The Effect of a Flipped Classroom Didactic Curriculum on Orthopaedic In-Training Examination Scores for a Resident Cohort.

Introduction: There is little research on the efficacy of flipped classroom (FC) models of learning in formal orthopaedic didactic curricula. The primary aim of this study was to compare resident Orthopaedic In-Training Examination (OITE) scores before and after implementation of an FC curriculum at a single academic institution.

Methods: An FC didactic model consisting of 3 hour-long weekly sessions focusing on highly tested topics was implemented for the start of the 2021 to 2022 academic year.

The Aging Surgeon.

Everyone ages-some more gracefully than others. The changes associated with aging are well known but not often discussed. Age-related changes in surgeons may eventually lead to a need for the surgeon to stop operating or even retire.

An Assessment of International Classification of Diseases, 10th Revision, Clinical Modification, Codes Used to Describe Common Pediatric Orthopedic Conditions.

The diagnosis coding system for health care providers that is used in the United States recently converted from the International Classification of Diseases, 9th Revision (ICD-9), to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). The authors are unaware of any studies specifically evaluating the utility and specificity of ICD-10-CM codes in the pediatric orthopedic literature. The authors chose 20 diagnoses that are commonly seen in general pediatric orthopedic practice.

The Atypical Patient With Slipped Capital Femoral Epiphyses May Be at Increased Risk for a Missed Contralateral Slip.

Slipped capital femoral epiphysis (SCFE) is a commonly encountered hip disorder. The goal of this study was to describe the incidence of missed contra-lateral SCFE as well as to identify risk factors. The authors hypothesized that contralateral slips are more often missed in patients with severe involvement of the treated side.

Football-Related Pediatric Extremity Fractures and Dislocations: Size Matters.

Football remains a popular sport in the United States despite sometimes significant injuries, such as fractures and dislocations, occurring. The objective of this study was to evaluate pediatric extremity fractures and dislocations related to football. A retrospective review was conducted at a level 1 pediatric trauma center to identify patients who were treated specifically for American football-related injuries (International Classification of Diseases, Ninth Revision, code E007.

Hiring your next partner: AOA critical issues.

Hiring a new partner into an orthopaedic department or group can be a daunting task. A recent American Orthopedic Association symposium sought to address three major aspects of hiring that affect orthopaedic leaders: (1) when to hire-the chairperson's role; (2) generational issues that affect hiring; and (3) the development of an initial compensation package.How does the chairperson recruit new physicians? Hiring a new partner into the academic setting requires a good deal of foresight.

Is a Physician "Provider Tax" the Solution to Michigan's Medicaid Woes?

Background: Michigan is facing a Medicaid budget shortfall. Evidence suggests that the underlying factors causing reliance on Medicaid and cost of treatment to increase are getting worse. A tax on Michigan physicians has been proposed by legislators to meet the budget demands of Michigan's Medicaid program.

Concurrent septic arthritis and osteomyelitis in children.

Introduction: Septic arthritis and osteomyelitis can both independently cause substantial morbidity. With concomitant septic arthritis and osteomyelitis, the septic arthritis may be treated without knowledge of the adjacent osteomyelitis resulting in delayed treatment. This study aims to identify factors that may help to diagnosis concurrent infections (CI) earlier.

Cyclodextrin-erythromycin complexes as a drug delivery device for orthopedic application.

Background: Erythromycin, a hydrophobic antibiotic used to treat infectious diseases, is now gaining attention because of its anti-inflammatory effects and ability to inhibit osteoclasts formation. The aim of this study was to explore a cyclodextrin-erythromycin (CD-EM) complex for sustained treatment of orthopedic inflammation.

Methods And Results: Erythromycin was reacted with β-cyclodextrin to form a nonhost-guest CD-EM complex using both kneading and stirring approaches.

A novel strontium-doped calcium polyphosphate/erythromycin/poly(vinyl alcohol) composite for bone tissue engineering.

It is our goal to develop bactericidal bone scaffolds with osteointegration potential. In this study, poly(vinyl alcohol) (PVA) coating (7%) was applied to an erythromycin (EM)-impregnated strontium-doped calcium polyphosphate (SCPP) scaffold using a simple slurry dipping method. MicroCT analysis showed that PVA coating reduced the average pore size and the percentage of pore interconnectivity to some extent.

Increased risk of Blount disease in obese children and adolescents with vitamin D deficiency.

Background: Poor dietary habits and decreased outdoor activity has led to an epidemic of obese children and vitamin D deficiency. The lack of vitamin D alters bone development and mineralization by diminishing physiological levels of calcium and phosphorus. Given vitamin D's role in bone and growth plate mineralization and regulation, we hypothesized that vitamin D deficiency would lead to higher rates of fractures, slipped capital femoral epiphysis (SCFE), and Blount disease in obese youth.

Treatment of pediatric diaphyseal femur fractures.

Methods of treating pediatric diaphyseal femur fractures are dictated by patient age, fracture characteristics, and family social situation. The recent trend has been away from nonsurgical treatment and toward surgical stabilization. The clinical practice guideline on pediatric diaphyseal femur fractures was undertaken to determine the best evidence regarding a number of different options for surgical stabilization.

Effect of oral erythromycin therapy in patients with aseptic loosening of joint prostheses.

There is currently no cure for aseptic loosening (AL) of total joint replacement (TJR) except surgical revision. The purpose of this study was to determine whether oral EM could improve the periprosthetic tissue profiles and reduce serum cytokine production in AL patients who are candidates for surgical revision. We recruited 32 AL patients.

The problem of the aging surgeon: when surgeon age becomes a surgical risk factor.

The question of when a surgeon should retire has been the subject of debate for decades. Both anecdotal evidence and objective testing of surgeons suggest age causes deterioration in physical and cognitive performance. Medical education, residency and fellowship training, and technology evolve at a rapid pace, and the older a surgeon is, the more likely it is he or she is remote from his or her initial education in his or her specialty.

Traumatic dislocation of the hip in a high school football player.

Background: Although traumatic dislocation of the hip often occurs as a result of automobile accidents, dislocations have been reported to occur during sports activities.

Objective: Using the experience in treating a 17-year-old high school football player with a posterior dislocation, complicated by involvement of the sciatic nerve, this case report provides background information on hip dislocations and provides a description of the immediate treatment by the physician, followed by 6 weeks of immobilization, and a detailed account of the 5-month intervention.

Case Description: The patient was injured while making a tackle during a high school football game when another player fell on him from behind.

External rotation of the glenohumeral joint: ligament restraints and muscle effects in the neutral and abducted positions.

External rotation of the glenohumeral joint is important in a variety of pathologic states, yet the ligamentous restraints to external rotation have not been thoroughly investigated and the muscle effects have received even less attention. The purpose of this study was to investigate the ligamentous restraints and muscle effects limiting external rotation of the glenohumeral joint in a biomechanical cadaveric model. External rotation torque was applied to the humeri of 15 shoulders mounted in the supine position in a custom fixture while varying rotator cuff and biceps loads in 15 degrees and 60 degrees of glenohumeral abduction.