{"title":"Is Everyone Covered? A Resident's Perspective on Radiation Exposure in Orthopedic Surgery.","authors":"Emilie R C Williamson, Lew C Schon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Orthopedic surgeons frequently use fluoroscopy and flat plate X-ray in the operating room. As the length of surgeons' careers gets longer, the risk of potential for harm from radiation exposure also grows. Knowledge of the background and science of radiation, the C-arm, and various ways that surgeons can protect themselves is fundamental and should be incorporated into residency education for orthopedic surgery. This review provides information that we hope will better prepare residents in orthopedic surgery to use fluoroscopy and X-rays and protect themselves from radiation risks.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10777895","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":"Contemporary Management of Massive Irreparable Rotator Cuff Tears Where Are We In 2023?","authors":"Charles Wang, Jonathan L Glashow, Michael J Alaia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The treatment of massive irreparable rotator cuff tears has been a controversial topic with multiple procedures described. Research trends have been growing rapidly over the past decade resulting in a greater understanding of its natural evolution. No singular superior procedure has been described. Rather, treatment options should be weighed in the setting of patient expectations, comorbidities, and the findings from clinical examinations. Based on the current literature, practitioners should be aware of the available treatment options and the most appropriate settings for employing each option. This review discusses the history of massive irreparable rotator cuff tears and evaluates each treatment option based on the highest quality of research available.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10836381","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}
Jonathan Haskel, Guillem Gonzalez-Lomas, Laith Jazrawi
{"title":"Anterior Cruciate Ligament Repair Back to the Future?","authors":"Jonathan Haskel, Guillem Gonzalez-Lomas, Laith Jazrawi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anterior cruciate ligament (ACL) repair is a procedure that has been used to treat torn ACLs dating back to the early 1900s. With unpredictable outcomes of repair, a paradigm shift led to surgeons to opt for ACL reconstruction as a new gold standard, as the evidence showed a more reliable outcome. However, there has been a recent resurgence in ACL repair worthy of review, particularly in proximal avulsions. Suture anchor repair is one repair technique in which recent studies show low failure rates, low reoperation rates, and favorable clinical outcomes. More recent data supports augmenting this strategy with suture tape. An innovation in ACL repair techniques is the Bridge-Enhanced ACL Repair (BEAR) technique, which combines a patient's whole blood with a collagen-based scaffold to augment the repair. While promising results have been shown with these techniques, narrow indications are necessary for a successful ACL repair.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10836387","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":"Evolution of the Human Hand from Early Hominid to Today.","authors":"Matthew Gonzalez, Steven Green","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The human body has evolved greatly over time and the hand has shown some of the most intricate changes. Most evolutionary experts attribute this to the greater use of tools facilitated by the early hominid's transition to a bipedal gait. Increased tool use drove these changes by providing a convincing reproductive advantage for early humans. In particular, hand adaptations resulted from two types of grips that were fundamental in our development: the precision grip and the power grip. To fully understand how these changes in development occurred, a review of evolutionary theory will be proffered and further discussion of the unique architecture of the hands of our closest living relatives compared with that of humans will follow. Finally, we will examine the two uniquely human grips, the anatomic adaptations that allowed for their development, and the reasoning behind how these grips provided a compelling reproductive advantage.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10836384","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}
Emily M Pflug, Sebastian A Giordano, Lorraine Hutzler, Joseph A Bosco, Jordan Howard, Nader Paksima
{"title":"Assessing the Adequacy and Readability of Surgical Consents in Orthopedic Surgery.","authors":"Emily M Pflug, Sebastian A Giordano, Lorraine Hutzler, Joseph A Bosco, Jordan Howard, Nader Paksima","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Handwritten consent forms for medical treatment are commonly used despite the associated risk of documentation errors. We performed an internal audit of handwritten surgical consent forms to assess the quality of consenting practices within the department of hand surgery at our orthopedic specialty hospital.</p><p><strong>Methods: </strong>A sample of 1,800 charts was selected. Con- sents were assessed for procedure type, physician details, abbreviations, consistency, and legibility.</p><p><strong>Results: </strong>A total of 1,309 charts met the inclusion crite- ria. Two hundred and eight consents contained at least one illegible word. The name of the consenting physician was not listed or illegible on 114 forms. Medical abbreviations were found on 1.8% of all included forms, and 19 consent forms contained a crossed-out word or correction.</p><p><strong>Conclusions: </strong>Although the majority of the handwrit- ten consent forms were complete, accurate, and legible, there were notable errors in the consenting process at our institution. Documentation errors have medical and ethical ramifications. Further research into consenting practices is necessary to improve the quality of consent forms and the process of informed consent.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40477296","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 Clinician's Guide to Differential Diagnosis of Non-Localized Musculoskeletal Pain A Primer on Musculoskeletal Medicine.","authors":"Elisha Krasin, Yaniv Warschawski, Amal Khoury","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Orthopedic surgeons may encounter patients with musculo- skeletal complaints that are not localized to a specific joint or anatomical area. The list of diagnoses that may cause generalized pain originating from bones, muscles, fasciae, and joints, including surrounding tissues like tendons, ligaments, and bursae, is vast; starting with influenza or fibromyalgia and ending with mycetism and ultra-rare he- reditary disorders. A systematic multidisciplinary approach is required. Many of these patients require referral to rheu- matology, endocrinology, or other specialties but at least a basic understanding of differential diagnosis is needed. The purpose of this review is to comprehensively examine the clinical presentation of various causes of generalized musculoskeletal pain and create a mental framework to aid the diagnostician in achieving the correct diagnosis in an orderly and efficient manner.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501905","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}
David A Bloom, Matthew Gonzalez, Eoghan T Hurley, Matthew T Kingery, Cordelia W Carter, Laith M Jazrawi, Eric J Strauss
{"title":"Sex-Based Differences in Outcomes of Tibial Tubercle Anteromedialization.","authors":"David A Bloom, Matthew Gonzalez, Eoghan T Hurley, Matthew T Kingery, Cordelia W Carter, Laith M Jazrawi, Eric J Strauss","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bulletin of the Hospital for Joint Diseases 2022;80(4):252-6252 Bloom DA, Gonzalez M, Hurley ET, Kingery MT, Carter CW, Jazrawi LM, Strauss EJ. Sex-based differences in outcomes of tibial tubercle anteromedi- alization. Bull Hosp Jt Dis. 2022;80(4):252-6. Abstract Background: Previous research has demonstrated sex- based differences in patient-reported outcomes of orthopedic surgical procedures. The hypothesis of the current study was that females would have inferior patient-reported outcomes to their male peers following a tibial tubercle anteromedial- ization (AMZ) procedure for both patellofemoral instability and cartilage defects.</p><p><strong>Methods: </strong>Patients who had undergone AMZ for isolated osteochondral defect or patellofemoral instability with a minimum follow-up time of 1 year were identified. They were then asked to complete several patient-reported outcome questionnaires that were then statistically analyzed.</p><p><strong>Results: </strong>Overall, 109 patients were included in this study. Seventy-nine patients (72.5%) were female with a mean follow-up duration of 3.4 ± 2.0 years. Forty-seven females had AMZ for patellar instability while 32 females had AMZ for osteochondral defects. There were no statistically signifi- cant differences between sexes with respect to concomitant procedures performed, visual analog scale (VAS) pain score, or patient reported outcome (PRO) scores at follow-up (p > 0.05). There was no statistically significant difference with respect to outcomes between the sexes for AMZ overall and when isolating the sexes based on indication.</p><p><strong>Conclusion: </strong>This study demonstrates that female patients undergoing AMZ have short-term clinical and functional outcomes that are not significantly different to those reported in males.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501907","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}
Ludovico Panarella, Monica Gasparini, Franz Federico Sesti, Francesco Oliva
{"title":"Reconstruction of Chronic Triceps Brachii Tendon Rupture Using Semitendinosus Autograft Surgical Technique.","authors":"Ludovico Panarella, Monica Gasparini, Franz Federico Sesti, Francesco Oliva","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Rupture of the triceps tendon is a rare event, and the care could be often problematic for orthopedic surgeons. Cases of triceps tendon re-rupture are even rarer. The stump is often retracted, atrophic, and the tissue quality is poor. Several surgical techniques have been reported. We present our surgi- cal reconstruction using free semitendinosus (ST) autograft.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501900","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}
Mackenzie A Roof, Lorraine Hutzler, Anna Stachel, Scott Friedlander, Michael Phillips, Joseph A Bosco
{"title":"Lack of Seasonal and Temporal Variability in Total Hip Arthroplasty Surgical Site Infections.","authors":"Mackenzie A Roof, Lorraine Hutzler, Anna Stachel, Scott Friedlander, Michael Phillips, Joseph A Bosco","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are a signifi- cant cause of morbidity and mortality following total joint arthroplasty (TJA). While many risk factors are known, the seasonal and temporal associations of SSI are less under- stood. Understanding the associations can help reduce SSI rates.</p><p><strong>Methods: </strong>We tracked rates of deep surgical site infec- tions (dSSIs) following total hip arthroplasty (THA) at a single large urban academic medical center from January 2009 through August 2018. Using a Poisson regression, we determined the monthly and seasonal variability of dSSIs. We also calculated the change in dSSI rate over the entire 9.67-year study period.</p><p><strong>Results: </strong>In total, 15,703 THA cases between January 2009 and August 2018 were analyzed. There was no signifi- cant difference in the dSSI rate following THA in fall, winter, or spring as compared to summer. Similarly, there was no significant difference in dSSIs in July as compared to other months of the year. The average rate of dSSIs following THA was 1.04 (SD, 0.90) per 100 patients. The dSSI rate following THA decreased over the study period (r = 0.93, 95% CI: 0.84-1.03) but did not reach statistical significance.</p><p><strong>Conclusion: </strong>This study demonstrated a non-significant, albeit decreasing, rate of dSSIs following THA over the study period. Contrary to previous reports, there was no difference in the dSSI rate in the summer months as compared to other seasons. The month of the year also does not appear to be a significant risk factor for SSIs, calling into question previous reports arguing for the importance of the \"July effect.\"</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501901","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}
Michael J Moses, David Novikov, Tyler Luthringer, Lazaros Poultsides, Jonathan M Vigdorchik
{"title":"Clinical Outcomes of Total Hip Arthroplasty in Patients with Prior Periacetabular Osteotomy.","authors":"Michael J Moses, David Novikov, Tyler Luthringer, Lazaros Poultsides, Jonathan M Vigdorchik","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Periacetabular osteotomy (PAO) has been used as a treatment modality for development dysplasia of the hip (DDH). Many patients will progress to total hip arthroplasty (THA) following PAO. There is a discrepancy in the literature regarding outcomes of THA after PAO.</p><p><strong>Methods: </strong>A retrospective study was performed. Ten pa- tients (12 hips) with prior PAO who progressed to THA with at least 1-year follow-up after THA were identified. A control group of patients matched for age, sex, and body mass index (BMI) who underwent primary THA with minimum of 1-year follow-up were included. Demographic and radiographic parameters as well as clinical outcomes using the modified Harris Hip Score (mHHS) were collected.</p><p><strong>Results: </strong>The mean age at the time of THA was 36.2 ± 9.7 years for the PAO and 37.8 ± 9.1 years for the control cohorts. There was no difference in the demographics be- tween the groups. At mean follow-up time of 22.8 ± 10.7 months for the PAO group and 25 ± 13.8 months for the control group, there was no significant difference in mHHS following THA. There was significant improvement in mHHS from preoperative to postoperative levels (p < 0.01).</p><p><strong>Conclusion: </strong>Total hip arthroplasty is an effective means to restore quality of life and function in patients who develop osteoarthritis following PAO, with equivalent outcomes to those undergoing primary THA.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40501902","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}