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Differentiating Shoulder Pathology from Cervical Spine Pathology: An Algorithmic Approach. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-28 Christopher M Brusalis,Karan S Patel,Howard S An,Nikhil N Verma
Accurate and timely diagnosis of musculoskeletal conditions is an essential component of high-quality orthopaedic care. The proximity of the shoulder to the cervical spine leads to a multitude of pathologic conditions whose clinical presentations overlap, posing a diagnostic challenge to orthopaedic providers. Missed or delayed diagnosis of the etiology for patient-described 'shoulder pain' causes
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Opportunities for Increasing Diversity in Orthopaedics Through Virtual Mentorship Programs. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-22 Ambika E Paulson,Alex Gu,Christopher J Dy,Duretti T Fufa,Lauren E Wessel
Orthopaedic surgery lags in recruiting women and under-represented minorities (URMs). In addition, women and URMs hold fewer leadership roles across orthopaedic subspecialties. This inequity is geographically heterogeneous, with female URM residents and attendings being more concentrated in some areas of the country. For instance, practicing female orthopaedic surgeons are more prevalent in Northeast
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A Framework for Studying Healthcare Equity in Adolescent Idiopathic Scoliosis: Scoping Review and Meta-Analysis of Existing Literature. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-22 Nikki Bensen Covell,Tristan Chari,Steph Hendren,Emily Poehlein,Cynthia L Green,Anthony A Catanzano
INTRODUCTION Health inequities remain a notable barrier for pediatric patients, especially in conditions such as adolescent idiopathic scoliosis (AIS), where the efficacy of nonsurgical treatment is dependent on early diagnosis and referral to a specialist. Social determinants of health (SDOH) are nonmedical factors that affect health outcomes, such as economic stability, neighborhood environment,
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Predictors of Failure to Achieve Planned Same-Day Discharge after Primary Total Joint Arthroplasty: a Multivariable Analysis of Perioperative Risk Factors. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-22 David P Foley,Priyanka Ghosh,Mary Ziemba-Davis,Kevin A Sonn,R Michael Meneghini
INTRODUCTION Failure to achieve planned same-day discharge (SDD) primary total joint arthroplasty (TJA) occurs in as many as 7% to 49% of patients in the United States. This study evaluated the association between 43 perioperative risk factors and SDD failure rates. METHODS A retrospective analysis of prospectively collected data from 466 primary TJAs with planned SDD to home was performed. Surgeries
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Open Reduction And Internal Fixation of Tarsometatarsal (Lisfranc) Fracture Dislocations-Is Arthrodesis Necessary? J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-17 Noah M Joseph,Raahil Patel,Clara Freedman,Kaitlyn Cox,Hassan R Mir
INTRODUCTION Controversy remains regarding the optimal management of tarsometatarsal (Lisfranc) fracture dislocations. Open reduction and internal fixation (ORIF) and ORIF with primary arthrodesis (PA) have been described in the treatment of these injuries, although adverse sequelae remain problematic. Previous work has yielded small cohorts with heterogenous results. We aimed to describe the outcomes
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ChatGPT's Ability to Assist with Clinical Documentation: A Randomized Controlled Trial. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-17 Hayden P Baker,Emma Dwyer,Senthooran Kalidoss,Kelly Hynes,Jennifer Wolf,Jason A Strelzow
INTRODUCTION Clinical documentation is a critical aspect of health care that enables healthcare providers to communicate effectively with each other and maintain accurate patient care records. Artificial intelligence tools, such as chatbots and virtual assistants, have the potential to assist healthcare providers in clinical documentation. ChatGPT is an artificial intelligence conversational model
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Identification and Analysis of the Ankle Microbiome Using Next-Generation DNA Sequencing: An Observational Analysis. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-14 Caroline Hoch,J Ryan Allen,Joshua Morningstar,Solangel Rodriguez Materon,Daniel J Scott,Christopher E Gross
INTRODUCTION Next-generation DNA sequencing (NGS) technologies have increased the sensitivity for detecting the bacterial presence and have been used in other areas of orthopaedics to better understand the native microbiome of various joints. This study uses NGS to determine whether (1) a unique microbiome exists in human ankle tissues, (2) if components of the ankle microbiome affect patient outcomes
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A Telemedicine Solution to Minimize Unnecessary Emergency Department Transfers for Low-acuity Pediatric Orthopaedic Patients: A Model for Cost Minimization. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-03 Arlene R Maheu,Yushane C Shih,Drake G LeBrun,Peter D Fabricant,Alfred W Atanda
INTRODUCTION Unnecessary emergency department (ED) transfers represent a notable source of excess costs and misutilization of healthcare resources, particularly with management of acute pediatric musculoskeletal injuries. This study used institutional data to create a model investigating the expected costs of a formal peer-to-peer telemedicine intervention designed to triage pediatric orthopaedic transfers
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The Biomechanical Effects of Intramedullary Fixation to the Level of the Physeal Scar on Distal Tibia Fracture Stability. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-11-02 Brian A Schneiderman,Giovanni Oppizzi,Jayesh Gupta,Cynthia E Burke,Murty Munn,Brandon Wilkinson,Li-Qun Zhang,Todd Jaeblon,Robert V O'Toole,Marcus F Sciadini
INTRODUCTION The purpose of this study was to evaluate whether intramedullary nail contact with physeal scar improves construct mechanics when treating distal tibial shaft fractures. METHODS Axially unstable extra-articular distal tibia fractures were created in 30 fresh frozen cadaveric specimens (15 pairs, mean age 79 years). Specimens underwent intramedullary nailing to the level of the physeal
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Outcomes of Long Bones Treated With Carbon-Fiber Nails for Oncologic Indications: International Multi-institutional Study. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-31 Santiago A Lozano-Calderon,Zeger Rijs,Oliver Q Groot,Marie W Su,Joseph O Werenski,Nelson Merchan,Caleb M Yeung,Alisha Sodhi,Emily Berner,Vania Oliveira,Giuseppe Bianchi,Eric Staals,Debora Lana,Davide Donati,Ortal Segal,Stefano Marone,Raimondo Piana,Simone De Meo,Pietro Pellegrino,Nicola Ratto,Carmine Zoccali,Maurizio Scorianz,Cecilia Tomai,Guido Scoccianti,Domenico Andrea Campanacci,Lorenzo Andreani
BACKGROUND Intramedullary nail fixation is commonly used for prophylactic stabilization of impending and fixation of complete pathological fractures of the long bones. However, metallic artifacts complicate imaging evaluation for bone healing or tumor progression and postoperative radiation planning. Carbon-fiber implants have gained popularity as an alternative, given their radiolucency and superior
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An Evidence-Based Approach to Managing Adolescent (Ages 10 to 19 Years) Diaphyseal Clavicle Fractures. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-30 Brendon C Mitchell,Henry Ellis,Philip Wilson,Andrew T Pennock
Diaphyseal clavicle fractures occur most frequently in adolescents (defined as ages 10 to 19 years by the World Health Organization). Multiple prospective comparative studies exist in the adult literature, whereas studies focusing on adolescents are limited. Given the notable differences in healing potential between pediatric, adolescent, and adult diaphyseal clavicle fractures, treatment algorithms
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American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary of Surgical Management of Osteoarthritis of the Knee. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-24 Ajay Kumar Srivastava,
The Surgical Management of Osteoarthritis of the Knee Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies for surgical management of osteoarthritis of the knee in skeletally mature patients. This guideline contains 16 recommendations and seven options to assist orthopaedic surgeons and all qualified physicians with the surgical management of patients with
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Magnetic Resonance Imaging of the Shoulder: Interpretation of Common Orthopaedic Injuries. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-20 Rupert O Stanborough,Hillary W Garner,Ryan W Simovitch,Bradley S Schoch
Magnetic resonance imaging (MRI) is frequently obtained to assess for pathology in the setting of shoulder pain and dysfunction. MRI of the shoulder provides diagnostic information that helps optimize patient management and surgical planning. Both general and subspecialized orthopaedic surgeons routinely order and review shoulder MRIs in practice. Therefore, familiarity with the MRI appearance of common
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No Delay in Age of Crawling, Standing or Walking with Pavlik Harness Treatment: A Prospective Cohort Study. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-19 Tyler J Stavinoha,Stephanie Y Pun,J Damian McGlothlin,Maechi B Uzosike,Nicole A Segovia,Meghan N Imrie
BACKGROUND Pavlik harness treatment is the standard of care for developmental dysplasia of the hip in infants younger than 6 months. The effect of Pavlik harness treatment on the achievement of motor milestones has not previously been reported. METHODS In this prospective cohort study, 35 patients were prospectively enrolled to participate and received questionnaires with sequential clinical visits
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The Effect of Guided Growth Surgery on Langenskiold Stage and Mechanical Axis in Early-Onset Blount Disease: A Retrospective Case Series. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-18 Regina Hanstein,Christopher A Schneble,Jacob F Schulz,Yungtai Lo,Adrienne R Socci,Melinda S Sharkey
INTRODUCTION Our understanding of the efficacy of guided growth surgery with tension-band plating (TBP) in early-onset Blount disease is evolving. Preliminary work has demonstrated that TBP can normalize the mechanical axis, yet its effect on Langenskiöld stage (LS) has not previously been reported. The primary outcome of this study was improvement in LS after TBP. Secondary outcomes were improvement
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Challenges in the Management of Complex Soft-Tissue Sarcoma Clinical Scenarios. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-18 Alan Blank,Michael P Fice
With nearly 15,000 new cases of soft-tissue sarcoma (STS) in the United States each year, early diagnosis and therapeutic management is imperative for successful patient outcomes. Primary STS is conventionally treated with a combination of wide-margin resection, neoadjuvant or adjuvant radiation therapy, and, in specific cases, adjuvant chemotherapy. However, in situations of complex disease presentation
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Understanding Shoulder and Elbow Injuries in the Windmill Softball Pitcher. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-18 Stephanie A Boden,Justin W Arner,James P Bradley
Although pitching-related injuries in the overhead athlete have been studied extensively, injuries associated with windmill pitching are not as clearly elucidated. Windmill pitching produces high forces and torques in the upper extremity, and studies have shown it creates similar shoulder and elbow joint loads to those reported in baseball pitchers. Studies have shown that the windmill pitching motion
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Pearls and Pitfalls of an Orthopaedic Mission Trip. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-16 Adam Pearl,Khaled Saleh,
Many physicians chose to pursue years of rigorous medical training because of an innate desire to care for others, which often translates into volunteering in their local communities. Some physicians take this a step further by contributing their time and skills to global health delivery through medical mission trips. The need is apparent: a 40-year discrepancy in average life span, 36 deaths versus
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Does Fibular Displacement Predict Tibial Malrotation in Simulated Tibia-Fibula Fractures. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-16 Abrianna S Robles,Christian L Blough,Steven Kurapaty,Anderson Lee,Brett A Ewing,Geoffrey S Marecek
INTRODUCTION Tibial malrotation can occur with medullary nailing of diaphyseal tibial fractures. Fibular alignment has been proposed as a surrogate for axial plane reduction intraoperatively. The purpose of this study was to determine whether fibular alignment is a reliable marker of accurate tibial rotation. METHODS Deidentified CT scans of 50 patients with normal tibial anatomy were selected. Using
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Periprosthetic Infection in Patients With Multiple Joint Arthroplasties. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-12 Elie Mansour,Henry D Clarke,Mark J Spangehl,Joshua S Bingham
The number of total joint arthroplasties performed in the United States is increasing every year. Owing to the aging population and excellent long-term prosthesis survival, 45% of patients who undergo joint arthroplasty will receive two or more joint arthroplasties during their lifetimes. Periprosthetic joint infection (PJI) is among the most common complications after arthroplasty. Evaluation and
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Impact of Surgeon Case Volume on Outcomes After Reverse Total Shoulder Arthroplasty. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-12 Steven J Girdler,Noor Maza,Alexander M Lieber,Alexander Vervaecke,Hanish Kodali,Nicole Zubizarreta,Jashvant Poeran,Paul J Cagle,Leesa M Galatz
INTRODUCTION Despite a rapid increase in utilization of reverse total shoulder arthroplasty (rTSA), volume-outcome studies focusing on surgeon volume are lacking. Surgeon-specific volume-outcome studies may inform policymakers and provide insight into learning curves and measures of efficiency with greater case volume. METHODS This retrospective cohort study with longitudinal data included all rTSA
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Pelvic Ring Injuries: Stable or Not? J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-10 Joseph G Elsissy,David E Ruckle,Christopher LeBrun,Joey P Johnson
Pelvic ring injuries occur in varying severity and in vastly different patient demographics. Knowledge regarding which of these injuries require surgical intervention and which can be managed nonsurgically continues to evolve. Previous studies have shown validated criteria for sacral fractures and the posterior ring, explored the role of examination under anesthesia, and other forms of dynamic imaging
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Indications and Technique: Rotator Cuff Repair Augmentation. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-10 Adam Yanke,Navya Dandu,Kevin Credille,Dhanur Damodar,Zachary Wang,Brian J Cole
Rotator cuff repair (RCR) augmentation is often considered for patients with large-to-massive rotator cuff tears or chronic tears with poor tissue quality. Augmentation can provide mechanical stability and improved biology to improve the likelihood of a successful repair. This article discusses the indications, diagnosis, surgical techniques, and outcomes for RCR augmentation using an acellular dermal
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Health Considerations for Female Orthopaedic Surgeons. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-05 Loretta B Chou,Stephanie T Kha,Lauren M Shapiro
The number of female orthopaedic surgeons is increasing. They face unique health concerns, which include cancer risk, pregnancy and fertility problems, musculoskeletal issues, and mental health disorders. In 2010, a survey study showed a 2.9-fold increased prevalence of breast cancer in female orthopaedic surgeons, compared with women in the general US population. A follow-up study 13 years later showed
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Preoperative Planning Software Does Not Accurately Predict Range of Motion in Reverse Total Shoulder Arthroplasty. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-05 Logan G Thomas,Peter N Chalmers,Heath B Henninger,Evan W Davis,Robert Z Tashjian
BACKGROUND The purpose of this study was to determine whether preoperative planning software (PPS) accurately predicts clinical range of motion (ROM) in patients with reverse total shoulder arthroplasty 1 year postoperatively with preoperative and postoperative computed tomography (CT) scans. METHODS This was a retrospective study of 16 reverse total shoulder arthroplasty patients with preoperative
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Dual Surgical Setup Associated with Reduced Infection Recurrence for Hip and Knee Arthroplasty After Two-Stage Exchange. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-03 Ashish Mittal,Amy Z Blackburn,Akhil Katakam,Hany S Bedair,Christopher M Melnic
INTRODUCTION Two-stage exchange (TSE) is the gold standard for the treatment of chronic periprosthetic joint infection (PJI) after total joint arthroplasty of the hip and knee in the United States. Failure of treatment can have devastating consequences for the patient, including poor functional outcomes, multiple further surgeries, and increased mortality. Several factors associated with infection
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Evidence and Controversies in Geriatric Odontoid Fracture Management. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-03 Brian C Goh,Tariq Z Issa,Yunsoo Lee,Alexander R Vaccaro,Arjun S Sebastian
Geriatric odontoid fractures are some of the most common spine injuries in our aging population, and their prevalence is only continuing to increase. Despite several investigational studies, treatment remains controversial and there is limited conclusive evidence regarding the management of odontoid fractures. These injuries typically occur in medically complex and frail geriatric patients with poor
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Predicting Risk of 30-day Postoperative Morbidity Using the Pathologic Fracture Mortality Index. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-03 Ashish Vankara,Christopher R Leland,Ridge Maxson,Micheal Raad,Samir Sabharwal,Carol D Morris,Adam S Levin
INTRODUCTION The purpose of this study was to evaluate the ability of the Pathologic Fracture Mortality Index (PFMI) to predict the risk of 30-day morbidity after pathologic fracture fixation and compare its efficacy with those of the American Society of Anesthesiologists (ASA) physical status, modified Charlson Comorbidity Index (mCCI), and modified frailty index (mFI-5). METHODS Cohorts of 1,723
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Forty-Six Years of Technological Innovation in Musculoskeletal Medicine: An Analysis of a Patent Database (1973 to 2018). J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-03 Ajay S Potluri,Ramón A Arza,Pedro J Rullán,Ignacio Pasqualini,Mitchell Ng,Nicolas S Piuzzi
BACKGROUND Technological innovation in orthopaedics is key to advancing patient care. As emerging technologies near maturity, clinicians must be able to objectively assess where and when these technologies can be implemented. Patent databases are an underappreciated resource for quantifying innovation, especially within orthopaedic surgery. This study used a patent database to assess patent activity
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Postoperative Spinal Orthoses: Types and Outcomes. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-02 Zachary Donato,Derek Gonzalez,Moses Markowitz,Joseph Gjolaj
INTRODUCTION Postoperative bracing (POB) after spinal surgery is a common practice that has been used for many decades. In the past few years, the indications, types, and outcomes of POB have been heavily questioned after many studies revealed no consistent evidence to support or refute the use of spinal orthoses after surgery. SUMMARY Currently, there are no indications of the type, duration, or indication
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Management of Hip Abductor Tears and Recalcitrant Trochanteric Bursitis in Native Hips. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-10-01 Katharine D Harper,Kwan J Park,Stephen J Incavo
Hip abductor tears have recently gained recognition as a more prevalent injury than previously thought. This article will detail the pathophysiology of injury, physical symptoms commonly found at presentation, diagnostic imaging to best diagnose tears and when they should be ordered, and how to properly classify the injury and finally summarize the treatment options available with expert opinions about
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Preoperative Optimization for Orthopaedic Surgery: Steps to Reduce Complications. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-27 Lauren M Shapiro,Michael P Bolognesi,Kevin Bozic,Robin N Kamal
As the population ages and patients maintain higher levels of activity, the incidence of major and minor orthopaedic procedures continues to rise. At the same time, health policies are incentivizing efforts to improve the quality and value of musculoskeletal health services. As such, orthopaedic surgeons play a key role in directing the optimization of patients before surgery by assessing patient risk
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Diabetes in Orthopaedic Sports Medicine Surgeries Standard Review. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-26 Nicholas Morriss,Robert H Brophy
Diabetes mellitus has been shown to affect the outcomes of various orthopaedic procedures. Although orthopaedic sports medicine procedures tend to be less invasive and are often performed on younger and healthier patients, diabetes is associated with an increased risk of postoperative infection, readmission, and lower functional outcome scores. However, this risk may be moderated by the glycemic control
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Dedicated Early Morning Orthopaedic Trauma Operating Room Is Associated With Shorter Time to Surgery and Decreased Length of Hospital Stay for Children Undergoing Surgical Treatment of Supracondylar Humerus Fractures: A Retrospective Cohort Study. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-26 Vivian Chen,Reiko Hara,Ali A Siddiqui,Hanna N Omar,Alexander Nazareth,Nina Lightdale-Miric,Alex Phan,Tishya A L Wren,Rachel Y Goldstein
INTRODUCTION The purpose of this study was to investigate whether the use of a dedicated early morning orthopaedic trauma operating room (OR) resulted in shorter wait times, decreased surgical times, decreased length of stay (LOS), and decreased complications in children treated with urgent surgical intervention for supracondylar humerus fractures. METHODS This retrospective comparative cohort study
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Nationwide Effect of COVID-19 on Cases Performed During Pediatric Orthopaedic Surgery Fellowship Training in the United States. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-19 Jason Silvestre,Terry L Thompson,John M Flynn
INTRODUCTION The COVID-19 pandemic negatively affected surgical training in the United States. We hypothesized that reported case volume during pediatric orthopaedic surgery fellowship training would decrease markedly during the 2019 to 2020 academic year, which corresponded with the COVID-19 outbreak. METHODS The Accreditation Council for Graduate Medical Education provided nationwide case logs for
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Overlapping Surgery in Orthopaedics: A Review of Efficacy, Surgical Costs, Surgical Outcomes, and Patient Safety. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-19 Muhammad Ahmed,Ameen Suhrawardy,Adam Olszewski,Tahsin Rahman,Eric C Makhni
INTRODUCTION Overlapping surgery (OS) refers to when an attending surgeon supervises two surgeries at the same time with noncritical portions of both surgeries occurring simultaneously. Limited literature reviewing OS exists in orthopaedics. Our goal is to provide insight into this practice across orthopaedic subspecialities to inform its future utilization. METHODS A review of the literature was conducted
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Comparing Orthopaedic Randomized Control Trials Published in High-Impact Medical and Orthopaedic Journals. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-15 Richard N Puzzitiello,Andrew D Lachance,Anna Michalowski,Mariano E Menendez,Matthew J Salzler
INTRODUCTION Orthopaedic studies published in high-impact medical journals are often believed to have a high prevalence of negative or neutral results and possess methodological characteristics that may bias toward nonsurgical treatments. The purpose of this study was to compare study characteristics, methodologic quality, exposure, and outcome direction among orthopaedic randomized control trials
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Perceptions of Preference Signaling in Orthopaedic Surgery: A Survey of Applicants and Program Directors. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-15 Arjun Minhas,Fehmi Berkay,Tanner Hudson,Kenton Barry,Andrew W Froehle,Anil Krishnamurthy
INTRODUCTION To improve transparency between candidates and training programs, a preference signaling program (PSP) was implemented before the 2022 to 2023 orthopaedic surgery match. The PSP allows applicants to 'signal' up to 30 programs, informing the program of the applicant's particular interest in interviewing for their available position(s). This study reports the perspectives of orthopaedic
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American Academy of Orthopaedic Surgeons Appropriate Use Criteria for Humeral Component Design During Primary Anatomic Total Shoulder Arthroplasty. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-15 Edward H Yian,Adam Dann,Kamal Bohsali
The American Academy of Orthopaedic Surgeons (AAOS) has developed appropriate use criteria (AUC) for humeral component design during primary anatomic total shoulder arthroplasty. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to determine the appropriateness of various humeral component designs during primary anatomic total shoulder
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Arthroscopic Training: Historical Insights and Future Directions. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-12 Edward J Testa,Paul D Fadale
Arthroscopy is an orthopaedic technique that provides surgical solutions in a minimally invasive fashion. Since its introduction, arthroscopy has become a preferred surgical approach for treating various orthopaedic pathologies, such as meniscal tears, anterior cruciate ligament ruptures, rotator cuff tears, and wrist, elbow, ankle, and hip conditions. Despite its ubiquity, surgical training in arthroscopy
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The Intersection of Race and Sex: A New Perspective Into Diversity Trends in Orthopaedic Surgery. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-12 Jennifer C Wang,Stephanie W Chang,Ikenna Nwachuku,William Hill,Alana M Munger,Linda I Suleiman,Nathanael D Heckmann
INTRODUCTION Studies on diversity in orthopaedic surgery have exclusively examined challenges from a race or sex perspective. This study examines trends in the diversity of entering orthopaedic surgery residents from the intersection of race and sex. METHODS The American Association of Medical Colleges was queried for individuals entering orthopaedic surgery residencies in the United States from 2001
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Risk Factors for Postoperative Urinary Retention After Lumbar Fusion Surgery: Anesthetics and Surgical Approach. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-08 Jeremy C Heard,Yunsoo Lee,Mark J Lambrechts,Teeto Ezeonu,Azra N Dees,Bright M Wiafe,Justin Wright,Gregory R Toci,Eric S Schwenk,Jose A Canseco,Ian D Kaye,Mark F Kurd,Alan S Hilibrand,Alexander R Vaccaro,Gregory D Schroeder,Christopher K Kepler
INTRODUCTION Postoperative urinary retention (POUR) after lumbar fusion surgery can lead to longer hospital stays and thus increased risk of developing other postoperative complications. Therefore, we aimed to determine the relationship between POUR and (1) surgical approach and (2) anesthetic agents, including sugammadex and glycopyrrolate. METHODS After institutional review board approval, L4-S1
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Demographics and Early Outcomes of Commercial Antibiotic Cement Usage for Infection Prophylaxis During Primary Total Knee Arthroplasty in Patients Older Than 65 Years: An American Joint Replacement Registry Study. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-06 Benjamin F Ricciardi,Kimberly R Porter,Thomas G Myers,John G Ginnetti,Nathan Kaplan,Caroline P Thirukumaran
INTRODUCTION The use of antibiotic-laden bone cement (ALBC) for infection prophylaxis in the setting of primary total knee arthroplasty (TKA) remains controversial. Using data from the American Joint Replacement Registry (AJRR), (1) we examined the demographics of ALBC usage in the United States and (2) identified the effect of prophylactic commercially available ALBC on early revision and readmission
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Surgeon Implicit Association of Women With Supportive Roles in Medicine. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-06 Jeremiah Alexander,Dayal Rajagopalan,Sina Ramtin,Marielle Ngoue,David Ring,Julie Adams
BACKGROUND In a previous study, we documented patient implicit bias that surgeons are men. As a next step, we tested the implicit bias of surgeons that women in medicine have leading (chair, surgeon) or supporting roles (medical assistant, physician assistant). QUESTIONS/PURPOSE (1) What is the relationship between the implicit associations and expressed beliefs of surgeons regarding women as leaders
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The Fragility of Statistical Significance in Sham Orthopaedic Surgery: A Systematic Review of Randomized Controlled Trials. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-06 Christian Pearsall,Michael Constant,Bryan M Saltzman,Robert L Parisien,William Levine,David Trofa
OBJECTIVES The purpose of this study was to determine the stability of statistical findings among sham surgery randomized controlled trials (RCTs) in orthopaedic surgery using fragility analysis. METHODS PubMed systematic review was conducted to include studies reporting dichotomous outcomes pertaining to sham surgery. The final review included eight RCTs involving only partial meniscectomies and vertebroplasties
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Advising Orthopaedic Hopefuls in the Wake of a Pass/Fail US Medical Licensing Examination Step 1: A Proposed Method for Predicting US Medical Licensing Examination Step 2 Clinical Knowledge Outcomes. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-06 Lucas Paladino,Abhishek Deshpande,Asher Lichtig,Ye Lin,Julio Castillo Tafur,Alondra Diaz,Laura E Hirshfield,Geoff Thames,Mark H Gonzalez
INTRODUCTION Matching into orthopaedic residency has become difficult, and the US Medical Licensing Examination Step 1 transition to pass/fail scoring has complicated the process. Advisors' ability to mentor students has decreased, and program directors may rely on Step 2 Clinical Knowledge (CK) scores in selecting which candidates to interview. This study aims to offer a method to predict Step 2 CK
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Letter to Editor: Peripheral Nerve Block Delays Mobility and Increases Length of Stay in Patients with Geriatric Hip Fracture. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-06 Sheng Zhao,Caining Wen,Yuanmin Zhang
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Comparison of ChatGPT-3.5, ChatGPT-4, and Orthopaedic Resident Performance on Orthopaedic Assessment Examinations. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-04 Patrick A Massey,Carver Montgomery,Andrew S Zhang
INTRODUCTION Artificial intelligence (AI) programs have the ability to answer complex queries including medical profession examination questions. The purpose of this study was to compare the performance of orthopaedic residents (ortho residents) against Chat Generative Pretrained Transformer (ChatGPT)-3.5 and GPT-4 on orthopaedic assessment examinations. A secondary objective was to perform a subgroup
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Journal of the American Academy of Orthopaedic Surgeons Patient-Reported Outcome Measurements (PROMs) Special Issue: The Value of PROMs in Orthopaedic Surgery. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-04 Prakash Jayakumar,Kevin Bozic
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The Obesity Paradox: A Nonlinear Relationship Between 30-Day Postoperative Complications and Body Mass Index After Total Shoulder Arthroplasty. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-09-01 Keegan M Hones,Kevin A Hao,Robert J Cueto,Jonathan O Wright,Joseph J King,Thomas W Wright,Richard J Friedman,Bradley S Schoch
BACKGROUND An inverse relationship coined the "obesity paradox" has been propositioned, in which body mass index (BMI) may be contradictorily protective in patients undergoing surgery or treatment of chronic disease. This study sought to investigate the BMI associated with the lowest rate of medical complications after total shoulder arthroplasty (TSA). METHODS The American College of Surgeons National
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Using Discrete Choice Experiments to Quantify Patient Preferences. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-29 Nathan N O'Hara,Marcus F Sciadini
Discrete choice experiments are a robust technique for quantifying preferences. With this method, respondents are presented with a series of hypothetical comparisons described by attributes with varying levels. The aggregated choices from respondents can be used to infer the relative importance of the described attributes and acceptable trade-offs between attributes. The data generated from discrete
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Predicting Factors for Blood Transfusion in Primary Total Knee Arthroplasty Using a Machine Learning Method. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-21 Daniel R Cavazos,Zain Sayeed,Tannor Court,Chaoyang Chen,Bryan E Little,Hussein F Darwiche
INTRODUCTION Acute blood loss anemia requiring allogeneic blood transfusion is still a postoperative complication of total knee arthroplasty (TKA). This study aimed to use machine learning models for the prediction of blood transfusion after primary TKA and to identify contributing factors. METHODS A total of 2,093 patients who underwent primary TKA at our institution were evaluated using data extracted
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Current Evidence-based Approaches to Multimodal Pain Control and Opioid Minimization After Arthroscopic and Knee Preservation Surgery. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-21 Michael Sean Day,Andrew Boryan
Nonarthroplasty knee procedures are common and may cause a wide spectrum of postoperative pain, ranging from minimal to severe, depending on the patient, pathology, and procedure. Procedures include ligament repair and reconstruction, especially anterior cruciate ligament reconstruction, meniscal débridement, repair and transplant, periarticular osteotomy, and cartilage restoration. Multimodal analgesia
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Comparison of Pneumonia and Major Complications After Total Joint Arthroplasty With Spinal Versus General Anesthesia: A Propensity-matched Cohort Analysis. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-21 Andrew B Harris,Joshua Valenzuela,Nicholas Andrade,Amil Agarwal,Alex Gu,Gregory Golladay,Savyasachi Thakkar
INTRODUCTION Spinal anesthesia (SA) allows total joint arthroplasty to be done while minimizing opioids and systemic anesthetic agents compared with general anesthesia (GA). SA has been associated with shortened postoperative recovery; however, the relationship between SA, major postoperative complications, and pneumonia (PNA) remains unclear. METHODS Patients in a large, national database who underwent
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Risk of Infection After Total Knee or Hip Arthroplasty After Receipt of Multiple Corticosteroid or Hyaluronic Acid Injections. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-21 Hayley E Raymond,Joseph P Barbera,Kush C Shah,Nicole Zubizarreta,Hsin-Hui Huang,Jashvant Poeran,Darwin D Chen,Calin S Moucha,Brett L Hayden
BACKGROUND Few studies have assessed the relationship between the quantity of preoperative corticosteroid injections (CSIs) or hyaluronic acid injections (HAIs) and postoperative infection risk after total knee or hip arthroplasty (TKA, THA). We aimed to (1) determine whether the number of injections administered before TKA/THA procedures is associated with postoperative infections and (2) establish
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The Major Extremity Trauma Research Consortium: Development and Impact of an Orthopaedic Trauma Research Program. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-18
The Major Extremity Trauma Research Consortium (METRC) is a unique and ongoing military-civilian collaboration that resulted in the largest orthopaedic trauma research enterprise to date. The Consortium was established in September 2009 with funding from the Department of Defense. It employs a centralized data coordinating center and has grown into a network of nearly 400 investigators at 70 clinical
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Elliptical Humeral Head Implants in Anatomic Total Shoulder Arthroplasty. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-15 Matthew R Cohn,Luke S Austin,Gerald R Williams,Joseph A Abboud
Humeral implants for anatomic total shoulder arthroplasty and hemiarthroplasty have typically used spherical humeral heads that have a uniform diameter and radius of curvature. However, the native humeral head has a more elliptical morphology, which has spurred interest in nonspherical implant designs. Cadaveric studies indicate that the native humeral head diameter is 10% longer in the superior-inferior
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Diagnosis and Management of Intraoperative Periprosthetic Fractures in Primary Total Knee Arthroplasty. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-15 Ahmed Siddiqi,Declan Tozzi,Bryan D Springer,Adam Rosen
Intraoperative periprosthetic fracture is an uncommon but notable complication that can occur during primary total knee arthroplasty. These fractures may occur at various stages during the procedure, including surgical exposure, implant preparation, implant trialing, and final implantation. Management of femoral and tibial fractures necessitates intraoperative recognition, including attentiveness of
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Introducing the Patient-Reported Outcome Measures Workgroup and How It Is Helping Patients and Physicians Harness the Benefits. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-11 Lauren M Shapiro,Jason Koh,Clifford Jones,Richard F Seiden,Kurt Spindler
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The Use of the Lateral Tibial Line to Assess Ankle Alignment: A Preliminary Investigation. J. Am. Acad. Orthop. Surg. (IF 3.2) Pub Date : 2023-08-11 Brendan M Striano,Shalin S Patel,Emily Parker,Joshua J Vaughn,Jeremy T Smith,Mitchel B Harris,Christopher P Chiodo
BACKGROUND Although the medial clear space (MCS) is commonly used to assess talar alignment and ankle stability, its measurement is variable with multiple reported normal values. We have observed that the lateral tibial shaft is a reliable landmark to assess talar alignment. The objective of the current investigation was to determine the normal relationship of the lateral tibia to the superolateral