Acetabular Rim Ossification Variants Are Found in Almost 20% of Patients Presenting With Hip Pain.

Purpose: To determine the prevalence of 4 different types of acetabular rim ossifications, including partial labral ossification or punctate calcification, true os acetabuli, acetabular rim stress fracture, and complete labral ossification, and to determine whether different types of periacetabular ossifications are linked to demographic or radiological factors.

Methods: We retrospectively reviewed the medial records of patients presenting for hip-related complaints at 2 sports medicine practices from September 2007 to December 2009. An anteroposterior radiograph of both hips and a lateral radiograph of each hip was obtained for all patients and reviewed for findings of cam and pincer femoroacetabular impingement, degenerative changes (Tönnis grade), and periacetabular calcifications for both hips.

Takedown of Ankle Fusions and Conversion to Total Ankle Replacements.

Background: With ankle replacements gaining credibility, there is a small subset of patients who might benefit from a conversion of an ankle fusion to a replacement. The objective of this study is to present clinical and radiographic results of patients who had their ankle fusion converted to total ankle arthroplasty (TAA).

Methods: Patients presented to the senior author with ongoing ankle pain following fusion or increasing pain after a period of relative comfort after an ankle fusion.

Quadriceps Strength following Anterior Cruciate Ligament Reconstruction: Normative Values based on Sex, Graft Type and Meniscal Status at 3, 6 & 9 Months.

Background: Higher postoperative quadriceps function has been positively associated with surgical outcomes after anterior cruciate ligament reconstruction (ACLR). However, the impact of autograft harvest and/or a concomitant meniscal procedure on the recovery of quadriceps strength is not well defined.

Purpose: To describe postoperative recovery of quadriceps strength following ACLR related to autograft selection, meniscal status, and sex.

Arthroscopic Debridement Versus Refixation of the Acetabular Labrum Associated With Femoroacetabular Impingement: Updated Mean 7-Year Follow-up.

Background: Short- and midterm follow-up studies suggest that arthroscopic labral refixation/preservation leads to superior outcomes compared with labral excision/debridement.

Purpose: To update the previous early (16 months) and midterm (mean, 42 months) follow-up of this cohort, which reported better patient-reported outcome measures and lower failure rates in the repair/refixation group.

Study Design: Cohort study; Level of evidence, 3.

Implementation of formal prescription guidelines reduces the economic cost of unused opioids after orthopedic surgery.

Prior literature has reported on the concerning emergence of opioid overprescribing, yet there remains a lack of knowledge in understanding the cost of waste of this over-prescription and underconsumption of opioids. As such, further investigating the cost of waste of opioids following orthopedic surgery is of interest to patients, providers, and payors. In one of the largest private orthopedic practices in the United States, opioid prescribing and consumption patterns were tracked prior to, and after the implementation of, formal prescription guidelines.

Opioid Prescribing Practices and Quality Improvements Within an Outpatient Orthopedic Practice.

Background During the last several decades, the opioid epidemic throughout the United States has been recognized as an increasing problem. The aim of this study was to identify and implement processes throughout a single private orthopedic practice and managed ambulatory surgery centers to reduce opioid prescription pill quantity and strength, while also reducing consumption. Methodology A baseline assessment along with the development of four separate phases was implemented.

Opioid-Prescribing Practices Between Total Knee and Hip Arthroplasty in an Outpatient Versus Inpatient Setting.

Despite trends showing increases in the utilization of outpatient (OP) ambulatory surgery centers (ASCs) and decreases in the utilization of inpatient (IP) facilities for total knee arthroplasty (TKA) and total hip arthroplasty (THA), little is known about opioid prescribing for these procedures between each setting. This study evaluated differences in opioid prescribing and consumption between OP ASC and IP settings for elective TKA and THA surgeries over a 1-year period. Data collection also included pain and satisfaction of pain control postsurgery.

Is Matching Exercise Intensity to Heart Rate Variability a Key to Effective Conditioning for Dancers? A Prospective Randomized Controlled Trial.

Dancers seek studio-based conditioning methods that improve fitness to help them meet the demands of their discipline. Heart rate variability (HRV) mobile technology offers one such potential method. The purpose of this prospective randomized controlled trial was to investigate how HRV impacted fitness outcomes over a 4 to 6 week period of supplemental training.

Femoral Head Allografts for Talar Body Defects.

Background: Large structural bone deficits after a failed ankle arthroplasty or avascular necrosis (AVN) of the talus present a complex reconstruction challenge. The aim of this study was to report the results of patients undergoing an ankle arthrodesis or tibiotalocalcaneal fusion using a femoral head allograft (FHA).

Methods: All ankle and tibiotalocalcaneal fusions using FHA between February 2006 and January 2019 were included.

Outcomes of Nitinol Compression Staples in Tarsometatarsal Fusion.

Background: Tarsometatarsal (TMT) arthrodesis is commonly performed in the management of midfoot arthritis, trauma, or deformity. The purpose of this study was to collect aggregate data (demographic, surgical, and perioperative outcomes) on patients who previously had a TMT fusion with BME compression staples.

Methods: Sixty-six patients underwent TMT fusion with BME compression staples.

Patient-Reported Outcomes and Early Complications After Synthetic Cartilage Device Implantation.

Background: Previous Level I studies show promising results for the use of a hydrogel synthetic cartilage implant (SCI) for the treatment of hallux rigidus. A recent independent retrospective review has put those results into question, however. The purpose of this article is to report patient-reported outcomes and early complications using this implant so as to add to the paucity of data in the literature regarding this implant.

Management of Ankle Arthritis After Severe Ankle Trauma.

Objectives: There are still unanswered questions about the best treatment options for ankle arthritis after severe lower leg trauma. This study compared results in outcomes and complications for 3 groups.

Design: Retrospective cohort study case-control study.

The Dancer's Hip: The Hyperflexible Athlete: Anatomy and Mean 3-Year Arthroscopic Clinical Outcomes.

Purpose: To report preoperative anatomy, patient-related outcomes measures, and return to dance rates in a cohort of competitive dancers undergoing an arthroscopic hip procedure.

Methods: Competitive dancers who underwent an arthroscopic hip procedure between 2008 and 2016 were included. Specific types of dance performed, morphology, and radiographic parameters were documented.

Subtalar Arthrodesis with Use of Adipose-Derived Cellular Bone Matrix Compared with Autologous Bone Graft: A Multicenter, Randomized Controlled Trial.

Update: This article was updated on November 7, 2019, because of a previous error. On page 1909, in the section entitled "Discussion," the sentence that had read "Radiographic nonunion rates of 69.2% and 45.

Outcomes of the First 1,000 Total Hip and Total Knee Arthroplasties at a Same-day Surgery Center Using a Rapid-recovery Protocol.

Background: Outpatient (<24 hour stay) total joint arthroplasty (TJA) has emerged as an alternative to traditional inpatient TJA. Patient-reported outcomes in the past have revealed favorable comparisons with inpatient controls. However, a higher outpatient TJA readmission rate has been reported.

Arthroscopic Surgery for Femoroacetabular Impingement in Skeletally Immature Athletes: Radiographic and Clinical Analysis.

Purpose: To evaluate radiographic and clinical outcomes after arthroscopic femoroacetabular impingement (FAI) correction in symptomatic adolescent athletes with open physes.

Methods: We retrospectively reviewed radiographic and clinical outcomes in patients treated with a non-physeal-sparing arthroscopic approach for symptomatic FAI with open physes and a minimum 1-year follow-up. Specific plain radiographic and computed tomography parameters were determined, and preoperative and postoperative outcomes were prospectively evaluated with modified Harris Hip Score (mHHS), 12-Item Veterans-Rand, and pain on a visual analog scale.

Predicting outstanding results after reverse shoulder arthroplasty using percentage of maximal outcome improvement.

Background: The purpose of this study was to determine whether thresholds regarding the percentage of maximal improvement in the Simple Shoulder Test (SST) score and American Shoulder and Elbow Surgeons (ASES) score exist that predict excellent patient satisfaction after reverse shoulder arthroplasty (RSA).

Methods: Patients undergoing RSA with a single implant system were evaluated preoperatively and at a minimum 2-year follow-up. Receiver operating characteristic curve analysis determined thresholds to predict excellent patient satisfaction by evaluating the percentage of maximal improvement for SST and ASES scores.

Comorbidity effect on speed of recovery after arthroscopic rotator cuff repair.

Background: Comorbidities have been shown to affect rotator cuff healing and postoperative outcomes. The purpose of this study was to analyze the effect of comorbidities on speed of recovery (SOR) and overall outcomes after arthroscopic rotator cuff repair (RCR).

Methods: We identified 627 patients who underwent primary arthroscopic RCR from 2006 to 2015.

The procedure value index: a new method for quantifying value in shoulder arthroplasty.

Background: The purpose of this study was to introduce the procedure value index (PVI) and apply this value instrument to shoulder arthroplasty. The PVI uses the value equation in units of minimal clinically important difference (MCID) to provide an objective system of quantifying value-driven care. Secondarily, we describe the PVI for both primary anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) to highlight value differences between these patient populations.

Predicting outstanding results after anatomic total shoulder arthroplasty using percentage of maximal outcome improvement.

Background: The purpose of this study was to determine whether thresholds in the percentage of maximal improvement in the Simple Shoulder Test (SST) or American Shoulder and Elbow Surgeons (ASES) score exist for predicting "excellent" patient satisfaction after total shoulder arthroplasty (TSA).

Methods: A retrospective query identified patients who underwent TSA with a minimum of 2 years' follow-up. Preoperative and postoperative SST and ASES scores and postoperative patient satisfaction were recorded.

Prevalence of Rotator Cuff Repairs with and Without Concomitant Subacromial Decompressions Has Not Changed.

Background: Recent research from the American Board of Orthopaedic Surgery database indicates a decreasing rate of subacromial decompression (SAD) performed with rotator cuff repair (RCR) by younger orthopedic surgeons.

Questions/purposes: The purpose of this study was to determine the rate of RCR with and without SAD and whether the rate of RCR with SAD decreased over time. Further, we set out to determine if there was significant variation in the rate of RCR with SAD by state.

Retrospective review of 65 atrioesophageal fistulas post atrial fibrillation ablation.

Background: Although a rare complication of catheter based ablation for atrial fibrillation (AF), atrioesophageal fistula (AEF) is a serious and fatal event [1-5]. Most reports of AEF are single cases or small case series.

Objective: The purpose of this study was to perform a comprehensive literature search of all published atrioesophageal fistula following catheter ablation for AF in order to identify the mortality rates associated with therapeutic modalities and suggest the most definitive management in reducing mortality.

Predictors of Clinically Suspected Intra-articular Hip Symptoms and Prevalence of Hip Pathomorphologies Presenting to Sports Medicine and Hip Preservation Orthopaedic Surgeons.

Purpose: The first purpose of the study was to evaluate the prevalence of various radiographic parameters and pathomorphologies for patients presenting with the diagnosis of hip pain. The second purpose of this study was to identify those pathomorphologies and radiographic parameters that were predictive of clinically suspected intra-articular and hip joint-related symptoms.

Methods: A total of 998 hips (499 patients, 228 males, 271 females, mean age 38 years) presented to 2 orthopaedic surgeons with the diagnosis of hip pain.

Generalized Hypermobility, Knee Hyperextension, and Outcomes After Anterior Cruciate Ligament Reconstruction: Prospective, Case-Control Study With Mean 6 Years Follow-up.

Purpose: To determine whether generalized hypermobility and contralateral knee hyperextension affect failure rates and patient-related outcomes after anterior cruciate ligament reconstruction (ACLR).

Methods: A total of 226 consecutive patients presenting with acute ACL tears were prospectively evaluated for generalized hypermobility by a modified Beighton criteria. Minimum 2-year follow-up was achieved for 183 knees (81%).

Radiographic Hip Anatomy Correlates With Range of Motion and Symptoms in National Hockey League Players.

Background: Hip disorders in athletes have been increasingly recognized.

Purpose: To characterize radiographic hip anatomy for National Hockey League (NHL) players and correlate it with hip range of motion and hip symptoms and/or surgery.

Study Design: Cross-sectional study; Level of evidence, 3.