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Bulletin of the Hospital for Joint Diseases

Ian David Kaye, Themistocles S Protopsaltis
Pyogenic cervical facet joint infections are rare and such infections from a dental origin are even less common. Of these few cases, none have described infection with Streptococcus intermedius as the pathogen. A 65-year-old orthopaedic surgeon complained of fevers, right-sided radiating neck pain, stiffness, swelling, erythema, and right upper extremity weakness one month after he had broken a crown over his right mandibular premolar, a continued source of pain. Imaging of the cervical spine showed a right C4-C5 facet inflammatory arthropathy and a small epidural abscess that was cultured and initially treated with intravenous antibiotics...
September 2016: Bulletin of the Hospital for Joint Diseases
Nicholas A Ferran, Doron Sher
A case of simultaneous bilateral distal biceps tendon rupture in a recreational gymnast is presented. Achieving bilateral acute primary repair can be challenging as any immobilization will lead to disability and difficulty with self-care and activities of daily living. We have reviewed the evidence of this rare condition and demonstrate that modern rehabilitation techniques, which allow early mobilization, can make simultaneous bilateral primary repair a viable option in such cases.
September 2016: Bulletin of the Hospital for Joint Diseases
John P Begly, Claudette M Lajam
A 35-year-old female presented to orthopaedic clinic with a chief complaint of chronic left hip pain, beginning 17 years prior when she had sustained a gunshot wound to her left buttock. Imaging demonstrated significant left hip arthritis with a retained projectile in the femoral head. Lead levels were also found to be significantly elevated. The patient underwent successful left total hip arthroplasty, with subsequent postoperative pain relief and consistent decrease in serum lead level. This report presents a rare case that emphasizes lead intoxication as a potentially dangerous complication of gunshot wounds and retained projectiles in the orthopaedic patient...
September 2016: Bulletin of the Hospital for Joint Diseases
Blaine T Manning, Rachel M Frank, Nathan G Wetters, Bernard R Bach, Aaron G Rosenberg, Brett R Levine
Knee-related complaints are among the most commonly encountered conditions by orthopaedic surgeons. Knee pathology varies widely and includes arthritis, deformities, fractures, infections, neuromuscular disorders, oncologic diseases, and soft-tissue injury. While nonoperative treatment modalities (activity modification, medications, injections, and physical therapy) are typically used as primary interventions, surgical treatment may ultimately become necessary. The purpose of this review is to discuss the most common open approaches to the knee, with an emphasis on surgically relevant anatomy for each approach...
September 2016: Bulletin of the Hospital for Joint Diseases
Sonya Khurana, Roy I Davidovitch, Young K Kwon, Joseph D Zuckerman, Kenneth A Egol
BACKGROUND: In order to compare open reduction and internal fixation (ORIF) with locked plating to hemiarthroplasty for the treatment of three- and four-part proximal humerus fractures, we compared two groups of patients treated during the same time period. MATERIALS AND METHODS: Sixty-five patients who underwent repair of a three- or four-part proximal humerus fracture with locked plates (Group A) were identified in a prospective database and were compared to 29 patients who underwent hemiarthroplasty for similar injuries (Group B)...
September 2016: Bulletin of the Hospital for Joint Diseases
Michael Day, M Phil, Richard A McCormack, Samir Nayyar, Laith Jazrawi
INTRODUCTION: Ultrasonography offers a fast and inexpensive method to evaluate the rotator cuff in the office setting. However, the accuracy of ultrasound is highly user dependent. The purpose of this study is to investigate the learning curve of an orthopaedic surgeon in using ultrasound to diagnose rotator cuff tears. METHODS: A sports medicine fellowship trained orthopaedic surgeon was taught how to perform and interpret an ultrasound examination of the shoulder by a musculoskeletal radiologist...
September 2016: Bulletin of the Hospital for Joint Diseases
Jenifer Hashem, Maya Deza Culbertson, John Munyak, Jack Choueka, Nima P Patel
BACKGROUND: Complaints related to the hands, wrists, and fingers comprise approximately 3.7 million emergency department visits annually. The complexity of this subject can confound timely diagnosis and treatment, particularly if the treating physician has not received specialized training. We set out to determine whether emergency medicine training in the USA provides adequate preparation for dealing with the identification, management, and treatment of hand, wrist, and finger injuries...
September 2016: Bulletin of the Hospital for Joint Diseases
Michael S Guss, David Kaye, Michael Rettig
A Bennett fracture is a common injury that involves an intra-articular fracture at the base of the first metacarpal. This fracture typically results in a dorsally and radially displaced metacarpal shaft relative to the well-anchored volar ulnar fragment. Most Bennett fractures are treated with operative fixation, including closed reduction and percutaneous fixation, open reduction and internal fixation, or arthroscopically assisted fixation. However, the optimal surgical approach is controversial. There is a paucity of literature comparing the outcomes of the various treatments, leaving the surgeon without a clear treatment algorithm...
September 2016: Bulletin of the Hospital for Joint Diseases
Richard M Hinds, Michael B Gottschalk, Kenneth A Egol, John T Capo
BACKGROUND: The objectives of this investigation were to report temporal trends in resident performed upper extremity fracture procedures and analyze case volume variability. METHODS: Orthopaedic resident case logs from the Accreditation Council for Graduate Medical Education were reviewed for graduating years 2007 to 2014. The mean number of wrist, forearm, elbow, humerus, and shoulder fracture-dislocation procedures performed by residents was analyzed. The median number of procedures reported by the top 30% and bottom 30% of residents (by case volume) was also recorded...
September 2016: Bulletin of the Hospital for Joint Diseases
Michael P Gaspar, Jonathan P Gaspar, Patrick M Kane
Inflammatory bowel diseases (IBD) are chronic immunemediated inflammatory conditions involving the gastrointestinal system with potential to adversely affect the musculoskeletal system as well. The numerous overlapping immunogenic and pathophysiologic disease mechanisms of the gastrointestinal and musculoskeletal systems have led to the concept of the "Joint-Gut Axis," illustrating an intimate link between the two organ systems. A solid understanding of the Joint-Gut Axis is necessary for the rheumatologist as well as the orthopaedic surgeon, as concomitant musculoskeletal disease may impart a profoundly negative impact on the quality of life of patients with IBD...
September 2016: Bulletin of the Hospital for Joint Diseases
John Haskoor, Sammy Sinno, Alan Blank, Pierre Saadeh, Timothy Rapp
Computer assisted modeling (CAM) has become an important tool in surgical oncology and reconstructive surgery. The preservation of the limb is an important consideration when approaching the treatment of lower extremity and pelvic tumors. The use of cutting guides allows for optimal conservation of disease-free bone and maintenance of function. We present a small case series that illustrates the use of CAM in patients with lower extremity and pelvic bone tumors.
June 2016: Bulletin of the Hospital for Joint Diseases
Graeme Whyte, Andrew Rokito
Anterior shoulder dislocation in the athlete may result in an assortment of injuries that often benefit from surgical stabilization procedures. These injury patterns can be complex, requiring a multimodal approach to treatment. We present a rare case of a traumatic anterior shoulder dislocation in a teenage athlete that resulted in humeral avulsion of the glenohumeral ligament, rotator cuff tear, and axillary nerve palsy. Surgical treatment enabled return to football within 1 year of injury, and full function was restored...
June 2016: Bulletin of the Hospital for Joint Diseases
Hiroyasu Ogawa, Kazu Matsumoto, Yoshiki Ito, Kenji Kawashima, Iori Takigami, Haruhiko Akiyama
Popliteal artery injury in total knee arthroplasty (TKA) is rare but a devastating complication with consequence from transient bleeding to death. We report a case of 83-yearold woman suffering from an unusual early postoperative indirect popliteal artery transection in revision TKA for an infected knee. This injury was triggered by surgical correction of stiffened and distorted soft tissue, which resulted in excessive tensioning and eventual indirect transection of the artery. To avoid this devastating complication, early elimination of infection concomitant with perioperative maintenance of the normal anatomy of the knee is important...
June 2016: Bulletin of the Hospital for Joint Diseases
Shaleen Vira, Richard McCormack, Gabriel Felder, Norman Otsuka
Coalitions involving three joints of the midfoot are rare. To our knowledge, this is the first report of a patient having fibrocartilaginous coalition of the calcaneonavicular joint along with partial osseous fusion of the naviculocuneiform (Chopart's joint) and medial cuneiform-first metatarsal joints. These multi-coalition pathologies are challenging to address operatively as pain can persist even after recognizing and surgically addressing each coalition in a patient.
June 2016: Bulletin of the Hospital for Joint Diseases
Ravi Vaswani, Arthur Manoli, Abraham Goch, Kenneth A Egol
In end stage renal disease (ESRD) patients on hemodialysis (HD), it is known that renal bone disease has a negative impact on postoperative complication rate of fracture repair compared to non-ESRD patients. Previous studies have examined complications following surgical hip fracture repair in ESRD patients on HD. However, there is paucity of information outside of hip fracture repair. This study was undertaken to investigate complications associated with surgical fracture repair in ESRD patients on hemodialysis and to compare quality measures with a control group for various fracture types...
June 2016: Bulletin of the Hospital for Joint Diseases
Jared Bookman, Romney Duffey, Lorraine Hutzler, James Slover, Richard Iorio, Joseph Bosco
Increased volume has been shown to be associated with improved outcomes for many orthopaedic procedures. For individual surgeons, the concepts of learning curves and volume effects have been well established in the literature. For institutions, high-volume hospitals have also been shown to have better outcomes for orthopaedic procedures such as total joint replacements. However, exactly how hospital volume mediates this improvement is not well understood. Learning theory states that learning occurs as a result of accumulated experience, not based on time...
June 2016: Bulletin of the Hospital for Joint Diseases
Alexander Gubin, Dmitry Borzunov, Tatiana Malkova
Since its origination in the middle of the past century, the Ilizarov method has advanced greatly and has become a viable method for bone lengthening, severe deformity correc- tion, and defect management. As the reported studies show, it remains one of the most used tools for bone reconstruction. The original method and its modifications continue to be the topic of interest for orthopaedic scientists as evidenced by the number of clinical studies on the Ilizarov method that have been published in orthopaedic journals in the period from 2000 through 2014, most of which present the out- comes of treating large series of patients using distraction osteogenesis for bone lengthening, defect management, and deformity correction...
June 2016: Bulletin of the Hospital for Joint Diseases
John Haskoor, Joseph Bosco, Lorraine Hutzler
Since 2000, 31 hospitals have closed in New York State. This has primarily been due to the financial difficulties endured by these institutions, many of which were located in areas inhabited predominantly by patients of lower socioeconomic status. Additionally, recommendations by the NYS Depart- ment of Health (Berger Commission) cited excess hospital capacity as a driver for the struggles of the healthcare delivery system in New York, forcing financially stable in - stitutions to close their doors as well...
June 2016: Bulletin of the Hospital for Joint Diseases
Kunal Kalra, Edward Tang, Abiola Atanda, Omar Khatib, Steven Shamah, Robert Meislin, Laith Jazrawi
PURPOSE: This study aims to study femoral tunnel lengths drilled with a flexible reamer and the distance to important lateral structures obtained by flexing the knee at various angles and by drilling the guide pins arthroscopically to resemble clinical practice. The purpose of this cadaveric study was twofold: 1. to determine whether femoral tunnel lengths of greater than 20 mm can be created with a flexible reamer system at 90 ° of knee flexion and 2. to determine whether the lateral structures of the knee are safe with this technique...
June 2016: Bulletin of the Hospital for Joint Diseases
Munish Chitkara, Marissa Albert, Tony Wong, John O'Donnell, Soterios Gyftopoulos
OBJECTIVE: To assess for a difference in the characteriza - tion of rotator cuff (RC) muscle fatty infiltration (FI) between the sagittal and coronal planes in the setting of a large or massive RC tear. MATERIALS AND METHODS: Retrospective review of pa - tients with MRIs demonstrating large or massive RC tears (study group-SG) and no tearing (control group-CG) was conducted. Sagittal T1W and coronal PD images of the supraspinatus and infraspinatus muscles from each patient were selected, separated, and placed in random order...
June 2016: Bulletin of the Hospital for Joint Diseases
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