Fracture Lines and Patterns in Intra-articular Distal Femur Fractures.

Introduction: Distal femur fractures are complex injuries that often present with multiple fragments, posing notable challenges to fixation. This study aimed to (1) use preoperative CT scans to graphically display fracture lines in intra-articular distal femur fractures and (2) identify common fracture patterns in these injuries.

Methods: All skeletally mature patients that underwent surgical fixation of Orthopaedic Trauma Association type 33C distal femur fractures between 2012 and 2022 were identified across two level 1 trauma centers (n = 63).

Similar Medium-Term Revision Rates Following Acute Total Hip Arthroplasty Versus Open Reduction and Internal Fixation for Acetabular Fractures in the Elderly.

Background: The management of elderly acetabular fractures is complex, with high rates of conversion total hip arthroplasty (THA) after open reduction and internal fixation (ORIF), but potentially higher rates of complications after acute THA.

Methods: The California Office of Statewide Health Planning and Development database was queried between 2010 and 2017 for all patients aged 60 years or older who sustained a closed, isolated acetabular fracture and underwent ORIF, THA, or a combination. Chi-square tests and Student t tests were used to identify demographic differences between groups.

Arthroscopic debridement for acute hemorrhagic subacromial bursitis following COVID-19 vaccine administration: A case report.

The rapid rollout of vaccinations in response to the COVID-19 pandemic has led to their widespread distribution and administration throughout the world. The benefit of these vaccinations in preventing the spread of the disease and diminishing symptoms in patients who contract COVID-19 has been fervently studied and reported. While vaccinations remain an effective and generally safe method of limiting disease transmission and virus-related mortality, vaccine administration is not completely without risk.

Higher Rates of Readmission After Acute Total Hip Arthroplasty Versus Open Reduction Internal Fixation for Elderly Acetabular Fractures, a National Study From 2010 to 2019.

Objectives: To evaluate the initial complications and short-term readmissions and reoperations after open reduction internal fixation (ORIF) versus acute total hip arthroplasty (THA) for elderly acetabular fractures.

Design: Retrospective database review.

Setting: All hospitalizations in the National Readmissions Database and National Inpatient Sample.

Increasing Rate of Shoulder Arthroplasty for Geriatric Proximal Humerus Fractures in the United States, 2010-2019.

Introduction: The two historically dominant surgical options for displaced geriatric proximal humerus (PHFx) fractures are open reduction internal fixation (ORIF) and hemiarthroplasty (HA). However, shoulder arthroplasty (SA), predominantly in the form of reverse total shoulder arthroplasty (RTSA), has emerged as an attractive treatment option. We aim to compare the utilization trends, complications, and costs associated with surgical management of geriatric proximal humerus fractures (PHFs) between 2010 and 2019.

Outcomes of Second-stage Reimplantation After Modular Knee Arthrodesis for Periprosthetic Joint Infection.

Background: Modular knee arthrodesis (MKU) is a salvage treatment for recurrent periprosthetic joint infection (PJI) or PJI associated with notable bone loss. Reimplantation endoprosthetic reconstruction (REI) is an option in patients with MKU who have PJI clearance but are not satisfied with pain or functional outcomes with MKU. The purpose of this study was to evaluate the outcomes of MKU to REI conversion.

Outcomes of Modular Knee Arthrodesis for Challenging Periprosthetic Joint Infections.

Background: Modular knee arthrodesis (MKA) is a salvage treatment option for patients with challenging periprosthetic joint infections (PJI). The purpose of this study was to investigate the outcomes of patients who underwent MKA for PJI with a single technique and determine if specific factors are associated with MKA failure.

Methods: This was a retrospective review of 81 patients who underwent MKA at a single institution.

A Critical Analysis of Lateral Versus Central Endpoint in Distal Tibia Nailing: Does It Affect Alignment?

Objectives: To evaluate the effect of a traditional "center-center" end point for distal tibia nailing in comparison with a lateral-of-center end point on fracture malalignment in a cadaver model.

Methods: Nine matched pairs of human cadaveric lower-extremity specimens were used to model the effect of nail end point on fracture alignment in extra-articular distal tibia fractures. After simulation of the fracture through a standardized osteotomy, 1 member of each pair was fixed with an intramedullary nail using a "center-center" end point, whereas a lateral-of-center end point was used for the other member of the pair.

Wide en bloc resection of an extraskeletal myxoid chondrosarcoma about the knee with single-stage knee extensor mechanism reconstruction: A case report.

Soft tissue sarcomas about the patellar tendon necessitate wide resection and thus present a significant reconstructive challenge. This article describes the novel use of a synthetic mesh graft to reconstruct the knee extensor mechanism as a single stage procedure after wide en bloc resection of an extraskeletal myxoid chondrosarcoma (EMC) in a patient with an invasive mass that was intimately associated with her patellar tendon.

Resident Involvement in Arthroscopic Knee Surgery Is Not Associated With Increased Short-term Risk to Patients.

Background: Whether resident involvement in surgical procedures affects intra- and/or postoperative outcomes is controversial.

Purpose/hypothesis: The purpose of this study was to compare operative time, adverse events, and readmission rate for arthroscopic knee surgery cases with and without resident involvement. We hypothesized that resident involvement would not negatively affect these variables.

Factors Associated With Distal Femoral Osteotomy Survivorship: Data From the California Office of Statewide Health Planning and Development (OSHPD) Registry.

Background: Malalignment of the lower extremity can lead to early functional impairment and degenerative changes. Distal femoral osteotomy (DFO) can be performed with arthroscopic surgery to correct lower extremity malalignment while addressing intra-articular abnormalities or to help patients with knee osteoarthritis (OA) changes due to alignment deformities.

Purpose: To examine survivorship after DFO and identify the predictors for failure.

National Trends in Use of Regional Anesthesia and Postoperative Patterns of Opioid Prescription Filling in Shoulder Arthroscopy: A Procedure-Specific Analysis in Patients With or Without Recent Opioid Exposure.

Background: There are few large database studies on national trends in regional anesthesia for various arthroscopic shoulder procedures and the effect of nerve blocks on the postoperative rate of opioid prescription filling.

Hypothesis: The use of regional nerve block will decrease the rate of opioid prescription filling after various shoulder arthroscopic procedures. Also, the postoperative pattern of opioid prescription filling will be affected by the preoperative opioid prescription-filling history.

Modulation of Hedgehog Signaling by Kappa Opioids to Attenuate Osteoarthritis.

Objective: Inhibition of hedgehog (HH) signaling prevents cartilage degeneration and promotes repair in animal models of osteoarthritis (OA). This study, undertaken in OA models and in human OA articular cartilage, was designed to explore whether kappa opioid receptor (KOR) modulation via the inhibition of HH signaling may have therapeutic potential for achieving disease-modifying activity in OA.

Methods: Primary human articular cartilage and synovial tissue samples from patients with knee OA undergoing total joint replacement and from healthy human subjects were obtained from the National Disease Research Interchange.

High Tibial Osteotomy Survivorship: A Population-Based Study.

Background: High tibial osteotomy (HTO) was developed to treat early medial compartment osteoarthritis in varus knees.

Purpose: To evaluate the midterm and long-term outcomes of HTO in a large population-based cohort of patients.

Study Design: Case-control study; Level of evidence, 3.

Pathomechanics Underlying Femoroacetabular Impingement Syndrome: Theoretical Framework to Inform Clinical Practice.

Over the last decade, there has been a marked increase in attention to, and interest in, femoroacetabular impingement syndrome (FAIS). Despite continued efforts by researchers and clinicians, the development, progression, and appropriate treatment of FAIS remains unclear. While research across various disciplines has provided informative work in various areas related to FAIS, the underlying pathomechanics, time history, and interaction between known risk factors and symptoms remain poorly understood.

The Relative Importance of Race Compared to Health Care and Social Factors in Predicting Prostate Cancer Mortality: A Random Forest Approach.

Purpose: There is a differential in prostate cancer mortality between black and white men. Advances in precision medicine have shifted the research focus toward underlying genetic differences. However, nonbiological factors may have a large role in these observed disparities.

The impact of prior upper-extremity surgery on orthopedic injury and surgery in collegiate athletes.

Background: The influence of prior upper-extremity (UE) surgery on a collegiate athletic career is poorly understood. This study aimed to investigate the impact of prior UE surgery on participation, injury, and surgery rates in collegiate athletes.

Methods: Division I athletes who commenced collegiate athletics from 2003-2009 were retrospectively identified.

Are Orthopaedic Surgeons Performing Fewer Arthroscopic Partial Meniscectomies in Patients Greater Than 50 Years Old? A National Database Study.

Purpose: To report the trends in arthroscopic partial meniscectomy (APM) for degenerative meniscal tears in a large private insurance database among patients older than 50 years.

Methods: The Humana database between 2007 and 2015 was queried for this study. Patients meeting the inclusion criteria with degenerative meniscal tears who underwent APMs were identified by International Classification of Diseases, Ninth Revision codes, followed by Current Procedural Terminology codes.

Injections Prior to Rotator Cuff Repair Are Associated With Increased Rotator Cuff Revision Rates.

Purpose: To determine whether shoulder injections prior to rotator cuff repair (RCR) are associated with deleterious surgical outcomes.

Methods: Two large national insurance databases were used to identify a total of 22,156 patients who received ipsilateral shoulder injections prior to RCR. They were age, sex, obesity, smoking status, and comorbidity matched to a control group of patients who underwent RCR without prior injections.

Resident Involvement in Shoulder Arthroscopy Is Not Associated With Short-term Risk to Patients.

Background: Shoulder arthroscopy is a commonly performed, critical component of orthopaedic residency training. However, it is unclear whether there are additional risks to patients in cases associated with resident involvement.

Purpose: To compare shoulder arthroscopy cases with and without resident involvement via a large, prospectively maintained national surgical registry to characterize perioperative risks.

Should antibiotics be administered before arthroscopic knee surgery? A systematic review of the literature.

Aim: To explore the current evidence surrounding the administration of prophylactic antibiotics for arthroscopic knee surgery.

Methods: Databases were searched from inception through May of 2018 for studies examining prophylactic antibiotic use and efficacy in knee arthroscopy. Studies with patient data were further assessed for types of arthroscopic procedures performed, number of patients in the study, use of antibiotics, and outcomes with the intention of performing a pooled analysis.

Vertical Extension of the T-Capsulotomy Incision in Hip Arthroscopic Surgery Does Not Affect the Force Required for Hip Distraction: Effect of Capsulotomy Size, Type, and Subsequent Repair.

Background: Interportal and T-capsulotomies are popular techniques for exposing femoroacetabular impingement deformities. The difference between techniques with regard to the force required to distract the hip is currently unknown.

Purpose: To quantify how increasing interportal capsulotomy size, conversion to T-capsulotomy, and subsequent repair affect the force required to distract the hip.

NONOPERATIVE TREATMENT FOR INJURIES TO THE IN-SEASON THROWING SHOULDER: A CURRENT CONCEPTS REVIEW WITH CLINICAL COMMENTARY.

Unlabelled: Repetitive overhead throwing generates tremendous demands on the shoulder joint of the overhead athlete. Clinicians, therapists, and medical staff are charged with optimizing a throwing athlete's shoulder mobility and stability to maximize performance and prevent injury. Modifiable risk factors such as strength asymmetry, glenohumeral range of motion deficits, and scapulothoracic joint abnormalities contribute to the overhead athlete's predisposition to shoulder injury.

How Variable Are Achilles Allografts Used for Anterior Cruciate Ligament Reconstruction? A Biomechanical Study.

Background: Allograft tendon used in anterior cruciate ligament reconstruction (ACLR) requires sterilization before implantation. Low-dose gamma irradiation is a means of sterilization that may minimize tissue damage.

Purpose: To quantify the variability in mechanical properties between low-dose irradiated Achilles tendon allografts used for ACLR.

Propionibacterium Acnes Persists Despite Various Skin Preparation Techniques.

Purpose: To investigate the efficacy of various skin preparations at eradicating Propionibacterium acnes in the dermal layer of the skin.

Methods: Twelve healthy volunteers consented to participate in this study. Each subject's upper back was prepped using 4 different techniques: an isopropyl alcohol control, chlorhexidine gluconate paint, chlorhexidine gluconate plus a mechanical scrub, and a high-concentration chlorhexidine gluconate plus a mechanical scrub.