The Iowa orthopaedic journal最新文献

{"title":"New Orthopedic Faculty.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"xvi"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296467/pdf/IOJ-2023-xvi.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Post-Operative Neurological Deficit After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: Possible Association With Post-Operative Anemia.","authors":"Pedro Fernandes, Joaquim Soares do Brito, Lori Dolan, Stuart Weinstein","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>To present a patient with adolescent idiopathic scoliosis who developed a significant neurological deficit after posterior spinal fusion, in association with anemia on postoperative day two.</p><p><strong>Case report: </strong>A 14-year-old otherwise healthy female underwent a T3-L3 instrumented posterior spinal fusion for idiopathic scoliosis which was uneventful. Immediate post-operative clinical examination was unremarkable but at postoperative day three the patient developed generalized lower extremity weakness with inability to stand and an urinary retention needing continuous intermittent catheterization program. Her hemoglobin (Hg) dropped from 10 g/dL on postoperative day one to 6.2 g/dL at day two, despite no significant bleeding was noticed. Compressive etiology was ruled out by postoperative myelogram-CT. The patient started to improve significantly after transfusion support. At three months follow-up the patient was neurologically normal.</p><p><strong>Conclusion: </strong>Close clinical neurological evaluation over 48 to 72 hours is needed in order to detect unexpected delayed paralysis following scoliosis surgery. <b>Level of Evidence: IV</b>.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"117-122"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296456/pdf/IOJ-2023-117.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication and Career Trends of Ruth Jackson Orthopaedic Society Grant Winners Over the Past Decade.","authors":"Natalia Czerwonka, Christen M Russo, Lisa K Cannada","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The Ruth Jackson Orthopaedic Society awards the Jacquelin Perry, MD Resident Research Grant and RJOS/Zimmer Biomet Clinical/Basic Science Research Grant to female orthopedic surgeons, intending to aid women in the progression and completion of their orthopedic research and bolster their pursuit or current career in academic orthopedic surgery. The impact of these grants has not yet been studied. The purpose of this study is to determine the percentage of scholarship/grant-winners who went on to publish the findings of their research, pursue academic positions, and currently hold positions of leadership in the field of orthopedic surgery.</p><p><strong>Methods: </strong>The titles of the winning research projects were searched in PubMed, Embase, and/or Web of Science to ascertain publication status. For each award recipient, the number of publications prior to the award year, number of publications after the award year, total number of publications, and H-index were calculated. Each award recipient was searched online through the websites of their employment and social media pages to determine their residency institution, whether they pursued a fellowship, the number of fellowships they pursued, their subspecialty within orthopedics, their current job, and whether they are in academic or private practice.</p><p><strong>Results: </strong>Of the fifteen Jacquelin Perry, MD Resident Research Grant winners, 73.3% of awarded research projects have since been published. 76.9% of award winners currently work in an academic setting and are affiliated with a residency program, and 0% currently hold leadership positions in orthopedic surgery. Of the eight winners of the RJOS/Zimmer Biomet Clinical/Basic Science Research Grant, 25% have published the findings of their awarded grant. 87.5% of award winners currently work in academics, and 75% hold leadership positions in orthopedic surgery.</p><p><strong>Conclusion: </strong>Our results show that many of the winners of the Jacquelin Perry, MD Resident Research Grant and RJOS/Zimmer Biomet Clinical/ Basic Science Research Grant have published their research findings, continued research within the field of orthopedic surgery, and pursued academic careers and leadership positions. Many of the barriers to career progression and entry into orthopedic surgery that women and underrepresented groups face could be overcome through more grant opportunities and mentorship. <b>Level of Evidence: V</b>.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"7-13"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296483/pdf/IOJ-2023-007.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Orthopedics and Rehabilitation Faculty 2022-2023.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"viii-ix"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296459/pdf/IOJ-2023-viii.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2023 Michael Bonfiglio Award for Student Research in Orthopaedic Surgery: the 2023 Iowa Orthopaedic Society Medical Student Research Award for Musculoskeletal Research.","authors":"Benjamin J Miller","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"xvii"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Vary Significantly Using a Tiered Approach To Define Success After Total Hip Arthroplasty.","authors":"Christopher N Carender, Morgan L Gulley, Ayushmita De, Kevin J Bozic, John J Callaghan, Nicholas A Bedard","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Clinical outcomes following primary total hip arthroplasty (THA) are commonly assessed through patient-reported outcome measures (PROM). The purpose of this study was to use progressively more stringent definitions of success to evaluate clinical outcomes of primary THA at 1-year postoperatively and to determine if demographic variables were associated with achievement of clinical success.</p><p><strong>Methods: </strong>The American Joint Replacement Registry (AJRR) was queried from 2012-2020 for primary THA. Patients that completed the following PROMs preoperatively and 1-year postoperatively were included: Western Ontario and McMaster Universities Arthritis Index (WOMAC), Hip Injury and Osteoarthritis Outcome Score (HOOS) and HOOS for Joint Replacement (HOOS, JR). Mean PROM scores were determined for each visit and between-visit changes were evaluated using paired t-tests. Rates of achievement of minimal clinically important difference (MCID) by distribution-based and anchor-based criteria, patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) were calculated. Logistic regression was used to evaluate associations between demographic variables and odds of success.</p><p><strong>Results: </strong>7,001 THAs were included. Mean improvement in PROM scores were: HOOS, JR, 37; WOMAC-Pain, 39; WOMAC-Function, 41 (p<0.0001 for all). Rates of achievement of each metric were: distribution-based MCID, 88-93%; anchor-based MCID, 68-90%; PASS, 47-84%; SCB, 68-84%. Age and sex were the most influential demographic factors on achievement of clinical success.</p><p><strong>Conclusion: </strong>There is significant variability in clinical outcomes at 1 year after primary THA when using a tiered approach to define success from the patient's perspective. Tiered approaches to interpretation of PROMs should be considered for future research and clinical assessment. <b>Level of Evidence: III</b>.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"45-54"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296457/pdf/IOJ-2023-045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9728035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Sport After Knee Injuries in Collegiate Wrestling.","authors":"Kory Ford, Andrew L Schaver, Steven Leary, Jerrod N Keith, Robert W Westermann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Wrestling is known to be a sport of relatively high injury incidence, and knee injuries account for a large percentage of those injuries. Treatment of these injuries varies considerably depending on injury and wrestler characteristics, leading to variability in complete recovery and return to sport (RTS). The purpose of this study was to evaluate injury trends, treatment strategies, and RTS characteristics after knee injuries in competitive collegiate wrestling.</p><p><strong>Methods: </strong>NCAA Division I collegiate wrestlers who sustained knee injuries between January 2010 and May 2020 were identified using an institutional Sports Injury Management System (SIMS). Wrestling-related knee, meniscus, and patella injuries were identified, and treatment strategies were documented to investigate potential recurrent injury trends. Descriptive statistics were used to quantify the number of days, practices, and competitions missed, return to sport times, and recurrent injuries among wrestlers.</p><p><strong>Results: </strong>Overall, 184 knee injuries were identified. After excluding non-wrestling injuries (n=11), 173 injuries remained (77 wrestlers). The mean age at time of injury was 20.8 ± 1.4 years, and the mean BMI was 25.9 ± 3.8 kg/m2. There were 135 primary injuries (74 wrestlers), which consisted of 72 (53%) ligamentous injuries, 30 (22%) meniscus injuries, 14 patellar injuries (10%), and 19 other injuries (14%). The majority of ligamentous injuries (93%) and patellar injuries (79%) were treated non-operatively, while the majority of meniscus tears (60%) underwent surgery. Twenty-three wrestlers (22%) sustained recurrent knee injuries, of which 76% were treated non-operatively after their initial injury. Recurrent injuries consisted of 12 (32%) ligamentous injuries, 14 (37%) meniscus injuries, eight (21%) patellar injuries, and four (11%) other injuries. Fifty percent of recurrent injuries were treated operatively. When comparing recurrent injuries to primary injuries, recurrent injuries had a significantly longer return to sport time (Recurrent 68.3 ± 96.0 days vs. Primary 26.0 ± 56.4 days, p=0.01).</p><p><strong>Conclusion: </strong>The majority of NCAA Division I collegiate wrestlers who sustained knee injuries were initially treated non-operatively, and approximately one in five wrestlers sustained recurrent injuries. Return to sport time was significantly increased after a recurrent injury. <b>Level of Evidence: IV</b>.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"131-135"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296484/pdf/IOJ-2023-131.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution, Current State and Clinical Benefits of Far Cortical Fracture Fixation.","authors":"Yanin Plumarom, Matthew D Karam, J Lawrence Marsh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment of distal femur fractures have reported high fracture healing complications in several studies. The development of far cortical locking (FCL) technology results in improved fracture healing outcomes. There are biomechanical and animal studies demonstrating that the locked plating incorporating FCL screws provides a more flexible form of fixation compared to traditional locking plates (LP). Clinical studies have shown that the commercially available Zimmer Motionloc system with FCL screws provide good results in distal femur fractures and periporsthetic distal femur fractures. FCL constructs may help resolve fracture healing problems in the future. However, there is not enough available clinical evidence to conclusively indicate whether clinical healing rates are improved with FCL screw constructs compared to traditional LP's. Therefore, further prospective study designs are needed to compare FCL to LP constructs and to investigate the role of interfragmentary motion on callus formation. Level of Evidence: V.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"177-183"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296479/pdf/IOJ-2023-177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Emptive Opioid-Sparing Medication Protocol Decreases Pain and Length of Hospital Stay in Children Undergoing Posterior Spinal Instrumented Fusion for Scoliosis.","authors":"Selina Poon, De-An Zhang, Frederic Bushnell, Vangie Luong, Emmanuel Barragan, Manu Raam, Alexander VanSpeyBroeck, Paul Choi, Robert Cho","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Poorly controlled post-operative pain following Posterior Spinal Instrumented Fusion (PSIF) for scoliosis may be associated with delayed ambulation and longer hospital stays. Multimodal analgesia use has been shown to provide superior analgesia with improved recovery and reduction of post-operative morbidity in other orthopedic subspecialties, but has not been described with pediatric patients undergoing spinal surgery.</p><p><strong>Objective: </strong>We describe a novel, pre-emptive, opioid-sparing pediatric pain medication protocol that is started two days prior to surgery, in accordance with first-order pharmacokinetics, and continued post-operatively until discharge with the goal of decreasing post-operative pain, improving early mobilization, and ultimately decreasing the patient's length of hospital stay.</p><p><strong>Methods: </strong>We retrospectively reviewed 116 PSIF cases from March 2014 to November 2017. Fifty-two patients received standard analgesia before August 2016, and 64 patients after August 2016 received the pre-emptive protocol consisting of a standardized combination of acetaminophen, celecoxib, and gabapentin two days prior to surgery and continued during their inpatient stay. Scheduled oxycodone and intravenous hydromorphone via patient controlled analgesia (PCA) were given to both groups equally during the post-operative hospital stay. We analyzed length of stay, total opioid consumption, and maximum pain scores per day from surgical to discharge date.</p><p><strong>Results: </strong>116 patients were included: 64 patients in the pre-emptive group and 52 patients in the standard group. Length of hospital stay significantly differed, with means of 3.9 days in the pre-emptive group and 4.5 days in the standard analgesia group (p<0.05). Patients in the pre-emptive group recorded significantly lower maximal pain levels than those in the standard analgesia group on post-operative days #1 (4.9 vs. 5.8, p=0.0196), #3 (4.4 vs. 6.1, p=0.0006), and #4 (4.2 vs. 5.4, p=0.0393). Total post-operative morphine equivalents taken did not significantly differ between the two groups.</p><p><strong>Conclusion: </strong>This is a preliminary report demonstrating a significant decrease in maximal pain score and length of stay following PSIF on a cohort of patients receiving a novel pre-emptive opioid-sparing pain medication protocol based on first order pharmacokinetics. Future studies should investigate degree of mobilization and opioid consumption and maximal pain level after discharge from the hospital. <b>Level of Evidence: III</b>.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"111-115"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296464/pdf/IOJ-2023-111.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9734429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Tis Time 'Tis Time: The Importance of Operative Time, Thoroughness, and Shakespeare in Dair Procedures in Total Joint Arthroplasty.","authors":"Michael C Marinier, Bryan Mouser, Ayobami S Ogunsola, Jacob M Elkins","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic joint infections (PJIs), while rare, are a devasting complication of both total joint arthroplasty (TJA). With most patients undergoing surgical treatment for PJI, options vary between one-stage or two-stage (the gold standard) procedures. Debridement, antibiotics, and implant retention (DAIR) procedures are a common, less morbid alternative to two-stage revisions, but patients undergoing DAIR procedures more often experience reinfections. This is likely in part due to non-standardized irrigation and debridement (I&D) methods within these procedures. Furthermore, DAIR procedures are often desired due to their cost effectiveness and lesser operative times, but no investigations have occurred regarding operative-time-based outcomes. This study aimed to compare reinfection incidence with procedure time in DAIR procedures. In addition, this study aimed to introduce the novel Macbeth Protocol for the I&D portion of DAIR procedures and assess its efficacy.</p><p><strong>Methods: </strong>Records of unilateral DAIR procedures for primary TJA PJI performed by arthroplasty surgeons from 2015-2022 were retrospectively reviewed for patient demographics, select medical history, body mass index (BMI), joint, microbiology, and follow-up data. In addition, a single surgeon's DAIR procedures (for primary and revision TJA) were reviewed and use of The Macbeth Protocol was noted.</p><p><strong>Results: </strong>A total of 71 patients (mean age 64.00 ± 12.81 years) who underwent unilateral DAIR were included. Patients with reinfections following their DAIR procedure had significantly (p = 0.034) lower procedure times (93.72 ± 15.01 min) compared to those without reinfections (105.87 ± 21.91 min). Twenty-two patients underwent 28 DAIR procedures by the senior author, where 11 (39.3%) DAIR procedures utilized The Macbeth Protocol. The use of this protocol did not significantly affect reinfection rate (p = 0.364).</p><p><strong>Conclusion: </strong>This study concluded that increased operative time led to less reinfections for DAIR procedures treating unilateral primary TJA PJIs. Additionally, this study introduced The Macbeth Protocol, which demonstrated promising potential as an I&D technique despite not showing statistical significance. Arthroplasty surgeons should not sacrifice patient outcomes determined by reinfection rate for decreased operative time. <b>Level of Evidence: III</b>.</p>","PeriodicalId":35582,"journal":{"name":"The Iowa orthopaedic journal","volume":"43 1","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10296452/pdf/IOJ-2023-063.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}