative length of stay (LOS) in phase I, total LOS, and patient-reported pain level at discharge. The authors identified 80 patients undergoing distal radius ORIF from March to August 2016. A total of 37 (46.3%) patients received general anesthesia only and 43 (53.8%) patients received peripheral nerve block without gene...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Johnson P, Hustedt J, Matiski T, Childers R, Lederman E Tags: Orthopedics Source Type: research
Outpatient Orthopedic Rehabilitation in New York State During the COVID-19 Pandemic: Therapist Perspectives.
Abstract The COVID-19 pandemic has had a strong impact on the care of orthopedic patients. This impact has been particularly difficult in New York State, which experienced the largest number of COVID-19 cases and led to a state- mandated pause on all elective surgeries. As a result, physical and occupational therapists became the principal providers of care and had to adjust their workflow to ensure quality care. Understanding the perspectives and needs of therapists relative to the circumstances created by COVID-19 is critical to safe and effective care. The goal of this study was to define the perspectives of th...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Parnes N, Tousant C, Perrine J, DeFranco MJ Tags: Orthopedics Source Type: research
Current Treatment Considerations for Osteosarcoma Metastatic at Presentation.
Abstract Approximately one-fourth of osteosarcoma patients have metastases at presentation. The best treatment options for these patients include chemotherapy, surgery, and radiotherapy; however, the optimal scheme has not yet been defined. Standard chemotherapy for osteosarcoma metastatic at presentation is based on high-dose methotrexate, doxorubicin, and cisplatin (the MAP regimen), with the possible addition of ifosfamide. Surgical treatment continues to be fundamental; complete surgical resection of all sites of disease (primary and metastatic) remains essential for survival. In patients whose tumors do not r...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Tsukamoto S, Errani C, Angelini A, Mavrogenis AF Tags: Orthopedics Source Type: research
Use of a Suture Anchor Technique to Replace the Tethering Effect of the Ligamentum Teres in the Treatment of Complex Hip Dysplasia.
Abstract After open hip reduction in hip dysplasia, some hips can have persistent instability, even after pelvic and femoral osteotomies as well as capsulorrhaphy. While the diseased ligamentum teres in a dislocated hip is thought to contribute to inadequate reduction, the native ligament is thought to provide some level of stability. As such, the purpose of this study was to investigate the utility of a suture augment that replaces the function of the ligamentum teres to provide added stability. [Orthopedics. 2020;43(x):xx-xx.]. PMID: 32745219 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Magister SJ, Liu RW Tags: Orthopedics Source Type: research
Atraumatic Fracture of Cemented Vanguard Total Knee Arthroplasty Femoral Component.
Abstract The authors report the case of an atraumatic femoral component fracture 10 years after primary total knee arthroplasty (TKA) with a modern cemented fixed bearing system. The patient, a 70-year-old man, had the complication without inciting trauma, and he subsequently had severe pain and disability. This rare mode of TKA failure occurred at the superolateral aspect of the femoral component's anterior flange. At the time of revision, no femoral osteolysis was seen and the backside of the prosthesis fracture fragment was found to be free of cement. To the authors' knowledge, this is the first case of femoral...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Vovos TJ, Watters TS, Hughes EM, McNabb DC Tags: Orthopedics Source Type: research
Denosumab for Bone Giant Cell Tumor of the Distal Radius.
This study found that denosumab increases the risk of local recurrence after curettage, function is better after curettage, and vascularized fibular graft is the optimal reconstruction after resection of distal radius GCTB. [Orthopedics. 2020;43(x):xx-xx.]. PMID: 32745221 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Tsukamoto S, Mavrogenis AF, Tanzi P, Leone G, Ciani G, Righi A, Akahane M, Honoki K, Tanaka Y, Donati DM, Errani C Tags: Orthopedics Source Type: research
In-depth Analysis of Adult Reconstruction Fellowship Websites.
This study highlights deficits in online resources available for adult reconstruction fellowship program information and the gap that exists between the current means of information sharing. Efforts to encourage an online presence and optimize a program's online content may be of benefit to prospective applicants and the program itself. [Orthopedics. 2020;43(x):xx-xx.]. PMID: 32745222 [PubMed - as supplied by publisher] (Source: Orthopedics)
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Ahmed SA, Elnemer W, Eltorai AEM, Mariorenzi M, Daniels AH, Cohen EM Tags: Orthopedics Source Type: research
Enhanced Recovery After Pediatric Scoliosis Surgery: Key Components and Current Practice.
Abstract With the goal of safety and efficiency in health care delivery, enhanced recovery protocols (ERPs) continue to gain traction throughout various surgical disciplines, including in pediatric scoliosis surgery. The growing body of literature reporting decreased length of stay and cost with no change in readmissions or complications has brought these protocols to the forefront. The key components of ERPs include preoperative patient counseling, perioperative pain management, and early patient mobilization. In this review, the authors aim to describe the foundational history and major components of ERPs follow...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Song BM, Kadhim M, Shanmugam JP, King AG, Heffernan MJ Tags: Orthopedics Source Type: research
Impact of Pediatric Subspecialty Training on Perioperative Complications in Adolescent Idiopathic Scoliosis Surgery.
The objective was to evaluate the effect of pediatric fellowship training on 30-day perioperative morbidity and mortality following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Several pathways exist in North America by which physicians acquire the clinical and technical skills to manage AIS surgically. Previous work has noted that surgeons with pediatric fellowship training tend to perform the bulk of pediatric spine surgeries. However, no study has been performed that examines if pediatric fellowship training (PFT) has an impact on early postoperative outcomes. A total of 14,194 AIS surgical p...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Yohe N, Ciminero M, Solomito M, Lee MC Tags: Orthopedics Source Type: research
Confirmation of Femoral Button Deployment Under Direct Visualization During ACL Reconstruction Is Not Beneficial.
Abstract The purpose of this study was to determine whether direct visualization of adjustable-loop cortical suspensory button deployment onto the lateral femur increases the cortical contact rate of the button, thereby improving clinical outcomes after anterior cruciate ligament (ACL) reconstruction. Sixty-five single-bundle anteromedial portal ACL reconstructions using an adjustable-loop button were retrospectively divided into 2 groups according to use of the blind pulling technique (control group; 32 patients) or the direct visualization technique (visualization group; 33 patients) when confirming deployment o...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Sohn S, Koh IJ, Kim MS, In Y Tags: Orthopedics Source Type: research
In-Hospital Morbidity and Mortality of Traumatic Lower-Extremity Amputations.
Abstract Traumatic lower-extremity amputations often result in complications and surgical revisions. The authors report the in-hospital morbidity and mortality of traumatic lower-extremity amputations at a metropolitan level I trauma center for a large rural region and compare below-knee (BK) vs higher-level amputation complications. They retrospectively reviewed 168 adult patients during a 10-year period (2005 to 2015) who had a traumatic injury to the lower extremity that required an amputation. Main outcome measurements included amputation level, complication rates, intensive care unit (ICU) admission rates, le...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Thompson SF, McCall KB, Patel DV, Schwerdtfeger WA, Stoner J, Hollabaugh K, Teague DC Tags: Orthopedics Source Type: research
Osseous Integration of the Central Peg of an All-Polyethylene Glenoid With 3 Different Surgical Techniques.
Abstract All-polyethylene glenoid components designed for osseous integration of the central peg can be placed with no graft (NG), autogenous bone graft (ABG), or demineralized bone matrix (DBM). The purpose of this study was to compare osseous integration with these 3 techniques. A randomized controlled trial was performed of 153 total shoulder arthroplasties using a pegged allpolyethylene glenoid component designed for osseous integration. Central peg treatment included NG, ABG, or DBM. The primary outcome was central peg osseous integration defined as bone presence between the central fins 1 year postoperativel...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Denard PJ, Gobezie R, Griffin JW, Romeo AA, Lederman E Tags: Orthopedics Source Type: research
Improved Outcomes Using a Fibular Strut in Proximal Humerus Fracture Fixation.
Abstract Proximal humerus fractures, although common, have high rates of failure after open reduction and internal fixation. The use of a fibular allograft has been explored as a means to decrease complications, particularly varus collapse and the need for revision surgery. The authors performed a retrospective review of 133 proximal humerus fractures managed surgically with locking plates (n=72) or locking plates with fibular allograft intramedullary struts (n=61). Demographic, intraoperative, and postoperative variables were collected and analyzed. The fibular allograft group was more likely to be older (P
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Myers DM, Triplet JJ, Warmoth PJ, Passias BJ, McGowan SP, Taylor BC Tags: Orthopedics Source Type: research
Gravity-Assisted Passive Flexion in Total Knee Arthroplasty Recovery.
This study examined the use of gravity-assisted passive flexion (GAP-FLEX) for perioperative total knee arthroplasty (TKA) recovery. The main questions associated with this technique were: (1) Can GAP-FLEX improve patient recovery of range of motion after TKA? (2) Does GAP-FLEX reduce patient time and effort associated with therapy compared with continuous passive motion (CPM)? (3) Does GAP-FLEX reduce overall episodic care cost? A prospective, randomized multicenter study was conducted. Two senior surgeons used identical surgical approach, prosthesis, and postoperative management protocols. Patients consenting to the stud...
Source: Orthopedics - August 3, 2020 Category: Orthopaedics Authors: Buttacavoli FA Tags: Orthopedics Source Type: research
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