The Iowa orthopaedic journal最新文献

{"title":"Is Femoral Head to Acetabular Cup Ratio Associated With Dislocation After Total Hip Arthroplasty?","authors":"Ronit Shah, Nihir Parikh, Tilak Patel, Ryan M Sutton, Justin A Magnuson, Chad A Krueger","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Dislocation remains a common complication following total hip arthroplasty (THA). Previous literature has shown that the femoral head-to-neck ratio is essential in hip motion, function, and stability. While large femoral heads and dual mobility bearings have been developed to improve stability, it remains unknown if the ratio between femoral head size to acetabular cup size also plays a role in stability. This study aimed to investigate if the relationship between the femoral head size and the acetabular cup size factors into the risk of hip dislocation.</p><p><strong>Methods: </strong>3155 patients who underwent primary THA for the indication of osteoarthritis between 2016 and 2019 were identified. Patient demographic, radiographic, implant and procedural data were analyzed. The primary outcome was determining head-to-cup ratios calculated by dividing the femoral head size by the acetabular cup size. Head-to-cup ratios were then compared in patients who suffered a dislocation after THA to those who did not. Univariate and logistic regression was conducted to determine additional dependent variables for hip dislocation.</p><p><strong>Results: </strong>Patients in this study had an average age of 64 ± 11 years. Females comprised 51% of the cohort, and BMI was 29.2 ± 5.2. A total of thirty-six (1.1%) patients sustained a dislocation at a median of 51 days following surgery. The dislocation cohort was similar to the non-dislocation cohort in age, gender, BMI, CCI, and ASA scores. The head-to-cup ratio was also identical between the dislocation (0.64 ± 0.05 mm) and non-dislocation (0.64 ± 0.05 mm) patients, P=0.317. Logistic regression adjusting for age, sex, BMI, and surgical approach demonstrated that the head-to-cup ratio was not associated with an increased risk of dislocation (p=0.728).</p><p><strong>Conclusion: </strong>Head-to-cup ratio was not found to be predictive of dislocation. Hip dislocation is complex and multifactorial, and it is difficult to isolate specific risks, such as the head-to-cup ratio analyzed in our study. Further investigation is needed to define groups benefiting from specialized implants such as large-diameter or dual mobility heads and the optimal head-to-cup size ratio. <b>Level of Evidence: III</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 2","pages":"61-66"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985880","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":"Searching for a Job: A Survey of Hand Fellowship Applicants and Current Hand Surgeons.","authors":"Nicholas James, Nolan Farrell, Derek Dixon, Reed Hoyer, F Thomas Kaplan, William J Weller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Core curricula do not include courses on how to find employment after hand fellowships. Little data exists in literature regarding job selection in hand surgery. This study's purpose was to provide information to future hand surgeons on ways of finding a job that meets their expectations and to elucidate factors that should be considered before deciding on a hand practice.</p><p><strong>Methods: </strong>A web-based survey asked hand fellows and fellowship applicants how they were searching for employment, the kind of practice they sought, expectations about hours, call, salary, possible niches, and importance of location, research, and passive income. A second survey was sent to hand surgeons. Statistical analysis determined how fellow expectations differed from reality.</p><p><strong>Results: </strong>Prospective hand surgeons completed 96 of 270 (36%) surveys and hand surgeons completed 63/107 (59%). Most prospective hand surgeons utilize word of mouth, mentors/faculty to search for employment, whereas most surgeons received connections through residency, friends/ family, or cold calling. The niches that prospective hand surgeons planned to bring to their practice differed from those of practicing surgeons. Expectations of call matched those of practicing hand surgeons, with most expecting to work 50 to 60 hours per week. For prospective surgeons, location and passive income were important but research was less so. Most hand surgeons have passive income and indicated low research participation.</p><p><strong>Conclusion: </strong>Minimal training in job selection has been cited as a reason for changing jobs. The applicants' and fellows' expectations on call, work hours, passive income, and research were similar to hand surgeons, but the niches they hoped to fill differed, perhaps indicating those may not be possible in actual practice. This study provides perspective on what practice as a hand surgeon is like and things to consider when job searching. <b>Level of Evidence: IV</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 2","pages":"7-12"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985922","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":"Department of Orthopedics and Rehabilitation Faculty 2023-2024.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 1","pages":"viii-ix"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452597","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":"E-Publication - December.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 1","pages":"i-ii"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452601","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":"Menstrual Cycle Hormone Relaxin and ACL Injuries in Female Athletes: A Systematic Review.","authors":"Emily A Parker, Kyle R Duchman, Alex M Meyer, Brian R Wolf, Robert W Westermann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Female athletes are at increased risk for anterior cruciate ligament (ACL) injuries. The influence of hormonal variation on female ACL injury risk remains ill-defined. Recent data suggests that the collagen-degrading menstrual hormone relaxin may cyclically impact female ACL tissue quality. This review aims to identify any correlation between menstrual relaxin peaks and rates of female ACL injury.</p><p><strong>Methods: </strong>A systematic review was performed, utilizing the MEDLINE, EMBASE, and CINAHL databases. Included studies had to directly address relaxin/female ACL interactions. The primary outcome variable was relaxin proteolysis of the ACL, at cellular, tissue, joint, and whole-organism levels. The secondary outcome variable was any discussed method of moderating relaxin levels, and the clinical results if available.</p><p><strong>Results: </strong>AllThe numerous relaxin receptors on female ACLs upregulate local collagenolysis and suppress local collagen production. Peak serum relaxin concentrations (SRC) occur during menstrual cycle days 21-24; a time phase associated with greater risk of ACL injury. Oral contraceptives (OCPs) reduce SRC, with a potential ACLprotective effect.</p><p><strong>Conclusion: </strong>A reasonable correlative and plausible causative relationship exists between peak relaxin levels and increased risk of ACL injury in females, and further investigation is warranted. <b>Level of Evidence: III</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 1","pages":"113-123"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452609","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":"Improving Applicant Satisfaction in Orthopaedic Surgery Residency Matching: The Role of Preference Signaling.","authors":"Lisa M Tamburini, Annabelle P Davey, James C Messina, Francine Zeng, Lauren E Geaney","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The orthopaedic surgery residency match is becoming increasingly more competitive with a disproportionate number of applicants to positions. As the residency application process has become more competitive, applicants have resorted to applying broadly to improve their chance of a successful match. Preference signaling was implemented for orthopaedic surgery for the 2022-2023 match cycle which allowed applicants to \"signal\" 30 programs of their choosing.</p><p><strong>Methods: </strong>The purpose of this study was to assess the impact of preference signaling on orthopaedic surgery applicant experiences and outcomes in the 2023 residency application cycle and match. An anonymous electronically based survey study developed using Research Electronic Data Capture (REDCap) was send to 895 applicants to a single orthopedic residency program. 148 applicants filled out some portion of the survey for a 16.5% response rate.</p><p><strong>Results: </strong>51% of applicants applied to 61-100 programs. Applicants received more interview offers from programs they signaled compared to programs they did not signal. 50% of applicants responded that the number of allotted signals was \"just right\", with more applicants responding that the number of signals allotted was \"too many\" rather than \"too few\". 62% of applicants agreed that signaling increased his/her chances of receiving an interview offer at a signaled program, 66% were satisfied with the results of the match, and 50% thought signaling had a positive impact on the application process.</p><p><strong>Conclusion: </strong>Overall, preference signaling was well received by applicants and may help to connect applicants with residency programs they are specifically interested in. <b>Level of Evidence: III</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452604","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":"Identifying Predictors of Extended Intensive Care Unit Stay Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Analysis of 101 ACS NSQIP Pediatric Participating Centers.","authors":"Neil V Shah, Marine Coste, Nathan S Kim, David J Kim, Carolyn Andrews, Rachel Baum, Alejandro Friedman, Kyle Smith, Samuel Gedailovich, Adam J Wolfert, Amanda M Dave, Vincent Challier, Renaud Lafage, Peter G Passias, Virginie Lafage, Frank J Schwab, Jad Bou Monsef, Carl B Paulino, Bassel G Diebo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.</p><p><strong>Methods: </strong>AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database. Patients were subsequently grouped by ICU LOS 0-1 day; 2-3 days; and >3 days. Multivariate regression identified predictors of increased ICU LOS.</p><p><strong>Results: </strong>2,346 AIS patients were included. The >3 days and 2-3 days groups had higher asthma rates compared to 0-1 day. The >3 days group had higher rates of structural airway abnormalities and he-matologic disorders. Cognitive impairment rates were highest for >3-day ICU LOS. Hematologic dis-orders, structural airway abnormalities, asthma and cognitive impairment were associated with prolonged ICU LOS.</p><p><strong>Conclusion: </strong>These results help inform targets for optimization of acute short-term postoperative care as well as assisting in risk stratification to improve outcomes and reduce costs for ICU-level care of AIS patients at ACS NSQIP Pediatric program-participating hospitals. <b>Level of Evidence: III</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 2","pages":"83-88"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985879","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":"Department of Orthopedics and Rehabilitation Residents 2023-2024.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 1","pages":"x"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452598","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":"The 2024 Michael Bonfiglio Award for Student Research in Orthopaedic Surgery The 2024 Iowa Orthopaedic Society Medical Student Research Award for Musculoskeletal Research.","authors":"Heather Kowalski","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 1","pages":"xvii"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452613","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":"Efficacy of Intraoperative Cell Salvage on Perioperative Blood Transfusion in Pelvic and Acetabular Surgery: A Matched Cohort Analysis.","authors":"Gireesh B Reddy, Neil V Mohile, Jessica D Leuchter, Rajan R Murgai, Joseph S Geller, Akhil Sharma, Ramakanth R Yakkanti, James C Shaw","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pelvic fractures often result in traumatic and intraoperative blood loss. Cell salvage (CS) is a tool where autologous blood lost during surgery is collected and recycled with anticoagulation, centrifugation to separate red blood cells, and washing to be reinfused back to the patient. The purpose of this study was to investigate our experience with CS in pelvic and acetabular surgery and its relationship to perioperative transfusion requirements.</p><p><strong>Methods: </strong>After institutional review board approval, adult patients who underwent pelvic ring or acetabular open reduction internal fixation between 01/2014-11/2021 at a tertiary care level-one trauma center were retrospectively reviewed. Peri-operative outcomes including pre-/post-operative hemoglobin and hematocrit, estimated blood loss, use of CS, and perioperative blood transfusions were collected. Pooled two-sample t-tests were used to compare parametric populations while Fischer's exact test or Pearson's Chi squared test were used for nonparametric data.</p><p><strong>Results: </strong>402 patients were included (85 in the CS group and 317 in the non-CS group). Patients had a higher proportion of acetabular fractures. The use of CS was associated with longer operative time (366 mins vs. 269 mins, p<0.0001), EBL (911 mL vs. 473 mL, p<0.0001), and allogenic transfusion of RBC units intraoperatively (1.75 u vs. 1.28 u, p=0.0442) and postoperatively (1.38 u vs. 0.66 u, p<0.0012).</p><p><strong>Conclusion: </strong>The use of CS was associated with higher total and postoperative allogenic units transfused. Future prospective randomized trials would help to further delineate the risks and benefits of CS utilization in surgical treatment of these fractures. <b>Level of Evidence: III</b>.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"44 2","pages":"149-156"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985815","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}