Innovations in Small Joint Arthroscopy.

With advancements in surgical instrumentation and techniques, the role of arthroscopic and arthroscopic-assisted surgical procedures is ever-growing. Arthroscopy offers direct, magnified visualization of pathology and reductions and is more accurate than relying on intraoperative fluoroscopy alone. It also minimizes soft tissue stripping, which is of particular importance to smaller fracture fragments whose vascularity is precarious and can be injured through open approaches.

Utility of preoperative MRI for assessing proximal fragment vascularity in scaphoid nonunion.

Aims: The benefit of MRI in the preoperative assessment of scaphoid proximal fragment vascularity remains controversial. The purpose of this study is to compare preoperative MRI findings to intraoperative bleeding of the proximal scaphoid.

Methods: A retrospective review of 102 patients who underwent surgery for scaphoid nonunion between January 2000 and December 2020 at a single institution were identified.

Validating Clinical Distal Radioulnar Joint Examination With Radiographic Parameters.

Background: The purpose of this study was to quantify the in vivo displacement of bilateral distal radioulnar joints (DRUJs) in resisted pronosupination. We hypothesize that this will demonstrate no appreciable difference between the left and right DRUJ, thus validating the concept of using the uninjured wrist as a control for physical examination as well as dynamic imaging studies.

Methods: Thirty-two participants without a history of wrist pathology underwent a dynamic computed tomography (CT) protocol evaluating bilateral forearm rotation in neutral forearm rotation, 60° pronation, and 60° supination, including maximal isometric muscle loading.

Wound Complications with Multiple Wrist Incisions in Distal Radius Reconstruction.

 Placement and spacing of skin incisions are important for maintaining soft tissue perfusion and viability, particularly in the setting of local trauma.  The aim of this article is to determine if multiple skin incisions in the surgical management of distal radius fractures result in an increased risk of postoperative wound complications, particularly in the setting of high-energy mechanisms of injury with substantial initial displacement and associated soft-tissue insult that require multiple incisions for distal radius reconstruction.  A multicenter, retrospective chart review was performed for all adult patients who underwent open reduction, internal fixation of a closed distal radius fracture with multiple (≥2) hand, and wrist incisions with minimum follow-up of 6 weeks.

Outcomes Following Surgical Treatment of Hamate Arthrosis Lunotriquetral Ligament Injuries.

Background: An institutional review board-approved study of the functional outcomes of patients after surgical treatment of hamate arthrosis lunotriquetral ligament tear (HALT) lesions was conducted.

Methods: In all, 21 wrists in 19 patients underwent arthroscopic, open, or combined treatment of HALT lesions. Seven patients underwent isolated hamate debridement and 14 had concomitant procedures to address lunotriquetral pathology.

Management of Comminuted Distal Radius Fractures: A Critical Analysis Review.

Distal radius fractures occur in a bimodal age and sex distribution. Their incidence continues to rise with an increasingly active aging population. The current American Academy of Orthopaedic Surgeons guidelines for operative intervention are radial shortening of >3 mm, dorsal tilt of >10[degrees], or intra-articular displacement or step-off of >2 mm.

Soft tissue resurfacing for glenohumeral arthritis: a systematic review.

Background: Severe glenohumeral arthritis in the young/active patient remains challenging. Historically, glenohumeral arthrodesis was recommended with limited return of function. Total shoulder arthroplasty has shown increasing survivorship at 15 years; however it is still not ideal for young patients.

Radiation Exposure in Minimally Invasive Transforaminal Lumbar Interbody Fusion: The Effect of the Learning Curve.

Background: Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) has comparable fusion rates and outcomes to the open approach, though many surgeons avoid the technique due to an initial learning curve. No current studies have examined the learning curve of MI-TLIF with respect to fluoroscopy time and exposure. Our objective with this retrospective review was to therefore use a repeatable mathematical model to evaluate the learning curve of MI-TLIF with a focus on fluoroscopy time and exposure.

The Efficacy of Intraoperative Neurophysiological Monitoring to Detect Postoperative Neurological Deficits in Transforaminal Lumbar Interbody Fusion Surgery.

Background: Despite the extensive use of intraoperative neurophysiological monitoring (IONM) in spinal procedures, there is no standard guideline for what types of IONM tests should be monitored during lumbar procedures with instrumentation. Moreover, the efficacy of IONM during transforaminal lumbar interbody fusion (TLIF) surgery in detecting postoperative neurological deficits has not been well described.

Objective: To analyze waveform changes from individual IONM tests (somatosensory evoked potentials [SSEP], motor evoked potentials [MEP], and electromyography [EMG]) during TLIF and compare the sensitivity and specificity of these tests in order to determine the best combination to detect postoperative neurological deficits.

Is Cervical Bracing Necessary After One- and Two-Level Instrumented Anterior Cervical Discectomy and Fusion? A Prospective Randomized Study.

Study Design: Prospective randomized control trial.

Objective: To investigate the role of cervical collars in postoperative care following 1- and 2-level instrumented anterior cervical discectomy and fusion (ACDF).

Methods: The Cervical Spine Research Society Resident Fellow Grant funded this project.

A Preliminary Algorithm Using Spine Measurement Software to Predict Sagittal Alignment Following Pedicle Subtraction Osteotomy.

Study Design: Retrospective case series.

Objective: To evaluate if spine measurement software can simulate sagittal alignment following pedicle subtraction osteotomy (PSO).

Methods: We retrospectively reviewed consecutive adult spinal deformity patients who underwent lumbar PSO.

A Matched Cohort Analysis Comparing Stand-Alone Cages and Anterior Cervical Plates Used for Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective cohort study.

Objective: To compare perioperative characteristics of stand-alone cages and anterior cervical plates used for anterior cervical discectomy and fusion (ACDF).

Methods: We reviewed 40 adult patients who received a stand-alone cage for elective ACDF and matched them with 40 patients who received an anterior cervical plate.

Differences in Fundamental Sagittal Pelvic Parameters Based on Age, Sex, and Race.

Study Design: This is a retrospective cohort study.

Objective: To determine whether age, sex, and race have independent effects on sagittal pelvic parameters.

Summary Of Background Data: Pelvic parameters and sagittal balance correlate with health-related quality of life and are important for patient assessment and surgical planning.

Cervical disc replacement surgery: indications, technique, and technical pearls.

Purpose Of Review: Cervical disc replacement (CDR) is a surgical option for appropriately indicated patients, and high success rates have been reported in the literature. Complications and failures are often associated with patient indications or technical variables, and the goal of this review is to assist surgeons in understanding these factors.

Recent Findings: Several investigations have been published in the last 5 years supporting the use of CDR in specific patient populations.