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Micheal Raad, Amit Jain, Brian J Neuman, Hamid Hassanzadeh, Munish C Gupta, Douglas C Burton, Gregory M Mundis, Virginie Lafage, Eric O Klineberg, Richard A Hostin, Christopher P Ames, Shay Bess, Daniel M Sciubba, Khaled M Kebaish
STUDY DESIGN: Retrospective analysis of prospective registry OBJECTIVE.: To investigate associations of preoperative narcotic use with outcomes after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: We hypothesized that preoperative narcotic use would predict longer hospital stays, greater postoperative narcotic use, and greater disability 2 years after ASD surgery. METHODS: A multicenter database of surgical ASD patients was analyzed retrospectively for patients with self-reported data on preoperative narcotic use...
March 13, 2018: Spine
Christopher Klifto, Austin 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
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
Kai Zhou, Zongke Zhou, Xiaojun Shi, Bin Shen, Pengde Kang, Jing Yang, Fuxing Pei
BACKGROUND: Proper limb alignment and implant positioning are important for successful total knee arthroplasty (TKA). It remains unknown whether any differences exist in the restoration of limb alignment for valgus knees between fixed and individual femoral valgus correction angle (VCA) for distal femoral resection. METHODS: A total of 63 patients (66 knees) had fixed 4° VCA (fixed group), and 55 patients (59 knees) had individual VCA (individual group). We compared the VCA, mechanical femorotibial (MFT) angle, femoral component angle (α), and tibial component angle (β) between the two groups...
March 10, 2018: International Journal of Surgery
Kai-Yu Ho, Jayson McClaren, Skyler Sudweeks
BACKGROUND AND PURPOSE: Although discomfort during walking is a common complaint in individuals with knee osteoarthritis (OA), how an acute bout of walking affects femoral cartilage remains unclear. Current literature has suggested that frontal plane knee malalignment (ie, varus and valgus) is associated with the initiation and/or progression of knee OA. However, the association between knee alignment and femoral cartilage deformation after an acute bout of loading has not yet been investigated...
March 12, 2018: Journal of Geriatric Physical Therapy
Bradley Wills, Sung Ro Lee, Parke William Hudson, Bahman SahraNavard, Cesar de Cesar Netto, Sameer Naranje, Ashish Shah
BACKGROUND: Calcaneal osteotomy is a commonly used surgical option for the correction of hindfoot malalignment. A previous cadaveric study described a neurological "safe zone" for calcaneal osteotomy. We performed a retrospective chart review to evaluate the presence of neurological injuries following calcaneal osteotomies and the location of the osteotomy in relation to the reported safe zone. METHODS: In this retrospective study, we reviewed charts of patients who underwent calcaneal osteotomy at our institution from 2011 to 2015...
March 1, 2018: Foot & Ankle Specialist
Idil Kurut Aysin, Ayhan Askin, Berna Dirim Mete, Ece Guvendi, Murat Aysin, Hikmet Kocyigit
Objective: The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). Materials and Methods: We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI...
February 2018: Eurasian Journal of Medicine
Luis A Aponte-Tinao, Jose I Albergo, Miguel A Ayerza, D Luis Muscolo, Federico Milano Ing, German L Farfalli
BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...
March 2018: Clinical Orthopaedics and related Research
Christopher T Born, Joseph A Gil, Joey P Johnson
Periprosthetic fractures around total knee arthroplasty have become an increasingly common and challenging orthopaedic problem. Appropriate management of these fractures depends on careful scrutiny of radiographs and a thorough clinical history to exclude the diagnosis of a periprosthetic infection. In a periprosthetic tibial fracture with a stable, well-aligned tibial component and well-aligned mechanical tibial axis, the fracture can be successfully managed with closed reduction and cast immobilization; meticulous follow-up is essential to ensure that the alignment is maintained...
March 9, 2018: Journal of the American Academy of Orthopaedic Surgeons
Simon W Young, Mustafa Saffi, Mark J Spangehl, Henry D Clarke
BACKGROUND: Malrotation of tibial and femoral components is a potential source of pain following total knee arthroplasty (TKA). This study aimed to 1) compare component rotation in TKA patients with unexplained pain versus a control group with well-functioning TKAs and 2) investigate the relationship between TKA component rotation and pain. METHODS: Seventy one patients with unexplained pain after primary TKA were compared to a control cohort of 41 well functioning TKA patients...
March 8, 2018: Knee
Niv Marom, Joseph J Ruzbarsky, Naomi Roselaar, Robert G Marx
The multiple ligament injured knee presents a challenge with regard to management and treatment. Immediate management of the acute injury requires special attention and thorough examination because knee dislocations have been associated with significant complications. Treatment options range from closed reduction and immobilization to surgical repair and/or reconstruction of the injured ligaments. This article focuses on complications that may result from surgical treatments of the multiple ligament injured knee and ways of prevention...
April 2018: Clinics in Sports Medicine
Aakash Chauhan, Alan Slipak, Mark C Miller, Daniel T Altman, Gregory T Altman
INTRODUCTION: The use of a postoperative brace may be beneficial after open reduction and internal fixation of tibial plateau fractures. However, bracing has potential drawbacks related to cost, fitting, wound complications, and compliance. We hypothesized that no difference will be found between patients with and without bracing after open reduction and internal fixation of tibial plateau fractures. METHODS: In this prospective, comparative trial, patients were randomized to 6 weeks of bracing or no bracing after open reduction and internal fixation of tibial plateau fractures...
March 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Andrea Achtnich, Wolf Petersen, Lukas Willinger, Andreas Sauter, Michael Rasper, Klaus Wörtler, Andreas B Imhoff, Theresa Diermeier
PURPOSE: Meniscus extrusion has always been described as an indirect sign of meniscus pathology and is associated with a loss of function of the affected meniscus. The current cut-off value of 3 mm displacement is indicated as abnormal and has been determined on magnetic resonance images (MRI) and ultrasound (US). However, it has to be considered that there is no description of the physiological meniscus extrusion in healthy knees depending on age or different weight-bearing conditions...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Takafumi Tajima, Yukichi Zenke, Yoshiaki Yamanaka, Kunitaka Menuki, Akinori Sakai
BACKGROUND: The association of scaphoid or other carpal bone fractures with distal radius fractures is frequently reported, whereas few studies have described pisiform malalignment associated with distal radius fractures. The purpose of this study was to investigate the frequency and characteristics of pisiform malalignment associated with distal radius fractures. METHODS: We performed a retrospective study by reviewing the data of 152 consecutive patients with a mean age of 63 years who were treated surgically for distal radius fractures during a five-year period...
March 1, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Mariëtte Z Meulekamp, Peter van der Wurff, Alfred van der Meer, Cees Lucas
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS, it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center...
November 28, 2017: Military Medical Research
Zhendong Zhang, Hong Zhang, Dianzhong Luo, Hui Cheng, Kai Xiao, Shuxun Hou
PURPOSE: We aimed to identify the coronal plane alignment of lower limbs in patients with unilateral developmental hip dislocation (UDHD) and observe the difference between Hartofilakidis type II and III. PATIENTS AND METHODS: The radiographic data of 76 patients who met the inclusion criteria were retrospectively reviewed, including the hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), anatomical lateral distal femoral angle (aLDFA), mechanical proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA)...
March 3, 2018: International Orthopaedics
Gregory W Poorman, Peter G Passias, Rabia Qureshi, Hamid Hassanzadeh, Samantha Horn, Cole Bortz, Frank Segreto, Amit Jain, Michael Kelly, Richard Hostin, Christopher Ames, Justin Smith, Virginie LaFage, Douglas Burton, Shay Bess, Chris Shaffrey, Frank Schwab, Munish Gupta
OBJECT: Cost-utility analysis, a special case of cost-effectiveness analysis, estimates the ratio between the cost of an intervention to the benefit it produces in number of quality-adjusted life years. Cervical deformity correction has not been evaluated in terms of cost-utility and in the context of value-based health care. Our objective, therefore, was to determine the cost-utility ratio of cervical deformity correction. METHODS: Retrospective review of a prospective, multicenter cervical deformity database...
February 27, 2018: Spine Journal: Official Journal of the North American Spine Society
Fateme Esfandiarpour, Constance M Lebrun, Sukhvinder Dhillon, Pierre Boulanger
Understanding of the exact cause of Patellofemoral Pain has been limited by methodological challenges to evaluate in-vivo joint motion. This study compared six degree-of-freedom patellar motion during a dynamic lunge task between individuals with patellofemoral pain and healthy individuals. Knee joints of eight females with patellofemoral pain and ten healthy females were imaged using a CT scanner in supine lying position, then by a dual-orthogonal fluoroscope while they performed a lunge. To quantify patellar motion, the three-dimensional models of the knee bones, reconstructed from CT scans, were registered on the fluoroscopy images using the Fluomotion registration software...
February 28, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Georg Matziolis, Tanja Mueller, Frank Layher, Andreas Wagner
PURPOSE: Although the spacer block technique has been recommended for the implantation of unicompartmental knee arthroplasty (UKA), there is still a lack of data concerning the resulting component positioning. METHODS: This retrospective study included 193 consecutive patients who had undergone medial UKA using the spacer technique. On the basis of the postoperative long standing radiographs, the coronal component alignment was determined in relation to the mechanical axes and the sagittal component alignment in relation to the anatomical axes of the tibia and femur...
February 26, 2018: Archives of Orthopaedic and Trauma Surgery
Amir Ali Jafarnezhadgero, Mahdi Majlesi, Hojat Etemadi, D G E Robertson
BACKGROUND: Previous studies have demonstrated increased medial stresses in knee varus alignment. Selecting a suitable treatment strategy for individuals with knee malalignment should be a priority. OBJECTIVES: We aimed to investigate the effects of a 16-week corrective exercise continuum (CEC) program on 3-D joint angles of the dominant and non-dominant lower limbs in children with genu varus during walking. METHODS: Overall, 28 male children with genu varus (age range 9-14 years) volunteered to participate in this study...
February 21, 2018: Annals of Physical and Rehabilitation Medicine
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