American journal of orthopedics (Belle Mead, N.J.)最新文献_第2页

Trends in Utilization of Total Hip Arthroplasty for Femoral Neck Fractures in the United States. 美国股骨颈骨折全髋关节置换术的应用趋势。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-12-01 DOI: 10.12788/ajo.2018.0103

Spencer Summers, Luis C Grau, Dustin H Massel, Alvin Ong, Fabio Orozco, Samuel Rosas, Victor Hernandez

{"title":"Trends in Utilization of Total Hip Arthroplasty for Femoral Neck Fractures in the United States.","authors":"Spencer Summers, Luis C Grau, Dustin H Massel, Alvin Ong, Fabio Orozco, Samuel Rosas, Victor Hernandez","doi":"10.12788/ajo.2018.0103","DOIUrl":"https://doi.org/10.12788/ajo.2018.0103","url":null,"abstract":"The ideal mode of fixation for patients with femoral neck fractures is not well defined in the current literature. This study describes the recent trends in surgical management of femoral neck fractures with an analysis on perioperative outcomes. The National Hospital Discharge Survey was used to identify femoral neck fractures in the United States between 1990 and 2007 (n = 1,155,960) treated with open reduction and internal fixation (ORIF), total hip arthroplasty (THA), or hemiarthroplasty (HA). Trends were examined over the following 3 time periods: 1990 to 1995 (group 1), 1996 to 2001 (group 2), and 2002 to 2007 (group 3). Elixhauser Comorbidity Index and perioperative complications were calculated. Use of HA increased (74.4% to 84.6%), whereas that of THA (7.3% to 4.9%) and ORIF (18.3% to 10.6%) decreased, from group 1 to group 3 in the age group of >80 years. The use of ORIF increased (63.9% to 81.4%), whereas the use of both HA and THA decreased, from group 1 to group 3 in the age group of <50 years. The rate of adverse events increased across all fixation types but was greatest among THA (32.2% to 48.3%). The femoral neck patient population is now older and has more medical comorbidities. We observed a trend toward performing HA in older patients and ORIF in younger patients. Despite superior functional outcomes reported in THA, this study found a decreased utilization of THA in all age groups along with an increase in adverse events and nonroutine discharges for patients with femoral neck fractures treated with THA.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36859657","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: 6

Arthroscopic SLAP IIb Repair Using Knot-Tying Versus Knotless Suture Anchors: Is There a Difference? 关节镜下使用打结与无打结缝合锚钉修复SLAP IIb:有区别吗?

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-12-01 DOI: 10.12788/ajo.2018.0101

S Joseph de Groot, Justin W Arner, Clair N Smith, James P Bradley

{"title":"Arthroscopic SLAP IIb Repair Using Knot-Tying Versus Knotless Suture Anchors: Is There a Difference?","authors":"S Joseph de Groot, Justin W Arner, Clair N Smith, James P Bradley","doi":"10.12788/ajo.2018.0101","DOIUrl":"https://doi.org/10.12788/ajo.2018.0101","url":null,"abstract":"The use of knotless suture anchors has increased in popularity; however, there is a paucity of literature examining the difference in clinical outcomes with traditional knotted fixation. It was hypothesized that knotless fixation would provide superior clinical outcomes, improved return to play (RTP), and lower revision rates as compared with traditional knotted fixation in the repair of SLAP IIb tears. Seventy-four athletes who underwent arthroscopic SLAP IIb repair with traditional (n = 42) and knotless anchors (n = 32) by a single surgeon were evaluated after a minimum 2-year follow. Demographic and surgical data, RTP, Kerlan-Jobe Orthopaedic Clinic (KJOC) score, American Shoulder and Elbow Surgeons (ASES) score, stability, strength, and pain scores were compared. Knotless anchors had slightly higher RTP (93.5% vs 90.2%, P = .94) and RTP at the same level (58.1% vs 53.7% P = .81) compared with knotted fixation, but the difference did not reach statistical significance. Knotless anchors were less likely to require revision surgery than traditional anchors (9% vs 17%, P = .50), but the difference was not statistically significant. When comparing knotless and traditional knotted suture anchor repair of type llb SLAP tears, knotless fixation required less revision surgery and had higher RTP, ASES, and KJOC scores; however, statistical significance was not achieved in this relatively small cohort.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36870007","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

Fragility Fractures: Diagnosis and Treatment. 脆性骨折:诊断与治疗。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-12-01 DOI: 10.12788/ajo.2018.0112

Lauren Bledsoe, Kaitlyn Alessi, Jose B Toro, Brian Giordano, Bryan T Hanypsiak

{"title":"Fragility Fractures: Diagnosis and Treatment.","authors":"Lauren Bledsoe, Kaitlyn Alessi, Jose B Toro, Brian Giordano, Bryan T Hanypsiak","doi":"10.12788/ajo.2018.0112","DOIUrl":"https://doi.org/10.12788/ajo.2018.0112","url":null,"abstract":"Fragility fractures are estimated to affect 3 million people annually in the United States. As they are associated with a significant mortality rate, the prevention of these fractures should be a priority for orthopedists. At-risk patients include the elderly and those with thyroid disease, diabetes, hypertension, and heart disease. Osteoporosis is diagnosed by the presence of a fragility fracture or by dual-energy x-ray absorptiometry (DXA) in the absence of a fragility fracture. In 2011, the United States Preventive Services Task Force (USPSTF) recommended that all women ≥65 years should be screened for osteoporosis by DXA. Women <65 years with a 10-year fracture risk =∕> than that of a 65-year-old white woman should also be screened for osteoporosis. Lifestyle changes, such as calcium and vitamin D supplementation, exercise, and smoking cessation, are non-pharmacologic treatment options. The National Osteoporosis Foundation recommends treating osteoporosis with pharmacotherapy in patients with a high risk for fracture (T score <-2.5) or history of fragility fracture. Understanding risk factors and eliminating medications known to cause decreased BMD are vital to prevention and will be necessary to limit these fractures and their associated expenses in the future.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36870009","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: 9

Nutrition-Related Considerations in Soccer: A Review. 足球运动中与营养有关的考虑:综述。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-12-01 DOI: 10.12788/ajo.2018.0100

Rikki Keen

引用次数: 7

Safety and Efficacy of Percutaneous Injection of Lipogems Micro-Fractured Adipose Tissue for Osteoarthritic Knees. 经皮脂质体微骨折脂肪组织注射治疗膝关节骨性关节炎的安全性和有效性。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-11-01 DOI: 10.12788/ajo.2018.0098

Jay Panchal, Gerard Malanga, Mitchell Sheinkop

{"title":"Safety and Efficacy of Percutaneous Injection of Lipogems Micro-Fractured Adipose Tissue for Osteoarthritic Knees.","authors":"Jay Panchal, Gerard Malanga, Mitchell Sheinkop","doi":"10.12788/ajo.2018.0098","DOIUrl":"https://doi.org/10.12788/ajo.2018.0098","url":null,"abstract":"The aim of this study was to evaluate the safety and efficacy of using autologous, micro-fractured, minimally manipulated adipose tissue in patients with refractory knee osteoarthritis (OA). A total of 17 subjects (26 knees) with a median age of 72 years (range: 54-78 years) and a history of knee OA (Kellgren-Lawrence, grade of 3 or 4) underwent treatment with ultrasound-guided injection of micro-fractured adipose tissue. Micro-fractured fat was obtained using a minimal manipulation technique in a closed system (Lipogems), without the addition of enzymes or any other additives. The study subjects were clinically evaluated using the numerical pain rating scale (NPRS), the 100-point Knee Society Score (KSS) with its functional component (FXN), and the lower extremity activity scale (LEAS) at 6 weeks, 6 months, and 12 months following this procedure. When compared with baseline, significant improvements were noted in the mean values of NPRS, FXN, and LEAS at 6 weeks, 6 months, and 12 months. The mean KSS significantly improved at 6 weeks and 12 months. In particular, the average KSS score improved from 74 to 82, the FXN score improved from 65 to 76, and the LEAS score improved from 36 to 47. These values were significantly greater than the previously published minimal clinically important difference described for KSS and FXN in patients who underwent total knee arthroplasty for primary OA. No serious adverse events were reported. The injection of autologous, micro-fractured, minimally manipulated adipose tissue appears to be a safe and effective treatment option for patients with refractory, severe (grade 3 or 4) knee OA. This study demonstrated significant improvements in pain, quality of life, and function for at least 12 months in this study population. This intervention may represent a nonsurgical treatment option to avoid knee joint replacement in this population; however, further investigation is needed.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36753675","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: 39

Lower Extremity Injuries in Ice Hockey: Current Concepts. 冰球运动中的下肢损伤:当前概念。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-11-01 DOI: 10.12788/ajo.2018.0099

James N Irvine, Sean Lynch, Bryan T Hanypsiak, Charles A Popkin

引用次数: 5

The PASTA Bridge--A Repair Technique for Partial Articular-Sided Rotator Cuff Tears: A Biomechanical Evaluation of Construct Strength. PASTA桥-部分关节侧肩袖撕裂的修复技术:结构强度的生物力学评估。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-10-01 DOI: 10.12788/ajo.2018.0095

Alan M Hirahara, Wyatt J Andersen

{"title":"The PASTA Bridge--A Repair Technique for Partial Articular-Sided Rotator Cuff Tears: A Biomechanical Evaluation of Construct Strength.","authors":"Alan M Hirahara, Wyatt J Andersen","doi":"10.12788/ajo.2018.0095","DOIUrl":"https://doi.org/10.12788/ajo.2018.0095","url":null,"abstract":"Partial articular-sided supraspinatus tendon avulsion (PASTA) tears are a common clinical problem that can require surgical intervention to reduce patient symptoms. Currently, no consensus has been reached regarding the optimal repair technique. The PASTA Bridge technique was developed by the senior author to address these types of lesions. A controlled laboratory study was performed comparing the PASTA Bridge with a standard transtendon rotator cuff repair to confirm its biomechanical efficacy. A 50% articular-sided partial tear of the supraspinatus tendon was created on 6 matched pairs of fresh-frozen cadaveric shoulders. For each matched pair, 1 humerus received a PASTA Bridge repair, whereas the contralateral side received a repair using a single suture anchor with a horizontal mattress suture. The ultimate load, yield load, and stiffness were determined from the load-displacement results for each sample. Video tracking software was used to determine the cyclic displacement of each sample at the articular margin and the repair site. Strain at the margin and repair site was then calculated using this collected data. There were no significant differences between the 2 repairs in ultimate load (P = .577), strain at the repair site (P = .355), or strain at the margin (P = .801). No instance of failure was due to the PASTA Bridge construct itself. The results of this study have established that the PASTA Bridge is biomechanically equivalent to the transtendon repair technique. The PASTA Bridge is technically easy, percutaneous, reproducible, and is associated with fewer risks.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36710067","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: 2

The Three H's: Head, Heart, and Heat Considerations in Soccer. 三个H:足球中的头脑、心脏和热量考虑。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-10-01 DOI: 10.12788/ajo.2018.0087

M Terese Whipple, Aaron L Baggish, Elizabeth M Pieroth, George T Chiampas

引用次数: 2

Foot and Ankle Injuries in Soccer. 足球中的足部和踝关节损伤。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-10-01 DOI: 10.12788/ajo.2018.0096

Enrique Feria-Arias, Karim Boukhemis, Christopher Kreulen, Eric Giza

{"title":"Foot and Ankle Injuries in Soccer.","authors":"Enrique Feria-Arias, Karim Boukhemis, Christopher Kreulen, Eric Giza","doi":"10.12788/ajo.2018.0096","DOIUrl":"https://doi.org/10.12788/ajo.2018.0096","url":null,"abstract":"The ankle is one of the most commonly injured joints in soccer and represents a significant cost to the healthcare system. The ligaments that stabilize the ankle joint determine its biomechanics-alterations of which result from various soccer-related injuries. Acute sprains are among the most common injury in soccer players and are generally treated conservatively, with emphasis placed on secondary prevention to reduce the risk for future sprains and progression to chronic ankle instability. Repetitive ankle injuries in soccer players may cause chronic ankle instability, which includes both mechanical ligamentous laxity and functional changes. Chronic ankle pathology often requires surgery to repair ligamentous damage and remove soft-tissue or osseous impingement. Proper initial treatment, rehabilitation, and secondary prevention of ankle injuries can limit the amount of time lost from play and avoid negative long-term sequelae (eg, osteochondral lesions, arthritis). On the other hand, high ankle sprains portend a poorer prognosis and a longer recovery. These injuries will typically require surgical stabilization. Impingement-like syndromes of the ankle can undergo an initial trial of conservative treatment; when this fails, however, soccer players respond favorably to arthroscopic debridement of the lesions causing impingement. Finally, other pathologies (eg, stress fractures) are highly encouraged to be treated with surgical stabilization in elite soccer players.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36723406","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: 11

Use of Musculoskeletal Ultrasound and Regenerative Therapies in Soccer. 在足球运动中使用肌肉骨骼超声和再生疗法。

American journal of orthopedics (Belle Mead, N.J.) Pub Date : 2018-10-01 DOI: 10.12788/ajo.2018.0093

Alejandro J Centurion, Harrison Youmans, Ibrahim Mamdouh Zeini

{"title":"Use of Musculoskeletal Ultrasound and Regenerative Therapies in Soccer.","authors":"Alejandro J Centurion, Harrison Youmans, Ibrahim Mamdouh Zeini","doi":"10.12788/ajo.2018.0093","DOIUrl":"https://doi.org/10.12788/ajo.2018.0093","url":null,"abstract":"Improvements in ultrasound technology have increased the popularity and use of ultrasound as a diagnostic and therapeutic modality for many soccer-related musculoskeletal (MSK) injuries. As a dynamic imaging modality, ultrasound offers increased accuracy and efficacy with minimally invasive procedures, such as guided injections, percutaneous tenotomy, and regenerative therapies, in the clinical setting. Emerging evidence indicates that regenerative therapies, such as platelet-rich-plasma (PRP), mesenchymal stem cells, and amniotic products, are a promising treatment for many MSK injuries and are gaining popularity among professional athletes. PRP is a safe treatment for a number of MSK conditions and has been included in the standard of care. However, conflicting evidence on return-to-play timeframes and efficacy in certain MSK conditions have led to inconsistent recommendations on indications for use, dose, and timing of treatment. Mesenchymal stem cell therapy, while promising, lacks high-level evidence of efficacy despite its increasing use among athletes. Currently, no data are available regarding the outcome of the use of amniotic products for the treatment of injuries in athletes. Furthermore, preparation of many regenerative therapies eclipses the concept of minimal manipulation and is subject to US Food and Drug Administration phase I to III trials. High-level research on regenerative medicine therapies should be continuously conducted to establish their clinical efficacy and safety data.","PeriodicalId":79316,"journal":{"name":"American journal of orthopedics (Belle Mead, N.J.)","volume":"47 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36710071","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: 2