Effect of Obesity on Short- and Long-Term Complications After Ankle Fracture Fixation.

Objectives: This study evaluated the relationship between obesity and postoperative complications in patients undergoing ankle open reduction internal fixation (ORIF).

Design: Retrospective cohort study.

Setting: PearlDiver-Mariner All-Payor Database.

Injury Risk in Collegiate Football Players With Generalized Joint Hypermobility: A Prospective Cohort Study Over 2 Years.

Background: Generalized joint hypermobility (GJH) has been identified as a risk factor for injury in various athletic patient populations.

Purpose: To evaluate GJH as a predisposing risk factor for injury in a population of National Collegiate Athletic Association (NCAA) Division I football players.

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

The Influence of Reverse Total Shoulder Arthroplasty Implant Design on Biomechanics.

Purpose Of Review: As reverse total shoulder arthroplasty indications have expanded and the incidence of its use has increased, developments in implant design have been a critical component of its success. The purpose of this review is to highlight the recent literature regarding the effect of implant design on reverse total shoulder arthroplasty biomechanics.

Recent Findings: Implant design for reverse total shoulder arthroplasty has evolved considerably from the modern design developed by Paul Grammont.

Effect of obesity on short- and long-term complications of shoulder arthroplasty.

Background: The proportion of patients undergoing total shoulder arthroplasty (TSA) with obesity continues to grow every year in the United States. Although comorbid obesity is common among TSA patients, the relationship of obesity on medical and surgical complications remains debated. The goal of this study was to evaluate a national database for postoperative medical and surgical complications in patients undergoing TSA with comorbid obesity.

Arthroscopic Single-Portal Suprapectoral Biceps Tenodesis With All-Suture Anchor.

Tenodesis of the long head of the biceps tendon can be performed through arthroscopic and open techniques with various fixation methods and at different locations on the humerus. Many techniques have been described, with controversy surrounding the advantages and disadvantages of each. In this Technical Note, we describe an all-arthroscopic, intra-articular, single-portal, suprapectoral biceps tenodesis with an all-suture anchor.

Physical Examination of the Hip: Assessment of Femoroacetabular Impingement, Labral Pathology, and Microinstability.

Purpose Of Review: Determining the correct diagnosis can be challenging in patients presenting with hip pain. The physical examination is an essential tool that can aid in diagnosis of hip pathology. The purpose of this review is to provide an updated summary of recent literature on the physical exam of the hip, particularly as it relates to diagnosis of femoroacetabular impingement (FAI) syndrome, labral injury, and hip microinstability.

Prior Bone Marrow Stimulation Surgery Influences Outcomes After Cell-Based Cartilage Restoration: A Systematic Review and Meta-analysis.

Background: Cell-based cartilage restoration with autologous chondrocyte implantation (ACI) is a safe and effective treatment for symptomatic cartilage lesions. Many patients undergoing ACI have a history of prior surgery, including bone marrow stimulation (BMS). There is mounting evidence that a history of prior BMS may impede healing of the ACI graft.

Evaluating Utilization Trends in Adhesive Capsulitis of the Shoulder: A Retrospective Cohort Analysis of a Large Database.

Background: Nonoperative and operative treatment modalities have been used for symptom management of adhesive capsulitis, but neither has been shown to significantly alter the long-term natural history.

Purpose/hypothesis: The purpose was to evaluate the current trends in resource and treatment strategy utilization for patients with adhesive capsulitis. It was hypothesized that (1) patients with idiopathic adhesive capsulitis will primarily undergo nonoperative treatment and (2) patients with systemic medical comorbidities will demonstrate relatively higher utilization of nonoperative therapies.

Association Between Comorbid Depression and Rates of Postoperative Complications, Readmissions, and Revision Arthroscopic Procedures After Elective Hip Arthroscopy.

Background: Depression and related psychiatric diagnoses are common in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). The effects of depression on postoperative complications, readmissions, and additional ipsilateral hip surgery are not well studied.

Hypothesis: Patients with preoperative depression who undergo hip arthroscopy for FAIS would experience higher rates of 90-day postoperative complications and readmissions, with an increased risk of additional ipsilateral hip procedures, as compared with patients without depression.

Preoperative Peripheral Nerve Blocks in Orthopaedic Trauma Surgery: A Guide to Diagnosis-Based Treatment.

Perioperative pain management remains an important focus of both patient and provider attention in orthopaedic trauma surgery. There is a constant effort to improve pain management while decreasing opioid consumption, and peripheral nerve blocks are a safe and effective way to achieve these two goals. This is particularly relevant because more procedures are being done in outpatient surgery centers, and the need to safely provide analgesia without the systemic risk of opioid medications is paramount.

Hepatitis C infection and complication rates after total shoulder arthroplasty in United States veterans.

Background: Few studies have evaluated the effect of hepatitis C (HCV) on primary total shoulder arthroplasty (TSA). Our purpose was to determine if HCV infection is associated with increased complication rates after TSA in United States (US) veterans and, secondarily, to determine if preoperative HCV treatment with direct-acting antivirals (DAAs) affects postoperative complication rates.

Methods: US Department of Veterans Affairs (VA) data sets were used to retrospectively identify patients without HCV, patients with untreated HCV, and patients with HCV treated with DAAs who underwent TSA from 2014 to 2019.

An Assessment of Normal Tibiofibular Anatomy on Lateral Fluoroscopy.

Background: Intraoperative identification of syndesmotic malreduction during ankle fracture fixation can be challenging. Prior studies describe the normal tibiofibular relationship on anteroposterior and mortise views to aid assessment, but the normal anatomic variation on the lateral view has not been well defined. The aim of this study was to describe the normal anatomy of the lateral radiographic view of the ankle, focusing on the relative position of the fibula and tibial plafond.

Role of peripheral nerve block in pain control for the management of acute traumatic orthopaedic injuries in the emergency department: Diagnosis-based treatment guidelines.

Trauma remains one of the largest problems that the global healthcare system faces today. In the United States it remains the leading cause of death for young and middle-aged patients, and its economic burden in direct cost and loss of productivity is tremendous. Additionally, the challenge of acute pain control in orthopaedic trauma remains substantial, and the over-reliance on opioid medications has resulted in unintended acute and chronic complications and problems.

Arthroscopic treatment of type II superior labral anterior to posterior (SLAP) lesions in a younger population: minimum 2-year outcomes are similar between SLAP repair and biceps tenodesis.

Purpose: Compared to a relatively older population over 30-40 years of age, the efficacy of biceps tenodesis for type II SLAP lesions in a younger population is not well studied. The purpose of this study was to compare outcomes between biceps tenodesis and labral repair for type II SLAP lesions in a young active population.

Methods: Patients aged 15-40 who underwent primary arthroscopic biceps tenodesis or SLAP repair for type II SLAP tears between 2009 and 2016 were included.

Concussions in NCAA Varsity Football Athletes: A Qualitative Investigation of Player Perception and Return to Sport.

Background: The objective of this study was to understand the experiences and perspectives of varsity football athletes on return to play following a concussion injury.

Methods: Two experienced interviewers conducted qualitative, semistructured interviews of college-level football players who had sustained at least one concussion during their varsity careers.

Results: Twenty varsity football players who averaged 2.

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement.

Background: Hip arthroscopy for femoroacetabular impingement (FAI) is known to produce excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semistructured patient interviews on patients with hip labral tears.

Purpose: To understand the factors influencing the decision to return to sport after arthroscopic hip surgery for FAI.

Pediatric Hand Injuries.

Pediatric hand injuries are extremely common. Although many hand injuries are adequately managed in the emergency department, some may need evaluation and treatment by a pediatric hand surgeon to ensure a good functional outcome. This article discusses the diagnosis and management of the most common pediatric hand maladies: fingertip injuries/amputation, tendon injuries, and phalangeal and metacarpal fractures.

Assessment of Intraoperative Intra-articular Morphine and Clonidine Injection in the Acute Postoperative Period After Hip Arthroscopy.

Background: Previous authors have suggested that intra-articular morphine and clonidine injections after knee arthroscopy have demonstrated equivocal analgesic effect in comparison with bupivacaine while circumventing the issue of chondrotoxicity. There have been no studies evaluating the effect of intra-articular morphine after hip arthroscopy.

Purpose: To evaluate the efficacy of intra-articular morphine in combination with clonidine on postoperative pain and narcotic consumption after hip arthroscopy surgery for femoroacetabular impingement.