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Orthopedics

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https://read.qxmd.com/read/30964542/anterior-cervical-corpectomy-and-fusion-versus-posterior-laminoplasty-for-cervical-oppressive-myelopathy-secondary-to-ossification-of-the-posterior-longitudinal-ligament-a-meta-analysis
#1
Rongqing Qin, Weiwei Sun, Baiyu Qian, Jie Hao, Pin Zhou, Chunxiang Xu, Cheng Chen, Kai Yang, Feng Zhang, Xiaoqing Chen
The purpose of this study was to compare the clinical effect of anterior cervical corpectomy with fusion vs laminoplasty for cervical ossification of the posterior longitudinal ligament. The outcome measures included the Japanese Orthopaedic Association score, neurological recovery rate, and complication rate. Subgroup A represented studies with the mean preoperative canal occupying ratio being less than 50%, whereas subgroup B represented studies with the mean canal occupying ratio being 50% or greater. In subgroup A, no difference was found between the 2 groups in the postoperative Japanese Orthopaedic Association score and neurological recovery rate...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30964541/single-use-custom-instrumentation-in-total-knee-arthroplasty-effect-on-in-hospital-complications-length-of-stay-and-discharge-disposition
#2
Ryan E Harold, Jonathan Macleod, Bennet A Butler, Ryan Sullivan, Matthew D Beal, David W Manning
Total knee arthroplasty (TKA) is a quality surgical intervention with rapidly increasing use. This growth has brought with it a host of new technologies, including custom instrumentation (CI). With the current emphasis on value-based health care, the clinical benefit of CI TKA must be evaluated. The goal of this study was to compare CI and conventional TKA regarding multiple quality metrics, in-hospital complications, length of stay, and discharge destination. The authors propensity score matched 231 conventional TKAs to 231 consecutive CI TKAs for age, sex, and body mass index...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30964540/performance-and-return-to-sport-after-femoroacetabular-impingement-surgery-in-national-football-league-players
#3
Kyle R Sochacki, Robert A Jack, Takashi Hirase, Justin Vickery, Patrick C McCulloch, David M Lintner, Anthony Echo, Joshua D Harris
The purpose of this study was to determine the (1) return-to-sport rate for National Football League (NFL) players following femoroacetabular impingement surgery, (2) postoperative career length and games per season, (3) pre- and postoperative performance, and (4) postoperative performance compared with control players matched by position, age, years of experience, and performance. National Football League athletes who underwent hip arthroscopy for femoroacetabular impingement and matched controls were identified...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30964539/prevalence-and-trends-of-patient-reported-outcome-measures-used-in-hip-arthroscopy
#4
Jesse Renouf, Nicholas Pergaminelis, Phong Tran, Oren Tirosh, Camdon Fary
The aim of this review was to determine the prevalence of patient-reported outcome measures concerning outcomes of arthroscopic hip surgery. The PubMed database was comprehensively reviewed in March 2016 using the key terms "hip" and "arthroscopy." A total of 192 eligible studies were identified. The most commonly used patient-reported outcome measures were the modified Harris Hip score (61%) and the Non-arthritic Hip Score (27%). Seventy-one percent of total patient-reported outcome measures articles were published between 2011 and 2015...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30964538/a-systematic-review-of-the-laboratory-risk-indicator-for-necrotizing-fasciitis-score-and-its-utility-in-orthopedics-for-diagnosing-necrotizing-fasciitis-in-adults
#5
Peyton A Keeling, Christopher M Domes
Given its association with trauma and surgery, necrotizing fasciitis is a disease orthopedists are likely to encounter. The laboratory risk indicator for necrotizing fasciitis score is an adjunct diagnostic test designed to help diagnose early necrotizing fasciitis infections, but studies evaluating the scoring system have reported conflicting results. The purpose of this systematic review was to provide clarity on the laboratory risk indicator for necrotizing fasciitis score's capabilities and when it is best used...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30964537/anterior-cruciate-ligament-reconstruction-in-young-females-a-systematic-review-of-patellar-tendon-versus-hamstring-tendon-autografts
#6
Hytham S Salem, Matthew J Kraeutler, Aaron H Carter, Fotios P Tjoumakaris, Kevin B Freedman
A systematic review was performed to compare patellar tendon-bone (BTB) and hamstring tendon (HS) autografts following anterior cruciate ligament reconstruction in young females, young patients, or females. One study compared BTB and HS in young females and found a lower rate of graft failure with BTB (P<.02). Of the 11 studies that made this comparison in females, 1 reported decreased laxity in females with BTB (P=.035). Of 4 studies comparing autografts in young patients, 1 reported a decreased rate of graft failure with BTB (P=...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30964536/synthetic-mesh-allograft-reconstruction-for-extensor-mechanism-insufficiency-after-knee-arthroplasty
#7
Dexter K Bateman, Jared S Preston, Stephen Kayiaros, Alfred J Tria
Extensor mechanism (EM) insufficiency after knee arthroplasty is a rare but devastating complication resulting in severe disability. To date, primary repair and allograft reconstructive options have produced suboptimal results. A synthetic mesh allograft reconstruction technique has recently been introduced with promising outcomes. A retrospective chart review was performed to identify all patients who experienced EM failure after total or unicompartmental knee arthroplasty and subsequently underwent synthetic mesh EM reconstruction using a previously described technique...
April 9, 2019: Orthopedics
https://read.qxmd.com/read/30913299/failure-patterns-of-femoral-neck-fracture-fixation-in-young-patients
#8
David J Stockton, Karan Dua, Peter J O'Brien, Andrew N Pollak, C Max Hoshino, Gerard P Slobogean
The primary purpose of this study was to describe the failure patterns of femoral neck fracture fixation in young patients. The secondary purpose was to determine if pattern of failure varies by type of implant. Adult patients (age range, 18-55 years) who experienced a "fixation failure" following internal fixation of a femoral neck fracture were identified from 5 level 1 trauma centers. Failure was defined by screw cutout, implant breakage, varus collapse (<120° neck-shaft angle), or severe fracture shortening (≥1 cm)...
March 26, 2019: Orthopedics
https://read.qxmd.com/read/30913298/radiographic-calibration-with-a-prosthetic-femoral-head-allows-accurate-preoperative-templating-for-total-hip-arthroplasty
#9
Cole S Pachter, Jonathan H Garfinkel, David W Romness, Brian P Gladnick
Templating for total hip arthroplasty requires proper radiographic calibration. One option for radiograph calibration is using a cobalt-chrome femoral head ball. The authors reviewed radiographs and clinical data for patients undergoing primary total hip arthroplasty. Radiographs were calibrated using a 28-mm cobalt-chrome femoral head ball. Agreements between templated and actual implant size were calculated. The templated acetabulum matched within one size of the actual acetabulum in 76.7% to 80.0% of cases...
March 26, 2019: Orthopedics
https://read.qxmd.com/read/30913297/surgical-outcomes-in-endoscopic-versus-open-bursectomy-of-the-septic-prepatellar-or-olecranon-bursa
#10
Timothy C Meade, Marcus S Briones, Adam W Fosnaugh, Jeffrey M Daily
In this study, the authors investigated the viability of endoscopic bursectomy as a treatment for septic prepatellar and olecranon bursitis. Conventional treatment of septic bursitis consists of aspiration, antibiotics, and rest. When conservative treatment fails, however, surgical intervention is sometimes required to resolve the infection. Typical surgical intervention consists of open bursectomy, in which the infected bursa is excised via an incision in the region of the skin directly above the bursa. The tenuous nature of the blood supply to this region of the skin results in a rather high rate of wound healing issues such as necrosis and wound dehiscence...
March 26, 2019: Orthopedics
https://read.qxmd.com/read/30913296/surgical-delay-is-not-warranted-for-patients-with-hip-fractures-receiving-non-warfarin-anticoagulants
#11
Ariana Lott, Jack Haglin, Rebekah Belayneh, Sanjit R Konda, Philipp Leucht, Kenneth A Egol
The purpose of this study was to evaluate whether patients with hip fractures receiving antiplatelet and direct oral anticoagulants treated within 48 hours of admission had worse surgical and clinical outcomes than those whose surgery was delayed more than 48 hours. Consecutive patients 55 years and older with an operatively treated hip fracture were analyzed. Patients receiving the following anticoagulants were included: antiplatelet drugs, factor Xa inhibitors, and direct thrombin inhibitors. Outcomes included surgical blood loss, procedure time, transfusion requirement, length of stay, complication rate, and need for intensive care unit or step-down unit level care...
March 26, 2019: Orthopedics
https://read.qxmd.com/read/30913295/efficacy-and-cost-effectiveness-of-topical-vancomycin-powder-in-primary-cementless-total-hip-arthroplasty
#12
Eric M Cohen, Stephen Marcaccio, Avi D Goodman, Nicholas J Lemme, Richard Limbird
Topical vancomycin has been shown to effectively reduce infections after spinal surgery while remaining safe and cost-effective; however, there are few studies evaluating topical vancomycin in total hip arthroplasty. The authors hypothesized that the incidence of periprosthetic joint infection would decrease with the use of topical vancomycin in total hip arthroplasty and that topical vancomycin would be cost-effective. A retrospective patient chart review was performed to evaluate consecutive primary cementless total hip arthroplasties performed in the authors' hospital system between April 2015 and December 2016...
March 26, 2019: Orthopedics
https://read.qxmd.com/read/30913294/preoperative-patient-functional-status-is-an-independent-predictor-of-outcomes-after-primary-total-hip-arthroplasty
#13
Micheal Raad, Raj M Amin, Jad M El Abiad, Varun Puvanesarajah, Matthew J Best, Julius K Oni
This study was designed to determine whether preoperative functional status of patients with osteoarthritis predicts outcomes after primary total hip arthroplasty. The American College of Surgeons National Surgical Quality Improvement Program database was queried for records of patients who underwent primary total hip arthroplasty for a principal diagnosis of osteoarthritis from 2009 to 2013 (N=43,179). Patients were categorized as dependent or independent according to their preoperative functional status. The groups were compared regarding several potential confounders using Student's t and chi-square tests...
March 26, 2019: Orthopedics
https://read.qxmd.com/read/30861076/operative-time-and-cost-vary-by-surgeon-an-analysis-of-supracondylar-humerus-fractures-in-children
#14
Brendan M Striano, Christopher M Brusalis, John M Flynn, Divya Talwar, Apurva S Shah
Operative time is a critical driver of cost in orthopedics and an important target for improving value in health care. This study used an archetypal pediatric orthopedic procedure to identify surgeon-dependent variability in operative time. The authors reviewed patients 12 years or younger treated with closed reduction and percutaneous pinning for extension-type supracondylar humerus fractures. Variability in operative time across surgeons was assessed. Surgeon experience at the time of the procedure and case volume (quarterly) were evaluated to explain variations in operative time...
March 12, 2019: Orthopedics
https://read.qxmd.com/read/30861075/total-hip-arthroplasty-templating-a-simple-method-to-correct-for-radiograph-magnification
#15
Stanley E Asnis, Yonah Y Heller
Several factors can cause magnification errors when templating. Parallax, distance from the plate, and printing or monitoring the radiographs can lead to errors. Steel balls, 25.4 mm, underwent radiography on a standard radiograph plate in different positions from the center of the x-ray beam for evaluation of parallax and at different heights from the x-ray table for evaluation of the effects of distance on magnification. Difference in size between the center steel ball and the peripheral balls was less than 0...
March 12, 2019: Orthopedics
https://read.qxmd.com/read/30810758/transformation-of-ischial-osteoblastoma-into-high-grade-osteoblastoma-like-osteosarcoma
#16
Anokha A Padubidri, Todd E Bertrand
The authors report an osteoblastoma-like variant of osteosarcoma of the right ischial tuberosity in a 14-year-old boy. Radiographs initially showed a bone-forming lesion of the right ischial tuberosity. The patient underwent biopsy with curettage and bone grafting, with final pathology revealing osteoblastoma. Two years after the initial procedure, he presented with exuberant bone formation about the operative site concerning for recurrence. He underwent a second biopsy that showed transformation into a high-grade osteoblastoma-like osteosarcoma...
February 26, 2019: Orthopedics
https://read.qxmd.com/read/30810757/the-effect-of-race-on-early-perioperative-outcomes-after-shoulder-arthroplasty-a-propensity-score-matched-analysis
#17
Clark Yin, David C Sing, Emily J Curry, Hussein Abdul-Rassoul, Joseph W Galvin, Josef K Eichinger, Xinning Li
There is a paucity of data on how racial disparities may affect early outcomes following shoulder arthroplasty. The purpose of this study was to evaluate differences in 30-day complications and readmission rates after shoulder arthroplasty based on race. White and black patients who underwent hemiarthroplasty, anatomic or reverse total shoulder arthroplasty (Current Procedural Terminology codes 23470 and 23472) between 2006 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
February 26, 2019: Orthopedics
https://read.qxmd.com/read/30810756/brachialis-muscle-tendon-rupture-of-the-distal-ulnar-attachment-in-a-competitive-weight-lifter
#18
Emily J Curry, Antonio Cusano, Osama Elattar, Andrew Bogart, Akira Murakami, Xinning Li
Isolated tears of the brachialis muscle are rare and often take on the clinical appearance of other pathology, such as a distal biceps brachii tendon tear or an intramuscular tumor, thus making diagnosis especially difficult. The authors describe the case of a 31-year-old competitive male weight lifter who was found to have a full-thickness tear of the brachialis tendon at its distal ulnar attachment after performing a 40.8-kg biceps curl. The authors describe the differential diagnosis, radiographic findings, and methods used that led to the diagnosis and also provide a comprehensive review of the literature on brachialis muscle injuries...
February 26, 2019: Orthopedics
https://read.qxmd.com/read/30810755/surgical-management-for-olecranon-fractures-in-adults-a-systematic-review-and-meta-analysis
#19
Alex Koziarz, Taylor Woolnough, Colby Oitment, Siddharth Nath, Herman Johal
Olecranon fractures are common upper-extremity fractures amenable to various surgical techniques. The authors conducted a systematic review and meta-analysis to evaluate surgical management strategies for olecranon fractures in adult patients. Two investigators independently screened articles from records obtained from MEDLINE, Embase, SPORTDiscus, CINAHL, and the Cochrane Library databases. The authors compared tension-band wiring (TBW) with plate fixation (PF) for the outcomes of complications and hardware removal...
February 26, 2019: Orthopedics
https://read.qxmd.com/read/31099883/mechanisms-of-suture-integration-in-living-tissue-biomechanical-and-histological-in-vivo-analysis-in-sheep
#20
Dominik C Meyer, Anita Hasler, Seraina Wyss, Katja Nuss, Mario C Benn, Christian Gerber, Karl Wieser
The potential of nonabsorbable suture material to augment tissue strength in the long-term is by far not exploited by most of the currently used sutures. The authors hypothesized that different sutures yield specific histological tissue reactions associated with specific mechanical shear resistance of the suture against the tissue. Four different suture types (Orthocord, Ethibond, FiberTape, and FiberWire) were implanted in 36 sheep shoulders (supraspinatus/greater tuberosity). One thread at each time point (6, 16, and 22 weeks) was used for histology, and 11 threads at each time point (0, 6, 16, and 22 weeks) were used for biomechanical longitudinal pullout testing...
May 1, 2019: Orthopedics
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