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Hiroshi Sasaki, Kazunari Ishida, Nao Shibanuma, Koji Takayama, Shinya Hayashi, Shingo Hashimoto, Takahiro Niikura, Masahiro Kurosaka, Ryosuke Kuroda, Tomoyuki Matsumoto
Recent advances in surgical tools such as navigation systems have contributed to accurate implantation in total knee arthroplasty. Although several navigation systems have been developed, reports regarding which navigation system has better accuracy are few. Therefore, this study aimed to compare the accuracy of postoperative coronal alignment among 3 navigation systems. A total of 90 knee prostheses were implanted for 90 patients with osteoarthritis. Thirty patients were enrolled in each of the following 3 navigation groups: Stryker Navigation System II (computed tomography-free navigation; Stryker, Mahwah, New Jersey); OrthoPilot version 4...
July 16, 2018: Orthopedics
Shuai Han, Dongdong Li, Peixun Zhang, Xiaofeng Yin, Yuhui Kou, Na Han, Zhongguo Fu
Pain and reoperation after fixation using tension band wiring and K-wires is not uncommon. A novel hook plate was designed to improve the treatment of patella fractures. The aim of this study was to compare the stability of the hook plate with that of tension band wiring and K-wires in a simulated patellar transverse fracture model (AO/OTA classification 34-C1.1). The authors tested 16 embalmed cadaver knee joints fixed with the hook plate and tension band wiring and K-wires under cyclic loading. Specimens underwent 100 cycles extending the knee joint from 90° of flexion to full extension at a velocity of 50 mm/min...
July 16, 2018: Orthopedics
Liselore Maeckelbergh, Tine Peeters, Joseph Moskal, Kristoff Corten
Patient-reported outcome measures play an important role in evaluating the functional outcome of surgical and nonsurgical treatments of the hip joint. One thousand healthy volunteers completed the modified Harris hip score, the University of California, Los Angeles score, the Hip Osteoarthritis Outcome Score, and the Western Ontario and McMaster Universities Osteoarthritis Index score. Between September 2010 and December 2015, a total of 127 periacetabular osteotomies were performed in 111 patients with symptomatic developmental dysplasia of the hip...
July 16, 2018: Orthopedics
Joon Yub Kim, Byung Chan Yoo, Jong Pil Yoon, Sung Jin Kang, Seok Won Chung
Thirty patients with displaced midshaft clavicle fractures were prospectively enrolled in this study. Fifteen were randomly assigned to the minimally invasive plate osteosynthesis group and 15 to the conventional plate osteosynthesis group. Constant score, visual analog scale satisfaction score, operative time, scar length, and complications, including hypoesthesia, were evaluated at least 1 year postoperatively to determine functional outcomes and time to bone union as a radiological outcome. Factors related to bone union, including the gap interval between fracture fragments and the number of fracture fragments, were also evaluated...
July 16, 2018: Orthopedics
Ariel D Davila-Parrilla, James Wylie, Courtney O'Donnell, Daniel A Maranho, Patrick Carry, Eduardo N Novais
The authors sought to determine the intra- and interrater reliability of contemporary measures of acetabular morphology among a group of hip surgeons and to determine the correlations between measures of acetabular morphology. On 2 separate occasions, 3 hip surgeons independently performed blinded evaluations of anteroposterior pelvic radiographs of 40 patients. The lateral center-edge angle, medial center-edge angle, acetabular arc, extrusion index, acetabular index, Sharp's angle, posterior wall sign, crossover sign, femoro-epiphyseal acetabular roof index, acetabular wall indexes, and delta angle were assessed...
July 16, 2018: Orthopedics
Anthony E Bozzio, Christopher R Johnson, Jill A Fattor, Christopher J Kleck, Vikas V Patel, Evalina L Burger, Andriy Noshchenko, Christopher M J Cain
Fusion outcomes and costs of stand-alone anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF) in association with posterior fusion, and anterior/posterior (A/P) fusion were compared using clinical, radiographic, and billing data. Adult patients with symptomatic 1- or 2-level degenerative disk disease in isolation or in association with a grade 1 or 2 degenerative or lytic spondylolisthesis and canal and/or foraminal stenosis who underwent elective stand-alone ALIF, TLIF, or A/P fusion were compared...
July 16, 2018: Orthopedics
Jane Liu, Nicholas B Frisch, Nima Mehran, Mossub Qatu, S Trent Guthrie
The purpose of this retrospective cohort study was to evaluate whether there is an increased rate of short-term medical complications following short vs long cephalomedullary nails for the treatment of intertrochanteric hip fractures. A total of 899 patients treated surgically with cephalomedullary nails from January 1, 2005, to September 1, 2014, were included. Patients who received short nails (n=334) were older and had a higher incidence of coronary artery disease and diabetes mellitus compared with patients who received long nails (n=565)...
July 16, 2018: Orthopedics
Yanzi Zhang, Zhen Tan, Ren Liao, Zongke Zhou, Pengde Kang, Xu Cheng, Kun Huang, Jing Yang, Bin Shen, Fuxing Pei, Xiao Wang, Jing Yang
In this prospective, randomized, placebo-controlled study, the authors compared the analgesic efficacy of the single-shot adductor canal block (SS-ACB) vs the continuous adductor canal block (C-ACB) with intermittent boluses during the 72-hour postoperative period. Seventy-five patients randomly received the following: a single shot of 20 mL of 0.5% ropivacaine preoperatively followed by intermittent saline boluses at 12 hours and 24 hours postoperatively (SS-ACB group); 20 mL of 0.5% ropivacaine preoperatively and 12 hours and 24 hours postoperatively (C-ACB group); or saline preoperatively and postoperatively (control group)...
June 25, 2018: Orthopedics
Doo Sup Kim, Hoe Jeong Chung, Chang-Ho Yi, Seong-Hyeon Kim
Numerous surgical options have been introduced for the treatment of chronic refractory lateral epicondylitis of the elbow, but it remains unclear which option is superior. The clinical outcomes of an open surgery group and an arthroscopic surgery group were evaluated, and the results of the 2 procedures were compared. From among patients with lateral epicondylitis refractory to 6 months of conservative treatment, 68 patients satisfying study criteria were recruited. Open surgery was performed in 34 cases (group 1), and arthroscopic surgery was performed in 34 cases (group 2)...
June 25, 2018: Orthopedics
Nicole D Rynecki, Daniel Coban, Owen Gantz, Raghav Gupta, Varun Ayyaswami, Arpan V Prabhu, Jeremy Ruskin, Sheldon S Lin, Kathleen S Beebe
A recent study that evaluated the risk of facing a malpractice claim by physician specialty found that orthopedic surgeons were at a significantly greater risk of being sued than other medical specialists. To date, no studies have characterized trends in orthopedic surgery malpractice claims. The Westlaw legal database was used to locate state and federal jury verdicts and settlements related to medical malpractice and orthopedic surgery from 2010 to 2016. Eighty-one cases were analyzed. The mean age of the affected patients and/or plaintiffs was 53...
June 25, 2018: Orthopedics
Nathan W Skelley, James T Stannard, Pat Laupattarakasem
The authors describe a technique for visualizing the deployment of femoral suspensory fixation during ligament reconstructions that avoids the need for intraoperative fluoroscopic radiographs. Many surgeons currently use intraoperative fluoroscopic radiographs to confirm satisfactory deployment of the suspensory button on the femur; however, this technique involves prolonged surgical time, additional costs, and radiation exposure to the surgical team and patient. The authors' technique uses novel leg and camera positioning to allow for direct visualization of the button deployment...
June 25, 2018: Orthopedics
Remi M Ajiboye, Austin Drysch, Gina M Mosich, Akshay Sharma, Sina Pourtaheri
Consensus is lacking regarding optimal surgical treatment of recurrent lumbar disk herniation. A systematic search of multiple databases was conducted for studies evaluating outcomes after treatment for recurrent lumbar disk herniation. Treatment options included decompression surgeries and fusion surgeries. Although fusion surgeries eliminated re-recurrence of disk herniation, this coincided with higher incidences of complications and reoperation. Decompression surgeries and fusion surgeries both resulted in improvements in Japanese Orthopaedic Association, Oswestry Disability Index, and visual analog scale back and leg scores postoperatively (P<...
June 25, 2018: Orthopedics
Jean-David Werthel, Bradley Schoch, Julie E Adams, Cathy Schleck, Robert Cofield, Scott P Steinmann
Hemiarthroplasty (HA) of the shoulder has several potential advantages over total shoulder arthroplasty (TSA), particularly in the elderly population. This study reviewed long-term results of HA and TSA in patients older than 70 years with glenohumeral osteoarthritis. During a 30-year period, 403 shoulders had undergone HA (n=74) or TSA (n=329) for glenohumeral osteoarthritis. Outcome measures included pain, range of motion, and postoperative modified Neer ratings. All patients were included in the mortality and revision analyses...
June 25, 2018: Orthopedics
Phob Ganokroj, Pisit Lertwanich
A groin mass is an unusual presentation of hip-related problems. Paralabral cysts are common radiographic findings that are often associated with intraarticular pathology. The authors describe a 57-year-old woman who presented with a left groin mass for 6 months. Magnetic resonance imaging showed an acetabular paralabral cyst at the anterior aspect of the hip joint. Arthroscopic paralabral cyst decompression was performed. An associated degenerative anterosuperior labrum and partial tear of the ligamentum teres were also identified and treated with arthroscopic debridement...
June 18, 2018: Orthopedics
Apiruk Sangsin, Hideki Murakami, Takaki Shimizu, Satoshi Kato, Hiroyuki Tsuchiya
Acinic cell carcinoma metastasizing to the spine is extremely rare. The authors present a case of acinic cell carcinoma of the parotid gland with subsequent lung and spinal metastases, treated with en bloc spondylectomy. A 41-year-old man presented with a left parotid mass. After being diagnosed with acinic cell carcinoma, he underwent a total parotidectomy. Imaging studies revealed a metastatic osteoblastic lesion in the T4 vertebral body and multiple lung metastases. Total en bloc spondylectomy and reconstruction with a frozen tumor-bearing bone graft were performed to treat the T4 metastasis...
June 18, 2018: Orthopedics
Ryan Nelson, Jeremiah T Lowe, Sarah M Lawler, Megan Fitzgerald, Matthew T Mantell, Andrew Jawa
Heterotopic ossification and scapular notching are common following reverse total shoulder arthroplasty. Compared with the original Grammont-style prosthesis with a medialized center of rotation (COR) and a 155° neck-shaft angle, lateralization of COR and reduction of neck-shaft angle have been associated with decreased incidence of scapular notching. The authors hypothesized that these design features may also be effective in reducing heterotopic ossification after reverse total shoulder arthroplasty. Ninety-seven consecutive patients who underwent reverse total shoulder arthroplasty performed by a single surgeon were included in the study...
June 18, 2018: Orthopedics
Brian P Gladnick, John L Masonis
Release of the conjoined tendon has been reported to facilitate femoral exposure during a direct anterior hip approach. However, the authors are not familiar with any description of an anterior approach repair technique for this important structure. Conjoined tendon repair is commonly performed in the posterior approach to help preserve hip biomechanics and restore anatomic tissue planes. The authors describe their algorithm for sequential soft tissue releases to facilitate femoral exposure and a technique for repairing the insertion of the conjoined tendon after it has been released for exposure during the direct anterior approach...
June 18, 2018: Orthopedics
Allison K Tetreault, Derek P Axibal, Frank A Scott
Neonatal compartment syndrome is rare. There are multiple proposed etiologies, including infection, vascular insult, and mechanical compression. Much like compartment syndrome in adults, delayed surgical intervention for neonatal compartment syndrome can have catastrophic results. The authors present a unique case of a neonate who presented with left forearm and hand swelling and skin ulceration after vaginal delivery. Findings from the evaluation for vascular injury, infection, and hypercoagulability were normal...
June 18, 2018: Orthopedics
Charles S Carrier, Kirsten D Garvey, Emily M Brook, Elizabeth G Matzkin
The purpose of this study was to determine the efficacy of nonopioid pain management following arthroscopic partial meniscectomy and/or chondroplasty and to assess patients' attitudes regarding their need for opioid pain medication following these procedures. Patients who underwent a knee arthroscopy procedure for either partial meniscectomy and/or chondroplasty from July 2016 to January 2017 by a single surgeon at a single institution were included. Medical records were reviewed, and demographics were recorded...
June 18, 2018: Orthopedics
Victor Ortiz-Declet, Leslie C Yuen, David R Maldonado, Garrett Schwarzman, Joseph R Laseter, Benjamin G Domb
There are approximately 25 million amateur golfers in the United States, making up almost 10% of the entire US population. The purpose of this study was to evaluate short-term outcomes and rates of return to sport among recreational golfers who underwent hip arthroscopy for the treatment of labral tears. Data were prospectively collected and retrospectively reviewed for patients who underwent hip arthroscopy by one surgeon between August 2008 and February 2015. Exclusion criteria were previous ipsilateral hip surgeries or conditions, preoperative Tönnis osteoarthritis grade greater than 1, or workers' compensation status...
May 29, 2018: Orthopedics
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