Publications by authors named "Dickens J"
Background: Operating room (OR) efficiency is of paramount importance for scheduling, cost efficiency and to allow for the high operating volume required to address the growing demand for arthroplasty. The purpose of this study was to develop a machine learning predictive model for Total Shoulder Arthroplasty (TSA) procedure duration and to identify factors which are predictive of a prolonged procedure.
Methods: A retrospective review was undertaken of all TSA between 2013-2021 in a large academic institution.
Purpose: The purpose of this study was to perform a systematic review to determine whether there were clinically significant differences in patient reported outcomes (PROMs) from 1- to 2-year follow-up following rotator cuff repair (RCR).
Methods: A literature search of three databases was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) reporting on PROMS at 1- and 2-years follow-up following RCR were included.
Background: The purpose of this study was to systematically review the literature to ascertain the clinical outcomes of the Latarjet procedure in patients with seizure disorders (SD) versus controls.
Methods: Two independent reviewers performed a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using PubMed, Embase and Scopus databases. Only studies reporting on outcomes of the Latarjet procedure comparing patients with pre-existing SDs, or those comparing such patients versus controls were considered for inclusion.
Objective: To perform a systematic review and meta-analysis to compare the results of the Latarjet procedure performed using screws (S) or suture-button for coracoid graft fixation.
Methods: A systematic search in Pubmed, EMBASE, and The Cochrane Library databases was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Cohort studies comparing outcomes in the Latarjet procedure with screw fixation versus the Latarjet procedure with suture-button fixation were included.
Background: The purpose of this study was to systematically review the rate and time frame to return to sports in collision athletes following arthroscopic Bankart repair.
Methods: A systematic literature search based on Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases was performed. Manuscripts were included if they studied collision or contact athletes, reported on return to play rates or percentages, underwent arthroscopic Bankart repair, published in a peer-reviewed journal, and published in English.
Background: To systematically review the literature assessing glenoid bone loss restoration by different bone block options and compare their dimensions.
Methods: Systematic examination of articles in PubMed and EMBASE databases was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to find studies of bone grafts for treating anterior glenohumeral instability. Statistical analyses were conducted via Review Manager, and a -value of <0.
Purpose: To determine the prevalence of spin in systematic reviews (SRs) and meta-analyses of clinical studies of the remplissage procedure.
Methods: Two reviewers independently performed a literature search of the PubMed, Scopus, and Embase databases using the search term "remplissage" in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The full article of each included SR was assessed for the presence of the 15 most common types of spin.
Risk Factors for Recurrence After Latarjet Procedure- A Systematic Review and Meta-Analysis.
J Shoulder Elbow Surg
November 2024
Background: The risk factors associated with recurrent instability following Latarjet procedure remain poorly understood. The purpose of this study was to conduct a systematic review to elucidate risk factors contributing to therapeutic failure after the Latarjet procedure.
Methods: A comprehensive literature search was performed using the PubMed/MEDLINE and Embase databases based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
Background: Nonoperative management of posterior shoulder instability is common. However, limited data are available to assess the pathomorphologic factors associated with its failure.
Purpose/hypothesis: The purpose of this study was 2-fold: (1) to determine glenohumeral pathomorphologic features predictive of nonoperative management failure of posterior instability; and (2) to determine the relationship between nonoperative management failure and posterior glenoid bone loss (pGBL) progression.
Background: The aim of this study was to systematically review the literature on concomitant repair of superior labral and rotator cuff tears, in light of the paucity of published clinical evidence.
Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses compliant search of PubMed, Embase, and Cochrane Library databases was performed for clinical studies of patients undergoing combined repairs of the rotator cuff and superior labrum.
Results: Ten studies comprising 241 shoulders were included, with a mean age of 52.
Background: Reverse shoulder arthroplasty (RSA) is an established operative treatment for failed rotator cuff repair (RCR) that may not be amenable to revision repair. The purpose of this meta-analysis is to evaluate the clinical outcomes for patients undergoing RSA following prior failed RCR compared with patients without prior RCR undergoing primary RSA.
Methods: A systematic search of articles in Pubmed, EMBASE and The Cochrane Library databases was carried out according to PRISMA guidelines.
Treatment of Anterior Shoulder Instability: A Comprehensive Review.
J Hand Surg Glob Online
September 2024
Article Synopsis
- Anterior shoulder instability involves excessive movement of the humeral head in the shoulder joint, causing symptoms like discomfort and potential dislocations.
- Accurate diagnosis requires a detailed history, physical examination, and imaging to assess the instability's severity.
- Treatment options range from conservative methods to various surgical repairs, with choices depending on factors such as the patient's anatomy, severity of instability, and personal recovery goals.
Article Synopsis
- The study aimed to systematically review clinical research on bioinductive collagen implants (BCI) for treating rotator cuff tears.
- After analyzing 21 studies, results showed significant improvements in patient-reported outcomes (ASES scores) and increased tendon thickness for both full and partial thickness tears.
- The study also highlighted low re-tear rates post-treatment and indicated BCI may be cost-effective, potentially saving between $5,338 and $13,061 per healed tendon.
Article Synopsis
- Anterior shoulder dislocations are prevalent among young, active males, and open Bankart repair is recommended for recurrent instability due to its lower recurrence rates and quicker recovery compared to arthroscopic methods.
- The open surgery involves a specific technique where the subscapularis tendon is "spared" by splitting it to minimize damage during repair, while a capsulotomy allows access to the joint for proper labrum repair using suture anchors.
- Indications for this surgical approach include failed previous arthroscopic repair, multiple dislocations, and situations involving subcritical bone loss, especially in individuals engaged in high-risk sports.
Background: Hill-Sachs lesions are common after shoulder instability, and treatment options vary but include remplissage or implantation of structural bone graft. Large Hill-Sachs lesions not addressed by remplissage are challenging to manage and may frequently require an open surgical approach for bone filling treatment options. The optimal approach to maximize visualization of the humeral head during these procedures remains unclear.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to analyze the minimal clinically important difference (MCID) and patient-acceptable satisfactory state (PASS) values for patient-reported outcomes following shoulder instability surgeries (Bankart, Latarjet, and Remplissage).
- A systematic review was performed on studies published from 1985 to 2023, focusing on how MCID and PASS values were derived and their usage frequency in the literature.
- Out of 174 records screened, 8 studies were included, revealing that MCID was commonly reported, while PASS was less frequently mentioned, with the American Shoulder and Elbow Surgeons score being the most researched outcome measure.
Article Synopsis
- The article discusses the challenges and strategies for managing anterior shoulder instability, particularly focusing on cases with subcritical bone loss, where traditional soft tissue repairs may fail more frequently.
- It highlights the importance of restoring both bony and soft tissue structures during treatment, suggesting that combining these approaches can lead to better outcomes, even when bone loss is moderate.
- The authors emphasize the need for personalized treatment plans that consider patient-specific factors and encourage collaborative care among surgeons, patients, and therapists for optimal recovery and reduced chances of recurrence.
Pachydermoperiostosis: cosmetic implications in a multisystem genetic condition.
Clin Exp Dermatol
December 2024
Article Synopsis
- - A 17-year-old patient was diagnosed with pachydermoperiostosis, a rare genetic condition that causes painful joint swelling and distinct facial features, after being referred to rheumatology.
- - Genetic testing revealed a specific variant (SLCO2A1) linked to more severe symptoms, including significant functional impairment and psychosocial issues due to the patient's appearance.
- - The condition is multi-systemic and can lead to serious complications like myelofibrosis and gastric issues, emphasizing the need for early detection and further research in medical management options.
Article Synopsis
- Posterior shoulder instability affects about 5% of shoulder instability cases, presenting a diagnostic and treatment challenge, particularly when bone loss occurs in up to 25% of patients.
- Young athletes, particularly football linemen and throwers, often experience symptoms ranging from pain to reduced performance, with diagnosis relying on medical history, physical exams, and imaging techniques.
- Management of posterior glenoid bone loss requires careful consideration, as significant loss may necessitate reconstruction procedures, and ongoing research is essential for improving surgical outcomes and treatment strategies.
Understanding the anatomical structure of a patient's shoulder joint is essential in surgical decision-making, especially regarding glenohumeral bone loss. The use of various imaging techniques, such as magnetic resonance imaging (MRI) and computed tomography (CT), bring certain advantages and disadvantages in assessing joint structure. Before a surgical procedure, bone loss can be observed and measured using these imaging techniques in both 2-dimensional and 3-dimensional (3D) views.
View Article and Find Full Text PDF» There is no clear agreement on the optimal timing or superior type of fixation for medial collateral ligament (MCL) tears in the setting of anterior cruciate ligament (ACL) injury.» Anatomic healing of medial knee structures is critical to maintain native knee kinematics, supported by biomechanical studies that demonstrate increased graft laxity and residual valgus rotational instability after ACL reconstruction (ACLR) alone in the setting of concomitant ACL/MCL injury.» Historically, most surgeons have favored treating acute combined ACL/MCL tears conservatively with MCL rehabilitation, followed by stress radiographs at 6 weeks after injury to assess for persistent valgus laxity before performing delayed ACLR to allow for full knee range of motion, and reduce the risk of postoperative stiffness and arthrofibrosis.
View Article and Find Full Text PDFRisk factors for recurrence following arthroscopic Bankart repair: a systematic review.
J Shoulder Elbow Surg
November 2024
Article Synopsis
- A study systematically reviewed literature to identify and quantify risk factors for recurrent instability following arthroscopic Bankart repair, aiming to reach a consensus on these factors.
- The analysis included 111 studies with over 19,000 patients, revealing a higher recurrence rate in younger patients (<20 years) and associations with glenoid bone loss and specific lesion types.
- Findings suggested that factors like age, the presence of an off-track Hill-Sachs lesion, and the number of anchors used in the repair could significantly influence the likelihood of recurrent instability post-surgery.
Background: Posterior shoulder instability makes up approximately 10% of all shoulder instability cases and its diagnosis and treatment is less well understood. Recently, however, there has been increased recognition of posterior instability and posterior stabilization. The purpose of this study was to systematically review the literature to ascertain the outcomes on arthroscopic stabilization of posterior shoulder instability.
View Article and Find Full Text PDFBackground: Evidence on return to sports/work after high tibial osteotomy (HTO) is limited, especially in a young, high-demand population.
Purpose: To (1) identify whether preoperative knee pathology or intraoperative correction was associated with successful return to duty (RTD) and (2) assess whether postoperative complications and reoperation were associated with failure to RTD.
Study Design: Case series; Level of Evidence, 4.