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American Journal of Orthopedics

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https://www.readbyqxmd.com/read/29719012/proximal-humerus-fracture-3-d-modeling
#1
Krishn Khanna, Eugene W Brabston, Usama Qayyum, Thomas R Gardner, William N Levine, Charles M Jobin, Christopher S Ahmad
The objective of this study is to determine the reproducibility and feasibility of using 3-dimensional (3-D) computer simulation of proximal humerus fracture computed tomography (CT) scans for fracture reduction. We hypothesized that anatomic reconstruction with 3-D models would be anatomically accurate and reproducible. Preoperative CT scans of 28 patients with 3- and 4-part (AO classification 11-B1, 11-B2, 11-C1, 11-C2) proximal humerus fractures who were treated by hemiarthroplasty were converted into 3-D computer models...
April 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29719011/short-term-storage-of-platelet-rich-plasma-at-room-temperature-does-not-affect-growth-factor-or-catabolic-cytokine-concentration
#2
Brooke H Wilson, Brian J Cole, Margaret B Goodale, Lisa A Fortier
The aim of this study was to provide clinical recommendations about the use of platelet-rich plasma (PRP) that was subjected to short-term storage at room temperature. We determined bioactive growth factor and cytokine concentrations as indicators of platelet and white blood cell degranulation in blood and PRP. Additionally, this study sought to validate the use of manual, direct smear analysis as an alternative to automated methods for platelet quantification in PRP. Blood was used to generate low-leukocyte PRP (Llo PRP) or high-leukocyte PRP (Lhi PRP)...
April 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29719010/fat-fracture-a-rare-cause-of-anterior-and-medial-knee-pain-in-a-professional-baseball-player
#3
Ronak M Patel, Lonnie Soloff, Jason Genin, Pamela Lund, Mark S Schickendantz
Blunt trauma to the anterior knee typically results in a contusion or fracture of the patella. Additionally, injury to the extensor mechanism may come from a partial or full disruption of the patellar or quadriceps tendon. A professional baseball player suffered an injury to his knee after he collided with an outfield wall. Acute swelling in the suprapatellar soft tissues concealed a palpable defect, which initially was suspected to be an injury to the quadriceps tendon. Magnetic resonance imaging of the knee revealed an intact extensor mechanism; moreover, a fracture of the subcutaneous fat anterior to the quadriceps tendon was evident and diagnosed as a fat fracture...
April 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611851/managing-glenoid-bone-deficiency-the-augment-experience-in-anatomic-and-reverse-shoulder-arthroplasty
#4
Rowan J Michael, Bradley S Schoch, Joseph J King, Thomas W Wright
Glenoid bone deficiency in the setting of shoulder replacement surgery is far more common than originally reported. The frequency and severity of the glenoid defects are noted to be more common and severe with the advent of computer-assisted surgery. The results of an anatomic total shoulder arthroplasty (aTSA) with glenoid deficiency have been reported to be inferior to aTSA patients without a glenoid deficiency. Options for treating the glenoid deficiency include eccentric reaming, bone grafting, and the use of augmented glenoid components...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611850/prevalence-and-impact-of-self-citation-in-academic-orthopedic-surgery
#5
Jason Silvestre, Atul F Kamath
The h-index is a commonly utilized metric for academic productivity. Previous studies have proposed that self-citation may limit the utility of the h-index. The purpose of this study is to evaluate the impact of self-citation on the h-index among orthopedic investigators. The study cohort consisted of program directors, chairpersons, and faculty at orthopedic surgery residency programs in the United States. The Scopus database was used to determine the h-index and number of citations ± self-citations. The total number of publications was correlated with the change in the h-index via self-citation...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611849/glenoid-bone-loss-in-reverse-shoulder-arthroplasty-treated-with-bone-graft-techniques
#6
Tom R Norris
The reverse shoulder arthroplasty facilitates surgical treatment of primary and revision shoulder with rotator cuff and bone deficiencies. Wear pattern classifications and a logical treatment approach for glenoid bone loss enable the surgeon to address a difficult series of problems in the reconstructions where the glenoid might not otherwise be able to support the implants. Bone grafting using the native humeral head in primary cases, and in revision cases, iliac crest are the most reliable sources for structural grafts for the worn or deficient glenoid vault...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611848/special-considerations-for-pediatric-patellar-instability
#7
Sean Keyes, Meghan Price, Daniel W Green, Shital N Parikh
Patellar instability in children and adolescents is a challenging subset to treat. Varied forms of instability, ranging from episodic dislocation to fixed dislocation, have been recognized. It is of utmost importance for the treating physician to recognize these different patterns of instability and their associated risk factors, as more complex patterns of instability would require more extensive surgical procedures. Medial patellofemoral ligament (MPFL) reconstruction, by itself, may not suffice or may not be appropriate for the more complex instability patterns...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611847/the-prevention-and-treatment-of-femoral-trial-head-loss-in-total-hip-arthroplasty
#8
Douglas Navasartian, Paul Allegra, Benjamin Giliberti, David Chalnick
This article aims to provide the information necessary to prevent femoral trial head loss and to offer information regarding retrieval of the trial head if it is lost within the surgical field. These techniques can be used to help guide practice in the future. A review of the literature was conducted using a computerized search of PubMed in regard to this issue to investigate how such an occurrence can be prevented and what steps can be taken if preventative measures fail.
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611846/implant-survivorship-and-complication-rates-after-total-knee-arthroplasty-with-a-third-generation-cemented-system-15-year-follow-up
#9
Muthana Sartawi, David Zurakowski, Aaron Rosenberg
This work is a retrospective cohort study evaluating patients who had undergone third-generation cemented total knee arthroplasty (TKA) with prostheses (NexGen, Zimmer Biomet) utilizing posterior-stabilized (PS) and cruciate-retaining (CR) designs at a single center at their 15-year follow-up. The purpose of this study is to determine the functional knee scores, reoperations, and long-term survivorship for patients with the NexGen Zimmer Biomet Knee system at the 15-year follow-up. In total, 99 patients who had undergone primary TKA were followed for 15 years...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29611845/dual-radial-styloid-and-volar-plating-for-unstable-fractures-of-the-distal-radius
#10
Matthew R Garner, Patrick C Schottel, Ryan R Thacher, Stephen J Warner, Dean G Lorich
As the operative management of displaced distal radius fractures evolves, intraoperative techniques and fixation strategies evolve as well. Achieving and maintaining an acceptable reduction is paramount but can be difficult with particular fracture patterns. In this article, we describe the use of a radial column plate as a reduction tool in the management of unstable distal radius fractures, along with clinical and radiographic clinical outcomes. This technique can be useful in situations where multiplanar instability exists, or simply when intraoperative assistance is limited...
March 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494718/patient-specific-guides-instrumentation-in-shoulder-arthroplasty
#11
Brian E Ward, Joshua S Dines
Optimal outcomes following total shoulder arthroplasty TSA and reverse shoulder arthroplasty RSA are dependent on proper implant position. Multiple cadaver studies have demonstrated improved accuracy of implant positioning with use of patient-specific guides/instrumentation compared to traditional methods. At this time, there are 3 commercially available single use patient-specific instrumentation systems and 1 commercially available reusable patient-specific instrumentation system. Currently though, there are no studies comparing the clinical outcomes of patient-specific guides to those of traditional methods of glenoid placement, and limited research has been done comparing the accuracy of each system's 3-dimensional planning software...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494717/convertible-glenoid-components-facilitate-revisions-to-reverse-shoulder-arthroplasty-easier-retrospective-review-of-13-cases
#12
Philippe Valenti, Denis Katz, Jean Kany, Jean-David Werthel
Removal of a cemented glenoid component often leads to massive glenoid bone loss, which makes it difficult to implant a new glenoid baseplate. The purpose of this study was to demonstrate the feasibility of revisions with a completely convertible system and to report clinical and radiographic results of a retrospective review of 13 cases. Between 2003 and 2011, 104 primary total shoulder arthroplasties (TSAs) were performed with an uncemented glenoid component in our group. Of these patients, 13 (average age, 64 years) were revised to reverse shoulder arthroplasty (RSA) using a modular convertible platform system and were included in this study...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494716/treating-humeral-bone-loss-in-shoulder-arthroplasty-modular-humeral-components-or-allografts
#13
Ian Power, Thomas W Throckmorton
Reconstructing proximal humeral bone loss in the setting of shoulder arthroplasty can be a daunting task. Proposed techniques include long-stemmed humeral components, allograft-prosthesis composites (APCs), and modular endoprosthetic reconstruction. While unsupported long-stemmed components are at high risk for component loosening, APC reconstruction techniques have been reported with success. However, graft resorption and eventual failure are significant concerns. Modular endoprosthetic systems allow bone deficiencies to be reconstructed with metal, which may allow for a more durable reconstruction...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494715/use-of-a-novel-magnesium-based-resorbable-bone-cement-for-augmenting-anchor-and-tendon-fixation
#14
Brandon L Roller, Keiichi Kuroki, Chantelle C Bozynski, Ferris M Pfeiffer, James L Cook
The aim of this study was to assess the efficacy and safety of a novel magnesium-based resorbable bone cement (OsteoCrete, Bone Solutions Incorporated) for anchor and tendon fixation. Cadaveric humeral testing involved straight pull-to-failure of rotator cuff suture anchors; OsteoCrete was injected through one anchor, and a second anchor served as the uninjected control. Testing was conducted 15 minutes post-injection. A canine preclinical model was used to evaluate the safety of the following parameters: Rotator cuff repair: A double-row technique was used to repair transected infraspinatus tendons; OsteoCrete was injected through both anchors in one limb, and the contralateral limb served as the uninjected control...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494714/patient-specific-implants-in-severe-glenoid-bone-loss
#15
Ivan De Martino, David M Dines, Russell F Warren, Edward V Craig, Lawrence V Gulotta
Complex glenoid bone deformities present the treating surgeon with a complex reconstructive challenge. Although glenoid bone loss can be encountered in the primary setting (degenerative, congenital, post-traumatic), severe glenoid bone loss is encountered in most revision total shoulder arthroplasties. Severe glenoid bone loss is treated with various techniques including hemiarthroplasty, eccentric reaming, and glenoid reconstruction with bone autografts and allografts. Despite encouraging short- to mid-term results reported with these reconstruction techniques, the clinical and radiographic outcomes remain inconsistent and the high number of complications is a concern...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494713/total-shoulder-arthroplasty-using-a-bone-sparing-precision-multiplanar-humeral-prosthesis
#16
Steven S Goldberg, Eric S Baranek
Proper reconstruction of proximal humeral anatomy is of primary importance to maximize patient outcomes after total shoulder arthroplasty. This article describes a new arthroplasty technique, where a fixed multiplanar bone resection is made and a novel implant, which is designed to precisely match the bone resection, is inserted.
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494712/humeral-bone-loss-in-revision-shoulder-arthroplasty
#17
Paul B McLendon, Jacob L Cox, Mark A Frankle
Revision shoulder arthroplasty is becoming more prevalent as the rate of primary shoulder arthroplasty in the US continues to increase. The management of proximal humeral bone loss in the revision setting presents a difficult problem without a clear solution. Different preoperative diagnoses often lead to distinctly different patterns of bone loss. Successful management of these cases requires a clear understanding of the normal anatomy of the proximal humerus, as well as structural limitations imposed by significant bone loss and the effect this loss has on component fixation...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29494711/use-of-a-small-bore-needle-arthroscope-to-diagnose-intra-articular-knee-pathology-comparison-with-magnetic-resonance-imaging
#18
Carl A Deirmengian, Joshua S Dines, Joseph V Vernace, Michael S Schwartz, R Alexander Creighton, James N Gladstone
The use of arthroscopy for purely diagnostic purposes has been largely supplanted by noninvasive technologies, such as magnetic resonance imaging (MRI). The mi-eye+TM (Trice Medical) technology is a small-bore needle unit for in-office arthroscopy. We conducted a pilot study comparing the mi-eye⁺™ unit with MRI, using surgical arthroscopy as a gold-standard reference. We hypothesized that the mi-eye⁺™ needle arthroscope, which can be used in an office setting, would be equivalent to MRI for the diagnosis of intra-articular pathology of the knee...
February 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29447306/knotless-tape-suture-fixation-of-quadriceps-tendon-rupture-a-novel-technique
#19
James M Paci, Amanda Pawlak
Quadriceps tendon ruptures disrupt the extensor mechanism of the knee and require urgent surgical management. Traditional repair techniques have had mixed biomechanical and clinical results risking weakness and extensor lag. We describe a novel technique using tape suture and knotless anchors, which has performed superiorly during biomechanical testing and yielded terrific early clinical results.
January 2018: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29447305/pseudo-pedicle-heterotopic-ossification-from-use-of-recombinant-human-bone-morphogenetic-protein-2-rhbmp-2-in-transforaminal-lumbar-interbody-fusion-cages
#20
Charles D Rosen, P Douglas Kiester, Thay Q Lee
We conducted a study to determine the common characteristics of patients who developed radiculopathy symptoms and corresponding heterotopic ossification (HO) from transforaminal lumbar interbody fusions (TLIF) using recombinant human bone morphogenetic protein 2 (rhBMP-2). HO can arise from a disk space with rhBMP-2 use in TLIF. Formation of bone around nerve roots or the thecal sac can cause a radiculopathy with a consistent pattern of symptoms. We identified 38 patients (26 males, 12 females) with a mean (SD) age of 50...
January 2018: American Journal of Orthopedics
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