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Orthopedics

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https://www.readbyqxmd.com/read/29136258/ultra-short-versus-conventional-uncemented-stems-for-hip-replacement-in-octogenarians
#1
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The aim of this study was to determine how an ultra-short anatomic uncemented stem vs a diaphyseal filling five-eighths porous coated uncemented femoral stem (conventional stem) affects the survival of primary total hip arthroplasties in octogenarians. The current study consisted of 52 patients (55 hips) in the ultra-short stem group (mean age, 85.5±5.3 years) and 61 patients (72 hips) in the diaphyseal (conventional) stem group (mean age, 84.1±4.8 years). The predominant diagnosis was osteoarthritis, followed by osteonecrosis of the femoral head, in both groups...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136257/risk-factors-for-pathological-fracture-and-metastatic-epidural-spinal-cord-compression-in-patients-with-spinal-metastases
#2
Catherine S Hibberd, Gerald M Y Quan
Vertebral pathological fracture and metastatic epidural spinal cord compression (MESCC) due to metastatic cancer inevitably cause pain, neurological deficit, impaired function, and decreased quality of life and are indications for surgery. In such cases, earlier surgical intervention has the potential to prevent permanent neurological deficit and disability and to maintain function and quality of life. Therefore, the aim of this study was to identify and evaluate risk factors for pathological fracture and MESCC in patients with spinal metastases...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136256/incidence-of-and-risk-factors-for-inpatient-stroke-after-hip-fractures-in-the-elderly
#3
Andre M Samuel, Pablo J Diaz-Collado, Lauren K Szolomayer, Stephen J Nelson, Matthew L Webb, Adam M Lukasiewicz, Jonathan N Grauer
Although uncommon, stroke can be a catastrophic inpatient complication for patients with hip fractures. The current study determines the incidence of inpatient stroke after hip fractures in elderly patients, identifies risk factors associated with such strokes, and determines the association of stroke with short-term inpatient outcomes. A retrospective review of all patients aged 65 years or older with isolated hip fractures in the 2011 and 2012 National Trauma Data Bank was conducted. A total of 37,584 patients met inclusion criteria...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136255/loss-of-internal-tibial-rotation-after-anterior-cruciate-ligament-reconstruction
#4
Shawn R Brandenburg, Thomas M Matelic
The flexion angle of the knee and the position of the tibia need to be considered during tensioning of the anterior cruciate ligament (ACL) graft to avoid overconstraining the knee. The purpose of this report was to describe 2 cases of loss of tibial internal rotation after single-bundle anatomic ACL reconstruction with graft tensioning in flexion. Retrospective review of each patient's operative chart revealed that the graft was tensioned in flexion and placed in an anatomic position in the femoral tunnel at the time of the index operation...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136254/completion-of-multiple-fellowships-by-orthopedic-surgeons-analysis-of-the-american-board-of-orthopaedic-surgery-certification-database
#5
J Mason DePasse, Alan H Daniels, Wesley Durand, Brandon Kingrey, John Prodromo, Mary K Mulcahey
Orthopedic surgeons have become increasingly subspecialized, and recent studies have shown that American Board of Orthopaedic Surgery (ABOS) Step II applicants are performing a higher percentage of their cases within their chosen subspecialties. However, these studies focused exclusively on surgeons who have completed a single fellowship; little data exist on those who pursue a second fellowship. All applicants to the ABOS Part II examination from 2004 to 2016 were classified by their self-reported fellowship training history using the ABOS Part II examination database...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136253/fatty-degeneration-of-the-rotator-cuff-reflects-shoulder-strength-deficits-in-patients-with-rotator-cuff-tears
#6
Jong Pil Yoon, Jae Wook Jung, Chang Hwa Lee, Young Gun Kim, Seok Won Chung, Joon Yub Kim, Hyun Joo Lee, Jee Wook Yoon, Hoseok Lee
Fatty degeneration is an important clinical factor in patients with rotator cuff tears. Goutallier grade, occupation ratio, and tangent sign help identify fatty degeneration; however, little is known about how closely these measurement techniques correlate with actual muscle strength deficits. The authors evaluated each method's ability to determine the correlation between fatty degeneration and muscle strength deficits. The authors included 203 patients who underwent full-thickness rotator cuff repair (mean age, 61...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29120008/three-year-outcomes-of-a-highly-porous-acetabular-shell-in-primary-total-hip-arthroplasty
#7
Nipun Sodhi, Timothy Izant, John Diana, Daniel Del Gaizo, Michael Baratz, Alana Levine, Danielle Campbell, Steven F Harwin, Michael A Mont
This multicenter study evaluated survivorship, functional outcomes, complications, and radiographic outcomes for patients who underwent total hip arthroplasty using a newly developed highly porous 3-dimensional titanium implant. Excellent aseptic (99.6%) and all-cause (98%) survivorship and functional outcomes were found at 3-year follow-up. This highly porous acetabular shell holds promise in total hip arthroplasty. [Orthopedics. 201x; xx(x):xx-xx.].
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29120007/incidence-of-heterotopic-ossification-following-a-multimodal-pain-protocol-in-total-hip-arthroplasty-with-the-posterior-approach
#8
Peter B White, Prem N Ramkumar, Morteza Meftah, Narges Ghazi, Amar S Ranawat, Chitranjan S Ranawat
Heterotopic ossification (HO) is prevalent after total hip arthroplasty (THA). Oral nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 (COX-2) inhibitors have reduced the incidence of HO; however, to the authors' knowledge, no studies have reported the incidence and severity of HO with a pain protocol highlighted by celecoxib in the pre- and postoperative period with a posterolateral approach. Between October 2014 and October 2015, a retrospective study was conducted of 687 consecutive primary THAs with minimum 1-year follow-up performed between January 2009 and December 2013...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29120006/manufactured-brace-modalities-for-elbow-stiffness
#9
Nipun Sodhi, Anton Khlopas, Michael D Vaughn, Jaiben George, George Yakubek, Assem A Sultan, Steven F Harwin, Michael A Mont
Multiple surgical and nonsurgical treatment options exist for patients with elbow stiffness. Many nonsurgical mobilization bracing options have been implemented to increase elbow range of motion. Three of the main bracing options for these patients are turnbuckle, static progressive stretch, and dynamic bracing. The purpose of this study was to review the current literature on turnbuckle, static progressive stretch, and dynamic bracing to provide information for practitioners and patients regarding which brace is more appropriate to use for elbow stiffness...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29120005/peripheral-neuropathy-due-to-recreational-use-of-nitrous-oxide-presenting-after-an-ankle-sprain-with-foot-drop
#10
Jackson A Middleton, John A Roffers
A 22-year-old man was referred for orthopedic follow-up after an ankle injury. Initial evaluation in urgent care included radiographs with negative findings. After a delayed presentation, a course of functional treatment was recommended. Subsequently, he developed a deep venous thrombosis and pulmonary emboli. He was found to be factor V Leiden deficient and was fully anticoagulated on warfarin. Later reevaluation revealed a steppage gait and foot drop. Electrodiagnostic studies (ie, electromyography and nerve conduction studies) revealed a severe peripheral polyneuropathy...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29120004/nerve-traction-injury-after-subacute-revision-external-fixation-of-a-tibial-plateau-fracture
#11
Lauren E Wessel, Alexander B Christ, David Helfet, David S Wellman
Nerve traction injuries are common clinical entities that can be confused with nerve palsies secondary to alternate etiologies. Common mechanisms of nerve injury include direct laceration, crush injury, compression injury, elevated compartment pressures, or traction injury. Traction injuries commonly occur after trauma or aberrant patient positioning; however, traction injury following external fixation for lower extremity injury is rare. This case report describes a 42-year-old man who initially sustained a Schatzker VI tibial plateau fracture that required revision of external fixation for pin-site infection as soft tissues recovered from the initial trauma...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29120003/a-novel-method-of-patient-positioning-using-shoulder-arthroscopy-equipment-for-elbow-arthroscopy
#12
Julianne M Kowalski, James T Monica
Indications for elbow arthroscopy are expanding; however, it is uncommon compared with shoulder arthroscopy. Elbow arthroscopy can be complicated by positioning, including the need to obtain specific arm holders required by most operating rooms. Surgery can be performed in the supine, prone, or lateral position. Arm traction allows for distraction of the joint space, full insufflation, and therefore visualization of intra-articular anatomy. This article outlines a new technique using previously available shoulder arthroscopy equipment to avoid increased cost incurred by procuring new, elbow-specific equipment...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29058759/implant-failure-rates-and-cost-analysis-of-contoured-locking-versus-conventional-plate-fixation-of-distal-fibula-fractures
#13
Lewis K Moss, Michael H Kim-Orden, Robert Ravinsky, Christopher M Hoshino, Daniel M Zinar, Stuart M Gold
The authors analyzed 330 consecutive Weber B distal fibula fractures that occurred during a 3-year period and were treated with either a contoured locking plate or a conventional one-third tubular plate to compare the cost and failure rates of the 2 constructs. The primary outcomes were failure of the distal fibular implant and loss of reduction. Secondary outcomes were surgical wound infection requiring surgical debridement and/or removal of the fibular implant, and removal of the fibular plate for persistent implant-related symptoms...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29058758/features-of-921-patients-with-spinal-tuberculosis-a-16-year-investigation-of-a-general-hospital-in-southwest-china
#14
Yuan Yao, Weilin Song, Kuiyou Wang, Bingtao Ma, Huan Liu, Wenjie Zheng, Yu Tang, Yue Zhou
Southwest China has a high burden of spinal tuberculosis (TB). Few large case studies of spinal TB in southwest China have been conducted. This study investigated the features of 921 patients who were treated for spinal TB at a general hospital in southwest China between 2001 and 2016. Demographic data, clinical data, laboratory data, imaging findings, treatment methods, and outcomes of patients who were admitted to the hospital for spinal TB were reviewed retrospectively. The annual incidence of spinal TB increased throughout the study period...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29058755/functional-outcomes-for-nonoperatively-treated-proximal-fifth-metatarsal-fractures
#15
Hannah A Dineen, Timothy D Murphy, Sabrina Mangat, Eric Z Lukosius, Feng-Chang Lin, Brett J Pettett, Stephen J Peoples, Shepard R Hurwitz
Fractures of the proximal fifth metatarsal are relatively common and can be treated with a variety of treatment modalities. The goals of the current study were to answer the following questions: (1) Is there a difference in functional outcomes with different nonoperative treatment modalities for avulsion and Jones fractures? (2) What is the long-term functional impairment? This study included 53 patients who were treated for proximal fifth metatarsal fracture at 1 university health care system between 2004 and 2013...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29058754/partial-resurfacing-for-humeral-head-defects-associated-with-recurrent-shoulder-instability
#16
Matthew C Bessette, Nicholas C Frisch, Pradeep Kodali, Morgan H Jones, Anthony Miniaci
Recurrent traumatic shoulder instability is a complex clinical entity that commonly affects young, active patients. Humeral head defects are frequently associated with this condition, but specific treatment to stabilize the shoulder is rarely needed. Management options for defects of the humeral head that do necessitate treatment carry various risks and disadvantages, including the need for bone or soft tissue healing, complications related to hardware, and loss of motion. Partial prosthetic resurfacing has been reported as a treatment option...
October 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28968480/topically-applied-epsilon-aminocaproic-acid-reduces-blood-loss-and-length-of-hospital-stay-after-total-knee-arthroplasty
#17
Robert A Harper, Mark G Sucher, Mauro Giordani, Alexander J Nedopil
Perioperative blood loss after total knee arthroplasty (TKA) affects postoperative recovery. Tranexamic acid is safe and efficient in reducing blood loss without increasing thromboembolic events. Epsilon-aminocaproic acid (ε-ACA) is less expensive than and as safe as tranexamic acid. Its efficiency when locally applied in TKA is unknown. The authors retrospectively followed 240 consecutive patients treated by 1 surgeon with TKA from January 2012 to August 2016. From January 2013 to May 2015, the authors topically applied 5 g of ε-ACA to the open wound after tourniquet release and before closure (ε-ACA-after-tourniquet-release group)...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28968479/biceps-tenodesis-biomechanical-assessment-of-3-arthroscopic-suprapectoral-techniques
#18
George Vestermark, David Hartigan, Dana Piasecki, James Fleischli, Susan M Odum, Nigel Zheng, Donald F D'Alessandro
Biceps tenodesis maintains the cosmetic appearance and length-tension relationship of the biceps with an associated predictable clinical outcome compared with tenotomy. Arthroscopic suprapectoral techniques are being developed to avoid the disadvantages of the open subpectoral approach. This study biomechanically compared 3 arthroscopic suprapectoral biceps tenodesis techniques performed with a suture anchor with lasso loop technique, an interference screw, and a compressive rivet. For a total of 15 randomized paired tests, 15 pairs of human cadaveric shoulders were used to test 1 technique vs another 5 times with 3 customized setups...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28968478/the-direct-anterior-approach-does-not-increase-return-to-function-following-hemiarthroplasty-for-femoral-neck-fracture
#19
Victor R Carlson, Alvin C Ong, Fabio R Orozco, Rex W Lutz, Andres F Duque, Zachary D Post
The purpose of this study was to evaluate functional outcomes for hemiarthroplasty using a direct anterior approach or a direct lateral approach for femoral neck fracture. This retrospective review used data collected from a single institution between 2006 and 2016. Eighty-five and 75 consecutive patients who underwent hemiarthroplasty via a direct anterior approach and a direct lateral approach, respectively, met inclusion criteria. All patients with femoral neck fractures were treated by 1 of 2 fellowship-trained orthopedic surgeons using the direct anterior approach or the direct lateral approach to hemiarthroplasty...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28968477/retrospective-analysis-of-20-patients-with-schwannomas-magnetic-resonance-imaging-characteristics-pain-and-outcomes-following-excision
#20
Jette Hooper, Ian T O'Connor, Ivan J Golub, Alexander P Decilveo, James C Wittig
A Tinel's sign, a percussion-induced, painful sensation, has been reported as the most useful sign for diagnosing a schwannoma. On magnetic resonance imaging, schwannomas often exhibit a split fat sign and a target sign. The typical treatment for schwannomas is surgical excision; however, excision often results in high rates of neurological deficit. The authors retrospectively reviewed 20 patients who underwent excision of a schwannoma from 2007 to 2015. Twenty patients presented with a split fat sign and 12 patients presented with a Tinel's sign on magnetic resonance imaging...
October 2, 2017: Orthopedics
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