The Effect of Mechanical Leg Alignment on Cartilage Restoration With and Without Concomitant High Tibial Osteotomy.

Purpose: To assess graft survivorship in patients who underwent autologous chondrocyte implantation (ACI) or osteochondral allograft transplantation (OCA) for the treatment of focal full-thickness cartilage lesions on the medial femoral condyle with and without concomitant high tibial osteotomy (HTO), depending on the preoperative lower-extremity alignment. A secondary purpose was to retrospectively evaluate associated factors for ACI and OCA graft failures.

Methods: A total of 168 patients who underwent cartilage repair with ACI or OCA with or without HTO for focal chondral defects on the medial femoral condyle by a single surgeon between March 2007 and February 2018 were included.

Effect of intrasite vancomycin powder on development of epidural fibrosis.

Placement of vancomycin powder into the surgical wound prior to closure has been shown to reduce postoperative infections in spine surgery. This study examines the effect of vancomycin powder on formation of epidural fibrosis (EF). Twenty-two rats underwent a two-level lumbar laminectomy.

Validation of the Oswestry Risk of Knee Arthroplasty Index (ORKA-1) for Patients Undergoing Autologous Chondrocyte Implantation.

Objective: The purpose of this study was first to externally validate the Oswestry Risk of Knee Arthroplasty index (ORKA-1) by applying it to an autologous chondrocyte implantation (ACI) patient cohort in the United States with a broader definition of failure than only arthroplasty, and second, to determine predictive factors for the risk of ACI failure as defined by the senior author.

Design: A total of 171 patients that underwent ACI were included to validate the ORKA-1 as all factors needed for calculation and outcomes were recorded. For Cox regression analysis, 154 patients were included as they completed preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, Lysholm, International Knee Documentation Committee (IKDC), and 12-item Shor Form (SF-12) scores.

Acute Both Bone Fracture in a Chronic Contracted Forearm.

Introduction: There is a paucity of information on management of forearm fractures through pre-existing ischemic contractures. The prevention of a Volkmann's contracture in forearm compartment syndrome requires vigilant clinical evaluation and emergent fasciotomy, but many of the patients who develop these contractures often do so as a result of delayed presentation due to substance abuse and intoxication. This case describes the first report and management of a severely displaced both bone (BB) forearm fracture through a chronic forearm Volkmann's contracture.

Bilateral Hemiarthroplasty in a Patient with Below-Knee and Above-Knee Amputations: A Case Report.

Case: This case involved a sixty-two-year-old male patient with bilateral femoral neck fractures that occurred six months apart in the setting of bilateral lower-extremity amputation. Hemiarthroplasty was performed at each presentation, with the use of a standard femoral stem on the right side and a short stem on the left. At the time of follow-up, the patient had returned to his preoperative ambulatory status.

Open perilunate injury with lunate revascularization after complete ligamentous avulsion.

Perilunate dislocations are a devastating injury to the carpus that carry a guarded long-term prognosis. Mayfield type 4 perilunate dislocations are rare, high-energy injuries that carry a risk for avascular necrosis (AVN) of the lunate. When AVN ensues and the carpus collapses, primary treatment with a proximal row carpectomy or arthrodesis has been advocated.

National access to care for children with fractures.

Background: Access to health care for many pediatric orthopaedic patients is becoming more difficult. In some communities, children with fractures have limited access to care regardless of insurance status. The purpose of this study was to determine the level of difficulty in obtaining access to care for children with fractures nationally and compare our results to the published results of a national survey in 2006.

Two-year outcome with the AperFix system for ACL reconstruction.

The purpose of the study was to assess the fixation durability of the AperFix System (Cayenne Medical, Inc, Scottsdale, Arizona) used in arthroscopic reconstruction of the anterior cruciate ligament. The AperFix System consists of a femoral and tibial component designed to secure either allograft or autograft. The outcomes of 185 knees (180 patients) were retrospectively reviewed at a minimum of 2 years postoperatively.

Selected anatomists: at the boundary of contemporary ethics.

Fascination with the interworkings of the human body has permeated scientific discovery for eons. Materials for dissection proved problematic for anatomists. Andreas Vesalius solved his dilemma by visiting local gallows where criminals had been executed.

Endovascular repair of infrarenal aortic aneurysms in octogenarians and nonagenarians.

Objective: The purpose of this report was to present short and midterm results of endovascular aortic aneurysm repair (EVAR) of infrarenal aortic aneurysms in octogenarians and nonagenarians.

Methods: Between March 1994 and March 2011, elective EVAR was performed in 967 patients in our institution. This includes 279 patients older than 80 years at the time of the procedure (octogenarians: n = 252, nonagenarians: n = 27).