Outcomes of arthroscopic revision rotator cuff repair with acellular human dermal matrix allograft augmentation.

Background: The purpose was to assess the minimum 2-year patient-reported outcomes and failure rate of patients who underwent revision arthroscopic rotator cuff repair augmented with acellular human dermal matrix (AHDM) allograft for repairable retears.

Methods: From 2008-2014, patients who underwent revision rotator cuff repair augmented with AHDM with greater than 2 years' follow-up by a single surgeon were retrospectively reviewed. Data regarding surgical history, demographic characteristics, and medical comorbidities were collected.

Long-Term Outcomes of Scaphoid Malunion.

The optimal treatment of patients with a scaphoid malunion remains controversial. The long-term outcomes of operative and nonoperative management have not been established. We conducted a retrospective review of the outcomes of all scaphoid malunions treated at single institution over a 30-year period.

Biomechanics of a novel technique for suprapectoral intraosseous biceps tenodesis.

Background: The Caspari-Weber (C.W.) tenodesis is a standard miniopen intraosseous technique to fix the long head of the biceps tendon.

Venous thromboembolism and mortality associated with tranexamic acid use during total hip and knee arthroplasty.

TKA and THA are associated with blood transfusion and risk for postoperative venothromboembolism (VTE). Reports show that tranexamic acid (TA) may be safe to use in high-risk orthopedic patients, but further data are needed to substantiate its use. All patients who underwent primary or revision TKA or THA in a five year period were retrospectively identified.

Economic impact of tranexamic acid in healthy patients undergoing primary total hip and knee arthroplasty.

Tranexamic acid (TA) has been shown to reduce perioperative blood loss and blood transfusion. While concern remains about the cost of antifibrinolytic medication, we hypothesized that routine use of tranexamic acid would result in lower direct hospital total cost by decreasing costs associated with blood transfusion, laboratory testing, and room & board. Patients with an American Society of Anesthesiologists (ASA) class II or less undergoing primary total hip or knee arthroplasty at a single institution during 2007-2008 were retrospectively reviewed.

Preliminary results suggest tranexamic acid is safe and effective in arthroplasty patients with severe comorbidities.

Background: Tranexamic acid (TXA) reduces blood loss and transfusion after total joint arthroplasty (TJA) but concerns remain that patients with severe medical comorbidities might be at increased risk for thromboembolic complications.

Questions/purposes: Among patients undergoing primary TJA with severe systemic medical disease, (1) was TXA associated with increased symptomatic thromboembolic events; (2) was TXA associated with decreased blood transfusion rates; and (3) were there differences in symptomatic thromboembolism or transfusions in the subset of patients with a history of, or risk factors for; thromboembolic disease?

Methods: We performed a retrospective review of 1131 primary TJAs in 1002 patients with American Society of Anesthesiologists score III or IV. Of these, 402 had at least one of seven risk factors for thromboembolic events and were designated as high risk; 240 of those patients received TXA.

Allograft versus autograft in posterior cruciate ligament reconstruction: an evidence-based systematic review.

Controversy exists as to the superior graft source for posterior cruciate ligament (PCL) reconstruction. Allogeneic and autogeneic tissue have unique advantages and disadvantages, but little is known about the performance of one versus the other. This study is an evidence-based, systematic literature review comparing clinical and functional outcomes of allograft and autograft PCL reconstruction.

Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty.

Background: The use of antifibrinolytic medications in hip and knee arthroplasty reduces intraoperative blood loss and decreases transfusion rates postoperatively. Tranexamic acid (TXA) specifically has not been associated with increased thromboembolic (TE) complications, but concerns remain about the risk of symptomatic TE events, particularly when less aggressive chemical prophylaxis methods such as aspirin alone are chosen.

Questions/purposes: We determined whether the rate of symptomatic TE events differed among patients given intraoperative TXA when three different postoperative prophylactic regimens were used after primary THA and TKA.

Transtibial versus inlay posterior cruciate ligament reconstruction: an evidence-based systematic review.

Optimal surgical technique for posterior cruciate ligament (PCL) reconstruction remains controversial. Authors have reported satisfactory outcomes with both transtibial and inlay techniques. Although biomechanical data has failed to demonstrate a difference between the two, there is little clinical data directly comparing transtibial versus inlay PCL reconstruction.