Instructional course lectures最新文献

How to Optimize Outcomes in the Total Joint Arthroplasty Patient With Modifiable Risk Factors. 危险因素可改变的全关节置换术患者如何优化预后。

Instructional course lectures Pub Date : 2026-01-01

Nirav Mungalpara, Menachem M Meller, Mark H Gonzalez

{"title":"How to Optimize Outcomes in the Total Joint Arthroplasty Patient With Modifiable Risk Factors.","authors":"Nirav Mungalpara, Menachem M Meller, Mark H Gonzalez","doi":"","DOIUrl":"","url":null,"abstract":"Modifiable risk factors significantly influence both perioperative safety and long-term success in total joint arthroplasty. A structured, patient-focused model should be used for optimizing high-impact factors, including obesity, malnutrition, anemia, and poorly controlled diabetes. Practical guidance on anesthesia selection and surgical technique adjustments is important to accommodate body habitus and reduce surgical complexity. Targeted medication dosing strategies are needed to avoid undertreatment or toxic exposures in patients with altered pharmacokinetics. It is also important to underscore the value of robust behavioral interventions, such as smoking cessation and alcohol reduction, to lower wound complication rates and enhance overall recovery. Central sensitization of pain with an emphasis on using specific therapeutic approaches, including neuromodulators, will improve postoperative comfort and patient satisfaction. In addition, there are recommendations for mitigating infection risk, ranging from careful glycemic control to selective methicillin-resistant Staphylococcus aureus decolonization protocols. By addressing these modifiable elements, surgeons and their care teams can substantially decrease complication rates, optimize implant longevity, and promote enhanced functional outcomes.","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"75 ","pages":"337-354"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607623","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}

引用次数: 0

Novel and Alternative Surgical Techniques for Cartilage Disorders of the Knee. 膝关节软骨疾病的新颖和替代手术技术。

Instructional course lectures Pub Date : 2026-01-01

Andrew S Bi, Larry Chen, James Lee Pace, Alexander Golant, Laith M Jazrawi

{"title":"Novel and Alternative Surgical Techniques for Cartilage Disorders of the Knee.","authors":"Andrew S Bi, Larry Chen, James Lee Pace, Alexander Golant, Laith M Jazrawi","doi":"","DOIUrl":"","url":null,"abstract":"Articular cartilage lesions of the knee, ranging from focal defects to tricompartmental osteoarthritis, present significant clinical challenges because of cartilage's limited regenerative capacity. It is important to highlight modern surgical advancements in the treatment of chondral pathology beyond injection therapy, traditional osteotomies, and arthroplasty options. Surface- and cell-based repair techniques, including matrix-induced autologous chondrocyte implantation, offer improved long-term outcomes, with emerging fourth-generation variants facilitating single-stage arthroscopic implantation. Off-the-shelf cartilage repair strategies, such as particulated juvenile cartilage, micronized allografts, and viable cartilage allografts, represent promising alternatives that bypass the need for two-stage procedures. For osteochondral defects, osteochondral autograft transfer and fresh allograft transplantation remain the gold standard, although decellularized and cryopreserved viable allografts are under investigation. Recently approved artificial osteochondral scaffolds, such as Agili-C, offer an FDA-cleared, acellular biphasic implant with promising midterm results. For patients with malalignment-associated osteoarthritis, patient-specific instrumentation in high tibial and distal femoral osteotomies enhances accuracy, particularly in biplanar corrections, and reduces intraoperative variability. Novel load-sharing implants, such as fiber-reinforced rafting nails and the MISHA knee system, provide less invasive alternatives to osteotomy, showing early success in reducing medial compartment load and improving functional outcomes. There is an expanding arsenal of biologically and biomechanically innovative treatments for articular cartilage restoration and osteoarthritis management.","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"75 ","pages":"157-170"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607595","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}

引用次数: 0

Evolving Concepts in Adult Spinal Deformity Surgery. 成人脊柱畸形手术概念的演变。

Instructional course lectures Pub Date : 2026-01-01

Arman Kishan, Joseph E Nassar, Kishan S Shah, Max Ray Fisher, Oluwatobi O Onafowokan, Paritash Tahmasebpour, Pawel P Jankowski, Bassel Georges Diebo, Robert K Eastlack, Peter G Passias

{"title":"Evolving Concepts in Adult Spinal Deformity Surgery.","authors":"Arman Kishan, Joseph E Nassar, Kishan S Shah, Max Ray Fisher, Oluwatobi O Onafowokan, Paritash Tahmasebpour, Pawel P Jankowski, Bassel Georges Diebo, Robert K Eastlack, Peter G Passias","doi":"","DOIUrl":"","url":null,"abstract":"Adult spinal deformity is a multifaceted condition increasingly encountered in aging populations, often complicated by coexisting hip and knee osteoarthritis. It is important to present an integrated review of biomechanical, surgical, and technologic advances shaping modern adult spinal deformity management. First, the hip-spine-lower extremity relationship and how lower limb pathology impairs compensatory mechanisms, alters spinopelvic alignment, and influences surgical outcomes should be examined. Next, the evolution of classification systems and alignment philosophies-ranging from the Scoliosis Research Society-Schwab classification to patient-specific, age-adjusted models-should be outlined alongside technologic innovations such as artificial intelligence, three-dimensional planning, and robotics. The role of minimally invasive surgery is rising, and its benefits, limitations, and patient selection criteria should be evaluated. Critical topics include frailty-adjusted surgical planning, prevention of proximal junctional kyphosis or failure, and multidisciplinary strategies to improve functional outcomes and reduce complications. Collectively, there is a paradigm shift toward personalized, precision-driven care in adult spinal deformity surgery.","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"75 ","pages":"705-726"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607631","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}

引用次数: 0

The Pulseless Supracondylar Humerus Fracture: To Explore or Not. 无脉肱骨髁上骨折：探讨与否。

Instructional course lectures Pub Date : 2026-01-01

Lauren Swany, Elinor Stern, Matthew Stepanovich

引用次数: 0

The Role of Arthroplasty in Acute and Failed Fracture Surgery Around the Hip. 髋关节置换术在急性和失败髋周骨折手术中的作用。

Instructional course lectures Pub Date : 2026-01-01

Chinyelu Uchechukwu Menakaya, Adam Sassoon, Andrew H Schmidt, Michael D McKee, Emil H Schemitsch

引用次数: 0

Treatment of Rotator Cuff Tears: Around the World From Partial Thickness to Irreparable. 肩袖撕裂的治疗：世界各地从部分厚度到不可修复。

Instructional course lectures Pub Date : 2026-01-01

Zaamin B Hussain, Kier Maddox Blevins, Jesse Seilern Und Aspang, Eric R Wagner

引用次数: 0

Pediatric Medial Epicondyle Fractures: To Fix or Not To Fix? 小儿内上髁骨折：修复还是不修复？

Instructional course lectures Pub Date : 2026-01-01

Julia L Conroy, Joshua M Abzug, Matthew Stepanovich, Martin J Herman, Alexandra Miller Dunham

{"title":"Pediatric Medial Epicondyle Fractures: To Fix or Not To Fix?","authors":"Julia L Conroy, Joshua M Abzug, Matthew Stepanovich, Martin J Herman, Alexandra Miller Dunham","doi":"","DOIUrl":"","url":null,"abstract":"Pediatric medial epicondyle fractures are common elbow injuries that represent an avulsion fracture of the apophysis. These fractures are commonly associated with elbow dislocation, and as such, acknowledging the soft-tissue injury and resultant potential elbow instability is important. Treatment decision making is controversial because few absolute indications for surgery exist, and no true displacement cutoffs have been settled despite plentiful research. Although fracture incarceration in the joint, open fractures, ulnar nerve entrapment, and frank elbow instability are indications for surgery, fracture displacement is not a set tolerance. As patient expectations and activities have evolved with time, so have surgical techniques and the understanding of weighing risks and benefits of surgery. Fractures with less than 2 mm displacement are commonly treated with casting only, fractures with 2 to 15 mm displacement have been shown to represent a gray zone that may be indicated for surgery, and fractures with greater than 15 mm displacement are commonly recommended for surgery. Fixation strategies include pin fixation, screw fixation with or without a washer, and more recently suture anchors. As more fractures undergo surgical fixation, the understanding of patient outcomes, surgical risks including nonunion, and revision tactics will continue to expand.","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"75 ","pages":"585-594"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607673","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}

引用次数: 0

Periprosthetic Fractures Around Shoulder Arthroplasty: Tips and Tricks for Management of Challenging Injuries. 肩关节置换术周围假体骨折：处理挑战性损伤的提示和技巧。

Instructional course lectures Pub Date : 2026-01-01

Niloofar Dehghan, Midhat Patel, Michael Haessam Amini, Michael D McKee

{"title":"Periprosthetic Fractures Around Shoulder Arthroplasty: Tips and Tricks for Management of Challenging Injuries.","authors":"Niloofar Dehghan, Midhat Patel, Michael Haessam Amini, Michael D McKee","doi":"","DOIUrl":"","url":null,"abstract":"Periprosthetic fractures associated with shoulder arthroplasty are on the rise, which include humeral shaft fractures as well as scapular spine and acromion fractures. Although some of these fractures can be treated nonsurgically, surgery is indicated in certain situations. Because it is related to periprosthetic humeral shaft fractures, the Unified Classification System for Periprosthetic Fractures can be used to guide treatment. Type A fractures are stable and can be treated nonsurgically. Type B fractures at the tip of the stem have a high risk of failure with nonsurgical treatment, and benefit from surgical fixation. If the stem is stable (type B1), the fracture can be treated with open reduction and internal fixation. If the stem is unstable (type B2), revision arthroplasty is the treatment of choice. If there is bone loss associated with the loose stem (type B3), revision arthroplasty with allograft or megaprosthesis is the preferred method of treatment. For fractures well distal to the stem (type C) treatment is similar to that for native humeral fractures. Regarding acromial and scapular spine fractures, it is now recognized that patients who sustain this complication have poor outcomes with nonsurgical treatment, and surgical fixation is performed more frequently. Fixation techniques for acromial fractures are still evolving, and more literature in this field is needed.","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"75 ","pages":"237-246"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607731","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}

引用次数: 0

Managing and Avoiding Complications During Patellar Stabilization Surgery. 髌骨稳定手术中并发症的处理和避免。

Instructional course lectures Pub Date : 2026-01-01

Miho J Tanaka, Seth L Sherman, Melissa Albersheim, John P Fulkerson

引用次数: 0

Recent Advances in Pediatric Sports Medicine. 儿童运动医学的最新进展。

Instructional course lectures Pub Date : 2026-01-01

Saral Patel, Adam Nasreddine, Mininder S Kocher, Morgan Swanson, Theodore J Ganley, Jalen Paulos, Eric W Edmonds, Tyler R Mange, Daniel W Green, Shital N Parikh

引用次数: 0