Arthroscopically Assisted Percutaneous Screw Fixation of Tibial Plateau Fractures.

Unlabelled: Tibial plateau fractures account for approximately 1% to 2% of fractures in adults. These fractures exhibit a bimodal distribution as high-energy fractures in young patients and low-energy fragility fractures in elderly patients. The goal of operative treatment is restoration of joint stability, limb alignment, and articular surface congruity while minimizing complications such as stiffness, infection, and posttraumatic osteoarthritis.

No Difference Between Anchorless and Traditional Suture Anchors in Arthroscopic Bankart Repair: A Clinical Comparison.

Background Shoulder instability and recurrent dislocations are common problems encountered by orthopedic surgeons and are frequently associated with a Bankart lesion. These are classically treated with either open or arthroscopic repair utilizing traditional suture anchors, though anchorless fixation techniques have recently been developed as an alternate fixation method that reduces native bone loss and has comparable pull-out strength. Methods A retrospective review was performed at a single institution for patients who underwent Bankart repair from January 2008 through February 2014.

Measurement of value in rotator cuff repair: patient-level value analysis for the 1-year episode of care.

Background: Rotator cuff repair (RCR) is one of the most common elective orthopedic procedures, with predictable indications, techniques, and outcomes. As a result, this surgical procedure is an ideal choice for studying value. The purpose of this study was to perform patient-level value analysis (PLVA) within the setting of RCR over the 1-year episode of care.

Locked plating of geriatric olecranon fractures leads to low fixation failure and acceptable complication rates.

Hypothesis: The purpose of this study was to report the rate of major complications in patients with geriatric olecranon fractures managed operatively with a locking plate. Secondary objectives included minor complications, as well as pain and range of motion at the final follow-up. We hypothesized that these patients have a low rate of complications as well as low pain and satisfactory elbow range of motion at the final follow-up.

Osteochondritis Dissecans: Current Understanding of Epidemiology, Etiology, Management, and Outcomes.

➤: Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis.

➤: While generally considered an idiopathic phenomenon, various etiopathogenetic theories are being investigated, including local ischemia, aberrant endochondral ossification of the secondary subarticular physis, repetitive microtrauma, and genetic predisposition.

➤: Diagnosis is based on the history, physical examination, radiography, and advanced imaging, with elbow ultrasonography and novel magnetic resonance imaging protocols potentially enabling early detection and in-depth staging.

Advanced Templating for Total Shoulder Arthroplasty.

»: Longitudinal clinical and radiographic success of total shoulder arthroplasty (TSA) is critically dependent on optimal glenoid component position.

»: Historically, preoperative templating utilized radiographs with commercially produced overlay implant templates and a basic understanding of glenoid morphology.

»: The advent of 3-dimensional imaging and templating has achieved more accurate and precise pathologic glenoid interrogation and glenoid implant positioning than historical 2-dimensional imaging.

Variation of the Inpatient Cost of Care in the Treatment of Isolated Geriatric Intertrochanteric Hip Fractures.

Introduction: Geriatric hip fractures are a major, costly public health issue, expected to increase in incidence and expense with the aging population. As healthcare transitions towards value-based care, understanding cost drivers of hip fracture treatment will be necessary to perform adequate risk adjustment. Historically, cost has been variable and difficult to determine.

Does Implant Selection Affect the Inpatient Cost of Care for Geriatric Intertrochanteric Femur Fractures?

Introduction: Geriatric intertrochanteric (IT) femur fractures are a common and costly injury, expected to increase in incidence as the population ages. Understanding cost drivers will be essential for risk adjustments, and the surgeon's choice of implant may be an opportunity to reduce the overall cost of care. This study was purposed to identify the relationship between implant type and inpatient cost of care for isolated geriatric IT fractures.

Reliability of EOS compared to conventional radiographs for evaluation of lower extremity deformity in adult patients.

Objective: The purpose of this study was to compare reliability of lower extremity imaging measurements using EOS and conventional X-ray (CR) of adult patients with mechanical axis malalignment.

Materials And Methods: Ten patients (20 lower limbs) of mean age of 31.6 years (range 21-39) with post-traumatic deformities who presented for evaluation of osteotomies and/or ligament and cartilage reconstructions were prospectively enrolled.

Complementary and Alternative Medicine for Postoperative Pain: A Systematic Review.

Background: The treatment of postoperative pain is an ongoing challenge for orthopaedic surgeons. Poorly controlled pain is associated with poorer patient outcomes, and the prescription of opioids may lead to prolonged, nonmedical use. Complementary and alternative medicine is widely adopted by the general public, and its use in chronic musculoskeletal pain conditions has been studied; however, its efficacy in a postoperative context has not yet been established.

Factors Associated with a Second Opioid Prescription Fill in Total Knee Arthroplasty.

Background: Total knee arthroplasty (TKA) creates a relatively large degree of nociception, making it a good setting to study variation in pain intensity and pain alleviation. The purpose of this study is to investigate factors associated with a second prescription of opioid medications within 30 days of primary TKA.

Methods: Using an insurance database, we studied 1372 people over a 6-year period with no mental health comorbidities including substance misuse and no comorbid pain illness at the time of TKA.

Osteochondral Allograft Cartilage Transplantation for a Full-Thickness Femoral Condyle Chondral Lesion.

Cartilage lesions of the knee pose a difficult challenge for orthopaedic surgeons. Osteochondral allograft transplantation is an option in the setting of large chondral or osseous defects, or after failure of other treatment options. The use of allograft offers the benefit of utilizing both viable hyaline cartilage and bone.

Cost Savings of Carpal Tunnel Release Performed In-Clinic Compared to an Ambulatory Surgery Center: Time-Driven Activity-Based-Costing.

The purpose of our study was to investigate carpal tunnel release (CTR) performed in the clinic versus the ambulatory surgery center (ASC) to evaluate for potential cost savings. Patients who underwent either CTR in clinic under a local anesthetic or CTR in the ASC with sedation and local anesthetic were prospectively enrolled in a registry between 2014 and 2016. All patients completed a Visual Analog Scale (VAS) pain scale for procedural and postprocedure pain.

Unilateral striae distensae of the knee after a steroid injection for the treatment of Osgood-Schlatter disease.

We report a 12-year-old girl with new diagnosisof right knee Osgood-Schlatter who developedhorizontal purple striae below the right tibial tubercletwo months after a right knee intra-articular steroidinjection. She is the second reported case of unilaterallocalized striae after an intra-articular steroid injectionand the first with triamcinalone as the corticosteroid.

The Inverted Discoid Meniscus Segment: Clinical, Radiographic, and Arthroscopic Description of a Hidden Tear Pattern.

Background: A flipped, or inverted, meniscus segment is easily visualized in the normal meniscus. However, an inverted discoid meniscus segment may be difficult to appreciate because the tear occurs more centrally and leaves more meniscal rim; thus, it may be undertreated if not addressed during arthroscopy.

Purpose: To describe findings on clinical history, radiographs, MRI, and arthroscopy of a lateral discoid meniscus with an inverted segment and compare them with characteristics of a lateral discoid meniscus without an inverted segment.

Prevalence of Discoid Meniscus During Arthroscopy for Isolated Lateral Meniscal Pathology in the Pediatric Population.

Background: Meniscus tears in the young patient are becoming more prevalent. Knowledge of presenting characteristics and morphology can affect treatment decisions. The purpose of this study was to review and evaluate all the isolated lateral meniscus pathology that required arthroscopic treatment in a pediatric sports medicine practice and compare presenting characteristics between those with a discoid meniscus and those with normal meniscal morphology.

Glenoid Bone Loss in Traumatic Glenohumeral Instability in the Adolescent Population.

Background: Glenoid bone loss can affect the outcome and treatment for posttraumatic recurrent anterior glenohumeral instability. Clinical presentation in the adolescent age group with shoulder instability and glenoid bone loss is largely unknown. On the basis of this information, we believe there will be a high incidence of glenoid bone loss in adolescent patients with recurrent glenohumeral instability.

The current state of engineered nanomaterials in consumer goods and waste streams: the need to develop nanoproperty-quantifiable sensors for monitoring engineered nanomaterials.

As nanomaterials are harnessed for medicine and other technological advances, an understanding of the toxicology of these new materials is required to inform our use. This toxicological knowledge will be required to establish the medical and environmental regulations required to protect consumers and those involved in nanomaterial manufacturing. Nanoparticles of titanium oxide, carbon nanotubes, semiconductor quantum dots, gold, and silver represent a high percentage of the nanotechnology currently available or currently poised to reach consumers.