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Strategies for Deficit Recovery for the Orthopaedic Service Line: Lessons Learned from the COVID-19 Pandemic: AOA Critical Issues Symposium. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-10 Charles S Day,Charles A Goldfarb,Lisa L Lattanza,Maxwell T Yoshida,L Scott Levin
The COVID-19 pandemic and the mandated cessation of surgical procedures for a substantial portion of the 2020 year placed tremendous strain, both clinically and financially, on the health-care system in the United States. As a surgical specialty that accounts for nearly a quarter of all hospital net income, the revenue recovery of orthopaedic service lines (OSLs) is of particular importance to the
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The Influence of Surgeon Sex on Adverse Events Following Primary Total Hip Arthroplasty: A Register-Based Study of 11,993 Procedures and 200 Surgeons in Swedish Public Hospitals J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Per Jolbäck, Cecilia Rogmark, Camila Bedeschi Rego De Mattos, Antonia F. Chen, Emma Nauclér, Georgios Tsikandylakis
Background: Stereotypes may prevail, but little is known about the influence that the sex of an orthopaedic surgeon may have on outcomes. In a recently published study, there were no differences in the rate of adverse events following total hip arthroplasties (THAs) performed by female or male orthopaedic surgeons. The objective of the present study was to investigate whether there was any difference
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Periprosthetic Osteolysis as a Risk Factor for Revision After Total Ankle Arthroplasty: A Single-Center Experience of 250 Consecutive Cases J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Gun-Woo Lee, Keun-Bae Lee
Background: Periprosthetic osteolysis after total ankle arthroplasty (TAA) is a challenging problem. This study aimed to evaluate the prevalence of and predisposing factors for osteolysis and its effects on clinical outcomes. Methods: We enrolled 236 patients (250 ankles) who underwent primary TAA using a mobile-bearing HINTEGRA prosthesis, with a mean follow-up of 83.5 months (range, 36 to 182 months)
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Total Hip Arthroplasty Leads to Better Results After Low-Energy Displaced Femoral Neck Fracture in Patients Aged 55 to 70 Years: A Randomized Controlled Multicenter Trial Comparing Internal Fixation and Total Hip Arthroplasty J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Stefan Bartels, Torbjørn B. Kristensen, Jan-Erik Gjertsen, Frede Frihagen, Cecilia Rogmark, Filip C. Dolatowski, Wender Figved, Jūratė Šaltytė Benth, Stein Erik Utvåg
Background: The optimal treatment of displaced femoral neck fractures in patients 55 to 70 years old remains controversial. The aim of the present study was to assess the effect of closed reduction and internal fixation with cannulated screws (IF) compared with total hip arthroplasty (THA) on hip pain and function, with use of data for outcome measures, complications, and reoperations. Methods: This
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Diagnostic Performance of Advanced Metal Artifact Reduction MRI for Periprosthetic Shoulder Infection J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Jan Fritz, Prashant Meshram, Steven E. Stern, Benjamin Fritz, Uma Srikumaran, Edward G. McFarland
Background: The diagnosis of periprosthetic shoulder infection (PSI) in patients with a painful arthroplasty is challenging. Magnetic resonance imaging (MRI) may be helpful, but shoulder implant-induced metal artifacts degrade conventional MRI. Advanced metal artifact reduction (MARS) improves the visibility of periprosthetic bone and soft tissues. The purpose of our study was to determine the reliability
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Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis: A Propensity Score-Matched Analysis J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Jacob M. Kirsch, Richard N. Puzzitiello, Daniel Swanson, Kiet Le, Paul-Anthony Hart, Ryan Churchill, Bassem Elhassan, Jon J.P. Warner, Andrew Jawa
Background: Reverse shoulder arthroplasty (RSA) is increasingly being utilized for the treatment of primary osteoarthritis. However, limited data are available regarding the outcomes of RSA as compared with anatomic total shoulder arthroplasty (TSA) in the setting of osteoarthritis. Methods: We performed a retrospective matched-cohort study of patients who had undergone TSA and RSA for the treatment
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Lateral Ulnar Collateral Ligament of the Elbow Joint: Reconsideration of Anatomy in Terms of Connection with Surrounding Fibrous Structures J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Atsuhiro Fukai, Akimoto Nimura, Masahiro Tsutsumi, Hitomi Fujishiro, Koji Fujita, Junya Imatani, Keiichi Akita
Background: To improve the clinical results of lateral ulnar collateral ligament (LUCL) reconstruction of the elbow joint, better understanding of the anatomy of the aponeuroses and joint capsule could be relevant. This study considers the previously described anatomy of the LUCL in relation to the related aponeuroses and joint capsule rather than as a discrete ligament. We hypothesized that the deep
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Exposure-Related Anxiety and Improving Patient Satisfaction with Medical Undergarments During Surgery: A Randomized Controlled Trial J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Marc C. Jacofsky, Richard L. Auran, Alyse Williams, Susan Mauro, Debra Sietsema
Background: The standard of care for patients undergoing a surgical procedure is to have patients remove all clothing and don a hospital-provided gown. A growing number of patients have anxiety when exposing their bodies in a medical setting, which increases stress for those patients. Methods: This study prospectively enrolled patients at a single orthopaedic specialty hospital into 1 of 2 garment
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A Prospective, Longitudinal Study of the Influence of Obesity on Total Knee Arthroplasty Revision Rate: Results from the Australian Orthopaedic Association National Joint Replacement Registry J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Christopher J. Wall, Christopher J. Vertullo, Srinivas Kondalsamy-Chennakesavan, Michelle F. Lorimer, Richard N. de Steiger
Background: The aim of this study was to investigate the relationship of obesity with all-cause revision and revision for infection, loosening, instability, and pain after total knee arthroplasty (TKA) performed in Australia. Methods: Data for patients undergoing primary TKA for osteoarthritis from January 1, 2015, to December 31, 2020, were obtained from the Australian Orthopaedic Association National
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Development and Validation of a Health-Related Quality-of-Life Measure in Older Children and Adolescents with Early-Onset Scoliosis: Early-Onset Scoliosis Self-Report Questionnaire (EOSQ-SELF) J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Hiroko Matsumoto, Afrain Z. Boby, Rishi Sinha, Megan L. Campbell, Chun Wai Hung, Fay C. Gbolo, Gerard F. Marciano, Sonya Levine, Adam N. Fano, Matthew E. Simhon, Theodore Quan, Nicole M. Bainton, Ameeka George, Amber S. Mizerik, Benjamin D. Roye, David P. Roye, Michael G. Vitale
Background: The 24-question Early-Onset Scoliosis Questionnaire (EOSQ-24) is a proxy measure assessing health-related quality of life (HRQoL) among patients with early-onset scoliosis (EOS). There exists an increasing need to assess HRQoL through a child’s own perspective, particularly for older children and adolescents with EOS. The purpose of this study was to develop and validate a self-reported
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Current State of Platelet-Rich Plasma and Cell-Based Therapies for the Treatment of Osteoarthritis and Tendon and Ligament Injuries J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Charles A. Su, Toufic R. Jildeh, Matthew L. Vopat, Robert A. Waltz, Peter J. Millett, Matthew T. Provencher, Marc J. Philippon, Johnny Huard
➤ Orthobiologics encompass numerous substances that are naturally found in the human body including platelet-rich plasma (PRP), isolated growth factors, and cell therapy approaches to theoretically optimize and improve the healing of cartilage, fractures, and injured muscles, tendons, and ligaments. ➤ PRP is an autologous derivative of whole blood generated by centrifugation and is perhaps the most
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Preperitoneal Pelvic Packing for Hypotension Has a Greater Risk of Venous Thromboembolism Than Angioembolization: Management of Refractory Hypotension in Closed Pelvic Ring Injury. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Joseph T Patterson,Julian Wier,Joshua L Gary
BACKGROUND Patients with traumatic pelvic ring injury may present with hypotension secondary to hemorrhage. Preperitoneal pelvic packing (PPP) and angioembolization (AE) are alternative interventions for management of hypotension associated with pelvic ring injury refractory to resuscitation and circumferential compression. We hypothesized that PPP may be independently associated with increased risk
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Sleep Disturbances and Disorders in Patients with Knee Osteoarthritis and Total Knee Arthroplasty. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-04 Kimberly Bartosiak,Maria Schwabe,Brendan Lucey,Charles Lawrie,Robert Barrack
➤ There is increasing evidence that patient-reported outcomes following total knee arthroplasty (TKA) are associated with psychosocial factors and pain catastrophizing. Sleep disturbance, pain, and mental health have a complex interaction, which, if unrecognized, can be associated with impaired patient-reported outcomes and dissatisfaction following TKA. ➤ The gold standard of objective sleep assessment
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What's Important: Dealing with Gun Violence. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-04 Robert A Schultz,Paul F Lachiewicz
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The First Description of Acute Compartment Syndrome, by Al-Zahrawi. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-04 Arash Aslanabadi,Zakieh Zare,Majid Aslanabadi
Acute compartment syndrome (ACS) is defined as increased pressure within a confined compartmental space, leading to a decline in the perfusion pressure of the tissue within that compartment. To date, the commonly held belief has been that ACS was first described by Richard von Volkmann in 1881. However, we propose that ACS was originally described by Abul Qasim Al-Zahrawi approximately 900 years earlier
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Erratum: Recommendations from the ICM-VTE: Hip & Knee. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03
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Erratum: Recommendations from the ICM-VTE: General. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03
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Different Surgeries, Same Result?: Commentary on an article by Jacob M. Kirsch, MD, et al.: "Outcomes After Anatomic and Reverse Shoulder Arthroplasty for the Treatment of Glenohumeral Osteoarthritis. A Propensity Score-Matched Analysis". J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Alexander Macfarlane,Thomas R Duquin
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Surgical Outcomes and the Sex of the Orthopaedic Surgeon: Commentary on an article by Per Jolbäck, RN, PhD, et al.: "The Influence of Surgeon Sex on Adverse Events Following Primary Total Hip Arthroplasty. A Register-Based Study of 11,993 Procedures and 200 Surgeons in Swedish Public Hospitals". J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-08-03 Lisa C Howard
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What's New in Osteoporosis and Fragility Fractures. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-25 Derek G Hansen,Teerapat Tutaworn,Joseph M Lane
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No Difference in Conversion Rate to Hip Arthroplasty After Intramedullary Nail or Sliding Hip Screw for Extracapsular Hip Fractures: An Observational Cohort Study of 19,604 Individuals. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-25 Helmi-Sisko Pyrhönen,Johan Lagergren,Olof Wolf,Alicja Bojan,Sebastian Mukka,Michael Möller,Cecilia Rogmark
BACKGROUND The widespread use of intramedullary nails (IMNs) compared with sliding hip screws (SHSs) in extracapsular hip fractures (AO/OTA 31-A1, 31-A2, 31-A3) has been questioned because of a higher complication rate, although the outcome might have improved through more recent implant designs and the learning curve. This study aimed to investigate if there is a difference with regard to the cumulative
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Serum Glucose Variability Increases the Risk of Complications Following Aseptic Revision Hip and Knee Arthroplasty. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-22 Graham S Goh,Noam Shohat,Mohammad S Abdelaal,Ilan Small,Terence Thomas,Kerri-Anne Ciesielka,Javad Parvizi
BACKGROUND Increased serum glucose variability has been proposed as a risk factor for perioperative morbidity and mortality. Given the greater surgical complexity and complication risk of revision total joint arthroplasty (TJA), previous findings may not be generalizable to the revision population. The purpose of this study was to investigate the association between glucose variability and postoperative
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Choose Wisely: Surgical Selection of Candidates for Outpatient Anterior Cervical Surgery Based on Early Complications Among Inpatients. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-22 Bayard C Carlson,John M Dawson,Eduardo C Beauchamp,Amir A Mehbod,Benjamin Mueller,Christopher Alcala,Kevin J Mullaney,Joseph H Perra,Manuel R Pinto,James D Schwender,Eiman Shafa,Ensor E Transfeldt,Timothy A Garvey
BACKGROUND Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are attractive targets for transition to the outpatient setting. We assessed the prevalence of rapid responses and major complications in the inpatient setting following 1 or 2-level ACDFs and CDAs. We evaluated factors that may place patients at greater risk for a rapid response or a postoperative complication
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Patients Who Undergo Rotator Cuff Repair Can Safely Return to Driving at 2 Weeks Postoperatively. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-21 Ariel E Badger,Linsen T Samuel,Allison N Tegge,Mariette Metrey,Miguel A Perez,John R Tuttle,Peter J Apel
BACKGROUND Evidence-based guidelines are lacking for return to driving following rotator cuff repair (RCR). As a result, surgeons are often overly conservative in their recommendations, placing potential undue burden on patients and their families. Therefore, the primary objective of this study was to formulate evidence-based return-to-driving guidelines. METHODS Thirty-two subjects planning to undergo
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Applying Deep Learning to Establish a Total Hip Arthroplasty Radiography Registry: A Stepwise Approach. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-21 Pouria Rouzrokh,Bardia Khosravi,Quinn J Johnson,Shahriar Faghani,Diana V Vera Garcia,Bradley J Erickson,Hilal Maradit Kremers,Michael J Taunton,Cody C Wyles
BACKGROUND Establishing imaging registries for large patient cohorts is challenging because manual labeling is tedious and relying solely on DICOM (digital imaging and communications in medicine) metadata can result in errors. We endeavored to establish an automated hip and pelvic radiography registry of total hip arthroplasty (THA) patients by utilizing deep-learning pipelines. The aims of the study
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15% of Talar Osteochondral Lesions Are Present Bilaterally While Only 1 in 3 Bilateral Lesions Are Bilaterally Symptomatic. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-21 Quinten G H Rikken,Lisanne M E Wolsink,Jari Dahmen,Sjoerd A S Stufkens,Gino M M J Kerkhoffs
BACKGROUND The primary aim of the present study was to determine the prevalence of osteochondral lesions of the contralateral talus in patients with computed tomography (CT)-confirmed osteochondral lesions of the talus (OLT). The secondary aims were to determine if the contralateral lesions were symptomatic and to describe the demographic characteristics and radiographic presentation of patients with
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Effect of Supplemental Perioperative Oxygen on SSI Among Adults with Lower-Extremity Fractures at Increased Risk for Infection: A Randomized Clinical Trial J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Major Extremity Trauma Research Consortium (METRC)
Background: Supplemental perioperative oxygen is a low-cost intervention theorized to reduce the risk of surgical site infections, but its effect among patients undergoing surgery for a tibial plateau, tibial pilon, or calcaneal fracture is unknown. We aimed to determine the effectiveness of a high fraction of inspired oxygen (FiO2, 80%) versus low FiO2 (30%) in reducing surgical site infections in
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Low Rates of Reporting Race, Ethnicity, and Socioeconomic Status in Studies Published in Top Orthopaedic Journals J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Cody Crnkovic, Robert Quiring, Andrew G. Chapple, Amy Bronstone, Peter C. Krause, Vinod Dasa
Background: Although there have been calls for the routine reporting of patient demographics associated with health disparities, including race, ethnicity, and socioeconomic status (SES), in published research, the extent to which these variables are reported in orthopaedic journals remains unclear. Methods: We identified and examined all research articles with human cohorts published in 2019 in
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InSpace Implant Compared with Partial Repair for the Treatment of Full-Thickness Massive Rotator Cuff Tears: A Multicenter, Single-Blinded, Randomized Controlled Trial J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Nikhil Verma, Uma Srikumaran, Colleen M. Roden, Edwin J. Rogusky, Peter Lapner, Heather Neill, Joseph A. Abboud, on behalf of the SPACE GROUP*
Background: The purpose of this study was to prospectively evaluate the efficacy and safety of a subacromial balloon spacer (InSpace implant; Stryker) compared with arthroscopic partial repair in patients with irreparable, posterosuperior massive rotator cuff tears. Methods: Patients ≥40 years of age with symptomatic, irreparable, posterosuperior, massive rotator cuff tears and an intact subscapularis
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The Axillary Nerve Danger Zone in Percutaneous Fixation in the Pediatric Shoulder: The “1-Mountain-3-Valleys” Principle J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Tyler J. Stavinoha, Sahej D. Randhawa, Sunny Trivedi, Aleksei Dingel, Kevin G. Shea, Steven L. Frick
Background: Adult literature cites an axillary nerve danger zone of 5 to 7 cm distal to the acromion tip for open or percutaneous shoulder surgery, but that may not be valid for younger patients. This study sought to quantify the course of the axillary nerve in adolescent patients with reference to easily identifiable intraoperative anatomic and radiographic parameters. Methods: A single-institution
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Modified Scarf Osteotomy with Medial Capsular Interposition Combined with Metatarsal Shortening Offset Osteotomy: A Comparison of Patients with Noninflammatory Arthritis and Rheumatoid Arthritis of the Foot J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Yuki Etani, Makoto Hirao, Kosuke Ebina, Hideki Tsuboi, Takaaki Noguchi, Gensuke Okamura, Akira Miyama, Kenji Takami, Akihide Nampei, Shigeyoshi Tsuji, Hajime Owaki, Seiji Okada, Jun Hashimoto
Background: Patients who have noninflammatory arthritis of the feet may develop destructive changes on the first metatarsal head and painful dislocation of the metatarsophalangeal (MTP) joint of 1 or more lesser toes. This aim of this study was to compare feet with noninflammatory arthritis and those with rheumatoid arthritis (RA) with respect to the clinical and radiographic outcomes after treatment
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Quality Reporting Windows May Not Capture the Effects of Surgical Site Infections After Orthopaedic Surgery J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Lauren M. Shapiro, Laura A. Graham, Mary T. Hawn, Robin N. Kamal
Background: Postoperative surgical site infections (SSIs) and the associated complications impact morbidity and mortality and result in substantial burden to the health-care system. These complications are typically reported during the 90-day surveillance period, with implications for reimbursement and quality measurement; however, the long-term effects of SSI are not routinely assessed. We evaluated
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The Rotator Cable Does Not Stress Shield the Crescent Area During Shoulder Abduction J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Christopher C. Schmidt, Christopher S. Spicer, Dimitrios V. Papadopoulos, Sean M. Delserro, Yoshiaki Tomizuka, Thomas R. Zink, Ryan J. Blake, Michael P. Smolinski, Mark Carl Miller, James M. Greenwell, Luis F. Carrazana-Suarez, Patrick J. Smolinski
Background: It is accepted by the orthopaedic community that the rotator cable (RCa) acts as a suspension bridge that stress shields the crescent area (CA). The goal of this study was to determine if the RCa does stress shield the CA during shoulder abduction. Methods: The principal strain magnitude and direction in the RCa and CA and shoulder abduction force were measured in 20 cadaveric specimens
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Clinical Manifestations of Constriction Band Syndrome J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Leah R.F. Demetri, Anne G. Starcevich, Mary Claire B. Manske, Michelle A. James
Background: Constriction band syndrome (CBS) is a congenital limb anomaly with varying presentation. We sought to characterize the clinical manifestations of CBS by analyzing a large cohort of patients. Our secondary aim was to evaluate potential risk factors for CBS. Methods: We retrospectively reviewed the records for all patients with CBS who had presented to our tertiary medical center between
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Meniscal Repair Outcomes at Greater Than 5 Years: A Systematic Review and Meta-Analysis J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Jeffrey J. Nepple, Andrew M. Block, Matthew T. Eisenberg, Noel E. Palumbo, Rick W. Wright
Background: The utilization of meniscal repair techniques continues to evolve in an effort to maximize the rate of healing. Meniscal repair outcomes at a minimum of 5 years postoperatively appear to better represent the true failure rates. Thus, a systematic review and meta-analysis of the current literature was conducted to assess the rate of failure at a minimum of 5 years after meniscal repair
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Leadership Principles in Uncertain Times. Presidential Address to the AOA, June 10, 2021: AOA Critical Issues J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Serena S. Hu
One of the core foundations of leadership is communication. This past pandemic year gave us lessons in how to improve communication during uncertain times as well as examples of strong leadership in the public sphere. The AOA has formulated important Leadership Principles to guide future educational offerings. I will discuss the importance of these Leadership Principles and give examples of how we
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The InSpace Balloon: Useful Augmentation or First-Line Therapy?: Commentary on an article by Nikhil Verma, MD, et al.: "InSpace Implant Compared with Partial Repair for the Treatment of Full-Thickness Massive Rotator Cuff Tears. A Multicenter, Single-Blinded, Randomized Controlled Trial". J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Rony-Orijit Dey Hazra,Maria E Dey Hazra,Jared A Hanson,Peter J Millett
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High Perioperative Inspiratory Oxygen Fraction for High-Risk Orthopaedic Trauma: Commentary on an article by the Major Extremity Trauma Research Consortium (METRC): "Effect of Supplemental Perioperative Oxygen on SSI Among Adults with Lower-Extremity Fractures at Increased Risk for Infection. A Randomized Clinical Trial". J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 William D Lack
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Race and Ethnicity Data in JBJS Publications. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Kanu Okike,Marc Swiontkowski
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Validation of A Predictive Tool for Discharge to Rehabilitation or a Skilled Nursing Facility After TJA. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-20 Dionisio Ortiz,Chelsea Sue Sicat,Daniel E Goltz,Thorsten M Seyler,Ran Schwarzkopf
BACKGROUND Cost excess in bundled payment models for total joint arthroplasty (TJA) is driven by discharge to rehabilitation or a skilled nursing facility (SNF). A recently published preoperative risk prediction tool showed very good internal accuracy in stratifying patients on the basis of likelihood of discharge to an SNF or rehabilitation. The purpose of the present study was to test the accuracy
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Is the Revision Rate for Femoral Neck Fracture Lower for Total Hip Arthroplasty Than for Hemiarthroplasty?: A Comparison of Registry Data for Contemporary Surgical Options. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-19 Wayne Hoskins,Sophia Corfield,Michelle Lorimer,Yi Peng,Roger Bingham,Stephen E Graves,Kelly G Vince
BACKGROUND When arthroplasty is indicated for a femoral neck fracture (FNF), it is unclear whether total hip arthroplasty (THA) or hemiarthroplasty (HA) is best. This study compares data from the Australian Orthopaedic Association National Joint Replacement Registry using contemporary surgical options. METHODS Patients from 60 to 85 years old who were treated with arthroplasty for FNF, between September
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Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-18 Anthony A Catanzano,Peter O Newton,Tracey P Bastrom,Carrie E Bartley,Stefan Parent,Firoz Miyanji,Daniel G Hoernschemeyer,Ahmet Alanay,Laurel Blakemore,Kevin Neal,Baron Lonner,Lawrence Haber,Suken A Shah,Burt Yaszay,,
BACKGROUND Growth modulation through anterior vertebral body tethering (AVBT) has emerged as a fusionless option for the treatment of progressive scoliosis. When tethering the main thoracic curve, the compensatory thoracolumbar/lumbar curve must correct indirectly as a result. The present study evaluated the response of these lumbar curves following AVBT of the main thoracic curves. METHODS Patients
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What's Important: Recon: Arts & Humanities. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-15 John S Shields
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Does Value-Based Care Threaten Joint Arthroplasty Access for Vulnerable Patient Populations?: AOA Critical Issues. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-15 Eugenia Lin,Kevin J Bozic,Said Ibrahim,Mary I O'Connor,Charles L Nelson
Health-care expenses have been projected to increase from 17.7% of the U.S. gross domestic product (GDP) in 2014 to 19.6% in 2024. The unsustainable increase in health-care costs has contributed toward support for value-based health care (VBHC) reform. Contemporary VBHC reform programs relevant to orthopaedic surgery include the voluntary Bundled Payments for Care Improvement initiatives (BPCI and
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Orthopaedic Society Leadership Diversity and Academic Participation: Where Do We Stand Now? J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-13 Patrick Albright,Evan Banks,Lily Wood,Caitlin Chambers,Ann Van Heest
BACKGROUND In the United States, female and minority representation in the field of orthopaedic surgery remains low, and there are few reports regarding orthopaedic society leadership composition, selection criteria, and academic participation. We aimed to determine the demographic composition of national orthopaedic societies and report the academic participation metrics of leadership. METHODS This
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What's Important: Landscapes of North Carolina: Arts & Humanities. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-11 John S Shields
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Cobalt Mining in the Democratic Republic of the Congo for Orthopaedic Implants: A Complex Ethical Issue with No Simple Solutions. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-11 Eric S Secrist,Thomas K Fehring
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Defining Minimally Important Differences in Functional Outcomes in Musculoskeletal Oncology. J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-08 Aaron M Gazendam,Patricia Schneider,Mohit Bhandari,Jason W Busse,Michelle Ghert,
BACKGROUND Functional outcomes are commonly reported in studies of patients undergoing limb-salvage surgery for the treatment of musculoskeletal tumors; however, interpretation requires knowledge of the smallest amount of improvement that is important to patients: the minimally important difference (MID). We established the MIDs for the Musculoskeletal Tumor Society Rating Scale-93 (MSTS-93) and Toronto
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Tranexamic Acid Was Not Associated with Increased Complications in High-Risk Patients with Intertrochanteric Fracture J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Steven B. Porter, Aaron C. Spaulding, Christopher M. Duncan, Benjamin K. Wilke, Mark W. Pagnano, Matthew P. Abdel
Background: For elective total joint arthroplasty, tranexamic acid (TXA) is considered safe and efficacious. However, evidence of TXA’s safety in high-risk patients undergoing nonelective surgery for hip fracture is sparse. This study aimed to assess whether TXA administration to high-risk patients with an intertrochanteric (IT) hip fracture increased the risk of thromboembolic complications or mortality
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Histologic Differences in Human Rotator Cuff Muscle Based on Tear Characteristics J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Lindsey Ruderman, Abigail Leinroth, Helen Rueckert, Troy Tabarestani, Rafeal Baker, Jay Levin, Chad E. Cook, Christopher S. Klifto, Matthew J. Hilton, Oke Anakwenze
Background: Fatty accumulation in the rotator cuff is associated with shoulder dysfunction and a risk of failure of rotator cuff repair. The aims of this study were to (1) describe cellular findings in rotator cuff muscles in patients presenting with varying degrees of rotator cuff tendon pathology by examining fat content and myofiber cross-sectional area of rotator cuff muscles and (2) correlate
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Racial, Ethnic, and Gender Diversity in Academic Orthopaedic Surgery Leadership J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Austin M. Meadows, Madelyn M. Skinner, Majd T. Faraj, Alaa A. Hazime, Russell G. Day, Jessi A. Fore, Charles S. Day
Background: Multiple investigations in the past 50 years have documented a lack of racial/ethnic and gender diversity in the orthopaedic surgery workforce when compared with other specialties. Studies in other industries suggest that diversification of leadership can help diversify the underlying workforce. This study investigates changes in racial/ethnic and gender diversity of orthopaedic surgery
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Getting the Message: The Declining Trend in Opioid Prescribing for Minor Orthopaedic Injuries in Children and Adolescents J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Arielle R. Krakow, Divya Talwar, Nishank N. Mehta, Jigar S. Gandhi, John M. Flynn
Background: Opioids constitute the fastest-growing drug problem among children and adolescents in the United States. Recent heavy media coverage on the opioid prescription epidemic has garnered increased attention from prescribers and policymakers. The purpose of this study was to analyze trends in opioid prescribing for nonoperatively managed pediatric fractures and dislocations in order to examine
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Surgical Anatomy of the Radial Nerve at the Dorsal Region of the Humerus: A Cadaveric Study J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Kristian Welle, Christian Prangenberg, Roslind K. Hackenberg, Martin Gathen, Faramarz Dehghani, Koroush Kabir
Background: Surgery for humeral shaft fractures is associated with a high risk of iatrogenic radial nerve palsy (RNP). Plausible causes are difficult anatomical conditions and variants. Methods: We performed a cadaveric study with 23 specimens (13 female and 10 male Caucasian donors) to assess the course and anatomy of the radial nerve (RN) with its branches alongside the humeral shaft. The accuracy
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Internal Torsion of the Knee: An Embodiment of Lower-Extremity Malrotation in Patients with Patellar Instability J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Yi Qiao, Xiuyuan Zhang, Junjie Xu, Caiqi Xu, Song Zhao, Jinzhong Zhao
Background: Torsion of the lower extremities has been suggested to be a predisposing factor for patellar instability. However, no clear torsional factors have been clarified. This study aimed to elucidate the rotational geometry of the lower limb through segmental analysis in patients with patellar instability. Methods: Eighty-three patients with patellar instability were included. Computed tomography
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Modular Fluted Tapered Stems for Periprosthetic Femoral Fractures: Excellent Results in 171 Cases J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Charles P. Hannon, Kevin P. Sheehan, Stephanie Q. Duong, Brandon J. Yuan, David G. Lewallen, Daniel J. Berry, Matthew P. Abdel
Background: Modular fluted tapered (MFT) stems have advanced treatment of Vancouver B2 and B3 periprosthetic femoral fractures, but series to date have been limited with respect to cohort size and follow-up duration. The purpose of this study was to determine implant survivorship, radiographic results, complications, and clinical outcomes of Vancouver B2 and B3 periprosthetic femoral fractures treated
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Arthroscopic Versus Open Ankle Arthrodesis: A 5-Year Follow Up J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Monther Abuhantash, Andrea Veljkovic, Kevin Wing, Oliver Gagne, Hong Qian, Hubert Wong, Hooman Sadr, Murray Penner, Alastair Younger
Background: End-stage ankle arthritis has long been managed surgically with open ankle arthrodesis (OAA). Since the first published report in 1983, arthroscopic ankle arthrodesis (AAA) has been thought to be associated with improved patient-reported outcome measures (PROMs) and fewer complications. The purpose of the present study was to compare the long-term PROMs, major complications, and reoperations
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Transphyseal Distal Humeral Fractures: A 13-Times-Greater Risk of Non-Accidental Trauma Compared with Supracondylar Humeral Fractures in Children Less Than 3 Years of Age J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Mary Crowe, Luke Byerly, Charles T. Mehlman
Background: The transphyseal distal humeral fracture has been well described as a concerning fracture pattern for non-accidental trauma (NAT) in young pediatric patients. Because of the infrequent presentation of this fracture, the association historically has been anecdotal. The purpose of this study was to determine and compare the incidence of NAT among displaced transphyseal distal humeral fractures
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Conceptualizing Biological Aging and Frailty in Orthopaedics: A Framework for Clinical Practice J. Bone Joint. Surg. (IF 6.558) Pub Date : 2022-07-06 Ting Cong, Arielle J. Hall, Zhimeng Jia, Anthony Christiano, Hannah C.K. Elsevier, Zoe B. Cheung, David Wellman, David Forsh, Joseph M. Lane
➤ Biological aging can best be conceptualized clinically as a combination of 3 components: frailty, comorbidity, and disability. ➤ Despite advancements in the understanding of senescence, chronological age remains the best estimate of biological age. However, a useful exercise for practitioners is to look beyond chronological age in clinical and surgical decision-making. ➤ A chronologically aging person