Preference signaling in orthopaedic surgery: applicant perspectives and opinions.

Context: Orthopaedic surgery has become increasingly competitive over the years, with the COVID-19 pandemic creating additional challenges for applicants and programs. To promote an equitable match experience, the American Orthopaedic Association (AOA) introduced a formal preference signaling (PS) system into the 2022-2023 application cycle. PS allows applicants to indicate their heightened interest in specific programs, which improves the likelihood of receiving an interview and ultimately matching at their desired residency program.

Trauma Research Funding: An Emergency in Emergency Care.

Introduction: Trauma remains a significantly underfunded area of medical research despite its status as a leading cause of death and substantial economic burden in the United States. This study explores the disparity in trauma research funding, focusing on Oklahoma compared to neighboring and populous states.

Methods: Using data from the Centers for Disease Control and Prevention (CDC)'s Web-based Injury Statistics Query and Reporting System (WISQARS™) and the National Institutes of Health (NIH)'s RePORT databases, we analyzed age-adjusted years of potential life lost (YPLL) due to trauma and corresponding NIH funding across different states and nationally.

Inadequate harms reporting among randomized controlled trials cited as supporting evidence in the AAOS management of hip fractures in older adults clinical practice guideline recommendations.

Background: Recommendations within clinical practice guidelines (CPGs) are heavily influenced by results from randomized controlled trials (RCTs). Therefore, it is imperative that all RCT outcomes are reported thoroughly to ensure CPGs are created using accurate information. Here, we evaluate the quality of harms reporting using the CONSORT Extension for Harms in RCTs underpinning recommendations in the American Academy of Orthopedic Surgeons (AAOS) Management of Hip Fractures in Older Adults CPG.

Cemented vs Uncemented hemiarthroplasties for femoral neck fractures: An overlapping systematic review and evidence appraisal.

Background: The purpose of our study is to assess the methodology of overlapping systematic reviews related to cemented vs uncemented hip hemiarthroplasties for the treatment of femoral neck fractures to find the study with the best evidence. Also, we assess the gaps in methodology and information to help with direction of future studies.

Methods: A systematic search was conducted in September 2022 using Pubmed, Embase, and Cochrane Library.

Complication and revision rates after reverse total shoulder revision from hemiarthroplasty: a systematic review.

Background: Thus, the purpose of the present study was to (1) characterize common postoperative complications and (2) quantify the rates of revision in patients undergoing hemiarthroplasty to reverse total shoulder arthroplasty revisional surgery. We hypothesize that hardware loosenings will be the most common complication to occur in the sample, with the humeral component being the most common loosening.

Methods: This systematic review adhered to PRISMA reporting guideline.

Network meta-analysis: What is its purpose in Orthopaedic literature?

Systematic reviews, of level-I primary literature, are the gold standard for the formation of Clinical Practice Guidelines in Orthopaedic Surgery. When systematic reviews have multiple groups of data, meta-analyses can be conducted to analyse the direct comparison of the data points (pairwise meta-analysis). Over recent years, statisticians have created a new statistical model called network meta-analyses that can be applied to systematic reviews.

Reoperation and Complication Rates Following Patellar Fracture Repair with Plates: A Retrospective Analysis with Patient-Reported Outcomes at More than 1 Year of Follow-up.

Unlabelled: Recent work has suggested good clinical and functional results with dorsal surface plating of patellar fractures. The primary outcome measurement of this study was reoperation rates for patellar fractures that had been treated with dorsal plating.

Methods: This work consists of a retrospective review of clinical and functional outcome data following repair of patellar fractures with dorsal plates.

Evaluation of spin in the abstracts of orthopedic trauma literature: A cross-sectional review.

Objectives: A cross-sectional analysis of orthopedic trauma randomized controlled trial (RCT) abstracts to assess the frequency and manifestations of spin, the misrepresentation or distortion of research findings, in orthopedic trauma clinical trials.

Methods: The top 5 orthopedic trauma journals were searched from January 1, 2012, to December 31, 2017. RCTs with nonsignificant endpoints (p > .

The induced membrane technique for bone defects: Basic science, clinical evidence, and technical tips.

The clinical management of large bone defects continues to be a difficult clinical problem to manage for treating surgeons. The induced membrane technique is a commonly employed strategy to manage these complex injuries and achieve bone union. Basic science and clinical evidence continue to expand to address questions related to the biology of the membrane and how interventions may impact clinical outcomes.

Treatments, cost and healthcare utilization of patients with segmental bone defects.

Background: Treatment of large segmental defects in skeletal long bones is challenging. Heterogeneity in patient presentation further increase the difficulty in designing and running randomized trials, hence the paucity of published data with large patient numbers. This study was designed to help understand patient presentation, costs and outcomes, using real world data sources.

Readmission Rates After Hip Fracture: Are There Prefracture Warning Signs for Patients Most at Risk of Readmission?

Background: The purpose of this study was to evaluate known and yet unknown risk factors associated with readmission to the hospital within 30 days after hip fracture.

Methods: In this study, we used the Cerner Health Facts Electronic Health Record database data from January to August 2015. The univariate association of each variable (discharge location, demographic details, and comorbidities) against the 30-day readmission status was evaluated using the Chi-square test or the Fisher exact test.

The use of systematic reviews to justify orthopaedic trauma randomized controlled trials: A cross-sectional analysis.

Objective: Orthopaedic trauma is one of the largest surgical fields in medicine, and as such, requires the latest evidence to ensure the best standard of care. Systematic reviews are an invaluable resource that compiles an exhaustive summary of the most current evidence on a given clinical question. The primary aim of this study is to evaluate the use of systematic reviews as justification in conducting randomized controlled trials published in high impact orthopaedic trauma journals.

Prevalence of Deep Surgical Site Infection After Repair of Periarticular Knee Fractures: A Systematic Review and Meta-analysis.

Importance: Surgical management of periarticular knee fractures can be challenging, and adverse outcomes may be severe. Recent literature indicates that the rate of periarticular knee surgical site infection (SSI) may range from 2% to 88% depending on the fracture site.

Objective: To examine the prevalence of deep SSI and the rate of septic arthritis after surgical repair of fractures around the knee.

Effects of a proposal to alter the statistical significance threshold on previously published orthopaedic trauma randomized controlled trials.

Introduction: A recent proposal suggests changing the threshold for statistical significance from a P value of .05 to .005 to minimize bias and increase reproducibility of future studies.

Absolute Versus Relative Fracture Fixation: Impact on Fracture Healing.

The goals of all orthopaedic surgeons treating fractures are, and will remain, obtaining union of the fracture with a well-aligned and functional limb while minimizing the risk of complications. This requires us to understand how the biomechanical environment of the fracture affects healing and to be able to discern which mechanical environment is preferred over another. Understanding the spectrum of stability imparted by our current surgical devices is paramount to giving our patients the best opportunity to heal and recover from their injury.

Critical-Size Bone Defects: Is There a Consensus for Diagnosis and Treatment?

There is a significant burden of disease associated with bone defects, and their management is challenging. These injuries have a profound clinical and economic impact, and outcomes are limited by high rates of complication and reoperation, as well as poor functional outcomes. There remains a lack of consensus around definitions, reliable models, and best practices for the surgical management of bone defects.

Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel's type C femoral neck fractures.

Background: The purpose of this study is to determine the biomechanical stability of a novel prototype femoral neck locking plate (FNLP) for treatment of Pauwels type C femoral neck fractures compared with other current fixation methods.

Methods: Forty femur sawbones were divided into groups and a vertical femoral neck fracture was made. Each group was repaired with one of the following: (CS) three parallel cancellous screws; (XCS) two cancellous lag screws into the head and one transverse lag screw into the calcar; and (FNLP) a novel FNLP with two 5.

Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases.

Introduction: Segmental bone loss, either from trauma, tumor or infection is a challenging clinical entity. Amputation is a possible outcome and part of the decision making process. Surgical management is almost always needed and can require several interventions to obtain bone union.

Kinetic and thermodynamic evaluation of the reversible N-heterocyclic carbene-isothiocyanate coupling reaction: applications in latent catalysis.

Using stopped flow and other spectroscopic techniques, the thermodynamic parameters of the coupling reaction between 1,3-dimesitylimidazolylidene and phenyl isothiocyanate were determined (H(o) = -96.1 kJ mol(-1) and ΔS(o) = -39.6 J mol(-1) K(-1)).

Evaluating the role of additive pKa on the proton conductivities of blended sulfonated poly(ether ether ketone) membranes.

Sulfonated poly(ether ether ketone) (sPEEK) membranes were blended with various functionalized imidazoles. The effect of the pKa of the added heterocycle on the dry proton conductivities of the blended membranes was evaluated over the temperature range of 40-150 degrees C. These membranes showed nonmonotonous conductivities with respect to temperature, as well as a clear correlation of peak temperature conductivity to the pKa of the heterocycle.

Adapting N-heterocyclic carbene/azide coupling chemistry for polymer synthesis: enabling access to aromatic polytriazenes.

A click by any other name: Coupling bis(N-heterocyclic carbene)s with bis(azide)s afforded a novel class of conjugated polytriazenes. These polymers were rendered electrically conductive upon doping, and fluorene-containing variants exhibited luminescence. This adaptation of N-heterocyclic carbene (NHC)/azide coupling chemistry to polymer synthesis reveals the potential of NHCs as building blocks for accessing polymers having useful electronic properties.