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Bulletin of the Hospital for Joint Diseases

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https://www.readbyqxmd.com/read/28236624/coronal-malalignment-in-the-adult-knee
#1
REVIEW
Carlos Uquillas, William Rossy, Eric Strauss
Coronal plane deformity in the adult patient is a complex clinical problem. Once the hip, knee, and ankle joint centers lose collinerarity, the knee is exposed to abnormal loads across its tibiofemoral compartments, leading to early degenerative changes. Malalignment can coexist with arthrosis and ligamentous instability. High tibial osteotomy and distal femoral osteotomy have been useful tools to realign the adult knee. They can be performed along with ligament reconstruction and cartilage restoration procedures with high success rates...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214465/acute-and-chronic-lateral-ankle-instability-diagnosis-management-and-new-concepts
#2
REVIEW
Rachel Shakked, Steven Sheskier
Lateral ankle instability is a common entity that can result in degenerative arthritis if left untreated. Acute ligament injuries should primarily be treated nonoperatively with a course of physical therapy and functional bracing. Chronic ankle instability is defined as mechanical or functional and can be diagnosed using a combination of history, physical examination, stress radiographs, and magnetic resonance imaging. After failure of nonoperative treatment, surgical treatment with anatomic ligament repair and inferior extensor retinaculum augmentation has the best clinical outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214464/cell-based-treatment-for-the-management-of-articular-cartilage-injuries-where-are-we
#3
William Rossy, Eric Strauss
Articular cartilage is a specialized tissue that lines the surface of joints. Injuries to articular cartilage pose challenges due to poor healing potential. Focal cartilage defects are typically the result of high impact or repetitive loads to the articular surface. They tend to occur in the younger, active population and have been shown to cause swelling, pain, and joint dysfunction. Although the natural history of these lesions has never been definitively elucidated in the literature, clinical experience suggests that if left untreated, these lesions will demonstrate an inability to heal and may lead to prolonged increased articular peak stresses, which in turn may lead to pain and significant limitations in the future...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214463/bridging-the-gap-in-peripheral-nerve-repair
#4
REVIEW
Donato Perretta, Steven Green
Peripheral nerve injuries following trauma present an ongoing challenge to the hand surgeon. This review presents an overview of the topic with a historical perspective. Nerve anatomy and nerve injury classifications are discussed followed by a description of the biology of nerve regeneration. Methods used to bridge gaps in peripheral nerve repair are discussed in detail with a critical appraisal of the most recent literature. Recommendations for surgical treatment are formulated based on evidence-based medicine...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214462/the-arthroscopic-latarjet-a-bony-solution-for-a-bony-injury
#5
REVIEW
David Ding, Robert Meislin
Treatment of shoulder instability has greatly evolved over the past century. Open capsulolabral repairs and bony augmentation procedures have slowly been replaced with arthroscopy. As arthroscopy and arthroscopic instruments have improved, surgeons have gravitated toward more minimally invasive procedures. The open Latarjet procedure has been historically very successful in preventing recurrent shoulder dislocation. While there is a steep learning curve, the arthroscopic Latarjet procedure as developed by Lafosse in 2007 can be effective in preventing shoulder instability in patients with significant bone loss of up to 30%...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214461/wide-awake-hand-surgery
#6
REVIEW
Matthew Cantlon, Steven Yang
Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214460/managing-acetabular-defects-in-total-hip-arthroplasty
#7
REVIEW
Brian Park, Frank Liporace, Scott Marwin
With the aging population and rising incidence of primary total joint arthroplasty has come the increasing incidence of revision total hip arthroplasties. One challenge in revision total hip arthroplasty is dealing with acetabular defects. The orthopaedic surgeon who chooses to take on these challenges requires a proper method for the evaluation of these defects as well as an evidence-based treatment algorithm. Initial assessment requires appropriate use and interpretation of imaging modalities such as x-rays and computed tomography...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214459/molecular-biomarkers-of-knee-pathology
#8
Vanessa Cuellar, Eric Strauss
The identification of biomarkers has become increasingly important in our fundamental understanding of the molecular basis for disease and subsequently in the advancement of modern medicine. Biomarkers have been identified in a plethora of normal and pathologic conditions and are most often found in blood, tissue, or synovial fluid. Orthopaedic research has more recently focused on biomarkers of cartilage and joint diseases, with an emphasis on understanding the molecular underpinnings of their pathophysiology...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214458/cervical-spondylotic-myelopathy-a-review-of-clinical-diagnosis-and-treatment
#9
REVIEW
Jason Cuellar, Peter Passias
Cervical spondylotic myelopathy (CSM) is a functional disturbance in the spinal cord as a result of degenerative changes within the cervical spinal column. This review discusses the history of CSM and its diagnosis, including clinical presentation, physical exam, and imaging studies. The pathophysiology, natural history, and treatment options are also discussed with support of the recent literature.
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214457/operative-fixation-of-rib-fractures-indications-techniques-and-outcomes
#10
REVIEW
David Galos, Benjamin Taylor, Toni McLaurin
Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214456/total-wrist-arthroplasty
#11
REVIEW
Edward Lin, Nader Paksima
Total wrist arthroplasty (TWA), first performed in the late 19th Century, is still an infrequently used operation. It is most commonly indicated in patients with rheumatoid arthritis who have pan-carpal wrist involvement. It is an alternative to total wrist arthrodesis in patients who wish to preserve joint motion. Patients must lead a low-demand lifestyle and have failed non-operative measures. Complications are not insignificant and have been reported to be as high as 43%. Modern generation implants most often fail due to dislocation or loosening...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214455/dorsal-plating-of-distal-radius-fractures-historical-context-and-appropriate-use
#12
REVIEW
Omri Ayalon, Nader Paksima
The management of distal radius fractures has evolved over time from a largely nonoperative paradigm to a more commonly performed operative procedures today. Surgical trends have similarly developed, with dorsal plating falling out of favor due to complications involving extensor tendon pathology as well as due to the ubiquity of the volar plate along with the advent of locking plate technology. However, with the improvement in design of newer generation dorsal plates, this technique should be used in the appropriate clinical situation, including dorsal comminution and angulation with concomitant carpal pathology...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815958/coracoid-fracture-following-latarjet-failure-a-case-report
#13
Brian Capogna, William E Ryan, Alan W McGee, Laith M Jazrawi
The Latarjet procedure involves the transfer of the coracoid process with its soft tissue attachments, thereby providing both bony and soft tissue articular reinforcement for glenohumeral stabilization. Most studies show positive outcomes with this procedure and complications at rates as low as 1%, predominately secondary to technical error. We present a case of recurrent anterior instability after two attempts at soft tissue stabilization (arthroscopic labral repair followed by open inferior capsular shift) in which an open Latarjet procedure was performed followed by subsequent revision secondary to coracoid autograft fracture...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815957/staphylococcus-lugdunensis-septic-arthritis-of-a-native-knee-a-case-report
#14
John P Begly, Michael Sobieraj, Frank A Liporace, Alan Dayan
A 67-year-old man presented to orthopaedic care with a painful knee. Workup was consistent with septic arthritis of a native knee, and the patient underwent operative treatment. Cultures from the operating room were speciated to Staphylococcus lugdunensis. To the investigators' knowledge, this is the first reported S. lugdunensis infection in a peripheral joint in the absence of an orthopaedic prosthesis. Although traditionally associated with infectious endocarditis, S. lugdunensis has been identified as a causative agent in many organ systems, including orthopaedic infections...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815956/synovial-hemangioma-presenting-as-a-painful-locked-knee-a-case-report
#15
John P Begly, Timothy B Rapp, Mehul R Shah
A 39-year-old man presented to orthopaedic care with a painful, fully locked knee. Workup revealed free intraarticular nodules, which were subsequently arthroscopically removed and identified to be synovial hemangioma. To the investigators' knowledge, this is the second reported case of synovial hemangioma presenting as a painful, definitively locked knee. Synovial hemangioma should be considered in the differential diagnosis of knee pain, particularly after more common diagnoses have been ruled out. Efficient and appropriate diagnosis and treatment may result in favorable patient outcomes and avoid long-term disability and dysfunction...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815955/permanent-motor-function-loss-by-delayed-treatment-of-peroneal-intraneural-ganglion
#16
Yasushi Oshima, Joseph F Fetto
The low incidence of intraneural ganglion makes it difficult to diagnose and treat before it becomes serious nerve damage. This case describes a 69-year-old female, who suffered from the right drop foot and was diagnosed as a peroneal intraneural ganglion. Resection of the mass relieved the pain; however, motor function was not recovered. Early diagnosis and nerve decompression are essential for the peroneal intraneural ganglion before critical nerve symptoms.
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815954/development-of-a-middle-age-and-geriatric-trauma-mortality-risk-score-a-tool-to-guide-palliative-care-consultations
#17
Sanjit R Konda, Rachel Seymour, Arthur Manoli, Jordan Gales, Madhav A Karunakar
INTRODUCTION: This study aimed to develop a tool to quantify risk of inpatient mortality among geriatric and middleaged trauma patients. This study sought to demonstrate the ability of the novel risk score in the early identification of high risk trauma patients for resource-sparing interventions, including referral to palliative medicine. MATERIALS AND METHODS: This retrospective cohort study utilized data from a single level 1 trauma center. Regression analysis was used to create a novel risk of inpatient mortality score...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815953/early-complications-associated-with-the-thompson-approach-to-the-proximal-radius
#18
Donato J Perretta, Kenneth M Brock, Nirmal C Tejwani
PURPOSE: The purpose of this study was to investigate the early complications associated with the dorsal approach to the proximal radius. This approach, also called the Thompson approach, is used relatively infrequently for the treatment of forearm fractures. It is primarily reserved for proximal one-third radius fractures where a volar plate may not be placed sufficiently proximal for adequate fixation. METHODS: A retrospective chart review was performed on forearm fractures performed at our institution...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815952/incidence-of-distal-femoral-periprosthetic-fractures-after-total-knee-arthroplasty
#19
Tyler Welch, Richard Iorio, Andrew J Marcantonio, Michael S H Kain, John F Tilzey, Lawrence M Specht, William L Healy
BACKGROUND: The incidence of distal femoral periprosthetic fractures associated with total knee arthroplasty (TKA) has been reported as 0.3% to 2.5%. This study examined the incidence of distal femoral periprosthetic fractures at one hospital over a 16-year period. We hypothesized that the incidence of these fractures would be lowered after the introduction of lugged femoral implants and insertion of a distal femoral intramedullary bone graft during TKA. METHODS: From 1994 to 2010, 4,943 primary TKAs were performed...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27815951/the-centralization-of-total-joint-arthroplasty-in-new-york-state-an-analysis-of-168-247-cases
#20
COMPARATIVE STUDY
Murillo Adrados, Jason Theobald, Lorraine Hutzler, Joseph Bosco
We identified 168,247 total hip and total knee arthroplasties performed in New York State between 2010 and 2012 to examine the evidence for increased geographical and institutional centralization of these procedures. We measured the increased growth of high volume institutions as compared to lower volume hospitals in New York State. We found a high proportion of total arthroplasties already performed in the dozen biggest hospitals in New York back in 2010 and a significant higher growth of these high volume, "centers of excellence," hospitals when compared to low volume hospitals...
November 2016: Bulletin of the Hospital for Joint Diseases
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