BACKGROUND Accurate and timely differential diagnosis of hip prosthesis failures remains a major clinical challenge. Radiographic examination remains the most cost-effective and common first-line imaging modality for hip prostheses, and integrating deep learning has the potential to improve its diagnostic accuracy and efficiency. METHODS A deep learning-based clinical classification system (Hip-Net)

BACKGROUND Initial surgical management of Gustilo-Anderson type-I to IIIA open fractures varies from surgical fixation of the fracture with immediate closure of the traumatic wound to various combinations of staged fracture and wound management. The decision to choose staged management has historically been based on wound contamination and the severity of the open fracture. The purpose of this study

BACKGROUND Food deserts-communities with limited access to healthy food-have been linked with poor surgical outcomes; however, their impact on orthopaedic trauma outcomes remains unknown. The aims of this study were to determine the prevalence of food desert residency among orthopaedic trauma patients and to investigate the impact of food desert residency on the rate of unplanned reoperation with use

BACKGROUND External fixation is often used in the management of open lower-extremity fractures. The objectives of this study were to identify hospital characteristics that are associated with greater use of temporary external fixation and to determine if external fixation reduces the odds of surgical site infection (SSI) and unplanned reoperation among patients with open lower-extremity fractures.

BACKGROUND The purpose of this study was to describe the culture and speciation results of patients with surgical site infection (SSI) from the PREPARE and Aqueous-PREP studies from the PREP-IT Investigators. METHODS Patients with suspected SSI underwent collection of deep or organ tissue samples for culture. The culture positivity rate was estimated as a percentage along with the exact binomial 95%

BACKGROUND A preoperative chlorhexidine gluconate (CHG) bath is used to reduce the risk of surgical site infection (SSI) in elective surgery, but its efficacy in the trauma setting is unknown. We compared the incidence of SSI between patients who did versus did not receive a CHG bath before operative fixation of extremity and/or pelvic fractures. METHODS We conducted a secondary analysis of the PREP-IT

BACKGROUND We evaluated antimicrobial resistance (AMR) patterns following local antibiotic use in a large cohort of patients with fractures from the PREP-IT (A Program of Randomized Trials to Evaluate Preoperative Antiseptic Skin Solutions in Orthopaedic Trauma) study. We hypothesized that, among patients with extremity fractures who developed fracture-related infection (FRI), there would be no difference

BACKGROUND The ideal antibiotic prophylaxis for open fractures is unknown. We evaluated outcomes following different antibiotic prophylaxis regimens for open fractures. METHODS This is a secondary analysis of data from PREP-IT. Prophylactic antibiotics were defined as any intravenous antibiotic given on the day of admission. The outcomes were surgical site infection (SSI) within 90 days and reoperation

BACKGROUND The purpose of this study was to compare the simplified modification of the Orthopaedic Trauma Association-Open Fracture Classification (OTA-OFC3) with the original OTA-OFC and Gustilo-Anderson classification systems in predicting surgical site infection and unplanned reoperation. METHODS This was a retrospective cohort study conducted using the PREP-IT (A Program of Randomized Trials to

BACKGROUND Skin antisepsis remains a vital component in prophylaxis against surgical site infection (SSI); however, for open fractures, it is unclear whether alcohol-based or aqueous solutions should be preferred. The purpose of this study was to compare the use of alcohol-based and aqueous skin antisepsis solutions, using data from the 2 PREP-IT trials, with respect to the risks of SSI and unplanned

BACKGROUND Sciatic neuropathy can result from pressure, injury, or inflammation around the sciatic nerve. In rare instances, sciatic neuropathy is caused by an intraneural ganglion cyst (IGC) originating from the hip joint. However, an effective treatment modality for this condition has not yet been established. The purpose of the present study was to evaluate the clinical and radiographic outcomes

BACKGROUND The aging-related escalation of muscle degeneration impacts the structure and function of rotator cuff muscles, contributing to spontaneous and tear-induced muscle atrophy. This study investigated how prostaglandin E2 (PGE2), a regulator of muscle regeneration, influences muscular structure and mitochondrial function in aged mice by using SW033291 to inhibit PGE2 degradation, revealing potential

BACKGROUND The management of distal radial fractures (DRFs) in elderly patients remains controversial. Although conservative treatment with cast immobilization is widely accepted, the optimal duration for immobilization is unclear. This study aimed to compare pain control, functional outcomes, and complication rates between 4-week and 6-week immobilization periods in elderly patients treated nonoperatively

BACKGROUND Surgeons often lack objective data on patient functional outcomes, particularly as compared with the patient's baseline. The present study aimed to determine whether gait parameters recorded on Apple iPhones provided longitudinal mobility data following lower-extremity fracture surgery that matched clinical expectations. We hypothesized that iPhones would detect the mobility changes of injury

BACKGROUND While the morbidity associated with revision total hip arthroplasty (THA) or periprosthetic infection (PJI) has been well characterized, less is known about the risk of mortality. With this study, we aimed to determine the long-term mortality associated with revision THA for PJI and associated risk factors. METHODS Data from the Australian Orthopaedic Association National Joint Replacement

BACKGROUND There has been minimal literature evaluating how a prior myocardial infraction (MI) influences outcomes after total knee arthroplasty (TKA). Thus, the purpose of this study was to evaluate how the timing, type, and treatment of MI prior to TKA affect postoperative cardiac complications, general medical complications, and surgical complications. METHODS A retrospective comparative study was

BACKGROUND The integration of artificial intelligence (AI), particularly large language models (LLMs), into scientific writing has led to questions about its ethics, prevalence, and impact in orthopaedic literature. While tools have been developed to detect AI-generated content, the interpretation of AI detection percentages and their clinical relevance remain unclear. The aim of this study was to

BACKGROUND Skin tenting is a commonly utilized surgical indication for clavicular fractures. The impact of skin tenting on fracture outcomes has not been investigated in adolescents. The present study compared the clinical and patient-reported outcome measures (PROMs) of nonoperatively and operatively treated adolescent clavicular fractures with skin tenting at presentation. METHODS Patients 10 to

BACKGROUND Bone marrow aspirate concentrate (BMAC) augmentation at the time of hip arthroscopy is a potential solution to improve functional outcomes in patients with cartilage damage concomitant with acetabular labral tearing; however, follow-up functional scores to date have not exceeded 24 months. Therefore, the present study compares minimum 5-year outcomes in patients treated with or without BMAC

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

BACKGROUND The use of opioids to manage pain after anterior cruciate ligament (ACL) reconstruction remains problematic. This study evaluated the impact of opioid-limiting perioperative pain management education and counseling on postoperative opioid consumption. METHODS A parallel-arm, randomized controlled trial was conducted at a single academic institution. We included patients ≥14 years old who

BACKGROUND The outcomes of bone grafting for severe glenoid defects in reverse shoulder arthroplasty (RSA) are unpredictable. The purpose of this study was to describe the intermediate-term outcomes of glenoid bone grafting in RSA for severe glenoid defects utilizing a baseplate with a long central post. METHODS All patients who underwent glenoid bone grafting for severe glenoid defects during RSA

➢ Three-dimensional (3D) printing and virtual modeling, using computed tomographic (CT) scans as a base for the 3D-printed model, help surgeons to visualize relevant anatomy, may provide a better understanding of fracture planes, may help to plan surgical approaches, and can possibly simulate surgical fixation options.➢ Navigation systems create real-time 3D maps of patient anatomy intraoperatively

BACKGROUND The use of a 2-stage exchange remains a common management strategy for periprosthetic joint infection (PJI). The use of an "antibiotic holiday" before the second stage to confirm the clearance of infection is often employed, but there is little evidence to guide this practice. The aim of this review was to systematically map the literature reporting on the use of an antibiotic holiday as

BACKGROUND An intraoperative midsubstance injury to the medial collateral ligament (MCL) is a devastating complication of total knee arthroplasty (TKA). No single treatment method has been shown to yield optimal stability. This cadaveric study compared primary MCL repair, increasing prosthetic constraint, and a combination of both techniques on tibiofemoral compartment gapping after an iatrogenic MCL

BACKGROUND Patients with apical spinal cord deformity have been shown to be at a greater risk for intraoperative neuromonitoring (IONM) alerts when undergoing posterior spinal instrumented fusion (PSF) for adolescent idiopathic scoliosis (AIS). The use of intraoperative traction during deformity correction has also been associated with an increased risk of IONM alerts. With use of the Spinal Cord Shape

BACKGROUND There has been weak consensus and a paucity of robust literature with regard to the best postoperative weight-bearing and immobilization regime for operatively treated ankle fractures. This trial compared immediate protected weight-bearing (IWB) with non-weight-bearing (NWB) with cast immobilization following ankle fracture fixation (open reduction and internal fixation [ORIF]), with a particular

BACKGROUND Previous studies have not compared airway resistance and morphological parameters before and after the treatment of severe scoliosis. In the present study, 3-dimensional (3D) computed tomographic (CT) reconstruction and impulse oscillometry (IOS) were used to evaluate the changes in airway dilation and airway resistance caused by posterior spinal fusion for the treatment of severe kyphoscoliosis

BACKGROUND The obesity epidemic has given rise to an orthopaedic patient subgroup with a body mass index (BMI) of ≥50 kg/m2. Without sound evidential guidance, arthroplasty surgeons and anesthesiologists do not know whether they can push the limits of the surgical feasibility of total knee arthroplasty (TKA) without risks of harm. METHODS In a retrospective cohort study of patients who had undergone

BACKGROUND Periprosthetic tibial fractures around a total knee replacement (TKR) remain challenging to manage, with little published information for guidance. The purpose of this study was to review the types, management techniques, and outcomes of periprosthetic tibial fractures in the largest series to date. METHODS We identified 300 periprosthetic tibial fractures (285 patients) around a TKR (43%

BACKGROUND Long-bone fractures in children can lead to premature physeal bar formation and growth disturbance. Bar excision has been studied, but data on prophylactic tissue interposition into physeal fractures are limited. This study used an established animal model to evaluate acute placement of fat autograft. The number of animals was selected to give 80% power on the basis of pilot data on induction

➢ Medical ethics education is a required component of orthopaedic surgery resident training per the Accreditation Council for Graduate Medical Education (ACGME) guidelines, although no standardized curriculum currently exists.➢ Beyond the 4 principles of bioethics (autonomy, beneficence, nonmaleficence, justice), additional ethical concepts relevant to orthopaedic care include utilitarianism, deontology

BACKGROUND Acute compartment syndrome (ACS) is a medical emergency and a cause of medical litigation across multiple specialties. We sought to compare the characteristics and outcomes of ACS-related litigation levied against surgeons in orthopaedics compared with other specialties. METHODS The Westlaw database was queried for ACS-related cases filed within the United States between 1980 and 2023 using

BACKGROUND Brachial plexus injury (BPI) leads to a variety of life-altering changes, both physically and mentally. While tremendous effort has been dedicated to improving patients' upper-extremity function through surgical and rehabilitation advances, patients' life experiences after BPI are largely understudied and poorly understood. Our study aims were to qualitatively assess the patient experience

BACKGROUND Depression and anxiety are recognized as adverse prognostic factors in various orthopaedic surgical interventions. The aim of this study is to report the intermediate-term outcomes of hip arthroscopy for the treatment of femoroacetabular impingement (FAI) and labral tears in patients with depression and/or anxiety. METHODS Data were retrospectively analyzed for patients with a self-reported

BACKGROUND The calcaneonavicular distance has yet to be definitively defined on the basis of morphological studies and thus remains a somewhat elusive value for orthopaedists. The purposes of the present study were to measure the calcaneonavicular distance with use of magnetic resonance imaging (MRI) in a control pediatric population and to assess whether sex and age affected this distance. METHODS

BACKGROUND Osseointegration of a bone-anchored limb (BAL) establishes a direct skeletal interface for prosthesis attachment, simplifying the donning/doffing process. The Timed Up and Go (TUG) test reliably assesses mobility in individuals with lower-extremity amputation who use socket prostheses, but it does not account for the time required to don a prosthetic limb. The aim of this study was to develop

BACKGROUND Conventional sonication is a recommended method in the diagnosis of periprosthetic joint infection (PJI), but the accuracy of diagnosis is still not ideal. We have applied the use of a handheld ultrasonic device and the intraoperative direct sonication of prostheses and soft tissues retrieved during surgery to improve the efficacy of the microbiological diagnosis of PJI and the incubation

➢ An at-risk lunate (due to anatomic factors) subjected to a trigger event (axial load, embolism, hypercoagulability) leads to the development of lunate osteonecrosis.➢ Children, adolescents, and elderly patients with Kienböck disease respond well to nonoperative treatments, and this should be considered before any surgical intervention.➢ For disease limited to the lunate, treatment decisions should