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Orthopedics

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https://www.readbyqxmd.com/read/28075438/quantitative-anatomical-differences-in-the-shoulder
#1
Usman Ali Mohammed Syed, Daniel E Davis, Jia-Wei Ko, Brian K Lee, Daniel Huttman, Adam Seidl, Carl Deirmengian, Joseph A Abboud
This study explored the radiographic and anatomical differences in normal shoulders between men and women, as well as factors such as race, height, weight, and age. A total of 205 patients with documented normal anatomical radiographs comprised the study population. Five fellowship-trained orthopedic surgeon reviewers measured head diameter, humeral head size, head to tuberosity distance, greater tuberosity width, neck-shaft angle, surface-arc angle, glenoid neck length, and distance from the lateral acromion process to the greater tuberosity on anteroposterior radiographs with the shoulder in external rotation...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28075437/comparison-of-irrigation-times-using-gravity-and-high-pressure-lavage
#2
Stefano Muscatelli, Andrea Howe, Nathan N O'Hara, Robert V O'Toole, Sheila A Sprague, Gerard P Slobogean
The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28075436/gait-kinematic-deviations-in-patients-with-developmental-dysplasia-of-the-hip-treated-with-total-hip-arthroplasty
#3
Yong Nie, Ning Ning, Fuxing Pei, Bin Shen, Zongke Zhou, Zongming Li
Comprehensive gait analysis of patients with Crowe type II and III developmental dysplasia of the hip (DDH) after successful total hip arthroplasty (THA) is lacking in the literature. This study evaluated gait function in joint kinematics after unilateral and bilateral THA in patients with DDH. In addition, the effect of high cup position on gait function was investigated. A total of 16 unilateral and 15 bilateral cementless THA patients due to DDH and 10 healthy participants comprised the study population...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28075435/cardiac-biomarkers-predict-1-year-mortality-in-elderly-patients-undergoing-hip-fracture-surgery
#4
Spyridon Katsanos, Andreas F Mavrogenis, Nikolaos Kafkas, Celestino Sardu, Vasileios Kamperidis, Panagiota Katsanou, Dimitrios Farmakis, John Parissis
This prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28056159/obturator-artery-injury-resulting-in-massive-hemorrhage-from-a-low-energy-pubic-ramus-fracture
#5
Mark K Solarz, Justin M Kistler, Saqib Rehman
Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28056158/mycobacterium-avium-complex-septic-arthritis-presenting-as-osteonecrosis-of-the-femoral-head-in-a-patient-with-systemic-lupus-erythematosus
#6
Alexander B Christ, Elena V Zininberg, Kethy M Jules-Elysee, Michael L Parks
Mycobacterium avium complex is a rare cause of musculoskeletal infection, usually occurring in patients with compromised immune systems. Obtaining the diagnosis requires a high index of suspicion, and treatment can be delayed because of difficulty with isolating the organism. Treatment involves prolonged, targeted combination antibiotic therapy, and it is unclear whether eradication of the infection can occur in the presence of a foreign body, such as antibiotic spacers. The authors report a case of M avium infection presenting as presumed osteonecrosis of the femoral head in a young woman with systemic lupus erythematosus...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28056157/evaluation-of-orthopedic-trauma-surgery-follow-up-and-impact-of-a-routine-callback-program
#7
Aaron J Casp, Jodi Wells, Russell Holzgrefe, David Weiss, David Kahler, Seth R Yarboro
A high rate of patients lost to follow-up is a common problem in orthopedic trauma surgery. This adversely affects the ability to produce accurate clinical outcomes research. The purpose of this project was to (1) evaluate the rate of loss to follow-up at an academic level I trauma center; (2) identify the patient-reported reasons for loss to follow-up; and (3) evaluate the efficacy of a routine patient callback program. All patients who underwent surgery in the orthopedic trauma division of the University of Virginia Medical Center from April 1, 2014, to September 30, 2014, and did not complete their postoperative clinic follow-up were analyzed...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28056156/deep-infections-after-syndesmotic-fixation-with-a-suture-button-device
#8
Amanda J Fantry, Seth W O'Donnell, Chris T Born, Roman A Hayda
Suture button devices such as the TightRope (Arthrex, Naples, Florida) have been increasingly used for syndesmotic fixation of ankle fractures. Despite proposed advantages, prior studies have shown equivalent outcomes, with a theoretical decreased need for removal of hardware. Complications of suture button fixation of syndesmotic instability may be underreported and include lateral suture knot inflammation with or without granuloma formation, infection, aseptic osteolysis with widening of the tibial drill tunnels, heterotopic ossification, and osteomyelitis...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28027388/spinal-anesthesia-in-elderly-patients-undergoing-lumbar-spine-surgery
#9
Noah L Lessing, Charles C Edwards, Charles H Brown, Emily C Ledford, Clayton L Dean, Charles Lin, Charles C Edwards
Spinal anesthesia is increasingly viewed as a reasonable alternative to general anesthesia for lumbar spine surgery. However, the results of spinal anesthesia in elderly patients undergoing lumbar spine decompression and combined decompression and fusion procedures are limited in the literature. The aim of this study was to report a single institution's experience using spinal anesthesia in elderly patients undergoing lumbar spine surgery. A retrospective review was conducted using a prospectively collected database of consecutive lumbar spine surgeries performed under spinal anesthesia in patients 70 years or older at a single center between December 2013 and October 2015...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28027387/impact-of-smoking-cessation-counseling-prior-to-total-joint-arthroplasty
#10
Sina Akhavan, Long-Co Nguyen, Vanessa Chan, Jamal Saleh, Kevin J Bozic
Perioperative smoking has been linked to surgical complications including poor wound healing, infection, myocardial infarction, prolonged length of stay, need for mechanical ventilation, and death. This study evaluated the effectiveness of preoperative counseling on smoking cessation for patients undergoing elective total joint arthroplasty. Thirty smokers with hip or knee osteoarthritis seeking hip or knee replacement surgery were enrolled prospectively. Interventions included counseling, referrals to smoking cessation programs including the California Smokers' Helpline and the Fontana Tobacco Treatment Program, nicotine replacement therapy (NRT), or instructing patients quit through the "cold turkey" method of abstinence...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28027386/paresis-of-the-peroneal-nerve-a-rare-but-severe-long-term-complication-of-polyethylene-wear-in-knee-arthroplasty
#11
Matthias Aurich, Mark Lenz, Norman Best
One of the most important limiting factors in the long-term success of total knee arthroplasty is polyethylene wear. Particles of the polyethylene inserts have been shown to elicit a foreign body response, which produces bone resorption and osteolysis, ultimately leading to loosening and component failure. The authors report on a case of an elderly patient who underwent a total knee arthroplasty almost 2 decades ago. Clinical and radiological checkups of the knee had not been performed recently. He now presented with a painful and swollen knee, recurrent joint effusion and swelling of the lower leg, and paresis of the peroneal nerve...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28027385/a-novel-screening-technique-for-ulnar-sided-carpometacarpal-dislocations
#12
Vishnu C Potini, Peter D Gibson, Kaicheng Wu, Kang Li, Virak Tan
Diagnosing ulnar-sided carpometacarpal joint dislocation is difficult, and more than half of injuries are missed on initial examination. The authors hypothesized that measuring the angle between the capitate and the metacarpals (capitate-metacarpal angle) on a plain radiograph would provide a simple, reliable tool to aid in the diagnosis of ulnar-sided carpometacarpal dislocation. This study retrospectively reviewed patients who underwent surgery for ulnar-sided carpometacarpal dislocation (study group). Two authors identified the contour of the capitate and the second, fourth, and fifth metacarpals on plain radiographs...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28027384/an-anatomical-study-on-the-safe-placement-of-orthopedic-hardware-for-syndesmosis-fixation
#13
Franklin D Shuler, Daniel Woods, Zach Tankersley, Clint McDaniel, Jacob Hamm, Justin Jones, James Denvir, Brian Czarkowski
Articular cartilage and bony contact at the distal tibiofibular cartilage contact zone (TFCCZ) is variable. The appropriate placement of syndesmotic hardware would benefit from a more accurate characterization of the proximal extent of the TFCCZ allowing surgeons to place hardware that simultaneously improves biomechanical stability and decreases the risk of iatrogenic cartilage damage. In addition, Ilizarov wire fixation through the distal fibula and tibia can pass through the syndesmosis recess. Anatomically defining the proximal extent of this recess can help decrease the risk of inadvertent capsular penetration...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/27992643/recall-of-the-asr-xl-head-and-hip-resurfacing-systems
#14
Werner Maurer-Ertl, Joerg Friesenbichler, Lukas A Holzer, Lukas Leitner, Kathrin Ogris, Michael Maier, Andreas Leithner
At the beginning of the 21st century, use of large-diameter, metal-on-metal devices was a popular procedure for hip replacement in young and physically active patients; however, within a few years, the number of revisions increased, resulting in a worldwide recall for the articular surface replacement (ASR) system. Complication rates for the ASR devices implanted at the authors' department are reported, with revision rates of 32% and 30% in the ASR XL Head and ASR Resurfacing groups, respectively. Reasons for revision surgery were serum metal ion elevation, luxation or subluxation, aseptic loosening, soft tissue compromise (adverse reactions to metal debris [ARMD]), and infection...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27992642/revision-total-hip-arthroplasty-using-the-cement-in-cement-technique
#15
Derek F Amanatullah, Graham D Pallante, Lorena V Floccari, George I Vasileiadis, Robert T Trousdale
The cement-in-cement technique is useful in the setting of revision total hip arthroplasty (THA), especially to gain acetabular exposure, change a damaged or loose femoral component, or change the version, offset, or length of a fixed femoral component. The goal of this retrospective study was to assess the clinical and radiographic characteristics of revision THA using the cement-in- cement technique. Between 1971 and 2013, a total of 63 revision THAs used an Omnifit (Osteonics, Mahwah, New Jersey) or Exeter (Howmedica, Mahwah, New Jersey) stem and the cement-in-cement technique at the senior author's institution...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27992641/treatment-of-single-level-cervical-spondylosis-cervical-disk-arthroplasty-versus-anterior-cervical-decompression-and-fusion
#16
Wei Tan, Chusong Zhou, Dongying Guo, Jin Sun, Wei Cao, Liu-Zhu Yang, Mingxin Wu
A meta-analysis was performed to compare cervical arthroplasty with anterior cervical diskectomy and fusion for single-level cervical spondylosis. A comprehensive search was conducted with PubMed, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 2000, to April 30, 2015. Random-effects models were used for heterogeneous data. Fixed-effects models were used for pooled nonheterogeneous data. Mean difference or standard mean difference was used for continuous outcomes, and odds ratio, risk ratio, or risk difference was used for dichotomous outcomes...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27992640/complications-associated-with-bone-morphogenetic-protein-in-the-lumbar-spine
#17
Daniel G Kang, Wellington K Hsu, Ronald A Lehman
Complications associated with the use of recombinant human bone morphogenetic protein in the lumbar spine include retrograde ejaculation, ectopic bone formation, vertebral osteolysis and subsidence, postoperative radiculitis, and hematoma and seroma. These complications are controversial and remain widely debated. This article discusses the reported complications and possible implications for the practicing spine surgeon. Understanding the complications associated with the use of recombinant human bone morphogenetic protein and the associated controversies allows for informed decision making by both the patient and the surgeon...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27992639/accuracy-of-ultrasound-guided-intra-articular-hip-injections-performed-in-the-orthopedic-clinic
#18
Todd P Balog, Blair B Rhodehouse, Eric K Turner, John M Slevin, Lisabeth A Bush, Jason A Grassbaugh, Bryant G Marchant
Intra-articular hip injections have proven clinical value for both diagnostic and therapeutic purposes. Historically, these injections have been performed by radiologists using fluoroscopic guidance. This necessitates a radiology referral, delays the injection, and represents lost productivity for the orthopedist. Ultrasound-guided intra-articular hip injections have been described in the radiology literature with excellent accuracy. These injections were performed by radiologists. The purpose of this study was to determine the accuracy of ultrasound-guided hip injections performed in the orthopedic clinic by orthopedic surgeons and orthopedic physician assistants...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27992638/medial-malleolar-fractures-and-associated-deltoid-ligament-disruptions-current-management-controversies
#19
Nicholas A Kusnezov, Emmanuel D Eisenstein, Nabih Diab, Ahmed M Thabet, Amr Abdelgawad
Operative fixation of medial malleolar fractures, whether isolated or in the setting of bi- or trimalleolar fractures, remains controversial. Increasingly, anatomic reduction and internal fixation is used to treat medial malleolar fractures to avoid long-term sequelae of symptomatic nonunion and posttraumatic osteoarthritis. However, outcomes have not been significantly different between operative and nonoperative cohorts. Repair of associated deltoid ligament disruption is not common because of reportedly poor outcomes...
December 19, 2016: Orthopedics
https://www.readbyqxmd.com/read/27977040/anterior-cervical-corpectomy-and-fusion-using-a-synthetic-hydroxyapatite-graft-for-ossification-of-the-posterior-longitudinal-ligament
#20
Toshitaka Yoshii, Takashi Hirai, Kenichiro Sakai, Shinichi Sotome, Mitsuhiro Enomoto, Tsuyoshi Yamada, Hiroyuki Inose, Tsuyoshi Kato, Shigenori Kawabata, Atsushi Okawa
The significant complication rate associated with harvesting autologous iliac bone or fibula has encouraged development of alternative graft substitutes. In this study, the authors investigated the efficacy and safety of synthetic porous hydroxyapatite (HA) combined with local vertebral bone graft for use in anterior cervical corpectomy and fusion (ACCF) for the treatment of patients with ossification of the posterior longitudinal ligament (OPLL). Since 2006, twenty-five OPLL patients underwent ACCF using HA blocks (HA group)...
December 9, 2016: Orthopedics
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