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Brandon D Frye, Paul Hannon, Brandon G Santoni, Jason A Nydick
The purpose of this study was to determine if clinical differences exist between closed drainage use in primary shoulder arthroplasty and postoperative complications. A retrospective review was performed of all primary total shoulder and reverse total shoulder arthroplasty procedures at the authors' institution during a 2-year period. A total of 378 of 636 shoulder arthroplasty patients met inclusion criteria. Drains were used in 111 patients. The authors did not identify a significant relationship between drain use and postoperative complications...
November 7, 2018: Orthopedics
William Arroyo, Jennifer Misenhimer, Eric J Cotter, Kevin C Wang, Kenneth Heida, Mark P Pallis, Brian R Waterman
This study evaluated the role of anchor position in persistence of pain and/or revision biceps tenodesis after arthroscopic repair of type II superior labrum anterior and posterior (SLAP) lesions and assessed for patient- and injury-specific variables influencing clinical outcomes. Active-duty service members who underwent arthroscopic repair of type II SLAP lesions between March 1, 2007, and January 23, 2012, were identified. Patients with less than 2-year clinical follow-up; type I, III, and IV SLAP lesions; and primary treatment with biceps tenodesis and/or rotator cuff repair at the time of index surgery were excluded...
November 7, 2018: Orthopedics
Robert C Vercio, Troy G Shields, Lee M Zuckerman
Traditionally, intercalary allograft reconstruction after tumor resection has had a high rate of complications, particularly nonunion. Plate and intramedullary nail fixation have been used alone and in combination to improve union rates. This study sought to evaluate a new technique that uses a magnetic growing intramedullary nail to compress the osteotomy sites to aid in healing and to answer 2 questions: (1) What is the union rate and the time to union when using magnetic growing intramedullary nails? (2) What complications occur with this technique? Eight patients with 15 osteotomy sites with a minimum follow-up of 14 months were retrospectively reviewed...
November 7, 2018: Orthopedics
Yingchao Yin, Ruipeng Zhang, Shilun Li, Ke Su, Zhiyong Hou, Yingze Zhang
The aim of this systematic review was to investigate the incidence of complications of the internal fixator in the treatment of anterior pelvic ring injury. The literature was comprehensively searched from 1980 to January 2017 to identify potential studies. Six studies involving 272 cases of anterior pelvic ring injury treated with the internal fixator were included in this meta-analysis. The rates of wound infection, heterotopic ossification, nerve paresthesia, pain, and fracture dislocation were 5.7%, 35...
November 7, 2018: Orthopedics
Avi D Goodman, Andrew P Harris, Joseph A Gil, Joseph Park, Jeremy Raducha, Christopher J Got
Lunate and perilunate dislocations are potentially devastating injuries that are often unrecognized at initial evaluation. Prompt recognition and treatment is necessary to prevent adverse sequelae, including median nerve dysfunction, carpal instability, posttraumatic arthritis, reduced functionality, and avascular necrosis. In patients who are surgical candidates, operative intervention is warranted to restore carpal kinematics and provide optimal outcomes. [Orthopedics. 201x; xx(x):xx-xx.].
November 7, 2018: Orthopedics
Mandeep S Virk, Robert J Thorsness, Justin W Griffin, Jae Kim, Saleh Aiyash, Marissa Malaret, Anthony A Romeo
The purpose of this study was to evaluate the short-term clinical and radiographic outcomes of humeral hemiarthroplasty and concentric glenoid reaming ("ream and run" procedure) and to compare the outcomes with those of total shoulder arthroplasty (TSA) for glenohumeral arthritis. Patients with glenohumeral arthritis who underwent the ream and run procedure with a minimum follow-up of 2 years were retrospectively reviewed. The primary outcome was revision to TSA. Secondary outcome measures included functional outcome scores, range of motion, and radiographic assessment...
October 26, 2018: Orthopedics
Seung-Han Shin, Yong-Suk Lee, Il-Jung Park, Yang-Guk Chung, Seok-Whan Song, Hyoung-Min Kim, Jae-Young Lee
Among surgical methods for advanced trapeziometacarpal arthrosis, arthrodesis may benefit high-demand patients such as laborers because it preserves the osseous foundation of the thumb. The authors achieved successful trapeziometacarpal arthrodesis in 3 patients by a combination of chevron osteotomy, longitudinal K-wire, and K-wire compression staples without using bone graft. There were no complications specifically associated with the surgery other than asymptomatic slight pull-out of a staple. This combination is a good option for trapeziometacarpal arthrodesis, having the advantages of using a small incision and common devices and being low cost...
October 26, 2018: Orthopedics
Cheol Lee, Juhwan Lee, Gilho Lee, Hayeong Lee, Eunnim Koh, Jihyo Hwang
Pregabalin and dexmedetomidine have been introduced to manage postoperative pain. This study evaluated the effect of the 2 drugs combined on pain in patients undergoing total knee or hip arthroplasty. A total of 124 patients undergoing total knee or hip arthroplasty under spinal anesthesia were randomly assigned to either group C (n=31, placebo), group P (n=33, pregabalin), group PD (n=29, pregabalin and dexmedetomidine), or group D (n=31, dexmedetomidine). One hour before spinal anesthesia, patients received 150 mg of pregabalin or placebo orally, and a bolus dose of 0...
October 26, 2018: Orthopedics
Kevin H Kim, Mitchell K Long, Richard McCormack, Charles Ruotolo
The purpose of this study was to compare the location of the suture breakage between tying by hand vs with a safety clamp, needle driver. FiberWire No. 2 and 2-0 (Arthrex, Naples, Florida) were fastened onto the hook attachment of the digital force gauge. Sutures were placed under excessive strain using a hand tying technique vs a safety clamp, or instrument tying. Peak forces at which the sutures failed under tension along with locations of the suture breakage, measured from the site of the knot, were recorded...
October 26, 2018: Orthopedics
Madelyn F Lauer, Emily N Boschert, Jonathan R Dubin, Mark Bernhardt
The authors present a case of bilateral femoral emphysematous osteomyelitis caused by Escherichia coli in a 60-year-old woman with rheumatoid arthritis who was receiving long-term prednisone therapy. The infection in both femoral shafts was eradicated with surgical debridement, followed by insertion of intramedullary rods composed of culture-specific antibiotic cement into the femoral canals in conjunction with 6 weeks of intravenous antibiotics. The rods were subsequently removed, and no signs of further osteomyelitis were recognized at follow-up...
October 26, 2018: Orthopedics
Chih-Hsiang Chang, Chih-Chien Hu, Chun-Chieh Chen, John Mahajan, Yuhan Chang, Hsin-Nung Shih, Young-Min Kwon
There are several surgical options for addressing Paprosky type III acetabular defects during revision total hip arthroplasty. In physiologically young and active patients, using structural bone graft to restore bone defects and provide adequate initial support for the revision acetabular component is one such option. This study reports the mid-term results of using a structural allograft accompanied by a trabecular metal-coated hemispherical cup for Paprosky type III defects. A retrospective analysis was performed of the data collected for 20 consecutive hips in 20 patients (mean age, 56...
October 26, 2018: Orthopedics
Iqbal Multani, Patricia Schneider, Hassan Baldawi, Benjamin Deheshi, Michelle Ghert
The surgical management of benign and benign aggressive bone tumors typically involves intralesional curettage and reconstruction of the resulting defect with cement or bone graft material. At the authors' institution, an injectable synthetic calcium sulfate-calcium phosphate composite is now the standard graft material for these cases. This study reports the long-term follow-up, specifically the stability of bone regeneration, for the use of the synthetic graft material for oncologic reconstruction. Fourteen patients who underwent intralesional curettage of a primary bone tumor followed by cavitary reconstruction with synthetic graft material who had at least 4-year follow-up were identified from an institutional orthopedic oncology database...
October 26, 2018: Orthopedics
Motoya Kobayashi, Satoshi Kato, Hideki Murakami, Satoru Demura, Katsuhito Yoshioka, Noritaka Yonezawa, Naoki Takahashi, Takaki Shimizu, Hiroyuki Tsuchiya
Tumor excision surgeries of the spine present a distinct challenge regarding the maintenance of spinal cord blood supply because they often require preoperative embolization of segmental arteries, ligation of the corresponding nerve roots, and circumferential exposure of the dural sac. The authors present a case of delayed-onset spinal cord infarction after repeated tumor excision surgeries of the thoracic spine. A 49-year-old man had undergone a left nephrectomy for renal cell carcinoma, 2 pulmonary metastasectomies, and excision of a left sixth rib metastasis before referral to the authors' institution...
October 26, 2018: Orthopedics
Olga D Savvidou, Frantzeska Zampeli, George Georgopoulos, Leonidas Dimopoulos, Thekla Antoniadou, Ioannis Papanastassiou, Panayiotis J Papagelopoulos
Malignant tumors of the scapula are rare, and limb salvage surgery after tumor resection is challenging. The authors present a series of 6 patients who were treated by total scapulectomy and reconstruction with a custom-made scapular prosthesis and a constrained reverse shoulder arthroplasty. Postoperative oncologic and functional outcomes were assessed. The mean follow-up was 37 months (range, 9-84 months). Clear surgical margins were achieved in all patients. At the last follow-up, 4 patients showed no evidence of disease and 2 had died of systemic metastatic disease...
October 26, 2018: Orthopedics
Andrew J Curley, Elizabeth B Terhune, Anthony T Velott, Evan H Argintar
Negative pressure wound therapy is becoming more commonly used to prevent wound complications in joint arthroplasty, although few studies have assessed its outcomes compared with those of a traditional dry sterile dressing. This retrospective study assessed complications that required return to the operating room in a cohort of patients who received a dry sterile dressing (n=159) vs negative pressure wound therapy (n=32). There were significantly more overall complications (P=.0293) in the dry sterile dressing group (23...
October 15, 2018: Orthopedics
Andrea Sambri, Alessandra Maso, Elisa Storni, Panayiotis D Megaloikonomos, Vasilios G Igoumenou, Costantino Errani, Andreas F Mavrogenis, Giuseppe Bianchi
Limited data are available for the diagnosis of patients with tumors with infected endoprosthetic reconstructions. The purpose of this study was to evaluate whether sonication is effective for the diagnosis of infection and to compare it with tissue cultures. The files of 58 patients who underwent revision surgery for suspected infected endoprosthetic reconstructions were reviewed. Cultures were performed on 5 tissue samples obtained from each patient and on fluid obtained by sonication of the megaprosthesis...
October 15, 2018: Orthopedics
Moo-Ho Song, Kyung-Taek Kim, Youn-Soo Hwang, Jin-Wan Kim, Tae-Woong Eom, Jeong-Hoon Chae
The authors present 2 cases of late mobile-bearing dislocation after unicompartmental knee arthroplasty with long-term follow-up. Patients had anterior bearing dislocation more than 10 years after primary unicompartmental knee arthroplasty. Retrieved mobile bearings showed severe erosion on the posterior lip, suggesting frequent deep knee flexion as the cause of wear. Bearing dislocation is known to occur in the early postoperative phase. However, for Asians with a lifestyle that requires high knee flexion, dislocation might occur in the late postoperative phase...
October 15, 2018: Orthopedics
Sergio M Navarro, Heather S Haeberle, Olumide F Sokunbi, William C Frankel, Glenn D Wera, Michael A Mont, Prem N Ramkumar
Peroxide is a strong oxidizing agent and disinfectant frequently used in orthopedic surgery. The authors conducted a systematic literature review of peroxide in orthopedic surgery, evaluating use, complications, efficacy, and appropriate concentrations. One hundred seventy-five reports were identified, with 24 being eligible for analysis. Orthopedic surgeons used peroxide for irrigation and bacterial reduction in various procedures. Complications included cytotoxicity, allergic reactions, suture damage, and inflammation...
October 15, 2018: Orthopedics
Sean P Ryan, Cary Politzer, Cynthia Green, Samuel Wellman, Michael Bolognesi, Thorsten Seyler
Malnutrition is not uncommon in arthroplasty patients, and hypoalbuminemia has been shown to be predictive of postoperative complications. The authors sought to compare albumin concentration with a global assessment of physical health, the American Society of Anesthesiologists (ASA) score, to further discriminate the importance of albumin in predicting postoperative complications. A cohort of 128,412 patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) were identified from 2005 to 2015 through use of the American College of Surgeons National Surgical Quality Improvement Program database...
October 15, 2018: Orthopedics
Zlatan Cizmic, Emmanuel Edusei, Afshin A Anoushiravani, Joseph Zuckerman, Ronald Ruden, Ran Schwarzkopf
Poor outcomes associated with increased perioperative opioid use have led investigators to seek alternative pain management modalities after total joint arthroplasty. Nonpharmacological approaches, such as electroceuticals, have shown promise. The purpose of this study was to evaluate the effects of "havening," a specific form of psychosensory therapy, on postoperative pain scores and narcotic consumption. In this prospective, randomized controlled trial, the authors compared 19 patients who underwent psychosensory therapy with 22 patients who served as the control group...
October 15, 2018: Orthopedics
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