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Journal of Orthopaedics

Joshua P Herzog, Nicholas J Zarkadis, Gautham Prabhakar, Nicholas A Kusnezov
Background: Compare the biomechanical stability of a novel "U" posterior cervical fixation construct to four other posterior cervical atlantoaxial fixation constructs. Methods: Eight fresh frozen human cadaver spines were tested after a simulated odontoid fracture, and following stabilization with each construct. Results: All constructs significantly decreased flexion-extension and axial rotation compared to the destabilized spine...
June 2018: Journal of Orthopaedics
Garin Gil Hecht, Justin Neal Hopkins, Zachary Christopher Lum, Saba Fatima Ali, Cassandra Alda Lee
Case: We describe a case of extensive symptomatic bilateral lipoma arborescens of the knee in a 19-year-old man who suffered from recurrent knee effusions for many years. This patient had MRI evidence of progression of disease prior to arthroscopic intervention. He was treated with bilateral complete arthroscopic synovectomies, demonstrating no evidence of cartilage wear. Conclusion: Lipoma arborescens is a progressive disease. Timely diagnosis and treatment may prevent disease evolution and sequela...
June 2018: Journal of Orthopaedics
Nikhil Sharma, Ahmed El Refaiy, T F Sibly
We report outcomes of using GraftJacket to repair massive rotator-cuff-tears. Twenty patients with a mean age of 64.6y over 12-month duration were reviewed. Two patients had a single GraftJacket repair (group1), whilst 18 had the GraftJacket sheet doubled (group2). Pre and post oxford shoulder scores (OSS) and patient related outcome measures were evaluated. A statistically significant improvement of OSS was demonstrated in-group 2 from a mean of 22 to 45.5 (p < 0.00148) over a follow up of 18 months...
June 2018: Journal of Orthopaedics
Parth B Patel, Nirmal C Tejwani
This article aims to provide a systematic review of the limited literature and clinical knowledgebase available on the Hoffa fractures. It is inclusive of the normal anatomy, pathology, diagnosis, treatment options comprising of non-operative and operative protocols, and postoperative findings.
June 2018: Journal of Orthopaedics
Mohamed ElAttar, Ahmed El Naggar, Fahmy Fahmy Samir, Hossam Fathi
Background: Currently, correction of the first intermetatarsal angle associated with hallux valgus is done using two main categories of surgeries either a distal or a proximal first metatarsal osteotomy. The osteotomy-sparing technique using TigthRope ®device was developed to manage hallux valgus avoiding osteotomy complications. Our hypothesis was that osteotomy sparing technique using TightRope® implant would be suitable for moderate hallux valgus in young adult patients with strong larger bones giving good results with minimal complications...
June 2018: Journal of Orthopaedics
Masahiko Kemmochi, Shigeru Sasaki, Masako Takahashi, Tomitaka Nishimura, Chisa Aizawa, Jun Kikuchi
Introduction: Platelet-rich fibrin (PRF) is the only autologous blood product that releases growth factors and has scaffolding properties. We hypothesized that the use of PRF and Platelet-rich plasma (PRP) would improve operative results, including the recovery of function and repaired meniscus. Materials and Methods: Seventeen patients underwent arthroscopic meniscus repair with PRF and PRP (PRF group) using our novel device for the injection of the PRF into the joint...
June 2018: Journal of Orthopaedics
Nicholas Bene, Xing Li, Sumon Nandi
Background: We aimed to determine if reoperation-free survival following irrigation and debridement (I&D) with head and liner exchange of infected primary THA is affected by: 1) postoperative antibiotic duration; 2) patient characteristics; 3) infecting organism; or 4) postoperative versus hematogenous infection. Methods: Revision THAs from 2006 to 2012 (n = 1184) were observed; 26 underwent I&D with head and liner exchange with mean 4.1-year follow-up...
June 2018: Journal of Orthopaedics
William Mamane, Stenley Lippmann, Dan Israel, Reeta Ramdhian-Wihlm, Michael Temam, Virginie Mas, Jérome Pierrart, Emmanuel H Masmejean
Introduction: Since Kanavel in 1905, knowledge of phlegmon of flexor tendon sheaths of the fingers have evolved over the twentieth century. This serious infection is 20% of infections of the hand and may have adverse consequences for the function of the finger and even beyond, of the hand. Amputation is always a risk. Frequently face this type of infection, we conducted a retrospective study and made an inventory of knowledge in order to consolidate and improve the overall care. Materials & Methods: The study was retrospective and cross, focused on 120 patients operated on at Hand Surgery Unit, during 4 years...
June 2018: Journal of Orthopaedics
Abhijit Kawalkar, C M Badole
Femoral shaft fracture is the commonest major pediatric orthopedic injury requiring hospitalization. Controversy persists regarding management of femoral fractures in the patients aged between 5-15 years. 11 patients were followed up for the mean period of 12 months and evaluated using Flynn's criteria. All the fractures united between 8-12 weeks. 3 patients had knee stiffness, 1 patient had shortening > 2 cm and 1 had superficial infection. We conclude that TENs is simple, rapid & effective treatment for displaced pediatric femoral shaft fractures between 5-15 years of age with very less complication rate...
June 2018: Journal of Orthopaedics
Devin M Jagow, Shahan V Yacoubian, Edward J McCrink, Stephan V Yacoubian
One-hundred and three patients with intertrochanteric hip fractures as classified by the OTA 2007 system underwent fixation using the telescoping AOS Galileo lag screw system and ES Nail (a long IM nail). Thirty-one patients (76%) were female and ten (24%) were male, with an average age of 75.70 ± 11.3 years at date of surgery. At final follow-up 21 (53%) patients returned to their pre-fracture ambulatory status, 20 (47%) had a reduction in ambulatory status, and no patients were confined to a wheel chair...
June 2018: Journal of Orthopaedics
David Pomarino, Stephan Martin, Andrea Pomarino, Stefanie Morigeau, Saskia Biskup
Idiopathic toe walking (ITW) is a pathological gait pattern in which children walk on their tip toes with no orthopedic or neurological reason. Physiological characteristics of the gastrocnemius muscles, the Achilles tendon, and the foot of toe walkers differ from subjects with a plantigrade walking pattern. McArdle's disease is characterized by the inability to break down muscle glycogen. It is an autosomal-recessive condition, characterized by low exercise tolerance, muscular atrophy at the shoulder girdle, episodes of myoglobinuria after vigorous physical activities and the occurrence of the second wind phenomenon...
June 2018: Journal of Orthopaedics
S Pillai, S Govender
Chordoma is a rare malignant tumor with predilection for the sacrum. A favorable outcome depends on early diagnosis and surgical excision with tumor free margins. Aim: To review the incidence and prevalence of sacral chordoma and the appropriate surgical management and formulate a criteria for early diagnosis. Materials and methods: Thirty eight articles on the subject of sacral chordoma and extrapolated data of clinical and surgical significance. Results: The commonest presenting feature in patients with sacral chordoma was lower back pain which was worse on sitting and up to a third of these patients had associated urinary tract infections, constipation or symptoms of disc herniation...
June 2018: Journal of Orthopaedics
Zachary C Lum, Gavin C Pereira
Antibiotic-impregnated calcium sulfate (AICS) beads have been used for prevention and treatment of periprosthetic joint infections. We evaluated post-operative complications following the use of AICS beads. 56 patients undergoing complex primary or revision hip or knee arthroplasty received antibiotic calcium sulfate beads. Primary outcomes were wound complication rates. Secondary outcomes included reoperation and reinfection rates. One case (1.7%) of persistent wound drainage occurred requiring surgical irrigation and a poly-exchange...
June 2018: Journal of Orthopaedics
Jared M Newman, Sarah G Stroud, Andrew Yang, Nipun Sodhi, Anant Dixit, James P Doran, Andrew J Hayden, Danielle J Casagrande, Michael A Mont
This study used the National Surgical Quality Improvement Program to evaluate octogenarians who underwent total shoulder arthroplasty (TSA). Specifically, we evaluated: (1) patient demographics; (2) perioperative factors; and (3) 30-day postoperative complications. Compared to controls, the octogenarians had more females, white patients, lower BMIs, fewer smokers, less functionally independent, higher ASA scores, shorter operative times, and longer LOS. Octogenarians had greater odds for developing any (OR = 2...
June 2018: Journal of Orthopaedics
Stephen O'Neil, Kristopher Danielson, Kory Johnson, Thomas Matelic
Purpose: The purpose of this study was to evaluate immediate postoperative pain control modalities after total knee arthroplasty at the author's specific institution and compare those modalities with patient satisfaction, rehabilitation status, and length of hospital stay. Methods: A retrospective chart review of 101 patients who underwent total knee arthroplasty from 2013 to 2016 was performed. Data was collected including the pain control modality, total pain medication consumption, physical therapy progress, length of hospital stay and Visual Analog Scores...
June 2018: Journal of Orthopaedics
D Meijering, G J Harsevoort, A J M Janus, S H van Helden
No abstract text is available yet for this article.
June 2018: Journal of Orthopaedics
Jack W Martin, Mark A Williams, Karen L Barker
Background: When compared to total hip arthroplasty (THA), hip resurfacing arthroplasty (HRA) is usually undertaken in younger, more active patients with hip osteoarthritis. Previous research has noted that patients are able to return to pre-operative activity levels, with many even increasing their activity post HRA, but patterns in post-operative recovery have been less well investigated. Materials and Methodology: A randomised controlled trial dataset was analysed to explore activity levels attained after HRA...
June 2018: Journal of Orthopaedics
Aneesh J Dave, Darren B Chen, Bradley G Seeto, Samuel J MacDessi
ACL injury can be clinically diagnosed prior to imaging, and therefore understanding any symptomatology differences between age-groups and genders is critical. Data gathered from 341 patients with ACL injuries over six years showed no gender-based difference in ability to continue playing sport post-injury. Fewer males required crutches (37.2% vs. 49.5%, p = 0.04) and more males returned to sports prior to treatment (24.4% vs. 14.1%, p = 0.04). There was no age based difference in play continuation post-injury, however more elderly patients fell post-injury (<30 y: 91...
June 2018: Journal of Orthopaedics
Koji Murakami, Satoshi Hamai, Ken Okazaki, Hirotaka Gondo, Yifeng Wang, Satoru Ikebe, Hidehiko Higaki, Takeshi Shimoto, Hideki Mizu-Uchi, Yukio Akasaki, Yasuharu Nakashima
This study aimed to evaluate clinical outcomes and in vivo kinematics of bi-cruciate stabilized (BCS) total knee arthroplasty (TKA), using image-matching techniques. We analyzed tibiofemoral anteroposterior translation, axial rotation, and anterior/posterior cam-post contact for 22 BCS TKAs during squatting and stair-climbing. The functional activities on the 2011 Knee Society Score were significantly improved from 36 to 71. The tibiofemoral translation and axial rotation during squatting/stair-climbing were 16...
June 2018: Journal of Orthopaedics
Matthew Sloan, Neil P Sheth
Retrospective review of the National Inpatient Sample was performed. LOS and IHM were assessed among TJA patients and assessed by comorbidity status. LOS among TJA patients decreased from 4.31 to 5.87 days to 2.83-4.49 days. Relative risk for prolonged LOS among high comorbidity patients ranged from 3.01-5.62. IHM per 1,000 was 5.1 for revision THA, 1.8 for revision TKA, 1.1 for primary THA, and 0.4 for primary TKA. Relative risk for IHM in high comorbidity patients ranged from 443.9-780.9 (p < 0.0001)...
June 2018: Journal of Orthopaedics
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