Wide Awake Surgery Is Safe and Feasible in Pediatric Orthopaedic Surgery.

Objective: Wide awake local anesthesia no tourniquet (WALANT) techniques are increasingly utilized for hand surgeries in adults, given the clinical benefits to patients, reduced environmental waste during surgery, and lower costs to the health care system. This technique is not widely employed for pediatric hand surgeries given concerns for parental and patient anxiety, noncompliance during surgery, and tolerance of administration of local anesthesia. Select patients undergoing amenable procedures can potentially benefit from this method and enjoy the lower morbidities and costs that adult patients enjoy.

The impact of sleep apnea on primary reverse shoulder arthroplasty for the treatment of glenohumeral osteoarthritis.

Introduction: As the prevalence of sleep apnea (SA) increases nationwide, large sample sized studies following primary reverse shoulder arthroplasty (RSA) in SA patients are scarce. Therefore, this study evaluated whether SA is associated with 1) longer in-hospital lengths of stay (LOS) 2) readmissions 3) medical complications and 4) costs.

Methods: A retrospective nationwide Medicare analysis from 2005 to 2014 was performed.

Resident and Fellow Participation Does Not Affect Short-Term Postoperative Complications After Distal Radius Fracture Fixation.

 Complications after open reduction internal fixation (ORIF) for distal radius fractures (DRF) are well documented, but the impact of trainee involvement on postoperative outcomes has not been studied.  Does trainee involvement affect postoperative complication rates and length of hospital stay?  The American College of Surgeons National Surgical Quality Improvement Program was queried from 2006 to 2012 for patients undergoing DRF ORIF. A 1:1 propensity score matched resident/fellow involved cases to attending-only cases.

Benign prostatic hyperplasia is associated with increased 90-day medical complications but not peri-prosthetic joint infections following reverse shoulder arthroplasty.

Introduction: Studies have shown male sex to be a predisposing factor for peri-prosthetic joint infections (PJIs). Symptomatic benign prostatic hyperplasia (BPH) has been suggested as an additional risk for PJI. This study aimed to assess the impact of BPH on (1) lengths of stay (LOS), (2) complications (medical and implant-related), (3) readmission rates, and (4) healthcare expenditures after reverse shoulder arthroplasty (RSA).

Risk Factors for Infections Following Open Reduction and Internal Fixation for Distal Radius Fractures An Analysis of the Medicare Claims Database.

Unlabelled: Bulletin of the Hospital for Joint Diseases 2022;80(2):228-33228 Mahmood B, Golub IJ, Ashraf AM, Ng MK, Vakharia RM, Choueka J. Risk factors for infections following open reduction and internal fixation for distal radius fractures: an analysis of the medicare claims database. Bull Hosp Jt Dis.

A nationwide analysis on the effects of chronic obstructive pulmonary disease following primary total shoulder arthroplasty for glenohumeral osteoarthritis.

Background: Chronic obstructive pulmonary disease patients have been shown in orthopedic literature to have poorer outcomes and higher rates of complications from surgery. In this retrospective review, medical complications, length of stay, and costs were obtained to explore the effects of chronic obstructive pulmonary disease on patients undergoing primary total shoulder arthroplasty.

Methods: Total shoulder arthroplasty cases from January 2005 to March 2014 were queried and analyzed from a nationwide database.

Risk factors for nonunion following open reduction and internal fixation for proximal humerus fractures.

Purpose: The incidence of proximal humerus fractures (PHF) is rising and surgical intervention carries risk for fracture nonunion. The purpose was (1) to compare patient demographics of those that developed nonunion and (2) identify patient risk factors that predispose to nonunion following open reduction and internal fixation (ORIF) for PHF.

Methods: A retrospective review of the Medicare Claims Database from 2005 to 2014 for patients who underwent primary ORIF for PHFs.

Anemia Severity and the Risks of Postoperative Complications and Extended Length of Stay Following Primary Total Elbow Arthroplasty.

Background: Anemia is a modifiable risk factor that may influence postoperative complications following orthopedic surgical procedures. The objective was to determine the influence of preoperative anemia severity on postoperative complications and length of stay (LOS) following total elbow arthroplasty (TEA).

Methods: The American College of Surgeons National Surgical Quality Improvement Program registry was queried from 2006 to 2019 for patients undergoing primary TEA.

A Potentially Advantageous Use of a Zero-Profile, Stand-Alone Anterior Interbody Spacer at C2-3 for the Treatment of Hangman's Fracture: A Technical Case Report.

Hangman's fracture or traumatic spondylolisthesis of the axis is a common fracture pattern in the cervical spine. Nonoperative management with an external orthosis is appropriate in select cases. However, when surgery is necessary, both anterior and posterior approaches can be used, and the optimal approach has not been established.

A matched-control study on the effects of depressive disorders following open reduction and internal fixation for acetabular fractures.

Introduction: The World Health Organization (WHO) postulates that depressive disorders (DD) will be the leading cause of morbidity and mortality by 2030. Studies evaluating the association of DD following open reduction and internal fixation (ORIF) for the treatment of acetabular fractures are limited. Therefore, the purpose of this matched-control study was to determine whether DD patients undergoing ORIF for acetabular fractures have higher rates of: (1) in-hospital lengths of stay (LOS); (2) readmissions; (3) medical complications; and (4) costs of care.

A matched-control analysis on the effects of alcohol use disorder following primary reverse shoulder arthroplasty.

Introduction: The purpose of this study was to determine whether alcohol use disorder (AUD) patients undergoing reverse shoulder arthroplasty (RSA) have increased: 1) lengths of stay (LOS); 2) complications; and 3) costs.

Methods: The study identified 19,168 patients in the study (n = 3198) and control (n = 15,970) cohort. In-hospital LOS, 90-day complications, and costs were assessed.

Detecting structural and inflammatory response after in vivo stretch injury in the rat median nerve via second harmonic generation.

Background: Second Harmonic Generation (SHG) microscopy is a promising method for visualizing the collagenous structure of peripheral nerves. Assessing collagen continuity and damage after a stretch injury provides inferential insight into the level of axonal damage present.

New Methods: This study utilizes SHG microscopy after a calibrated in vivo stretch injury of rat median nerves to evaluate collagen continuity at several time points throughout the recovery process.

Reliable Detection of Mismatch Repair Deficiency in Colorectal Cancers Using Mutational Load in Next-Generation Sequencing Panels.

Purpose: Tumor screening for Lynch syndrome is recommended in all or most patients with colorectal cancer (CRC). In metastatic CRC, sequencing of RAS/BRAF is necessary to guide clinical management. We hypothesized that a next-generation sequencing (NGS) panel that identifies RAS/BRAF and other actionable mutations could also reliably identify tumors with DNA mismatch repair protein deficiency (MMR-D) on the basis of increased mutational load.

Germline Variants in Targeted Tumor Sequencing Using Matched Normal DNA.

Importance: Tumor genetic sequencing identifies potentially targetable genetic alterations with therapeutic implications. Analysis has concentrated on detecting tumor-specific variants, but recognition of germline variants may prove valuable as well.

Objective: To estimate the burden of germline variants identified through routine clinical tumor sequencing.

Identification of germline genetic mutations in patients with pancreatic cancer.

Background: Pancreatic adenocarcinoma (PAC) is part of several cancer predisposition syndromes; however, indications for genetic counseling/testing are not well-defined. In the current study, the authors sought to determine mutation prevalence and characteristics that are predictive of an inherited predisposition for PAC.

Methods: A total of 175 consecutive patients with PAC who underwent clinical genetics assessment at Memorial Sloan Kettering Cancer Center between 2011 and 2014 were identified.