Mental Health Disorders and Surgical Outcomes in Patients With Bone and Soft Tissue Sarcoma.

Background: We conducted a study to investigate the relationship between a mental health diagnosis (MHD) and postoperative outcomes in orthopedic patients with bone and soft tissue sarcoma. We hypothesized that patients with sarcoma with a preoperative MHD would have worse outcomes and more postoperative complications.

Materials And Methods: A retrospective review was performed of 356 patients who underwent surgical treatment for bone or soft tissue sarcoma.

Radiographic Comparison of Forearm Symmetry in Healthy Individuals and its Importance in the Diagnosis of Longitudinal Radioulnar Dissociation.

Purpose: Longitudinal radioulnar dissociation (LRD) is an injury often missed upon initial presentation. A recent study examined a radiographic screening test in cadavers that showed increased interosseous distance when the interosseous ligament (IOL) was divided. For this test to be clinically useful, it is necessary for uninjured forearms to have similar interosseous spaces.

Characterization of the gut microbiome in an osteosarcoma mouse model.

Compelling evidence has mounted surrounding the relationship between the gut microbiome and many intestinal and extraintestinal cancers. Few studies exist investigating the relationship between the gut microbiome and sarcoma. We hypothesize that the presence of distant osteosarcoma induces change to the profile of flora within the mouse.

Cefiderocol for prosthetic joint infection: a case report.

Treatment of infections is difficult due to its predilection to form biofilms and susceptibility to a limited number of antibiotics. We report a case of -associated periprosthetic joint infection successfully treated with a combination of the novel therapeutic agent, cefiderocol, and trimethoprim-sulfamethoxazole after debridement and implant retention.

Knee Pain and Functional Outcomes after Retrograde Femoral Nailing: A Retrospective Review.

Objectives: To investigate the incidence and severity of knee pain following retrograde intramedullary nailing of femur fractures and to better understand functional outcomes using validated patient-reported outcome measures.

Methods: Fifty-three patients with OTA 32 or 33 fractures treated by retrograde nail at a single academic Level 1 trauma center between 2009 and 2020 were retrospectively reviewed. Patients verbally completed the Oxford Knee Score (OKS) and Patient-Reported Outcome Measurement Information System (PROMIS) Short Form 6b, minimum one year postoperatively.

Intraosseous Lipoma: An Elusive Cause of Long Bone Pain: A Case Series.

Introduction: Intraosseous lipomas are benign tumors composed of mature fat that reside within the intramedullary canal. Although many cases are asymptomatic, some patients report pain that interferes with daily living. For patients presenting with refractory pain, surgical excision may be performed.

Ancient Schwannoma with Hemorrhagic Degeneration Causing Chronic Intramuscular Hematoma: A Case Report.

Introduction: The value of this manuscript is that it highlights a common diagnostic challenge facing orthopedic surgeons, involving the reality that both benign and malignant soft-tissue tumors can present as large cystic masses masquerading as a hematoma. This is the first report of its kind to describe a schwannoma presenting as such a large hematoma in the thigh.

Case Presentation: A 64-year-old male presented with 2 days of worsening pain over a left posterior thigh mass that was enlarging for 12 years.

Intraosseous hibernoma: Two case reports and a review of the literature.

Intraosseous hibernomas are exceedingly rare tumors with only 35 cases reported worldwide. They are composed of vestigial brown adipose tissue and require biopsy and pathologic analysis for definitive diagnosis. Given their propensity to mimic more insidious malignant neoplasms, early and accurate identification may spare the patient both anxiety and invasive therapeutic interventions.

Reliability and accuracy in radiographic measurements of musculoskeletal tumors.

Tumor size and growth are important parameters when evaluating bone and soft tissue neoplasms. There are no reports comparing the intra- and interobserver reliability among physicians in their evaluation of musculoskeletal (MSK) tumor imaging. This study investigates the accuracy and precision of measurements made by orthopedic and radiology physicians in different stages of training.

The Delivery of Orthopaedic Care midst COVID-19 and Social Distancing.

In this paper we present the findings of a literature review covering articles published in the last three decades describing the application of telemedicine in orthopaedics. A review of the PubMed Central and Medline provided 75 articles studying the role of telemedicine, the majority directly examining the application of telemedicine in orthopaedic patients. We report the summarized findings of these studies, the financial and HIPAA considerations of using telemedicine, and provide an example of our single urban level-1 trauma center's strategy for incorporating telemedicine into the clinical practice of orthopaedic surgeons during the COVID-19 pandemic.

A Virtual Curriculum to Prepare Medical Students to Achieve Accreditation Council for Graduate Medical Education Level-1 Milestones in Orthopaedic Surgery.

As a part of the American healthcare system's response to the Coronavirus Disease 2019 (COVID-19) global pandemic, the Association of American Medical Colleges recommended that medical schools temporarily remove students from clinical settings and transition to an entirely online learning environment. This posed an unprecedented challenge to students in the clinical years of their medical education. To address this unexpected shift, we modified an in-person workshop to teach orthopaedic trauma basics to 5-week virtual course for third year medical students from several schools in New Jersey and Pennsylvania.

"Dry Arthroscopy" is a Valuable Tool in the Excisional Curettage of Chondroblastoma: A Case Series.

Introduction: Chondroblastomas are benign, locally aggressive bone tumors that occur in the epiphysis of young patients, requiring surgical excision. The anatomic locations of these lesions pose technical challenges to the surgeon; their proximity to the articular surface and the physis make surgical approach and visualization difficult. This case series describes the use of intramedullary arthroscopic assistance during excisional curettage of three distal femoral chondroblastomas.

The Use of Anterior Superior Iliac Spine Osteotomy to Access the Anterior Column in Tumor Resection: A Case Report.

Case: A 24-year-old woman with chondrosarcoma of the superior pubic ramus underwent a Type III pelvic resection through an ilioinguinal approach, modified with anterior superior iliac spine (ASIS) osteotomy. The osteotomy mobilized the ASIS and sartorious distally, exposing the anterior wall and superior ramus. A custom cutting guide was placed on the anterior acetabular wall for en bloc superior ramus resection with hip-sparing osteotomy and negative margins.

Outcomes after antibiotic megaspacer implantation in patients with severe chronic periprosthetic infections.

Periprosthetic joint infection (PJI) is a rare postoperative complication that is treated with antibiotic spacers. Some patients develop severe, treatment-resistant, chronic PJI despite multiple attempts at salvaging the joint. Permanent resection of the joint or amputation may be the only definitive treatment.

Hospital Resource Utilization Associated With Endoprosthetic Reconstruction Versus Primary Arthroplasty.

Endoprosthetic reconstructions of the hip and knee are currently reimbursed as primary hip and knee arthroplasty according to Current Procedural Terminology (CPT) coding guidelines. The purpose of this study was to compare hospital resources consumed by patients undergoing endoprosthetic reconstruction with those consumed by patients undergoing primary arthroplasty. The authors' hypothesis was that the former group carries more comorbidities, experiences longer length of stay (LOS), and has greater resource consumption.

Team Approach: Rehabilitation Strategies for Patients After Osteosarcoma Reconstructive Surgery.

The multimodal treatment of osteosarcoma with chemotherapy, surgical resection, and reconstruction has improved outcomes after a limb-salvage surgical procedure. Physical rehabilitation considerations after surgical resection vary, depending on the location of the tumor. Physical medicine and rehabilitation physicians incorporate lymphedema specialists, orthotists, and prosthetists to help to improve limb function.

Recurrent Adolescent Giant-Cell Tumor of the Scaphoid: Scaphoid Excision with Intracarpal Fusion after Failed Curettage and Bone Grafting.

We present a case of the giant-cell tumor of bone in the scaphoid of a 17-year-old female. Imaging revealed an expansile lytic lesion of her scaphoid, and the diagnosis was confirmed with open biopsy. She was treated with curettage and iliac crest bone graft, in an effort to spare reconstruction of her wrist.

Should the Use of Biologic Agents in Patients With Renal and Lung Cancer Affect Our Surgical Management of Femoral Metastases?

Background: Biologic agents may prolong survival of patients with certain kidney and lung adenocarcinomas that have metastasized to bone, and patient response to these agents should be considered when choosing between an endoprosthesis and internal fixation for surgical treatment of femoral metastases.

Questions/purposes: Among patients undergoing surgery for femoral metastases of lung or renal cell carcinoma, (1) Does survival differ between patients who receive only cytotoxic chemotherapy and those who either respond or do not respond to biologic therapy? (2) Does postsurgical incidence of local disease progression differ between groups stratified by systemic treatment and response? (3) Does implant survival differ among groups stratified by systemic treatment and response?

Methods: From our institutional longitudinally maintained orthopaedic database, patients were identified by a query initially identifying all patients who carried a diagnosis of renal cell carcinoma or lung carcinoma. Patients who underwent internal fixation or prosthetic reconstruction between 2000 and 2016 for pathologic fracture of the femur and who survived ≥ 1 year after surgery were studied.

Interosseous Ligament and Transverse Forearm Stability: A Biomechanical Cadaver Study.

Purpose: The interosseous ligament (IOL) is known to be an important longitudinal stabilizer of the forearm. We hypothesize that it may also contribute to transverse stability, with pronosupination tensioning of the radius relative to the ulna. Therefore, when injured, we predict the interosseous space should widen in the transverse plane, enough to be appreciable on plain radiographs.

Management of Bone Sarcoma.

Treatment of bone sarcoma requires careful planning and involvement of an experienced multidisciplinary team. Significant advancements in systemic therapy, radiation, and surgery in recent years have contributed to improved functional and survival outcomes for patients with these difficult tumors, and emerging technologies hold promise for further advancement.

Utility of opposed-phase magnetic resonance imaging in differentiating sarcoma from benign bone lesions.

Purpose: To investigate the utility of opposed-phase magnetic resonance imaging (OP MRI) in differentiating malignant from benign bone lesions.

Materials And Methods: MRI scans of musculoskeletal lesions including opposed-phase imaging sequences were reviewed by both an experienced musculoskeletal attending radiologist, and a second year radiology resident. The change in signal from IP to OP images was measured.

Protocol-Based Arthroplasty: Less Is More.

As a result of reading this article, physicians should be able to: 1. State an argument for, and background information on, patient-centered arthroplasty protocols. 2.

Use of High-Speed X ray and Video to Analyze Distal Radius Fracture Pathomechanics.

The purpose of this study is to investigate the failure sequence of the distal radius during a simulated fall onto an outstretched hand using cadaver forearms and high-speed X ray and video systems. This apparatus records the beginning and propagation of bony failure, ultimately resulting in distal radius or forearm fracture. The effects of 3 different wrist guard designs are investigated using this system.

Comparison of crossed screw versus plate fixation for radial neck fractures.

Background: Fixation of radial neck fractures can be achieved with a plate and screw construct or, in absence of comminution, with two obliquely-oriented screws. This study investigated the mechanical properties, specifically the stiffness and load to failure, of these two fixation strategies in a cadaver model.

Methods: Ten matched-pair radii were removed from fresh cadaver arms.