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Bulletin of the Hospital for Joint Diseases

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https://www.readbyqxmd.com/read/29537961/importance-of-the-sagittal-plane-in-understanding-adult-spinal-deformities
#1
Justin C Paul, Shaleen Vira, Martin Quirno, Themistocles Protopsaltis
The sagittal plane is known to be important in correction of adult spinal deformity. When surgery is indicated, the surgeon is provided with several tools and techniques to restore balance. But proper use of these tools is essential to avoid harmful complications. This article examines these tools with a focus on lumbar lordosis and the lumbopelvic junction. Positioning, releases, osteotomies, and instrumentation are considered with special attention to the alignment measurements they affect.
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537960/minimally-invasive-surgery-mis-approaches-to-thoracolumbar-trauma
#2
Ian David Kaye, Peter Passias
Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537959/evaluation-and-management-of-pediatric-bone-lesions
#3
Alan T Blank, Norman Y Otsuka, Timothy B Rapp
Bone abnormalities on pediatric radiographs are not uncommon findings for both the general orthopedist as well as the specialist. Although the majority of lesions encountered are benign, the treating physician should also be aware of more concerning diagnoses. General orthopedists and pediatric orthopedists should exhibit a basic level of comfort with working up and diagnosing these benign lesions. When evaluating the pediatric patient with a bone lesion it is crucial to keep in mind important aspects of the clinical history, physical exam, and radiographic findings...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537958/strategies-for-management-of-periprosthetic-joint-infection
#4
Aldo M Riesgo, Frank A Liporace
Periprosthetic joint infection (PJI) is one of the most catastrophic and difficult to manage complications following total hip and total knee arthroplasty. As the number of total joint arthroplasties continues to increase, the burden of PJI will continue to further strain resources. As such, orthopedic surgeons consider four principles crucial in appropriately managing difficult or complex cases of PJI: identification, debridement, antibiotics, and patience. Indications and techniques for nonoperative treatment, debridement with implant retention, and one- and two-stage exchange arthroplasty are reviewed...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537957/beyond-the-scope-open-treatment-of-femoroacetabular-impingement
#5
Michael K Ryan, Thomas Youm, Jonathan M Vigdorchik
Hip arthroscopy as we know it today developed over the last 15 to 20 years, yet its true beginning is far more dated. Initially developed as a means of removing loose bodies or as a means of lavage, hip arthroscopy was not utilized to treat femoroacetabular impingement (FAI) until much later. Its usefulness as a means of treating FAI did not arise until hip impingement was understood to be causal in the development of degenerative changes of the labrum and articular surfaces. As our understanding of FAI grew, the tools for treating it developed in tandem...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537956/ultra-high-molecular-weight-polyethylene-uhmwpe-in-total-joint-arthroplasty
#6
Michael Sobieraj, Scott Marwin
Total joint arthroplasty of the hip and knee are successful orthopedic procedures that reduce pain and improve mobility in patients. As the implanted materials used in these procedures have improved, the lifetime of the implants has now reached more than 20 years. Younger patients are undergoing total joint arthroplasty at increasing rates, which has increased the need for improvements in materials for extended implant longevity. In this review, we aim to provide historical perspective on the evolution of ultra-high-molecular-weight polyethylene in total joint arthroplasty...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537955/perilunate-injuries-and-dislocations-etiology-diagnosis-and-management
#7
Nicole M Montero Lopez, Nader Paksima
Perilunate injuries most commonly occur in high energy trauma situations; however, they are rare and frequently missed. Familiarity with the complex bony and ligamentous anatomy is required to fully understand these complex injury patterns. Careful orthogonal imaging and evaluation is required to ensure timely diagnosis of a perilunate injury. Early recognition and management of acute perilunate injuries has been demonstrated to correlate with better patient outcomes. Delayed treatment of chronic injuries can result in post-traumatic osteoarthritis and carpal collapse requiring salvage interventions...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537954/scaphoid-nonunions
#8
Christopher S Klifto, Austin J Ramme, Anthony Sapienza, Nader Paksima
Scaphoid nonunions are challenging injuries to manage and the optimal treatment algorithm continues to be debated. Most scaphoid fractures heal when appropriately treated; however, when nonunions occur, they require acute treatment to prevent future complications like scaphoid nonunion advanced collapse. Acute nonunion treatment technique depends on nonunion location, vascular status of the proximal pole, fracture malalignment, and pre-existing evidence of arthrosis. Bone grafting and vascular grafts are common in nonunion management...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537953/ulnar-collateral-ligament-reconstruction-past-present-and-future-past-present-and-future
#9
Christopher A Looze, Eric J Strauss, Laith M Jazrawi
Shoulder and elbow injuries have been described in baseball players as early as the 1940s. Ulnar collateral ligament (UCL) tears have been recognized as a significant source of disability for baseball players and have been seen in increasing frequency as training regimens and level of play have become more intense and rigorous. Our understanding and treatment of these injuries have also evolved over time. This article summarizes the evolution of the treatment of UCL tears and discusses future directions for the treatment and prevention of these injuries...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537952/meniscal-root-tears-evaluation-and-management
#10
Michael S Day, Michael K Ryan, Eric J Strauss
The management of meniscal root injuries has changed as biomechanical studies have demonstrated the importance of meniscal integrity in load distribution across the knee joint. Meniscal injury causes altered joint mechanics, which is postulated to be related to the onset of arthrosis. Arthroscopic meniscal root repair has been shown to restore more normal joint mechanics and is considered a treatment option in the appropriately indicated patient. Short- and midterm clinical results of meniscal root repair are promising, but long-term results are yet to be established...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537951/impact-of-intramedullary-nailing-in-the-treatment-of-femur-fractures-an-evolutionary-perspective
#11
Richard S Yoon, Frank A Liporace
Today intramedullary nails (IMN) are the gold standard in the treatment of femur fractures. Since its inception, improved design and understanding of the surrounding anatomy has exponentially increased successful patient treatment and outcomes by promoting early mobilization and reliable union. In this review, we provide an in-depth look into the evolutionary process that has led IMN to becoming today's gold standard in femur fractures.
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29537950/management-of-bone-defects-in-orthopedic-trauma
#12
Mark J Gage, Frank A Liporace, Kenneth A Egol, Toni M McLaurin
Treatment of traumatic bone defects is dictated by a multitude of clinical factors including the defect size, patient comorbidities, soft tissue condition, and the possibility of infection present in the defect. With a variety of treatment strategies described, it is critical to choose the approach that will maximize outcomes in addressing this difficult problem. When addressing small-scale defects, bone grafting is the primary treatment. For large-scale defects, there are two major options to consider: induced membrane technique and distraction osteogenesis...
March 2018: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29154729/single-bone-intramedullary-nailing-of-pediatric-both-bone-forearm-fractures-a-systematic-review
#13
REVIEW
Chang-Yeon Kim, Mark Gentry, Debra Sala, Alice Chu
Traditional operative management of unstable, pediatric both-bone forearm fractures is fixation of both ulna and radius. Literature suggests single-bone fixation with intramedullary nailing obtains good results and is less technically demanding and invasive. This systematic review evaluates the efficacy of single-bone intramedullary nailing of pediatric both-bone forearm fractures. Medline and Embase were searched for English-language primary studies published in peer-reviewed journals. Two independent investigators extracted data...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151017/neuroleptic-malignant-syndrome-following-bilateral-cemented-total-hip-replacements
#14
Usman Halim, Sanil Ajwani, Martyn Lovell
Neuroleptic malignant syndrome (NMS) is a rare, serious complication caused by neuroleptic medications. It is characterized by rigidity, hyperthermia, tachycardia, leukocytosis, and an elevated creatine kinase (CK). We present a case of a 50-year-old male who underwent bilateral total hip replacements and subsequently developed NMS. This condition is typically triggered by the sudden introduction, omission, or change in dose of a neuroleptic; in contrast with previous case reports of post-surgical NMS, however, no such trigger was identifiable for our patient...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151016/osteomyelitis-after-calcium-phosphate-subchondroplasty-a-case-report
#15
Andrew Dold, Donato Perretta, Thomas Youm
Subchondroplasty is a relatively new procedure developed to treat bone marrow lesions by injecting a calcium phosphate bone substitute into the pathologic, subchondral area of bone under fluoroscopic guidance. The procedure is described as a minimally invasive strategy that provides reliable relief of pain while preserving the native joint with minimal risk of significant complications. No prospective, randomized clinical trials have reported the efficacy of the procedure. Here, we present the case of a 64-year-old healthy male who developed Staphylococcus aureus osteomyelitis following subchondroplasty requiring further surgical intervention and intravenous antibiotic therapy...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151015/diffuse-idiopathic-skeletal-hyperostosis-dish-as-a-cause-of-failure-following-distal-clavicle-excision-a-case-report-and-review-of-the-literature
#16
REVIEW
John Begly, Vineet Tyagi, Eric Strauss
Diffuse idiopathic skeletal hyperostosis (DISH) is common spinal condition characterized by increased calcification and ossification of ligaments and entheses, typically in the anterior aspect of the spine. However, extraspinal manifestations of the disease can occur and depending on the degree and location of involvement, may become symptomatic. We present the case of a 63-year-old male with a history of DISH, who failed initial open distal clavicle excision due to the postoperative development of heterotopic bone bridging across the acromioclavicular joint...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151014/consent-in-elective-hip-arthroplasty-what-has-changed-over-the-last-15-years
#17
Rohit Singh, George Evans, Amit Patel, Richard Jones
PURPOSE: It is regular practice that patients undergoing orthopaedic procedures particularly those related to arthroplasty are given both verbal and written information prior to their surgery. The aim of this study was to complete a 15 year audit cycle by assessing the patient understanding of the consent process in elective orthopaedic surgery following the introduction of patient information booklets, DVDs, web links, and "joint school." METHODS: 150 patients (50 patients in each cycle of the study) undergoing primary total hip arthroplasty were counselled about the audit and prospectively enrolled...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#18
REVIEW
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151012/the-role-and-timing-of-treatment-strategies-during-two-stage-revision-for-periprosthetic-joint-infections
#19
REVIEW
Shobhit Minhas, Russell Odono, Kristopher Collins, Jonathan Vigdorchik, Ran Schwarzkopf
INTRODUCTION: Prosthetic joint infection continues to be a source of significant morbidity to patients and an economic burden to society as a whole. Two-stage revision is the current gold standard for treatment of periprosthetic joint infection in North America. Despite this, much discussion persists about treatment strategies surrounding the interim of the two-stage revision and treatment beyond reimplantation. The aim of this review is to answer some of these questions, specifically: are C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) helpful prior to reimplantation, is aspiration helpful, what is the role and timing for systemic antibiotics, and is there a role for oral suppression following second-stage reimplantation? METHODS: A literature review was completed in an attempt to address unanswered questions associated with two-stage reimplantation...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29151011/the-association-between-scholarly-impact-and-national-institutes-of-health-funding-in-orthopaedic-surgery
#20
Elizabeth Zhu, Shai Shemesh, James Iatridis, Calin Moucha
The assessment of scholarly productivity assumes a strong role in evaluating faculty in academic orthopaedic surgery. The investigators examine the association between scholarly impact, as measured by the h-index, and National Institutes of Health (NIH) funding in orthopaedic surgery. Orthopaedic surgery faculty from 20 randomly chosen departments that received NIH-funding were compared to non-NIH funded faculty from the same departments. Faculty members in orthopaedic surgery departments who received NIH funding had higher scholarly impact as measured by h-index than their non-funded peers (h = 11...
December 2017: Bulletin of the Hospital for Joint Diseases
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