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Orthopedics

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https://www.readbyqxmd.com/read/28632290/a-single-incision-technique-for-distal-biceps-repair-using-a-flexible-reamer
#1
Todd P Pierce, Casey M Pierce, Kimona Issa, Vincent K McInerney, Anthony Festa, Anthony J Scillia
Distal biceps tendon ruptures are rare injuries that usually occur in middle-aged men. Most of these injuries are repaired acutely to restore preinjury function and strength. There is concern regarding the higher prevalence of certain complications with the double-incision technique. As such, the single-incision technique has also been studied to determine if it may produce superior safety and efficacy. In addition, the point of fixation may be created with either a rigid or a flexible reamer. The authors describe a technique that uses a single-incision cortical fixation achieved with a flexible reamer...
June 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28632289/novel-anterior-plating-technique-for-patella-fracture-fixation
#2
Matthew P Siljander, Alexander D Vara, Denise M Koueiter, Brett P Wiater, Patrick J Wiater
Patella fracture fixation remains a significant challenge for orthopedic surgeons. Although tension band fixation allows for reliable osseous union, especially in simple fracture patterns, it still presents several problems. Plate fixation of patella fractures is a method that allows for more rigid stabilization and earlier mobilization. At the authors' level 1 trauma center, one fellowship-trained trauma surgeon has transitioned to using a novel anterior, low-profile mesh plate construct for all types of patella fractures...
June 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28632288/all-arthroscopic-superior-shoulder-capsule-reconstruction-with-partial-rotator-cuff-repair
#3
E Grant Sutter, Jonathan A Godin, Grant E Garrigues
Massive irreparable rotator cuff tears are difficult to treat. Although several treatment options exist, none provides superior long-term results. There is no consensus on optimal surgical technique. Superior capsular reconstruction is an operative treatment option aimed at restoring native biomechanics of the glenohumeral joint by providing a restraint to superior subluxation. Partial rotator cuff repair for massive tears has also been shown to improve shoulder kinematics and can be performed in conjunction with superior capsule reconstruction...
June 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28617519/pain-and-opioid-use-after-total-shoulder-arthroplasty-with-injectable-liposomal-bupivacaine-versus-interscalene-block
#4
Marc R Angerame, John A Ruder, Susan M Odum, Nady Hamid
Postoperative pain control is a significant concern after total shoulder arthroplasty. Injectable periarticular liposomal bupivacaine, which has been found to decrease opioid use after orthopedic procedures, has been proposed as a viable alternative to regional anesthesia. This study compared the efficacy of liposomal bupivacaine vs interscalene block among patients undergoing total shoulder arthroplasty. A retrospective review was conducted of 79 patients who underwent anatomic total shoulder arthroplasty performed by a single surgeon between January 2013 and April 2015...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28617518/tibiofemoral-instability-after-primary-total-knee-arthroplasty-posterior-stabilized-implants-for-obese-patients
#5
Ata Can, Fahri Erdogan, Ayse Ovul Erdogan
Tibiofemoral instability is a common complication after total knee arthroplasty (TKA), accounting for up to 22% of all revision procedures. Instability is the second most common cause of revision in the first 5 years after primary TKA. In this study, 13 knees with tibiofemoral instability after TKA were identified among 693 consecutive primary TKA procedures. Patient demographics, body mass index, clinical symptoms, previous deformity, previous knee surgery, complications, interval between index TKA and first tibiofemoral instability, causes of instability, and interval between index TKA and revision TKA were retrospectively reviewed...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28617517/selective-fasciotomy-for-chronic-exertional-compartment-syndrome-detected-with-exercise-magnetic-resonance-imaging
#6
Sehan Park, Ho Seong Lee, Sang Gyo Seo
Chronic exertional compartment syndrome that is refractory to conservative management should be treated with surgical fasciotomy. However, owing to the limitations of intracompartmental needle manometry in reaching a definite diagnosis, the appropriate timing for fasciotomy and on which compartment remain unclear. The authors report the case of a 22-year-old male military cadet who reported pain in his left calf when running or walking for long distances. The pain was located at the lateral aspect of the calf, from the mid-calf level to the ankle...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28598494/decreased-radiation-exposure-among-orthopedic-residents-is-maintained-when-using-the-mini-c-arm-after-undergoing-radiation-safety-training
#7
David Gendelberg, William L Hennrikus, Carissa Sawyer, Douglas Armstrong, Steven King
The resident curriculum of the American Board of Orthopaedic Surgery emphasizes radiation safety. Gendelberg showed that, immediately after a program on fluoroscopic safety, residents used less radiation when using the mini C-arm to reduce pediatric fractures. The current study evaluated whether this effect lasted. Residents underwent a new annual 3-hour session on mini C-arm use and radiation. Group A included 53 reductions performed before training. Group B included 45 reductions performed immediately after training...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28598493/adult-degenerative-lumbar-scoliosis
#8
Eugene Wong, Farhaan Altaf, Lawrence J Oh, Randolph J Gray
Adult degenerative lumbar scoliosis is a 3-dimensional deformity defined as a coronal deviation of greater than 10°. It causes significant pain and disability in the elderly. With the aging of the population, the incidence of adult degenerative lumbar scoliosis will continue to increase. During the past decade, advancements in surgical techniques and instrumentation have changed the management of adult spinal deformity and led to improved long-term outcomes. In this article, the authors provide a comprehensive review of the pathophysiology, diagnosis, and management of adult degenerative lumbar scoliosis...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28598492/use-of-2-octyl-cyanoacrylate-adhesive-and-polyester-mesh-for-wound-closure-in-primary-knee-arthroplasty
#9
Andrew J Holte, Josef N Tofte, Greta J Dahlberg, Nicolas Noiseux
Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. This article reports the use of a topical self-adhering, pressure-sensitive polyester mesh combined with 2-octyl cyanoacrylate adhesive for final skin closure of primary knee arthroplasty without external staples or sutures. During a 2.5-year period, 360 consecutive primary knee arthroplasty procedures (321 total knee arthroplasty procedures and 39 partial knee arthroplasty procedures) performed by 1 surgeon at 1 institution were reviewed...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28598491/modularity-in-total-hip-arthroplasty-benefits-risks-mechanisms-diagnosis-and-management
#10
Ben M Vierra, Sarah R Blumenthal, Derek F Amanatullah
Modular implants are currently widely used in total hip arthroplasty because they give surgeons versatility during the operation, allow for easier revision surgery, and can be adjusted to better fit the anatomy of the specific patient. However, modular implants, specifically those that have metal-on-metal junctions, are susceptible to crevice and fretting corrosion. This can ultimately cause implant failure, inflammation, and adverse local tissue reaction, among other possible side effects. Surgeons should be aware of the possibility of implant corrosion and should follow a set of recommended guidelines to systematically diagnose and treat patients with corroded implants...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585999/treatment-of-a-pediatric-t-type-intercondylar-humerus-fracture-with-hybrid-percutaneous-pinning-and-external-fixation
#11
D Alex Stroh, Brian T Sullivan, Brett A Shannon, Paul D Sponseller
T-type intercondylar fractures of the distal humerus are rare injuries in skeletally immature patients. Few studies are available to guide the treatment of these injuries. Small case series and expert recommendations suggest superiority of the open approach for direct reduction of the articular surface. This approach poses risks of vascular compromise and elbow stiffness. However, success with percutaneous intercondylar screw fixation has been described for simple split patterns. The authors present a case that illustrates a novel percutaneous technique to treat this fracture type...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585998/correlation-of-the-features-of-the-lumbar-multifidus-muscle-with-facet-joint-osteoarthritis
#12
Bo Yu, Kaibiao Jiang, Xinfeng Li, Jidong Zhang, Zude Liu
Facet joint osteoarthritis is considered a consequence of the aging process; however, there is evidence that it may be associated with degenerative changes of other structures. The goal of this study was to investigate the correlation between lumbar multifidus muscle features and facet joint osteoarthritis. This retrospective study included 160 patients who had acute or chronic low back pain and were diagnosed with facet joint osteoarthritis on computed tomography scan. Morphometric parameters, including cross-sectional area, muscle-fat index, and percentage of bilateral multifidus asymmetry at L3-L4, L4-L5, and L5-S1, were evaluated with T2-weighted magnetic resonance imaging...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#13
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585996/posterior-percutaneous-endoscopic-cervical-foraminotomy-and-diskectomy-with-unilateral-biportal-endoscopy
#14
Jae Hyun Park, Su Gi Jun, Je Tae Jung, Sang Jin Lee
This report describes a new, minimally invasive procedure, posterior percutaneous endoscopic cervical diskectomy, performed with a unilateral biportal endoscopic approach. The procedure is used to treat cervical foraminal soft disk protrusion. This report also describes the short-term results with this procedure. In 2015, 14 patients underwent this new, minimally invasive procedure. The technique was applied with a standard arthroscopy device and conventional spine instruments. The Neck Disability Index and visual analog scale scores for the neck and upper arm were evaluated, and 13 consecutive patients were included in the analysis...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585995/outcomes-of-primary-total-knee-arthroplasty-in-patients-with-hematopoietic-stem-cell-transplantation
#15
Brian P Chalmers, Cameron K Ledford, Kevin I Perry, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585994/new-technique-for-removal-of-screws-with-damaged-heads
#16
Takahiro Iwata, Satoshi Nozawa, Masato Maeda, Haruhiko Akiyama
Removal of orthopedic implants may sometimes be difficult because of ongrowth of new bone. Titanium screws can become encased or stripped during the process of initial open reduction and internal fixation or at the time of hardware removal. Difficulty in removing screws from a locking plate is particularly well-known. Two patients with tibial and femoral diaphyseal fractures were treated using a locking plate or an intramedullary nail. However, after fracture healing, it was difficult to remove the locking screw or reconstruction screws because of damage to the heads...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585993/a-modified-lateral-approach-for-total-knee-replacement-in-type-2-valgus-deformity
#17
Matthias Aurich, Mark Lenz, Norman Best
Total knee replacement for patients with osteoarthritis and valgus deformity remains challenging, with soft tissue balance often difficult to achieve. Most orthopedic surgeons use the medial parapatellar approach for total knee replacement. However, the lateral approach described in this case allows direct access to the pathology. The valgus deformity is corrected by using a modified lateral parapatellar arthrotomy with a staged and gradual release of the contracted lateral capsuloligamentous structures and the iliotibial tract...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#18
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28558115/comparison-of-magnetic-resonance-imaging-and-computed-tomography-scans-of-the-glenoid-version-in-anterior-dislocation-of-the-shoulder
#19
Ümit Aygün, Turan Duran, Olcay Oktay, Hilal Sahin, Yalkin Calik
The glenoid version is an important factor in the etiology of anterior dislocation of the shoulder and the planning of shoulder surgery. Few reports compare the magnetic resonance imaging (MRI) measurements of the glenoid version with those of computed tomography (CT). This study aimed to show that it is possible to use MRI instead of CT, which is accepted as the gold standard today for the evaluation of the glenoid version. A total of 55 patients with a history of 1 nonsurgically treated unilateral anterior dislocation of the shoulder who had both MRI and CT records for the dislocated shoulders constituted the study group...
May 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28558114/three-dimensional-templating-for-acetabular-component-alignment-during-total-hip-arthroplasty
#20
Ameer M Elbuluk, Paul Wojack, Nima Eftekhary, Jonathan M Vigdorchik
Appropriate placement of the acetabular cup is an important determinant of implant stability and longevity. Malposition of acetabular cups negatively influences prosthesis survival and leads to an increased dislocation rate. The objective of the study was to determine the role of 3-dimensional templating in obtaining accurate acetabular component placement in total hip arthroplasty. In this computed tomography-based study, the authors identified 93 patients who underwent primary total hip arthroplasty with computer-assisted navigation...
May 30, 2017: Orthopedics
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