Journal of Musculoskeletal Surgery and Research最新文献

{"title":"A different ball game","authors":"G. Dharmshaktu","doi":"10.25259/jmsr_126_2022","DOIUrl":"https://doi.org/10.25259/jmsr_126_2022","url":null,"abstract":"","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127892033","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":"Does liposomal bupivacaine reduce hospital length of stay for multilevel lumbar decompressions? A retrospective matched cohort study","authors":"Abduljabbar Alhammoud, H. Bouloussa, A. Oganesian, I. Moghamis, Calvin C. Kuo, K. Majid, Ravinder-Raj S. Bains","doi":"10.25259/jmsr_108_2022","DOIUrl":"https://doi.org/10.25259/jmsr_108_2022","url":null,"abstract":"\u0000\u0000Adequate post-operative pain control improves patient outcomes, leading to fewer analgesia-related complications and shorter length of hospital stay (LOS). Liposomal bupivacaine (LB) is a long-acting injectable anesthetic. This study evaluates the impact of local LB use on pain control outcomes (LOS, visual analog scale [VAS], narcotic usage, readmission, and complications) after multilevel spinal decompression surgery compared to matched cohorts without local LB.\u0000\u0000\u0000\u0000A single-center retrospective cohort study matched by age, gender, body mass index (BMI), medical comorbidities, and previous use of opioids was done at our institute. Subjects were divided into two groups; one who had LB at the end of spine surgery and one without LB. Patients’ demographics, number of operating levels, and outcomes parameters (LOS and VAS), number of pain medications used preoperatively, through the hospitalization and at discharge, complication rate, and readmission rate were collected.\u0000\u0000\u0000\u0000Eighty-six patients with spinal stenosis were included; 45 (52.3%) in the LB group and 41 (47.7%) in the non-LB group. The average age was 67.8 ± 10.5. Both groups were comparable in terms of BMI and medical comorbidities. There was no diffidence in pain killers consumption between the two groups, throughout hospitalization and at the discharge. Strong statistically significant difference with VAS score favoring LB use (P < 0.001). LOS was 15 h less in the LB group (32.4 ± 36.6 vs. 47.5 ± 39.1) (P = 0.069). The complication rate was 10.6%, with no difference between both groups (P = 0.49). Both groups had no readmissions or the emergency department visits for pain complaints. After excluding patients with complications, LOS was significantly shorter in the LB group (P = 0.029). In subgroup analysis for the LB group to look for the impact of the learning curve, the VAS score was less, and LOS was shorter in the second half of the included patients. However, the difference did not reach statistical significance.\u0000\u0000\u0000\u0000LB, as local infiltration at the end of a multilevel lumbar decompression, is an effective tool to decrease post-operative pain and shorten hospital stay, especially in patient with no post-operative complications.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126796383","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":"Repeat cultures in septic arthritis, do they change antibiotic management?","authors":"R. Judy, Mina Y. Girgis, J. Sewards","doi":"10.25259/jmsr_98_2022","DOIUrl":"https://doi.org/10.25259/jmsr_98_2022","url":null,"abstract":"\u0000\u0000Septic arthritis is an orthopedic surgical emergency. Repeat cultures increase cost and patient discomfort; however, it is unknown whether repeat cultures have any merit in guiding treatment. The primary purpose of this investigation is to determine if repeat septic arthritis synovial fluid cultures alter antibiotic management. The secondary purpose is to identify independent risk factors that may alter subsequent antibiotic therapy.\u0000\u0000\u0000\u0000Septic arthritis cases were retrospectively reviewed using the International Classification of Diseases, Ninth Revision codes between January 2011 and December 2015. Inclusion criteria were patients >18 years with >1 positive synovial culture taken >2 days apart.\u0000\u0000\u0000\u0000Two hundred and ninety-two synovial cultures were taken. Seventy were repeat cultures. Around 3 quarters (74.3%) yielded the same bacteria and 25.7% yielded different bacteria. Less than half (45.7%) of repeat cultures were associated with a change in antibiotics. Of the 18 repeat cultures that yielded different bacteria, six repeat cultures contained the same bacteria ± a different organism. Thirteen of the eighteen repeat cultures with different bacteria required a change in antibiotics. Patients who had their antibiotic therapy changed after repeat cultures were more likely to have diabetes mellitus (66.7% vs. 38.5%; P = 0.04, OR = 3.2 [1.04, 9.89]). Patients with hepatitis C more frequently required a different antibiotic regimen on repeat cultures (69.2% vs. 40.4%; P = 0.06, OR = 3.3 [0.91, 12.1]).\u0000\u0000\u0000\u0000Repeat culture data in patients with septic arthritis changed antibiotic regimens in 45.7% of patients and yielded different bacteria in 25.7%. Patients with diabetes more frequently required alternate antibiotic regimens.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133058860","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":"Epithelioid malignant peripheral nerve sheath tumor: A rare tumor with an unusual presentation in the ankle: A case report and literature review","authors":"Mohammed Alwhabi, M. Almalki, Assem S. Alrumeh, Nasser Almadan, Salman A. Alfaifi","doi":"10.25259/jmsr_95_2022","DOIUrl":"https://doi.org/10.25259/jmsr_95_2022","url":null,"abstract":"Malignant peripheral nerve sheath tumor (MPNST) is a rare sarcoma with aggressive clinical zehavior. Epithelioid MPNSTs (EMPNSTs) are distinct and rare variant of MPNST. They are described by the World Health Organization and they account for <5% of these tumors and have unclear clinical behavior. Due to the rarity of the EMPNST and the overlapping features and similarity with other tumors exhibiting epithelioid cytomorphology, EMPNSTs impose a diagnostic challenge. Therefore, it is critical to be aware of this entity and other mimickers to reach the correct diagnosis. Hence, this is a case of a 45-year-old lady who presented with persistent left ankle swelling for 2 years. A biopsy was performed, which confirmed the diagnosis of EMPNST. The aim of reporting this case of this rare tumor with this presentation was to help both pathologists and orthopedic oncology surgeons to understand the behavior of this tumor and help differentiate it from mimickers, and enrich interested readers’ knowledge with the presented literature review.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126985871","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 prevalence of flatfoot among Saudi population: A systematic review","authors":"Abdulmajeed S Almansouf, Meshari Alosaimi, Sarah Alsinan, Reem K AlManea, A. Almansoof, Ayman H Jawadi","doi":"10.25259/jmsr_83_2022","DOIUrl":"https://doi.org/10.25259/jmsr_83_2022","url":null,"abstract":"Flatfoot is a foot deformity characterized by a collapsed medial arch, plantar flexion and medial rotation of the talus, eversion of the calcaneus, and forefoot abduction. The flatfoot prevalence and causes are not well known despite its correlation with multiple factors. This study aimed to systematically review all studies that estimated the flatfoot prevalence among Saudi population and list the associated factors. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and Joanna Briggs Institute reviewer’s manual were followed to perform this systematic review. Data collection was through several databases using terms including prevalence, Saudi, and flatfoot with their synonyms. The inclusion criteria were both adults and children’s studies that were carried out in Saudi Arabia (Saudi and non-Saudi), with the exclusion of secondary flatfoot (due to traumatic or pathological causes) studies. A total of 361 published studies before July 2021 which involved 6190 participants were reviewed, and only six studies were included in the study. The participants’ age ranged from 4.2 ± 3.6 to 37 ± 11.26 years. There was male predominance, with body mass index (BMI), age, and gender being common factors studied in the articles. Flatfoot prevalence in Saudi Arabia differed according to multiple factors as reported by different authors. This review revealed a wide range of flatfoot prevalence among the Saudi population. Most of the included studies reported that BMI, age, gender, residence, family history of flatfoot, footwear type during childhood, hypermobility, functional mobility, balance, and flexibility of the whole body had a significant impact on flatfoot prevalence.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124937379","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":"Developmental dysplasia of the hip in an epidermolysis bullosa patient; how to deal with surgical difficulties: A case report","authors":"M. Almalki, Abdulrahman Almalki, A. K. Alanazi, Raed M. Almousa, A. Saeed, Shahid A. Abak","doi":"10.25259/jmsr_94_2022","DOIUrl":"https://doi.org/10.25259/jmsr_94_2022","url":null,"abstract":"Epidermolysis bullosa (EB) is defined as a separation of the dermoepidermal junctions resulting in an increased risk of infection and the formation of fibrous tissue. We are presenting a case of a 22-month-old girl with developmental dysplasia of the left hip and EB. The patient was operated on, with the left hip open reduction, acetabuloplasty and hip spica application. For a safe surgery on EB patients, pre-operative anesthesia assessment is necessary to ensure proper neck movement and examine the mouth and airway for the presence of blisters. Certain intraoperative measures should be taken, like gentle handling of the patient to reduce the events of blistering and scarring. Avoiding all adherent dressings, tapes, and stickers, using non-adhesive dressings and applying a good cotton padding for patients, are crucial steps in such cases to achieve good results. Surgery for this patient went smoothly without acute complications. In this report, we hope to provide helpful information on the surgical management of such patients.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128504238","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":"Cauda equina syndrome a rare early surgical complication in a pediatric patient with dysplastic high-grade lumbosacral spondylolisthesis: A case report","authors":"A. Alzakri","doi":"10.25259/jmsr_77_2022","DOIUrl":"https://doi.org/10.25259/jmsr_77_2022","url":null,"abstract":"Recent literature supports the surgical reduction of high-grade spondylolisthesis, particularly with an unbalanced pelvis and spine. Drop foot is the most common neurological complication reported in the literature. Scoliosis Research Society database reported only one patient (child) with cauda equina syndrome after surgery for dysplastic high-grade lumbosacral spondylolisthesis. The lack of longitudinal clinical follow-up of that patient limited their result. There is another report of 12 cauda equina syndrome cases after in situ arthrodesis for lumbosacral spondylolisthesis. The current report is the first case in the literature of cauda equina syndrome after partial reduction of dysplastic high-grade lumbosacral spondylolisthesis in a child. The aim was to raise awareness of the possibility of this post-operative complication happening in children and the possibility of avoiding it. A child who developed a cauda equina syndrome as an early neurological complication after surgery, which recovered completely 6 weeks after revision surgery, is reported. During the revision surgery, an L5-S1 transforaminal interbody fusion was performed by insertion of polyetheretherketone cage. Bilateral anal compound muscle action potential is seen after implant removal and sacral dome resection. Using somatosensory, motor evoked potential and continuous electromyogram for both rectal and external bladder sphincters in children with high-grade lumbosacral dysplastic spondylolisthesis undergoing surgical reduction are important to prevent a devastating neurological complication. Sacral dome resection and appropriate L5-S1 discectomy prevent stretching of the cauda equina over the posterosuperior border of the sacrum postoperatively.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133672811","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":"Causes of anterior cruciate ligament reconstruction failure: A meta-analysis","authors":"M. Elfekky, H. Mostafa, U. Shahi, Eslam Shalaby, Mohamed Alharoun, Mohamed Elghaish, E. Ahmed, Sari Aidek, Sharif M. Allaham, Ahmed H. Abouhelwo, Farah Noureddine, P. Theobald","doi":"10.25259/jmsr_72_2022","DOIUrl":"https://doi.org/10.25259/jmsr_72_2022","url":null,"abstract":"Anterior cruciate ligament (ACL) injury is one of the most common knee injuries among athletes and during sports activities for which ligament reconstruction is the optimal therapeutic procedure. Functional instability of the knee because of ACL injury is prone to relapse. Relapse is commonly reported following surgery due to various reasons. Knowing the possible causes are major key in the management of patients with an ACL tear after reconstruction. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Cochrane library, and Google Scholar were searched for eligible articles from January 1, 2010, to December 31, 2020. The articles were selected on inclusion and exclusion criteria mentioned in the study protocol. Following the screening of all the articles, the short-listed articles were subjected to full-text review by two independent reviewers. The overall search process gave us 1571 articles in total, from which 13 were selected for meta-analysis. A total of 891 patients were included in the 13 studies evaluated with respect to the factors responsible for failure of the primary ACL reconstructive procedure. Tunnel placement error and traumatic reinjury were the most reported associated factors responsible for primary ACL reconstruction failure. However, the overall summary estimate for the two major etiologies was not significant. The P-value for overall effect was 0.76, along with a Z score of 0.30 and an I2 test value of 91%, indicating high study variability. The odd’s ratio was calculated using the Mantel-Haenszel random effects model for ACL reconstruction failure, which was 0.88. Understanding the cause of primary ACL failure and developing strategies to minimize or avoid it completely will help in reducing the incidence of ACL reconstructive failure and improve patient outcomes.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129188673","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":"Bizarre parosteal osteochondromatous proliferation or Nora’s lesion affecting the extremities: A concise update","authors":"G. Dharmshaktu, Ishwar S. Dharmshaktu, N. Agarwal, T. Pangtey","doi":"10.25259/jmsr_66_2022","DOIUrl":"https://doi.org/10.25259/jmsr_66_2022","url":null,"abstract":"The bizarre parosteal osteochondromatous proliferation or Nora’s lesion is an unusual clinical entity that presents with localized swelling and pain. The characteristic radiological appearance includes a cluster of variably calcified lesions adjacent to a particular bone. However, it does not necessarily have direct continuity with its medullary region. The etiopathogenesis of this disorder is not yet fully understood. Various other lesions require careful exclusion and the use of advanced imaging modalities to supplement the diagnosis. The final diagnosis of the lesion, however, is based on the histopathological basis. However, these lesions are reported as sporadic reports or small series in the literature and are also discovered in areas other than the common locations in hands and feet. The recent research aims to throw more advanced knowledge into their causation, including genetic etiology. The symptomatic lesions may require excision for clinical relief, but recurrence is not uncommon. The future research, and preferably multi-center collaboration, is required for more insight into their comprehensive nature and clinical spectrum. A brief and crisp update of the articles published in the past 10 years describing bizarre parosteal oseochondromatous proliferation in the extremities is presented here for educational purposes for orthopedists and generalists alike.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"12 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132502477","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":"Outcomes of modified Sofield procedure in children with osteogenesis imperfecta in Oman","authors":"Asma A. Alrasbi, Mazin U. Khalil, Y. S. Al Mufargi","doi":"10.25259/jmsr_49_2022","DOIUrl":"https://doi.org/10.25259/jmsr_49_2022","url":null,"abstract":"\u0000\u0000Osteogenesis imperfecta (OI) is the most commonly inherited bone disease, with a wide variety of clinical features, most commonly recurrent fractures and bone deformities. The management is multidisciplinary, and surgical management usually aims to correct deformities or prevent further fractures.\u0000\u0000\u0000\u0000This study aimed to assess the outcomes of Omani OI patients who underwent a modified Sofield procedure. This was a descriptive retrospective study. All patients who underwent a modified Sofield procedure from 2013 to 2019 in one center in Oman were included in the study. Demographic data were collected, as well as surgical details. The level of mobility pre operatively and postoperatively was also included in the study. A survey to assess the quality of life was sent to all patients to assess the impact of the procedure on their lives.\u0000\u0000\u0000\u0000The procedure was done on a total of 37 bones, 66.7% of them were male. The complication rate was found to be 13.5%. The mean quality-of-life score was found to be 82.3 after the surgeries compared to 77.4 before the procedure (P = 0.097).\u0000\u0000\u0000\u0000We report a lower complication rate in our cohort of OI patients compared to what has been observed in other studies. The level of mobility improved in one-third of the patients, and in most of the remaining two-thirds, the level that was achieved was maintained. Interestingly, although patients reported reduced fractures postoperatively, they still feared getting new fractures, which restricted their daily activities.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123141857","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}