Medical and Interventional Management of Hereditary Hemorrhagic Telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder of the blood vessels that leads to the formation of telangiectasias and arteriovenous malformations (AVMs). HHT affects ∼1/5,000 people, but this varies significantly by geography and ancestry. The Curaçao criteria for HHT consist of four diagnostic criteria: spontaneous epistaxis, first-degree relative with HHT, AVMs in characteristic location (liver, lung, brain), and telangiectasias.

Sex estimation from humeral and femoral head diameters using CT-scans of living Finns.

This study used 155 computed tomography (CT) scans of Finns (81 males, 74 females) for creating population-specific sectioning points from femoral and humeral head diameters for the purposes of sex estimation. The study included four measurements: vertical and transverse diameter of the femoral head and vertical and transverse diameter of humeral head. All the measured dimensions were sexually dimorphic and the following sectioning points were calculated: Femur: vertical diameter 46.

Hepatic Artery Thrombectomy after Orthotopic Liver Transplantation: A Stent Retriever and/or Aspiration-Guided Catheter Approach.

Retransplantation has been the primary treatment for hepatic artery thrombosis (HAT) in patients with orthotopic liver transplant (OLT); however, because of scarcity of grafts, endovascular revascularization via mechanical thrombectomy offers an alternative to retransplantation should it provide similar long-term benefits. Data regarding a series of 8 patients with hepatic artery thrombectomies across 10 procedures (1 early HAT and 9 late HAT) utilizing stent retriever and/or suction catheter were collected. All had technically successful restoration of flow with stent placement of the anastomotic stenosis in 8 cases.

Surprise Billing in Elective Shoulder Surgery and Its Effect on Patient Satisfaction.

Patients often receive multiple bills following surgery, which may come as a surprise to them if they are not appropriately informed or educated prior to surgery. The purpose of this study was to identify whether surprise billing occurs following shoulder rotator cuff repair and its effect on patient satisfaction. The study surveyed adult patients who underwent elective rotator cuff repair from January 2020 to October 2021.

Associating Outcomes After Hip Arthroscopy With Patient Resilience.

Background: Higher patient resilience has been shown to be associated with improved patient-reported outcome measures (PROMs) at 6 months after hip arthroscopy.

Purpose: To examine the relationship between patient resilience and PROMs at minimum 2 years after hip arthroscopy.

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

Clinical Outcomes After Ulnar Collateral Ligament Reconstructions With Concomitant Ulnar Nerve Transposition in Overhead Athletes: A Matched Cohort Analysis.

Background: Injury of the ulnar collateral ligament (UCL) has become increasingly common, particularly in overhead athletes. There is no consensus on management of the ulnar nerve in UCL reconstruction (UCLR) in patients with preoperative ulnar nerve symptoms, as literature supports both not decompressing the nerve as well as ulnar nerve transposition (UNT).

Hypothesis/purpose: The purpose of this study was to compare subjective clinical outcomes and return-to-sports (RTS) metrics between patients who received UNT during UCLR and a matched cohort who underwent UCLR alone.

Return to driving following anatomic and reverse shoulder arthroplasty: a comparative analysis.

Background: The currently recommended time to return to driving following shoulder arthroplasty is controversial. The purpose of this study was to determine patient-specific factors associated with early return to driving after anatomic (aTSA) and reverse total shoulder arthroplasty (RTSA).

Methods: All patients aged >18 years undergoing primary aTSA or RTSA at a single institution over a 3-year period were retrospectively identified.

Risk of Noise-Induced Hearing Loss for Orthopaedic Surgeons.

Background: Noise-induced hearing loss (NIHL) affects the ability of an individual to communicate and can negatively impact quality of life. The risk to orthopaedic surgeons of developing NIHL as a result of occupational exposures in the operating room (OR) is currently unknown. Hearing protection is recommended for levels of >85 decibels (dB), irrespective of length of exposure.

Malpractice against shoulder surgeons: what the data say.

Background: Thousands of orthopedic surgeons in the United State face medical malpractice claims annually; however, little is known regarding the common causes for litigation against shoulder surgeons. In addition, the current analysis does not take into consideration how surgical frequency affects the litigation likelihood. The purpose of our investigation was to identify the most common causes of litigation against shoulder surgeons in the United States adjusting for surgical frequency.

Biomechanical comparison of elbow stability constructs.

Background: Despite surgical stabilization of complex elbow trauma, additional fixation to maintain joint congruity and stability may be required. Multiple biomechanical constructs include a static external fixator (SEF), a hinged external fixator (HEF), an internal joint stabilizer (IJS), and a hinged elbow orthosis (HEO). The optimal adjunct fixation to surgical reduction is yet to be determined.

Late Femoral Component Revision for Femoral Canal Perforation.

Femoral perforation during total hip arthroplasty is a rare complication. Most of the existing literature regarding the complication involves acutely recognized perforations. We report a case of femoral component revision for a symptomatic femoral perforation 12 years after a primary cementless total hip arthroplasty.

Next-generation osteometric sorting: Using 3D shape, elliptical Fourier analysis, and Hausdorff distance to optimize osteological pair-matching.

Determining which bilateral bones belong to the same person based on shape and size similarity is called pair-matching and it is instrumental for sorting commingled skeletons. To date, pair-matching has popularly been accomplished by visual inspection and/or linear caliper measurements; however, attention is turning increasingly to computational analysis. In this paper, we investigate a fast three-dimensional (3D) computerized shape-analysis method for whole-bone pair-matching using a test sample of 14 individuals (23 femora, 26 humeri, and 26 tibiae).

Amount of CMS Reduction in Facility Reimbursement Following Removal of Total Hip Arthroplasty From the Inpatient-Only List Far Exceeds Reduction in Actual Care Cost.

Background: Starting in 2020, Centers for Medicare and Medicaid Services (CMS) removed total hip arthroplasty (THA) from the inpatient-only list, resulting in an average of $1637 per case reduction in facility reimbursement. The purpose of this study is to determine whether the reduction in reimbursement is justified by comparing the difference in true facility costs between inpatient and outpatient THA.

Methods: We identified a consecutive series of 5271 primary THA procedures from 2015 to 2019.

Unusual anatomic variant of the axillary nerve challenging the deltopectoral approach to the shoulder: a case report.

Background: The deltopectoral approach is a well-described surgical approach to the proximal humerus and glenohumeral joint. One of the structures at risk during this approach is the axillary nerve. Typically, the axillary nerve arises off the posterior cord of the brachial plexus and courses lateral to the proximal humerus and inferior to the glenohumeral joint, exiting the axilla through the quadrangular space.

Overlapping and differential functions of ATF6α versus ATF6β in the mouse heart.

Hemodynamic stress on the mammalian heart results in compensatory hypertrophy and activation of the unfolded protein response through activating transcription factor 6α (ATF6α) in cardiac myocytes, but the roles of ATF6α or the related transcription factor ATF6β in regulating this hypertrophic response are not well-understood. Here we examined the effects of loss of ATF6α or ATF6β on the cardiac response to pressure overload. Mice gene-deleted for Atf6 or Atf6b were subjected to 2 weeks of transverse aortic constriction, and each showed a significant reduction in hypertrophy with reduced expression of endoplasmic reticulum (ER) stress-associated proteins compared with controls.

Mutant myocilin impacts sarcomere ultrastructure in mouse gastrocnemius muscle.

Myocilin (MYOC) is the gene with mutations most common in glaucoma. In the eye, MYOC is in trabecular meshwork, ciliary body, and retina. Other tissues with high MYOC transcript levels are skeletal muscle and heart.

Binding of a glaucoma-associated myocilin variant to the αB-crystallin chaperone impedes protein clearance in trabecular meshwork cells.

Myocilin () was discovered more than 20 years ago and is the gene whose mutations are most commonly observed in individuals with glaucoma. Despite extensive research efforts, the function of WT MYOC has remained elusive, and how mutant MYOC is linked to glaucoma is unclear. Mutant MYOC is believed to be misfolded within the endoplasmic reticulum, and under normal physiological conditions misfolded MYOC should be retro-translocated to the cytoplasm for degradation.

Analysis of Three Commonly Used Tibia Length Measurement Techniques.

This study analyzes three tibia length measurement techniques on a sample of 107 tibiae. Two of the techniques meet published criteria by resting the tibia on its posterior surface with the longitudinal axis parallel to an osteometric board. The third technique does not adequately keep the longitudinal axis parallel to the board.

Z-Transform Method for Pairwise Osteometric Pair-matching.

A new pairwise osteometric pair-matching approach based on the Z-transform method is presented. In contrast to previous methods that perform a global t-test on the summed skeletal element pair measurement distances, this approach performs t-tests on each individual distance, facilitating the capture of measurement-specific variation. This new approach is compared to published pairwise sorting methods using a standard reference dataset of postcranial remains maintained by the Defense POW/MIA Accounting Agency.

Reanalysis of the Trotter Tibia Quandary and its Continued Effect on Stature Estimation of Past-Conflict Service Members.

Forensic casework from past-conflicts relies on the corrected historical Trotter data for stature estimation in Fordisc. For roughly 10 years', stature estimation using this data has produced point estimates for the tibia that are on average 1.25 inches less than the other long bones.

An Automated Two-dimensional Pairwise form Registration Method for Pair-matching of Fragmented Skeletal Remains.

This study introduces an automated pairwise method for osteological pair-matching of fragmented skeletal remains using two-dimensional fragmented outlines extracted from photographs. The form data are used in pairwise iterative closest point registrations with rigid transformations. A modified version of the average Hausdorff distance is calculated to remove any coordinate correspondences with outline fracture margins, which allow the distance analysis of fragmented outlines.

Full-length myocilin protein is purified from mammalian cells as a dimer.

Myocilin (MYOC) is a secreted protein found in human aqueous humor (AH) and mutations in the MYOC gene are the most common mutation observed in glaucoma patients. Human AH analyzed under non-reducing conditions suggests that MYOC is not normally found in a monomeric form, but rather is predominantly dimeric. Although MYOC was first reported almost 20 years ago, a technical challenge still faced by researchers is an inability to isolate full-length MYOC protein for experimental purposes.

An Automated Two-Dimensional Form Registration Method for Osteological Pair-Matching.

This study introduces an automated method for osteological pair-matching using two-dimensional outline form data extracted from photographs. A procedure for acquiring photographs that improve the differentiation of specimens from the background is presented along with an extraction procedure that allows the capture of form data from photographs. The raw form data are used in a two-dimensional registration procedure, which combines iterative closest point, K-nearest neighbor search, and iterations around an estimated mean.

The Automation of Regression Modeling in Osteometric Sorting: An Ordination Approach.

This study compares the original osteometric sorting association method with an ordination approach across all combinations of the humerus, ulna, radius, femur, tibia, and fibula. This includes both the original prediction interval and t-statistic approaches. Standard measurements are utilized in the models with full measurements combined and without length measurements.