Persistently elevated joint contact stress after periacetabular osteotomy is associated with joint failure at minimum 10-year follow-up.

Periacetabular osteotomy (PAO) is a common treatment for prearthritic hip dysplasia. The goal of this investigation was to determine if computationally assessed hip contact mechanics are associated with joint failure at minimum 10-year follow-up. One hundred patients with hip dysplasia (125 hips) completed patient-reported outcomes an average of 13.

Providing a computationally derived, mechanically optimised target correction during preoperative planning can improve joint contact mechanics of hip dysplasia treated with periacetabular osteotomy.

Aim: Preoperative identification of acetabular corrections that optimally improve joint stability and reduce elevated contact stresses could further reduce osteoarthritis progression in patients with hip dysplasia who are treated with periacetabular osteotomy (PAO). The purpose of this study was to investigate how providing patient-specific, mechanically optimal acetabular reorientations to the surgeon during preoperative planning affected the surgically achieved correction.

Methods: Preoperative CT scans were used to create patient-specific hip models for 6 patients scheduled for PAO.

Incidence and risk factors for non-union of the superior ramus osteotomy when hip dysplasia is treated with periacetabular osteotomy.

Periacetabular osteotomy (PAO) is a well-established surgical treatment for hip dysplasia. Few studies report risk factors for the development of superior ramus osteotomy non-union. The purpose of this investigation was to document the incidence and risk factors for this complication.

Substantial Loss of Skeletal Muscle Mass Occurs After Femoral Fragility Fracture.

Background: Femoral fragility fractures in older adults can result in devastating loss of physical function and independence. Skeletal muscle atrophy likely contributes to disability. The purpose of this study was to characterize the change in skeletal muscle mass, investigate the relationship with malnutrition and physical function, and identify risk factors for skeletal muscle loss.

Food Insecurity Is Common in the Orthopedic Trauma Population at a Rural Academic Trauma Center.

Background: Food insecurity is an increasingly recognized public health issue. Identifying risk factors for food insecurity would support public health initiatives to provide targeted nutrition interventions to high-risk individuals. Food insecurity has not been investigated in the orthopedic trauma population.

Radiographically successful periacetabular osteotomy does not achieve optimal contact mechanics in dysplastic hips.

Background: Optimal correction of hip dysplasia via periacetabular osteotomy may reduce osteoarthritis development by reducing damaging contact stress. The objective of this study was to computationally determine if patient-specific acetabular corrections that optimize contact mechanics can improve upon contact mechanics resulting from clinically successful, surgically achieved corrections.

Methods: Preoperative and postoperative hip models were retrospectively created from CT scans of 20 dysplasia patients treated with periacetabular osteotomy.

Syndesmosis Malposition Assessed on Weight-Bearing CT Is Common After Operative Fixation of Intra-articular Distal Tibia Plafond Fracture.

Objectives: To evaluate reliability of measurement techniques for syndesmosis position after operative fixation of distal tibia plafond fracture on weight-bearing computed tomography (WBCT), identify risk factors for syndesmosis malposition, and determine if syndesmosis malposition is associated with higher pain and lower physical function.

Design: Prospective cohort study.

Setting: Three Level 1 trauma centers.

Reliability of Multifrequency Bioelectrical Impedance Analysis to Quantify Body Composition in Patients After Musculoskeletal Trauma.

Background: Changes in body composition, especially loss of lean mass, commonly occur in the orthopedic trauma population due to physical inactivity and inadequate nutrition. The purpose of this study was to assess inter-rater and intra-rater reliability of a portable bioelectrical impedance analysis (BIA) device to measure body composition in an orthopedic trauma population after operative fracture fixation. BIA uses a weak electric current to measure impedance (resistance) in the body and uses this to calculate the components of body composition using extensively studied formulas.

Malnutrition is Common and Increases the Risk of Adverse Medical Events in Older Adults With Femoral Fragility Fractures.

Background: Femoral fragility fractures are one of the most common injuries managed by orthopedic surgeons. Malnutrition influences the poor outcomes observed in this population. Our purpose was to assess the annual trends of malnutrition diagnosis and determine risk factors for malnutrition and complications in patients 65 years and older presenting with femoral fragility fractures.

Conditionally Essential Amino Acid Supplementation Reduces Postoperative Complications and Muscle Wasting After Fracture Fixation: A Randomized Controlled Trial.

Background: Postoperative complications and substantial loss of physical function are common after musculoskeletal trauma. We conducted a prospective randomized controlled trial to assess the impact of conditionally essential amino acid (CEAA) supplementation on complications and skeletal muscle mass in adults after operative fixation of acute fractures.

Methods: Adults who sustained pelvic and extremity fractures that were indicated for operative fixation at a level-I trauma center were enrolled.

Risk Factors for Composite Failure of Hip Dysplasia Treated With Periacetabular Osteotomy: A Minimum 10-Year Follow-up.

Introduction: Periacetabular osteotomy (PAO) is a common surgical treatment of prearthritic hip dysplasia in young adults, but there are few long-term studies of clinical outcomes. The purpose of this investigation was to report a minimum 10-year clinical follow-up of hip dysplasia treated with PAO and identify risk factors for composite failure.

Methods: We identified 151 patients (198 hips) who underwent PAO to treat hip dysplasia at a single institution.

Emergency Department Telemedicine Consults are Associated with Faster Time-to-Electrocardiogram and Time-to-Fibrinolysis for Myocardial Infarction Patients.

Acute myocardial infarction (AMI) is a time-sensitive condition. Meeting guideline-recommended time metrics for these patients can be challenging in rural emergency departments (EDs). Telemedicine has been shown to improve the quality and timeliness of emergency care in rural areas.

Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort.

Introduction: Telemedicine can improve access to emergency stroke care in rural areas, but the benefit of telemedicine across different types and models of telemedicine networks is unknown. The objectives of this study were to (a) identify the impact of telemedicine on emergency department (ED) stroke care, (b) identify if telemedicine impact varied by network and (c) describe the variation in process outcomes by telemedicine across EDs.

Methods: A prospective cohort study identified stroke patients in four telemedicine networks between November 2015 and December 2017.