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Advances in Orthopedics

Koichiro Ono, Kazuo Ohmori, Takeshi Hori
Despite the accumulated knowledge of spinal alignment and clinical outcomes the full corrective surgery cannot be applied to all the deformity patients as it requires considerable surgical burden to the patients. The aim of this study was to investigate the clinical and radiological outcomes of the patients who have received short and long fusion for ASD. A total of 21 patients who received surgical reconstructive spinal fusion procedures and were followed up for at least one year were retrospectively reviewed...
2019: Advances in Orthopedics
Adam M Katchky, Mitchell L Smith, Andrew J Shimmin, Stephen J McMahon, Jeremy Latham, Jonathan V Baré
Despite strongly positive results of total hip arthroplasty (THA), patients remain at risk for complications including dislocation. Spinopelvic motion and the hip-spine relationship have been recognized as important factors in surgical planning and implant positioning in THA. Periarticular osteophytes are one of the hallmark pathoanatomic features of osteoarthritis and may influence implant positioning and joint stability; residual osteophytes at the anterior femoral neck may cause anterior impingement and posterior instability...
2019: Advances in Orthopedics
Kensei Yoshimoto, Masahiko Noguchi, Akifumi Yamada, Yuki Nasu
It is important to evaluate the subtalar joint and hip-knee-ankle alignment to understand lower extremity alignment. In this review, we focused on the compensatory changes in the subtalar joint alignment for the deformity of the knee and ankle joint, reviewing previous research. The subtalar joint alignment was compensatory valgus in patients with varus knee and ankle deformity, whereas it was uncertain whether the subtalar joint alignment was compensatory varus in patients with valgus knee and ankle deformity...
2019: Advances in Orthopedics
Y Watanabe, N Takenaka, K Kinugasa, T Matsushita, T Teramoto
Osteotomies are the established surgical procedure for the deformity of the lower limb induced by osteoarthritis (OA) of the knee and ankle. Closed-wedge (CW) and open-wedge (OW) high tibial osteotomy (HTO) are extra-articular surgery, which aim to shift the mechanical axis from medial to slightly lateral and reduce the overload in the medial compartment of the varus deformed knee by extra-articular correction. However, varus deformity of the knee with the teeter effect, which could be accompanied with subluxation and thrust due to the medial-lateral soft tissue imbalance, is not resolved only by the shift of mechanical axis...
2019: Advances in Orthopedics
Robert P Runner, Amanda Mener, James R Roberson, Thomas L Bradbury, George N Guild, Scott D Boden, Greg A Erens
Introduction: Historically, a majority of prosthetic joint infections (PJIs) grew Gram-positive bacteria. While previous studies stratified PJI risk with specific organisms by patient comorbidities, we compared infection rates and microbiologic characteristics of PJIs by hospital setting: a dedicated orthopaedic hospital versus a general hospital serving multiple surgical specialties. Methods: A retrospective review of prospectively collected data on 11,842 consecutive primary hip and knee arthroplasty patients was performed...
2019: Advances in Orthopedics
Vahhab Zarei, Sharon C Yson, Joan E Bechtold, Jonathan N Sembrano
Study Design. Mathematical Model. Objectives. To investigate the relationship between pelvic osteotomy opening angle (OA) and its effect on spinopelvic sagittal parameters as well as the resting length of surrounding muscles. Methods. Predictive equations correlating OA with spinopelvic parameters were derived using geometric relationships. A geometric model calculated spinopelvic parameters (SVA, pelvic incidence [PI], PT, and T1 pelvic angle [TPA]) produced by progressively increasing the OA. These values were compared to optimal balance criteria in the literature...
2019: Advances in Orthopedics
Kivanc Atesok, Nobuhiro Tanaka, Yohan Robinson, Jason Pittman, Steven Theiss
No abstract text is available yet for this article.
2019: Advances in Orthopedics
Ivan Micic, Erica Kholinne, Yucheng Sun, Jae-Man Kwak, In-Ho Jeon
Objectives: Several methods have been proposed to treat AO type C distal radius fracture. External fixator has gained popularity for its simple procedure and rapid recovery. Some surgeons suggested that additional K-wires may play a critical role in the outcome. The purpose of study is to evaluate the role of additional K wires in treating distal radial fracture with external fixator regarding its outcome. Material and Methods: From January 2006 to January 2010, 40 patients with AO type C distal radius fracture were treated with external fixator, with (EF) or without additional K wires (EFK)...
2019: Advances in Orthopedics
Jordan Trafimow, Alexander S Aruin
Objectives: Injury associated with lifting, especially low back injury, is a big problem in industry that accounts for loss of work and high medical expenses. Studies of biomechanics of lifting provide a basis for optimization of lifting. The aim of the study was to further investigate the role of the upward force due to negative acceleration during a lift. Methods: Nine healthy subjects lifted an empty box and a box with additional load of 10, 20, and 25 lb. Kinematic data were recorded during the lifts and accelerations were calculated, and angular positions of the trunk and knee were obtained during the lifting when negative accelerations were used...
2018: Advances in Orthopedics
D Banaszek, D Spence, P O'Brien, K Lefaivre
Nonunion is a relatively rare, yet challenging problem after fracture of the femoral neck. Risk factors include verticality of the fracture line and presence of comminution of the posteromedial calcar, as well as quality of reduction. Treatment options consist of valgus intertrochanteric osteotomy versus arthroplasty. Treatment should be tailored to the individual patient, taking into account patient age and activity demands. This review outlines the principles and technical considerations for valgus osteotomy of the proximal femur in the setting of femoral neck nonunion...
2018: Advances in Orthopedics
Sharon Babcock, James F Kellam
In the United States, more than 300,000 hip fractures occur annually in the elderly population with associated significant morbidity and mortality. Both intracapsular and extracapsular hip fractures have inherent treatment challenges and therefore are at risk of nonunion complications. A systematic assessment including radiographic, metabolic, and infectious evaluations should be completed for all patients suspected of nonunion. Failed internal fixation of intracapsular hip fractures is typically treated with arthroplasty, while extracapsular proximal femur nonunions may be amenable to revision internal fixation or arthroplasty...
2018: Advances in Orthopedics
Sanjit R Konda, Hesham Saleh, Ariana Lott, Kenneth A Egol
Patterns of discharge location may be evident based on the "sickness" profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization...
2018: Advances in Orthopedics
Timothy A Damron, Kenneth A Mann
Introduction: Synthetic bone graft materials are commonly used to fill defects after curettage of benign bone lesions. Ultraporous beta tricalcium phosphate (TCP) is a popular synthetic compound used in this situation. Prior clinical studies based on plain X-ray analysis suggest incorporation of TCP is incomplete, even when combined with bone marrow (BMA). Purpose: The purpose was to analyze volumetric CT-based changes in defects grafted with TCP with/without BMA in a completed prospective RCT to objectively determine (1) relationship between size and age versus TCP incorporation and (2) whether there is an advantage to addition of BMA...
2018: Advances in Orthopedics
Eric Robinson, Dani Gaillard-Campbell, Thomas P Gross
Background: To date, there have been no published investigations on the cause of acetabular debonding, a rare failure phenomenon in metal-on-metal hip resurfacing where the acetabular porous coating delaminates from the implant while remaining well fixed to the pelvic bone. Purposes: This study aims to summarize the current understanding of acetabular debonding and to investigate the discrepancy in rate of debonding between two implant systems. Patients and Methods: To elucidate potential causes of debonding, we retrospectively analyzed a single-surgeon cohort of 839 hip resurfacing cases...
2018: Advances in Orthopedics
Andrew S Moon, Kivanc Atesok, Thomas E Niemeier, Sakthivel R Manoharan, Jason L Pittman, Steven M Theiss
Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis. Although reports in the literature include nonoperative and operative management, most authors advocate for surgical treatment with open reduction and decompression with instrumentation and fusion...
2018: Advances in Orthopedics
Christopher Jackson, Mina Tanios, Nabil Ebraheim
Subtrochanteric femur fractures are an uncommon injury in orthopedics, but when they are encountered they may present difficulties in management. The purpose of this paper is to examine the recent literature on the epidemiology, classification, initial evaluation, and definitely treatment for these injuries. These will assist the physician to determine the optimal treatment strategy and avoid potential surgical complication.
2018: Advances in Orthopedics
Thomas S Moores, Benjamin D Chatterton, Matthew J Walker, Phillip J Roberts
Background: This study aims to evaluate outcomes for warfarinised hip fracture patients and compare them with a matched nonwarfarinised group, before and after the introduction of national hip fracture guidelines in the United Kingdom. Methods: A retrospective cohort study of 1743 hip fracture patients was undertaken. All patients admitted taking warfarin were identified. These patients were then matched to nonwarfarinised patients using nearest neighbour propensity score matching, accounting for age, sex, hip fracture type, and Nottingham Hip Fracture Score...
2018: Advances in Orthopedics
Britta K Krautwurst, Jürgen R Paletta, Sylvia Mendoza, Adrian Skwara, Melvin Mohokum
Objective: Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data: A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods: Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48...
2018: Advances in Orthopedics
Jackson Rucker Staggers, Thomas Elliot Niemeier, William E Neway, Steven Michael Theiss
Objective: Blunt spinal trauma classification systems are well established and provide reliable treatment algorithms. To date, stability of the spine after civilian gunshot wounds (CGSWS) is poorly understood. Herein, we investigate the validity of trauma classification systems including the Thoracolumbar Injury Classification and Severity Score (TLICS), Subaxial Cervical Spine Injury Classification and Severity Score (SLIC), and Denis' three-column model when applied to spinal penetrating trauma from gunshots, while secondarily evaluating stability of these injuries...
2018: Advances in Orthopedics
Jennifer J Beck, Dai Sugimoto, Lyle Micheli
Introduction: Concern regarding ability of autologous chondrocyte implantation (ACI) to correct for the bone and cartilage pathology of knee juvenile osteochondritis dissecans (JOCD) exists. The purpose of this study was to determine long-term, patient-based outcomes of ACI treatment of JOCD in young patients. Authors hypothesized long-term outcomes are comparable to reported mid-term outcomes. Methods: A single institution, longitudinal cohort study design combining medical record review and outcome surveys was used...
2018: Advances in Orthopedics
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