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Journal of the American Academy of Orthopaedic Surgeons

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https://www.readbyqxmd.com/read/29933260/complete-talar-extrusion-treated-with-an-antibiotic-cement-spacer-and-staged-femoral-head-allograft
#1
Philip Huang, Mary Elizabeth Lundgren, Rajeev Garapati
Complete talar extrusion is rare and usually associated with a high-energy mechanism of injury causing complete dissociation of the talus from the surrounding bony and soft-tissue structures with enough force to expel the talus out of the body. Treatment can be complicated by infection, osteonecrosis, posttraumatic osteoarthritis, and leg length discrepancy, which may require multiple subsequent surgeries for improved outcome and quality of life. Reimplantation of the native talus affords maintenance of joint height and favorable outcomes have been reported...
June 21, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29912032/spinopelvic-dissociation-a-retrospective-case-study-and-review-of-treatment-controversies
#2
Daud Tai Shan Chou, Ibraheim El-Daly, Arun Ranganathan, Alexander Montgomery, Paul Culpan, Peter Bates
INTRODUCTION: Spinopelvic dissociation is a rare injury resulting in discontinuity between the spine and pelvis. We review the English- language literature and discuss critical treatment controversies. We present a series of spinopelvic dissociation cases from a level I trauma center. METHODS: In this retrospective review of 18 consecutive cases treated surgically over a period of 4 years, we collected patient, injury, and surgical demographics and clinical and radiographic outcome measures...
June 14, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29905597/extremity-war-injuries-xii-homeland-defense-as-a-translation-of-war-lessons-learned
#3
Maj Daniel J Stinner, Andrew H Schmidt
The 12th Extremity War Injuries Symposium focused on issues related to the transitions in medical care that are occurring as the focus of the war on terror changes. The symposium highlighted the results of Department of Defense-funded research in musculoskeletal injury, the evolution of combat casualty care, and the readiness of the fighting force. Presentations and discussions focused on force readiness of both troops and their medical support as well as the maintenance of the combat care expertise that has been developed during the previous decade of conflict...
June 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29901481/reverse-reamed-intercalary-allograft-a-surgical-technique
#4
Benjamin Wilke, Anna Cooper, C Parker Gibbs, Andre Spiguel
Allograft reconstruction of large segmental intercalary bone defects after tumor resection is a well-accepted surgical technique. Although results generally have been satisfactory, nonunion at the allograft-host bone junction site remains a notable concern. Various reports have described attempts to enhance junctional healing with a variety of complex osteotomies, often complicating an already complex procedure. The use of an innovative reverse reaming technique can decrease the level of intraoperative difficulty mating the allograft-host junction and theoretically may improve junctional healing by enhancing stability and increasing the contact surface area...
June 11, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29878970/comprehensive-review-of-current-constraining-devices-in-total-hip-arthroplasty
#5
Johannes Michiel Van der Merwe
Hip instability after total joint arthroplasty is a devastating complication. Appropriate management of instability is a challenge. Three components that are commonly used in these challenging scenarios are constrained liners, constrained tripolar components, and nonconstrained tripolar components. The biomaterials and biomechanics of these devices vary. Surgeons must take into account the risks associated with each of these components and some surgical pearls for their use. A thorough review of the recent literature allows comparison of results addressing the short-, medium-, and long-term survival of each component...
June 6, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29877919/concomitant-proximal-and-distal-tibiofibular-joint-dislocation-associated-with-a-tibial-shaft-fracture
#6
John S Hwang, Michael S Sirkin, Zachary Gala, Mark Adams, Mark C Reilly
An association exists between tibial shaft fractures and ankle injuries. In addition, although uncommon, an association between tibial shaft fractures and proximal tibiofibular dislocations has also been established. A review of the previous literature resulted in one case report of a complete proximal and distal tibiofibular joint dislocation without fracture of the tibia or fibula. Here, we discuss a case of a complete proximal and distal tibiofibular syndesmotic complex dislocation associated with a tibial shaft fracture...
June 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29877918/analysis-of-femoral-version-in-patients-undergoing-periacetabular-osteotomy-for-symptomatic-acetabular-dysplasia
#7
Wudbhav N Sankar, Eduardo Novais, Denise Koueiter, Christian Refakis, Ernest Sink, Michael B Millis, Young-Jo Kim, John Clohisy, Joel Wells, Jeffrey Nepple, Ira Zaltz
INTRODUCTION: A paucity of information exists on the range of femoral version, its effect on hip stability, clinical examination, and presentation in patients with symptomatic acetabular dysplasia. The purpose of this study was to describe the range of version in symptomatic acetabular dysplasia, the association between femoral version and proximal femoral morphology and degree of dysplasia, and the effect of version on clinically measured hip range of motion and on preoperatively measured hip outcome scores...
June 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29870418/letter-to-the-editor-factors-motivating-medical-students-in-selecting-a-career-specialty-relevance-for-a-robust-orthopaedic-pipeline
#8
Rebecca Broom, Craig Cadwallader
No abstract text is available yet for this article.
June 4, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29870417/venous-thromboembolism-prophylaxis-in-spine-surgery
#9
Christopher K Kepler, James McKenzie, Tyler Kreitz, Alexander Vaccaro
Venous thromboembolism (VTE) is a source of morbidity and mortality in patients undergoing orthopaedic surgery. A substantial body of literature supports the use of VTE prophylactic agents in patients undergoing lower extremity surgery. Treatment options include early mobilization, mechanical prophylaxis via pneumatic compression devices, pharmacologic agents, and venous filters. No consensus has been established regarding utilization or timing of VTE prophylaxis measures after spine surgery. The risk of VTE in patients undergoing spine surgery is not well characterized and varies substantially by the procedure and degree of neurologic compromise...
June 4, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29870416/the-orthopaedic-surgery-residency-application-process-an-analysis-of-the-applicant-experience
#10
Prem N Ramkumar, Sergio M Navarro, Morad Chughtai, Heather S Haeberle, Samuel A Taylor, Michael A Mont
INTRODUCTION: Orthopaedic surgery residency positions are highly sought after. The purpose of this survey study was to report the following components of the applicant experience: (1) the number of programs to which applicants applied and interviewed, (2) the performance criteria associated with receiving interviews, (3) the way applicants respond to e-mail interview offers, (4) the pre- and post-interview communication between applicants and programs, (5) the importance of interview day activities and the determinants of the applicant rank order list (ROL), and (6) the financial cost of the application process...
June 4, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29864036/managing-sports-related-concussions-from-time-of-injury-through-return-to-play
#11
Eric Shirley, L Jared Hudspeth, Jennifer R Maynard
Sports-related concussions continue to generate widespread interest. A concussion is a complex pathophysiologic process, with or without loss of consciousness, that results in a disturbance of brain function. Risk factors include age <18 years, female sex, and history of a previous concussion. A sideline physical examination with standardized assessment tools can assist diagnosis. Management for suspected concussion begins with immediate removal from play and requires clinical follow-up. Symptoms are usually self-limited and resolve within 2 to 3 weeks...
June 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29851695/hip-instability-in-patients-with-down-syndrome
#12
Daniel Maranho, Kathryn Fuchs, Young-Jo Kim, Eduardo N Novais
The incidence of hip instability in children with Down syndrome is 1% to 7%. The natural history is often progressive, with the typical onset of hypermobility of the hip evolving to habitual dislocation, persistent subluxation, and fixed dislocation, and eventually leading to the loss of independent mobility. Treatment focuses on stabilizing the hip joint and depends on the patient's age and the severity of the disease. Typically, surgical intervention is recommended for the treatment of patients with habitual dislocation, subluxation, and complete dislocation of the hip...
May 30, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29847421/the-role-of-mentoring-in-the-development-of-successful-orthopaedic-surgeons
#13
Mary K Mulcahey, Brian R Waterman, Robert Hart, Alan H Daniels
Mentoring plays an integral role in orthopaedic surgeons' career development and personal growth. Effective mentors are committed to their roles, provide skilled instructional support, model continuous learning, and communicate optimism. Numerous obstacles impede productive mentoring relationships in medicine, including reluctance to ask for help, time constraints due to extensive work obligations, lack of institutional support, relational difficulties, and lack of mentoring skills. Effective partnerships require a concerted effort to establish behaviors conducive to mentoring, such as sharing knowledge and providing constructive feedback...
May 28, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29847420/sex-based-differences-in-common-sports-injuries
#14
Cordelia W Carter, Mary Lloyd Ireland, Anthony E Johnson, William N Levine, Scott Martin, Asheesh Bedi, Elizabeth G Matzkin
The patient's sex plays an important role in mediating the risk for, and experience of, disease. Injuries of the musculoskeletal system are no exception to this phenomenon. Increasing evidence shows that the incidence, clinical presentation, and treatment outcomes for male and female patients with common sports injuries may vary widely. Stress fracture, which is associated with the female athlete triad, is a sports injury with known sex-based differences. Other common sports-related injuries may also have distinct sex-based differences...
May 28, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29847419/teaching-professionalism-in-orthopaedic-residency-efficacy-of-the-american-academy-of-orthopaedic-surgeons-ethics-modules
#15
B Corbett Walsh, Raj Karia, Kenneth Egol, Joeseph D Zuckerman, Donna Phillips
INTRODUCTION: To aid implementing an ethics curriculum in an orthopaedic residency program, the American Academy of Orthopaedic Surgeons (AAOS) created 14 ethics scenarios. Because delivery of this curriculum could be burdensome, an online module-based curriculum might be optimal. METHODS: Two cohorts of orthopaedic residents participated: cohort I completed 14 online ethics modules converted from the 14 AAOS ethics scenarios. For each module, we gave a multiple-choice assessment immediately before the module, immediately afterward, and 3 months afterward...
May 28, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29787464/costs-and-radiographic-outcomes-of-rotational-ankle-fractures-treated-by-orthopaedic-surgeons-with-or-without-trauma-fellowship-training
#16
Walter W Virkus, Robert J Wetzel, Todd O McKinley, Anthony T Sorkin, Jeffrey S Cheesman, Lauren C Hill, Laurence B Kempton
INTRODUCTION: We evaluated the radiographic outcomes and surgical costs of surgically treated rotational ankle fractures in our health system between providers who had completed a trauma fellowship and those who had not. METHODS: We grouped patients into those treated by trauma-trained orthopaedic surgeons (TTOS) and non-trauma-trained orthopaedic surgeons (NTTOS). We graded the quality of fracture reductions and calculated implant-related costs of treatment. RESULTS: A total of 208 fractures met the inclusion criteria, with 119 in the TTOS group and 89 in the NTTOS group...
May 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29787463/lateral-patellar-instability-in-the-skeletally-mature-patient-evaluation-and-surgical-management
#17
David R Diduch, Abdurrahman Kandil, M Tyrrell Burrus
Lateral patellar instability is a common disease process that affects all types of patients. Depending on the patient's anatomy and the results of preoperative imaging, surgical management options include medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, and sulcus-deepening trochleoplasty. Medial patellofemoral ligament reconstruction or repair is useful for almost all patients, whereas tibial tubercle osteotomy is helpful to correct a lateralized tibial tubercle and the associated elevated lateral pull of the extensor mechanism...
May 18, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29781819/staging-of-bone-and-soft-tissue-sarcomas
#18
Robert J Steffner, Eugene S Jang
The purpose of staging in orthopaedic oncology is to provide a framework for classifying tumors based on their risk of local recurrence and distant metastasis to guide treatment decisions. Two separate systems are commonly used to categorize bone and soft-tissue sarcomas. The Musculoskeletal Tumor Society system for bone sarcomas and the Enneking system for soft-tissue sarcomas are the original staging systems developed by orthopaedic surgeons. The American Joint Committee on Cancer staging systems for bone and soft-tissue sarcomas are periodically updated based on new data, and they are currently on their eighth edition...
May 17, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29781823/reply-to-the-letter-to-the-editor-the-weight-bearing-shoulder
#19
Ronak M Patel, Jonathan D Gelber, Mark S Schickendantz
No abstract text is available yet for this article.
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29781822/letter-to-the-editor-the-weight-bearing-shoulder
#20
Joseph J King, Thomas W Wright
No abstract text is available yet for this article.
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
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