Intrathecal Morphine Use in Adolescent Idiopathic Scoliosis Surgery is Associated with Decreased Opioid Use and Decreased Length of Stay.

Background: Length of stay (LOS) in the hospital following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) has decreased over the past decade due to well-defined postoperative clinical pathways, earlier mobilization, and improved pain control methods. Historically, liberal use of parenteral and oral opioids for pain control caused side effects, resulting in delayed discharge. Intraoperative intrathecal morphine (ITM) has been posited to reduce the need for postoperative opioids and to expedite the discharge process.

Are Serum Ion Levels Elevated in Pediatric Patients With Metal Implants?

Background: Previous studies report elevated serum titanium (Ti) levels in children with spinal implants. To provide additional data on this topic, we sought to assess serum ion levels at multiple timepoints in pediatric patients with growing spine devices, spinal fusion instrumentation, and extremity implants placed for fracture treatment. We hypothesized that serum Ti, cobalt (Co), and chromium (Cr) levels would be elevated in pediatric patients with growing spine devices compared with patients with extremity implants.

Progressive adult spinal deformity following placement of intrathecal opioid pump: a report of four cases.

Introduction: Placement of intrathecal opioid pumps (ITOP) for chronic pain is a rare, but described cause of progressive spinal deformity. Over the last two decades there has been several suspected cases at our institution. In this case series, we described the apparent association between placement of an intrathecal opioid pump and progression of spinal deformity.

Early clubfoot recurrence after use of the Ponseti method in a New Zealand population.

Background: Nonoperative treatment of idiopathic clubfoot has become increasingly accepted worldwide as the initial standard of care. The Ponseti method has become particularly popular as a result of published short and long-term success rates in North America. The purpose of the current study was to examine the early rate of clubfoot recurrence following the use of the Ponseti treatment method in a New Zealand population and to analyze patient characteristics to identify factors predictive of recurrence.

A biomechanical analysis of polyethylene liner cementation into a fixed metal acetabular shell.

Background: A common clinical scenario encountered by an orthopaedic surgeon is a patient with a secure cementless acetabular shell and a failed polyethylene liner. One treatment option is to cement a new liner into the fixed shell. The purpose of this study was to evaluate technical variables to improve the mechanical strength of such cemented liner constructs.

Polyethylene liner cementation into fixed acetabular shells.

A patient presenting with a secure cementless acetabular component and with femoral head penetration through the polyethylene liner is a common clinical problem. Cementing a new liner into the fixed shell is one option. We evaluated this option in a clinical series of 17 cases and with a preliminary mechanical study.