Anatomic Distal Biceps Tendon Repair With All-Suture Cortical Buttons.

Acute, traumatic distal biceps tendon ruptures are a common injury in the middle-aged athletic male population, with direct anatomic surgical repair being the most effective technique to restore maximal strength. Multiple techniques for distal biceps tendon repair have been described, including single- or dual-incision approaches and tendon fixation with cortical buttons, interference screws, suture anchors, and transosseous sutures. In this Technical Note, we demonstrate an anatomic distal biceps tendon repair technique with a single-incision approach using 2 all-suture cortical buttons.

Arthroscopy-Assisted Core Decompression and Bone Grafting for Avascular Necrosis of the Hip.

Although specific techniques vary, core decompression is generally accepted as the treatment of choice for precollapse avascular necrosis (AVN) of the hip to delay or prevent progression of the disease. This can be combined with hip arthroscopy to allow visual assessment of the femoral head as well as treatment of intra-articular pathologies, which may contribute to pain and joint degeneration. We describe a technique of hip arthroscopy and concurrent core decompression using an expandable reamer and bone grafting for treatment of hip AVN.

Biomechanical Evaluation of Suture Augmentation of Dorsal Locking Plate Fixation in Transverse Patella Fractures.

Introduction: Adjunctive suture augmentation of patellar plate fixation has yet to be investigated. Our biomechanical study sought to evaluate whether suture augmentation improves dorsal patellar locking plate fixation. Our hypothesis was that suture augmentation would improve fixation of this construct.

Biomechanical investigation of arm position on deforming muscular forces in proximal humerus fractures.

Background: Muscular forces drive proximal humeral fracture deformity, yet it is unknown if arm position can help mitigate such forces. Our hypothesis was that glenohumeral abduction and humeral internal rotation decrease the pull of the supraspinatus and subscapularis muscles, minimizing varus fracture deformity.

Methods: A medial wedge osteotomy was performed in eight cadaveric shoulders to simulate a two-part fracture.

Suture Augmentation Neutralizes Deforming Muscular Forces in a Simulated 2-Part Osteoporotic Proximal Humeral Fracture Model.

Objectives: To evaluate the contribution that tension-relieving sutures, placed between a proximal humeral locking plate and the rotator cuff muscles, had on preventing varus malalignment in an osteoporotic 2-part proximal humerus fracture model.

Methods: A 2-part fracture model was created in 8 cadaveric specimens and then fixed with a lateral locking plate. A custom shoulder testing system was used to increase loading through the supraspinatus (SS) tendon to drive varus deformity.

Muscular Forces Responsible for Proximal Humeral Deformity After Fracture.

Objectives: To evaluate the contribution of each of the rotator cuff muscles and deltoid to fracture deformity in a 2-part proximal humerus fracture model. Our hypothesis was that superior cuff muscles would have the greatest contribution to coronal plane deformity, whereas muscles with anterior and posterior attachments would have the greatest contribution to axial and sagittal plane deformity.

Methods: A medial wedge osteotomy was created in 8 cadaveric shoulder specimens.

Posterior stabilized total knee arthroplasty reproduces natural joint laxity compared to normal in kinematically aligned total knee arthroplasty: a matched pair cadaveric study.

Purpose: As the goal of kinematic aligned (KA) total knee arthroplasty (TKA) is to preserve soft tissue tension to the native knee, many KA surgeons recommend cruciate-retaining (CR) prosthesis. However, how a posterior-stabilizing (PS) prosthesis affects the biomechanics of a KA TKA remains unclear. This cadaveric study tested the hypothesis that a PS prosthesis in KA TKA would produce biomechanics similar to CR prosthesis and KA TKA with a PS prosthesis would produce more native knee biomechanics than mechanical aligned (MA) TKA with PA prosthesis.

Major Orthopaedic Conference Abstract Publication: An Analysis of Abstracts Accepted for the AAOS Annual Meetings Between 2014 and 2017.

Introduction: The American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting provides an opportunity for clinicians to attain the most recent advancements in the orthopaedic field. However, the most recent study analyzing publication rates from the 2001 Annual Meeting determined that only 49% of the podium and poster abstracts were eventually published. The purpose of this study was to determine the publication rate, likelihood of publication based on the presentation format, and time to publication for abstracts presented at the 2014 to 2017 AAOS Annual Meetings.

The utility of a statewide prescription drug-monitoring database vs the Current Opioid Misuse Measure for identifying drug-aberrant behaviors in emergency department patients already on opioids.

Background: The most recent guidelines on prescribing opioids from the United States Centers for Disease Control recommend that clinicians not prescribe opioids as first-line therapy for chronic non-cancer pain. If an opioid prescription is considered for a patient already on opioids, prescribers are encouraged to check the statewide prescription drug monitoring database (PDMP). Some additional guidelines recommend screening tools such as the Current Opioid Misuse Measure (COMM) which may also help identify drug-aberrant behaviors.

Screening Tools Validated in the Outpatient Pain Management Setting Poorly Predict Opioid Misuse in the Emergency Department: A Pilot Study.

Background: Currently, no universally accepted methods exist to assess drug-related aberrant behaviors in emergency department (ED) patients. There are several screening tools to identify opioid misuse in patients with chronic pain, however, the validity of these screening tools to assess for misuse within the ED remains unclear.

Objectives: This study investigated the effectiveness of three commonly used screening tools, previously validated in outpatient pain management settings, to assess risk of opioid misuse in ED patients.

Kinematically aligned total knee arthroplasty reproduces more native rollback and laxity than mechanically aligned total knee arthroplasty: A matched pair cadaveric study.

Background: A growing body of evidence supports that kinematically aligned (KA) total knee arthroplasty (TKA) provides superior clinical outcomes and satisfaction than mechanically aligned (MA) TKA. In theory, KA TKA would restore knee kinematics closer to the native condition than MA TKA, but the current biomechanical evidence is lacking.

Hypothesis: KA TKA would restore knee biomechanics to the native condition better than MA TKA.

Kinematically aligned total knee arthroplasty reproduces native patellofemoral biomechanics during deep knee flexion.

Purpose: The implant positioning for kinematically aligned total knee arthroplasty (TKA) differs fundamentally from conventional mechanically aligned TKA. This difference may affect patellofemoral (PF) biomechanics after TKA. This cadaveric study tested the hypothesis that kinematically aligned TKA would restore PF biomechanics to the native condition better than mechanically aligned TKA.