Suture Button Fixation in Shoulder Instability Surgery to Achieve Bone Healing: A Critical Analysis Review.

» Suture button fixation has emerged as an effective surgical construct in arthroscopic and open Latarjet and anterior glenoid reconstruction with free autograft bone with high rates of bone block healing.» Biomechanical data suggest that screw and suture button mechanical fixation constructs provide similar load to failure and stability for the Latarjet procedure.» Preliminary bone healing models have identified that flexible fixation may exhibit a higher degree of bone callus maturation, whereas rigid fixation results in excessive callus hyperplasia» Mechanical tensioner use provides consistent tensioning of suture button constructs and improves bone-to-bone healing rates when used for anterior glenoid reconstruction surgery.

Use of pre-operative 3D planning software for revision shoulder arthroplasty: clinical experience data from a survey in a real-world setting.

Background: Preoperative 3D planning is routinely used in primary shoulder arthroplasty, while specific challenges in the revision setting make such approaches more cumbersome and less accessible. Recently, an established preoperative planning software (Blueprint; Stryker, Tornier SAS, Montbonnot-Saint-Martin, France) was expanded to offer a capability for planning of revision and complex primary shoulder arthroplasty cases. The aim of this study was to survey experienced surgeons on their perception of the new software feature for preoperative 3D planning in the setting of revision shoulder arthroplasty.

Increased Deltoid and Acromial Stress with Glenoid Lateralization and Onlay Humeral Stem Constructs in Reverse Shoulder Arthroplasty.

Background: Reverse shoulder arthroplasty (RSA) designs include multiple options for glenoid component lateralization, and humeral component lateralization and distalization (inlay/onlay constructs). The influence of combined glenoid lateralization, and humeral distalization on acromial and deltoid stresses is not well understood. The purpose of this study was to evaluate changes in deltoid and acromial stresses with variations in glenoid lateralization, and with inlay versus onlay humeral components in RSA.

Utility of Recovery Room vs Post-Operative Day 1 Radiographs Following Shoulder Arthroplasty.

Background: Postoperative radiographs may be performed on different timelines after shoulder arthroplasty. Radiographs obtained in the post-operative recovery unit (PACU) are often of poorer quality. The purpose of the current study was to explore and compare the quality of PACU radiographs and radiographs performed in the radiology suite on post-operative Day 1 (POD1), as well as determine their impact on changes in post-operative management.

Musculoskeletal Biorepository: Establishment, Sustainment, and Tips for Success.

A biorepository, also referred to as a "biobank," is a collection of biologic samples that are stored for laboratory research. With the emergence of precision medicine, the importance of leveraging individual patient biomolecular signatures to improve diagnosis, prognosis, and treatment is becoming increasingly recognized. Successful development and sustainment of a biorepository provides the potential for transformative preclinical research.

Rate of incidental findings on routine preoperative computed tomography for shoulder arthroplasty.

Background: Incidental findings are commonly noted in advanced imaging studies. Few data exist regarding the rate of incidental findings on computed tomography (CT) for preoperative shoulder arthroplasty planning. This study aims to identify the incidence of these findings and the rate at which they warrant further work-up to help guide orthopedic surgeons in counseling patients.

Patient Initiated Discrimination and Harassment-A Descriptive Survey of Experiences Within a Single Academic Department.

Background: Diversity in orthopedics is lacking despite ongoing efforts to create a more inclusive workforce. Increasing diversity necessitates recruitment and retainment of underrepresented providers, which involves representation among leadership, mentorship initiatives, and development of a safe work environment. Discrimination and harassment behaviors are prevalent within orthopedics.

Modifiable and Nonmodifiable Risk Factors Associated with the Development of Recurrent Rotator Cuff Tears.

Nonoperative and operative strategies exist to manage rotator cuff pathology. Although surgical repair is successful for most patients, others may experience retear or nonhealing of the rotator cuff. Several modifiable and nonmodifiable risk factors are associated with an increased retear rate.

Outcomes of Geriatric Periprosthetic Distal Femur Fractures: Comparison of Fixation Versus Reconstruction.

Objective: Comparing outcomes of periprosthetic distal femur fractures treated with open reduction and internal fixation (ORIF) versus distal femoral replacement (DFR).

Setting: Three major academic hospitals within one metropolitan area.

Design: Retrospective.

A Surgical Framework for the Management of Incomplete Axillary Nerve Injuries.

Background:  Axillary nerve injury is the most common nerve injury affecting shoulder function. Nerve repair, grafting, and/or end-to-end nerve transfers are used to reconstruct complete neurotmetic axillary nerve injuries. While many incomplete axillary nerve injuries self-resolve, axonotmetic injuries are unpredictable, and incomplete recovery occurs.

Increasing Awareness of Complications of Nerve Injury Following Shoulder Surgery: Preventing Delays in Referral and Treatment.

Background: Nerve injuries remain a challenging complication after shoulder surgery. While most resolve spontaneously, some require surgical intervention. This study describes the characteristics of patients sustaining nerve injuries following shoulder surgery, evaluates referral patterns to nerve surgeons, and characterizes nerve surgeries performed and their outcomes.

Current Concept Review: Risk Factors for Infection Following Open Fractures.

Infection following open fracture is a significant source of morbidity and mortality. Therefore, a central tenet of treatment is to minimize the risk of infection. The initial risk of infection is determined by wound characteristics, such as size, soft tissue coverage, vascular injury, and contamination.

Physician-Patient Communication in the Orthopedic Clinic: Surgeon-Identified Challenges.

Background: Effective communication between the physician and the patient is crucial to quality healthcare. The orthopedic surgery clinic setting provides an environment for cultivating the physician-patient relationship, eliciting diagnostic data, and developing treatment strategies. However, little is known about the orthopedic surgeon perspective on communicating with patients.

Standardizing Screw Head Orthopaedic Trauma Implants. Is There an Interest? An OTA Member Survey.

Objective: To determine the level of interest in standardization of design for fracture fixation implants within the orthopaedic trauma community.

Methods: A survey regarding implant removal concerns and implant design preferences was electronically distributed to members of Orthopaedic Trauma Association (OTA).

Results: Three hundred thirty respondents participated in the survey (response rate of 19%) Only 2.

New versus old: 95 degree angled blade plate versus distal femoral locking plate. A randomized clinical trial.

Introduction: The purpose was to compare the locking condylar plate (LCP) with the 95° angled blade plate (ABP) for distal femoral fracture patterns amenable to either device. Our hypothesis was that LCP would outperform ABP with primary outcome of nonunion and secondary outcomes of reoperation and malunion.

Methods: 78 adult patients with 79 eligible fractures and mean age of 60 years were prospectively randomized to LCP (n = 45) or ABP (n = 34).

Transformation from a traditional model to a virtual model of care in orthopaedic surgery: COVID-19 experience and beyond.

Virtual encounters have experienced an exponential rise amid the current COVID-19 crisis. This abrupt change, seen in response to unprecedented medical and environmental challenges, has been forced upon the orthopaedic community. However, such changes to adopting virtual care and technology were already in the evolution forecast, albeit in an unpredictable timetable impeded by regulatory and financial barriers.

Influence of Interfacial Bonding on the Mechanical and Impact Properties Ring-Opening Metathesis Polymer (ROMP) Silica Composites.

Polymers formed by ring-opening metathesis polymerization (ROMP) such as poly(dicyclopentadiene) (pDCPD) exhibit a technologically desirable combination of high toughness, high glass transition temperature, and outstanding low-temperature performance. However, because of their nonpolar molecular structure, they tend to suffer from relatively low elastic moduli and poor adhesion to common fillers, fibers, and substrates, limiting their utility as adhesives and composite binders without specialized bonding agents. Here, we investigate the mechanical properties of a pDCPD-based copolymer filled with well-defined spherical microparticles having four distinct surface chemistries capable of strong, moderate, or weak bonding to the matrix with surfaces ranging from polar to nonpolar.

Artificial Intelligence to Identify Arthroplasty Implants From Radiographs of the Knee.

Background: Revisions and reoperations for patients who have undergone total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and distal femoral replacement (DFR) necessitates accurate identification of implant manufacturer and model. Failure risks delays in care, increased morbidity, and further financial burden. Deep learning permits automated image processing to mitigate the challenges behind expeditious, cost-effective preoperative planning.