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Advances in Orthopedics

Jordan Trafimow, Alexander S Aruin
Objectives: Injury associated with lifting, especially low back injury, is a big problem in industry that accounts for loss of work and high medical expenses. Studies of biomechanics of lifting provide a basis for optimization of lifting. The aim of the study was to further investigate the role of the upward force due to negative acceleration during a lift. Methods: Nine healthy subjects lifted an empty box and a box with additional load of 10, 20, and 25 lb. Kinematic data were recorded during the lifts and accelerations were calculated, and angular positions of the trunk and knee were obtained during the lifting when negative accelerations were used...
2018: Advances in Orthopedics
D Banaszek, D Spence, P O'Brien, K Lefaivre
Nonunion is a relatively rare, yet challenging problem after fracture of the femoral neck. Risk factors include verticality of the fracture line and presence of comminution of the posteromedial calcar, as well as quality of reduction. Treatment options consist of valgus intertrochanteric osteotomy versus arthroplasty. Treatment should be tailored to the individual patient, taking into account patient age and activity demands. This review outlines the principles and technical considerations for valgus osteotomy of the proximal femur in the setting of femoral neck nonunion...
2018: Advances in Orthopedics
Sharon Babcock, James F Kellam
In the United States, more than 300,000 hip fractures occur annually in the elderly population with associated significant morbidity and mortality. Both intracapsular and extracapsular hip fractures have inherent treatment challenges and therefore are at risk of nonunion complications. A systematic assessment including radiographic, metabolic, and infectious evaluations should be completed for all patients suspected of nonunion. Failed internal fixation of intracapsular hip fractures is typically treated with arthroplasty, while extracapsular proximal femur nonunions may be amenable to revision internal fixation or arthroplasty...
2018: Advances in Orthopedics
Sanjit R Konda, Hesham Saleh, Ariana Lott, Kenneth A Egol
Patterns of discharge location may be evident based on the "sickness" profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization...
2018: Advances in Orthopedics
Timothy A Damron, Kenneth A Mann
Introduction: Synthetic bone graft materials are commonly used to fill defects after curettage of benign bone lesions. Ultraporous beta tricalcium phosphate (TCP) is a popular synthetic compound used in this situation. Prior clinical studies based on plain X-ray analysis suggest incorporation of TCP is incomplete, even when combined with bone marrow (BMA). Purpose: The purpose was to analyze volumetric CT-based changes in defects grafted with TCP with/without BMA in a completed prospective RCT to objectively determine (1) relationship between size and age versus TCP incorporation and (2) whether there is an advantage to addition of BMA...
2018: Advances in Orthopedics
Eric Robinson, Dani Gaillard-Campbell, Thomas P Gross
Background: To date, there have been no published investigations on the cause of acetabular debonding, a rare failure phenomenon in metal-on-metal hip resurfacing where the acetabular porous coating delaminates from the implant while remaining well fixed to the pelvic bone. Purposes: This study aims to summarize the current understanding of acetabular debonding and to investigate the discrepancy in rate of debonding between two implant systems. Patients and Methods: To elucidate potential causes of debonding, we retrospectively analyzed a single-surgeon cohort of 839 hip resurfacing cases...
2018: Advances in Orthopedics
Andrew S Moon, Kivanc Atesok, Thomas E Niemeier, Sakthivel R Manoharan, Jason L Pittman, Steven M Theiss
Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis. Although reports in the literature include nonoperative and operative management, most authors advocate for surgical treatment with open reduction and decompression with instrumentation and fusion...
2018: Advances in Orthopedics
Christopher Jackson, Mina Tanios, Nabil Ebraheim
Subtrochanteric femur fractures are an uncommon injury in orthopedics, but when they are encountered they may present difficulties in management. The purpose of this paper is to examine the recent literature on the epidemiology, classification, initial evaluation, and definitely treatment for these injuries. These will assist the physician to determine the optimal treatment strategy and avoid potential surgical complication.
2018: Advances in Orthopedics
Thomas S Moores, Benjamin D Chatterton, Matthew J Walker, Phillip J Roberts
Background: This study aims to evaluate outcomes for warfarinised hip fracture patients and compare them with a matched nonwarfarinised group, before and after the introduction of national hip fracture guidelines in the United Kingdom. Methods: A retrospective cohort study of 1743 hip fracture patients was undertaken. All patients admitted taking warfarin were identified. These patients were then matched to nonwarfarinised patients using nearest neighbour propensity score matching, accounting for age, sex, hip fracture type, and Nottingham Hip Fracture Score...
2018: Advances in Orthopedics
Britta K Krautwurst, Jürgen R Paletta, Sylvia Mendoza, Adrian Skwara, Melvin Mohokum
Objective: Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data: A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods: Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48...
2018: Advances in Orthopedics
Jackson Rucker Staggers, Thomas Elliot Niemeier, William E Neway, Steven Michael Theiss
Objective: Blunt spinal trauma classification systems are well established and provide reliable treatment algorithms. To date, stability of the spine after civilian gunshot wounds (CGSWS) is poorly understood. Herein, we investigate the validity of trauma classification systems including the Thoracolumbar Injury Classification and Severity Score (TLICS), Subaxial Cervical Spine Injury Classification and Severity Score (SLIC), and Denis' three-column model when applied to spinal penetrating trauma from gunshots, while secondarily evaluating stability of these injuries...
2018: Advances in Orthopedics
Jennifer J Beck, Dai Sugimoto, Lyle Micheli
Introduction: Concern regarding ability of autologous chondrocyte implantation (ACI) to correct for the bone and cartilage pathology of knee juvenile osteochondritis dissecans (JOCD) exists. The purpose of this study was to determine long-term, patient-based outcomes of ACI treatment of JOCD in young patients. Authors hypothesized long-term outcomes are comparable to reported mid-term outcomes. Methods: A single institution, longitudinal cohort study design combining medical record review and outcome surveys was used...
2018: Advances in Orthopedics
Brian T Grisez, Andrew E Hanselman, Karim W Boukhemis, Trapper A J Lalli, Brock A Lindsey
Traditional above-the-knee amputation prosthetics utilize a stump-socket interface that is well-known for skin/socket problems, sitting difficulty, disuse osteopenia, and increased work of ambulation. As a result, we evaluated a novel osseointegrated transcutaneous implant in a large animal. The implant was designed to promote osseointegration at the bone-implant interface and minimize complications. As proof of concept, four Dorset sheep underwent a two-stage surgery for forelimb placement of an osseointegrated transcutaneous implant utilizing Compress® technology (Biomet, Inc...
2018: Advances in Orthopedics
J M Wilson, C A Staley, A L Boden, A R Boissonneault, A M Schwartz, M L Schenker
Introduction: On-call orthopedic clinicians have long speculated that daily consult volume is closely correlated with weather. While prior studies have demonstrated a relationship between weather and certain fracture types, the effect of weather on total orthopaedic consult volume has not yet been examined. The aim of this study was to investigate this relationship. Methods: We retrospectively reviewed orthopaedic consult data from 405 consecutive days at an urban, level one trauma center...
2018: Advances in Orthopedics
Abdulrahman D Algarni, Hassan M Al Moallem
Objective: Femoral head osteonecrosis is a progressive clinical condition with significant morbidity and long-term disability. Several treatment modalities including both surgical and nonsurgical options have been used with variable levels of success. High-energy extracorporeal shock wave therapy is a nonoperative treatment option that has been described for early-stage disease. We aimed to assess the functional and radiological outcomes of extracorporeal shockwave therapy (ESWT) in the treatment of osteonecrosis of the femoral head (ONFH)...
2018: Advances in Orthopedics
Panagiotis Korovessis, Vasileios Syrimpeis, Vasileios Tsekouras, Konstantinos Vardakastanis, Peter Fennema
Purpose: A retrospective study that aims to report Adjacent Segment Degeneration (ASD) incidence and spinopelvic balance in short lumbosacral instrumentation for degenerative lumbar spinal stenosis. Although ASD is a common complication following lumbar fusion, the effect of an interspinous spacer (IS) in the supradjacent segment in short lumbosacral instrumented fusion and its interaction with spinopelvic balance has not been studied adequately. Methods: From 55 consecutive age-, diagnosis-, and gender-matched patients aged 60±11 years, 17 (Group R) received PEEK IS; 18 (Group S) received Silicon IS compared with 20 controls (Group C) without receiving any IS...
2018: Advances in Orthopedics
Frank W M Faber, Monique J L Mastboom, Sabine T van Vliet-Koppert, Ilse C E Bouman, Paulien M van Kampen
While ankle arthrodesis was traditionally the gold standard method of treatment for disabling end-stage ankle arthritis, total ankle replacement (TAR) has been an acceptable alternative. The satisfaction rate of patients with TAR however differs. The purpose of our study is to investigate whether implant survival and results with special emphasis on the satisfaction rate of patients treated with a TAR implanted by a single surgeon were comparable to the literature. This was a retrospective cohort study in a teaching hospital...
2018: Advances in Orthopedics
Eric W Edmonds, John W Kemppainen, Joanna H Roocroft, John Munch, Tracey P Bastrom
Maintenance of certification (MOC) within a medical society requires continuing medical education that demonstrates life-long learning, cognitive expertise, and practice-based self-assessment. This prospective study sought to evaluate whether a self-directed Practice Improvement Module (PIM) would improve pediatric orthopedic patient outcomes, thus demonstrating evidence of life-long learning (Part II MOC credit) in treating supracondylar humerus fractures. Six surgeons and 113 patients were included. There was no significant difference in actual fracture outcome before or after PIM at any level of surgeon experience regarding radiographic appearance or need for reoperation ( p > 0...
2018: Advances in Orthopedics
Riccardo Luigi Alberio, Matteo Del Re, Federico Alberto Grassi
Background: The aim of this study was to evaluate the clinical and radiographic results after minimally invasive plate osteosynthesis (MIPO) for proximal humerus fractures. Potential advantages of this approach include the easier exposure of the greater tuberosity and the limited surgical dissection around the fracture site. Materials and Methods: From October 2011 to March 2016, thirty-nine patients (32 women, 7 men) with a mean age of 64.9 years (range: 48-80) were surgically treated with the MIPO technique for proximal humeral fractures...
2018: Advances in Orthopedics
Daniel A Müller, Giovanni Beltrami, Guido Scoccianti, Pierluigi Cuomo, Francesca Totti, Rodolfo Capanna
Introduction: Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction. Methods: In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft. Results: The mean follow-up was 6...
2018: Advances in Orthopedics
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