Journal of Orthopaedic Experience & Innovation最新文献

{"title":"Structural and Clinical Outcomes after Tenex Debridement for Rotator Cuff Tendinopathy","authors":"Akash Trivedi, Edward Yian, Yung Cho, James Hwang","doi":"10.60118/001c.88229","DOIUrl":"https://doi.org/10.60118/001c.88229","url":null,"abstract":"Rotator cuff tendinopathy (RCT) is a frequently encountered condition by the orthopedic surgeon. Patients presenting with tendinopathy or partial thickness tear present a difficult challenge to treat. Treatments for rotator cuff tendinopathy include nonsurgical and surgical intervention. While surgical management can be effective in the treatment of RCT, patients must be willing to accept risks of anesthesia and surgery and be willing to potentially undergo a lengthy post-operative rehabilitation course. Our study evaluates the use of percutaneous ultrasonic debridement (percutaneous ultrasonic tenotomy (PUT)) of tendinopathy lesions for rotator cuff tendinopathy. This study consisted of 15 patients with symptomatic rotator cuff pathology diagnosed by physical exam and magnetic resonance imaging (MRI). Operative and non-operative treatment options for RCT were discussed with the patients, including the Tenex procedure. The 15 patients who underwent the Tenex procedure were followed post-procedure for clinical improvement with Shoulder Pain and Distability Index (SPADI) scores and for structural improvement with MRI. The present study included 15 patients (16 shoulders) consisting of 8 women and 7 men. The average age of our cohort was 59.9. 14 of the patients achieved improvements in their SPADI (Shoulder Pain and Disability Index) scores and had similar or improved structural appearance on MRI after undergoing percutaneous ultrasonic debridement. The results from this study show that patients with RCT who have tried conservative treatment but are not interested in surgical intervention can consider the Tenex procedure. The procedure carried a high safety profile with significant improvement in outcomes in the majority of patients.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"136 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140369659","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":"Inflating a thigh tourniquet anteriorly displaces the popliteal artery relative to the posterior tibial cortex: an in vivo magnetic resonance imaging study","authors":"Justen Elbayar, David Swanson, Nicholas Tsouris, Dorian Cohen, G. Coden, Elaine Gould, Mingqian Huang, David E. Komatsu, K. Wengler, Corey Ho, Dharmesh Tank, James M. Paci, James Penna","doi":"10.60118/001c.82079","DOIUrl":"https://doi.org/10.60118/001c.82079","url":null,"abstract":"Previous work has demonstrated that with increasing knee flexion angles, the popliteal artery is located further away from the posterior tibial cortex (PTC), thus offering a safer position for procedures about the knee. Prior studies did not, however, incorporate the use of a surgical thigh tourniquet, a device commonly used by orthopaedic surgeons. Thigh tourniquet effect on popliteal spatial anatomy will be assessed in this study. Using 3 Tesla magnetic resonance imaging, 6 volunteer knees were evaluated in both full extension and 90 degrees (°) of flexion, with and without a thigh tourniquet inflated to 200 millimeters of mercury. Axial images at the level of the posterior cruciate ligament (PCL) tibial insertion were obtained. The distance of the popliteal artery from the PCL tibial insertion and the PTC at this level were calculated. Without a tourniquet, at 0° and 90° of flexion, the mean distance between the popliteal artery and the PTC was 6.9 and 9.4 millimeters, respectively. With a tourniquet, at 0° and 90° the mean distance between the popliteal artery and the PTC decreased to 6.2 (-0.7) and 8 (-1.4) millimeters, respectively. These reductions in distances with inflating the tourniquet were statistically significant (p<0.05). The distance between the artery and the PCL attachment did not change with and without inflating the tourniquet. Inflating a thigh tourniquet moves the popliteal artery approximately 1 millimeter (8.5 percent) anterior towards the PTC and has no effect on the relationship between the popliteal artery and PCL insertion.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140385607","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":"Access to Total Knee Arthroplasty in Medicare Advantage Patients","authors":"Sarah J. Girshfeld, Brandon Macknofsky, William Srouji, Juan C Alvarez, A. Lavin, Clyde K. Fomunung, V. Sabesan","doi":"10.60118/001c.87962","DOIUrl":"https://doi.org/10.60118/001c.87962","url":null,"abstract":"Background: Total knee arthroplasty (TKA) is one of the most frequently performed procedures in Medicare patients in the United States. Among this population, enrollment in Medicare Advantage (MA) plans is rising but rates of elective TKA are 10-20% lower in MA health maintenance organization (HMO) plans compared to Traditional Medicare (TM). The purpose of this study was to evaluate the effect of Medicare type on patient access to TKA within the large population in Florida. Methods: The AAOS directory was queried for total joint surgeon practices within five Florida counties. Each office was called to assess the response to four insurance scenarios (Traditional Medicare, Blue Medicare Select PPO, Humana Gold Plus HMO, and commercial Cigna). Investigators used a Secret Shopper methodology with a standardized script to request a TKA. Data was gathered on insurance types accepted and number of business days to the next available appointment. Results: Of the 133 orthopaedics clinics called, 63 were accepting new TKA patients. Of those accepting new TKA patients, 91.7% accepted commercial Cigna, 96.8% accepted TM, 70.5% accepted MA HMO Humana Gold Plus, and 50.8% accepted MA PPO Blue Medicare Select. Compared to TM and commercial Cigna, both MA plans had significantly lower appointment success rates (all p<.003). Time to earliest appointment did not significantly vary by insurance type or county (p>.14). Conclusions: Patients in Florida with MA have decreased access to TKA compared to those with TM or commercial insurance, possibly explaining the lower rates of TKA utilization in the MA population.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"105 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140236702","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 updated analysis of the content and accessibility of hand surgery fellowship websites and fellowship directories","authors":"Scott A Wu, Manish P. Mehta, Alisha A Ho, Kelly H Wun, Erik B Gerlach, John Carney, Peter R Swiatek, Chirag M Shah","doi":"10.60118/001c.84082","DOIUrl":"https://doi.org/10.60118/001c.84082","url":null,"abstract":"Recent changes to the hand surgery fellowship application process and the pandemic-related transition to virtual interviews necessitate updated analyses of fellowship websites’ and directories’ content and accessibility. The study aims are to identify deficits in hand fellowship website and fellowship directory content and accessibility and compare current findings to those previously reported. A list of all accredited hand fellowship programs was queried from the ASSH fellowship directory in January 2022. Data for each program were recorded on 38 metrics across four different categories: General Overview, Accessibility Information, Educational Information, and Recruitment Information. Fisher’s exact test was used to assess differences between categorical variables. Unpaired t-test and analysis of variance (ANOVA) were used to compare continuous variables for two or more potential predictors, respectively. 92 program websites were analyzed. Only 53 (58%) ASSH links and 12 (13%) FREIDA links directly connected users to the website, with no improvement from prior investigation. Content accuracy was poor with just 13% of websites containing updated interview date information and 11% listing obsolete paper application information. Of the 30 program websites (33%) with supplemental application requirements listed, only 5 (17%) also listed these requirements on their corresponding ASSH page. Mean educational and recruitment information scores were 6.8±2.1 and 5.0±1.5 out of 10, respectively. Though improved, the accessibility, comprehensiveness, and accuracy of information found on hand fellowship websites remains poor and outdated. Educational content and recruitment content are largely homogenous among programs.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140246257","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…Top Ten Steps for Prevention of Surgical Site Infection after Joint Arthroplasty”","authors":"Armita Abedi, MD, Javad Parvizi, MD","doi":"10.60118/001c.92106","DOIUrl":"https://doi.org/10.60118/001c.92106","url":null,"abstract":"Prevention strategies can help orthopedic surgeons optimize circumstances to reduce the incidence of SSI and PJI.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"167 S357","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256574","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":"Objective gait analysis following total knee arthroplasty with a smart implant directs early intervention with manipulation under anesthesia","authors":"John Dundon, Patrick Aubin, William Hunter","doi":"10.60118/001c.89961","DOIUrl":"https://doi.org/10.60118/001c.89961","url":null,"abstract":"Total knee arthroplasty (TKA) is a procedure increasingly in demand. While advancements in surgical techniques and implant designs have led to low complication rates and improved outcomes following TKA, patient satisfaction has not risen commensurately. Routine care may include clinical assessments, physical therapy notes, and patient reported outcome measures, each of which provides a discrete evaluation but may miss significant changes in daily activities. Here we present the case of a patient who underwent TKA with a tibial implant fitted with an embedded inertial measurement unit capable of providing extensive data on gait kinematics. Despite a successful, well-balanced knee replacement surgery and good clinical outcomes at 2 weeks, by 4.5 weeks post-surgery, she had increased self-reported pain scores and her walking speed, stride length and tibial range of motion (ROM) were declining compared to her TKA peers. The patient was called in to the office for evaluation, 3.5 weeks prior to her scheduled 8-week routine follow up. We proceeded with early manipulation under anesthesia, which lead to normalization of her knee ROM. In this case, gait data from the smart implant alerted us to a TKA patient who was failing to progress, prior to her routine follow-up visit. The daily remotely acquired kinematic data was instrumental in the early recognition and intervention. Availability of objective, trended, high-fidelity gait data from smart implants has the potential to identify clinical concerns early, improve efficiency in care, and increase patient and physician engagement in the recovery process.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"28 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441248","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":"Which Behaviors Generate The Best Reviews? A Sentiment Analysis of Online Reviews on AOSSM Surgeons","authors":"Justin E. Tang, Ting Cong, A. Hall, Jun S. Kim, James Gladstone","doi":"10.60118/001c.87964","DOIUrl":"https://doi.org/10.60118/001c.87964","url":null,"abstract":"Online surgeon reviews can significantly influence a patient’s selection of a provider, and are important in the movement towards quality-based physician compensation models. Written reviews, however, are subjective and are thus difficult to quantitatively analyze. Sentiment analysis using artificial intelligence (AI) provides the ability to quantitatively assess surgeon reviews to provide actionable feedback. The objective of this study is to quantitatively analyze the online written reviews of AOSSM surgeons utilizing sentiment analysis and report trends in the most frequently used words in the best and worst reviews. Cross-sectional study using publicly-available online reviews Online reviews and star-ratings of AOSSM surgeons were obtained from healthgrades.com and zocdoc.com. A sentiment analysis algorithm was used to compute sentiment analysis scores of each written review. Sentiment scores were validated against star-ratings. Positive and negative word and word-pair frequency analysis was performed to identify common items associated with high and low scores. A multiple logistic regression was run on clinically relevant phrases. Following the inclusion and exclusion criteria, 18,386 AOSSM surgeon reviews were analyzed for 2071 surgeons. There was no significant difference in sentiment scores by provider gender. Surgeons who are younger than 50 years old had more positive reviews (mean sentiment = +0.536 versus +0.458, p < 0.01). The most frequently used and meaningful bi-grams used to describe top-rated surgeons are words correlating with kindness, caring personalities, and efficiency in pain management; whereas, those with the worst reviews are often characterized as unable to relieve the pain of their patients. The multiple logistic regression was significant for several clinically relevant words that confer greater or less odds of an improved score. Pain is significantly correlated with a decreased odds of receiving a positive review and positive behavioral factors confer a greater odds of receiving a positive review. Sentiment analysis provides a means of quantifying written reviews of surgeons, and analysis of the reviews. This study provides insight into factors contributing to positive reviews, especially surgeon confidence, staff friendliness, warm disposition, and pain relief. This study delineates factors that impact the public reviews on AOSSM providers.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"8 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140509920","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":"Epidemiology of Subsequent and Recurrent Injuries in Rugby: A Systematic Review","authors":"YuAn Fang, Andrew Belnap, Michaela Stamm, Mary Mulcahey","doi":"10.60118/001c.82080","DOIUrl":"https://doi.org/10.60118/001c.82080","url":null,"abstract":"To review and collate epidemiological data on recurrent and subsequent injuries in male rugby and identify risk factors such as injury type. Four databases were searched from January 1, 1974 through October 1, 2020. Keywords were:((“Football”[Mesh]) OR (rugby)) AND ((recurrent injury) OR (subsequent injury)) in PubMed, (‘rugby’/exp OR rugby) AND (recurrent AND (‘injury’/exp OR injury) OR subsequent) AND (‘injury’/exp OR injury) in Embase, rugby AND (subsequent injury OR recurrent injury) in CINAHL Plus, and TOPIC: (rugby) AND TOPIC: (subsequent injur* OR recurrent injur*) in Web of Science. Inclusion Criteria:(i) population consisted of male rugby players; (ii) used “time-loss” as an injury definition; (iii) included extractable data on both subsequent injury count and recurrent injury count; (iv) written in English. 6/1242 studies met criteria for inclusion. Quality was assessed using STROBE guidelines. Studies using “missed-match” as a definition of time-loss showed no difference in incidence of subsequent versus recurrent injuries. Studies using “24-hour time-loss” as the definition of injury reported 7,724 (71%) subsequent injuries (95% CI: 0.71–0.72) and 1,434 (14%) recurrent injuries (95% CI: 0.13–0.15). In pediatric players, 98 (23%) were subsequent (95% CI: 0.19–0.27) and 21 (5%) were recurrent (95% CI: 0.03–0.08). When specifying concussions as an index injury, 119 (40%; 95% CI: 0.34–0.46) subsequent injuries other than a concussion were reported with 27 (9%; 95% CI: 0.06–0.13) recurrent concussions. Injury definition and type of index injury plays a significant role when considering subsequent and recurrent injury incidence in male rugby players. Further investigation regarding incidence of secondary injury after specific types of index injury is warranted.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"9 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387528","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 utility of platelet-rich plasma in modern orthopedic practices: a review of the literature","authors":"John S. Barnett, Mitchell Borin, Louis Barry, Erryk S. Katayama, Akshar V. Patel, Greg L. Cvetanovich, Julie Y. Bishop, Ryan C. Rauck","doi":"10.60118/001c.87963","DOIUrl":"https://doi.org/10.60118/001c.87963","url":null,"abstract":"Citation analysis is a useful tool to understand the contributions publications make within their fields. As the use of platelet-rich plasma (PRP) by orthopedic shoulder and elbow surgeons increases, it is vital to highlight influential literature that may inform readers of innovations, new applications, and current trends within PRP research. The purpose of this study was to identify and analyze the 50 most-cited publications related to the use of PRP in shoulder and elbow orthopedics. The Clarivate Analytics Web of Science Database was searched using various Boolean searches. Author name, journal, study type, publication year, number of citations, level of evidence, and geographical origin were recorded for each publication. Included publications accumulated 6318 total citations with the most-cited article achieving 561 citations. Most studies were randomized controlled trials of Level I evidence. Authors from the United States (10) produced the most publications, and nearly half (22) of the articles were published in the American Journal of Sports Medicine. Randomized controlled trials composed much of this analysis. As PRP use within upper extremity orthopedics is refined, studies demonstrating evidence in favor of PRP may replace the publications reviewed in this analysis.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"41 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125151","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":"Publication History and Associated Academic Metrics of Selected Content Speakers at Arthroscopy Association of North America and American Orthopaedic Society for Sports MedicineAnnual Meetings","authors":"Edward J. Modica, Brandon J. Klein, Lucas E. Bartlett, Adam Lencer, Nicholas Andriani, Randy M. Cohn, N. Sgaglione","doi":"10.60118/001c.87623","DOIUrl":"https://doi.org/10.60118/001c.87623","url":null,"abstract":"Annual meetings held by the Arthroscopy Association of North America (AANA) and the American Orthopaedic Society for Sports Medicine (AOSSM) are important platforms for showcasing relevant sports medicine innovation and research. While meeting planning committees likely consider multiple factors when selecting content speakers, it may be assumed that these speakers are well-published or have an academic reputation on their topic of presentation. To assess the peer-reviewed publication history and associated academic metrics of selected content speakers of prominent sports medicine society meetings and to identify content areas that lack speakers with previous peer-reviewed publications on their topic of presentation. Cross-Sectional Review The 2016-2019 conference programs of AANA and AOSSM annual meetings were screened for selected content speakers. Each selected content speaker was searched in the Scopus database to identify prior peer-reviewed publications that were relevant to their presentation topic. Each selected content speaker, presentation, and content category was analyzed to determine the speakers’ Hirsch index (H-index), number of speakers’ previous topic-specific publications, manuscripts’ weighted citation count (WCC), and number of speakers using means and proportions. Comparisons were performed with two-sample T-tests for continuous variables and two-sample Z-tests for proportions for categorical variables, with p-values less than 0.05 indicating statistical significance. Of 432 total lectures, 371 (86%) were given by speakers who were previously published on their topic, leaving only 61 lectures (14%) by speakers without previous topic-specific publication (p=0.0005). Nonoperative sports medicine had the highest proportion (34%, 24/71) of lectures delivered by speakers without prior topic-specific publications. Speakers presenting on the hip had the highest H-index (41.67); speakers presenting on the elbow held the highest average number of prior topic-specific publications (12.17); and speakers presenting on biologics held the highest average WCC (8.56). There were no differences between conferences in regard to the proportion of speakers without previous topic-specific publications, the total average number of prior topic-specific publications per speaker, or the total average WCC. The AANA and AOSSM annual meetings largely include selected content speakers with prior peer-reviewed literature. While publication history and associated academic metrics may be factors in speaker selection, each organization likely has its own individual selection criteria for delivering high-quality programs.","PeriodicalId":503083,"journal":{"name":"Journal of Orthopaedic Experience &amp; Innovation","volume":"85 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139155740","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}