Archives of Bone and Joint Surgery

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OBJECTIVES: Based on WHO data, as of June 2022, there were 532.2 million confirmed COVID-19 cases globally. In the initial phase of the COVID -19 pandemic, patients experiencing critical illness marked by severe respiratory distress were commonly subjected to corticosteroid treatment. Regrettably, the administration of exogenous corticosteroids stands as the prevailing cause of ONFH. In the current narrative review, we aim to evaluate if active screening should be utilized to diagnose post-COVID-19 ONFH in its early stages...

OBJECTIVES: The present study aimed to determine the prevalence of low bone mineral density (BMD) and low bone mineral content (BMC) as chronic complications of juvenile systemic lupus erythematosus (JSLE) and identify the associated variables and patient characteristics to investigate the relationship between BMD and influential factors. METHODS: This cross-sectional study enrolled 54 patients with JSLE, including 38 females and 16 males. The BMD and BMC were assessed by dual-energy X-ray absorptiometry in the hip (femoral neck) and the lumbar spine...

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OBJECTIVES: Total knee arthroplasty (TKA) serves as an effective surgical treatment method for advanced osteoarthritis (OA). Nonetheless, it is associated with postoperative pain that can influence patients' functional outcome. This study aimed to compare the analgesic effect of subperiosteal and periarticular injection methods of a special local anesthetic in patients who underwent TKA. METHODS: This double-blind prospective clinical study was conducted on patients with advanced knee OA who underwent TKA...

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OBJECTIVES: Headless screw fixation used to treat metacarpal neck and metacarpal shaft fractures is gaining popularity. The aim of the study is to determine the proportion of the metacarpal head articular surface that is compromised during retrograde insertion of headless screws. METHODS: Metacarpal screw fixation through a metacarpal head starting point was performed using fluoroscopic guidance on 14 metacarpals. Headless compression screws, with a tail diameter of 3...

OBJECTIVES: Major surgical approaches for volar plating of the distal radius include the standard flexor carpi radialis (FCR) approach, the extended FCR (eFCR) approach, and the extended FCR approach combined with radial-sided carpal tunnel release (eFCR+CTR). The purpose of this study was to determine which of these three surgical approaches offers the greatest exposure and visualization of the distal radius. METHODS: Sequential dissections were performed on each of 30 fresh frozen below elbow cadaveric samples in order to simulate the three surgical approaches for distal radius volar plating, starting with the standard FCR approach, advancing to eFCR, and finishing with eFCR+CTR...

OBJECTIVES: The study aimed at discovering the existing differences in lower limb joints' kinematics, and EMG signals of 4 particular muscles of the ankle joint during gait, between normal subjects and patients with bilateral triple arthrodesis. METHODS: In this research, a 3D motion analysis system was used and joints' angles were calculated using a MATLAB code, and based on the data collected from markers movements, for patients with bilateral triple arthrodesis and normal subjects...

OBJECTIVES: Internal rotation (IR) remains unpredictable following reverse total shoulder arthroplasty (rTSA). This study aimed to determine if increasing IR limits range of motion in other planes, and to determine pre- and intra-operative factors associated with post-operative IR. METHODS: A retrospective analysis of a single surgeon's primary rTSA with a single implant was undertaken, excluding patients with acute fracture or infection. A lesser tuberosity osteotomy (LTO) or subscapularis peel tenotomy was performed and repaired at the surgeon's discretion...

Radiofrequency (RF) is a minimally invasive procedure for interrupting or modifying nociceptive pathways to manage musculoskeletal neuropathic and nociplastic pain. RF has been used to manage cervical and lumbar facet joint syndromes. The benefits of RF are the following: it is safer than surgery; it doesn´t need general anesthesia, by that means diminishing the complications; it causes pain alleviation for a minimum of 3-4 months; it can be repeated if needed; it improves joint function; and it minimizes the necessity for oral pain treatment...

OBJECTIVES: There is debate about when to start exercises in the nonoperative treatment of a proximal humerus fracture. This randomized trial compared immediate and one-month delayed shoulder exercises in the nonoperative treatment of fractures of the proximal humerus. METHODS: Twenty-six patients with a fracture of the proximal humerus who chose nonoperative treatment were randomized to start pendulum exercises within a few days and 24 were randomized to delayed exercises and started with active self-assisted stretching 1 month after fracture...

The lateral talar dome osteochondral fracture has been described as shallow or wafer-shaped and is more likely to have an associated flake fracture than medial injuries. Displacement into the extracurricular space, however, is a rare occurrence. We present a case of ankle trauma with persistent pain and edema. A CT scan revealed a displaced osteochondral fracture of the lateral dome of the talus and an avulsion fracture of the tip of the medial malleolus. After appropriate dissection and exposure, the fragment was found below the skin, outside the ankle joint capsule...

Periprosthetic femoral fracture is the third most frequent complication after total hip replacement (THR). It is mainly caused by low-energy trauma in the elderly. Open periprosthetic fractures are significantly rarer and are caused by high-energy trauma. Here we present a case of a 73-year-old man who sustained an open (Gustilo II) left periprosthetic femoral fracture with an unstable femoral component (Vancouver B2). After an early stabilization with a temporary external fixator, a single-stage revision using a tapered long femoral stem was performed...

OBJECTIVES: The primary purpose of this study was to compare the rates of nonunion among different osteotomy designs (company brand) and the rates of nonunion between oblique and transverse osteotomies. We secondarily aimed to assess the differences in reoperation and hardware removal rates after ulnar shortening osteotomy (USO). METHODS: A retrospective cohort study of patients undergoing ulnar shortening osteotomy between 2015 and 2022 in our institute amongst 17 providers resulted in 92 consecutive patients...

OBJECTIVES: The study aimed to evaluate the clinical and radiological results after endoscopic repair of gluteus medius muscle injuries and proposed an anatomical classification for the different injury classes. METHODS: A retrospective case series, including patients who had undergone endoscopic repair of the hip abductor tendon. The surgical procedure was standardized. Magnetic resonance imaging (MRI) studies were analyzed, and the injuries were classified into three types: nontransfixing partial-extension (nTPE) tear, transfixing partial-extension (TPE) tear, and transfixing full-extension (TFE) tear...

OBJECTIVES: Impaired proprioception and muscle weakness may not only be a consequence of knee osteoarthritis (OA) but also part of its pathogenesis. Thus, the enhancement of quadriceps strength and proprioceptive accuracy can play a pivotal role in the management of knee OA. This study aimed to investigate the effects of Kinesio tape and flexible knee orthosis in terms of clinical and neuromuscular outcomes in patients with knee OA. METHODS: This clinical trial was conducted on 56 patients with knee OA, randomly allocated to two groups: knee orthosis or Kinesio tape...

Studies that compare routine immediate operative treatment of fractures with selective later reconstructive surgery for malunion or nonunion may be misleading because it discounts the people who did well with nonoperative treatment. We identified 20 studies comparing routine operative fracture treatment and later reconstruction in the hip, clavicle, proximal humerus, elbow, and distal radius. Fifteen of 20 studies favored immediate operative treatment on the basis of lower reoperation rates, fewer complications, better patient reported outcome scores, and higher satisfaction...

OBJECTIVES: In order to treat a rat model of rotator cuff rupture, this work concentrated on the expression of TNMD and RUNX2, followed by rotator cuff repair and secretome-hMSCs. METHODS: A total of thirty 10-weeks-old male Sprague-Dawley rats were separated into five groups randomly, RC on week 0, lesion treated with a rotator cuff repair and saline (RC + NaCl group, n = 6) for 2 and 8 weeks, and lesion treated with a rotator cuff repair and secretome-hMSCs (RC + secretome-hMSC group, n = 6) for 2 and 8 weeks...

The potential for many of the commonly used surgical site wound adhesives, skin antiseptic solutions, topical antibiotics, and suture materials to sensitize and subsequently result in allergic contact dermatitis (ACD) has become increasingly recognized within orthopedic surgery. Particularly with subsequent exposure to the offending allergen, the cutaneous allergic reaction may present in a similar fashion to cellulitis, thus making early differentiation between the two etiologies to initiate the appropriate and timely treatment crucial...