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Orthopedic review

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https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#1
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28723700/pediatric-supracondylar-humerus-fractures-is-surgeon-experience-a-surrogate-for-the-need-of-open-reduction
#2
Mauricio Silva, Maria Kazantsev, Bianka Aceves Martin, Erin M Delfosse
Although there are many factors that are likely to influence the need for open reduction and percutaneous pinning (ORPF) in the treatment of pediatric supracondylar humerus fractures (SCHFs), the role of surgeon's experience (as represented by the total number of surgically treated SCHFs) on the need for ORPF has seldom been investigated. We reviewed the data on all completely displaced, pediatric SCHFs that were treated surgically by a single, fellowship-trained, pediatric orthopedic surgeon over the first 10 years of the surgeon's clinical practice...
July 18, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28719391/pediatric-and-congenital-hand-transplantation
#3
Sandra Amaral, L Scott Levin
PURPOSE OF REVIEW: We review the approach and challenges associated with pediatric hand transplantation, including new knowledge gleaned from our recent case of bilateral hand-forearm transplantation in an 8-year old child. RECENT FINDINGS: Bilateral heterologous hand-forearm transplantation was performed in a child with a prior kidney transplant in July 2015. The initial surgery necessitated a large team of experts in microvascular surgery, transplant surgery, orthopedics and plastic surgery as well as pediatric anesthesia...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28718058/cultural-biases-in-current-medical-practices-with-a-specific-attention-to-orthopedic-surgery-a-review
#4
Gracia Etienne, Todd P Pierce, Anton Khlopas, Morad Chughtai, Carlos J Lavernia, Teva Y Vogelstein, Craig M Thomas, Charles S Modlin, Michael A Mont
Due to the increasing diversity within the United States population, there is an ever-increasing need for increased education on cultural literacy and tolerance in medical schools and residency programs. The purpose of this article was to review how a person's culture can play a substantive role in effecting and influencing (1) medical diagnosis, (2) patient and health provider medical decision-making, (3) the patient's perception of disease, and (4) the doctor-patient relationships. Many of the decisions we make as orthopedic surgeons must account for the patient's cultural needs, as much of our work impacts patients' daily activities and function...
July 17, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28715928/lack-of-evidence-the-anti-stepwise-introduction-of-metal-on-metal-hip-replacements
#5
Aleksi Reito, Lari Lehtovirta, Olli Lainiala, Keijo Mäkelä, Antti Eskelinen
Background and purpose - Orthopedics and especially joint replacement surgery have had more than their fair share of unsuccessful innovations that have violated widely endorsed principles for the introduction of new surgical innovations. We aimed to investigate (1) the trends in the use of the Birmingham Hip Resurfacing (BHR), the ASR hip resurfacing (ASR HRA) and the ASR XL total hip replacement (ASR XL THR) system with very different market approval processes and (2) whether their use was corroborated by clinical trials published in the peer-reviewed literature...
July 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28711310/acquired-heterotopic-ossification-of-the-temporomandibular-joint
#6
REVIEW
L G Mercuri, B M Saltzman
Although the risk factors and diagnosis of heterotopic ossification (HO) are discussed in the orthopedics literature, the etiology of HO, as well as its prevention and management, remain theoretical. Furthermore, there is a lack of information in the literature regarding HO in temporomandibular joint replacement (TMJR). This article provides a qualitative review of information relative to the etiology, diagnosis, and management of HO to inform and encourage further investigation in TMJR. The orthopedic HO literature considered for this qualitative review was drawn from a comprehensive examination of the subject published previously by one of the authors...
July 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28708327/sonography-of-non-neoplastic-disorders-of-the-hand-and-wrist-tendons
#7
REVIEW
Salvatore Gitto, Anna Guja Draghi, Ferdinando Draghi
Tendon disorders commonly cause hand and wrist disability and curtail the performance of work-related duties or routine tasks. Imaging is often needed for diagnosis, but it requires knowledge of the complex anatomic structures of the tendons of the hand and wrist as well as familiarity with related disorders. This review article aims to provide medical professionals with guidelines for the sonographic assessment of the tendons of hand and wrist and related disorders. Sonographic features of tendon disorders affecting the hand and wrist are described here, specifically: infectious tenosynovitis; tendon rupture or tearing; stenosing forms of tenosynovitis such as De Quervain disease and trigger finger; intersection syndrome; insertional tendinopathy; several forms of tendinous instability such as extensor carpi ulnaris instability, climber finger, and boxer knuckle; and tendinopathy in inflammatory rheumatic diseases...
July 14, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28706378/soft-tissue-damage-during-total-knee-arthroplasty-focus-on-tourniquet-induced-metabolic-and-ionic-muscle-impairment
#8
REVIEW
Constantin Mayer, Alexander Franz, Jan-Frieder Harmsen, Fina Queitsch, Michael Behringer, Johannes Beckmann, Rüdiger Krauspe, Christoph Zilkens
PURPOSE: Advantages of tourniquet use in TKA include benefits for surgeons and patients, varying from a bloodless operation site to a reduced intervention time. The time under ischemia and the reperfusion period are crucial phases for affected soft-tissue, most commonly the extensor mechanism. CASE REPORTS: documented its impact on soft-tissue, ranging from necrotic muscle damage to systemic inflammation. Recently, research regarding tourniquet application patterns discuss clinical outcome parameters in the context of soft-tissue damage, excluding the underlying pathophysiological mechanisms...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28698718/the-holy-grail-of-orthopedic-surgery-mesenchymal-stem-cells-their-current-uses-and-potential-applications
#9
REVIEW
Roberto Berebichez-Fridman, Ricardo Gómez-García, Julio Granados-Montiel, Enrique Berebichez-Fastlicht, Anell Olivos-Meza, Julio Granados, Cristina Velasquillo, Clemente Ibarra
Only select tissues and organs are able to spontaneously regenerate after disease or trauma, and this regenerative capacity diminishes over time. Human stem cell research explores therapeutic regenerative approaches to treat various conditions. Mesenchymal stem cells (MSCs) are derived from adult stem cells; they are multipotent and exert anti-inflammatory and immunomodulatory effects. They can differentiate into multiple cell types of the mesenchyme, for example, endothelial cells, osteoblasts, chondrocytes, fibroblasts, tenocytes, vascular smooth muscle cells, and sarcomere muscular cells...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28695714/evaluation-of-specialist-referrals-at-a-rural-health-care-clinic
#10
Mary Ellen Biggerstaff, Nancy Short
PURPOSE: Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience. DATA SOURCES: A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers...
July 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28693329/a-novel-approach-to-improving-patient-experience-in-orthopedics
#11
Spencer M Stein, Sarav S Shah, Alanna Carcich, Marlena McGill, Isaac Gammal, Michael Langino, Thomas Mauri
The patient experience domain comprises a significant portion of the Hospital Value-Based Purchasing program. This study investigated whether an intervention focusing on attending physician awareness, resident and physician assistant education, and multidisciplinary patient-centric care had an effect on patient perceived physician communication and overall hospital ratings. Responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey were reviewed in 2014 and 2015. Patients' perceptions that the physician explained their condition in ways they understood and the overall hospital rating improved significantly after implantation of the model ( P < ...
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28692690/risk-of-surgical-site-infection-acute-kidney-injury-and-clostridium-difficile-infection-following-antibiotic-prophylaxis-with-vancomycin-plus-a-beta-lactam-versus-either-drug-alone-a-national-propensity-score-adjusted-retrospective-cohort-study
#12
MULTICENTER STUDY
Westyn Branch-Elliman, John E Ripollone, William J O'Brien, Kamal M F Itani, Marin L Schweizer, Eli Perencevich, Judith Strymish, Kalpana Gupta
BACKGROUND: The optimal regimen for perioperative antimicrobial prophylaxis is controversial. Use of combination prophylaxis with a beta-lactam plus vancomycin is increasing; however, the relative risks and benefits associated with this strategy are unknown. Thus, we sought to compare postoperative outcomes following administration of 2 antimicrobials versus a single agent for the prevention of surgical site infections (SSIs). Potential harms associated with combination regimens, including acute kidney injury (AKI) and Clostridium difficile infection (CDI), were also considered...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28691555/idiopathic-congenital-talipes-equinovarus-not-always-an-isolated-anomaly-a-review-of-long-term-outcomes
#13
Peter Stone, Walston Martis, Haemish Crawford
OBJECTIVE: To describe the long-term outcomes of children at school age who were thought to have isolated idiopathic congenital talipes equino varus (ICTEV) at birth. METHOD: A retrospective review of all children attending a regional talipes clinic who had achieved school age. RESULTS: One hundred sixty-three children were followed up. ICTEV was more common in Maori and other Polynesian children and in males. Additional abnormalities were apparent in 30...
July 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28690745/closed-reduction-of-a-traumatic-hip-dislocation-in-children-case-report
#14
Achraf El Bakkaly, Fouad Ettayebi, Houda Oubeja, Mounir Erraji, Hicham Zerhouni
Traumatic dislocation of the hip in children is a rare disease. It only represents 5% of hip dislocations in all age groups. Before 10 years, the mechanism is often a minimal domestic accident; after 10 years, the dislocation occurs with the waning of an accident of the public highway. It is different from that of the adult by its rarity, its ease of reduction and better prognosis. This is an emergency trauma: risk necrosis of the femoral head (If delayed reduction). We report a rare case of a 3 year old boy, who suffered from bipolar trauma after a fall near his height of his house causing him a detachment of the right humerus and post-traumatic dislocation of the left hip...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28690468/bone-mineral-density-response-from-teriparatide-in-patients-with-osteoporosis
#15
So-Young Kim, Meng Zhang, Richard Bockman
BACKGROUND: A review of data from large clinical trials reported more than 90% of subjects significantly improved their bone mineral density (BMD) at the lumbar spine (LS) with teriparatide (TPTD) (bone 39:1268-1275, 1). However, our clinical experience suggests that many patients may be non-responders, raising questions as to the true efficacy of TPTD in improving BMD in osteoporotic patients. QUESTIONS/PURPOSES: The purpose of the study is to determine the rate of improvement in BMD following 18-24 months of teriparatide (TPTD) in patients with osteoporosis within an orthopedic hospital setting...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28690462/open-wedge-distal-femoral-osteotomy-accuracy-of-correction-and-patient-outcomes
#16
Osama Elattar, Ishaan Swarup, Aaron Lam, Joseph Nguyen, Austin Fragomen, S Robert Rozbruch
BACKGROUND: There is a renewed interest in joint preservation surgery, and lateral opening wedge distal femoral osteotomy (DFO), a joint-preserving procedure, has been used to treat symptomatic genu valgum when the deformity originates in the distal femur. QUESTIONS/PURPOSES: This study aimed to measure the accuracy of lateral opening wedge DFO in achieving deformity correction using radiographic parameters. In addition, the ability of lateral opening wedge DFO to improve patient outcomes as measured by Short Form Health Survey (SF-36) scores and American Academy of Orthopedic Surgeons (AAOS) lower limb module (LLM) scores leading to successful joint preservation was assessed...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28684099/an-analysis-of-the-most-commonly-tested-topics-and-their-taxonomy-from-recent-self-assessment-examinations
#17
Chad A Krueger, Sean Moroze, Andrew S Murtha, Jessica C Rivera
OBJECTIVE: The purpose of this study is to determine the most commonly tested topics and the question taxonomy of the American Academy of Orthopaedic Surgeons Self-Assessment Examinations (SAE) from 2009 through 2014. DESIGN: All SAEs were analyzed from 2009 through 2014. The SAEs were separated by subject and the questions of each SAE were analyzed for topic, taxonomic classification, and question type. RESULTS: A total of 2107 questions were reviewed from 10 different subjects...
July 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28682898/heterotopic-ossification-related-to-the-use-of-recombinant-human-bmp-2-in-osteonecrosis-of-femoral-head
#18
Lijun Shi, Wei Sun, Fuqiang Gao, Liming Cheng, Zirong Li
Despite the wide use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in bone defect, its application in treating osteonecrosis of femoral head (ONFH) is yet to be elucidated. The heterotopic ossification (HO) after rhBMP-2 usage in some orthopedic surgeries has been reported previously; however, only a few studies describe this complication in the treatment of ONFH.The present study investigated whether the rhBMP-2 application would increase the risk of HO formation in selected ONFH patients with nonvascularized bone grafting surgery and enhance the surgical results of nonvascularized bone grafting as compared to patients who did not receive intraoperative rhBMP-2...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28681679/artificial-intelligence-for-analyzing-orthopedic-trauma-radiographs
#19
Jakub Olczak, Niklas Fahlberg, Atsuto Maki, Ali Sharif Razavian, Anthony Jilert, André Stark, Olof Sköldenberg, Max Gordon
Background and purpose - Recent advances in artificial intelligence (deep learning) have shown remarkable performance in classifying non-medical images, and the technology is believed to be the next technological revolution. So far it has never been applied in an orthopedic setting, and in this study we sought to determine the feasibility of using deep learning for skeletal radiographs. Methods - We extracted 256,000 wrist, hand, and ankle radiographs from Danderyd's Hospital and identified 4 classes: fracture, laterality, body part, and exam view...
July 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28676968/melorheostosis-a-rare-sclerosing-bone-dysplasia
#20
REVIEW
Anupam Kotwal, Bart L Clarke
PURPOSE OF REVIEW: Melorheostosis is a rare sclerosing bone dysplasia that affects both cortical bone and adjacent soft tissue structures in a sclerotomal distribution. In this review, we describe the natural history, radiological features, proposed pathogenesis, and management options for this debilitating condition. RECENT FINDINGS: Since its first description in 1922, about 400 cases of melorheostosis have been reported, either as single reports or in small case series...
July 4, 2017: Current Osteoporosis Reports
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