Effect of Anatomic Variations in the Anterior Tibial Artery on Risk of Injury During Orthopaedic Knee Surgeries.

Background: Injury to the posterior vasculature is a potential complication in orthopaedic knee surgery that may be associated with variations in its anatomy, such as the type II-A2 variant, which places the anterior tibial artery (ATA) in closer proximity to the tibia. However, how close surgical instrumentation comes to injuring the ATA is not well described.

Purpose: To determine how the type II-A2 variant of the popliteal vasculature affects proximity of the ATA to instrumentation for orthopaedic knee procedures.

Opiate Use Patterns Among Collegiate Athletes.

Objective/aim: The purpose of this study is to determine the rates of prescribed opiate use and misuse among current collegiate athletes.

Materials And Methods: This was an bservational survey study conducted at a single institution; Division I Collegiate Athletics Department. The participants in the study were current Division I Collegiate Student-Athletes.

High Prevalence of Sleep Disturbance Is Associated with Femoroacetabular Impingement Syndrome.

Purpose: The purpose of this study was to identify an association between Patient-Reported Outcomes Measurement Information System (PROMIS) sleep scores and other PROMIS domains in patients with femoroacetabular impingement syndrome (FAIS).

Methods: Patients were retrospectively identified for FAIS pathology, and PROMIS outcomes were assessed at multiple visits. Individual generalized linear mixed-effects models were fit with PROMIS sleep score as the predictor variable, and each subsequent PROMIS metric as the response variable.

Orthopedic sleep and novel analgesia pathway: a prospective randomized controlled trial to advance recovery after shoulder arthroplasty.

Background: Lack of sleep is associated with adverse effects on postsurgical pain and recovery. We hypothesized that a multimodal sleep pathway, including nonpharmacologic sleep hygiene interventions and the use of zolpidem and melatonin, could improve patient analgesia and sleep after total shoulder arthroplasty.

Methods: We performed a prospective randomized controlled study in which patients undergoing anatomic and reverse total shoulder arthroplasty were treated with or without an interventional multimodal sleep pathway.

Use of an Individualized Development Plan to Identify Career Development Needs in Prospective Orthopaedic Sports Medicine Fellows.

Background: Mentorship is a key aspect of leadership development for orthopaedic surgeons, but there are few formalized mentorship programs in medical training. The individualized development plan (IDP) is a tool that potentially improves mentorship opportunities through identifying specific competency deficiencies and facilitating communication with mentors.

Purpose: To assess the views of prospective orthopaedic surgery sports medicine fellows on the skills necessary for career development and the utility of an IDP for longitudinal career mentorship during a sports medicine fellowship.

Effect of a novel healthcare leadership program on leadership and emotional intelligence.

The purpose of this study was to assess the effectiveness of the Feagin Leadership Program (FLP) in teaching leadership domains and emotional intelligence. An anonymous survey of 178 graduates of FLP (2011-2019) including the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) was used to assess emotional intelligence and program views. ANOVA was used to compare the difference in emotional intelligence domains between groups.

Proximal Hamstring Injuries.

Proximal hamstring injuries can present as chronic tendinosis, acute strain, partial tendinous avulsions, or complete 3-tendon rupture. Nonoperative management for chronic insertional tendinosis and low-grade tears includes activity modification, anti-inflammatories, and physical therapy. Platelet-rich plasma injections, corticosteroid injections, dry needling, and shock wave therapy are newer therapies that also may provide benefit.

Rotator cuff to deltoid and pectoralis tendon to anatomic neck distances: methods for anatomic restoration of humeral height and tuberosity position in proximal humerus fractures for operative fixation and arthroplasty.

Introduction: Proper anatomic tuberosity reduction and restoration of humeral height during surgical treatment of proximal humerus fractures leads to fewer complications and better outcomes. In the presence of significant displacement and comminution in proximal humerus fractures, the assessment of the correct tuberosity position and humeral height can be challenging. The goal of this cadaveric study was to provide new and useful measurements for intraoperative guidance of proper tuberosity position and humeral height when treating proximal humerus fractures with open reduction internal fixation, anatomic hemiarthroplasty, or reverse total shoulder arthroplasty.

Risk of suprascapular nerve injury during glenoid baseplate fixation for reverse total shoulder arthroplasty: a cadaveric study.

Background: Reverse total shoulder arthroplasty (rTSA) is an effective treatment for patients with advanced rotator cuff arthropathy. During implantation of the glenoid baseplate, screws are inserted through the glenoid face into the scapular body to achieve adequate fixation. Placement of peripheral baseplate screws in the superior and posterior glenoid may increase the risk of injury to the suprascapular nerve (SSN).

Hypoalbuminemia is a risk factor for predicting early postoperative complications after proximal humerus fracture fixation.

Background: Hypoalbuminemia is a marker for malnourishment and is associated with poor outcomes in the setting of hip fractures, periprosthetic joint fractures, and spine surgery. We hypothesized that hypoalbuminemia is associated with higher rates of early complication in patients undergoing surgical treatment for proximal humerus fractures.

Methods: Utilizing the ACS NSQIP database, all proximal humerus fractures treated with plate fixation were extracted from 2006 to 2015.

Use of three-dimensional printing and intraoperative navigation in the surgical resection of metastatic acetabular osteosarcoma.

A 21-year-old man underwent a joint-preserving posterior acetabular resection of metastatic osteosarcoma using a three-dimensional (3D) printed model and intraoperative navigation. The combined application of these advanced technologies can allow for surgical planning of osteotomies involving complex anatomy and help guide resections intraoperatively. They can maximise the achievement of negative oncological margins, preservation of native hip stability and critical neurovascular structures, and optimal postoperative function in an effort to resect all clinically evident disease.

Clavicle Fracture Malunion Treated with an Osteotomy Guided by a Three-Dimensional-Printed Model: A Case Report.

Case: This case report describes the management of a chronic and symptomatic clavicle malunion with use of a 3-dimensional (3D)-printed model during the preoperative surgical planning.

Conclusion: The use of 3D printing has many applications in the medical field. Constant improvement in the quality of 3D printing has contributed to its increased use in a variety of surgeries.

Does Intrathecal Morphine in Spinal Anesthesia Have a Role in Modern Multimodal Analgesia for Primary Total Joint Arthroplasty?

Background: Intrathecal morphine (ITM) combined with bupivacaine spinal anesthesia can improve postoperative pain, but has potential side effects of postoperative nausea/vomiting (PONV) and pruritus. With the use of multimodal analgesia and regional anesthetic techniques, postoperative pain control has improved significantly to a point where ITM may be avoided in total joint arthroplasty (TJA).

Methods: We performed a retrospective study of primary TJA patients who underwent a standardized multimodal recovery pathway and received bupivacaine neuraxial anesthesia with ITM vs bupivacaine neuraxial anesthesia alone (control).

Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: a prospective cohort study.

Background: Studies on perioperative pain control in shoulder arthroplasty focus on regional anesthesia, with little research on other approaches. Perioperative multimodal analgesia regimens decrease opioid intake and opioid-related side effects in lower-extremity arthroplasty. In this study we compare pain scores, opioid consumption, length of stay, and readmission rates in postoperative shoulder arthroplasty patients treated with a standard or multimodal analgesia regimen.

The perioperative effects of chronic preoperative opioid use on shoulder arthroplasty outcomes.

Hypothesis And Background: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty.

Methods: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed.

Long-Acting Opioid Use Independently Predicts Perioperative Complication in Total Joint Arthroplasty.

Background: Opioid therapy is an increasingly used modality for treatment of musculoskeletal pain despite multiple associated risks. The purpose of this study was to evaluate how preoperative opioid use affects early outcomes after total joint arthroplasty.

Methods: A total of 174 patients undergoing total joint arthroplasty were matched by age, gender, and procedure into 3 groups stratified by preoperative opioid use (nonuser, short acting [eg, Vicodin], long acting [eg, Oxycontin]).