Journal of Orthopaedic Experience & Innovation最新文献

{"title":"\"In My Experience…Implant Arthroplasty for the Base of the Thumb is Underutilized","authors":"Alejandro Badia, MD","doi":"10.60118/001c.91554","DOIUrl":"https://doi.org/10.60118/001c.91554","url":null,"abstract":"I would argue that we try to preserve the hapless trapezium.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"59 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139530656","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":"In my Experience: Obtaining Efficiency in Orthopaedic and Spinal Surgery","authors":"Alan Daniels, MD","doi":"10.60118/001c.91631","DOIUrl":"https://doi.org/10.60118/001c.91631","url":null,"abstract":"The author shares his experience in obtaining peak OR efficiency.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"88 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139440497","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":"BENEFICIAL EFFECTS OF A NOVEL INTRAOPERATIVE SURGICAL IRRIGANT ON POST-OPERATIVE KNEE SWELLING AND LIMB FUNCTION IN PRIMARY TOTAL KNEE ARTHROPLASTY","authors":"Louis Battista, A. Wickline","doi":"10.60118/001c.89994","DOIUrl":"https://doi.org/10.60118/001c.89994","url":null,"abstract":"Total knee arthroplasty (TKA) is one of the most common elective orthopedic procedures performed in inpatient and outpatient settings. Swelling, stiffness and pain are common complications that occur after TKA resulting in functional impairment of the joint. Reducing post-operative (PO) inflammation, which consequently helps mitigate edema, swelling and pain, is critical to functional recovery after surgery. This pilot study was designed to evaluate the effects of the intraoperative application of a novel surgical irrigant called XPERIENCE® Advanced Surgical Irrigation (XP), on post TKA lower extremity swelling, joint function, and pain, as part of an all-encompassing swelling reduction regimen. Intraoperative povidone-iodine (PI) application was used as the control. Swelling; an indicator of inflammation, was measured by single frequency-bioimpedance assessment (SF-BIA). Range of motion (ROM) and reliance on ambulatory assistive devices (AAD) were evaluated as indicators of functional recovery. Narcotic consumption for pain management and numerical pain scoring were evaluated as surrogate, limited indicators of quality of life. These parameters were assessed over a period of 6 weeks post index TKA and compared between the control cohort treated intraoperatively with PI and the intervention cohort treated intraoperatively with XP. Intraoperative irrigation with XP resulted in statistically significant improvements in PO swelling at days 7 (p<0.05) and 14 (p<0.01) post index surgery compared to the PI treated control cohort. Statistically significant improvements in ROM at day 7 (p=0.043) and AAD usage at day 21 (p=0.049) were noted in the XP cohort compared to the PI cohort. The XP cohort exhibited a quicker “weaning off opioids” timeline evidenced by the PI cohort reaching half of the maximum percentage of subjects using opioids 8 days later than the XP cohort. There was no statistically significant difference noted in numerical pain scores between the two cohorts. This pilot study signifies the utility of XP as a multifunctional, intraoperative surgical irrigation solution which has demonstrable benefits of reducing PO swelling with the potential to impact functional recovery after TKA.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"42 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138950916","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 Effect Of Automated Component Impaction On The Surgeon’s Ergonomics, Fatigue And Stress Levels In Total Hip Arthroplasty","authors":"F. Vandeputte, Christophe Hausswirth, Alexandre Coste, Cyril Schmit, Olivier Vanderhaeghen, Aline Vandeputte, Jeroen Dille, Frederik Matthys, K. Corten","doi":"10.60118/001c.87622","DOIUrl":"https://doi.org/10.60118/001c.87622","url":null,"abstract":"Total Hip Arthroplasty (THA) surgery is physically and cognitively challenging. Sub-optimal posture during component impaction may influence surgeon’s ergonomics and fatigue. Thirty THA procedures were executed for 3 days. Only during the first day, manual impaction (MI) was performed. Postural risk was evaluated with Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) score. Three cognitive tasks (Simon, pattern comparison and pursuit rotor test) and five physical tests (isometric wall-sit, plank-to-fatigue, handgrip, supra-postural task, and shoulder endurance) assessed surgeon’s psycho-physiological load in the morning, midday, and afternoon. Surgeon’s cortisol concentration and sound level of the broaching process was also recorded. RULA and REBA scores were 1.7 to 3 times lower with automated impaction (AI). Physical exhaustion was lower with AI: isometric wall-sit test (10.6% vs. 22.9%), plank-to-fatigue (2.2% vs. 43.8%), supra-postural task (-0.7% vs. -7.7%), handgrip force production (dominant hand -6.7% vs. -12.7%; contralateral +4.7% vs. +7.7%), and in shoulder endurance (-15s vs. -56s). After AI, the cognitive performance showed faster response times and lower error rates for all cognitive tests compared to MI. The salivary cortisol level decreased during the AI-days by 51% in comparison to a 38% increase following the MI-day. Mean broaching time with AI was 7’3’’ compared to 6’20’’ with MI. The mean sound level with the AI-device was 64.3 dBA compared to 68.2 dBA with manual impaction. Automated THA component impaction improved the surgeon’s ergonomics which resulted in reduced hormonal stress levels and lower physical and cognitive exhaustion.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"21 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138965720","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":"Comparison of post-operative outcomes in arthroscopic repair of traumatic and atraumatic rotator cuff tears","authors":"Erryk S. Katayama, John S. Barnett, Akshar V. Patel, Andrew Stevens, Grant Jones, Greg L. Cvetanovich, Julie Y. Bishop, Ryan C. Rauck","doi":"10.60118/001c.87427","DOIUrl":"https://doi.org/10.60118/001c.87427","url":null,"abstract":"Traumatic or atraumatic etiologies are associated with different pathophysiology, and thus, may lead to different post-operative outcomes after arthroscopic rotator cuff repair (RCR). Institutional records were used to identify patients who underwent arthroscopic RCR in 2019-2020. Retrospective review of medical records was performed to determine mechanism of injury, pre- and post-operative range of motion and strength measures. Among 100 RCR patients, 53 sustained a traumatic RC injury. Patients with traumatic rotator cuff tears (TR) presented to the clinic after onset of pain sooner than patients with atraumatic tears (aTR) (TR: 166±193 vs aTR: 595±679 days; P<0.001). Pre-operative measurements were worse among traumatic patients than atraumatic patients: forward elevation (TR: 130º±48º vs aTR: 152º±25º; P=0.036), external rotation (TR: 49º±17º vs aTR: 55º±16º; P=0.076), internal rotation (TR: L4 vs aTR: L3; P=0.033), forward elevation strength (TR: 4/5 vs aTR: 5/5; P=0.035), external rotation strength (TR: 5/5 vs aTR: 5/5; P=0.065), and internal rotation strength (TR: 5/5 vs aTR: 5/5; P=0.150). However, there was no significant difference in post-operative measurements between cohorts: forward elevation (TR: 158º±19º vs aTR: 153º±28º; P=0.433), external rotation (TR: 53º±16º vs aTR: 50º±15º, P=0.332), internal rotation (TR: L2 vs aTR: L2; P=0.703), forward elevation strength (TR: 5/5 vs aTR: 5/5; P=0.926), external rotation strength (TR: 5/5 vs aTR: 5/5; P=0.920), and internal rotation strength (TR: 5/5 vs aTR: 5/5; P=0.519). Traumatic RCR patients had significantly worse functional measurements during pre-operative exam than atraumatic RCR patients, but there was no significant difference in post-operative outcomes.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"2012 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139001927","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":"In My Experience…Navigation and Robotics in Total Joint Arthroplasty","authors":"Stefan Kreuzer","doi":"10.60118/001c.90848","DOIUrl":"https://doi.org/10.60118/001c.90848","url":null,"abstract":"I present my experience with navigation and robotics in total hip arthroplasty.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"17 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138980812","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":"Registration of Knee Articulating Surface Utilizing a Portable Handheld Laser Scanner: A Cadaveric Study","authors":"Morteza Meftah, Akram A. Habibi, Gordon Goodchild","doi":"10.60118/001c.87400","DOIUrl":"https://doi.org/10.60118/001c.87400","url":null,"abstract":"Image-based navigation systems for total knee arthroplasty (TKA) require intra-operative registration of anatomical landmarks to the pre-operative images. Unfortunately, this process is long, tedious, and involves multiple steps with an optical tracking probe to bony identify landmarks. We hypothesized that use of a handheld laser scanner can achieve an accurate and fast registration of the cartilage surface. Magnetic resonance imaging (MRI) scans were obtained for six cadavers and images were segmented to produce 3-dimenstional (3D) models of the articulating surface of the tibia and femur using commercial software (MIMICS, Materialise). A portable, hand-held laser scanner (E4D Technologies) was used to generate surface models of the same tibia and femur. An iterative closest point (ICP) algorithm was then used to align the handheld scans to the MRI scans. The accuracy of the registration fit was determined by the Root Mean Square (RMS) difference between the two surfaces. There were a total of 72 scans. All 6 cadaveric knees were successfully registered to their MRI images with <1mm mean RMS error. The mean time for successful registration was 54 +/- 24 seconds. The inter- and intra-observer reliability were 0.92 and 0.87 respectively. A handheld laser scanner can produce fast and accurate registration of the tibia and femur during a TKA. Registration was accurate within less than 1mm with multiple operators of different training. Further studies should assess in vivo accuracy of scanned bone topography and implant positioning compared to other technologies.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"87 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586825","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 COVID-19 Pandemic Shut Down Did Not Adversely Affect Outcomes of Arthroscopic Rotator Cuff Repair","authors":"Akshar V. Patel, Andrew J. Stevens, Amogh I. Iyer, Noah Takacs, Vikas Munjal, Greg L. Cvetanovich, Grant Jones, Julie Y. Bishop, Ryan C. Rauck","doi":"10.60118/001c.84518","DOIUrl":"https://doi.org/10.60118/001c.84518","url":null,"abstract":"We investigated whether patients who received an arthroscopic rotator cuff repair (RCR) in January-March 2020 had a difference in outcomes compared to patients who received it the previous year. Institutional records were queried to identify patients who underwent an arthroscopic RCR between 1/1/19 to 3/17/19 and 1/1/20 to 3/17/20. The 2020 patients were contacted by phone in October 2022 for follow-up. Patients were divided into cohorts based on year of surgery. Demographic information, range of motion (ROM), and physical therapy were analyzed using inferential statistics. This study identified 50 and 51 patients in 2020 and 2019, who had a minimum of 1 year follow-up. Rotator cuff repairs done in 2019 had improvements in forward elevation (FE) (135º to 161º; p<0.01) and internal rotation (IR) (L4 to L1; p-value<0.01) whereas those done in 2020 did not improve their forward elevation (146º to 151º; p=0.42) or internal rotation (L3 to L2; p=0.29). Patients in 2019 completed more physical therapy sessions (2019: 25.0; 2020: 16.7; p<0.01). Patients in 2020 also experienced a significant delay from date of surgery to date of first physical therapy session (2019: 28.5 ± 11.9 days; 2020: 35.0 ± 16.5 days; p-value=0.03). Of the 2020 patients, 8% (4/50) patients did not initiate physical therapy after RCR, 16% (8/50) reported a delay in physical therapy while 44% (22/50) reported that the COVID-19 pandemic affected their recovery following RCR. At final follow up, patients reported a SANE score of 78.2 ± 12.1 on the affected shoulder, 91.3 ± 10.4 on the unaffected shoulder, a mean VAS pain score of 2.3 ± 1.8. Patients who underwent arthroscopic RCR in early 2020 had a longer delay to starting PT, did less PT overall, but still had comparable range of motion and strength at final follow-up.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"80 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138606002","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 Basic and Clinical Science of Wounds in the Austere Environment","authors":"Michael J. Langworthy, Kreszentia Hankins, Travis Storey","doi":"10.60118/001c.75162","DOIUrl":"https://doi.org/10.60118/001c.75162","url":null,"abstract":"Surgery in developing countries is challenging on many levels. U.S. organizations sponsor approximately 200,000 surgeries performed abroad every year (Miclau et al. 2021a). These altruistic surgeons and physicians– despite their good intentions—may not be equipped with the specific surgical and communication skills necessary for a successful surgery in an austere environment. Surgical skill set, nutrition, facilities, and sociology all play a role in successful surgical outcomes. A thorough understanding of the basic science and clinical science of wounds in the austere environment is imperative for physicians and surgeons providing care in developing nations. Basic science research, in regards to nutrition, parasites; skin, dermal, and bone physiology; as well as microbiome interaction with these structures, can help optimize surgical outcome and reduce adverse events such as infection. Clinical science research and the development of algorithms for surgery in the austere environment can also help improve surgical outcomes and mitigate these adverse events.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129324112","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":"Patient-Specific Pain Model for Identifying Patients at Risk Following TKA","authors":"Ricardo Antunes, P. Jacob, Bob Marchand, Elaine Justice, Kelly B. Taylor, E. Hampp, Matthias Verstraete","doi":"10.60118/001c.74712","DOIUrl":"https://doi.org/10.60118/001c.74712","url":null,"abstract":"Remote patient monitoring provides clinicians with visibility to patients’ recovery beyond what can be achieved with in clinic visits alone. Patients’ pain management is an important aspect of recovery following total knee arthroplasty (TKA), and one that is increasingly tracked remotely through digital applications. Its timely assessment may provide clinicians with a way to detect postoperative complications. We proposed a patient-specific model that predicts the probability of remotely collected pain scores for TKA patients along a 90-day recovery period, aimed at detecting patients with anomalous pain scores, and enable appropriate interventions by clinicians in a timely manner. We fitted and validated the model with a set of 4,782 remotely collected pain scores for 84 patients that underwent unilateral primary TKA.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124512037","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}