Finding Your Job in Orthopaedic Trauma: A Survey Revealing the Cold Hard Facts.

Objectives: Finding a first job after fellowship can be stressful due to the uncertainty about which resources to use, including fellowship program directors, residency faculty, and other sources. There are more than 90 orthopaedic trauma fellows seeking jobs annually. We surveyed orthopaedic trauma fellows to determine the job search process.

Lactococcus garvieae Periprosthetic Joint Infection in a Cattle Rancher with a Total Knee Arthroplasty: A Novel Reservoir Transmission.

Introduction: Periprosthetic joint infection (PJI) remains a challenging complication of joint replacement surgery. With the more frequent use of immune modifying drugs and dietary changes in human populations, the resultant blunting of immune defenses allows for infections with less common organisms.

Case Report: Lactococcus garvieae is an anaerobic, gram-positive coccus with reservoirs in fish and domesticated farm animals.

A lipoglycopeptide antibiotic for Gram-positive biofilm-related infections.

Drug-resistant Gram-positive bacterial infections are still a substantial burden on the public health system, with two bacteria ( and ) accounting for over 1.5 million drug-resistant infections in the United States alone in 2017. In 2019, 250,000 deaths were attributed to these pathogens globally.

Assessing the academic achievement of United States orthopaedic departments.

Background: Assessing academic productivity allows academic departments to identify the strengths of their scholarly contribution and provides an opportunity to evaluate areas for improvement.

Aim: To provide objective benchmarks for departments seeking to enhance academic productivity and identify those with significant improvement in recent past.

Methods: Our study retrospectively analyzed a cohort of orthopaedic faculty at United States-based academic orthopaedic programs.

Stress-Induced, Aseptic Osteolysis of the Mid-Tibia in a Revision Hinged Total Knee Arthroplasty Mimicking Infection.

In this report, we present the case of an 80-year-old female with pain located over the tip of her cemented tibial stem in a revision hinge total knee arthroplasty with localized osteolysis that looked suspicious for infection. A thorough workup was negative for infection. We postulate that the osteolysis at the end of her tibial stem was initiated by a modulus of elasticity mismatch at the stem tip, which generated a focal area of increased sagittal bone bending and microparticle generation.

International Orthopaedic Volunteer Opportunities in Low and Middle-Income Countries.

Globally, the burden of musculoskeletal conditions continues to rise, disproportionately affecting low and middle-income countries (LMICs). The ability to meet these orthopaedic surgical care demands remains a challenge. To help address these issues, many orthopaedic surgeons seek opportunities to provide humanitarian assistance to the populations in need.

Point-of-care antimicrobial coating protects orthopaedic implants from bacterial challenge.

Implant related infections are the most common cause of joint arthroplasty failure, requiring revision surgeries and a new implant, resulting in a cost of $8.6 billion annually. To address this problem, we created a class of coating technology that is applied in the operating room, in a procedure that takes less than 10 min, and can incorporate any desired antibiotic.

Spinal Cord Drift Following Laminoplasty Versus Laminectomy and Fusion for Cervical Spondylotic Myelopathy.

Background: Cervical laminoplasty and laminectomy and fusion (LF) are posterior-based surgical techniques for the surgical treatment of cervical spondylotic myelopathy (CSM). Interestingly, the comparative amount of spinal cord drift obtained from these procedures has not been extensively described. The purpose of this study is to compare spinal cord drift between cervical laminoplasty and LF in patients with CSM.

Occlusion of an Aortobifemoral Graft after Revision Total Hip Arthroplasty.

With the aging population, the demand for total hip arthroplasty is rising. Improvements in arthroplasty techniques and design allow for total hip arthroplasty to be increasingly performed in older patients and those with multiple comorbidities. Complications are rare in young and healthy patients; however, there is greater risk in patients with multiple medical comorbidities and those who have had prior revision procedures.

In vivo Mouse Model of Spinal Implant Infection.

Spine implant infections portend poor outcomes as diagnosis is challenging and surgical eradication is at odds with mechanical spinal stability. The purpose of this method is to describe a novel mouse model of spinal implant infection (SII) that was created to provide an inexpensive, rapid, and accurate in vivo tool to test potential therapeutics and treatment strategies for spinal implant infections. In this method, we present a model of posterior-approach spinal surgery in which a stainless-steel k-wire is transfixed into the L4 spinous process of 12-week old C57BL/6J wild-type mice and inoculated with 1 x 10 CFU of a bioluminescent strain of Staphylococcus aureus Xen36 bacteria.

Management of Pigmented Villonodular Synovitis (PVNS): an Orthopedic Surgeon's Perspective.

Purpose Of Review: Pigmented villonodular synovitis (PVNS) or tenosynovial giant cell tumor (TGCT) encompasses a wide spectrum of disease and is divided into localized and diffuse variants. Surgical resection remains the principal treatment for nearly all localized type disease and most diffuse type. Recent mechanistic understanding of the disease led to drug discovery that has opened new avenues for patients with recalcitrant disease.

Randomized Trial of a Virtual Reality Tool to Teach Surgical Technique for Tibial Shaft Fracture Intramedullary Nailing.

Introduction: Active learning methods have accumulated popularity due to improved results in knowledge acquisition as opposed to passive learning methods. For surgical resident physicians with limited training opportunities outside of the operating room due to time constraints, virtual reality (VR) is a relatively inexpensive and time-efficient active training method for procurement of surgical skills. We conducted a simulated intramedullary nailing (IMN) of a tibia to demonstrate VR training programs as a more effective modality of learning orthopedic surgical techniques compared to passive learning tools such as a standard guide (SG) through trained novice medical students performing a SawBones simulation of intramedullary nail fixation.

Current Trends in Orthopaedic Surgery Residency Applications and Match Rates.

Background: The current U.S. orthopaedic residency application process is becoming increasingly impersonal in the wake of an increasing number of applications.

An Early Look at Operative Orthopaedic Injuries Associated with Electric Scooter Accidents: Bringing High-Energy Trauma to a Wider Audience.

Background: There is a new method of transportation that started in our community in late 2017- rideshare electric scooters (e-scooters). These scooters have proven immensely popular and can now be found in many cities around the world. Despite the pervasiveness of e-scooters, their associated injury patterns are poorly understood.

Glenohumeral Dislocation Arthropathy: Etiology, Diagnosis, and Management.

Dislocation arthropathy describes the development of progressive degenerative changes of the glenohumeral joint in the setting of instability. Although the specific etiology remains unclear, the trauma of a single dislocation, repetitive injury associated with recurrent dislocations, changes in shoulder biomechanics, and complications associated with instability surgery have all been implicated in its development. Pain and restricted range of motion are the most common patient complaints.

Evaluation of the Trends, Concomitant Procedures, and Complications With Open and Arthroscopic Rotator Cuff Repairs in the Medicare Population.

Background: Medicare insures the largest population of patients at risk for rotator cuff tears in the United States.

Purpose: To evaluate the trends in incidence, concomitant procedures, and complications with open and arthroscopic rotator cuff repairs in Medicare patients.

Study Design: Cohort study; Level of evidence, 3.

Open shoulder stabilization: current trends and 1-year postoperative complications.

Background: Shoulder instability is commonly treated by arthroscopic stabilization. However, open stabilization procedures remain important in management of complex instability. Despite continued use of these procedures, the relative frequency of related complications remains poorly described.

Assessment of Vertebral Curves Using the Manual Post-It Technique.

Study Design: A prospective study of a new technique.

Objective: The aims of this study were to report a manual technique for measuring vertebral curves on digital spine radiographs, and to assess the agreement of this technique with that of digital software for measuring vertebral curves.

Summary Of Background Data: Modern picture archiving and communication systems (PACS) typically include software for evaluating radiographic measurements.

Utilization of Platelet-Rich Plasma for Musculoskeletal Injuries: An Analysis of Current Treatment Trends in the United States.

Background: Platelet-rich plasma (PRP) has emerged as a popular biologic treatment for musculoskeletal injuries and conditions. Despite numerous investigations on the efficacy of PRP therapy, current utilization of this treatment within the United States is not widely known.

Purpose: To investigate the national utilization of PRP, including the incidence and conditions for which it is used in the clinical setting, and to determine the current charges associated with this treatment.

Early complications of acromioclavicular joint reconstruction requiring reoperation.

Purpose: Prior studies have reported high complication rates with acromioclavicular joint reconstruction (ACJR). However, many of these reports have suffered from small sample sizes and inclusion of older surgical techniques. The purpose of this study was to determine the rates of early complications requiring reoperation in patients treated with ACJR.