Current Orthopaedic Practice最新文献

{"title":"A single shot arthroscopic reduction and screw fixation of posterior wall acetabular fracture","authors":"Eran Keltz, Noam Reshef, B. Peskin, Farouk J. Khury, I. Botser","doi":"10.1097/bco.0000000000001232","DOIUrl":"https://doi.org/10.1097/bco.0000000000001232","url":null,"abstract":"","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46561477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-platform social media analysis regarding ACL injury and surgery","authors":"Hunter L. Hasley, Lainey Bukowiec, Jay M. Zaifman, Martin Malik, Brian D. Batko, Y. Kissin, Michael Kelly","doi":"10.1097/bco.0000000000001229","DOIUrl":"https://doi.org/10.1097/bco.0000000000001229","url":null,"abstract":"\u0000 \u0000 Anterior cruciate ligament (ACL) injury affects a broad patient population, but there is limited knowledge on how ACL injury is discussed across social media platforms. This study aims to develop an extensive snapshot of the social media milieu for understanding who uses social media platforms, what topics users discuss, and how these platforms vary regarding ACL injury and surgery.\u0000 \u0000 \u0000 \u0000 We utilized a qualitative, descriptive design with quantitative statistical analysis including Kruskal-Wallis tests and Fisher’s Exact tests with post hoc analyses to examine new posts across Facebook, Instagram, Twitter, and TikTok using ACL-specific search terms from August 2021 to January 2022. Posts were analyzed by authorship, content characterization, and engagement.\u0000 \u0000 \u0000 \u0000 Across social media sites, 760 posts were examined involving ACL surgery and injury. There was statistically significant difference among the platforms when comparing categories of authorship (P<0.001). There were statistically significant differences where physicians (P<0.001) and patients (P<0.001) posted, with physicians representing 20.6% and 19.5% of posts on Facebook and Twitter, respectively. TikTok displayed the highest patient authorship (83.5%) and greatest content engagement. There were also significant differences among platforms regarding content characterization (P<0.001).\u0000 \u0000 \u0000 \u0000 This study breaks down a snapshot of social media revolving around ACL injury and surgery demonstrating differences in authorship, content, and engagement of posts across platforms. These findings demonstrate the frequent use of social media by patients to address unmet clinical needs and can help surgeons and patients connect on the same platforms.\u0000 \u0000 \u0000 \u0000 Level IV.\u0000","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46782177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study on total hip arthroplasty outcome in hip fracture compared with matched elective cohort","authors":"J. W. Lim, Tze Khiang Tan, N. Alkandari, D. Ridley, S. Sripada, A. Jariwala","doi":"10.1097/BCO.0000000000001230","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001230","url":null,"abstract":"Background: We conducted a prospective study to compare the outcomes of THA for hip fractures with a best-matched elective cohort. Method: We prospectively reviewed patients underwent THA for hip fractures from 2017 to 2019. The modified Harris Hip Score (mHHS) and complications were recorded. Our control group was elective THA cases matched for the month of operation, age, gender, implants, side of operation and surgeon’s grade. Unmatched cases were excluded. Results: Forty-one THA for hip fractures and forty-one matched elective THA were compared. The total modified Harris Hip Score [mHHS (total)] was significantly lower preoperatively in elective cohort (trauma vs. elective: 60.3 vs. 41.4, P<0.001) and achieved significantly higher score than trauma cohort one-year postoperatively (82.6 vs. 88.2, P= 0.029). The trauma cohort had similar mHHS (function) pre- and postoperatively, and no significant difference was witnessed between both cohorts postoperatively (35.1 vs. 37.6, P= 0.142). The mHHS (pain) was significantly higher in trauma cohort preoperatively (19.8 vs. 12.7, P=0.034), but the elective cohort achieved significantly higher mHHS (pain) than trauma cohort at one-year postoperative (40.1 vs. 42.7, P=0.027). Both cohorts had similar complication rates. Conclusions: This is the first matched prospective study on hip fracture patients that underwent THA, with one year follow up results and the involvement of preoperative and postoperative functional outcomes. With careful patient selection, trauma THA patients can return to their pre-injured function within a year and had comparable function scores with elective THA patients, without increased complication rates.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"257 - 262"},"PeriodicalIF":0.3,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46337413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal tibiofibular joint reconstruction with biceps femoris and iliotibial band autografts with suture tape augmentation","authors":"Nikolas J Sarac, C. Curatolo, T. Miller","doi":"10.1097/bco.0000000000001228","DOIUrl":"https://doi.org/10.1097/bco.0000000000001228","url":null,"abstract":"INTRODUCTION I nstability of the proximal tibiofibular joint (PTFJ) is a likely under-recognized condition. The true incidence is unknown, but it is likely under-reported in the literature due to spontaneous reductions in acute cases and misdiagnosis in chronic instability. Three types of instability exist: acute traumatic dislocations, chronic or recurrent dislocations, and atraumatic subluxations. Instability may be multidirectional, however most cases of PTFJ instability occur anterolaterally, owing to the weaker posterior stabilizing ligamentous complex. Chronic instability may be misdiagnosed as lateral meniscal pathology, and patients reporting lateral sided pain, instability with or without visible and audible popping sensations. Physical examination may reveal pain, apprehension, or translation of the fibula when the proximal fibula is translated or “shucked”, particularly anteriorly, with the knee flexed. Radiographs are unlikely to aid in diagnosis other than in cases of acute dislocations, although comparison radiographs to the contralateral knee may help detect subtle differences. Magnetic resonance imaging often demonstrates high T2 signal from fluid in the PTFJ or bone contusion of the fibular head or proximal tibia, but may also demonstrate subluxation of the PTFJ. Initial conservative management consists of activity modification, particularly avoiding knee hyperflexion, use of supportive straps, and undergoing physical therapy. If non-operative management fails, surgical intervention can be considered. A plethora of procedures have been described, which includes but is not limited to fibular head resection, fusion, stabilization with the use of suture buttons, and soft tissue reconstructions. Stabilization with autograft reconstruction may include biceps femoris tendon (BFT) and/or iliotibial band (ITB) rerouting. No “gold standard” has been recognized due to infrequency of the condition, and the literature on patient outcomes following stabilization being limited to case reports and small series. In an attempt to maximize patient outcomes, the authors elected to modify a previously described reconstruction technique which utilized ITB and BFT autografts for stabilizing the joint. The described modification is a hybrid technique which still utilizes the ITB and BFT but with added reinforcement of suture tape augmentation (Arthrex Internal Brace, Naples FL) for added stability. The authors feel this allows for a safer, less invasive procedure than previously described. The procedure was performed in an active 26-year-old female who sustained a left PTFJ dislocation which she manually reduced after a jumping injury. PTFJ pain and snapping persisted despite four months of nonoperative treatment. Physical examination in clinic revealed mild laxity at the PTFJ, andmagnetic resonance imaging demonstrated an effusion of the joint as well as edema of the fibular head. As such she was indicated for the procedure described below.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"248 - 250"},"PeriodicalIF":0.3,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44561175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascularized pronator quadratus pedicled bone grafting versus iliac crest bone grafting in the treatment of scaphoid nonunion: a retrospective study","authors":"Farshad Zandrahimi, Maryam Aazami, Alireza Sarhadi Zade, A. Saied","doi":"10.1097/BCO.0000000000001225","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001225","url":null,"abstract":"Background: Vascularized pronator quadratus pedicled bone grafting is a viable procedure for the treatment of scaphoid nonunion. However, its superiority over iliac crest bone grafting is unknown. In this study, we compare the union rate and outcomes of these procedures in the treatment of scaphoid nonunion. Methods: The medical profiles of the patients with scaphoid nonunion that were treated with either pronator quadratus pedicled bone grafting (n=23) or iliac crest bone grafting procedure (n=31) were retrospectively reviewed. Patients with avascular necrosis of the scaphoid and those with the involvement of the proximal pole were excluded. The outcome measures were the union rate and time, active wrist range of motion, pinch, and grip strength. Results: The mean age of the patients was 30±8.1 yr. Bony union was achieved in all patients of the study groups. The mean time to union was 9.1±2.8 wk in the pronator quadratus group and 8.7±3.5 wk in the iliac crest groups (P=0.14). The mean active flexion, extension, radial deviation, ulnar deviation, pinch, and grip strength of the involved wrist averaged 87.3%, 86.2%, 80.2%, 89.1%, 84.3%, and 85.6% of the contralateral wrist in the pronator quadratus group and 85.5%, 87%, 77.8%, 85.1%, 88.8%, and 87.8% of the contralateral wrist in the iliac crest group, respectively. These differences were not statistically significant. Conclusion: Pronator quadratus pedicled bone grafting provides a similar union rate and outcomes compared to the iliac crest bone grafting in the treatment of scaphoid nonunion. Level of Evidence: IV","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"225 - 228"},"PeriodicalIF":0.3,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48579349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do insurance and socioeconomic status affect outcomes for children who undergo surgery for medial epicondyle fractures?","authors":"Jacqueline Ziegman, Molly E Duncan, J. Balch Samora","doi":"10.1097/BCO.0000000000001227","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001227","url":null,"abstract":"Background: Low socioeconomic status (SES) and Medicaid insurance have been associated with poorer outcomes. The purpose of this study is to compare outcomes among children with Medicaid vs private insurance, and children with low vs high SES who undergo surgery for medial epicondyle fractures. Methods: This is a retrospective review of patients who underwent surgery for medial epicondyle fractures at a large pediatric hospital between 2015 and 2020. SES was measured using the Opportunity Atlas and the United States Small-Area Life Expectancy Estimate Project. A subset of patients were prospectively administered the PROMIS Pediatric Pain Intensity Numeric Rating Scale and PROMIS Pediatric Upper Extremity Short Form to gather additional information on outcomes as they relate to SES. Results: Of 117 patients, 59 (50.4%) were females, 90 (76.9%) were Caucasian, and average age was 11.1. The average household income was $44,889 (SD=$11,417) and most patients (72.6%) were privately insured. Higher household income was associated with increased number of follow-up appointments (β=0.29, 95% CI=0.08, 0.50) and increased likelihood of using physical therapy (OR=1.67, 95% CI=1.15, 2.42). Patients with private insurance returned to activity 20.5 days sooner than those with public insurance (β=−20.52, 95% CI=−39.5, −1.53). Private insurance tended to be related to less likelihood of complications and more likelihood of use of physical therapy. Conclusions: Insurance and SES may play a role in shaping healthcare outcomes for pediatric patients receiving surgery for medial epicondyle fractures. Level of Evidence: Prognostic Level III.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"263 - 268"},"PeriodicalIF":0.3,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48780353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haptic feedback during virtual reality training significantly improves First-Year orthopedic resident performance at tibia drilling: a randomized trial","authors":"A. Kanakamedala, John F. Dankert, Rown Parola, K. Egol, V. Aggarwal, Claudette M. Lajam","doi":"10.1097/BCO.0000000000001223","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001223","url":null,"abstract":"Background: Few studies have investigated whether haptic feedback improves the effectiveness of virtual reality (VR) simulation. This study aimed to determine whether new orthopedic surgery residents trained on haptic feedback-enabled VR performed basic drilling better than residents who had trained on VR without haptic feedback. Methods: Fourteen first-year orthopedic surgery residents were enrolled and randomized into “haptic” or “non-haptic” groups and blinded to study goals and randomization. Residents participated in a VR tibia drilling simulation with haptic feedback either turned on or off and then performed a plastic resin tibia model drilling session where overdrill depth was measured by two raters blinded to study groups. Questionnaires were completed before and after the hands-on sessions with responses on a five-point Likert scale. Results: There were no significant differences in demographics between groups. Overdrill depth during the first trial was significantly less in the haptic group than the non-haptic group (3.9 mm vs. 6.0 mm, P=0.005). Subsequent trials showed no significant difference in mean overdrill depth between groups (P>0.05). Haptic group participants reported higher confidence in the safe use of surgical tools (4 vs. 3, P<0.01) and more simulation realism (4 vs. 3, P<0.01). Conclusion: VR training with haptic feedback significantly improves initial performance during use of a surgical drill through a tibia model compared to VR training without haptic feedback in first year orthopedic residents. The addition of haptic feedback also increases the perceived value, realism, and enjoyment of VR simulation. Level of Evidence: Level II.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"251 - 256"},"PeriodicalIF":0.3,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42391451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The surgical management of scheurmann’s kyphosis: Efficacy and safety of a low density posterior pedicle screw construct","authors":"M. Khattab, M. Saad, Youssry K. El Hawary","doi":"10.1097/BCO.0000000000001220","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001220","url":null,"abstract":"Background: To see if employing a low pedicle screw density in the posterior therapy of Scheuermann kyphosis is safe, radiologically effective, and clinically effective. Methods: Patients with Scheuermann kyphosis underwent posterior surgical correction between 2016 and 2019. Low Screw Density, peri apical Ponte osteotomies and cantilever correction maneuver were our surgical technique for deformity correction. Two observers performed a radiological evaluation of the before and postoperative Spinopelvic parameters. Validated Arabic version of Scoliosis Research Society 22 questionnaire were used to assess the preoperative and postoperative clinical results. Cost saving analysis was performed. Results: This study enlisted the participation of thirty patients. The patients mean age 21.8 ±3.4 years and mean follow up 34.8±7.9 months. The mean surgical time was 165.33 ±17.9 minutes , the mean number of osteotomies was 4.2± 0.8 , and the mean blood loss was 770± 139.3cc.The mean preoperative dorsal kyphosis 87.5°±4.6 °and the mean postoperative dorsal kyphosis 43.1°± 3.7° at final follow up (P<0.001).The mean preoperative scoliosis research society 22 questionnaire 2.8±0.4 and the mean postoperative scoliosis research society 22 questionnaire 4.3±0.8 at final follow up (P<0.001). Conclusions: Posterior Surgical Intervention with low Screw Density construct and periapical Ponte osteotomies is safe , radiologically , clinically and cost effective way in surgical management of Scheuermann kyphosis. Study Design: Prospective Cohort Study. Level of Evidence: Level IV.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"240 - 247"},"PeriodicalIF":0.3,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44026615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of 32 orthopaedic society costs and benefits","authors":"Janae Rasmussen, Lisa K. Cannada, J. Balch Samora","doi":"10.1097/BCO.0000000000001218","DOIUrl":"https://doi.org/10.1097/BCO.0000000000001218","url":null,"abstract":"Background: Many orthopaedic surgeons belong to specialty groups or societies at the local, state, and national levels. We sought to understand costs and benefits of orthopaedic society memberships. Methods: We collected data on the cost of membership and benefits for 32 different orthopaedic societies in 2020 and 2021 by using website information and contacting the society’s administration. We grouped benefits into distinct categories: annual conference, continuing education, educational resources, leadership opportunities, career job listings, research grants, mentorship program, resident/fellow resources, medical student resources, and journal affiliation. Results: On average, attending surgeons pay $460 and residents/fellows pay $300 for a single annual membership. However, some organizations, such as the American Academy of Orthopaedic Surgeons (AAOS), the American Orthopaedic Association (AOA), and the Hip Society have higher annual dues ($1,115, $1,100, and $1,500, respectfully). Over 20 years, a physician belonging to both the AOA and the AAOS pay $44,300 in fees at the current cost. All 32 societies offer an annual conference, continuing education credit opportunities, other educational resources, leadership opportunities, and journal affiliations. Conclusions: Membership fees vary and benefits are often difficult to assess without becoming a member. The COVID-19 pandemic has moved society activities online, decreasing opportunities for in-person networking and education, with some societies considering reduced fees. The pandemic has also strained hospital budgets resulting in loss of funds for many physicians at academic organizations that would normally be used toward membership fees. Perhaps increased opportunities for resource pooling, with group access to educational opportunities and mentorship, should be considered. Level of Evidence: Level V.","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":"34 1","pages":"219 - 224"},"PeriodicalIF":0.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43482954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the effect of subacromial corticosteroid injections on intraocular pressure","authors":"Onur Engin, Ceren Durmaz Engin, Rumeysa Samanci, K. Teberik, S. Ataoğlu","doi":"10.1097/bco.0000000000001219","DOIUrl":"https://doi.org/10.1097/bco.0000000000001219","url":null,"abstract":"","PeriodicalId":10732,"journal":{"name":"Current Orthopaedic Practice","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44251065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}