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Orthopedics

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https://www.readbyqxmd.com/read/28437550/use-of-magnetic-resonance-imaging-to-predict-quadrupled-semitendinosus-graft-diameter-in-all-inside-anterior-cruciate-ligament-reconstruction
#1
Joseph Serino, Ryan Murray, Evan H Argintar
This study was conducted to evaluate whether preoperative magnetic resonance imaging (MRI) measurements of the cross-sectional area and length of the semitendinosus tendon correlated with graft diameter. The goal of the study was to identify tendons at risk for requiring graft augmentation. The records of 140 consecutive patients undergoing anterior cruciate ligament (ACL) reconstruction between 2013 and 2016 were examined retrospectively. The study included 39 patients who underwent all-inside ACL reconstruction with a semitendinosus autograft...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437549/poor-utility-of-gonadal-shielding-for-pediatric-pelvic-radiographs
#2
Mark C Lee, Jessica Lloyd, Matthew J Solomito
Plain pelvic radiographs are commonly used for a variety of pediatric orthopedic disorders. Lead shielding is typically placed over the gonads to minimize radiation exposure to these sensitive tissues. However, misplaced shielding can sabotage efforts to protect patients from excessive radiation exposure either by not covering radiosensitive tissues or by obscuring anatomic areas of interest, prompting repeat radiographic examinations. The goal of this study was to determine the incidence of misplaced shielding for pelvic radiographs obtained for pediatric orthopedic evaluation...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437548/arthroscopic-treatment-of-a-displaced-nonunion-of-the-anterior-inferior-iliac-spine-causing-extra-articular-impingement
#3
Motoi Shibahara, Yasuo Ohnishi, Eisaburo Honda, Dean K Matsuda, Soshi Uchida
This report describes a case of nonunion of an anterior inferior iliac spine (AIIS) apophyseal avulsion fracture with resultant subspine impingement combined with symptomatic femoroacetabular impingement (FAI). A 16-year-old male soccer player presented with a 6-month history of right groin pain exacerbated by kicking and running. The patient was diagnosed with a displaced nonunion of the AIIS apophysis avulsion fracture causing secondary extra-articular impingement beyond cam-type FAI by physical examination and radiological findings...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437547/concordance-of-patient-and-physician-perceptions-of-care-in-an-orthopedic-clinic
#4
Kelly Zhang, Charles Day, Matthew L Iorio
It is essential to study whether physicians' perceptions align with their patients' views, as understanding patient perception leads to superior satisfaction and health outcomes. Previous studies have established differences in physician-patient perceptions, but no studies have been conducted in orthopedic clinics. The authors' primary goal was to evaluate differences in physician and patient perceptions of an orthopedic clinic visit. Their secondary objective was to determine the influence of visit length, demographics, and depression risk-level on patient satisfaction...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#5
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437545/union-knee-alignment-and-clinical-outcomes-of-patients-treated-with-autologous-bone-grafting-for-medial-tibial-defects-in-primary-total-knee-arthroplasty
#6
Kunihiro Hosaka, Shu Saito, Teruyasu Oyama, Hirohisa Fujimaki, Eiji Cho, Kanki Ishigaki, Yasuaki Tokuhashi
Autologous bone grafting is an established method to overcome bone deficiencies in primary total knee arthroplasty (TKA). However, recently, metal augments have been used by many surgeons. Although autologous bone grafting is a common technique, few large studies have described its success in achieving bone union in primary TKA. The goal of this study was to evaluate primary TKA with autologous bone grafting for tibial defects. A total of 68 knees that had undergone arthroplasty with autologous bone grafting with more than 1 year of follow-up were evaluated...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418577/prospective-assessment-of-sleep-quality-before-and-after-primary-total-joint-replacement
#7
Blaine T Manning, Sean M Kearns, Daniel D Bohl, Tori Edmiston, Scott M Sporer, Brett R Levine
Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418576/the-safe-zone-technique-improves-suture-placement-and-accuracy-during-arthroscopic-remplissage
#8
Grant H Garcia, Ryan M Degen, Joseph N Liu, Cynthia A Kahlenberg, Daniel J Hurwit, Joshua S Dines
In response to recent concerns about the accuracy of suture passage during arthroscopic remplissage, this study was conducted to determine whether a previously described "safe zone" technique can improve the accuracy of suture passage. A recommended safe zone technique was used for arthroscopic remplissage on 6 cadaveric specimens. The safe zone was described as a region at least 1 cm lateral and no greater than 3 cm distal to the posterolateral acromion. Results were compared with a control group of 6 specimens for which the safe zone technique was not used...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418575/effects-of-previous-osteotomy-on-outcome-of-hip-resurfacing-arthroplasty
#9
Harlan Cabot Amstutz, Michel Jean Le Duff
The effect of previous conservative surgeries on the outcome of metal-on-metal hip resurfacing arthroplasty (HRA) has not been studied. This study compared postoperative clinical scores and survivorship results of hips with and without previous osteotomies in a population of patients who underwent HRA. A total of 1101 patients (1375 hips) with a mean age of 51.3 years at the time of surgery underwent HRA at a single center. Sixty-nine patients had undergone prior surgery on the operated hip including 14 osteotomies (1 pelvic, 6 femoral, and 7 combined pelvic and femoral osteotomies)...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#10
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28418573/trends-in-surgical-management-and-costs-for-operative-treatment-of-proximal-humerus-fractures-in-the-elderly
#11
Eddie K Hasty, Edward W Jernigan, Adrianne Soo, Dax T Varkey, Ganesh V Kamath
Proximal humerus fractures in the elderly are increasing in frequency as the population ages. The purpose of this study was to investigate surgical and cost trends in the Medicare population. The PearlDiver database was queried using diagnosis codes to identify Medicare recipients with proximal humerus fractures from 2005 to 2012. Surgical trends, demographics, and charge/reimbursement data were analyzed. There were 750,426 proximal humerus fractures in Medicare recipients during the 8-year period. Eighty-five percent of the fractures were treated nonoperatively; however, the percentage of operative vs nonoperative management increased significantly over time for all fractures, isolated fractures, and fracture dislocations...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399325/influence-of-surgical-approach-on-pelvic-lift-in-hip-arthroplasty-during-cup-insertion
#12
Steffen Brodt, Christoph Windisch, Linda Krakow, Dimitri Nowack, Georg Matziolis
The position of the acetabular cup is a major factor in the long-term outcome of total hip arthroplasty (THA). Malpositioning of the acetabular cup frequently has been reported with the use of a minimally invasive implantation technique. It remains unclear whether the limited visibility or the increased retractor traction and thus tilting of the pelvis during cup implantation is the cause. This study investigated the influence of iatrogenically related pelvic lift using an anterolateral minimally invasive THA technique...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399324/comparison-of-anteromedial-and-transtibial-acl-reconstruction-using-expandable-fixation
#13
Omer Ozel, Bulent Yucel, Osman Orman, Emre Demircay, Serhat Mutlu
The influence of anatomical or nonanatomical femoral tunnel position on tunnel widening and clinical outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction is not fully understood. This retrospective study examined the influence of tunnel width and placement on anterior knee stability and clinical outcomes after ACL reconstruction using the AperFix System (Cayenne Medical Inc, Scottsdale, Arizona), a direct expandable fixation technique with autologous hamstring grafts. The records of 80 patients (79 men and 1 woman) who underwent ACL reconstruction were evaluated...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399323/short-stem-reverse-total-shoulder-arthroplasty-periprosthetic-type-a-fracture
#14
Bryan M Saltzman, Timothy Leroux, Michael J Collins, Thomas A Arns, Brian Forsythe
Alterations have been made over the years to the standard reverse total shoulder arthroplasty (RTSA) prosthetic components in an effort to decrease adverse events; this has led to the advent of a short humeral stem prosthesis. To the authors' knowledge, there are no reports describing the complication of a traumatic periprosthetic Wright and Cofield classification type A fracture with use of a short metaphyseal humeral stem component for RTSA. The authors describe a 49-year-old woman with this pathology who was treated with open reduction and internal fixation using a proximal humerus locking plate, unicortical and bicortical screw fixation, and a cerclage wire construct without the need to violate the shoulder joint or revise components...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399322/antibiotic-use-and-kirschner-wire-fixation-in-forefoot-surgery-a-national-survey
#15
Gregory Pace, Samuel Dellenbaugh, Brian Stapinski, Umur Aydogan, Jorge Bustillo, Paul Juliano
In foot and ankle patients, the use of Kirschner wires is common, and the population in the typical foot and ankle practice has higher rates of comorbidities associated with infection. This study assessed national trends regarding the use of postoperative prophylactic antibiotic therapy in patients undergoing foot and ankle surgery treated with percutaneous Kirschner wires. Attending physicians at foot and ankle fellowships were mailed a questionnaire that included 3 clinical vignettes containing questions on the use of postoperative antibiotics in patients treated with percutaneous Kirschner wires...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28399321/septic-arthritis-of-the-wrist-incidence-risk-factors-and-predictors-of-infection
#16
John D Jennings, Elizabeth Zielinski, Rick Tosti, Asif M Ilyas
Septic arthritis of the wrist can result in permanent damage to the joint, making timely diagnosis crucial to initiate empiric antibiotics and surgical intervention. Although septic arthritis is routinely included in the differential diagnosis of atraumatic wrist pain, the incidence is unknown. Unlike large joints, there is no consensus on cell count values considered pathognomonic for wrist septic arthritis. The goal of this retrospective study was to determine the incidence of wrist septic arthritis and to identify the clinical, serum, and joint fluid values that predict infection...
April 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28358978/responsiveness-and-internal-validity-of-common-patient-reported-outcome-measures-following-total-shoulder-arthroplasty
#17
Aaron D Sciascia, Brent J Morris, Cale A Jacobs, T Bradley Edwards
The Constant-Murley (Constant) score, Western Ontario Osteoarthritis of the Shoulder (WOOS) index, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) score are commonly used to assess patient-reported function following shoulder surgery. However, psychometric properties for these tools are mostly unknown for patients with primary glenohumeral arthritis who have undergone anatomic total shoulder arthroplasty (TSA). The purposes of this study were to (1) compare the responsiveness and internal validity between the 4 patient-reported outcomes (PROs) and (2) identify PRO score values associated with patient satisfaction after TSA...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28358977/plantar-plating-for-the-treatment-of-proximal-fifth-metatarsal-fractures-in-elite-athletes
#18
Ronald J Mitchell, Neil L Duplantier, Domenica A Delgado, Bradley S Lambert, Patrick C McCulloch, Joshua D Harris, Kevin E Varner
Proximal fifth metatarsal fractures, zones II and III, are commonly treated surgically, especially in elite athletes. Intramedullary screw fixation remains the most used construct despite nonunion and refracture. High tensile forces on the plantar-lateral aspect of the fifth metatarsal are difficult to control, and intramedullary screw fixation depends on ideal screw position, length, and width. The authors present a plantar plating technique with cancellous bone autograft for zones II and III proximal fifth metatarsal fractures...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28358976/analysis-of-bony-and-internal-organ-injuries-associated-with-26-357-adult-femoral-shaft-fractures-and-their-impact-on-mortality
#19
Nidharshan S Anandasivam, Glenn S Russo, Jennifer M Fischer, Andre M Samuel, Nathaniel T Ondeck, Matthew S Swallow, Sophie H Chung, Daniel D Bohl, Jonathan N Grauer
The spectrum of injuries associated with femoral shaft fractures and those injuries' association with mortality have not been well delineated previously. Patients in the National Trauma Data Bank who presented with femoral shaft fractures from 2011 to 2012 were analyzed in 3 age groups (18-39, 40-64, and 65+ years). For each group, modified Charlson Comorbidity Index (CCI), mechanism of injury (MOI), injury severity score (ISS), and associated injuries were reported. Multivariate logistic regression was used to identify predictors of mortality...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28358975/age-related-outcome-of-mobile-bearing-total-ankle-replacement
#20
Federico G Usuelli, Camilla Maccario, Riccardo D'Ambrosi, Michele F Surace, Ettore Vulcano
The aim of this study was to investigate clinical and radiographic outcomes in patients 50 years and younger vs patients older than 50 years undergoing total ankle replacement. Seventy consecutive patients who underwent primary total ankle replacement were included in this retrospective study. Patients were assessed clinically and radiographically. There was a statistically significant difference between the 2 groups for the American Orthopaedic Foot & Ankle Society score at final follow-up. The younger group had significantly greater improvement compared with the older group...
March 30, 2017: Orthopedics
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