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Journal of the American Academy of Orthopaedic Surgeons

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https://www.readbyqxmd.com/read/28406880/aaos-appropriate-use-criteria-treatment-of-hip-fractures-in-the-elderly
#1
Varatharaj Mounasamy, Pierre Guy, Stephen L Kates
No abstract text is available yet for this article.
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406879/physical-examination-of-the-knee-meniscus-cartilage-and-patellofemoral-conditions
#2
Robert D Bronstein, Joseph C Schaffer
The knee is one of the most commonly injured joints in the body. Its superficial anatomy enables diagnosis of the injury through a thorough history and physical examination. Examination techniques for the knee described decades ago are still useful, as are more recently developed tests. Proper use of these techniques requires understanding of the anatomy and biomechanical principles of the knee as well as the pathophysiology of the injuries, including tears to the menisci and extensor mechanism, patellofemoral conditions, and osteochondritis dissecans...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406878/bone-loss-in-revision-total-knee-arthroplasty-evaluation-and-management
#3
Neil P Sheth, Marcelo Batista Bonadio, Marco Kawamura Demange
With the increasing number of total knee arthroplasty (TKA) procedures being performed annually, the burden of revision surgery is also expected to increase. Addressing bone loss during revision TKA is a considerable challenge that requires proper preoperative evaluation and surgical planning. In addition to an assessment of femoral and tibial bone loss, a systematic approach to the management of bone loss associated with TKA includes careful implant selection, adherence to the general principles of revision TKA, and an understanding of the available reconstruction options...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#4
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28406876/cartilage-restoration-techniques-for-the-patellofemoral-joint
#5
Robert H Brophy, Robert D Wojahn, Joseph D Lamplot
Symptomatic osteochondral lesions of the patellofemoral joint are clinically challenging to manage because of the limited healing potential of articular cartilage; the complex morphology of the patellofemoral joint; the heterogeneity of the articular surface between patients; and high stresses across the joint, which can be altered by malalignment, tilt, or maltracking. Indications for surgery include traumatic lesions, osteochondritis dissecans, and high-grade chondromalacia in association with persistent pain despite a course of nonsurgical management...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379915/total-knee-arthroplasty-in-patients-with-cerebral-palsy-a-matched-cohort-study-to-patients-with-osteoarthritis
#6
Matthew T Houdek, Chad D Watts, Cody C Wyles, Robert T Trousdale, Todd J Milbrandt, Michael J Taunton
INTRODUCTION: Currently, few data examine the use of total knee arthroplasty (TKA) in patients with cerebral palsy (CP). This study reviewed the outcomes of TKA in patients with CP compared with a matched cohort undergoing TKA for primary osteoarthritis. METHODS: Over a 28-year period, 15 TKAs in patients with a diagnosis of CP were identified. The cohort was 53% men, with a mean age of 58 years. Patients with CP were matched 1:2 based on age, sex, body mass index, and year of surgery with a group of patients undergoing TKA for osteoarthritis...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379914/treatment-of-hip-fractures-in-the-elderly
#7
Robert H Quinn, Pekka A Mooar, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the Appropriate Use Criteria (AUC) document Treatment of Hip Fractures in the Elderly to improve patient care and obtain optimal outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from indications typical of patients commonly presenting with hip fractures in clinical practice, as well as from current evidence-based clinical practice guidelines and supporting literature...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379913/misaligned-versus-straight-placement-of-anterior-cervical-plates-a-clinical-and-radiologic-outcomes-study
#8
Kingsley R Chin, Fabio J R Pencle, Shannon D Francis, Chloe A Francis, Jason A Seale, Elijah A Hothem
BACKGROUND: In anterior cervical diskectomy and fusion (ACDF), misaligned plates are concerning because of the risk of screw-and-plate failure; however, these plates also hypothetically have the potential for asymmetric micromotion on the facet and uncovertebral joint. The aim of this study was to determine whether misaligned plate placement during ACDF had clinical benefits compared with straight plate placement. METHODS: Postoperative AP radiographs of 128 consecutive patients who underwent ACDF with anterior cervical plate (ACP) fixation were reviewed, and plate alignment was assessed...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379912/functional-and-clinical-outcomes-of-nonsurgically-managed-tibial-plateau-fractures
#9
Christian A Pean, Adam Driesman, Anthony Christiano, Sanjit R Konda, Roy Davidovitch, Kenneth A Egol
INTRODUCTION: This study sought to assess and compare long-term functional and clinical outcomes in patients with tibial plateau fractures that are treated nonsurgically. METHODS: Over a period of 8 years, 305 consecutive tibial plateau fractures were treated by three surgeons at a single institution and followed prospectively in an Institutional Review Board-approved study. Overall, 41 patients (13%) were treated nonsurgically and 37 were available for follow-up...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379911/treatment-of-pregnant-patients-with-orthopaedic-trauma
#10
Nirmal Tejwani, Kevin Klifto, Christopher Looze, Christopher Scott Klifto
Fracture management in pregnant patients is challenging. Anatomic and physiologic changes in pregnancy increase the complexity of treatment. Maternal trauma increases the risk of fetal loss, preterm birth, placental abruption, cesarean delivery, and maternal death. Initial resuscitation and treatment in a facility equipped to handle the orthopaedic injury and preterm births are paramount. Pelvic and acetabular injuries are potentially life threatening. The benefits and risks of surgical treatment must be carefully considered...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28350548/pelvic-discontinuity-associated-with-total-hip-arthroplasty-evaluation-and-management
#11
Matthew P Abdel, Robert T Trousdale, Daniel J Berry
Pelvic discontinuity is a challenging complication encountered during revision total hip arthroplasty. Pelvic discontinuity is defined as a separation of the ilium superiorly from the ischiopubic segment inferiorly and is typically a chronic condition in failed total hip arthroplasties in the setting of bone loss. After a history and a physical examination have been completed and infection has been ruled out, appropriate imaging must be obtained, including plain hip radiographs, oblique Judet radiographs, and often a CT scan...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28323644/pediatric-acute-compartment-syndrome
#12
Kristin S Livingston, Michael P Glotzbecker, Benjamin J Shore
Pediatric acute compartment syndrome (PACS) is a clinical entity that must be carefully differentiated from the adult version (ie, acute compartment syndrome). Healthcare providers must understand the variable etiologies of PACS, of which trauma is the most common but can also include vascular insult, infection, surgical positioning, neonatal phenomena, overexertion, and snake and insect bites. In addition to the unique etiologies of PACS, providers must also recognize the different signs and symptoms of PACS...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291148/mechanical-signals-as-regulators-of-cartilage-degeneration-and-regeneration
#13
Muhammad Farooq Rai, Martin J Stoddart, Farshid Guilak
No abstract text is available yet for this article.
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291147/strategies-for-surgical-management-of-large-stiff-spinal-deformities-in-children
#14
Kevin M Neal, Evan Siegall
Management of large, severe, stiff spinal deformities in children can be challenging. Adjunctive treatments used in conjunction with spinal osteotomy, instrumentation, and fusion can improve the ultimate degree of deformity correction. These adjunctive treatments include preoperative halo-gravity traction, intraoperative halo-femoral traction, temporary internal spinal distraction, and anterior spinal release. Each of these techniques has unique indications and individual risks. When the appropriate protocols are followed, these techniques can be safe and efficacious...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291146/malignant-lymphoma-mimicking-an-infection-after-shoulder-surgery
#15
Jabari Ian Justin Martin, Jasmine Bauknight, Vincent Desiderio, Bahman Sadr
Involvement of the musculoskeletal system by primary or metastatic malignant neoplasms mimicking common orthopaedic conditions is well recognized. The diagnosis may be delayed in the absence of radiographic abnormalities. Twenty-five percent of lymphoma cases have skeletal involvement, and they can affect both bone and soft tissue. Lymphoma is sometimes discovered by means of routine histologic examination of tissue collected at the time of orthopaedic surgery. To the best of our knowledge, this is the first report of lymphoma occurring at the site of prior shoulder surgery and mimicking an infection...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291145/isolated-head-and-liner-exchange-in-revision-hip-arthroplasty
#16
David William Walmsley, James P Waddell, Emil H Schemitsch
As the number of primary total hip arthroplasties increases, so does the burden of revision procedures. The decision to revise well-fixed components in the setting of polyethylene wear and osteolysis is controversial. Modular head and liner exchange offers the advantages of reduced invasiveness, faster recovery, and bone preservation. These advantages come at the expense of higher rates of revision surgery for instability. Using the native locking mechanism for securing the new liner is preferred; however, cementing a liner into a well-fixed acetabular component is a practical alternative...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291144/physical-examination-of-knee-ligament-injuries
#17
Robert D Bronstein, Joseph C Schaffer
The knee is one of the most commonly injured joints in the body. A thorough history and physical examination of the knee facilitates accurate diagnosis of ligament injury. Several examination techniques for the knee ligaments that were developed before advanced imaging remain as accurate or more accurate than these newer imaging modalities. Proper use of these examination techniques requires an understanding of the anatomy and pathophysiology of knee ligament injuries. Advanced imaging can be used to augment a history and examination when necessary, but should not replace a thorough history and physical examination...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291143/the-role-of-multimodal-analgesia-in-spine-surgery
#18
Mark F Kurd, Tyler Kreitz, Gregory Schroeder, Alexander R Vaccaro
Optimal postoperative pain control allows for faster recovery, reduced complications, and improved patient satisfaction. Historically, pain management after spine surgery relied heavily on opioid medications. Multimodal regimens were developed to reduce opioid consumption and associated adverse effects. Multimodal approaches used in orthopaedic surgery of the lower extremity, especially joint arthroplasty, have been well described and studies have shown reduced opioid consumption, improved pain and function, and decreased length of stay...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28291142/lower-extremity-avulsion-fractures-in-the-pediatric-and-adolescent-athlete
#19
Jonathan Schiller, Steven DeFroda, Travis Blood
Lower extremity avulsion fractures are uncommon in the pediatric population and can be misdiagnosed without proper imaging and/or clinical suspicion for these injuries. The most common locations of avulsion injuries are the ischial tuberosity, anterior superior iliac spine, and anterior inferior iliac spine. Less often, avulsion fractures occur in the tibial tubercle, calcaneus, and greater and lesser trochanters. When treated properly with rest and altered weight bearing, most of these injuries heal without complication...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28252477/aaos-appropriate-use-criteria-anterior-cruciate-ligament-injury-prevention-programs
#20
Kevin R Vincent, Daniel C Herman
No abstract text is available yet for this article.
April 2017: Journal of the American Academy of Orthopaedic Surgeons
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