Journal of Surgical Orthopaedic Advances

The purpose of this study is to investigate the association between Hirsch index (h-index) and academic rank among foot and ankle surgeons affiliated with American Orthopaedic Foot and Ankle Society (AOFAS) fellowship programs. The total number of publications, academic rank, years in practice, fellowship training pedigree, and h-indices of 176 foot and ankle surgeons from 48 AOFAS fellowship programs were recorded, and statistical analysis was performed. We found a strong association between total number of publications and h-index...

This study evaluated the associations of demographics and social media (SM) usage on physician review websites for spine surgeons in New Jersey and Pennsylvania. Three physician rating websites were accessed to obtain training history, number of ratings/reviews, and overall rating (0-5). Surgeon web pages and publicly searchable SM accounts on Facebook (FB), Twitter (T), and/or Instagram (IG) were recorded. Of 246 spine surgeons included, 95.9% had a personal/institutional website while 12.2% were present on at least one SM platform...

The purpose of this study was to analyze the demographics and backgrounds of U.S. orthopaedic surgery residency program directors (PDs). We collected publicly available information on 189 orthopaedic surgery residency PDs. Of those PDs, 90% were male MDs with an average age of 52. The average age at PD appointment was 45. The average duration of appointment was 7 years. About 81% of programs were university-affiliated, and 61% were in an urban environment. PDs attended 100 medical schools, 129 residencies, and 96 fellowships...

A paucity of data exists for post-operative complications and survivorship in patients undergoing resection arthroplasty procedures for treatment of glenohumeral tumors. This study investigates patient and tumor characteristics, 90-day and long-term post-operative complications, and overall survivorship following glenohumeral tumor resection arthroplasty procedures. This single-center retrospective review identified 13 patients, with mean age of 51.6 ± 15.7 years, mean body mass index of 26.5 ± 6...

This study assessed the National Surgical Quality Improvement Program (NSQIP), which provides data on 30-day post-operative complications from 500+ institutions, to identify risk factors for wound complications in patients undergoing primary total hip arthroplasty (THA). Patients undergoing primary THA between 2010-2017 were retrospectively reviewed. Patients experiencing post-operative wound complications were stratified based on pre-operative characteristics. Multivariate regression model was used to assess these characteristics as independent risk factors for post-operative complications...

OpenFDA is an open access database maintained by the United States Food and Drug Administration (FDA) that we queried for adverse events (AEs) related to product devices used during tibia intramedullary nailing (IMN) procedures. There was a total of 1,799 reports pertaining to tibial intramedullary nailing from 1996 to 2020. Causes included infection (451), nonunion (380), intraoperative issue (343), painful hardware (234), implant fracture (195), other (68), loosening (35), surgeon error (24), packing problem (24), patient injury (12), expiration (12), contamination (11) and allergic reaction (10)...

This study's objective was to identify a difference in maximum temperature change during forward versus oscillating drilling of cadaveric bone. Paired femurs were dissected from the soft tissue of five cadavers. Each cadaver had one femur assigned to forward and the other to oscillation. The first drill hole was 2.5 cm distal to the lesser trochanter and the remaining 10 holes were evenly spaced 2 cm apart. A System 7 drill and 3.5 mm drill bit were attached to an Instron 5500R to provide a progressive force of 50 Newtons per minute for each drill hole...

This study aimed to determine intra-observer and inter-observer reliability of the Mayo Elbow Performance Score (MEPS). Patients undergoing elbow surgery completed a MEPS questionnaire initially and another 2-3 weeks later. During the second interview, patients completed the Oxford Elbow Score (OES) for comparison. Intraclass correlation coefficients (ICC) and Pearson correlation coefficients (PCC) > 0.80 indicated substantial agreement. In 42 patients who had elbow surgery, the average MEPS score initially was 78 (range, 5-100, SD 22...

COVID-19 pandemic rapidly progressed, resulting in temporary cessation of elective surgery in the U.S. The goal of this study was to evaluate the impact of COVID-19 on surgical volume, charges, work relative value units (WRVUs), and net receipts at an academic orthopaedic surgery department. Volume of cases per month decreased from 745 cases in February to 173 cases in April, with a 75% decrease in charges and a 73% decrease in WRVUs. The largest decreases in productivity were in Sports (92% decrease in charges and WRVUs), Pediatrics (88% decrease in charges, 87% decrease in WRVUs), and Joints (81% decrease in charges, 78% decrease in WRVUs)...

During the Coronavirus Disease 2019 (COVID-19) pandemic, states implemented social distancing guidelines. This study examines the effect of the severity of lockdown orders on orthopaedic trauma volume. Two institutions, one in a state with strict stay home (SH) orders and one in a state with lax social distancing (SD) orders, were examined. Surgical case counts, total orthopaedic case counts, orthopaedic trauma case counts, institution trauma activations, and mechanism of injury data were collected and compared to control periods...

The Certificate of Need (CON) program was established to respond to increasing healthcare costs; however, its impact on spine surgery trends is not well understood. The purpose of this study was to evaluate the impact of CON status on utilization of single-level lumbar discectomy. A combined Medicare and private payer database was used to identify single level lumbar discectomies performed from 2007 to 2015. Utilization and reimbursement trends were compared using the compound annual growth rate (CAGR) with reimbursement adjusted by the consumer price index...

The purpose of this analysis is to determine the effect of length of immobilization following total elbow arthroplasty (TEA) for rheumatoid arthritis on the outcomes, complications, and survival of the implant. A review of TEA literature was performed. Post-operative motion was categorized into three groups: no post-operative immobilization (group 1), short-term 2-5 days immobilization (group 2), and extended 7-14 days immobilization (group 3). Thirty-six articles reporting on 43 studies involving 2,346 elbows in 2015 patients were included...

This study aims to evaluate the research productivity trends in orthopaedic residents who were selected for shoulder and elbow fellowships from 2010 to 2019. We hypothesize that residents matching into orthopaedic shoulder and elbow fellowships are increasing both their publication number and publication quality from 2010 to 2019. Fellows of orthopaedic shoulder and elbow programs from 2010 to 2019 were identified through publicly accessible information on fellowship programs. Each fellow's publication data during their residency was collected via publicly available search engines, and analyzed to include: fellowship year, residency years, fellowship program and location, total publications, number of publications in high-impact general orthopaedic and shoulder and elbow journals, and authorship position...

The objective of this study is to measure the prevalence and demographic predictors of depressive symptoms in a diverse group of adolescent athletes. Retrospective chart review of demographic and Patient Health Questionnaire-Adolescent (PHQ-A) data obtained during a mass pre-participation physical exam (PPE) was examined. Independent variables included race and sex. A total of 16.9% (n = 115) of students had clinically meaningful depressive symptoms, while 2.5% (n = 23) reported having thoughts that they would be better off dead or of hurting themselves...

This study assessed the effect of preoperative planning using a 3D-printed periarticular fracture model on operative performance. A complex pilon fracture was 3D-printed, and a preoperative plan was developed. Orthopaedic surgery residents (n = 20) were randomized into two groups. Group 1 performed routine preoperative planning, while Group 2 was also practiced using a 3D-printed construct before performing fixation of the 3D-printed model. Resident performance was assessed using a video motion capture system and evaluated by blinded reviewers...

This study aimed to characterize postoperative infection rate among patients undergoing definitive fixation of both open and closed fractures during the same surgery. Outcomes between patients with open fractures (OF) treated first were compared to those with closed fractures (CF) treated first. We identified 303 adult patients with multiple (≥ 2) pelvis and extremity fractures who presented to our Level 1 Trauma hospital in 2017. Forty patients with at least one open and one closed fracture treated with operative fixation during the same surgery were included in analysis...

Pitching kinematic and kinetic assessments require normative values to make valuable comparisons to athletic peers. The purpose of this research note was to report normative values of pitching kinematics and kinetics and to compare kinetics by competition level. A retrospective review was performed on three-dimensional baseball pitching biomechanical evaluations. Kinematics and kinetics were calculated. Pitchers were portioned into competition level groups. Kinetic group differences were assessed through analyses of variance with significance level p < 0...

Despite improved surgical techniques and prophylactic procedures, orthopaedic implant-associated infections remain high with complications that can lead to devastating outcomes for the patient. Implant coatings and associated surface modification techniques represent a promising means to prevent infections. Various approaches have emerged to address the challenges associated with implant infections, such as antibacterial resistance, biofilm prevention, and appropriate efficacy kinetics. Methods including antibiotic and antimicrobial peptide surface tethering, use of osteo-conductive and -inductive materials, and altering hydrophobicity and hydrophilicity of the implant surface, have all demonstrated efficacy toward diminished infection risk...

Management of patients with non-unions or stress fractures of the tibia or distal femur with debilitating ipsilateral knee arthritis can be difficult to manage. In these examples of care, we present three illustrations of using long stemmed modular total knee components to successfully manage both tibial and femoral non-unions and stress fractures as well as ipsilateral arthritis with resultant deformity. The average improvement in our knee outcome scores for these three patients via pre-operative Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) and one-year post-operative KOOS, JR is 44...

We aimed to determine whether addition of an in vivo ectopic induced membrane (EM) to the Masquelet Technique enhanced angiogenesis and bone formation in a segmental defect. After generating and stabilizing a diaphyseal femur defect, 10 rats received a polymethylmethacrylate (PMMA) spacer within the defect (control); 10 received another PMMA spacer implanted subcutaneously (EM). We removed the spacers and added autograft; the excised EM was added to their autograft (EM group). Post-mortem x-rays assessed bone formation and bridging...