Hss Journal最新文献

{"title":"Comparison and Validation of Methods for Restoring Neck Length in Hip Arthroplasty That Can Be Applied for Femoral Neck Fracture.","authors":"Alex J Anatone, Rafa Rahman, Tyler J Uppstrom, Jason L Blevins, Peter K Sculco, William M Ricci","doi":"10.1177/15563316241306109","DOIUrl":"10.1177/15563316241306109","url":null,"abstract":"<p><p><i>Background:</i> Restoring leg length during total hip arthroplasty (THA) for femoral neck fracture is challenging due to the lack of an intact femoral neck on the fractured side. Thus, templating methods typically use size of the intact contralateral hip to estimate length. Common reference points include the distance from the lesser trochanter to the center of the femoral head (LTC) and femoral head diameter (FHD). <i>Objectives</i>: We sought to (1) investigate the LTC:FHD ratio as a preoperative templating method and (2) compare this method with calibrated LTC measurements. <i>Methods</i>: We performed a retrospective review of patients undergoing primary THA between 2021 and 2022 with recorded intraoperative measurements of LTC and FHD at a single academic orthopedic specialty hospital. Preoperative hip X-rays were used to determine the \"predicted LTC length\" with 2 separate methods: the LTC:FHD ratio yielding the \"Ratio Predicted LTC\" and the calibrated measurements method yielding the \"Calibrated Predicted LTC.\" These measurements were compared with intraoperative measurements of the LTC length to determine accuracy. <i>Results</i>: Sixty-two hips in 59 patients were studied. The ratio predicted LTC and contralateral ratio predicted LTC length showed no significant difference from the intraoperative LTC length with a strong correlation between the 2 measurements (correlation coefficient = 0.77 and 0.80). The calibrated predicted LTC lengths were significantly different from the intraoperative LTC lengths (mean difference, 3.0 mm; 95% confidence interval [CI] = [2.2, 3.8]). <i>Conclusions</i>: This retrospective review suggests the LTC:FHD ratio multiplied by intraoperative FHD may be an accurate method for restoring anatomic femoral head height in THA (LTC_a = [LTC_r/FHD_r] × FHD_a). This method may be useful in hip fracture populations with distorted proximal femoral anatomy.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241306109"},"PeriodicalIF":1.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Lupus Erythematosus, Thrombotic Microangiopathy, and Purtscher-Like Retinopathy in a Patient Who Experienced Resolution With Eculizumab Treatment: A Case Report.","authors":"Mehmet A Baltacı, Ayşe T Temiz Gençoğlu, Mehmet B Karakulak, Yasemin Ö Erol, Ayşe B Keleşoğlu Dinçer","doi":"10.1177/15563316241300474","DOIUrl":"10.1177/15563316241300474","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241300474"},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and In Vivo Testing of an Anatomic 3D-Printed Peripheral Nerve Conduit in a Rat Sciatic Nerve Model.","authors":"Peter S Chang, Tony Y Lee, David Kneiber, Christopher J Dy, Patrick M Ward, Greg Kazarian, John Apostolakos, David M Brogan","doi":"10.1177/15563316241299368","DOIUrl":"10.1177/15563316241299368","url":null,"abstract":"<p><p><i>Background:</i> Three-dimensional (3D) printer technology has seen a surge in use in medicine, particularly in orthopedics. A recent area of research is its use in peripheral nerve repair, which often requires a graft or conduit to bridge segmental defects. Currently, nerve gaps are bridged using autografts, allografts, or synthetic conduits. <i>Purpose</i>: We sought to improve upon the current design of simple hollow, cylindrical conduits that often result in poor nerve regeneration. Previous attempts were made at reducing axonal dispersion with the use of multichanneled conduits. To our knowledge, none has attempted to mimic and test the anatomical topography of the nerve. <i>Methods</i>: Using serial histology sections, 3D reconstruction software, and computer-aided design, a scaffold was created based on the fascicular topography of a rat sciatic nerve. A 3D printer produced both cylindrical conduits and topography-based scaffolds. These were implanted in 12 Lewis rats: 6 rats with the topographical scaffold and 6 rats with the cylindrical conduit. Each rodent's uninjured contralateral limb was used as a control for comparison of functional and histologic outcomes. Walking track analysis was performed, and the Sciatic Functional Index (SFI) was calculated with the Image J software. After 6 weeks, rats were sacrificed and analyses performed on the regenerated nerve tissue. Primary outcomes measured included nerve (fiber) density, nerve fiber width, total number of nerve fibers, G-ratio (ratio of axon width to total fiber width), and percent debris. Secondary outcomes measured included electrophysiology studies of electromyography (EMG) latency and EMG amplitude and isometric force output by the gastrocnemius and tibialis anterior. <i>Results</i>: There were no differences observed between the cylindrical conduit and topographical scaffold in terms of histological outcomes, muscle force, EMG, or SFI. <i>Conclusion</i>: This study of regeneration of the sciatic nerve in a rat model suggests the feasibility of 3D-printed topographical scaffolds. More research is required to quantify the functional outcomes of this technology for peripheral nerve regeneration.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241299368"},"PeriodicalIF":1.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commitment to Quality in Musculoskeletal Research Reporting.","authors":"Charles N Cornell","doi":"10.1177/15563316241290832","DOIUrl":"10.1177/15563316241290832","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":"20 4","pages":"462-463"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guillain-Barré Syndrome Following Lumbar Spine Surgery: A Case Report Highlighting Early Magnetic Resonance Neurography Findings.","authors":"Franziska C S Altorfer, Ashley Weng, Darryl B Sneag, Pantelis P Pavlakis, Darren R Lebl","doi":"10.1177/15563316241294049","DOIUrl":"10.1177/15563316241294049","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241294049"},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic and Clinical Outcomes of First Tarsometatarsal Joint Arthrodesis With a Biplanar Locking Plate System Versus the Modified Lapidus Technique With Crossed-Screw Fixation: A Retrospective Multicenter Comparison.","authors":"Amanda N Fletcher, Lindsey G Droz, Robert Fuller, Lavan Rajan, Jiaqi Zhu, Mark E Easley, James A Nunley, Elizabeth A Cody","doi":"10.1177/15563316241288514","DOIUrl":"10.1177/15563316241288514","url":null,"abstract":"<p><p><i>Background</i>: Hallux valgus (HV) is recognized as a triplanar deformity. A biplanar locking plate (BLP) system corrects this deformity through first tarsometatarsal joint (TMTJ) arthrodesis, with specialized reduction tools and cutting guides. Yet the optimal surgical technique and fixation construct for first TMTJ arthrodesis remains controversial. <i>Purpose</i>: We sought to compare the BLP system with a modified Lapidus (ML) technique with crossed-screw fixation in terms of radiographic outcomes, complications, and reoperations. <i>Methods</i>: In this retrospective multicenter study, we identified a series of consecutive patients who underwent first TMTJ arthrodesis for HV with either the ML procedure at institution A or the BLP system at institution B. Patients 18 years of age with a minimum of 6 months of postoperative radiographs were included. There were 130 patients, 65 in each group, including 121 women (93.8%) with a median age of 58 years and mean radiographic follow-up of 7.1 months. Data included preoperative and postoperative HV angle (HVA), intermetatarsal angle (IMA), and tibial sesamoid position (TSP), plus complications and reoperations. Statistical testing included Mann-Whitney <i>U</i>, Wilcoxon signed rank, Fisher exact, McNemar, and multivariable regression. <i>Results</i>: After adjusting for confounding variables, the BLP system was associated with significantly greater improvements in postoperative IMA and HVA but not TSP. There were no significant differences in rates of complications (ML: 18.4%; BLP: 9.2%) or reoperations (ML: 4.6%; BLP: 7.7%). <i>Conclusion</i>: This retrospective multicenter review found that the BLP system was associated with greater improvement in radiographic HV parameters compared with the ML procedure using crossed-screw fixation. Clinical significance is unclear as complication and reoperation rates were similar between groups. Further study in this regard is warranted.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241288514"},"PeriodicalIF":1.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound as a Complementary Tool to Electrodiagnostics in the Evaluation of Compressive Neuropathy of the Common Fibular Nerve.","authors":"Stephen J DeMartini, Amanda M Faust, Nathan P Olafsen, David M Brogan, Christopher J Dy","doi":"10.1177/15563316241285898","DOIUrl":"10.1177/15563316241285898","url":null,"abstract":"<p><strong>Background: </strong>Compressive neuropathy of the common fibular nerve (CFN) is increasingly recognized as an etiology for foot drop and falls. Electrodiagnostic (EDX) studies are widely used to evaluate this condition, but such tests are invasive and costly. As with carpal and cubital tunnel syndromes, there may be patients with characteristic symptoms of CFN compressive neuropathy but normal EDX studies in which ultrasound may aid in decision-making.</p><p><strong>Purpose: </strong>We sought to examine the association between ultrasound and nerve conduction studies (NCS) and electromyography (EMG) in the diagnosis of compressive neuropathy of the CFN.</p><p><strong>Methods: </strong>We performed a retrospective review identifying 104 patients who underwent CFN decompression from January 1, 2015, to June 30, 2023. Patients were included if they had both ultrasound and NCS/EMG prior to CFN decompression for compressive neuropathy and if they were older than 18 years at time of surgery. Patients were excluded if they had entrapment secondary to trauma, iatrogenic injury, or if they had had superficial fibular decompression alone without CFN decompression. After applying exclusion criteria, 17 patients remained in the cohort.</p><p><strong>Results: </strong>Mean ultrasound cross-sectional area and side-to-side (STS) ratios were significantly higher in those with abnormal compound muscle action potential (CMAP) amplitudes versus those with normal CMAP amplitudes. The probability of having an abnormal CMAP amplitude when STS ratio was abnormal was 18 times greater compared with those with normal STS ratio. With each unit increase in STS ratio, CMAP amplitude was reduced by 2.79 mV.</p><p><strong>Conclusions: </strong>This retrospective review found that ultrasound may provide complementary diagnostic information to EMG/NCS for compressive neuropathy of the CFN. Further study is needed to examine the relationship between ultrasound findings for CFN compressive neuropathy and results of surgical decompression.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241285898"},"PeriodicalIF":1.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital Network Centralization of Primary Total Joint Arthroplasty Is Associated With Reduced Early Complication Rates But Not Reduced Readmission or Reoperation Rates: A Retrospective Database Study.","authors":"Benjamin F Ricciardi, Gabriel Ramirez, Derek T Schloemann, Thomas G Myers, Caroline P Thirukumaran","doi":"10.1177/15563316241288513","DOIUrl":"10.1177/15563316241288513","url":null,"abstract":"<p><strong>Background: </strong>Hospital networks centralize primary total joint arthroplasty (TJA) within their existing systems to develop specialized service lines with higher surgical volumes to reduce adverse events. It is not known what role hospital network centralization has had on primary TJA outcomes.</p><p><strong>Purpose: </strong>We sought to determine whether the degree of hospital network centralization for primary TJA is associated with (1) 90-day postoperative complication rates, (2) 90-day hospital readmission rates, or (3) 1-year revision rates.</p><p><strong>Methods: </strong>We conducted a retrospective database study of Medicare Part A beneficiaries who underwent inpatient primary TJA for osteoarthritis in 2016 and 2017 (<i>n</i> = 523,142 patients); individual hospital-level characteristics and hospital networks were also identified (<i>n</i> = 360 unique networks, <i>n</i> = 3339 hospitals). Patients having surgery at a hospital that was not a member of a health care network were excluded (<i>n</i> = 163,998 patients) because we wanted to examine only the role of network structures on outcomes; this resulted in a cohort of 359,144 patients. Hospital network centralization, which was defined as the percentage of total network cases performed at the highest volume hospital and categorized into quartiles (eg, lowest 25% of networks by concentration, 26%-50% of networks by concentration, etc). Primary outcomes included postoperative 90-day complications, 90-day readmissions, and 1-year revisions. Multivariable logistic and linear regressions evaluated associations of hospital network centralization with outcomes and controlled for relevant patient-level and hospital-level covariates, including hospital network volumes.</p><p><strong>Results: </strong>Odds of 90-day complications were lower in the most centralized hospital networks than in least centralized networks (odds ratio [OR] = 0.85; 95% confidence interval [CI]: 0.75, 0.95). Degree of centralization was not associated with readmissions or 1-year revision rates. Non-modifiable patient and individual hospital characteristics appeared to have a greater association with complications, readmissions, and early revision rates than hospital network centralization or volume.</p><p><strong>Conclusion: </strong>This retrospective database study found that increased centralization of primary TJA within a hospital network was associated with lower 90-day complication rates but not with 90-day readmission or 1-year revision rates. This suggests that structural changes within hospital networks may be beneficial to reduce early complications in this patient population. In addition, our findings suggest that risk adjustment in assessing non-modifiable patient and hospital risk factors may be important when assessing TJA outcomes.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241288513"},"PeriodicalIF":1.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Navigation in Single-Level Transforaminal Lumbar Interbody Fusion Reduces Surgeons' Mental Workload Compared With Fluoroscopic and Computed Tomographic Techniques: A Nonrandomized Prospective Controlled Trial.","authors":"Kyle W Morse, Tejas Subramanian, Eric Zhao, Omri Maayan, Yousi Oquendo, Catherine Himo Gang, James Dowdell, Sheeraz Qureshi, Sravisht Iyer","doi":"10.1177/15563316241281064","DOIUrl":"10.1177/15563316241281064","url":null,"abstract":"<p><strong>Background: </strong>Pedicle screw placement during spine fusion is physically and mentally demanding for surgeons. Consequently, spine surgeons can become fatigued, which has implications for both patient safety and surgeon well-being.</p><p><strong>Purpose: </strong>We sought to assess the cognitive workload of surgeons placing pedicle screws using robotic-assisted navigation compared with fluoroscopic and computed tomography (CT)-assisted placement.</p><p><strong>Methods: </strong>We performed a nonrandomized prospective controlled trial to compare the cognitive workload of 3 surgeons performing single-level minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) using robotic, CT, or fluoroscopic navigation on 25 patients (15 in the robotic navigation group and 10 in the nonrobotic group). Immediately after each procedure, surgeons submitted the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), which has 6 subscales: mental demands, physical demands, temporal demands, performance, effort, and frustration. Four tasks associated with pedicle screw placement were assessed independently: (1) screw planning, (2) calibrating robot/obtaining imaging/registration, (3) pedicle cannulation, and (4) screw placement. Patient demographics and surgical characteristics were obtained and reviewed.</p><p><strong>Results: </strong>Surgeons' self-reported cognitive workload was significantly reduced when using robotic-assisted navigation versus CT/fluoroscopic navigation. Workload was reduced for screw planning, pedicle cannulation, and screw placement. In addition, there were significant reductions in each subdomain for these 3 tasks, encompassing mental demand, physical demand, temporal demand, effort, and frustration with improved task performance.</p><p><strong>Conclusions: </strong>This study found significant reductions in mental workload with improved perceived performance for robotic-assisted pedicle screw placement compared with fluoroscopic and CT-navigation techniques. Lowering the cognitive burden associated with screw placement may allow surgeons to address the remainder of the operative case with less decision fatigue, prevent complications, and increase surgeon wellness.</p>","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241281064"},"PeriodicalIF":1.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant Rupture of the Anterior Cruciate Ligament and the Patellar Tendon in a High-Level Athlete: A Case Report.","authors":"Jonathan D Harley, Jacob J Ristow, Jeffrey A Macalena","doi":"10.1177/15563316241287751","DOIUrl":"10.1177/15563316241287751","url":null,"abstract":"","PeriodicalId":35357,"journal":{"name":"Hss Journal","volume":" ","pages":"15563316241287751"},"PeriodicalIF":1.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}