Changes in femoral offset is not associated with increased incidence of lateral hip pain following total hip arthroplasty.

Purpose: Increased femoral offset following total hip arthroplasty allows for greater stability of the hip joint. However, the increase in femoral offset can cause an impingement of local structures resulting in persistent lateral hip pain. There is conflicting evidence whether changes in femoral offset increases the rates of lateral hip pain following total hip arthroplasty.

Biomechanics in an Incomplete Versus Complete Supraspinatus Tear: A Cadaveric Study.

Background: Degenerative and traumatic changes to the rotator cuff can result in massive and irreparable rotator cuff tears (RCTs).

Purpose/hypothesis: The study objective was to conduct a biomechanical comparison between a small, incomplete RCT and a large, complete RCT. We hypothesized that the incomplete supraspinatus (SS) tear would lead to an incremental loss of abduction force and preserve vertical position of the humeral head, while a complete SS tear would cause superior humeral migration, decrease functional deltoid abduction force, and increase passive range of motion (ROM).

Surgical Duration Implicated in Major Postoperative Complications in Total Hip and Total Knee Arthroplasty: A Retrospective Cohort Study.

Introduction: Total hip and knee arthroplasties are two of the most commonly performed orthopaedic surgeries and are expected to increase in incidence in the coming decades. We sought to examine whether the duration of these procedures is related to various postoperative complications using data from 2010 to 2017 from the American College of Surgeons National Surgical Quality Improvement Program database.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing total hip and knee arthroplasty by their respective Current Procedural Terminology codes.

Histological Assessment of Wallerian Degeneration of the Rat Tibial Nerve Following Crush and Transection Injuries.

Background:  Wallerian degeneration (WD) following peripheral nerve injury (PNI) is an area of growing focus for pharmacological developments. Clinically, WD presents challenges in achieving full functional recovery following PNI, as prolonged denervation of distal tissues for an extended period of time can irreversibly destabilize sensory and motor targets with secondary tissue atrophy. Our objective is to improve upon histological assessments of WD.

Biomechanical effects of superior capsular reconstruction in a rotator cuff-deficient shoulder: a cadaveric study.

Background: Superior capsular reconstruction (SCR) has been gaining popularity as a treatment for irreparable rotator cuff tears (RCTs), especially in younger patients. This biomechanical study aimed to investigate how SCR affects functional abduction force, humeral head migration, and passive range of motion following an irreparable RCT. We hypothesized that SCR will restore these parameters to nearly intact shoulder levels.

The biomechanics of the supraspinatus-deficient shoulder treated with superior capsular reconstruction vs. reverse total shoulder arthroplasty-experimental study.

Aim Of The Study: Our objective was to compare biomechanical effects of superior capsular reconstruction (SCR) and reverse total shoulder arthroplasty (rTSA) on shoulder motion, in the setting of an irreparable supraspinatus (SS) tear. We hypothesized that rTSA would produce greater improvement in abduction force and shift the humerus inferiorly, while SCR would produce greater range of motion (ROM) and prevent superior migration of the humerus during abduction.

Methods: Six cadaveric shoulders were evaluated using a custom biomechanical apparatus.

Periprosthetic Joint Infection After Bariatric Surgical Anastomotic Leak.

Four weeks after a bilateral total knee arthroplasty (TKA), an immunocompetent, 61-year-old, Caucasian man presented with a periprosthetic joint infection (PJI) of the left knee by (an enteric bacteria). The most likely source of his infection was due to an anastomotic leak after a bariatric surgery done 6 months before TKA. There is a growing focus on stratifying the risk of PJI after TKA.

A novel method for predicting superior gluteal nerve safe zones in the lateral approach to the hip.

Introduction: The superior gluteal nerve (SGN) is at risk for laceration during lateral approach total hip arthroplasty (THA). The purpose of this study is to assess the accuracy of the trochanter-to-iliac crest distance (TCD) and the nerve-to-trochanter distance (NTD) ratio in determining a reproducible safe zone around the SGN independent of height.

Materials And Methods: Eighteen hemipelvises were dissected and the SGNs were exposed.

Low Preoperative Albumin Levels Predict Adverse Outcomes After Total Joint Arthroplasty.

Background: Low albumin levels have previously been shown to be a risk factor for increased complications in the 30-day postoperative period after total hip or knee arthroplasty. In this study, we examined the effect that albumin levels have on complications in all total joint primary arthroplasties or revisions (shoulder, elbow, wrist, hip, knee, ankle, and fingers).

Methods: Patients who underwent a primary total joint arthroplasty or revision from 2005 to 2015 and who had preoperative serum albumin concentration levels recorded were identified from the U.

Progressive double major scoliotic curve with concurrent lumbosacral spondylolisthesis in a skeletally immature patient with Marfan syndrome treated with anterior scoliosis correction.

Study Design: Case report (review of patient records, imaging, and pulmonary function tests) and literature review.

Objectives: To describe the case of a skeletally immature patient with Marfan syndrome who underwent anterior scoliosis correction (ASC) and muscle-sparing posterior far lateral interbody fusion (FLIF) in a two-stage procedure to correct progressive severe double major scoliosis and spondylolisthesis. Patients with Marfan syndrome suffer from rapidly progressive scoliosis and spondylolisthesis.

In Hospital Outcomes of Total Hip Arthroplasty in the Medicaid Population.

Total hip arthroplasty (THA) is one of the most common orthopaedic procedures. This study's purpose was to evaluate national trends, patient demographics and hospital outcomes for Medicaid patients who underwent a primary THA. The National Hospital Discharge Survey (NHDS) database was queried for patients undergoing THA from 2001-2010.

Thyrotoxic Periodic Paralysis: A Spine Consultation.

As a consultant, the orthopaedic spine surgeon is often asked to evaluate patients with acute-onset extremity weakness. In some cases, patient's deficits can be attributed to nonspinal pathology; therefore, it is important to be aware of nonorthopaedic diagnoses when evaluating these patients. We report a case of thyrotoxic periodic paralysis that was initially confused by the consulting service with spinal pathology.

Hypoalbuminemia as an Independent Risk Factor for Perioperative Complications Following Surgical Decompression of Spinal Metastases.

Study Design: Retrospective cohort study.

Objective: Malnutrition has been shown to be a risk factor for poor perioperative outcomes in multiple surgical subspecialties, but few studies have specifically investigated the effect of hypoalbuminemia in patients undergoing operative treatment of metastatic spinal tumors. The aim of this study was to assess the role of hypoalbuminemia as an independent risk factor for 30-day perioperative mortality and morbidity after surgical decompression of metastatic spinal tumors using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2014.

Impact of Obesity on Surgical Outcomes Following Laminectomy for Spinal Metastases.

Study Design: Retrospective cohort study.

Objectives: To determine the effect of obesity (body mass index >30 kg/m) on perioperative morbidity and mortality after surgical decompression of spinal metastases.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database is a large multicenter clinical registry that collects preoperative risk factors, intraoperative variables, and 30-day postoperative morbidity and mortality outcomes from hospitals nationwide.

Progressive Neuromuscular Scoliosis Secondary to Spinal Cord Injury in a Young Patient Treated With Nonfusion Anterior Scoliosis Correction.

Ninety-eight percent of skeletally immature patients with spinal cord injury (SCI) suffer from progressive neuromuscular scoliosis (NMS). Operative treatment has typically been limited to posterior spinal fusion (PSF), but a newer technique as described may be less invasive and preserve more function. A PSF of the entire spine to the pelvis is standard of care.

Age Is a Risk Factor for Postoperative Complications Following Excisional Laminectomy for Intradural Extramedullary Spinal Tumors.

Study Design: Retrospective analysis.

Objective: The incidence of intradural extramedullary (IDEM) spinal tumors is increasing. Excisional laminectomy for removal and decompression is the standard of care, but complications associated with patient age are unreported in the literature.

Predicting Surgical Complications in Patients Undergoing Elective Adult Spinal Deformity Procedures Using Machine Learning.

Study Design: Cross-sectional database study.

Objective: To train and validate machine learning models to identify risk factors for complications following surgery for adult spinal deformity (ASD).

Summary Of Background Data: Machine learning models such as logistic regression (LR) and artificial neural networks (ANNs) are valuable tools for analyzing and interpreting large and complex data sets.

Age Stratification of 30-Day Postoperative Outcomes Following Excisional Laminectomy for Extradural Cervical and Thoracic Tumors.

Study Design: Retrospective cohort study.

Objectives: To evaluate age as an independent predictive factor for perioperative morbidity and mortality in patients undergoing surgical decompression for metastatic cervical and thoracic spinal tumors using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2011 to 2014.

Methods: We identified 1673 adult patients undergoing excisional laminectomy of cervical and thoracic extradural tumors.

Outcomes and Complications Following Laminectomy Alone for Thoracic Myelopathy due to Ossified Ligamentum Flavum: A Systematic Review and Meta-Analysis.

Study Design: Systematic review and meta-analysis.

Objective: Examine the functional outcomes and complications following laminectomy for thoracic myelopathy due to ossification of the ligamentum flavum (OLF).

Summary Of Background Data: OLF is a rare condition that can cause thoracic myelopathy.

Relationship between sagittal balance and adjacent segment disease in surgical treatment of degenerative lumbar spine disease: meta-analysis and implications for choice of fusion technique.

Study Design: Meta-analysis.

Objective: To conduct a meta-analysis investigating the relationship between spinopelvic alignment parameters and development of adjacent level disease (ALD) following lumbar fusion for degenerative disease. ALD is a degenerative pathology that develops at mobile segments above or below fused spinal segments.

The Impact of Metastatic Spinal Tumor Location on 30-Day Perioperative Mortality and Morbidity After Surgical Decompression.

Study Design: A retrospective cohort study from 2011 to 2014 was performed using the American College of Surgeons National Surgical Quality Improvement Program database.

Objective: The purpose of this study was to assess the impact of tumor location in the cervical, thoracic, or lumbosacral spine on 30-day perioperative mortality and morbidity after surgical decompression of metastatic extradural spinal tumors.

Summary Of Background Data: Operative treatment of metastatic spinal tumors involves extensive procedures that are associated with significant complication rates and healthcare costs.