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Journal of the American Academy of Orthopaedic Surgeons

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https://www.readbyqxmd.com/read/28957986/the-effect-of-obesity-on-surgical-treatment-of-achilles-tendon-ruptures
#1
Jamal Ahmad, Kennis Jones
INTRODUCTION: We conducted a retrospective comparison of surgical treatment outcomes for acute Achilles tendon ruptures in nonobese and obese patients. METHODS: Between October 2006 and April 2014, we studied 76 patients with acute midsubstance Achilles tendon rupture: 44 nonobese and 32 obese (body mass index >30 kg/m). Preoperative and postoperative function and pain were graded with the Foot and Ankle Ability Measure (FAAM) Sports subscale and the visual analog scale for pain, respectively...
September 27, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28938339/reduction-techniques-for-diaphyseal-femur-fractures
#2
Philip R Wolinsky, Justin F Lucas
Achieving and maintaining reduction in patients with a diaphyseal femur fracture may be difficult; therefore, thorough preoperative planning is required. To fully prepare for successful surgical management of diaphyseal femur fractures, surgeons must consider appropriate patient positioning and necessary tools, including surgical tables, traction devices, and instruments. Principles of acceptable reduction rely on the restoration of length, alignment, and rotation. Reduction of diaphyseal femur fractures should be attained in the least invasive manner, via percutaneous reduction techniques, if possible, to preserve fracture biology and promote successful fracture healing...
September 21, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953089/lawsuits-after-primary-and-revision-total-knee-arthroplasty-a-malpractice-claims-analysis
#3
Diana C Patterson, Ronald Grelsamer, Michael J Bronson, Calin S Moucha
INTRODUCTION: As the number of total knee arthroplasties (TKAs) increases, the number of associated complications will also increase. Our goal with this study was to identify common causes of and financial trends relating to malpractice claims filed after TKA. METHODS: We analyzed malpractice claims filed for alleged neglectful primary and revision TKA surgeries performed between 1982 and 2012 by orthopaedic surgeons insured by a large New York state malpractice carrier...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953088/spine-surgery-outcomes-in-workers-compensation-patients
#4
Alan H Daniels, Eren O Kuris, Dominic T Kleinhenz, Mark A Palumbo
Occupational spine injuries place a substantial burden on employees, employers, and the workers' compensation system. Both temporary and permanent spinal conditions contribute substantially to disability and lost wages. Numerous investigations have revealed that workers' compensation status is a negative risk factor for outcomes after spine injuries and spine surgery. However, positive patient outcomes and return to work are possible in spine-related workers' compensation cases with proper patient selection, appropriate surgical indications, and realistic postoperative expectations...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953087/cubital-tunnel-syndrome-current-concepts
#5
Jonathan Robert Staples, Ryan Calfee
Cubital tunnel syndrome is the second most common upper extremity compressive neuropathy. In recent years, rates of surgical treatment have increased, and the popularity of in situ decompression has grown. Nonsurgical treatment, aiming to decrease both compression and traction on the ulnar nerve about the elbow, is successful in most patients with mild nerve dysfunction. Recent randomized controlled trials assessing rates of symptom resolution and ultimate success have failed to identify a preferred surgical procedure...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953086/survivorship-of-hemiarthroplasty-with-concentric-glenoid-reaming-for-glenohumeral-arthritis-in-young-active-patients-with-a-biconcave-glenoid
#6
Charles L Getz, Kenneth A Kearns, Eric M Padegimas, Peter S Johnston, Mark D Lazarus, Gerald R Williams
INTRODUCTION: Hemiarthroplasty with concentric glenoid reaming (known as "ream and run") may be an option for treating glenohumeral arthritis in younger patients with a biconcave glenoid. The goal of this study was to evaluate early results of this technique. METHODS: Two senior, fellowship-trained shoulder surgeons (G.R.W. and M.D.L.) performed a retrospective review of 23 patients (24 shoulders) with a biconcave glenoid and end-stage degenerative glenohumeral arthritis treated with hemiarthroplasty with concentric glenoid reaming...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953085/efficacy-and-treatment-response-of-intra-articular-corticosteroid-injections-in-patients-with-symptomatic-knee-osteoarthritis
#7
Elizabeth G Matzkin, Emily J Curry, Qingwu Kong, Miranda J Rogers, Michael Henry, Eric L Smith
INTRODUCTION: Intra-articular corticosteroid injections are often used for short-term pain relief in patients with knee osteoarthritis (OA). This study investigates the efficacy of intra-articular corticosteroid injections in patients with symptomatic knee OA and factors that affect treatment response. METHODS: This prospective, multicentered cohort study had 100 participants with radiographic evidence of knee OA enrolled. Participants received one corticosteroid injection into the affected knee and were evaluated before the injection (baseline) and at 3 weeks, 6 weeks, 3 months, and 6 months after the injection...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953084/allergic-or-hypersensitivity-reactions-to-orthopaedic-implants
#8
Timothy T Roberts, Colin M Haines, Richard L Uhl
Allergic or hypersensitivity reactions to orthopaedic implants can pose diagnostic and therapeutic challenges. Although 10% to 15% of the population exhibits cutaneous sensitivity to metals, deep-tissue reactions to metal implants are comparatively rare. Nevertheless, the link between cutaneous sensitivity and clinically relevant deep-tissue reactions is unclear. Most reactions to orthopaedic devices are type IV, or delayed-type hypersensitivity reactions. The most commonly implicated allergens are nickel, cobalt, and chromium; however, reactions to nonmetal compounds, such as polymethyl methacrylate, antibiotic spacers, and suture materials, have also been reported...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953083/understanding-the-basics-of-computational-models-in-orthopaedics-a-nonnumeric-review-for-surgeons
#9
Samir Mehta, Andrew Tyler, Michael Hast
Computational models represent more than just finite element analysis, a term that many clinicians may know and globally apply. Over the past 30 years, many published studies have addressed clinically relevant orthopaedic questions with speed and precision by using a wide variety of computational approaches. Given such a wide spectrum of techniques, clinicians often do not have a full understanding of the methods used to create models and therefore do not appreciate the strengths, weaknesses, and potential pitfalls of published results...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953082/distal-humerus-fractures-in-the-elderly-population
#10
Thomas F Varecka, Chad Myeroff
Distal humerus fractures present complex challenges in the elderly patient. These fractures often occur in patients who are living independently but have poor bone quality and low physiologic reserve, thus complicating management decisions and treatment. The goal is a painless, functional, stable elbow that allows completion of the activities of daily living. Nonsurgical management is reserved for those who cannot tolerate surgery. Open reduction and internal fixation is the preferred choice in fractures amenable to rigid fixation and early motion...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28953081/measuring-surgical-skills-in-simulation-based-training
#11
Kivanc Atesok, Richard M Satava, J Lawrence Marsh, Shepard R Hurwitz
Simulation-based surgical skills training addresses several concerns associated with the traditional apprenticeship model, including patient safety, efficient acquisition of complex skills, and cost. The surgical specialties already recognize the advantages of surgical training using simulation, and simulation-based methods are appearing in surgical education and assessment for board certification. The necessity of simulation-based methods in surgical education along with valid, objective, standardized techniques for measuring learned skills using simulators has become apparent...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28857908/physical-examination-of-the-knee-meniscus-cartilage-and-patellofemoral-conditions
#12
R Grelsamer
No abstract text is available yet for this article.
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837461/management-of-lower-extremity-long-bone-fractures-in-spinal-cord-injury-patients
#13
Leah M Schulte, Ryan D Scully, Jason E Kappa
The AO classification system, used as a guide for modern fracture care and fixation, follows a basic philosophy of care that emphasizes early mobility and return to function. Lower extremity long-bone fractures in patients with spinal cord injury often are pathologic injuries that present unique challenges, to which the AO principles may not be entirely applicable. Optimal treatment achieves healing without affecting the functional level of the patient. These injuries often result from low-energy mechanisms in nonambulatory patients with osteopenic bone and a thin, insensate soft-tissue envelope...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837460/normal-palmar-anatomy-and-variations-that-impact-median-nerve-decompression
#14
John G Seiler, Jimmy H Daruwalla, Samuel H Payne, Gregory K Faucher
Annually, carpal tunnel release is one of the most commonly executed orthopaedic procedures. Despite the frequency of the procedure, complications may occur as a result of anatomic variations. Understanding both normal and variant anatomy, including anomalies in neural, vascular, tendinous, and muscular structures about the carpal tunnel, is fundamental to achieving both safe and efficacious surgery. Reviewing and aggregating this information reveals certain principles that may lead to the safest possible surgical approach...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837459/the-crankshaft-phenomenon
#15
Robert F Murphy, James F Mooney
The crankshaft phenomenon, a progressive rotational and angular spinal deformity that can occur after posterior spinal surgery, has been reported in pediatric patients with idiopathic, congenital, and neuromuscular scoliosis. In the skeletally immature patient, the crankshaft phenomenon is thought to occur secondary to continued growth of the anterior elements of the spine after solid posterior spinal fusion. The condition has also been reported in the setting of newer, so-called growth-friendly posterior distraction-based spinal instrumentation...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837458/early-lessons-on-bundled-payment-at-an-academic-medical-center
#16
Lindsay E Jubelt, Keith S Goldfeld, Saul B Blecker, Wei-Yi Chung, John A Bendo, Joseph A Bosco, Thomas J Errico, Anthony K Frempong-Boadu, Richard Iorio, James D Slover, Leora I Horwitz
INTRODUCTION: Orthopaedic care is shifting to alternative payment models. We examined whether New York University Langone Medical Center achieved savings under the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement initiative. METHODS: This study was a difference-in-differences study of Medicare fee-for-service patients hospitalized from April 2011 to June 2012 and October 2013 to December 2014 for lower extremity joint arthroplasty, cardiac valve procedures, or spine surgery (intervention groups), or for congestive heart failure, major bowel procedures, medical peripheral vascular disorders, medical noninfectious orthopaedic care, or stroke (control group)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837457/hallux-rigidus-grade-does-not-correlate-with-foot-and-ankle-ability-measure-score
#17
Devon C Nixon, Karly F Lorbeer, Jeremy J McCormick, Sandra E Klein, Jeffrey E Johnson
INTRODUCTION: Classification systems for hallux rigidus imply that, as radiographic changes progress, symptoms will concurrently increase in severity. However, symptom intensity and radiographic severity can be discordant for many patients. We studied the correlation between hallux rigidus grades and the Foot and Ankle Ability Measure (FAAM) scores to better understand this relationship. METHODS: We retrospectively reviewed weight-bearing radiographs of the foot and FAAM Activities of Daily Living (ADL) questionnaires for 84 patients with hallux rigidus...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837456/temporal-healing-of-achilles-tendons-after-injury-in-rodents-depends-on-surgical-treatment-and-activity
#18
Benjamin R Freedman, Nabeel S Salka, Tyler R Morris, Pankti R Bhatt, Adam M Pardes, Joshua A Gordon, Courtney A Nuss, Corinne N Riggin, George W Fryhofer, Daniel C Farber, Louis Soslowsky
INTRODUCTION: Achilles tendon ruptures affect 15 of 100,000 women and 55 of 100,000 men each year. Controversy continues to exist regarding optimal treatment and rehabilitation protocols. The objective of this study was to investigate the temporal effects of surgical repair and immobilization or activity on Achilles tendon healing and limb function after complete transection in rodents. METHODS: Injured tendons were repaired (n = 64) or left nonrepaired (n = 64)...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837455/revision-total-knee-arthroplasty-for-the-management-of-periprosthetic-fractures
#19
Paul R T Kuzyk, Evan Watts, David Backstein
Periprosthetic fractures after total knee arthroplasty (TKA) can present reconstructive challenges. Not only is the procedure technically complex, but patients with these fractures may have multiple comorbidities, making them prone to postoperative complications. Early mobilization is particularly beneficial in patients with multiple comorbidities. Certain patient factors and fracture types may make revision TKA the ideal management option. Periprosthetic fractures around the knee implant occur most frequently in the distal femur, followed by the tibia and the patella...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28837454/posterior-glenohumeral-instability-evidence-based-treatment
#20
Rachel M Frank, Anthony A Romeo, Matthew T Provencher
Posterior glenohumeral instability is an increasingly important clinical finding in athletic patients. Over the last decade, basic and clinical research has improved our understanding of the pathoanatomy and biomechanics of this challenging disorder, as well as our ability to diagnose and appropriately treat it. Although recurrent posterior shoulder instability is not as common as anterior instability, it is prevalent among specific populations, including football and rugby players, and may be overlooked by clinicians who are unaware of the typical physical examination and radiographic findings...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
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