Special Edition: COVID-19 Guest Editorial.
Authors: Rose P, Levine WN PMID: 32459408 [PubMed - in process] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 29, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Telehealth Utilization in Response to the Novel Coronavirus (COVID-19) Pandemic in Orthopaedic Surgery.
This study demonstrates the impressive measures academic orthopaedic institutions are taking to meet the needs of our patients by identifying a notable increase in new telehealth offerings throughout the United States with a positive correlation with COVID-19 disease burden. PMID: 32459409 [PubMed - in process] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 29, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Early Experience Managing a High-Volume Academic Orthopaedic Department During the Coronavirus Pandemic in New York City.
Authors: Sharfman ZT, Loloi J, Krystal J, Fornari E, Levin P, Levy IM, Cobelli NJ, Geller DS, Kim SJ Abstract Our orthopaedic surgery department at Montefiore Medical Center and Albert Einstein College of Medicine, is located within the Bronx, a borough of New York City, and serves a densely-populated urban community. Since the beginning of the Coronavirus (COVID) outbreak in New York City the medical center was forced to rapidly adapt to the projected influx of critically ill patients. The aim of this report is to outline how our large academic orthopaedic surgery department adopted changes and alternative practic...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 28, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Spinopelvic Dissociation: A Systematic Review and Meta-analysis.
CONCLUSION: Spinopelvic dissociation is a rare type of injury with limited data in the literature. Based on our review, it is possible that a streamlined, evidence-based algorithm may improve care for these difficult patients. LEVEL OF EVIDENCE: II STUDY DESIGN:: Systematic Review. PMID: 32453011 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 28, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Stepwise Safe Access in Hip Arthroscopy in the Supine Position: Tips and Pearls From A to Z.
Authors: Maldonado DR, Rosinsky PJ, Shapira J, Domb BG Abstract Hip arthroscopy is rapidly growing as a treatment with good outcomes for pathologic conditions such as femoroacetabular impingement syndrome and labral tears. At the same time, it is one of the most technically challenging and demanding procedures in orthopaedics with a technically demanding skill. The first challenge is to safely access the joint, which requires accurate anatomical knowledge, a strong sense of spatial orientation, and repeated practice. Iatrogenic chondrolabral injury has been reported as the most common complication in hip arthroscop...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 28, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Association of State Legislation and Industry Compensation to Orthopaedic Residents: A 3-Year Review of the Centers for Medicare and Medicaid Services Open Payments Database.
Authors: Wills BW, Almaguer AM, Robin JX, Archie A, McMichael BJ, McGwin G, Ames SE, Ponce BA Abstract BACKGROUND: The Sunshine Act aims to increase the transparency of physicians receiving compensation from pharmaceutical and medical device companies. Nine states have supplementary legislation in addition to the Federal Sunshine Act. The purpose of this study is to assess the characteristics of financial compensation to orthopaedic residents on the Centers for Medicare and Medicaid Services (CMS) Open Payments Database in states with more restrictive regulations compared with those without additional restrictions....
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 23, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Reaching for Peak Performance During Surgical Training: The Value in Assessment Tools and Critical Performance Measures.
Authors: Louie PK, McCarthy MH, Albert TJ, Kim HJ Abstract Peak performance is the ability to achieve optimal outcomes or performance of a given task in a consistent manner. Commonly studied in athletes and musicians, this topic is less often studied in medicine and rarely broached for trainees. However, residency is a crucial period of training where foundations for future success are sewn into habit and daily practice. As educators, we should aim to equip trainees with the tools necessary to achieve peak performance. Studies in athletes and musicians focus on achieving peak performance by setting goals, mastering...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Patient Outcomes After Transolecranon Fracture-Dislocation.
DISCUSSION: Patients with transolecranon fracture-dislocation had excellent return to function based on the QuickDASH outcome assessment. Patients with transolecranon fracture with associated radial head fracture, coronoid fracture, humeral condyle fracture, and/or ligamentous injury tend to have worse functional outcome than patients with simple transolecranon fracture. LEVEL OF EVIDENCE: Level IV-case series. PMID: 32433427 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Preoperative Carbohydrate Drinks Do Not Decrease Postoperative Nausea and Vomiting in Type 2 Diabetic Patients Undergoing Total Knee Arthroplasty-A Randomized Controlled Trial.
DISCUSSION: Preoperative CHO drink did not reduce PONV in diabetic patients after total knee arthroplasty. A statistically significant but clinically questionable improvement in the QoR was seen in the Oral CHO group. However, preoperative CHO drink did not increase hyperglycemia, which suggests that it may be a safe component of perioperative care in diabetic patients. PMID: 32433428 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Posterior Labral Injury and Glenohumeral Instability in Overhead Athletes: Current Concepts for Diagnosis and Management.
Authors: Sheean AJ, Kibler WB, Conway J, Bradley JP Abstract Posterior glenohumeral instability in overhead athletes presents a unique set of challenges for both diagnosis and treatment. Although a great deal of attention has been focused on the management of injuries to the biceps-labrum complex and rotator cuff in throwers, comparatively less has been written about posterior glenohumeral instability within this unique cohort. Historically, posterior instability has been observed secondary to either acute trauma or repetitive microtrauma, usually among collision athletes, weight lifters, and rowers. However, poste...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 21, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Predictors of Insurance Claim Rejection in Hand and Upper Extremity Surgery.
Authors: Matson AP, Earp BE, Benavent KA, Geresy KM, Collins JE, Blazar PE Abstract INTRODUCTION: Insurance claim rejections represent a challenge for healthcare providers because of the potential for lost revenue and administrative costs of reworking claims. METHODS: The billing records of five hand and upper extremity surgeons at a tertiary academic center were queried for all patient billing activity over a 1-year period yielding a total of 14,421 unique patient encounters. RESULTS: A total of 11,839 unique patient encounters were included, and the overall claim rejection rate was 19.3%. Claim rejection ...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 21, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Diabetes Status Affects Odds of Body Mass Index-dependent Adverse Outcomes After Total Hip Arthroplasty.
Authors: Kebaish KJ, Puvanesarajah V, Rao S, Zhang B, Ottesen TD, Grauer JN, Khanuja H Abstract INTRODUCTION: Obesity and diabetes have independently been shown to predispose to adverse outcomes after total hip arthroplasty (THA). These may have a coupled effect on perioperative risks. The purpose of this study was to evaluate the effect of body mass index (BMI) on adverse outcomes in nondiabetic (ND), non-insulin-dependent diabetes mellitus (NIDDM), and insulin-dependent diabetes mellitus (IDDM) patients. METHODS: Patients undergoing primary THA were selected from the National Surgical Quality Improvement Prog...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 16, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Reasons for Revision: Primary Total Hip Arthroplasty Mechanisms of Failure.
CONCLUSION: Based on our institutional experience over the past decade, mechanical failure without dislocation, metallosis, dislocation, periprosthetic fracture, and infection are typical reasons patients present for primary THA revision. Revisions within 2 years after primary THA are more likely to be the result of infection and periprosthetic fracture. Mechanical failure is the most common reason for revision THA overall, and mechanical failure and metallosis are more likely to be the reason revision is necessary 2 or more years after primary THA. PMID: 32404682 [PubMed - as supplied by publisher] (Source: The Journa...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 16, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

State Medical Cannabis Laws Associated With Reduction in Opioid Prescriptions by Orthopaedic Surgeons in Medicare Part D Cohort.
Authors: Lopez CD, Boddapati V, Jobin CM, Hickernell TR Abstract INTRODUCTION: Opioid prescriptions and abuse remain a significant national concern. Cannabinoids offer a potentially attractive nonopioid analgesic option for orthopaedic patients, and 32 US states have passed medical cannabis laws (MCLs), legalizing patient access to cannabinoids. We examine the association between implementation of state cannabis laws and prescribing patterns for opioids by orthopaedic surgeons in Medicare Part D patients between 2013 and 2017. METHODS: Using the Medicare Part D Prescription Drug Event database, we measured annu...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 16, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Efficacy and Validity of Orthopaedic Simulators in Surgical Training: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Authors: Polce EM, Kunze KN, Williams BT, Krivicich LM, Maheshwer B, Beletsky A, R Cohn M, Kogan M, Chahla J Abstract INTRODUCTION: The purpose of this study was to perform a systematic review and meta-analysis of the effects of training simulators on surgical skill measures across randomized controlled trials. The authors hypothesized that simulated training would (1) result in objective improvements in skill acquisition and (2) be heterogeneous regarding the outcomes and types of validity assessed. METHODS: The Cochrane Database of Systematic Reviews, the Central Register of Controlled Trials, PubMed, EMBASE,...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 15, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Fractures of the Coracoid Process: Evaluation, Management, and Outcomes.
Authors: Galvin JW, Kang J, Ma R, Li X Abstract Fractures of the coracoid process are relatively rare, and current management guidelines remain unclear. Most coracoid fractures occur in conjunction with other shoulder injuries, including dislocations and fractures. Identifying coracoid fractures can be difficult because most fractures are nondisplaced and can be missed on radiographs or may be masked by other injuries. Management is largely guided by fracture location and displacement. Conservative treatment is preferred for fractures that are minimally displaced, whereas indications for surgical fixation include f...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 11, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Letter to the Editor: A Perspective on the Effect of the 80-hour Work Week: Has it Changed the Graduating Orthopaedic Resident?
Authors: Foran IM PMID: 32384384 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 11, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

The Evaluation and Management of Suprascapular Neuropathy.
Authors: Strauss EJ, Kingery MT, Klein D, Manjunath AK Abstract Suprascapular neuropathy is a potential source of shoulder pain and functional limitation that can present secondary to various etiologies including entrapment or compression. Cystic lesions arising from a labral or capsular tear can compress the nerve along its course over the scapula. Nerve traction is theorized to arise from chronic overhead athletics or due to a retracted rotator cuff tear. The diagnosis of suprascapular neuropathy is based on a combination of a detailed history, a comprehensive physical examination, imaging, and electrodiagnostic ...
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 6, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Readmission Rates After Hip Fracture: Are There Prefracture Warning Signs for Patients Most at Risk of Readmission?
In this study, we used the Cerner Health Facts Electronic Health Record database data from January to August 2015. The univariate association of each variable (discharge location, demographic details, and comorbidities) against the 30-day readmission status was evaluated using the Chi-square test or the Fisher exact test. The significant variables (P
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 2, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Factors in Orthopaedic Residency Decision-making for Female Applicants: A Cross-sectional Study.
DISCUSSION: These data support the notion that efforts by orthopaedic residency programs to improve desirability for female applicants should focus on highlighting some of the more universal, nonsex-related factors such as the happiness and camaraderie among residents and the anticipated clinical experiences. This is opposed to showcasing features, such as maternity leave and number of current female faculty or residents, which would seemingly appeal to female applicants. PMID: 32355053 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 2, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Comparative Clinical Outcomes of Reverse Total Shoulder Arthroplasty for Primary Cuff Tear Arthropathy Versus Severe Glenohumeral Osteoarthritis With Intact Rotator Cuff: A Matched-Cohort Analysis.
DISCUSSION: Patients who underwent RTSA for severe GHOA with intact RC demonstrate similar consistent improvement in outcomes to demographically similar patients with RCA. The severity of GHOA defined by the Walch classification did not impact the outcomes at the 2-year follow-up. LEVEL OF EVIDENCE: Level III Therapeutic Study. PMID: 32345934 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 1, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Low Surgeon and Hospital Volume Increase Risk of Early Conversion to Total Knee Arthroplasty After Tibial Plateau Fixation.
DISCUSSION: High-volume treatment of tibial plateau fractures is associated with a lower rate of conversion to TKA, suggesting that the regionalization of care for these injuries may improve outcomes. LEVEL OF EVIDENCE: Level III. PMID: 32345935 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 1, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Collaboration in Hand Surgery: Experiences From Silicone Arthroplasty in Rheumatoid Arthritis, Finger Replantation and Amputation Challenges in Assessing Impairment, Satisfaction, and Effectiveness, Wrist and Radius Injury Surgical Trial, and Surgery of the Ulnar Nerve.
We present our experiences in conducting multicenter investigations to provide insight into this demanding and rewarding frontier of research. PMID: 32345936 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - May 1, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Contouring Plates in Fracture Surgery: Indications and Pitfalls.
Authors: Bishop JA, Campbell ST, Graves ML, Gardner MJ Abstract Effective fracture surgery requires contouring orthopaedic implants in multiple planes. The amount of force required for contouring is dependent on the amount and type of material contained within the plane to be altered. The type of contouring used depends on the desired plate function; for example, buttress mode often requires some degree of undercontouring, whereas compression plating may require prebending. Other reasons to contour a plate include matching patient anatomy either to maximize fixation options or to reduce implant prominence. Preconto...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 26, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Letter to the Editor: Letter Regarding "An Increasing Rate of Surgical Management of Closed Tibia Fractures in an Adolescent Population: A National Database Study".
Letter to the Editor: Letter Regarding "An Increasing Rate of Surgical Management of Closed Tibia Fractures in an Adolescent Population: A National Database Study". J Am Acad Orthop Surg. 2020 Apr 23;: Authors: Rehm A, Thahir A PMID: 32332262 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 26, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Occupation-related Cervical Spine Disease in Orthopaedic Surgeons.
CONCLUSION: Neck pain and cervical radiculopathy/myelopathy are common among orthopaedic surgeons. Associated factors included older age, higher stress levels, and performing arthroscopy. Cervical injuries are rarely reported, and ergonomic workplace evaluations are infrequent. PMID: 32324708 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 25, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

The American Board of Orthopaedic Surgery Response to COVID-19.
Authors: Wright RW, Armstrong AD, Azar FM, Bednar MS, Carpenter JE, Evans JB, Flynn JM, Garvin KL, Jacobs JJ, Kang JD, Lundy DW, Mencio GA, Murray PM, Nelson CL, Peabody T, Porter SE, Roberson JR, Saltzman CL, Sebastianelli WJ, Taitsman LA, Van Heest AE, Martin DF PMID: 32324709 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 25, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Recommendations for the Care of Pediatric Orthopedic Patients During the COVID Pandemic.
Authors: Farrell S, Schaeffer EK, Mulpuri K Abstract The COVID pandemic has necessitated modifications to pediatric orthopaedic practice to protect patients, families and healthcare workers, and to minimize viral transmission. It is critical to balance benefits of alterations to current practice to reduce chances of COVID infection, with the potential long-term impact on patients. Early experiences of the pandemic from orthopaedic surgeons in China, Singapore and Italy have provided opportunity to take proactive and preventive measures to protect all involved in pediatric orthopaedic care. These guidelines, based o...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 19, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Departmental Experience and Lessons Learned With Accelerated Introduction of Telemedicine During the COVID-19 Crisis.
This article provides practical instruction based on our experience for physicians who wish to implement telemedicine during the COVID-19 pandemic. Between telemedicine encounters and necessary in-person visits, providers may be able to achieve 50% of their typical clinic volume within 2 weeks. When handling the massive disruption to the routine patient care workflow, it is critical to understand the key factors associated with an accelerated introduction of telemedicine for the safe and effective continuation of orthopaedic care during this pandemic. LEVEL OF EVIDENCE:: V. PMID: 32301818 [PubMed - as supplied by publi...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 19, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Three-dimensional Volumetric Filling Ratio Predicts Stress Shielding in Short-stem Anatomic Total Shoulder Arthroplasty.
CONCLUSIONS: These methods enable early identification of patients at risk for stress shielding and can also be valuable in improving humeral stem designs. LEVEL OF EVIDENCE: Level III. Case-control study. PMID: 32301819 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 19, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Opioid Prescribing Patterns in Orthopaedic Surgery Patients: the Effect of New York State Regulations and Institutional Initiatives.
Authors: Lott A, Hutzler LH, Bosco JA, Lajam CM Abstract BACKGROUND: The opioid epidemic in the United States is a public health crisis. As a result, regulatory agencies, including state governments, have enacted initiatives to decrease the use of opioids in the perioperative setting. The purpose of this study was to compare opioid utilization in orthopaedic surgery patients at discrete points after implementation of State regulatory and institution/physician-led initiatives to decrease opioid utilization in the perioperative period. METHODS: We reviewed the electronic medication orders for all patients who und...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 19, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Orthopaedic Surgical Selection and Inpatient Paradigms During the Coronavirus COVID-19 Pandemic.
Authors: Massey PA, McClary K, Zhang AS, Savoie FH, Barton RS Abstract The Novel Coronavirus (COVID-19) pandemic, also known as SARS-CoV-2, has placed an immense strain on health care systems across the entire world. Consequently, multiple federal and state governments have placed restrictions on hospitals such as limiting "elective surgery" and recommending social or physical distancing. We review the literature on several areas that have been affected including surgical selection, inpatient care, and physician well-being. These areas affecting inpatient paradigms include surgical priority, physical or s...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 19, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Practice Management During the COVID-19 Pandemic.
Authors: Vaccaro AR, Getz CL, Cohen BE, Cole BJ, Donnally CJ Abstract On March 14, 2020 the Surgeon General of the United States urged a widespread cessation of all elective surgery across the country. The suddenness of this mandate and the concomitant spread of the COVID-19 virus left many hospital systems, orthopaedic practices, and patients with significant anxiety and confusion as to the near, intermediate, and long-term future of our healthcare system. As with most businesses in the United States during this time, many orthopaedic practices have been emotionally and fiscally devastated as a result of this cris...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 16, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Orthopaedic Education During the COVID-19 Pandemic.
Authors: Kogan M, Klein SE, Hannon CP, Nolte MT Abstract The COVID-19 global pandemic presents a challenge to orthopaedic education. Around the world, including in the United States, elective surgeries are being deferred, and orthopaedic residents and fellows are being asked to make drastic changes to their daily routines. In the midst of these changes are unique opportunities for resident/fellow growth and development. Educational tools in the form of web-based learning, surgical simulators, and basic competency tests may serve an important role. Challenges are inevitable, but appropriate preparation may help prog...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 15, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Peri-operative Considerations in Urgent Surgical Care of Suspected and Confirmed COVID-19 Orthopedic Patients: Operating rooms protocols and recommendations in the Current COVID-19 Pandemic.
This article provides evidence-based recommendations and measures for the appropriate personal protective equipment for different clinical and surgical activities in various settings. To reduce the occupational risk in treating suspected or confirmed COVID-19 urgent orthopaedic patients, recommended precautions and preventive actions (triage area, ED consultation room, induction room, operating room, and recovery room) are reviewed. PMID: 32282441 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 15, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

A Bioethical Perspective for Navigating Moral Dilemmas Amidst the COVID-19 Pandemic.
Authors: Dunham AM, Rieder TN, Humbyrd CJ PMID: 32282442 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 15, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Lateralization and Decreased Neck-Shaft Angle Reduces Scapular Notching and Heterotopic Ossification.
CONCLUSION: Implants with laterally offset glenospheres and 135° NSA may decrease postoperative HO and scapular notching. LEVEL OF EVIDENCE: Level III, retrospective cohort study. PMID: 32271176 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 11, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Drilling Energy Correlates With Screw Insertion Torque, Screw Compression, and Pullout Strength: A Cadaver Study.
Authors: Chen MJ, DeBaun MR, Thio T, Storaci H, Gardner MJ Abstract INTRODUCTION: To determine whether drilling energy correlates with bone mineral density (BMD), maximum insertion torque (MIT), maximum screw compression, and pullout strength (POS). METHODS: Ten cadaver tibias were used for testing. Unicortical pilot holes were drilled and the drilling energy measured. Drill site bone quality was determined with microcomputed tomography. Drill holes were randomly assigned to POS or MIT testing using 3.5-mm cortical screws engaging only the near cortex. Pearson correlation coefficients were calculated to determi...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 8, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

From Concept to Counter: A Review of Bringing an Orthopaedic Implant to Market.
This article provides a brief overview of the pertinent considerations of transforming a concept into an orthopaedic implant and bringing it to the market. Implant concept choice should consider medical or surgical necessity, regional variability, market characteristics, cost of goods sold, and average selling price. Implant development requires adherence to regulatory requirements and device classification. Implant production incorporates design specifications, mechanical testing, sterilization, packaging, and marketing and sales. Orthopaedic implant company agreements determine physician compensation through royalties an...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 8, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Are Routine Follow-up Radiographs Necessary for Extra-articular Scapula Body Fractures Managed Conservatively?
Authors: Steinmetz RG, Maupin JJ, Johnson EB, Cantrell AJ, Fox JA, Bernhardt JA, Pasque CB, Teague DC Abstract INTRODUCTION: Extra-articular scapula body fractures have been shown to have good outcomes with nonsurgical management. What is not known is whether routine postinjury imaging of these fractures is necessary for monitoring healing and alignment. As the shift toward providing cost-effective healthcare continues, we sought to evaluate if routine postinjury imaging of these fractures resulted in any change in management while secondarily evaluating the imaging for fracture patterns at risk of displacement. ...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 4, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

The Impact of Social Deprivation on Orthopaedic Outpatient Satisfaction Using the Press Ganey Outpatient Medical Practice Survey.
Authors: Stephens AR, Tyser AR, Kazmers NH Abstract INTRODUCTION: In orthopaedics, multiple factors (patient age, wait time, and depression) have been associated with lower Press Ganey Outpatient Medical Practice Survey (PGOMPS) patient satisfaction scores. We hypothesized that increased social deprivation is an independent predictor of lower patient satisfaction, as measured by the PGOMPS. METHODS: We retrospectively reviewed unique new outpatient orthopaedic surgery visits between January 1, 2014, and December 31, 2016, at a single tertiary academic institution. Given the high ceiling effects, satisfaction wa...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 4, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Venous Thromboembolism Prophylaxis After Pelvic and Acetabular Fractures: A Survey of Orthopaedic Surgeons' Current Practices.
CONCLUSION: Most surgeons treating P&A fractures use LMWH for VTE prophylaxis, but the decision on which agent to use and duration of treatment is multifactorial. Published VTE prophylaxis literature and guidelines provide some guidance, but there is no consensus. Overall, LMWH appears to be the VTE prophylaxis agent of choice for most orthopaedic trauma surgeons, irrespective of nonsurgical or surgical management of these fractures. PMID: 32235242 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 4, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Lymphedema: A Significant Risk Factor for Infection and Implant Failure After Total Knee Arthroplasty.
Authors: Kolz JM, Rainer WG, Wyles CC, Houdek MT, Perry KI, Lewallen DG Abstract BACKGROUND: Lymphedema is characterized by fluid buildup and swelling, leading to skin fibrosis and recurring soft-tissue infections. There is a paucity of data examining the impact of lymphedema in total knee arthroplasty (TKA). The purpose of this study was to review the outcomes of TKA in patients with lymphedema compared with a matched cohort with primary osteoarthritis. METHODS: One hundred forty-four knees underwent primary TKA with a preceding diagnosis of ipsilateral lymphedema. The mean follow-up was 7 years. A blinded 1:2...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 4, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Risk Factors for Re-Revision Surgery in Shoulder Arthroplasty.
CONCLUSION: The annual revision shoulder arthroplasty volume increased over the study period. Patient factors, including BMI and diabetes were associated with higher re-revision risks for hemiarthroplasty and RTSA primaries, respectively. RTSA revised for instability had a higher risk of re-revision compared with other indications. TSA and hemiarthroplasty requiring aseptic revision may be best treated with RTSA as opposed to another TSA or hemiarthroplasty. Further studies are needed to verify these findings and identify how the mechanism of failure may affect the procedure selection in the revision setting. LEVEL OF ...
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 2, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Increasing Fellow Recruitment: How Can Fellowship Program Websites Be Optimized?
DISCUSSION: To our knowledge, this is the first study to demonstrate that most orthopaedic trauma fellowship applicants use fellowship websites when researching programs. Programs may use this study to optimize their fellowship experience to reflect what the applicants value. In addition, programs may use this study as a guide when updating their websites. Fellowships with informative websites that meaningfully highlight their fellowship experience may have a competitive edge in attracting applicants to their programs. PMID: 32229783 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - April 2, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Prospective Study of Acute Opioid Use After Adolescent Anterior Cruciate Ligament Reconstruction Shows No Effect From Patient- or Surgical-Related Factors.
CONCLUSION: Patients take most pain medication during the first postoperative week after adolescent ACLR, although patient and surgical variables had no notable influence on pill consumption. LEVEL OF EVIDENCE: Level IV, case series. PMID: 32213778 [PubMed - in process] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - March 29, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Osteonecrosis of the Lunate: Kienb öck Disease.
Osteonecrosis of the Lunate: Kienböck Disease. J Am Acad Orthop Surg. 2020 Mar 17;: Authors: Rioux-Forker D, Shin AY Abstract Kienböck disease, osteonecrosis of the lunate, is a well-known but poorly understood complication seen by hand surgeons. This review presents the background and important patient-specific parameters of the disease and reviews the numerous treatment options that exist for the disease. PMID: 32195826 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - March 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Tuberosity Repair in Reverse Total Shoulder Arthroplasty for Fracture Using a Stem-based Double-row Repair: A Cadaveric Biomechanical Study.
CONCLUSION: The stem-based tuberosity repair technique afforded higher ultimate load to failure with less average cyclic displacement than the nonstem-based technique. Consideration to the stem-based technique should be given when performing a tuberosity repair in the setting of reverse total shoulder arthroplasty for fracture. LEVEL OF EVIDENCE: Level III. PMID: 32195827 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - March 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Mid-term Patient-reported Outcomes of Hip Arthroplasty After Previous Hip Arthroscopy: A Matched Case-control Study With a Minimum 5-year Follow-up.
CONCLUSION: Patients with PA demonstrated similar levels of PROs as those without previous ipsilateral hip arthroscopy. There may, however, be a higher rate of complications and revision surgery in the PA group. LEVEL OF EVIDENCE: III. PMID: 32195828 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - March 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Opioid Use and Appropriateness of Supply After Total Knee or Hip Arthroplasty: An Australian Perspective.
DISCUSSION: More than half of the patients undergoing total knee arthroplasty or total hip arthroplasty were still using opioids at 3 weeks postdischarge. Most patients were not supplied with excessive quantities at discharge. Future research should focus on identifying patients at risk of prolonged opioid use and improving the transition of these patients into the community. LEVEL OF EVIDENCE: Level II-Prognostic study = prospective observational study. PMID: 32195829 [PubMed - as supplied by publisher] (Source: The Journal of the American Academy of Orthopaedic Surgeons)
Source: The Journal of the American Academy of Orthopaedic Surgeons - March 22, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research