{"title":"Environmental Sustainability in Orthopaedic Surgery – Where We Are and Where We Are Going","authors":"Ian D. Engler , Andrew J. Curley","doi":"10.1016/j.oto.2022.100995","DOIUrl":"10.1016/j.oto.2022.100995","url":null,"abstract":"<div><p>“The triple bottom line” is an approach to mitigate the environmental consequences of any business endeavor by considering three important stakeholders - Profit, People, and Planet. While medicine is making appreciable progress on its environmental impact, the field of orthopaedic surgery is only beginning to research and prioritize environmental sustainability. Research, including Quality Improvement projects, is the avenue to understanding how to expand environmentally-conscious orthopaedic care. Research that identifies effective strategies for change cannot be effective without buy-in from medical staff, administrators, insurers, and governing bodies.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47895480","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}
Molly M. Herr , Rachel E. Outterson , Shreya Aggarwal
{"title":"Lost in the Ether: The Environmental Impact of Anesthesia","authors":"Molly M. Herr , Rachel E. Outterson , Shreya Aggarwal","doi":"10.1016/j.oto.2022.100997","DOIUrl":"10.1016/j.oto.2022.100997","url":null,"abstract":"<div><p>Health care systems contribute a significant amount of global greenhouse gas (GHG) emissions, and operating rooms are among the most resource intensive and waste producing locations in hospitals. Surgery's high environmental impact is due to many factors including: widespread use of anesthetic and medical gases; pharmaceutical production and waste; substantial non-recycled waste from disposable single-use devices; and energy consumption for equipment use and reprocessing, in addition to the significant energy needed for heating, cooling and ventilation of ORs. As the urgency of addressing global climate change increases, health care providers must do all they can to minimize the environmental impacts of health care in a sustainable, yet safe manner. Thoughtful management techniques by anesthesiologists, surgeons, and operating room staff before, during, and after procedures can minimize the environmental impact of surgery while maintaining cost-efficient, excellent patient care.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47059590","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":"Water – An Evaporating Resource","authors":"Allison R. Mitchell , Jason R. Saleh","doi":"10.1016/j.oto.2022.101000","DOIUrl":"10.1016/j.oto.2022.101000","url":null,"abstract":"<div><p>Humans are affected in numerous ways by climate change. Drought and water scarcity is an important area that must be addressed. Hospitals use a large amount of their community's water supply and therefore play a part in water conservation. The orthopaedist can minimize water waste in the operating room in multiple ways. The most immediate impact can be made by using less water for pre-operative scrubbing, either by turning off the water when not actively rinsing or by converting to waterless scrub. Eliminating rarely used surgical instruments from trays can save water and decrease costs to the hospital. Conserving water benefits both the hospital and the planet.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48502497","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 Brostrom Procedure: Open Reconstruction of the Lateral Ankle Ligament Complex","authors":"Paul G. Talusan","doi":"10.1016/j.oto.2022.100980","DOIUrl":"10.1016/j.oto.2022.100980","url":null,"abstract":"<div><p><span>Ankle inversion injuries are common and most patients will have complete resolution of symptoms with nonoperative treatment. Some patients will develop chronic ankle instability and may develop associated pathology such as peroneal tendonitis, osteochondral lesions, ankle </span>synovitis<span>, and ankle impingement. A careful physical examination is imperative to evaluate for ankle instability as well as concomitant pathology. Imaging begins with standard radiographs and advanced imaging is used to evaluate for osteochondral lesions, ligament integrity, tendinitis, and other soft tissue lesions. Nonoperative treatment consists of immobilization, bracing, and physical therapy. Surgical treatment is reserved for patients who have symptoms despite nonoperative treatment and often involves imbrication of the lateral ankle ligament complex. Outcomes are typically favorable and most patients can expect to return to athletic activity.</span></p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46985509","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":"Contributors (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(22)00049-0","DOIUrl":"https://doi.org/10.1053/S1048-6666(22)00049-0","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138288064","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":"Arthroscopic Ankle Lateral Ligament Repair for Chronic Lateral Ankle Instability","authors":"Masato Takao , Mark Glazebrook","doi":"10.1016/j.oto.2022.100982","DOIUrl":"10.1016/j.oto.2022.100982","url":null,"abstract":"<div><p><span>Minimally Invasive lateral ligament repair of the ankle has been developed in recent years. These repairs involve threading sutures to the remnant and can be classified into three types. These include arthroscopy-assisted mini-open procedure, arthroscopic with percutaneous procedure, and all-inside arthroscopic procedures. The all-inside arthroscopic procedure is the most minimally invasive procedure because all steps are performed arthroscopically through one portal. Further, since it is possible to suture the ligament with a direct arthroscopic view all-inside arthroscopic procedures can be performed anatomically. In this chapter, the authors provide the history of arthroscopic </span>lateral ankle ligament repair and a recommended procedure for all-inside arthroscopic ankle lateral ligament repair using a modified lasso-loop stitch technique.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46426972","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":"Techniques for Cavovarus Foot Reconstruction with Concomitant Ankle Instability","authors":"Todd A. Irwin MD","doi":"10.1016/j.oto.2022.100985","DOIUrl":"10.1016/j.oto.2022.100985","url":null,"abstract":"<div><p><span>Patients who present with lateral ankle ligament<span><span><span> instability always need to be evaluated for cavovarus foot deformity. Cavovarus reconstruction may need to be performed in order to ensure the ankle instability procedure is successful. Which procedures are required will depend on the specific deformity present, and may need to be determined intraoperatively depending on the initial deformity correction achieved through the first procedures performed. A general though not strict algorithm for sequence of procedures involves soft tissue releases first, followed by hindfoot correction, then </span>forefoot correction, and securing </span>ligament reconstruction<span> or tendon transfers as the final step. Tendon transfers can be an effective tool to aid in the deformity correction and several are described. For hindfoot and forefoot deformity correction, traditional </span></span></span>calcaneus<span> and metatarsal osteotomies<span> work well, but fusion should be considered for joints with degenerative change or in cases where the deformity is severe or can't be corrected through osteotomy alone.</span></span></p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47189538","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":"Anatomical Reconstruction of the Lateral Ligament of the Ankle (AntiRoLL) for Chronic Lateral Ankle Instability","authors":"Masato Takao , Mark Glazebrook","doi":"10.1016/j.oto.2022.100984","DOIUrl":"10.1016/j.oto.2022.100984","url":null,"abstract":"<div><p><span>Recently, anatomic reconstruction procedures for chronic lateral ankle instability (CLAI) using arthroscopic and percutaneous minimally invasive technique has been described with the goal of improving clinical outcomes of open non-MIS techniques. In this chapter we describe the history of reconstruction for CLAI and a new anatomical reconstruction of the </span>lateral ankle ligament (AntiRoLL) MIS techniques.</p></div>","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42389777","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":"Table of Contents (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(22)00048-9","DOIUrl":"https://doi.org/10.1053/S1048-6666(22)00048-9","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1048666622000489/pdfft?md5=d93758ec9166fafcb3cc8b2a626c5ae8&pid=1-s2.0-S1048666622000489-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138270540","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":"Editorial Board (pick up from previous issue w/updates)","authors":"","doi":"10.1053/S1048-6666(22)00047-7","DOIUrl":"https://doi.org/10.1053/S1048-6666(22)00047-7","url":null,"abstract":"","PeriodicalId":45242,"journal":{"name":"Operative Techniques in Orthopaedics","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1048666622000477/pdfft?md5=f6c8cf26d47f3c40e0474eeee6f40d8f&pid=1-s2.0-S1048666622000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138270541","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}