High failure rates in comminuted patella fractures (AO/OTA 34-C3) fixed with an isolated new patella specific 2.7 mm variable angle locking plate.

Objectives: To compare the outcomes of comminuted patella fractures fixed with a new patella-specific 2.7mm variable angle (VA) locking plate in isolation versus when augmentation of fracture fixation is applied with the plate.

Methods: Design:Retrospective.

Early weight bearing is not associated with short-term complications in ankle fractures.

Ankle fractures are common injuries and post-operative protocols continue to vary. We aim to compare postoperative complications between early weight bearing (EWB), intermediate weight bearing (IWB), and delayed weight bearing (DWB) in adult patients with isolated ankle fractures treated with open reduction internal fixation (ORIF). This retrospective cohort study includes 233 adult patients with isolated (medial malleolar, lateral malleolar, posterior malleolar, bimalleolar equivalent) or complex (trimalleolar, trimalleolar equivalent, bimalleolar, and Maisonneuve) ankle fractures treated with ORIF between 2020 and 2022 at a level I trauma center.

A Bedside-to-Bench-to-Bedside Journey to Advance Osteochondral Allograft Transplantation towards Biologic Joint Restoration.

More than 70 million adults in the United States are impacted by osteoarthritis (OA). Symptomatic articular cartilage loss that progresses to debilitating OA is being diagnosed more frequently and earlier in life, such that a growing number of active patients are faced with life-altering health care decisions at increasingly younger ages. Joint replacement surgeries, in the form of various artificial arthroplasties, are reliable operations, especially for older (≥65 years), more sedentary patients with end-stage OA, but have major limitations for younger, more active patients.

Lower extremity osteotomies for limb preservation: Indications, outcomes, and risk factors.

Objectives: To delineate the key factors associated with treatment success or failure for patients undergoing lower extremity osteotomies to address a spectrum of lower extremity joint and limb deformities at an Integrated Limb Preservation Center (ILPC).

Methods: Retrospective cohort study. Level I Academic Trauma Center.

Outcomes associated with hip preservation using osteochondral allograft transplants and acetabular labrum reconstruction.

Background: Osteochondral allograft (OCA) transplantation with or without labral reconstruction is considered a hip preservation surgical treatment option for young, active patients. This study aims to report early outcomes for use of OCA and labrum allograft transplants for patients treated for symptomatic femoral head chondral damage and/or acetabular labrum deficiency after implementation of a comprehensive joint restoration approach.

Methods: 33 patients from a lifelong registry were included for analysis.

Identifying Lower Extremity Deformities in the Coronal Plane: Lessons From Remote Learning During the COVID-19 Pandemic.

Introduction During the COVID-19 pandemic, the AO Foundation, an orthopedic education organization, had to transition its live education programs to an online format. Skills that were previously evaluated and corrected in person by educators were now assessed through online lectures and discussion groups. Our goal was to evaluate an online course designed to teach the skill of "leg length and coronal deformity measurement" and to assess participants' ability to demonstrate this skill using online software.

Treatment Failure After Repair of Displaced Femoral Neck Fractures in Patients Compared by "Decade of Life": An Analysis of 565 Cases in Adults Less Than 60 years of Age.

Objectives: To study the results of displaced femoral neck fractures (FNFs) in adults less than 60 years of age by comparing patients, injury, treatment, and the characteristics of treatment failure specifically according to patients' age at injury, that is, by their "decade of life" [ie, "under 30" (29 years and younger), "the 30s" (30-39 years), "the 40s" (40-49 years), and "the 50s" (50-59 years)].

Design: Multicenter retrospective comparative cohort series.

Setting: Twenty-six North American Level 1 Trauma Centers.

Optimal Fixation Strategies for Displaced Femoral Neck Fractures in Patients 18-59 Years of Age: An Analysis of 565 Cases Treated at 26 Level 1 Trauma Centers.

Objectives: The objective of this study was to determine the difference in failure rates of surgical repair for displaced femoral neck fractures in patients younger than 60 years of age according to fixation strategy.

Design: This is a retrospective, comparative cohort study.

Setting: Twenty-six Level 1 North American trauma centers.

Outcomes following open acetabular labrum reconstruction: Comparing fresh-frozen tendon with fresh meniscus allograft transplantation.

Background: Symptomatic acetabular labral insufficiency in young, active patients is often treated with labral repair or reconstruction using fresh-frozen allografts. However, fresh-frozen tendon allografts do not have tissue or material properties that closely mimic acetabular labral fibrocartilage. Recent studies suggest meniscal allografts may be a better biomechanical, geometric, and material alternative for acetabular labrum reconstruction (ALR).

Short-Term Outcomes After Bipolar Osteochondral Allograft Transplantation (OCAT) in the Ankle.

Treatment options for symptomatic cartilage loss in the ankle are not consistently effective. This study documents initial outcomes for patients undergoing bipolar OCAT in the ankle after advances in tissue preservation, transplantation techniques, and patient management strategies were implemented. Patients were prospectively enrolled into a registry designed to follow outcomes after OCAT in the ankle.

Evaluation of mechanistic serum and urine biomarkers for secondary osteoarthritis associated with developmental dysplasia of the hip.

Objective: Determine measurable differences for mechanistic urine and serum biomarkers in patients with developmental dysplasia of the hip (DDH) prior to, and following, secondary hip osteoarthritis (OA) when compared to controls.

Design: Urine and serum were collected from individuals with developmental dysplasia of the hip (n = 39), prior to (Pre-OA DDH, n = 32) and following diagnosis of secondary hip OA (Post-OA DDH, n = 7), age-matched Pre-OA controls (n = 35), and age-matched Post-OA controls (n = 12). Samples were analyzed for protein biomarkers with potential for differentiation of hip status through a Mann-Whitney test with a Benjamini-Hochberg correction.

Management of aseptic nonunions and severe bone defects: let us get this thing healed!

Effective nonunion and bone defect management requires consideration of multiple potential contributing factors including biomechanics, biology, metabolic, and patient factors. This article reviews these factors as well as several potential nonunion or bone defect treatments including bone grafts, bone graft substitutes, the induced membrane technique, and distraction osteogenesis. A summary of these concepts and guidelines for an overall approach to management are also provided.

Arthroscopic Hip Labral Reconstruction With Fresh Meniscal Allograft.

The acetabular labrum is essential to maintaining the functional health of the hip joint through contributions to joint congruity, stability, and the negative pressure suction seal. Injury, overuse, long-standing developmental disorders, or failed primary labral repair can eventually lead to functional labral insufficiency requiring management via labral reconstruction. While numerous graft options exist for hip labral reconstruction, there is no current gold standard.

Orthopaedic trauma patient non-adherence to follow-up visits at a level 1 trauma center serving an urban and rural population.

Objective: To assess key demographic and psychosocial variables that may be associated with non-adherence to clinic visits following orthopaedic trauma injuries to patients in an urban and rural population.

Methods: This retrospective review included all operative and non-operative patients presenting to a Level I academic trauma center serving an urban and rural population in the Midwest following an orthopaedic injury. The study tracked patient attendance to scheduled orthopaedic trauma follow-up clinic visits after a scheduled visit in the clinic following a trauma-related injury.

Does Irrigating While Drilling Decrease Bone Damage?

Background: Heat generated during bone drilling may be associated with thermal necrosis and direct damage, leading to complications after surgery. This preclinical study evaluates the in vivo effects of saline irrigation, drilling device type, and device sharpness on heat generation and bone damage in viable cortical bone.

Methods: Bicortical drilling of each tibial diaphysis from anesthetized research dogs was performed to evaluate temperature and bone damage using five different devices with or without saline irrigation.

Does Anterior Impaction Affect Radiographic Outcomes of Pilon Fractures?

Background: The outcomes of pilon fractures are multifactorial. Anterior articular impaction requires sagittal plane correction (anterior distal tibia angle (ADTA)) with articular reduction. However, there is a risk of avascular necrosis of the articular fragments and postoperative tibiotalar arthritis.

Risk of shortening in operatively treated proximal femur fractures with cephalomedullary nails with dynamically versus statistically locked helical blades.

Introduction: Cephalomedullary nails (CMN) have proven to be effective for the fixation of unstable pertrochanteric hip fractures, but limited data exists regarding the degree of shortening that occurs with nailing systems that offer "dynamically" versus "statistically" locked helical blades. This study aimed to determine the incidence, timing, and amount of postoperative fracture shortening in patients with pertrochanteric hip fractures treated with "dynamically" versus "statistically" locked helical blades.

Methods: A retrospective review was performed on patients requiring operative fixation of pertrochanteric fractures.

Graft Options for Hip Labral Reconstruction.

➢: Arthroscopic hip labral reconstruction is a complex procedure which is growing in use as indications, techniques, and surgical expertise advance.

➢: Graft selection is an important component of labral reconstruction based on relative advantages and disadvantages of available types of autografts and allografts.

➢: The ideal graft should mimic the native acetabular labrum form and function while also being affordable, readily available, and associated with low morbidity.

Preoperative Planning and Preservation of the Knee with Complex Osteotomies.

The knee is a complex structure composed of bone, cartilage, menisci, ligaments and muscles, which all work synergistically to optimize congruence, stability, and function. Osteotomies are procedures addressing an abnormal joint alignment, shifting the mechanical load from a diseased joint compartment to a healthier one. Preoperative planning is an important art of identifying the source of abnormal load distribution to the joint, enabling the surgeon to simulate a deformity correction ahead of the surgical procedure.