Use of a Novel Technique for Iliac Wing Osteosarcoma Metastasis Resection and Reconstruction: A Case Report.

Case: We present the case of a 15-year-old adolescent boy with recurrent metastatic osteosarcoma to the ilium and describe the surgical technique of iliac wing wide resection with allograft reconstruction using a custom 3D-printed cutting guide that accounts for complex anatomy by enabling nonlinear osteotomies.

Conclusion: Use of a custom 3D-printed cutting guide to resect a circumferential metastatic focus allows for targeted lesion removal with less morbidity than unguided resection. Importantly, this novel technique improves the ease of resecting a cylindrical bone segment.

Falling Rates of Public Orthopaedic Surgery Reimbursements and Utilization, 2016 to 2024.

Background: Declining reimbursement rates can lead to decreased access and utilization of common orthopaedic surgeries for patients on Medicare, which is a particularly vulnerable population for musculoskeletal injuries.

Methods: Using the Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool from 2016 to 2024 and utilization data for Medicare and part B beneficiaries from 2016 to 2022, we analyzed reimbursement and utilization trends. Simple linear regressions were executed to measure the annual trends, and Wilcoxon matched-pairs signed rank test were used to analyze the statistical significance of price and utilization changes.

Hemispheric annealing and lateralization under psychedelics (HEALS): A novel hypothesis of psychedelic action in the brain.

Current models of psychedelic action in the brain propose changes along the dorsal-ventral and anterior-posterior axes but neglect to address the lateral axis. This article proposes a novel model of psychedelic action called HEALS (Hemispheric Annealing and Lateralization Under Psychedelics) which involves the reversal of the typical hierarchical relationship between the two hemispheres of the brain. In typical modes of consciousness, the hemispheres act in parallel process with the left predominating.

OrthoACCESS 2.0: Redesigning a National Orthopaedic Surgery Curriculum for Medical Students using a Flipped-Classroom Blended Learning Model.

Objective: Due to limited musculoskeletal education, students pursuing orthopaedic surgery often feel unprepared for residency. Clinical rotations provide some education; however, prior to the development of the Ortho Acting-Intern Coordinated Clinical Education and Surgical Skills (OrthoACCESS) curriculum in 2019, no standardized didactic curriculum existed. Over time, students desired interactive, case-based learning opportunities.

The Epidemiology of Psychedelic Use Among United States Military Veterans.

We sought to identify patterns of psychedelic use among United States military veterans, compare demographic variables and perspectives of those who did and did not report use, and characterize benefits and adverse outcomes associated with use. Respondents ( = 426) were recruited to complete an online cross-sectional survey. Approximately one-half (51%) reported using psychedelics.

The Effect of Anesthetic Regimen on Bone Cement Implantation Syndrome in Cemented Hemiarthroplasty for Hip Fracture.

Introduction: Bone cement implantation syndrome (BCIS) is characterized by hypoxia, hypotension, and cardiovascular compromise during cementation in arthroplasty cases. This study examines the association between anesthetic regimen and risk of BCIS in cemented hemiarthroplasty for hip fractures. We hypothesized that neuraxial anesthesia would be associated with markedly lower BCIS incidence compared with general anesthesia alone or in combination with regional anesthesia.

Patients Who Have Prior Solid Organ Transplants Have Increased Risk of 10-Year Periprosthetic Joint Infection Revision Following Primary Total Knee Arthroplasty: A Propensity-Matched Analysis.

Background: Total knee arthroplasty (TKA) for solid organ transplant (SOT) patients is becoming more prominent as life expectancy in this population increases. However, data on long-term (10 year) implant survivorship in this cohort are sparse. The purpose of this study was to compare 90-day, 2-year, 5-year, and 10-year implant survivability following primary TKA in patients who did and did not have prior SOT.

Photoimmunotheranostics of epithelioid sarcoma by targeting CD44 or EGFR.

Epithelioid sarcoma (ES) is a rare soft tissue neoplasm with high recurrence rates. Wide surgical resection remains the only potential curative treatment. ES presents most commonly on the fingers, hands and forearm, making light-based cancer cell-targeted therapies such as near-infrared photoimmunotherapy (NIR-PIT) that is target-specific, but with limited penetration depth, suitable for ES treatment.

The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder.

We examined if the therapeutic alliance between study participants and intervention facilitators in a psilocybin-assisted therapy (PAT) trial changed over time and whether there were relationships between alliance, acute psilocybin experiences, and depression outcomes. In a randomized, waiting list-controlled clinical trial for major depressive disorder in adults (N = 24), participants were randomized to an immediate (N = 13) or delayed (N = 11) condition with two oral doses of psilocybin (20mg/70kg and 30mg/70kg). Ratings of therapeutic alliance significantly increased from the final preparation session to one-week post-intervention (p = .

Screening for Asymptomatic Osteonecrosis of the Hip in Systemic Lupus Erythematous: A Systematic Review and Meta-Analysis of MRI-Based Prevalence.

. This paper aims to estimate asymptomatic hip osteonecrosis prevalence in SLE patients using MRI examination and to determine the prevalence among higher risk subpopulations. .

Life Expectancy After Treatment of Metastatic Bone Disease: An International Trend Analysis.

Introduction: The decision to treat metastatic bone disease (MBD) surgically depends in part on patient life expectancy. We are unaware of an international analysis of how life expectancy among these patients has changed over time. Therefore, we asked (1) how has the life expectancy for patients treated for MBD changed over time, and (2) which, if any, of the common primary cancer types are associated with longer survival after treatment of MBD?

Methods: We reviewed data collected from 2000 to 2022 in an international MBD database, as well as data used for survival model validation.

The efficacy and safety of direct oral anticoagulants compared with low-molecular-weight heparin for venous thromboembolism prophylaxis after surgical resection of primary lower extremity bone or soft-tissue sarcoma.

Introduction: The incidence of postoperative venous thromboembolism (VTE) and wound complications is greater after sarcoma resection. We sought to identify differences in postoperative VTE and bleeding complications with direct oral anticoagulants (DOACs) versus low-molecular-weight heparin (LMWH) following resection of lower extremity primary bone or soft tissue sarcoma.

Methods: We retrospectively identified 2083 patients from the PearlDiver database who underwent resection of primary bone or soft tissue sarcoma of the lower extremity from January 2010 to October 2021 and prescribed LMWH or DOAC within 90-days postoperatively.

The low and disproportionate utilization of antiresorptive therapy in patients with osseous metastasis.

Introduction: Antiresorptive therapies are commonly utilized to mitigate and prevent skeletal-related-events in patients with metastatic osseous disease. However, limited data exists on the incidence or factors associated with prescription of antiresorptives or their effects on the incidence of pathologic fractures in patients with osseous metastatic disease. The aims of this study were to determine 1) the proportion of patients with osseous metastasis who receive antiresorptive therapy and sustain a pathologic fracture within 2-years of a new diagnosis, 2) factors associated with sustaining a pathologic fracture, and 3) factors are associated with the likelihood of receiving antiresorptive therapy.

The use of weakly supervised machine learning for necrosis assessment in patients with osteosarcoma: A pilot study.

Percent necrosis (PN) following chemotherapy is a prognostic factor for survival in osteosarcoma. Pathologists estimate PN by calculating tumor viability over an average of whole-slide images (WSIs). This non-standardized, labor-intensive process requires specialized training and has high interobserver variability.

Impact of Consolidative Radiation on Overall and Progression-Free Survival in Pediatric, Adolescent, and Young Adult Metastatic Bone and Soft Tissue Sarcoma.

Purpose: To determine the association between consolidative radiation (RT) and survival in children, adolescents, and young adults with metastatic sarcoma.

Methods And Materials: Eligibility criteria included patients aged ≤39 years with newly diagnosed metastatic bone or soft tissue sarcoma who completed local control of the primary tumor without disease progression. Consolidative RT was defined as RT to all known sites of metastatic disease.

Functional outcomes after open reconstruction or nonoperative management of 81 pathologic acetabular fractures from metastatic bone disease.

Background: Pathologic acetabular fracture secondary to skeletal metastasis may result in debilitating pain, inability to ambulate, and impaired quality of life, which may mark the first period of dependent care in cancer patients. Acetabular reconstruction may involve morbid procedures with increased complication rates. This study aimed to evaluate the evolution of pain, performance status, and ambulation following nonoperative management or open reconstruction of pathologic acetabular fractures.

Metastatic sarcomatoid carcinoma to bone.

Background And Objectives: Distinguishing sarcomatoid carcinoma from primary sarcoma is clinically important. We sought to characterize metastatic sarcomatoid bone disease and its management.

Methods: We analyzed the characteristics of all cases of sarcomatoid carcinoma to bone at a single institution from 2001 to 2021, excluding patients with nonosseous metastases.

Nodular cystic fat necrosis: a distinctive rare soft-tissue mass.

We report the case of a 34-year-old female who was evaluated for a right lower extremity soft-tissue mass, found to be a large cystic lesion bound by fibrous tissue containing innumerable, freely mobile nodules of fat. Her presentation suggested the diagnosis of nodular cystic fat necrosis (NCFN), a rare entity that likely represents a morphological subset of fat necrosis potentially caused by vascular insufficiency secondary to local trauma. Her lesion was best visualized using MRI, which revealed characteristic imaging features of NCFN including nodular lipid-signal foci that suppress on fat-saturated sequences, intralesional fluid with high signal intensity on T2-weighted imaging, and a contrast-enhancing outer capsule with low signal intensity on T1-weighted imaging.