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Orthopedics

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https://www.readbyqxmd.com/read/29771399/trends-in-total-hip-arthroplasty-under-the-patient-protection-and-affordable-care-act-a-national-database-analysis-between-2008-and-2015
#1
Jennifer I Etcheson, Nicole E George, Chukwuweike U Gwam, James Nace, Alexander T Caughran, Melbin Thomas, Sana Virani, Ronald E Delanois
The Patient Protection and Affordable Care Act expanded health coverage for low-earning individuals and families. With more Americans having access to care, the use of elective procedures, such as total hip arthroplasty (THA), was expected to increase. Therefore, the aim of this study was to evaluate trends in THA before and after the initiation of the Patient Protection and Affordable Care Act regarding race, age, body mass index, and sex between 2008 and 2015. The National Surgical Quality Improvement Program database was queried for all individuals who had undergone primary THA between 2008 and 2015...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29771398/a-cadaveric-study-of-the-mean-distance-of-the-radial-artery-during-the-approach-to-the-first-carpometacarpal-joint
#2
Baris Yildirim, Daniel E Hess, Jesse B Seamon, Matthew L Lyons, A Rashard Dacus
Multiple surgical procedures have been described to treat first carpometacarpal (CMC) arthritis. Although the superiority of one procedure over the others continues to be a controversial topic, they all approach the trapezium and require careful attention to the surrounding structures. One potential complication is injury to the radial artery, which lies in close proximity to the trapezium and is often encountered during surgical approach. Using cadaveric specimens, the authors dissected to identify and isolate the radial artery as it travels in the forearm, wrist, and hand while being careful not to disturb its native course...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29771397/long-term-wear-data-from-a-prospective-multicenter-study-of-second-generation-highly-cross-linked-polyethylene-inserts-in-total-hip-arthroplasty
#3
Peter M Bonutti, J Wesley Mesko, Rama Ramakrishnan
In a prospective multicenter trial on highly cross-linked polyethylene inserts in patients undergoing total hip arthroplasty, 118 patients consented to 10-year follow-up. Medium-term follow-up results showed low wear at 5 and 7 years after surgery. The current study focuses on long-term data at 10 years. Patients were followed up by either phone or office visit to collect long-term clinical data including Harris hip score and adverse events. There were 2 deaths and 2 revisions, 1 at 6.5 years for pelvic cyst and severe pain and another at 8...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29771396/lyme-arthritis-of-the-pediatric-elbow-a-case-series
#4
David Gendelberg, William L Hennrikus
Most patients with untreated Lyme disease will experience joint symptoms. Owing to their resemblance in clinical presentation, Lyme arthritis and septic arthritis are often difficult to differentiate. However, their treatment is different. The elbow is rarely the first joint to present with symptoms. Therefore, Lyme disease is not commonly included in the differential diagnosis for children presenting with isolated elbow pain. The authors report 4 cases of monoarticular Lyme arthritis presenting in the elbow...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29771395/glucosamine-and-chondroitin-sulfate-what-has-been-learned-since-the-glucosamine-chondroitin-arthritis-intervention-trial
#5
Nicholas DiNubile
Glucosamine and chondroitin sulfate, alone or in combination, are used worldwide by individuals suffering from osteoarthritis pain. They are by prescription in some countries but are available as over-the-counter dietary supplements in other countries, such as the United States. The inconclusive results of the National Institutes of Health-sponsored Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) did little to clarify the efficacy of these agents. However, some newer studies have provided a better perspective on the potential benefits that they can offer...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29771394/the-effect-of-intraoperative-hypothermia-on-shoulder-arthroplasty
#6
Toufic R Jildeh, Kelechi R Okoroha, Nathan E Marshall, Chad Amato, Hunter Trafton, Stephanie J Muh, Patricia Kolowich
Limited evidence is available regarding the correlation between intraoperative hypothermia and perioperative complications in shoulder arthroplasty. The purpose of this study was to determine the incidence of intraoperative hypothermia in patients treated with shoulder arthroplasty and its effect on perioperative complications. A retrospective chart review was performed on 657 consecutive patients who underwent shoulder arthroplasty at a single institution between August 2013 and June 2016. Demographic data, surgery-specific data, postoperative complications, length of stay, and 30-day read-mission were recorded...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29738601/the-meniscal-comma-sign-characterization-and-treatment-of-a-displaced-fragment-in-the-meniscotibial-recess
#7
Hytham S Salem, Aaron H Carter, Weilong J Shi, Fotios P Tjoumakaris, Steven B Cohen, Adam C Zoga, Kevin B Freedman
Displaced parrot beak flap tears in the meniscotibial recess are complex tears of the meniscus that begin as central radial tears and progressively extend toward the periphery, creating a detached fragment. These tears have not been described in the literature, but the authors have described them as the "meniscal comma sign" based on their appearance on magnetic resonance imaging. Displaced fragments are clinically significant because of the pain and mechanical symptoms they can cause as a result of tenting of the deep medial collateral ligament...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29738600/adapter-sleeves-are-not-needed-to-reduce-the-risk-of-fracture-of-a-new-ceramic-head-implanted-on-a-well-fixed-stem
#8
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The purpose of this study was to assess (1) the prevalence of the fracture of ceramic heads implanted on used trunnions of well-fixed stems without using a titanium adapter sleeve; (2) the prevalence of trunnionosis secondary to fretting and/or corrosion at the trunnion of the well-fixed stem; and (3) clinical and radiographic results and the survival rate of the revised acetabular components. Eighty-eight patients (100 hips) underwent isolated revision of the acetabular components for polyethylene wear and osteolysis of the acetabulum...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29738599/unanticipated-admission-following-outpatient-rotator-cuff-repair-an-analysis-of-18-061-cases
#9
Joseph A Gil, Wesley M Durand, Joey P Johnson, Avi D Goodman, Brett D Owens, Alan H Daniels
The objective of this investigation was to examine the characteristics that place patients at risk for unanticipated inpatient admission after outpatient arthroscopic rotator cuff repair. This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program data sets from years 2012 to 2015. Patients were included in the study based on the presence of a primary Current Procedural Terminology code for rotator cuff repair (23410, 23412, 23420, and 29827). Only outpatient, nonemergent, and elective procedures performed on patients with American Society of Anesthesiologists classification of 4 or less were considered...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29738598/epidemiology-workload-and-performance-of-major-league-baseball-pitchers-placed-on-the-disabled-list
#10
Nathan E Marshall, Toufic R Jildeh, Kelechi R Okoroha, Ankur Patel, Vasilios Moutzouros, Eric C Makhni
There is limited information on the effect of pitcher workload, pitch type, and performance of Major League Baseball pitchers placed on the disabled list (DL). This study evaluated demographic, performance, workload, and injury data of 330 Major League Baseball pitchers with 454 injuries who were placed on the DL during the 2014 and 2015 seasons. Upper extremity, lower extremity, core, hip/groin, and other injuries were analyzed, and injury year data were compared with career data as well as against other injury groups...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29738597/fall-risk-assessment-metrics-for-elderly-patients-with-hip-fractures
#11
Christos Th Vottis, Evanthia Mitsiokapa, Vasilios G Igoumenou, Panayiotis D Megaloikonomos, Ioannis P Galanopoulos, George Georgoudis, Panayiotis Koulouvaris, Panayiotis J Papagelopoulos, Andreas F Mavrogenis
The most common surgery performed by orthopedic surgeons likely involves that for hip fractures. The incidence of hip fractures is anticipated to rise in the coming decades. Hip fractures most commonly occur in elderly women with osteoporosis after a fall from standing position. In an effort to reduce the incidence, improve the postoperative care, and accelerate the rehabilitation of hip fractures, it is important to evaluate the fall risk of these patients, as it is an objective indication of their level of physical activity...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29738596/relatively-high-complication-and-revision-rates-of-the-mayo-%C3%A2-metaphysical-conservative-femoral-stem-in-young-patients
#12
Tal Frenkel Rutenberg, Yaniv Warshevski, Aviram Gold, Nadav Shasha, Nimrod Snir, Ofir Chechik, Oleg Dolkart, Dynai Eilig, Amir Herman, Ehud Rath, Moti Kramer, Michael Drexler
The Mayo metaphysical conservative femoral stem (Zimmer, Warsaw, Indiana) is a wedge-shaped implant designed to transfer loads proximally, reduce femoral destruction, and enable the preservation of bone stock in the proximal femur. Thus, it is a potentially preferred prosthesis for active, non-elderly patients who may require additional future surgeries. This retrospective case study analyzed the outcomes of consecutive patients who underwent total hip replacements with this stem between May 2001 and February 2013...
May 8, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708573/medial-compartment-decompression-by-proximal-fibular-osteotomy-a-biomechanical-cadaver-study
#13
Todd Baldini, Jesse Roberts, Jiandong Hao, Kenneth Hunt, Michael Dayton, Craig Hogan
Medial compartment knee osteoarthritis is a painful and debilitating disease. A proximal fibular osteotomy is a novel, simple surgical technique that may reduce pain and improve function for patients with osteoarthritis. The purpose of this biomechanical cadaver study was to determine what effect proximal fibular osteotomy had on knee joint and ankle pressures and tibia strain. Ten matched pairs of cadaver legs were tested in compression to 1.1 times body weight comparing intact and with proximal fibular osteotomy at 0°, 15°, and 30° of flexion...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708572/relationship-between-foraminal-area-and-degenerative-changes-in-the-lower-cervical-spine-with-implications-for-c5-nerve-root-palsy
#14
Matthew V Abola, Derrick M Knapik, Anahid A Hamparsumian, Randall E Marcus, Raymond W Liu, Zachary L Gordon
Preoperative foraminal stenosis at C4/5 is a predisposing risk factor for C5 nerve root palsy in elderly patients. However, the area of the C4/5 intervertebral foramen and its relationship to the extent of arthrosis and lower foraminal areas (C5/6 and C6/7) are unknown. The authors sought to compare the areas of the cervical intervertebral foramen at the C4/5, C5/6, and C6/7 levels, noting any differences across race or sex and the relationship between foraminal area and arthrosis grade. A total of 600 cervical foramina from an osseous collection were examined...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708571/reliability-of-the-anterior-humeral-line-index-compared-with-the-gartland-classification-for-posteriorly-hinged-supracondylar-humerus-fractures
#15
Margaret Siobhan Murphy-Zane, Laura Pyle
The Gartland classification of pediatric supracondylar humerus (SCH) fractures is commonly used but inconsistently defined regarding type 1 and type 2 (posteriorly hinged) SCH fractures. This study examined the reliability of the anterior humeral line (AHL) index compared with the Gartland classification. Fifty consecutive SCH fractures on anteroposterior and lateral elbow radiographs in pediatric patients (age range, 18 months to 15 years) were classified by 11 observers (9 attendings and 2 residents) according to the Gartland classification (types 1, 2, and 3) and the AHL index (AHL0, AHL passes anterior to the capitellum; AHL1, anterior one-third capitellum; and AHL2, middle one-third capitellum), with recommendations for treatment (cast immobilization vs surgery)...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708570/longer-operative-time-is-associated-with-increased-adverse-events-after-anterior-cervical-diskectomy-and-fusion-15-minute-intervals-matter
#16
Nathaniel T Ondeck, Daniel D Bohl, Ryan P McLynn, Jonathan J Cui, Patawut Bovonratwet, Kern Singh, Jonathan N Grauer
Little is known about the impact of operative time, as an independent and interval variable, on general health perioperative outcomes following anterior cervical diskectomy and fusion. Therefore, patients undergoing a 1-level anterior cervical diskectomy and fusion were identified in the American College of Surgeons National Surgical Quality Improvement Program. Operative time (as an interval variable) was tested for association with perioperative outcomes using a multivariate regression that was adjusted for differences in baseline characteristics...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708569/performance-based-outcomes-following-lisfranc-injury-among-professional-american-football-and-rugby-athletes
#17
Sameer K Singh, Andrew George, Anish R Kadakia, Wellington K Hsu
Professional National Football League (NFL) and rugby athletes have high rates of Lisfranc injuries. Although favorable return-to-play rates have been previously reported, a thorough assessment of postinjury performance is lacking. Professional NFL and rugby athletes who sustained a Lisfranc injury were identified using a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were determined for each athlete. League participation and game performance were collected 1 season prior to injury and up to 3 seasons after injury...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#18
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708567/relationship-of-blood-metal-ion-levels-and-leukocyte-profiles-in-patients-with-articular-surface-replacement-metal-on-metal-hip-replacement
#19
David C Markel, Christopher Bergum, Jeffrey Flynn, Nancy Jackson, Therese Bou-Akl, Weiping Ren
The purpose of this study was to compare blood leukocyte profiles and metal ion concentrations between hip resurfacing arthroplasty (articular surface replacement) patients with and without revision. A total of 25 articular surface replacement patients were recruited (10 with stable implants and 15 undergoing revision). Blood concentrations of chromium (Cr) and cobalt (Co) were measured. Flow cytometry was used to quantify the subpopulations of leukocytes, including CD14+ monocytes, CD16+ monocytes, CD3+ T-lymphocytes, CD19+ B-lymphocytes, CD4+ helper T-cells, and CD45+ RA memory vs naïve T-cells...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29708566/clinical-performance-of-ultra-short-anatomic-cementless-versus-fourth-generation-cemented-femoral-stems-for-hip-replacement-in-octogenarians
#20
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The aim of this study was to determine how ultra-short anatomic cementless vs cemented femoral stems affect the survival of primary total hip arthroplasties in octogenarians. Specifically, the authors investigated whether ultra-short anatomic cementless and cemented femoral components would have similar (1) functional results, (2) radiographic results, (3) revision and survival rates, and (4) complication rates in octogenarians. The authors evaluated 93 consecutive octogenarians (98 hips) in the ultra-short stem group (mean age, 86...
April 27, 2018: Orthopedics
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