Journal of Orthopaedic Experience & Innovation最新文献

{"title":"The Dorr Classification for Spinopelvic Functional Safe Component Positioning in Total Hip Replacement: A Primer for All","authors":"Russell J. Bodner, T. Tezuka, N. Heckmann, Brian C. Chung, Shaheen Jadidi","doi":"10.60118/001c.39783","DOIUrl":"https://doi.org/10.60118/001c.39783","url":null,"abstract":"Instability following total hip arthroplasty remains the most common cause for revision surgery. Preoperative identification of abnormalities in pelvic tilt and postural mobility can lead to patient specific alterations in component position to insure against impingement and mechanical instability. The Dorr Classification for spinopelvic outliers and associated component positional recommendations were introduced in 2017 but remains underutilized as a planning aid. This review article presents a focused understanding of the spinopelvic mechanics, the outlier groupings, and the recommendations hip surgeons can apply in evaluating and treating patients with spinopelvic abnormalities requiring hip replacement surgery.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132849363","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":"Surgical Repair and Augmentation of a Midsubstance Chronic Achilles Tendon Rupture with a Novel Biocomposite Scaffold: A Case Report","authors":"M. Redler","doi":"10.60118/001c.38922","DOIUrl":"https://doi.org/10.60118/001c.38922","url":null,"abstract":"A 31-year-old male presented with a midsubstance chronic ‘cavitation’ tear of his right Achilles tendon, significant retraction of the tendon, and infiltration of dense fibrous tissue into the gap. A 23x30mm BioBrace implant was cut in half length-wise in order to create two strips that were sutured in place to augment the strength and promote healing of the repair. Six months after surgery, the patient demonstrated markedly improved function and MRI showed near complete fill-in of the defect with new tendon-like tissue that was integrated with the underlying native tendon and BioBrace®. Repair of a chronic tear of the Achilles tendon with associated cavitation within the body of the tendon can be a true surgical challenge. Augmentation of the repair with BioBrace to increase strength and potential for tissue healing at the time of surgical repair may accelerate recovery and return to function. It may also improve the ultimate quality of the healed tendon tissue.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133770595","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":"Assessing the Current State of Twitter Usage by Spine Surgeons in the United States","authors":"N. Lanzetta, Alexander A. Linton, A. Furman, W. Hsu","doi":"10.60118/001c.38111","DOIUrl":"https://doi.org/10.60118/001c.38111","url":null,"abstract":"Twitter, one of the most widely used social media platforms, allows users to post short statements, media, and weblinks available for viewing and interaction. This study sought to characterize the way in which spine surgeons leverage Twitter as a professional tool and additionally, the extent to which the platform may be currently under-utilized. A list of neurosurgical and orthopaedic spine surgeons was randomized and the first 500 individuals from each group were searched for on Twitter. For surgeons without accounts, it was recorded if they were mentioned in others’ tweets. Independent T-tests were performed for comparing quantitative variables between the two groups (tweets, number of followers, etc.) as well as comparing age with presence of account. Of all spine surgeons, 17% had accounts, 49% had no account but were mentioned, and 34% had no account but were not mentioned. There were no differences in twitter usage between genders, geographic region, nor neurosurgical and orthopaedic spine surgeons. The average age of those with and without an account was 51 and 55, respectively (p=.0004). While 22% of surgeons aged 50 and younger had accounts, only 14% of surgeons over 50 had accounts (p=.003). In addition to younger surgeons being more likely to have an account, this study found a large discordance between the proportion of spine surgeons who actively engage on Twitter and those that are discussed on the platform by others.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124426883","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":"Value Creation vs. Value Capture in Orthopedics","authors":"W. Kurtz","doi":"10.60118/001c.37965","DOIUrl":"https://doi.org/10.60118/001c.37965","url":null,"abstract":"This article will discuss commoditization, market forces, value capture, and value creation. Using these terms, we are going to evaluate orthopedic decisions and discuss how these decisions might affect the future of orthopedics and digital therapeutic (DTx) MSK companies.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122192678","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 innovative technique - Axial Loading and Compression Fixation (ALCF Technique) of scaphoid fracture by percutaneous K-wire","authors":"M. Rao, N. P. K., Mohammed Shelin, Ranju Raj","doi":"10.60118/001c.37882","DOIUrl":"https://doi.org/10.60118/001c.37882","url":null,"abstract":"Surgical fixation techniques used for the treatment of scaphoid fracture is still a topic of discussion among hand surgeons especially in terms of approach, implants and surgical techniques. We present an innovative technique of scaphoid fracture fixation by K-wire, which we accidentally encountered when the guide wire broke while doing a cannulated screw for the scaphoid. This technique of axial aligning, compression loading over a bent tip of K-wire across the fracture fragments of scaphoid is innovative. The study included 16 patients operated for Scaphoid fracture between January-2017 to January-2020 by ALCF Technique. the patient age ranged from 18 to 69 years,M:F12:4, 13 fractures on dominant hand,10 fracture presented within 2 weeks, 7 were trans-scaphoid displaced fractures sustained in RTA, 3 proximal pole fractures sustained after a fall, 6 were delayed presentation more than 3 months. The technique used to pass a K wire from dorsally in ante grade fashion to align the fracture fragments along the anatomical axis of the scaphoid then bend the K wire at the proximal end so as to hook the proximal fragment. The distal end of the K wire is then applied manual traction load with gentle rotation to achieve compression at the fracture ends with rotational alignment on the distal fragment. The distal fragment is anvil on the proximal fragment by a K-wire binder before distally binding to achieve compression & relative stable fixation. It is a simple, easy to reproduce, economic method to achieve reduction, compression using axial traction and union in all types of scaphoid fractures.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131078862","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":"Surgical Repair and Augmentation of a Large Type-2 Re-tear of the Rotator Cuff with a Novel Biocomposite Scaffold: A Case Report","authors":"Sean Mc Millan, Elizabeth Ford, S. Sigman","doi":"10.60118/001c.38244","DOIUrl":"https://doi.org/10.60118/001c.38244","url":null,"abstract":"A 55-year-old female presented with pain and weakness in her right shoulder after a new traumatic event occurred. She had undergone a rotator cuff repair to this right shoulder 4 months earlier with dermal strip augmentation secondary to poor tissue quality at the time of index surgery. For historical context, her contralateral shoulder had undergone a previous primary rotator cuff repair with xenograft, which failed, and was ultimately revised to a full thickness repair 2 years prior. A repeat MRI demonstrated a recurrent large type-II rotator cuff tear with grade 3 Goutallier fatty infiltration. A novel biocomposite scaffold (BioBrace™) was used to augment a revision double row bridge repair with margin convergence. MRI at three and eight months after surgery suggested functional remodeling and growth of new tissue. At 10 months, arthroscopy was performed to evaluate bicipital pain and arthroscopic images demonstrated full incorporation of the biocomposite scaffold within the underlying native tendon and an intact repair. The source of bicipital pain was unrelated to the implant and a biceps tenodesis was performed to resolve the pain. Clinical outcomes were assessed preoperatively and at 1 year postoperatively using the Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) Shoulder Score, and Single Assessment Numeric Evaluation (SANE). The use of a novel biocomposite scaffold augmentation for revision rotator cuff repair demonstrated evidence of healing, incorporation, and remodeling at 10 months post-procedure. VAS, ASES, and SANE pre- and post-operative outcome scores were analyzed at 1 year demonstrating significant improvement across all metrics. This case report suggests the use of a novel biocomposite rotator cuff augment can provide a via option for revision rotator cuff repair.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123249540","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":"Number of Stairs at Home Does Not Influence Discharge Disposition following Elective Total Hip Arthroplasty","authors":"T. Murtaugh, M. Held, Matthew M. Levitsky, R. Iorio, Alexander L. Neuwirth, J. Geller, H. Cooper, R. Shah","doi":"10.60118/001c.37880","DOIUrl":"https://doi.org/10.60118/001c.37880","url":null,"abstract":"Pragmatic challenges of the patient’s home environment, specifically the number of stairs (NOS) required to enter or navigate a patient’s home may influence discharge destination (DD) and length of stay (LOS) following primary Total Hip Arthroplasty (THA). This study investigates whether the NOS at home predicts discharge to a post-acute-care-facility (PACF) following THA. 548 consecutive THA patients at a single urban arthroplasty center between 2011-2014 were reviewed. Patient factors including age, sex, BMI, length of stay, operative time, Anesthesia Score Assessment (ASA), the Risk-Assessment-and-Prediction-Tool (RAPT) and NOS stairs were analyzed. Logistic regression was performed to identify predictors for disposition to PACF. Groups were cohorted by number of stairs, and incidence of PACF discharge was determined. 238 (43.4%) patients were discharged to PACF. The NOS at home had no impact on discharge to PACF (OR 1.02, 95% CI .993-1.04, p=0.209). Older age (OR 1.09, 95% 1.07-1.10, p<0.0001), LOS (OR 1.23, 95% 1.08-1.39, p=0.001), higher ASA (OR 1.74, 95% 1.19-2.53, p=0.004), and lower RAPT score (OR 0.0.865, 95% 0.781-0.958, p=0.005) were significant predictors for disposition to PACF (p<0.005). Female sex was protective in discharge to PACF (OR 0.391, 95% 0.260-0.587, p<0.0001). The incidence of PACF discharge was similar between groups of unavoidable stairs at home. The NOS at home did not influence discharge destination following THA. This retrospective study helps discharge planning and in setting expectations for patients undergoing THA by supporting a home discharge in the setting of unavoidable stairs.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"169 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126745741","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 Effects of the COVID-19 Pandemic on Orthopaedic Surgery Residency Match Results, a Cohort Study","authors":"Andrew A Furman, Alexander A. Linton, N. Lanzetta, W. Hsu","doi":"10.60118/001c.36317","DOIUrl":"https://doi.org/10.60118/001c.36317","url":null,"abstract":"The COVID-19 pandemic disrupted the 2021 Orthopaedic residency recruitment process by eliminating visiting rotations and in-person interviews. In the fields of Plastic Surgery and Urology, this led to a significant increase in the rate at which residency applicants matched into residency at the same institution (“home match”) as their medical school. This study sought to investigate the effects the pandemic had on the outcomes of the 2021 Orthopaedic Surgery Match compared to the preceding four cycles 2017-2020. A list of all Orthopaedic Surgery residency programs with an affiliated medical school was obtained using ORINTM and Doximity. Program websites and official social media accounts were used to gather resident information including class year, medical school, and medical school state. Outcomes of interest were home matches and matches within the same region or state as one’s medical school. The rate of home matches increased by 41% from 22% in 2017-2020 to 31% in 2021 (p<0.001). This increased rate was consistent across medical school regions and sub-regions, as well as across program sizes and reputation rankings. Southern programs had a higher rate of home matches than all other regions both at baseline in 2017-2020 28% v. 20% (p<0.001) and in 2021 36% v. 28% (p<0.001). In 2021, the first residency match affected by the COVID-19 pandemic, the proportion of home matches increased compared to the prior four cycles. This may be a result of the inability of prospective residents to visit programs in-person during an away rotation or interview, resulting in programs preferring individuals they already knew via their affiliated medical school. Many pandemic-related changes such as virtual rotations and virtual interviews might stay for the long term; it will be interesting to see how these impact Orthopaedic Residency recruitment and resulting Match characteristics in subsequent cycles.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128559715","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":"So You Think You Are Not Losing Money in Your Practice","authors":"Nicola Hawkinson","doi":"10.60118/001c.36641","DOIUrl":"https://doi.org/10.60118/001c.36641","url":null,"abstract":"This is a summary article for physicans, provider, and staff to summarize basic pitfalls in revenue cycle management. Its intent is to increase utilization of current systems such as EMR while increasing efficieny through the creation of standardized operating procedures.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127284335","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":"Surgery avoidance rates among total knee replacement candidates following a non-invasive biomechanical intervention: A retrospective cohort study","authors":"Andrew Greene, Christopher Miles","doi":"10.60118/001c.37664","DOIUrl":"https://doi.org/10.60118/001c.37664","url":null,"abstract":"Nearly twenty million people are affected by osteoarthritis (OA) across the UK. For end-stage knee OA, total knee replacement (TKR) is considered as the standard of care, but this major surgery carries high costs, long waiting lists, and risk for further revision surgeries. Health systems are therefore looking for effective alternatives to treat these cohorts, significantly delaying, and potentially avoiding joint replacement surgery altogether. The purpose of this study was to examine the 2-year surgery avoidance rate amongst TKR candidates that received a non-invasive biomechanical intervention. A retrospective clinical audit was conducted on 365 NHS patients with end-stage knee OA patients eligible for TKR. Each patient was individually fitted with a non-invasive, shoe-like, biomechanical device, that alters the foot center of pressure, minimizes reported symptoms, and promotes neuromuscular control training using convex pods under the sole. Patients used the device for short periods during activities of daily living and were followed for two years. The primary outcome was surgery status after 2 years. Secondary outcomes were evaluated using the generalized linear mixed-models procedure and included changes in pain, function (WOMAC and Oxford Knee Score (OKS), and spatiotemporal gait measured at 3, 6, 12, and 24 months from baseline. Of the 365 candidates for TKR, 305 (84%) avoided surgery at 2 years. Patients displayed significant clinical improvements over time. Six months after starting treatment, average pain decreased by 42%, average function improved by 39%, and average OKS increased by 7.6 points. These continued to improve over the 2 years. All spatial-temporal gait measures improved over time (p<0.001). The current results suggest that a non-invasive biomechanical treatment may help end-stage knee OA patients delay knee replacement surgery for at least 2 years or avoid it altogether. This treatment may provide an effective non-surgical alternative for managing these patients in the community, alleviating pain, and improving gait and function.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129510844","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}