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Site of Service Disparities Exist for Total Joint Arthroplasty Orthopedics (IF 1.1) Pub Date : 2024-03-12 Nicole M. Truong, BS, Chelsea V. Leversedge, MPH, Thompson Zhuang, MD, MBA, Lauren M. Shapiro, MD, MS, Matthew Whittaker, MD, Robin N. Kamal, MD, MBA
Background: The rate of outpatient total joint arthroplasty procedures, including those performed at ambulatory surgical centers (ASCs) and hospital outpatient departments, is increasing. The purpose of this study was to analyze if type of insurance is associated with site of service (inpatient vs outpatient) for total joint arthroplasty and adverse outcomes. Materials and Methods: We identified patients
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Performance of Two Artificial Intelligence Generative Language Models on the Orthopaedic In-Training Examination Orthopedics (IF 1.1) Pub Date : 2024-03-12 Marc Lubitz, MD, Luke Latario, MD
Background: Artificial intelligence (AI) generative large language models are powerful and increasingly accessible tools with potential applications in health care education and training. The annual Orthopaedic In-Training Examination (OITE) is widely used to assess resident academic progress and preparation for the American Board of Orthopaedic Surgery Part 1 Examination. Materials and Methods: Open
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A Cost Analysis of Surgical Approach in Total Hip Arthroplasty Orthopedics (IF 1.1) Pub Date : 2024-03-12 Niall H. Cochrane, MD, Colleen Wixted, BS, Billy Kim, BA, Patrick J. Kelly, MD, Michael P. Bolognesi, MD, David Holst, MD, Samuel Wellman, MD, Sean P. Ryan, MD
Background: With pressures to decrease the financial burden of total hip arthroplasty (THA), it is imperative to understand the cost drivers of this procedure. This study evaluated operative and total encounter costs for two surgical approaches to THA—posterior (P) and direct anterior (DA). Materials and Methods: A total of 233 THAs (134 P and 99 DA) performed by two fellowship-trained arthroplasty
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Four-Year Outcomes of Cementless Versus Cemented Fixation of a Newly Introduced Total Knee Arthroplasty Design Orthopedics (IF 1.1) Pub Date : 2024-01-25 Timothy G. Costales, MD, David F. Dalury, MD
Background: Aseptic loosening continues to be a major cause of failure of total knee arthroplasty (TKA). Although cemented fixation remains the gold standard, there is renewed interest in cementless fixation as a means of decreasing this risk via biologic fixation. The purpose of this study was to evaluate the clinical outcomes of cemented and cementless versions of a newly introduced TKA design at
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Adamantinoma of the Ulnar Shaft Reconstructed With a Vascularized Free Fibula. Orthopedics (IF 1.1) Pub Date : 2023-11-01 John F Schutz,Matthew L Iorio,Carrie B Marshall,Michael R Clay,David C Gimarc,Andrew Park
We describe a 36-year-old man with a long-standing diagnosis of ulnar fibrous dysplasia with associated fracture of the ulna. He presented with a growing and increasingly tender forearm mass and was diagnosed with adamantinoma of the ulna, for which he underwent wide resection of the ulnar diaphysis followed by reconstruction with a vascularized fibula autograft. This case serves to emphasize the importance
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Cannabis Use Is Associated With Fewer Filled Opioid Prescriptions After Treatment of Proximal Humerus Fractures. Orthopedics (IF 1.1) Pub Date : 2023-11-01 Jacob Silver,Brian T Ford,Colin J Pavano,Nicholas Bellas,Cory Hewitt,Matthew Solomito,Christopher McCarthy
The purpose of this study was to use a large claims database to determine if there is a difference in opioid use after operative intervention for proximal humerus fractures in patients with known cannabis use compared with those who do not report cannabis use. The PearlDiver database was queried to find all patients who underwent proximal humerus open reduction and internal fixation. A group of patients
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Iatrogenic Excessive Clavicle Resection as a Complication of Arthroscopic Distal Clavicle Excision. Orthopedics (IF 1.1) Pub Date : 2023-11-01 Prashant Meshram,Rachit Saggar,Piotr Lukasiewicz,Joel A Bervell,Stephen C Weber,Edward G McFarland
Arthroscopic distal clavicle excision (DCE) is a reliable procedure to treat acromioclavicular joint arthritis. Typically, only 1 to 2 cm of distal clavicle should be removed. Resection of too much bone can lead to instability of the joint or lack of support to the shoulder. We describe 2 patients who had excessive clavicular bone removed arthroscopically, leading to irreparable clavicular pain and
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Nearly All Peer-to-Peer Reviews for CT and MRI Prior Authorization Denials for Orthopedic Specialists Are Approved. Orthopedics (IF 1.1) Pub Date : 2023-11-01 Nareena Imam,Jay M Zaifman,Rocco Bassora,Chris Cherian,Eitan M Kohan,Frank G Alberta,John D Koerner
In the event of prior authorization denial, physicians may request peer-to-peer review, which may delay treatment and increase administrative burden. The purpose of this study was to quantify the approval rate of peer-to-peer review and evaluate its efficiency in the context of advanced imaging use in an orthopedic practice. Patients at a single outpatient orthopedic clinic initially receiving an insurance
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Increased 90-Day Mortality and Morbidity Among Patients Recovering From Elective Primary Arthroplasty During the COVID-19 Pandemic in New York City. Orthopedics (IF 1.1) Pub Date : 2023-11-01 Megan M Mizera,Zeynep Seref-Ferlengez,Anna Tarasova,Evan Mostafa,Eli Kamara,Sun Jin Kim
All elective procedures were stopped in March 2020 because of the coronavirus disease 2019 (COVID-19) pandemic. We report the 90-day mortality and complications of patients who underwent primary arthroplasty before the stopping of elective procedures at a single academic medical center. A retrospective cohort study was conducted including patients who underwent elective primary arthroplasty between
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Use of a Continuous Intracompartmental Pressure Monitoring Device During Fasciotomy. Orthopedics (IF 1.1) Pub Date : 2023-11-01 Nicholas Frane,Stephen A Doxey,Fernando A Huyke-Hernández,Brian P Cunningham,Michael D McKee
A 52-year-old man presented with a bicondylar tibial plateau fracture and acute compartment syndrome. Continuous compartment pressure monitoring was used while the patient was treated with fasciotomies and application of an external fixator. The intraoperative pressure reading in the anterior compartment decreased from 105 mm Hg to 50 mm Hg after skin and subcutaneous tissue incision. Pressure continued
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Zone I Revision Finger Amputations Performed in the Emergency Department Compared With Those Performed in the Operating Room. Orthopedics (IF 1.1) Pub Date : 2023-11-01 Michael J Anderson,Brett R Campbell,Brittany E Homcha,Susan J Boehmer,Kenneth F Taylor
Finger amputations are commonly encountered. These may be revised in the emergency department (ED) or the operating room (OR). Previous studies have demonstrated the cost-effectiveness associated with procedures performed in the ED. Patient outcomes have not been described. We retrospectively reviewed patients who presented to our level 1 trauma center with a traumatic partial or complete finger amputation
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The Rapid Development of Artificial Intelligence: GPT-4's Performance on Orthopedic Surgery Board Questions. Orthopedics (IF 1.1) Pub Date : 2023-09-27 Hayden L Hofmann,Gage A Guerra,Jonathan L Le,Alexander M Wong,Grady H Hofmann,Cory K Mayfield,Frank A Petrigliano,Joseph N Liu
Advances in artificial intelligence and machine learning models, like Chat Generative Pre-trained Transformer (ChatGPT), have occurred at a remarkably fast rate. OpenAI released its newest model of ChatGPT, GPT-4, in March 2023. It offers a wide range of medical applications. The model has demonstrated notable proficiency on many medical board examinations. This study sought to assess GPT-4's performance
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Surprise Billing in Elective Shoulder Surgery and Its Effect on Patient Satisfaction. Orthopedics (IF 1.1) Pub Date : 2023-09-27 Joseph A S McCahon,Jeffrey C Lynch,Tyler Radack,Luke S Austin
Patients often receive multiple bills following surgery, which may come as a surprise to them if they are not appropriately informed or educated prior to surgery. The purpose of this study was to identify whether surprise billing occurs following shoulder rotator cuff repair and its effect on patient satisfaction. The study surveyed adult patients who underwent elective rotator cuff repair from January
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Facebook Data Analytics: An Orthopedic Arthroplasty Case Study and Guide for Physicians. Orthopedics (IF 1.1) Pub Date : 2023-09-27 Jonathon Florance,Jonathan Dattilo,Nitin Goyal,Thorsten Seyler
Social media is increasingly used for health queries and subspecialist selection, but physicians receive little training in its use. This case study describes use of the free data tool Facebook Audience Insights to understand population demographics relevant to an orthopedic practice. Face-book Audience Insights was used to compare demographics and activity patterns of two patient samples typical of
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Influence of Anxiety and Depression on Opioid Use After Cervical Spine Fusion: An Analysis of a National Claims Database. Orthopedics (IF 1.1) Pub Date : 2023-09-27 Heeren Makanji,Matthew J Solomito,Regina Kostyun,Sean Esmende
Patients with spine pathology demonstrate an above average rate of active psychiatric disorders, which can influence their recovery. This study was designed to understand how mental health diagnoses (ie, anxiety and depression) influence a patient's postoperative need for opioids after a single level cervical spine fusion. The PearlDiver database was used to identify patients. Patients were placed
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Alteration in Microcirculation With Osteonecrosis of the Femoral Head: A Study of Dynamic Contrast-Enhanced MRI. Orthopedics (IF 1.1) Pub Date : 2023-09-27 ZhaoFeng Yuan,DaWei Huan,WeiQiang Dou,ShaoWei Liu,Chao Lu,Chao Zhang,TianWei Xia,JiRong Shen
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is commonly used in clinical practice to detect tumor blood supply, and it has recently been applied to assess skeletal vasculature. In this study, we retrospectively analyzed DCE-MRI data from 37 patients with osteonecrosis of the femoral head to evaluate alterations in microvascular circulation of the femoral head. Time-intensity curves
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Improving the Patient Experience During Care in the Orthopedic Cast Room. Orthopedics (IF 1.1) Pub Date : 2023-09-27 Jerry Gibson,Jessica C Rivera
Patients regularly have casts, splints, and wounds that require attention in the clinic. Patients commonly experience anxiety and pain during such visits. We hypothesized that aromatherapy and music would improve these patients' pain and anxiety when compared with no exposure. Patients in the orthopedic cast room were randomly exposed to no experience, music, or aromatherapy. Postprocedural surveys
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The Utility of the Standardized Letter of Recommendation for Orthopedic Surgery Residency Applicants: A Systematic Review. Orthopedics (IF 1.1) Pub Date : 2023-09-06 Adam M Gordon,Michael A Mont,Jack Choueka
Despite widespread adoption for evaluating residency candidates, few studies have evaluated the orthopedic standardized letter of recommendation (SLOR). A systematic review using PubMed, Embase, and Web of Science was performed in June 2022. Study design and results from SLOR investigations were compiled. Common outcomes studied were summative rank statement scores and SLOR individual domains. Applicants
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Patient-Reported Outcomes and Computed Tomography Review After Minimally Invasive Fusion of the Sacroiliac Joint With Aggressive Joint Decortication and Joint Compression. Orthopedics (IF 1.1) Pub Date : 2023-09-06 William W Cross,Marko N Tomov,Michelle Y Hung,Jeffrey M Muir
The sacroiliac joint (SIJ) is a common, underrecognized source of low back pain. We evaluated outcomes in patients undergoing sacroiliac joint fusion (SIJF) using a novel, minimally invasive SIJF system emphasizing compressive forces across an aggressively debrided SIJ. We retrospectively reviewed data from a continuous set of patients presenting to a large, tertiary care hospital from September 2017
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Treatment of Calcific Tendonitis of the Rotator Cuff: An Updated Review. Orthopedics (IF 1.1) Pub Date : 2023-09-06 John P Avendano,David Pereira
Rotator cuff calcific tendonitis (RCCT) is a disorder that can greatly impair patients' quality of life. A literature review was conducted to find the most effective and newest treatments for RCCT. PubMed and Cochrane Review databases were searched, without strict inclusion/exclusion criteria, for peer-reviewed articles between 1941 and 2021 that discussed RCCT etiology and treatments. If nonoperative
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Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy. Orthopedics (IF 1.1) Pub Date : 2023-09-06 J W Thomas Byrd,Kay S Jones,Tandy R Freeman
Bull riders represent a microcosm of athletes in whom severe consequences of femoroacetabular impingement may challenge the limits of arthroscopic intervention. Observations of this cohort may provide meaningful insight into the treatment of other populations. All patients undergoing hip arthroscopy are prospectively assessed with a modified Harris Hip Score. Sixteen consecutive bull riders (21 hips)
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Coronoid Fragment Size in Monteggia Fractures Predicts Ultimate Function. Orthopedics (IF 1.1) Pub Date : 2023-08-09 Leah Gonzalez,Connor Littlefield,Joseph Johnson,Philipp Leucht,Sanjit Konda,Kenneth Egol
We sought to determine what effect the size of a displaced coronoid fracture fragment in Monteggia injuries has on clinical outcome. Sixty-seven patients presented to an academic medical center for operative fixation of a Monteggia fracture. Radiographs were assessed for length and height of the displaced coronoid fragment using measuring tools in our center's imaging archive system. Data were analyzed
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Risk Factors for Wound Failure After Primary Closure of Type IIIA Open Tibia Fractures. Orthopedics (IF 1.1) Pub Date : 2023-08-09 Brian Weatherford,Andrew Dubina,Raymond A Pensy,Ebrahim Paryavi,Robert V O'Toole
The objective of our investigation was to explore risk factors associated with primary closure of type IIIA tibial fractures resulting in subsequent flap coverage. A retrospective study identified 278 patients with acute type IIIA open tibial fractures who underwent primary closure at a single center during an 8-year period. Treatment factors, including the number of debridements before closure, duration
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The Effect of Timing Between Traumatic Flexor Tendon Injury of the Hand and Surgical Intervention on Repair Failure Rates. Orthopedics (IF 1.1) Pub Date : 2023-08-09 Rajiv P Reddy,Timothy Gao,Joseph Chen,Robert Goitz,Robert A Kaufmann,John R Fowler
Flexor tendon injuries of the hand, especially in zone II, pose a challenge for hand surgeons because of the region's intricate pulley mechanism and local avascularity, and post-surgical complications such as repair failure are not uncommon. One proposed predictor of outcomes following flexor tendon repair has been timing of surgery from initial injury. However, the effect of the timing of flexor tendon
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Analyzing Resilience in the Orthopedic Sports Medicine Patient Population. Orthopedics (IF 1.1) Pub Date : 2023-08-09 John Hayden Sonnier,Austin M Looney,Emma E Johnson,Zac Fuller,Fotios P Tjoumakaris,Kevin B Freedman
Little research has been done to compare resilience, as measured by the Brief Resilience Scale (BRS), across common sports medicine patient populations. Our purpose was to investigate resilience levels across sports medicine patient populations. All patients who underwent reconstruction of the anterior cruciate ligament (ACLR), partial meniscectomy (PM), meniscal repair (MR), rotator cuff repair (RCR)
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Early Versus Delayed Weight Bearing and Mobilization After Ankle Fracture Fixation Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Orthopedics (IF 1.1) Pub Date : 2023-08-09 Jaryd Tong,Prabjit Ajrawat,Jaskarndip Chahal,Anser Daud,Daniel B Whelan,Aaron Nauth,Niloofar Dehghan,Graeme Hoit
The purpose of this review was to determine whether there is a benefit to early weight bearing or mobilization in surgically treated ankle fractures. All randomized controlled trials that analyzed early vs delayed weight bearing and/or mobilization after an ankle surgery were included. The primary outcome measure was the pooled Olerud Molander Ankle Score 1 year postoperatively. No significant differences
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Evolution and New Generation of Dual Mobility Cups Orthopedics (IF 1.1) Pub Date : 2023-08-09 Domenico Tigani, MD, Lorenzo Banci, MSc, Stefano Stallone, MD, Giuseppe Melucci, MD, Giulio Pieratelli, MD, Emanuela Castiello, MD
Although total hip arthroplasty (THA) is considered a successful procedure, hip dislocation remains the main cause of early failure. Dual mobility cups (DMCs) have been shown to significantly reduce the dislocation rate in both primary and revision THAs. During the past several decades, DMCs have evolved in design and fixation interface. There have been three generations of DMCs. This article addresses
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Large Femoral Heads With Small Acetabular Components: An Examination of 10-Year Polyethylene Wear. Orthopedics (IF 1.1) Pub Date : 2023-08-09 Hope S Thalody,Danielle Y Ponzio,Adam J Santoro,Tyler M Radack,Zachary D Post,Alvin C Ong
Highly cross-linked polyethylene (HXLPE) has improved polyethylene (PE) wear rates while decreasing osteolysis and aseptic loosening. However, concerns exist regarding the risk of mechanical failure with thin HXLPE liners in total hip arthroplasty (THA). Our purpose was to evaluate long-term outcomes and PE wear rates in primary THAs pairing large femoral heads with small acetabular components and
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Update on Current Concepts of Blood Flow Restriction in the Perioperative Period of Anterior Cruciate Ligament Reconstruction. Orthopedics (IF 1.1) Pub Date : 2023-08-09 Morgan E Hasegawa,Chloe D Delos Reyes,Julian B Rimm,Joshua K Radi,Dylan S Singh,Kyle K Obana,Edward J Weldon,Tyler J Thorne,Trent M Tamate,Sarah Rosabelle Alferos,Kyong S Min
Anterior cruciate ligament tears or ruptures are common orthopedic injuries. Anterior cruciate ligament reconstruction (ACLR) is an orthopedic procedure allowing for earlier return to sports, improved maintenance of lifestyle demands, and restored knee stability and kinematics. A perioperative rehabilitative adjunct recently gaining interest is blood flow restriction (BFR), a method in which temporary
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Use of Peripheral Nerve Blocks Is Not Associated With Decreased Postoperative Opioid Prescription After ACL Reconstruction in Adolescents. Orthopedics (IF 1.1) Pub Date : 2023-06-21 Japsimran Kaur,Nicole Segovia Pham,Eli Cahan,Kristin Cory Halvorsen,Joanna L Langner,Xochitl M Bryson,Charles M Chan,John Schoeneman Vorhies
The rate of anterior cruciate ligament (ACL) injuries and reconstruction in pediatric patients is increasing. Perioperative peripheral nerve blocks (PNBs) are widely used for pain management in this population. We used a multi-state administrative claims database to describe the effect of PNB after ACL reconstruction on postoperative opioid consumption. We identified patients 10 to 18 years old undergoing
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The Effect of Povidone-Iodine Irrigation on the Efficacy of Antibiotic Cement In Vitro. Orthopedics (IF 1.1) Pub Date : 2023-06-21 Grant R McChesney,Marisa C Nielsen,Rong Fang,Natalie Williams-Bouyer,Ronald W Lindsey
Povidone-iodine is a common antiseptic demonstrating success in reducing infection rates in primary arthroplasty; however, recent data suggest that its use in revision arthroplasty may increase infection rates. This study evaluated the effect of povidone-iodine solution on antibiotic cement and investigated the connection between povidone-iodine and increased infection rates in revision arthroplasty
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Medicaid and Indigent Patients Experience Delayed Fixation of Distal Radius Fractures, Resulting in Worse Consequential Radiographic Outcomes. Orthopedics (IF 1.1) Pub Date : 2023-06-21 Cristina T Graphia,Samuel H Klatman,Rachel E Hein,Claudia Leonardi,Robert D Zura,Marc J Richard
Distal radius fractures are the most common upper extremity injury. Patients referred to safety-net tertiary facilities following a fracture experience significant delays in treatment because of financial and language barriers as well as poor access to care at outlying community hospitals. This delay in treatment can affect postoperative functional outcomes and complication rates because of failure
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Physeal Bar Formation After Pediatric Medial Malleolus Fractures. Orthopedics (IF 1.1) Pub Date : 2023-06-21 Matthew D Abbot,Matthew J Siebert,Robert L Wimberly,Philip L Wilson,Anthony I Riccio
Pediatric medial malleolus fractures are commonly Salter-Harris (SH) type III or IV fractures of the distal tibia and are associated with a risk of physeal bar formation and subsequent growth disturbance. The purpose of this study was to determine the incidence of physeal bar formation following pediatric medial malleolus fracture and evaluate for patient and fracture characteristics predictive of
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Analysis of Academic Accomplishments and Demographics for Elected Presidents of National Orthopedic Surgery Organizations in the United States. Orthopedics (IF 1.1) Pub Date : 2023-06-21 Jason Silvestre,Sanjum Singh,John D Kelly,Charles L Nelson,Terry L Thompson,James D Kang
This study analyzed the academic accomplishments and demographics of elected presidents of the American Academy of Orthopaedic Surgeons (AAOS), American Orthopaedic Association (AOA), and American Board of Orthopaedic Surgery (ABOS). Curriculum vitae and internet-based resources were reviewed to collect demographics, training characteristics, bibliometrics, and National Institutes of Health (NIH) research
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Preoperative Depression Is Associated With Increased Short-term Complications But Equivalent Long-term Outcomes in Total Knee Arthroplasty. Orthopedics (IF 1.1) Pub Date : 2023-06-05 Connor T Byrne,Caleb R Durst,Kevin T Rezzadeh,Zachary A Rockov,Anderson Lee,Karma S McKelvey,Andrew I Spitzer,Sean S Rajaee
Concomitant depression negatively impacts outcomes following total knee arthroplasty (TKA). Patient-Reported Outcomes Measurement Information System (PROMIS) surveys are validated measures that quantify depression, pain, and physical function. We hypothesized that higher preoperative PROMIS-depression scores would be associated with inferior outcomes following TKA. A total of 258 patients underwent
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Quantification of the Safe Zone of the First to Third Sacral Segments for Transiliac-Transsacral Screw Fixation in Normal and Dysmorphic Sacra. Orthopedics (IF 1.1) Pub Date : 2023-06-05 Po-Hsiang Chen,Chun-Yu Chen,Kai-Cheng Lin,Chien-Jen Hsu
Transiliac-transsacral screw fixation is widely used to stabilize unstable posterior pelvic ring injuries. Preoperative radiographic assessment of the safe osseous corridor is necessary because the safe space of sacrum is narrower for transiliac-transsacral screw placement than for traditional iliosacral screw placement. However, the radiographic assessment has rarely been studied in the Taiwanese
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The Impact of Surgeon Proficiency in Non-English-Speaking Patients' Primary Language on Outcomes After Total Joint Arthroplasty. Orthopedics (IF 1.1) Pub Date : 2023-06-05 Kyle W Lawrence,Thomas H Christensen,Thomas Bieganowski,Daniel B Buchalter,Morteza Meftah,Claudette M Lajam,Ran Schwarzkopf
Non-English-speaking patients face increased communication barriers when undergoing total joint arthroplasty (TJA). Surgeons may learn or have proficiency in languages spoken among their patients to improve communication. This study investigated the effect of surgeon-patient language concordance on outcomes after TJA. We conducted a single-institution, retrospective review of patients undergoing total
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Traumatic Degloving Wounds Treated With Low Continuous Wall Suction Drainage: A Novel and Effective Technique to Prevent Recurrence. Orthopedics (IF 1.1) Pub Date : 2023-06-05 Helyn G Fraser,Roberto C Hernandez-Irizarry,Kyle E Bundschuh,Michael A Maceroli
Soft tissue degloving wounds overlying fractures present a technical surgical challenge and have a high rate of recurrence. Despite several current treatment methods, there remains a need for improved therapies to address this complex issue. The purpose of this study was to introduce a novel technique for managing soft tissue degloving wounds in the setting of fractures requiring operative fixation
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The Effect of High-Normal Preoperative International Normalized Ratios on Outcomes and Complications After Anterior Cervical Spine Surgery. Orthopedics (IF 1.1) Pub Date : 2023-06-05 John T Strony,Junyoung Ahn,Jerry Y Du,Uri M Ahn,Lucas Haase,Nicholas U Ahn
Hematoma after anterior cervical spine surgery can result in neurologic and airway compromise. Current guidelines recommend an international normalized ratio (INR) <1.5 before elective spine surgery because of increased complications. The risk associated with an INR of 1.25 is not well studied. The purpose of this study was to determine the risk of complications associated with a preoperative INR >1
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Rank-Ordered List of Cost-effective Strategies for Preventing Prosthetic Joint Infection in Total Joint Arthroplasty in an Academic US Hospital. Orthopedics (IF 1.1) Pub Date : 2023-06-05 Adrian Azar,Kayla Ryan,Izuchukwu Ibe,Spencer Montgomery
Although the overall rate of prosthetic joint infection (PJI) is low, it remains a major complication associated with total joint arthroplasty (TJA). PJI represents a significant economic burden to the health care system that is projected to increase commensurate with increasing joint replacement volumes. This review provides a rank-ordered list of cost-effective strategies that are performable intraoperatively
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Application of Metagenomic High-Throughput Sequencing in a Rare Case of Multisite Infection With Two Microorganisms After Total Knee Arthroplasty. Orthopedics (IF 1.1) Pub Date : 2023-06-05 Dawei Hua,Qiang Zou,Zhanyu Wu,Daizhu Yuan,Long Yang,Chuan Ye
Postoperative deep infection is usually identified by microbial culture. However, frequent false-negative results have severely limited effective treatment. We report a rare case of intra-articular and paravertebral infection after total knee arthroplasty caused by Mycoplasma hominis and Ureaplasma urealyticum, with multiple negative microbial culture results. Eventually, the pathogens were identified
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Primary Cementless Femoral Stems in Conversion Hip Arthroplasty After Failed Fixation of Intertrochanteric Fractures. Orthopedics (IF 1.1) Pub Date : 2023-05-23 Hope S Thalody,Zachary D Post,Rex W Lutz,Miranda Czymek,Alvin C Ong,Danielle Y Ponzio
Salvage conversion hip arthroplasty is a viable solution to restore function and reduce pain after failed intertrochanteric hip fracture fixation. Our primary objective was to assess early outcomes achieved with primary cementless metaphyseal-engaging femoral stems for conversion hip arthroplasty compared with revision diaphyseal-engaging stems. This was a retrospective review of 70 patients with failed
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Return to Play Rates Following Operative Ankle Fractures Differ Between High- and Low-Performing National Football League Athletes. Orthopedics (IF 1.1) Pub Date : 2023-05-23 Jordan B Robbins,Daniel C Jupiter,Vinod K Panchbhavi,William M Weiss,John C Hagedorn,Jie Chen
This study investigated predictive factors for return to play among National Football League athletes after operative treatment of ankle fractures and the impacts of these injuries on career longevity and player performance. Athletes who underwent surgery to repair ankle fractures from the 2013 to 2017 seasons were identified from injury reserve lists and press releases. Demographics and season metrics
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Correlation of Patient-Reported Preoperative Narcotic Use and Postoperative Requirements in Total Joint Arthroplasty. Orthopedics (IF 1.1) Pub Date : 2023-05-23 Aaron A Olsen,Joseph H Dannenbaum,Timothy Horan,Ruijia Niu,Carl T Talmo
Preoperative narcotic use is associated with diminished outcomes and increased complications in patients undergoing primary total joint arthroplasty (TJA). The goal of this study was to compare self-reported and state database identified preoperative narcotic use and correlate it with perioperative narcotic requirements in patients undergoing primary arthroplasty. A total of 788 patients undergoing
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Cannabidiol Use Patterns and Efficacy for Children Who Have Cerebral Palsy. Orthopedics (IF 1.1) Pub Date : 2023-05-23 Ryan A Seltzer,Joanna L Langner,Nadine M Javier,Japsimran Kaur,Abdul-Lateef Shafau,Teeto Ezeonu,Xochitl Bryson,Katherine Hastings,Kali Tileston,John S Vorhies
Cannabidiol (CBD)-containing supplements are used by children with cerebral palsy (CP), but the prevalence and efficacy of their use have not been studied. We sought to describe CBD use patterns and perceived efficacy in the pediatric population with CP, evaluating any association between CBD use and health-related quality of life. Patients with CP were prospectively enrolled, and caregivers were offered
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Techniques for Managing the Subscapularis and Addressing Failures of the Tendon in Anatomic Total Shoulder Arthroplasty. Orthopedics (IF 1.1) Pub Date : 2023-05-23 Mark T Dillon,Casey M Beleckas,Ronald A Navarro
Anatomic total shoulder arthroplasty (aTSA) is an accepted treatment for a variety of degenerative conditions of the glenohumeral joint. The manner in which the subscapularis tendon is handled during the approach in aTSA is not universally agreed on. Failure of the repair after aTSA has been shown to be associated with poorer outcomes in some cases. There is no consensus on how to treat failures, as
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Predicting Which Species of Bacteria Will Cause an Infection After Fracture Surgery. Orthopedics (IF 1.1) Pub Date : 2023-05-23 Ajinkya Rane,Qasim M Ghulam,Zachary D Hannan,Phillip C McKegg,Kalin Fisher,Manjari Joshi,Nathan N O'Hara,Robert V O'Toole
The aim of this study was to develop and validate risk prediction models for deep surgical site infection (SSI) caused by specific bacterial pathogens after fracture fixation. A retrospective case-control study was conducted at a level I trauma center. Fifteen candidate predictors of the bacterial pathogens in deep SSI were evaluated to develop models of bacterial risk. The study included 441 patients
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The Relationship Between Postoperative Patient-Reported Psychological Outcomes and Preoperative Pain Characteristics in Patients Who Underwent Periacetabular Osteotomy. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Brandon P Everett,Jason Lin,Paul Gudmundsson,Rebisi Owhonda,Paul A Nakonezny,Emily Middleton,Avneesh Chhabra,Joel E Wells
This study sought to investigate the relationship between multiple preoperative characteristics of pain (maximum pain severity location, the presence of pain in certain locations, the highest level of pain, and the number of pain locations) and psychological outcome measures as reported by patients. Fifty-four hips (50 patients) that underwent periacetabular osteotomy to treat acetabular dysplasia
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Surgical Management of Failed Articular Cartilage Surgery in the Knee. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Michael P Campbell,John Hayden Sonnier,Margaret L Wright,Kevin B Freedman
Failure rates of cartilage restoration surgery range from 14% to 43%. When failure of prior cartilage restoration surgery is suspected, a thorough clinical workup should be performed to assess the timing and duration of symptoms. Attention should be paid to patient risk factors such as age, body mass index, and smoking status. Concomitant pathology such as malalignment, ligament insufficiency, and
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Patient Preferences in Short-Interval Staged Bilateral Rotator Cuff Repair. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Brian E Fliegel,Anya Hall,Akash Patel,Donghoon Lee,Steven B Cohen,Kevin Freedman,Fotios Tjoumakaris
The decision to seek and undergo treatment for bilateral rotator cuff tears is often complex. The purpose of this study was to investigate patient preferences for undergoing short-interval staged bilateral rotator cuff repair; timing of surgeries; and order of surgeries. A retrospective analysis was performed for patients who underwent bilateral arthroscopic rotator cuff repairs within 12 months at
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Risk Factors for Early Readmission and Reoperation After Outpatient Total Hip Arthroplasty. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Niall H Cochrane,Elshaday S Belay,Billy Kim,Mark Wu,Jeffrey O'Donnell,Sean Ryan,Michael P Bolognesi,Thorsten M Seyler
Outpatient total hip arthroplasty (THA) is a safe option for select patients. The purpose of this study was to analyze a national database and understand risk factors that lead to unplanned early readmission and reoperation after outpatient THA. The National Surgical Quality Improvement Program database was used to collect outpatient THAs performed from 2013 to 2020. The outpatient setting was defined
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Trends in ACGME Accreditation of Orthopedic Surgery Fellowship Training. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Jason Silvestre,Charles L Nelson,Terry L Thompson,James D Kang
Currently, most surgeons pursue subspecialty fellowship training. This study answers the following questions: (1) How does the rate of fellowship training in orthopedic surgery compare with that in other surgical specialties? (2) To what extent did adoption of Accreditation Council for Graduate Medical Education (ACGME) accreditation change from 2013 to 2021? Orthopedic subspecialties were analyzed
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Assessing the Diagnostic Accuracy of Next-Generation Sequencing in Patients With Antibiotic Spacers Before Reimplantation. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Beau J Kildow,Niall Cochrane,Patrick J Kelly,Jeffrey A O'Donnell,Mark Wu,Elizabeth Lyden,William A Jiranek,Thorsten M Seyler
Use of molecular sequencing modalities in periprosthetic joint infection diagnosis and organism identification has gained popularity recently. To date, there is no diagnostic test that reliably predicts infection eradication in patients with antibiotic spacers. The purpose of this study was to compare the diagnostic accuracy of next-generation sequencing (NGS), culture, the Musculoskeletal Infection
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Arthroscopic Excision of Pigmented Villonodular Synovitis of the Trochanteric Bursa. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Antonio Garrasi,George R Dodge,John D Kelly
Trochanteric bursitis is a common disorder affecting middle-aged adults and usually presents with lateral-based hip pain and swelling. It usually responds to conservative measures, including adductor stretching, abductor strengthening, and select injections of corticosteroid or platelet-rich plasma. For refractory cases, excision, open or arthroscopic, is usually recommended. We observed a 55-year-old
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Initial Validation of a Sacroiliac Joint-Specific Disability Questionnaire. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Vikas V Patel,Eric E Sawyer,Paul E Mintken,Lori A Michener,Claire L Cofer,Emily M Lindley
Low back pain is a multidimensional disorder that can originate from a variety of pain generators, including the sacroiliac (SI) joint. Although the Oswestry Disability Index (ODI) is often used in SI joint treatment studies, the effects of the SI joint on functional disability are likely different from those of other low back pain generators. Thus, we developed the Denver SI Joint Questionnaire (DSIJQ)
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Multicentric Giant Cell Tumor of Bone. Orthopedics (IF 1.1) Pub Date : 2023-05-02 Costantino Errani,Shinji Tsukamoto,Rebeca Angulo Alvarado,Alberto Righi,Yuji Nitta,Davide Maria Donati,Andreas F Mavrogenis
The typical presentation of giant cell tumor of bone is a solitary lesion involving the meta-epiphyseal region of the long bones. The presence of more than one distinct giant cell tumor in the same patient is rare. This study reports on 7 patients with multicentric giant cell tumor of bone. Clinical and radiologic features were reviewed to evaluate the behavior of multicentric giant cell tumor of bone
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Comparison of Patient-Reported Outcomes With or Without Prophylactic Carpal Tunnel Release After Distal Radius Fracture Stabilization. Orthopedics (IF 1.1) Pub Date : 2023-04-12 Jonathan F Dalton,Timothy J Luchetti,Landon M Cluts,Sumail S Bhogal,Robert A Kaufmann,Robert J Goitz,John R Fowler
Distal radius fractures (DRFs) are frequently complicated by acute carpal tunnel syndrome (CTS), which, if unrecognized, can cause permanent median neuropathy. Some surgeons recommend "prophylactic" carpal tunnel release (CTR) during open reduction and internal fixation (ORIF) of DRF. Patient-reported outcomes (PROs) and safety data regarding prophylactic vs symptomatic CTR strategies during DRF fixation
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Acquisition of Medical Knowledge Varies During Allopathic and Osteopathic Orthopedic Surgery Residency Training. Orthopedics (IF 1.1) Pub Date : 2023-04-12 Jason Silvestre,Terry L Thompson,John D Kelly,Robert H Wilson,Charles L Nelson
Currently, little is known about the differences in medical knowledge acquisition between osteopathic and allopathic orthopedic surgery residents. The purpose of this study was to determine the relationship between Orthopaedic In-Training Examination (OITE) performance and training pathway in orthopedic surgery. This was a retrospective cohort study of all orthopedic surgery residents taking the OITE
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Regional Anesthesia Is Safe and Effective for Low-Energy Tibial Plateau Fractures. Orthopedics (IF 1.1) Pub Date : 2023-04-12 Alexa R Deemer,Abhishek Ganta,Philipp Leucht,Sanjit Konda,Kenneth A Egol
The purpose of this study was to determine if the use of peripheral nerve blocks in the operative management of tibial plateau fractures is associated with improved outcomes when compared with the use of spinal and general anesthesia. Over a period of 16 years, 132 patients who underwent operative repair for a low-energy tibial plateau fracture and had at least 12 months of follow-up met the inclusion
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Postoperative Outcomes in Malleolar Fractures Fixed With a 3.5-mm Locking Compression Plate Hook Plate. Orthopedics (IF 1.1) Pub Date : 2023-04-12 Hadi Aziz,Sally M Trout,Rishabh Jethanandani,Christine D Bub,Lewis Collins,Ariel T Goldman
Ankle fractures are among the most common types of fractures seen in the United States. Few studies have analyzed the use of a locking compression plate (LCP) hook plate in the fixation of malleolar fractures. The goal of this study was to analyze postoperative outcomes in malleolar fractures fixed with a 3.5-mm LCP hook plate. A cohort of 74 patients with ankle fractures treated operatively with hook