Return to Sports After Joint Preservation Hip Surgery.
This article provides an overview of femoroacetabular impingement, including diagnosis and treatment, with focus on athletes and return to play. PMID: 32950212 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Yacovelli S, Parvizi J Tags: Orthop Clin North Am Source Type: research

Allowed Activities After Primary Total Knee Arthroplasty and Total Hip Arthroplasty.
This article reviews the current recommendations regarding return to physical activity after total knee arthroplasty and trying to find the balance between levels of activity and prosthetic joint preservation. In general, most total joint replacement patients are able to return to their previous level of activity and to a lesser extent to sports. This article discuss patients' actual levels of activity including their return to work and sport and the factors that influence meeting their expectations for surgery. PMID: 32950213 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Fawaz WS, Masri BA Tags: Orthop Clin North Am Source Type: research

Does Multimodal Therapy Influence Functional Outcome After Total Knee Arthroplasty?
Abstract Psychosocial health may influence the outcomes after total knee arthroplasty (TKA). We investigated the hypothesis that multimodal therapy influences the quality of life and function in patients diagnosed with osteoarthritis of the knee joint. Secondly, in patients who then proceed to have TKA post-multimodal therapy, does the response to the multimodal therapy influence the overall functional outcome of surgery? Patients diagnosed with osteoarthritis of the knee were enrolled in the study and prospectively followed-up. A total of 526 patients were enrolled and available for the study. All participants we...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Magan AA, Ahmed SS, Paton B, Konan S, Haddad FS Tags: Orthop Clin North Am Source Type: research

Ski and Snowboard - Related Orthopedic Injuries.
This article summarizes the epidemiology, risk factors, and specific injuries associated with skiing and snowboarding to better educate orthopedic surgeons regarding diagnosis and treatment of athletes partaking in these sports. PMID: 32950215 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Telgheder ZL, Kistler BJ Tags: Orthop Clin North Am Source Type: research

Soft Tissue Injury Considerations in the Treatment of Tibial Plateau Fractures.
This article aims to emphasize the high incidence of injury to associated soft tissue structures and provide general approach considerations to these complex injuries. PMID: 32950216 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Adams JDJ, Loeffler MF Tags: Orthop Clin North Am Source Type: research

Traumatic Patellar Dislocations in Childhood and Adolescents.
Abstract Patellar instability and associated patellar dislocation can result in significant pain, disability, and associated injuries in young athletes. The patellofemoral joint is a complex articulation with stabilizing restraints, both medially and laterally, that help guide the patella into the corresponding trochlear groove as the knee cycles through an extension-to-flexion arc. In addition to soft tissue injuries, many osseous aberrancies can contribute to patellar instability in young athletes, including trochlear dysplasia, patella alta, and axial and coronal plane abnormalities. There is a role for nonoper...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Grimm NL, Levy BJ, Jimenez AE, Crepeau AE, Lee Pace J Tags: Orthop Clin North Am Source Type: research

Gymnast's Wrist (Distal Radial Physeal Stress Syndrome).
Abstract The distal radial physis is a common site for injury in gymnasts because of the significant amount of load applied during upper extremity weight-bearing. Wrist pain has been reported in up to 88% of gymnasts. The long-term consequences of overuse wrist injuries, such as distal radial physeal arrest, include degenerative conditions that often cause pain and functional limitations. In the more immediate stage of many overuse injuries, early diagnosis can promote quicker care and recovery and thus faster return to play. Less time lost to injury can be very important in maintaining an athlete's quality of lif...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Mauck B, Kelly D, Sheffer B, Rambo A, Calandruccio JH Tags: Orthop Clin North Am Source Type: research

An Evidence-Based Review of Overuse Wrist Injuries in Athletes.
Abstract Overuse wrist injuries are a common problem in athletes and can be related to tendinopathies or osteoarticular pathology. Fortunately, athletes rarely miss time from their sport due to these conditions because many can be treated nonoperatively. For refractory cases, there often is a curative surgical procedure that can be done during the off-season. PMID: 32950219 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Phillips SG Tags: Orthop Clin North Am Source Type: research

Scaphoid Fractures in Athletes.
Abstract Scaphoid fractures are common injuries in athletes. Most can be treated with cast immobilization, with an expected rate of union of 90% to 95%. Cast treatment, however, has the disadvantages of longer immobilization time, joint stiffness, reduced grip strength, and longer time to return to manual work or athletics. Closed reduction and percutaneous screw fixation generally are preferred in athletes to allow a quicker return to sport; if closed reduction cannot be obtained, open reduction and internal fixation may be required. PMID: 32950220 [PubMed - as supplied by publisher] (Source: The Orthopedic ...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Weller WJ, Thompson NB, Phillips SG, Calandruccio JH Tags: Orthop Clin North Am Source Type: research

Current Trends and Impact of Early Sports Specialization in the Throwing Athlete.
Abstract Early sports specialization (ESS) is a relatively new trend that has led to many youth athletes to focus on only 1 sport at an increasingly young age. Although parents and coaches perceive that this will improve their athlete's chances of success at the collegiate and professional levels, studies have shown the opposite. ESS leads to increased injury risk, higher rates of burnout, and lower lifelong sports participation without increasing elite achievement. Throwing athletes are particularly vulnerable to these overuse injuries of the shoulder and elbow, which have been shown to correlate directly to the ...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Anderson FL, Knudsen ML, Ahmad CS, Popkin CA Tags: Orthop Clin North Am Source Type: research

Pulmonary Comorbidities Are Associated with Increased Major Complication Rates Following Indwelling Interscalene Nerve Catheters for Shoulder Arthroplasty.
Abstract Pulmonary comorbidities and ASA physical status class III and IV can significantly increase the rate of major complications after ISC placement. Patients with an underlying pulmonary comorbidity or lung disease (chronic obstructive pulmonary disease, asthma, or obstructive sleep apnea) have a 2.2-fold increased risk of having any complication and a 2.4-fold increased risk of having a major pulmonary complication compared to those without pulmonary comorbidities. Patients with pulmonary comorbidities may benefit from alternative pain management strategies to avoid complications in the early postoperative p...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Power I, Throckmorton TW, Smith RA, Azar FM, Brolin TJ Tags: Orthop Clin North Am Source Type: research

Management of Achilles Tendon Injuries in the Elite Athlete.
Abstract The management of Achilles tendon rupture continues to be controversial in the everyday athlete; however, there is strong evidence indicating that surgical intervention is preferred in elite athletes due to the return of greater strength and peak torque. We review the published literature, as well as our operative technique and post-operative protocol in the management of Achilles tendon injuries in elite athletes. PMID: 32950223 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Patel KA, O'Malley MJ Tags: Orthop Clin North Am Source Type: research

Jones Fracture Management in Athletes.
Abstract Jones fractures in both elite and recreational athletes are best treated with surgical fixation, given superior results as compared to nonoperative management. While screw specifics remain controversial, intramedullary screw fixation is established as the standard surgical technique. Plate fixation also has shown excellent outcomes. Complications of refracture, nonunion, and delayed union require careful evaluation for contributions of early return to play, implant characteristics, and anatomic/metabolic abnormality. Revision fixation with autograft and biologic augmentation is supported in the literature...
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Ruta DJ, Parker D Tags: Orthop Clin North Am Source Type: research

Preface.
PMID: 32950225 [PubMed - as supplied by publisher] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - September 21, 2020 Category: Orthopaedics Authors: Azar FM Tags: Orthop Clin North Am Source Type: research

Minimally Invasive Total Knee Arthroplasty: Does Surgical Technique Actually Impact the Outcome?
This article reviews the current literature and information regarding the effect of surgical approach on patients' outcomes. The results of the limited medial parapatellar, subvastus, midvastus, and quadriceps-sparing approaches were analyzed. All techniques can provide adequate exposure with successful outcomes. It is recommended that a surgeon perform the approach with which they are most comfortable, because that will likely yield the best patient outcome. PMID: 32498949 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Mora JP, Scuderi GR Tags: Orthop Clin North Am Source Type: research

What's New in Percutaneous Pelvis Fracture Surgery?
Abstract Percutaneous reduction and fixation of pelvic ring fractures is now widely accepted as a safe and effective treatment method. The only exception remains reduction and fixation of pubic symphyseal injuries. Several units from China and one from Spain have published clinical and biomechanical studies supporting percutaneous reduction and fixation of the pubic symphysis with various screw configurations. The initial clinical results are promising. Biomechanical data show there is little difference between plate and screw fixation. We review the current literature and also present a case performed by ourselve...
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Grewal IS, Starr AJ Tags: Orthop Clin North Am Source Type: research

Minimally Invasive Treatment of Displaced Intra-Articular Calcaneal Fractures.
Abstract Minimally invasive surgical techniques are increasingly used for definitive treatment of displaced intra-articular calcaneal fractures. These approaches have been shown to minimize soft tissue injury, preserve blood supply, and decrease operative time. These methods can be applied to all calcaneal fractures and have particular advantages in patients with higher than usual risks to the soft tissues. The literature suggests that results of limited soft tissue dissection approaches provide equivalent outcomes to those obtained with the extensile lateral approach. We predict that as imaging and other techniqu...
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Wilkinson BG, Marsh JL Tags: Orthop Clin North Am Source Type: research

Advances in Minimally Invasive Techniques in Pediatric Orthopedics: Percutaneous Spine Fracture Fixation.
Abstract Pediatric spine trauma presents unique management challenges. These injuries are often the result of high-energy mechanisms and are associated with other serious injuries that can complicate surgical and nonsurgical approaches. The pediatric population presents a host of challenges related to patient compliance, healing challenges, and patient tolerance of therapy. Percutaneous pedicle screw instrumentation, temporary fixation without fusion, continues to expand in its role of pediatric spine fracture treatment. Compared with open instrumentation and fusion, this technique addresses many of the previously...
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Bailey RS, Puryear A Tags: Orthop Clin North Am Source Type: research

Percutaneous Osteotomies in Pediatric Deformity Correction.
This article discusses the advantages and indications for each type of osteotomy. PMID: 32498953 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Nahm N, Boyce Nichols LR Tags: Orthop Clin North Am Source Type: research

Endoscopic Carpal Tunnel Release: Indications, Technique, and Outcomes.
Abstract Carpal tunnel is the most common peripheral compressive neuropathy. Nonoperative management may provide temporary alleviation of symptoms, but in most cases surgical decompression is warranted. There are a multitude of approaches ranging from open release under general anesthesia to wide awake in-office endoscopic carpal tunnel release. The present article describes the technical considerations for the single incision, antegrade approach to endoscopic carpal tunnel release using the SEGWay system and technique. PMID: 32498954 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Karamanos E, Jillian BQ, Person D Tags: Orthop Clin North Am Source Type: research

Office-Based Percutaneous Fasciotomy for Dupuytren Contracture.
Abstract Percutaneous fasciotomy is a safe, simple, and inexpensive treatment for mild to moderate Dupuytren contracture. The decrease in extension deficit in the metacarpophalangeal and proximal interphalangeal joints after release correlates with improvement in patient-reported outcomes. Complications are rare and primarily include skin tears, which occur in approximately 4% of patients. Most patients are satisfied with the outcomes of the procedure at 1 year. PMID: 32498955 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Chambers J, Pate T, Calandruccio J Tags: Orthop Clin North Am Source Type: research

Arthroscopic Latarjet for Shoulder Instability.
Abstract Arthroscopic Latarjet is a relatively new, but viable option for the treatment of anterior shoulder instability. Arthroscopic Latarjet has the advantage of faster recovery, reduced stiffness, identification of additional shoulder pathology, and improved cosmesis when compared with open Latarjet. By the majority of clinical and radiographic parameters, arthroscopic Latarjet produces equivalent outcomes compared with open Latarjet. A relatively substantial learning curve for arthroscopic Latarjet exists at about 25 cases; however, multiple studies have demonstrated comparable outcomes and surgical time afte...
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Getz CL, Joyce CD Tags: Orthop Clin North Am Source Type: research

Total Shoulder Arthroplasty Utilizing the Subscapularis-Sparing Approach.
Abstract Traditionally, total shoulder arthroplasty is performed through the deltopectoral approach with violation of the subscapularis tendon. In order to reduce the incidence of postoperative subscapularis dysfunction, the subscapularis-sparing approach, performed entirely through the rotator interval, was developed. This technique allows earlier rehabilitation and may potentially prevent subsequent subscapularis insufficiency and clinical failures. PMID: 32498957 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Rosenthal Y, Kwon YW Tags: Orthop Clin North Am Source Type: research

Minimally Invasive Achilles Repair Techniques.
Abstract Achilles tendon rupture is an increasingly common problem with an aging population participating in high-level physical activities. Appropriate treatment has been debated for decades, but good outcomes have been reported after conservative and surgical management. The development of minimally invasive surgical techniques for Achilles repair has reduced the incidence of complications and maintained the high level of function reported after open surgery. The Achilles Midsubstance SpeedBridge repair is a newer minimally invasive technique that has demonstrated promising results and is the authors' preferred ...
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Clanton T, Stake IK, Bartush K, Jamieson MD Tags: Orthop Clin North Am Source Type: research

Percutaneous Techniques in Orthopedic Foot and Ankle Surgery.
This article presents the indications, contraindications, preoperative surgical planning, surgical technique, and postoperative management of some of the most common percutaneous procedures in orthopedic foot and ankle surgery. The background of each procedure also is presented, supported by the latest in published literature to educate surgeons. Such topics include percutaneous bunionectomy, lesser toe deformity and bunionette correction, calcaneal osteotomy, cheilectomy, and first metatarsophalangeal joint arthrodesis. PMID: 32498959 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Schipper ON, Day J, Ray GS, Johnson AH Tags: Orthop Clin North Am Source Type: research

Deep Venous Thrombosis and Pulmonary Embolism After Minimally Invasive Transforaminal Lumbar Interbody Fusion: Report of 2 Cases in 315 Procedures.
Abstract When the guidelines of the North American Spine Society concerning deep venous thrombosis (DVT) prophylaxis were followed, only 2 (0.63%) of 315 patients with minimally invasive transforaminal lumbar interbody fusions developed DVT complications over a 9-year period. Based on these findings, mechanical DVT prophylaxis appears to be adequate in patients undergoing elective spinal surgery, with no current support for pharmacologic prophylaxis. PMID: 32498960 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Olinger CR, Gardocki RJ Tags: Orthop Clin North Am Source Type: research

Minimally Invasive Surgery: Is Less More?
PMID: 32498961 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - June 6, 2020 Category: Orthopaedics Authors: Azar FM Tags: Orthop Clin North Am Source Type: research

Challenges to Implementing Total Joint Replacement Programs in Developing Countries.
Abstract In this review article, the authors present the many challenges that orthopedic surgeons in developing countries face when implementing arthroplasty programs. The issues of cost, sterility, and patient demographics are specifically addressed. Despite the many challenges, developing countries are beginning to offer hip and knee reconstructive surgery to respond to the increasing demand for such elective operations as the prevalence of osteoarthritis continues to increase. The authors shed light on these nascent arthroplasty programs. PMID: 32138851 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Pedneault C, St George S, Masri BA Tags: Orthop Clin North Am Source Type: research

The Changing Face of Infection, Diagnosis, and Management in the United Kingdom.
This article summarizes recent developments in the diagnosis and management of this increasingly prevalent issue specifically focusing on outcomes following debridement, antibiotics, and implants retention and one-stage revision procedures. PMID: 32138852 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Ahmed SS, Yaghmour KM, Haddad FS Tags: Orthop Clin North Am Source Type: research

Unicompartmental Knee Arthroplasty: US and Global Perspectives.
Abstract Unicompartmental knee arthroplasty (UKA) is a treatment option for anteromedial osteoarthritis. Compared with total knee arthroplasty (TKA), UKA offers improved knee range of motion, functional recovery and decreased medical complications. Revision rates continue to be higher with UKA compared with TKA. With current UKA implants, there is no significant difference in mobile bearing or fixed bearing, or between cemented and cementless implants. Enabling technology, such as robotic-assisted surgery, has demonstrated improvements in component positioning, but no long-term difference in survival compared with...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Crawford DA, Berend KR, Thienpont E Tags: Orthop Clin North Am Source Type: research

International Collaboration in Total Joint Arthroplasty: A Framework for Establishing Meaningful International Alliances.
Abstract Despite the increase in utilization of total joint arthroplasty (TJA) throughout high-income countries, there is a lack of access to basic surgical care, including TJA, in low- and middle-income countries (LMICs). Multiple strategies, including short-term surgical trips, establishment of local TJA centers, and education-based international academic collaborations, have been used to bridge the gap in access to quality TJA. The authors review the obstacles to providing TJA in LMICs, the outcomes of the 3 strategies in use to bridge gaps, and a framework for the establishment and maintenance of meaningful in...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Gausden EB, Premkumar A, Bostrom MP Tags: Orthop Clin North Am Source Type: research

Global Perspectives on Arthroplasty of Hip and Knee Joints.
In this report, data from these registries in addition to manufacturer reports were used to evaluate procedure volumes and implants utilization trends of primary and revision total hip and knee replacement around the world. PMID: 32138855 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Abdelaal MS, Restrepo C, Sharkey PF Tags: Orthop Clin North Am Source Type: research

Impact of North American Institutions on Orthopedic Research in Low- and Middle-Income Countries.
This article presents a select list of models for high-income countries/low- and middle-income countries research partnerships including academic partnerships, international research consortia, professional society-associated working groups, and nongovernmental organization partnerships. Models that produce research with lasting legacy are those that promote mutually beneficial partnerships over individual gains. PMID: 32138856 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: von Kaeppler E, Donnelley C, Roberts HJ, O'Hara NN, Won N, Shearer DW, Morshed S Tags: Orthop Clin North Am Source Type: research

Intertrochanteric Femur Fracture Treatment in Asia: What We Know and What the World Can Learn.
This article summarizes 10 concepts in hip fracture treatment over the past 20 years, including fracture line mapping, proximal lateral wall and anterior cortex, posteromedial lesser trochanter-calcar fragment, anteromedial cortex support reduction, changes of fracture reduction after sliding and secondary stability, nail entry point and wedge-open deformity, tip-apex distance and calcar-referenced tip-apex distance, femoral anterior bowing and nail modification, long nails for wide medullary canal and large posterior coronal fragment, and postoperative stability score. PMID: 32138857 [PubMed - in process] (Sourc...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Chang SM, Hou ZY, Hu SJ, Du SC Tags: Orthop Clin North Am Source Type: research

The Burden of Pediatric Musculoskeletal Diseases Worldwide.
Abstract Global burden of disease (GBD) refers to the economic and human costs resulting from poor health. The disability-adjusted life year is a measure of life lost from premature death and life not lived at 100% health. Surgery has long been neglected in the distribution of resources for global health. Because of years of life lived with a disability and the large proportion of children in a population, pediatric musculoskeletal conditions early in life can contribute to the GBD. Fortunately, the World Health Organization has recently promoted essential surgical services through its Emergency and Essential Surg...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Schwend RM Tags: Orthop Clin North Am Source Type: research

Development of a Global Pediatric Orthopedic Outreach Program in Ecuador Through Project Perfect World: Past, Present, and Future Directions.
Abstract Global health delivery is a complex initiative requiring dedicated personnel to achieve a successful program. To be most beneficial, global health delivery should focus on cultural competence, bidirectional education, and capacity building through direct and purposeful means. The authors present the expansion of their global health delivery program in Ecuador focusing on the evolution of the program from a medical mission trip to a multilayered program that helps foster engagement, education, and learning while helping children who might not otherwise have access to care, along with future directions and ...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Fornari E, Schwend RM, Schulz J, Bray C, Schmitz MR Tags: Orthop Clin North Am Source Type: research

Ulnar Abutment Syndrome in the Athlete.
Abstract Ulnar abutment (ulnocarpal impaction) syndrome may be a source of ulnar-sided wrist pain in the athlete. This condition results from excessive load transfer across the triangular fibrocartilage complex and ulnocarpal joints with characteristic degenerative changes. It frequently occurs in patients with either static or dynamic ulnar positive variance. Treatment is tailored to the athlete and their sporting demands. Surgical treatment focuses on addressing ulnar variance to unload the ulnocarpal joint, with multiple surgical options, including the metaphyseal closing wedge osteotomy achieving this goal. Th...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Acott TR, Greenberg JA Tags: Orthop Clin North Am Source Type: research

Operative Distal Radial Fractures: A Comparison of Time to Surgery After Evaluation by Surgical and Nonsurgical Providers in a Walk-in Clinic.
Abstract To determine if orthopedic surgeons are more efficient than nonsurgical providers at care of operative injuries in walk-in clinics, patients in a walk-in clinic for evaluation of acute injury who subsequently had surgical treatment of isolated distal radial fracture were compared based on whether the initial visit was with a surgical or nonsurgical provider. Initial evaluation in a walk-in orthopedic clinic setting versus a conventional hand surgeon's clinic was associated with longer delay between initial evaluation and surgical treatment, but this difference may not be significant. Evaluation by a nonsu...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Fournier MN, Cline JT, Seal A, Smith RA, Throckmorton TW, Mauck BM Tags: Orthop Clin North Am Source Type: research

Global Perspectives on Management of Shoulder Instability: Decision Making and Treatment.
Abstract The glenohumeral joint is prone to instability. Patients with instability should have a physical examination. Imaging studies can provide additional information. Classification schemes that into account soft tissue pathology, neuromuscular control, bone loss, and activity level. An arthroscopic Bankart repair is the mainstay for unidirectional instability. Bone block procedures are indicated for patients with bone loss or a failed attempt at stabilization surgery. The arthroscopic Latarjet is a promising option for these patients. For patients with multidirectional instability, prolonged rehabilitation is...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Friedman LGM, Lafosse L, Garrigues GE Tags: Orthop Clin North Am Source Type: research

Obesity is Associated with an Increased Prevalence of Glenohumeral Osteoarthritis and Arthroplasty: A Cohort Study.
Abstract The relationship between obesity and glenohumeral osteoarthritis is relatively understudied. The purpose of this study was to better define this relationship by age- and gender-matching 596,874 patients across six body mass index (BMI) cohorts and determining the prevalence of glenohumeral osteoarthritis and the standardized rate of glenohumeral arthroplasty in each cohort. Individuals with a BMI over 24 were found to be at increased odds for developing glenohumeral osteoarthritis, compared to the normal BMI cohort, and individuals with a BMI over 30 were additionally found to be at increased odds for und...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Wall KC, Politzer CS, Chahla J, Garrigues GE Tags: Orthop Clin North Am Source Type: research

Elbow Hemiarthroplasty for the Treatment of Distal Humerus Fractures.
Abstract Distal humerus hemiarthroplasty is a good surgical option for nonreconstructable intraarticular distal humerus fractures in selected lower-demand patients. The lifetime activity restrictions have not been determined, but are likely less than a total elbow arthroplasty. From a technical standpoint, distal humeral prostheses should be implanted at the correct depth and rotation. The collateral ligaments, condyles, and epicondyles should be preserved and/or repaired to maintain joint stability. Short- to midterm retrospective studies have shown promising results. PMID: 32138864 [PubMed - in process] (So...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Chang N, King GJW Tags: Orthop Clin North Am Source Type: research

Orthopedic Surgical Foot Management in Hansen Disease.
Abstract Hansen disease remains a common problem worldwide with 750,000 new cases diagnosed each year. Nerve injury is a central feature of the pathogenesis because of the unique tendency of Mycobacterium leprae to invade Schwann cells and the peripheral nervous system, that can be permanent and develop into disabilities. The orthopedic surgeon has an important role in the management of neuropathy, performing surgical release of the tibial and common peroneal nerves in potentially constricting areas, thus providing a better environment for nerve function. In cases of permanent loss of nerve function with drop foot...
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Cohen JC, de Miranda ST Tags: Orthop Clin North Am Source Type: research

Brazilian Total Ankle Replacement Experience.
This article discusses the aspects of the Brazilian experience with total ankle replacement since the earliest procedures performed. PMID: 32138866 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Nery C, Lemos AVKC, Ferreira Martins CEC, Baumfeld D Tags: Orthop Clin North Am Source Type: research

Global Perspectives in Orthopedic Surgery.
PMID: 32138867 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - March 7, 2020 Category: Orthopaedics Authors: Azar FM Tags: Orthop Clin North Am Source Type: research

Safety and Cost-Effectiveness of Outpatient Unicompartmental Knee Arthroplasty in the Ambulatory Surgery Center: A Matched Cohort Study.
Abstract Using an age- and comorbidity-matched cohort, we compared patients who underwent unicompartmental knee arthroplasty in an ambulatory surgery center with those who underwent the procedure in a traditional hospital inpatient setting. Postoperatively, the ambulatory surgery center cohort had fewer major complications than the inpatient cohort. No ambulatory surgery center patients required acute hospital admission and none had major complications. Four major complications occurred in the inpatient cohort. There was no difference in complication rates. Our results suggest that outpatient unicompartmental knee...
Source: The Orthopedic Clinics of North America - November 21, 2019 Category: Orthopaedics Authors: Ford MC, Walters JD, Mulligan RP, Dabov GD, Mihalko WM, Mascioli AM, Throckmorton TW Tags: Orthop Clin North Am Source Type: research

Outcomes of Reconstruction of the Flexible Adult-acquired Flatfoot Deformity.
This article summarizes recent studies demonstrating that patients have significant improvements after operative treatment of flexible AAFD. It reviews current literature on clinical and radiographic outcomes of the MCO, LCL, and Cotton osteotomies. The authors describe how this information can be used in surgical decision making in order to tailor operative treatment to an individual patient's deformity. PMID: 31739874 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - November 21, 2019 Category: Orthopaedics Authors: Conti MS, Garfinkel JH, Ellis SJ Tags: Orthop Clin North Am Source Type: research

Peroneal Tendon Pathology: Treatment and Reconstruction of Peroneal Tears and Instability.
Abstract Peroneal tendon pathology is becoming an increasingly recognized source of lateral-sided ankle pain. High clinical suspicion, along with judicious physical examination coupled with confirmatory advanced imaging modalities, are necessary to make an accurate diagnosis and aid in guiding treatment. Peroneal pathology encompasses several distinct conditions. Peroneal tendon tears and injuries to the peroneal retinaculum must be identified to guide treatment. Patients with peroneal pathology report high levels of satisfaction after surgical management with most returning to their preinjury level of function. A...
Source: The Orthopedic Clinics of North America - November 21, 2019 Category: Orthopaedics Authors: Bahad SR, Kane JM Tags: Orthop Clin North Am Source Type: research

Open Reduction and Internal Fixation Plus Total Hip Arthroplasty for the Acute Treatment of Older Patients with Acetabular Fracture: Surgical Techniques.
This article describes the important intrinsic factors for acetabular component stability, choice of surgical approach for management of these injuries, and surgical technique for anterior and posterior approaches. PMID: 31739876 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - November 21, 2019 Category: Orthopaedics Authors: Manson TT Tags: Orthop Clin North Am Source Type: research

Acute Distal Femoral Replacement for Fractures About the Knee in the Elderly.
This article summarizes the existing literature plus the authors' personal experience with DFR use for distal femoral fractures of the native knee. PMID: 31739877 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - November 21, 2019 Category: Orthopaedics Authors: Rice OM, Springer BD, Karunakar MA Tags: Orthop Clin North Am Source Type: research

Treatment for Post-Slipped Capital Femoral Epiphysis Deformity.
Abstract In situ pinning of slipped capital femoral epiphysis (SCFE) is a safe and effective treatment modality, but often results in residual deformity leading to femoroacetabular impingement, which may limit patient activities and predispose to early onset arthritis. Enhanced understanding of the implications of femoroacetabular impingement and new surgical techniques have prompted interest in treating post-slipped capital femoral epiphysis deformity to both improve current symptoms and delay or prevent hip arthrosis. PMID: 31739878 [PubMed - in process] (Source: The Orthopedic Clinics of North America)
Source: The Orthopedic Clinics of North America - November 21, 2019 Category: Orthopaedics Authors: Allen MM, Rosenfeld SB Tags: Orthop Clin North Am Source Type: research