Open Ankle Fractures in Older Individuals: A Multi-center Study.

The purpose of this study is to identify demographics, etiology, comorbidities, treatment, complications, and outcomes for older patients with open ankle fractures. Patients ≥60 years old who sustained an open ankle fracture between January 1, 2004 and March 31, 2014 at 6 Level 1 trauma centers were retrospectively reviewed. Univariate analysis using chi-squared or Student's t test was performed to identify associations between preoperative variables and 2 postoperative outcomes of interest: amputation and 1-year mortality.

Augmenting ACL Repair With Suture Tape Improves Knee Laxity: A Biomechanical Study.

Background: Anterior cruciate ligament (ACL) repair is an alternative to reconstruction; however, suture tape support may be necessary to achieve adequate outcomes.

Purposes: To investigate the influence of suture tape augmentation (STA) of proximal ACL repair on knee kinematics and to evaluate the effect of the 2 flexion angles of suture tape fixation.

Study Design: Controlled laboratory study.

Heat-Related Complications from Radiofrequency and Electrocautery Devices Used in Arthroscopic Surgery: A Systematic Review.

Purpose: To investigate the occurrence of heat-related complications from radiofrequency and electrocautery devices in patients undergoing arthroscopic surgery.

Methods: A systematic review was performed using the PubMed/Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane databases, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies reporting complications after arthroscopy using electrosurgery devices were included.

Suture tape augmentation improves laxity of MCL repair in the ACL reconstructed knee.

Purpose: Medial collateral ligament (MCL) injury is very common and surgical repair is sometimes necessary. Especially in the setting of simultaneous anterior cruciate ligament reconstruction (ACLR) as the ACL is the secondary restraint against valgus stress. The goal of this study was to evaluate knee biomechanics after suture repair of the MCL augmented with suture tape, as compared to MCL repair alone, in the setting of concomitant ACL reconstruction (ACLR).

Medial Patellofemoral Ligament Reconstruction Using Achilles Tendon Allograft With Bone Block.

Recurrent patellar instability is a common problem and often leads to a tear of the medial patellofemoral ligament. Multiple reconstruction techniques for the medial patellofemoral ligament (MPFL) exist. This Technical Note presents a technique for performing MPFL reconstruction using Achilles tendon allograft with a bone block.

Notchplasty alters knee biomechanics after anatomic ACL reconstruction.

Purpose: The aims of this study were (1) to study the biomechanics of single-bundle anatomic ACL reconstructed knees with and without notchplasty using a robotic testing system and (2) to determine if there would be a difference between performing a small or large notchplasty.

Methods: Fifteen fresh-frozen specimens were used in this study. The ACL reconstruction (ACL-R) was performed using an anatomic single-bundle technique with the 8 mm soft tissue graft fixed at 30° with suspensory fixation on the femoral side and a screw and washer on the tibial side.

Atypical Lipomatous Tumors: Does Our Inconsistent Terminology Have Patient Repercussions? Results of a Meta-Analysis.

Objectives: Misnaming low-grade lipomatous tumors poses a clinical and medicolegal challenge, potentially subjecting patients to expensive and unnecessary surgeries. The terms atypical lipomatous tumor (ALT) and "well-differentiated" liposarcoma (WDL) have been used interchangeably in pathology reports, scholarly works and consensus recommendations, creating vagaries between low-virulence extremity tumors and retroperitoneal disease with metastatic potential.

Methods: A systematic review was performed on all studies that reported on the local recurrence rate and metastasis of ALTs and WDLs in living human subjects.

Bioelectric Silver-Zinc Dressing Equally Effective to Chlorhexidine in Reducing Skin Bacterial Load in Healthy Volunteers.

Purpose: The aim of the present study was to evaluate and compare the effectiveness of the silver-zinc bioelectric dressing as compared with skin preparation with 2% chlorhexidine or 4% chlorhexidine in reducing the bacterial count on the knee.

Methods: Three groups consisting of 48 healthy volunteers were included. Age range was 23 to 54 years old and 60% of participants were male.

Clinical outcomes of anconeus interposition arthroplasty after radial head resection in native and prosthetic radial heads.

Background: Radiocapitellar pathology after traumatic injury to the elbow can be challenging to treat. The anconeus interposition arthroplasty has been proposed to treat radiocapitellar or proximal radioulnar joint dysfunction and pain, or both. This study evaluated whether radial head excision (native or prosthetic), followed by an anconeus interposition arthroplasty, relieves pain and improves subjective and objective elbow function in patients with post-traumatic radiocapitellar pathology.

Suture Tape Augmentation of the Thumb Ulnar Collateral Ligament Repair: A Biomechanical Study.

Purpose: This study aimed to evaluate and compare the biomechanical strength of repair of the thumb ulnar collateral ligament (UCL) alone and repair augmented with suture tape.

Methods: Twelve fresh-frozen cadaveric specimens (6 matched pairs) had the UCL divided at its attachment on the base of the proximal phalanx and repaired with or without suture tape augmentation. A material testing machine was used to provide valgus stress at a rate of 0.

Web-Based Education Prior to Outpatient Orthopaedic Surgery Enhances Early Patient Satisfaction Scores: A Prospective Randomized Controlled Study.

Background: A good patient-surgeon relationship relies on adequate preoperative education and counseling. Several multimedia resources, such as web-based education tools, have become available to enhance aspects of perioperative care.

Purpose/hypothesis: The purpose of this study was to evaluate the effect of an interactive web-based education tool on perioperative patient satisfaction scores after outpatient orthopaedic surgery.

Outcomes After Dermal Allograft Reconstruction of Chronic or Subacute Pectoralis Major Tendon Ruptures.

Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction.

Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality.

Clinical outcomes of a single-tunnel technique for coracoclavicular and acromioclavicular ligament reconstruction.

Background: A large number of surgical techniques have been described to treat acromioclavicular (AC) joint separations. Despite the high success rates with double-tunnel reconstruction, this method has been associated with the risk of coracoid and clavicle fractures. This study aimed to evaluate the outcomes of the first cohort of patients who underwent single-tunnel AC and coracoclavicular (CC) ligament reconstruction.

Magnetic Resonance Imaging for Patellofemoral Chondromalacia: Is There a Role for T2 Mapping?

Background: Patellofemoral pain is common, and treatment is guided by the presence and grade of chondromalacia.

Purpose: To evaluate and compare the sensitivity and specificity in detecting and grading chondral abnormalities of the patella between proton density fat suppression (PDFS) and T2 mapping magnetic resonance imaging (MRI).

Study Design: Cohort study; Level of evidence, 2.

Is There a Role for Internal Bracing and Repair of the Anterior Cruciate Ligament? A Systematic Literature Review.

Background: Renewed interest has arisen in arthroscopic anterior cruciate ligament (ACL) repair techniques.

Hypothesis: ACL repair with or without some form of internal bracing could lead to good outcomes in a carefully selected subset of patients.

Study Design: Systematic review.

A Single-Tunnel Technique for Coracoclavicular and Acromioclavicular Ligament Reconstruction.

Acromioclavicular (AC) joint separation is a common injury seen in the young adult athletic population. Both the indications for surgical management and the best operative technique remain controversial. One of the most popular reconstruction techniques is the anatomic double-tunnel coracoclavicular (CC) ligament reconstruction.

Are professional handball players at risk for developing a glenohumeral internal rotation deficit in their dominant arm?

Objectives: Overhead athletes, such as baseball players, have been shown to have adaptive changes in the shoulder range of motion (ROM) of their dominant arm. Professional handball players are a unique subtype of overhead athletes with very different demands from baseball players. The aim of this study was to determine if professional handball players demonstrate differences in shoulder ROM between their dominant and non-dominant arm and try to relate them with new variables.

A novel MRI classification system for congenital functional lumbar spinal stenosis predicts the risk for tandem cervical spinal stenosis.

Purpose: The purpose of this study was to develop a simple and clinically useful morphological classification system for congenital lumbar spinal stenosis using sagittal MRI, allowing clinicians to recognize patterns of lumbar congenital stenosis quickly and be able to screen these patients for tandem cervical stenosis.

Methods: Forty-four subjects with an MRI of both the cervical and lumbar spine were included. On the lumbar spine MRI, the sagittal canal morphology was classified as one of three types: Type I normal, Type II partially narrow, Type III globally narrow.

Geriatric distal femur fracture: Are we underestimating the rate of local and systemic complications?

Background: Low energy distal femur fractures often occur in a fragile elderly population that is prone to local and systemic complications following operative treatment of extremity fractures. The nonunion rate and early complication rate following laterally based locked plating in this specific fracture are not well described.

Methods: We conducted a retrospective cohort study conducted at three affiliated tertiary care hospitals to evaluate nonunion, early post operative complications, discharge disposition, length of stay, and mortality in patients over 60 years old undergoing laterally based locked plating of a low energy distal femur fracture.

Increased Lateral Tibial Plateau Slope Predisposes Male College Football Players to Anterior Cruciate Ligament Injury.

Background: There are conflicting reports regarding the role of osseous morphologic characteristics such as an increased tibial slope as associated with an anterior cruciate ligament (ACL) injury. Few studies have analyzed the role of a combination of osseous morphologic characteristics in matched case control studies. The aim of this study was to determine if there is an association between osseous morphologic characteristics and ACL injury in male college American-football players.

Fibrin clot prevents bone tunnel enlargement after ACL reconstruction with allograft.

Purpose: Bone tunnel enlargement is a feared complication after ACL reconstruction. The aim of this study was to evaluate whether adding a fibrin clot to the allograft for anatomic single-bundle ACL reconstruction would reduce tunnel widening.

Methods: Fifty patients who underwent anatomic single-bundle ACL reconstruction were included.