Background: Developmental hip dysplasia (DDH) is a common condition associated with pain, disability and early hip osteoarthritis when untreated. Health utility scores have not previously been defined for a comprehensive set of DDH health states. The purpose of this study was to establish utility scores associated with DDH health states.
View Article and Find Full Text PDFBackground: Avascular necrosis (AVN) remains the most dreaded complication of unstable slipped capital femoral epiphysis (SCFE) treatment. Newer closed reduction techniques (with perfusion monitoring) have emerged as a technically straightforward means to address residual SCFE deformity while still minimizing the risk of osteonecrosis. However, limited data exists regarding the reliability of intraoperative epiphyseal perfusion monitoring to predict the development of AVN.
View Article and Find Full Text PDFCast application is a critical portion of pediatric orthopaedic surgery training and is being performed by a growing number of non-orthopaedic clinicians including primary care physicians and advanced practice providers (APPs). Given the tremendous remodeling potential of pediatric fractures, correct cast placement often serves as the definitive treatment in this age population as long as alignment is maintained. Proper cast application technique is typically taught through direct supervision from more senior clinicians, with little literature and few resources available for providers to review during the learning process.
View Article and Find Full Text PDFObjective: Developmental dysplasia of the hip is prevalent and is associated with dysplasia of both the femoral head and acetabulum. There is a paucity of literature describing femoral head remodeling after surgical reduction of developmentally dislocated hips. The purpose of this study was to describe and quantify changes in femoral head sphericity after closed or open reduction for developmental dysplasia of the hip.
View Article and Find Full Text PDFObjectives: The purpose of this study was to report clinical and surgical outcomes of medial patellofemoral ligament reconstruction (MPFLR) and concomitant quadriceps lengthening to treat fixed and obligatory patellofemoral instability (PFI) in the pediatric population.
Methods: Patients with obligatory or fixed PFI who underwent simultaneous MPFLR and quadriceps lengthening from 2008 to 2020 were reviewed. Of the 413 records, 24 fit the inclusion criteria.
J Am Acad Orthop Surg Glob Res Rev
November 2023
Introduction: The purpose of this study was to determine how the Limb Deformity-Modified Scoliosis Research Society (LD-SRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire scores differ between patients with femoral version abnormalities and healthy control subjects.
Methods: A retrospective database review identified patients with femoral version abnormalities between December 2018 and September 2022. A total of 21 adult patients scheduled for femoral derotational osteotomy and 33 control subjects were included.
Arch Orthop Trauma Surg
November 2023
Introduction: As patients increasingly utilize the Internet to obtain health-related information, the accuracy and usability of information prove critical, especially for patients and parents seeking care for relatively common orthopedic childhood disorders such as Legg-Calvé-Perthes (LCP) disease. Therefore, the purpose of this study is to evaluate available online health information regarding LCP disease. The study specifically seeks to (1) examine the accessibility, usability, reliability, and readability of online information, (2) compare the quality of sites from different sources, and (3) determine whether Health on the Net Foundation Code (HON-code) certification guarantees higher quality of information.
View Article and Find Full Text PDFBackground: Percutaneous femoral derotational osteotomies are performed in both adult and pediatric patients. There is little published on the outcomes after femoral derotational osteotomy in pediatric patients.
Methods: A retrospective cohort study of pediatric patients treated with percutaneous femoral derotational osteotomy by one of two surgeons between 2016 and 2022 was performed.
JBJS Essent Surg Tech
September 2022
Unlabelled: Percutaneous femoral derotational osteotomies are performed in both adult and pediatric patients for excessive symptomatic femoral anteversion or retroversion. The aim of the procedure is to correct version abnormalities with use of a minimally invasive technique.
Description: This is a percutaneous procedure that involves creation of femoral drill holes at the osteotomy site prior to reaming the canal.
Skeletally immature patients with coronal plane angular deformity (CPAD) may be at increased risk for intra-articular pathology and patellofemoral instability (PFI). These patients may be candidates for implant-mediated guided growth (IMGG) procedures with tension band plates to address CPAD in addition to procedures for concomitant knee pathology. However, there are limited data on performing these procedures simultaneously.
View Article and Find Full Text PDFBackground: The size of talocalcaneal tarsal coalitions (TCCs) is one of the main factors that is thought to influence patient outcomes after resection. Magnetic resonance imaging (MRI) is increasingly being used to diagnose and characterize TCCs. However, there is no reproducible MRI-based measurement of TCC size reported in the literature.
View Article and Find Full Text PDFBackground: A subset of patients successfully treated for developmental dysplasia of the hip (DDH) as infants have symptomatic acetabular dysplasia at skeletal maturity leading to periacetabular osteotomy (PAO). The purpose of this study was to compare femoral and acetabular morphology in PAO patients with late acetabular dysplasia after previous treatment for DDH with PAO patients who do not have a history of DDH treatment.
Methods: A single surgeon's patients who underwent PAO between 2011 and 2021 were retrospectively reviewed.
We introduce an algorithm of independently performing vastus lateralis lengthening followed by Z lengthening of the rectus and intermedius portion of the quadriceps tendon to treat fixed and obligatory patellar instability in the pediatric population. Performing this procedure in conjunction with medial patellofemoral ligament reconstruction minimizes subsequent episodes of instability without creating extensor mechanism weakness or contracture.
View Article and Find Full Text PDFIntroduction: The Orthopaedic In-Training Examination (OITE), produced by the American Academy of Orthopaedic Surgeons (AAOS), plays an important role in the educational mission of orthopaedic residency programs nationwide. An up-to-date understanding of this examination is critical for programs to develop an appropriate curriculum and for individuals to identify learning resources. This study presents an updated analysis of the basic science section of the OITE from 2014 to 2019.
View Article and Find Full Text PDFCurr Opin Pediatr
February 2021
Purpose Of Review: Adolescent and young adult hip dysplasia is a cause of hip pain which can lead to early hip osteoarthritis. This may result in early hip osteoarthrosis and possible total hip arthroplasty if dysplasia is not recognized and treated. Hip dysplasia in this population can be difficult to diagnose.
View Article and Find Full Text PDFBackground: The orthopedic in-training examination (OITE) continues to evolve over time. It is important for orthopedic residents and residency programs to have an up-to-date understanding of the content and resources being used on the OITE to study and tailor curricula accordingly. This study presents an updated analysis of the OITE hand domain from 2014 to 2019.
View Article and Find Full Text PDFBackground: It is vital for orthopedic residents and residency programs to have a current understanding of the materials and resources utilized on the Orthopedic In-Training Examination (OITE) to tailor resident educational curricula accordingly. This study presents an updated analysis of the hip and knee section of the OITE.
Methods: All OITE questions related to hip and knee reconstruction over six examinations between 2014 and 2019 were analyzed for topic, subtopic, taxonomy, imaging modalities, resident performance, and references.
Background: An updated analysis of the pediatrics section of the Orthopaedic In-Training Examination (OITE) is helpful for resident education and preparation for the OITE. The purpose of this study is to provide an updated evaluation of the pediatric category of the OITE, and to explore trends in question topics and taxonomy compared with the previously published analysis from 2011 to 2014.
Methods: Five years (2015-2019) of OITE questions, answers, and references were reviewed.
. Pigmented villonodular synovitis (PVNS) is a rare benign tumor affecting large joints and prompts excision to prevent local destruction of the joint. The purpose of this case report is to describe two differing surgical approaches for management of PVNS of the hip in patients requiring concomitant treatment for additional hip pathology.
View Article and Find Full Text PDFMalnutrition is prevalent in patients undergoing elective total joint arthroplasty (TJA). Malnutrition has been shown to be an independent risk factor for multiple postsurgical complications following TJA in addition to increasing postoperative mortality. In the current healthcare environment, it is important to recognize and correct modifiable risk factors preoperatively to minimize perioperative complications and improve patient outcomes.
View Article and Find Full Text PDFPurpose: The purpose of this study was to assess the quality of information available to patients on the Internet when using popular search engines to search the term "hip arthroscopy."
Methods: We analyzed the quality and content of information about hip arthroscopy (HA) on the first 50 websites returned by the search engines Google and Bing for the search term "hip arthroscopy." The sites were categorized by type, and quality and content were measured using the DISCERN score, along with an HA-specific content score.