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Journal of the American Academy of Orthopaedic Surgeons

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https://www.readbyqxmd.com/read/29443705/orthopaedic-considerations-in-the-management-of-skeletal-sarcoidosis
#1
Brooke Crawford, Fadi Badlissi, Santiago A Lozano Calderón
Advanced imaging has demonstrated that musculoskeletal manifestations of systemic sarcoidosis are more common than previously thought. A definitive strategy for the management of osseous sarcoidosis has not been defined. Some lesions resolve spontaneously, and no systemic medication for sarcoidosis consistently resolves lesions. The orthopaedic surgeon treating patients with musculoskeletal sarcoidosis must make an appropriate diagnosis of bony lesions, seek multidisciplinary input from specialists in pulmonology and rheumatology regarding systemic treatment, and decide when surgery is necessary to prevent dysfunction...
February 13, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29443704/lateral-collateral-ligament-injury-about-the-knee-anatomy-evaluation-and-management
#2
Brian Grawe, Amanda J Schroeder, Rafael Kakazu, Malynda S Messer
The lateral collateral ligament is the primary varus stabilizer of the tibiofemoral joint. Diagnosing an injury to this ligament can be challenging in the setting of multiligamentous trauma; however, failure to recognize these injuries can result in instability of the knee and unsatisfactory outcomes after cruciate ligament reconstruction. Recent literature exploring the anatomy and biomechanics of the lateral collateral ligament has enhanced our understanding and improved diagnosis and management of these injuries...
February 13, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29443703/the-thrower-s-shoulder
#3
Jonathan D Gelber, Lonnie Soloff, Mark S Schickendantz
Overhead athletes subject their shoulders to extreme repetitive torque, compression, distraction, and translation stresses, resulting in adaptive changes of the soft tissues and osseous structures within and around the glenohumeral joint. These anatomic adaptations result in biomechanical enhancements, which improve performance. Understanding the difference between necessary and adaptive changes and pathologic findings is critical when making treatment decisions. Injuries to the shoulder of the overhead athlete can be generally classified into three groups: internal impingement, internal impingement with acquired secondary anterior instability, and primary anterior or multidirectional instability...
February 13, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29432365/aaos-appropriate-use-criteria-management-of-carpal-tunnel-syndrome
#4
Noah M Raizman, Philip E Blazar
No abstract text is available yet for this article.
February 9, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29420323/management-of-carpal-tunnel-syndrome
#5
Pekka A Mooar, William J Doherty, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
The American Academy of Orthopaedic Surgeons (AAOS) has developed Appropriate Use Criteria (AUC) for Management of Carpal Tunnel Syndrome. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. To provide the evidence foundation for this AUC, the AAOS Evidence-Based Medicine Unit provided the writing panel and voting panel with the 2016 AAOS Clinical Practice Guideline titled Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline...
February 7, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29419726/the-effect-of-door-opening-on-positive-pressure-and-airflow-in-operating-rooms
#6
Mitchell C Weiser, Shai Shemesh, Darwin D Chen, Michael J Bronson, Calin S Moucha
INTRODUCTION: Door openings and increased foot traffic in operating rooms (ORs) during total joint arthroplasty are thought to increase the risk of surgical site infection. METHODS: Digital manometers were used to collect pressure data during off-hours at the thresholds of both the outer door (ie, the door to the common OR hallway) and the inner substerile door, which opens to the substerile hallway, of six empty ORs used for total joint arthroplasty. Airflow patterns were visualized with smoke studies to determine whether outside air entered the ORs during single or multiple door openings...
February 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29419725/effect-of-facility-ownership-on-utilization-of-arthroscopic-shoulder-surgery
#7
Eric M Black, John Reynolds, Mitchell G Maltenfort, Gerald R Williams, Joseph A Abboud, Mark D Lazarus
INTRODUCTION: We examined practice patterns and surgical indications in the management of common shoulder procedures by surgeons practicing at physician-owned facilities. METHODS: This study was a retrospective analysis of 501 patients who underwent arthroscopic shoulder procedures performed by five surgeons in our practice at one of five facilities during an 18-month period. Two of the facilities were physician-owned, and three of the five surgeons were shareholders...
February 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29419724/clinical-outcomes-after-reverse-shoulder-arthroplasty-with-and-without-subscapularis-repair-the-importance-of-considering-glenosphere-lateralization
#8
Brian C Werner, Alexandra C Wong, Gregory T Mahony, Edward V Craig, David M Dines, Russell F Warren, Lawrence V Gulotta
INTRODUCTION: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm. METHODS: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component...
February 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29389727/psychological-factors-affecting-outcomes-after-elective-shoulder-surgery
#9
Joseph A Gil, Avi D Goodman, Mary K Mulcahey
To optimize outcomes following elective shoulder surgery, it is important to address not only the injury or pathology itself, but also the cognitive and emotional factors that may influence a patient's recovery. Depression, anxiety, catastrophic thinking, distress, somatization, and decreased self-efficacy are among the most common psychological factors associated with adverse perioperative events and poor postoperative outcomes. Such factors may manifest at any point during recovery. Validated questionnaires can be used to measure psychological factors preoperatively, thereby enabling earlier intervention that may mitigate any potential negative effect of these factors on the patient's overall outcome...
January 30, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29337717/transforaminal-lumbar-interbody-fusion-traditional-open-versus-minimally-invasive-techniques
#10
Michael J Lee, James Mok, Pranay Patel
Recently, minimally invasive spine arthrodesis has gained popularity among spine surgeons. Minimally invasive techniques have advantages and disadvantages compared with traditional open techniques. Comparisons between short-term outcomes of minimally invasive transforaminal interbody fusion and open transforaminal interbody fusion in terms of estimated blood loss, postoperative pain, and hospital length of stay have been well documented and generally favor the minimally invasive technique. However, the advantages of minimally invasive transforaminal interbody fusion must be evaluated in the context of long-term results, such as patient-reported outcomes and the success of arthrodesis...
January 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29329124/septic-arthritis-of-the-wrist
#11
John D Jennings, Asif M Ilyas
Septic arthritis of the wrist is an uncommon condition, but one that can result in substantial morbidity. Timely identification and treatment is critical to patient care. No serum laboratory values have been shown to consistently confirm wrist joint infection. Thus, diagnosis is made based mainly on a thorough patient history, physical examination, and joint aspiration. When infection is suspected, aspiration of the wrist should be performed to confirm the diagnosis. Broad-spectrum antibiotics and joint aspiration or surgery are required to manage the infection and prevent sequelae...
January 11, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29329123/golf-injuries-epidemiology-pathophysiology-and-treatment
#12
Ioannis C Zouzias, Jeff Hendra, Jason Stodelle, Orr Limpisvasti
Increasing numbers of people are playing golf. Golf is a unique sport in that the ability to participate at a high level is not limited by age. In addition, participants tend to play more rather than less as they grow older. Injuries can occur at any point during the golf swing, from takeaway through follow-through. Upper extremity injuries can affect the hands, elbow, and shoulder and are usually a result of the golf swing at impact. Injuries are also common in the lower back as well as the lower extremities...
January 11, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29309292/polydactyly-of-the-hand
#13
Garet C Comer, Michael Potter, Amy L Ladd
Polydactyly is one of the most common congenital hand deformities managed by orthopaedic surgeons. It is most often found in isolation; however, rarely, it may be associated with genetic syndromes. Polydactyly is classified as postaxial, preaxial, or central depending on the radioulnar location of the duplicated digits. Postaxial polydactyly, which affects the ulnar side of the hand, is most common and is typically managed with excision or suture ligation of the supernumerary digit. Preaxial polydactyly, which affects the thumb or radial side of the hand, often requires reconstructive techniques to ensure a functional, stable thumb...
January 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29239870/factors-motivating-medical-students-in-selecting-a-career-specialty-relevance-for-a-robust-orthopaedic-pipeline
#14
David Segal
No abstract text is available yet for this article.
December 8, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29420327/defining-the-key-parts-of-a-procedure-implications-for-overlapping-surgery
#15
Joseph Bernstein, James J Bernstein, Samir Mehta, Eric L Hume, Mara L Schenker, Jaimo Ahn
INTRODUCTION: The American College of Surgeons' Statements on Principles requires attending surgeons to be present for the "key parts" of surgical procedures, but the term is not defined. The research question addressed in this study is whether a functional definition of the critical or key steps of common orthopaedic surgical procedures can be reliably constructed. We used the examples of hip and knee arthroplasty because these procedures are highly structured and divisible into distinct subroutines...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29351137/early-response-to-warfarin-initiation-and-the-risk-of-venous-thromboembolism-after-total-joint-arthroplasty
#16
Adam I Edelstein, Clara Terzaghi, Brandon Nudelman, Charles Qin, Mary Kwasny, David W Manning
BACKGROUND: Venous thromboembolism chemoprophylaxis with warfarin is common after total joint arthroplasty. Early response to warfarin initiation has been theorized to engender a transient increase in the risk of venous thromboembolism. We hypothesized that a rapid rise in the international normalized ratio is a risk factor for venous thromboembolism after total joint arthroplasty. METHODS: This study was a retrospective analysis of Medicare patients undergoing elective total joint arthroplasty who were given nomogram-dosed warfarin for venous thromboembolism prophylaxis...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29351136/trends-and-variability-in-the-use-of-total-shoulder-arthroplasty-for-medicare-patients
#17
Benjamin Zmistowski, Eric M Padegimas, Michael Howley, Joseph Abboud, Gerald Williams, Surena Namdari
INTRODUCTION: As policies are implemented to encourage high-quality care, it is important to identify any persistent limitations to the uniform delivery of anatomic and reverse total shoulder arthroplasty (TSA). The study's goal was to assess current TSA use and identify predictors of geographic variability. METHODS: We used data from 2012 through 2014 that was obtained from public Medicare databases to identify the case volume, locations, and names of surgeons performing >10 TSAs annually...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29351135/angiography-and-embolization-in-the-management-of-bleeding-pelvic-fractures
#18
Rahul Vaidya, Jacob Waldron, Alesha Scott, Kerellos Nasr
The use, timing, and priority of angioembolization in the management of bleeding pelvic fractures remain ambiguous. The most common vessels for angioembolization are, in decreasing order, the internal iliac artery and its branches, the superior gluteal artery, the obturator artery, and the internal pudendal artery. Technical success rates for this treatment option range from 74% to 100%. The fracture patterns most commonly requiring angioembolization are the Young and Burgess lateral compression and anterior-posterior compression types and Tile type C...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29337716/management-of-biceps-tendon-pathology-from-the-glenoid-to-the-radial-tuberosity
#19
Rachel M Frank, Eric J Cotter, Eric J Strauss, Laith M Jazrawi, Anthony A Romeo
Management of proximal and distal biceps tendon pathology is evolving. The long head of the biceps tendon, if inflamed, may be a pain-producing structure. In appropriately indicated patients, a symptomatic long head of the biceps tendon can be surgically managed via tenotomy, tenodesis, and/or superior labrum anterior to posterior repair. In some patients, primary superior labrum anterior to posterior pathology can be managed via biceps tenodesis. Determining which procedure is most appropriate and which technique and implant are preferred for a given patient with biceps tendon pathology is controversial...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29309293/orthopaedic-manifestations-of-sickle-cell-disease
#20
Kelly L Vanderhave, Crystal A Perkins, Brian Scannell, Brian K Brighton
Sickle cell disease (SCD) is an autosomal recessive disorder that results in hemolytic anemia related to abnormal hemoglobin and erythrocyte levels. SCD is characterized by vascular occlusive episodes, visceral sequestration, and aplastic or hemolytic crises. These crises most commonly occur in bone. The orthopaedic manifestations of SCD comprise much of the morbidity associated with this disorder. Osteonecrosis and osteomyelitis are among the most disabling and serious musculoskeletal complications in patients with SCD...
February 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
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