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Bulletin of the Hospital for Joint Diseases

Darryl Outlaw, Amitkumar Mehta, Sam R Dalvi
Sarcoidosis and Hodgkin's lymphoma represent two distinct diseases with different pathogenic mechanisms, therapeutic interventions, and prognoses. Nevertheless, both diseases can have overlapping presentations, thus blurring the line between successful identification and treatment. A propensity to develop one of these diseases following diagnosis of the other has long been appreciated. Here we review two cases of presumed sarcoidosis that were ultimately diagnosed as Hodgkin's lymphoma. Both patients initially presented with non-specific symptoms and underwent a thorough workup, including histological evaluation demonstrating non-caseating granulomas without evidence of malignancy...
June 2018: Bulletin of the Hospital for Joint Diseases
Allison Guttmann, Michael H Pillinger, Svetlana Krasnokutsky
Tracheal inflammation, or tracheitis, is a pathologic process that can occur secondary to a number of systemic inflammatory diseases, or it may be idiopathic in nature. Regardless of the underlying etiology, tracheitis can, in its most severe form, be life-threatening, thus making its treatment an area of interest. Our case is one of a 50-year-old man with a remote history of inflammatory bowel disease achieving clinical cure following surgical resection who presented with progressive dyspnea due to tracheal stenosis that was presumed secondary to an autoimmune and inflammatory etiology...
June 2018: Bulletin of the Hospital for Joint Diseases
Arthur Manoli, Lorraine Hutzler, Deirdre Regan, Eric J Strauss, Kenneth A Egol
Sharps-related injuries represent a significant occupational hazard to orthopedic surgeons. Despite increased attention and targeted interventions, evidence suggests that the majority of incidents continue to go unreported. The purpose of this study was to examine the incidence, attitudes, and factors that affect the reporting of sharps injuries among orthopedic surgery residents at a large academic teaching hospital in an effort to increase reporting rates and design effective interventions. This study administered an anonymous cross-sectional survey regarding intraoperative sharps exposures to current orthopedic house staff, with an 87% (54/62) response rate...
June 2018: Bulletin of the Hospital for Joint Diseases
Diana C Patterson, Ronald P Grelsamer
Faced with a patient who presents with unexplained disproportionate pain, a surgeon may be tempted to diagnose a low pain threshold, malingering, poor coping, anxiety, or other emotional condition. However, a variety of conditions must be ruled out before the orthopedist can prescribe watchful waiting. Computed tomography and magnetic resonance imaging can detect occult fractures, acute spinal conditions or vascular occlusions, but early on are inadequate to diagnose a compartment syndrome, necrotizing fasciitis, or reflex sympathetic dystrophy (RSD)...
June 2018: Bulletin of the Hospital for Joint Diseases
Christopher P Roche, Nicholas J Stroud, Pablo Palomino, Pierre-Henri Flurin, Thomas W Wright, Joseph D Zuckerman, Matthew J DiPaola
BACKGROUND: Achieving glenoid fixation with anterior bone loss can be challenging. Limited guidelines have been established for critical defect sizes that can be treated without supplemental bone graft when performing reverse shoulder arthroplasty. METHODS: We quantified the impact of two sizes of anterior glenoid defects on glenoid baseplate fixation in a composite scapula using the ASTM F 2028-14 reverse shoulder glenoid loosening test method. RESULTS: All glenoid baseplates remained well-fixed after cyclic loading in composite scapula without a defect and in scapula with an 8...
June 2018: Bulletin of the Hospital for Joint Diseases
Marcos A Matos, Ingrid C F Barboza, Marina V A R Ferraz, Guy Hembroff
This study evaluates hand functioning in patients with mucopolysaccharidosis (MPS) and validates the Michigan Hand Outcomes Questionnaire (MHQ) as a measure of hand functioning evaluation. Patients with diagnosis of MPS between the ages of 8 and 21 years were eligible for enrolment in the study irrespective of whether they were or were not receiving treatment (enzyme replacement therapy). Individuals with mental disorders and those who had already undergone hand surgery were excluded. Clinical and demographic data were collected as well as hand functioning evaluation based on the Brazilian-Portuguese version of the MHQ...
June 2018: Bulletin of the Hospital for Joint Diseases
Hassan Alosh, Omar A Behery, Brett R Levine
BACKGROUND: Predicting satisfaction following total knee arthroplasty (TKA) continues to be a clinical challenge. We sought to quantify radiographic variables associated with clinical improvement and satisfaction following TKA. METHODS: We reviewed a consecutive series of primary TKAs performed by a single surgeon with a minimum 2-year follow-up. Radiographic variables assessed included preoperative and postoperative mechanical axis alignment, osteophyte size and location, and the presence of tibial or patella subluxation...
June 2018: Bulletin of the Hospital for Joint Diseases
Vineet Tyagi, Russell Strom, Omar Tanweer, Anthony K Frempong-Boadu
Fusion and rigid instrumentation have been the mainstay for the surgical treatment of degenerative diseases of the spine for many years. Dynamic stabilization provides a theoretical advantage of decreased biomechanical stress on adjacent spinal segments and decreased fatigue failure of implants. Artificial discs provide an alternative treatment and have been well-studied in the literature. Another technology that is currently used in Europe but rarely in the USA is flexible rods attached to pedicle screws instead of rigid rods or bone fusion...
June 2018: Bulletin of the Hospital for Joint Diseases
Lauren Santiesteban, Brent Mollon, Joseph D Zuckerman
Neuropathic arthropathy, also known as Charcot arthropathy, is a degenerative disorder most commonly characterized by rapid destruction of the joint with extensive involvement of the bone and soft tissue. The underlying pathophysiology is thought to be due to loss of nociception (pain sensation), most frequently caused by diabetes mellitus, syphilitic myelopathy, or syringomyelia. A neuropathic shoulder is rare, with historic case series forming the bulk of the literature. The purpose of this review is to better understand the pathogenesis, clinical presentation, and management of neuropathic arthropathy of the glenohumeral joint...
June 2018: Bulletin of the Hospital for Joint Diseases
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
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
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
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
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
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
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
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
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
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
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
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