Core Decompression and Bone Marrow Aspirate Concentrate in the Treatment of Femoral Head Avascular Necrosis in Pediatric Sickle Cell Disease: Can We Improve Natural History?

Introduction: Femoral head avascular necrosis (AVN) affects between 10% and 41% of children with sickle cell disease (SCD), resulting in the development of proximal femoral deformity and residual hip pain in the majority of patients without treatment. There have been multiple adult studies published on the outcomes of core decompression with and without the use of bone marrow aspirate concentrate (BMAC) injection both in idiopathic and SCD-related AVN with promising results, however, few studies have reported on outcomes in skeletally immature patients.

Purpose: This study sought to report on a single surgeon's outcomes for core decompression with BMAC injection in pediatric patients with AVN of the femoral head secondary to underlying SCD.

Biomechanical evaluation of an intramedullary clavicle screw in simple oblique and butterfly wedge fractures.

This biomechanical study evaluates the performance of a solid titanium-alloy intra-medullary () clavicular screw in torsion and cantilever bending in cadaveric clavicle specimens with simulated simple oblique and butterfly wedge midshaft fractures. Thirty-two fresh-frozen male clavicles were sorted into six experimental groups: Torsion Control, Torsion Simple Oblique Fracture, Torsion Butterfly Wedge Fracture, Bending Control, Bending Simple Oblique Fracture, and Bending Butterfly Wedge Fracture. The experimental groups were controlled for density, length, diameter, and laterality.

Magnetically controlled growing instrumentation for early onset scoliosis: Caution needed when interpreting the literature.

Background: Magnetically controlled growing rods (MCGR) are a novel treatment option for early onset scoliosis (EOS). Although the complication profile with MCGR use has been reviewed, these reviews do not take into account important implants modifications, termed iterations, that were made due to early on postoperative complications is not well reported or understood.

Aim: To assess the effect of MCGR implant iterations on post-operative complications in EOS.

Defining the Normal Trends of Serum Creatine Kinase Levels Following Spinal Surgery.

Study Design: Prospective, prognostic study, level II evidence.

Purpose: To define the normal change in the creatine kinase (CK) levels in patients undergoing prone or supine lumbar or cervical spine surgery and to determine if positioning influences the postoperative changes in the CK levels.

Overview Of Literature: Spine surgery is one of the most commonly performed and fastest growing areas of surgery in the United States.

Inverted C-arm Orientation During Simulated Hip Arthroscopic Surgery.

Background: Fluoroscopic guidance is routinely utilized during hip arthroscopic surgery. Previous studies have shown that the C-arm orientation can significantly affect radiation exposure for both the surgeon and the patient during orthopaedic procedures. However, this has not been previously assessed for hip arthroscopic surgery.

Nighttime bracing with the Providence thoracolumbosacral orthosis for treatment of adolescent idiopathic scoliosis: A retrospective consecutive clinical series.

Background:: Orthotic treatment for adolescent idiopathic scoliosis is a mainstay in nonoperative treatment to prevent progressive spinal deformity.

Objective:: To determine the effectiveness of the Providence orthosis in the treatment of adolescent idiopathic scoliosis.

Study Design:: Retrospective review.

Preventing Construct Subsidence Following Cervical Corpectomy: The Bump-stop Technique.

Cervical corpectomy is a viable technique for the treatment of multilevel cervical spine pathology. Despite multiple advances in both surgical technique and implant technology, the rate of construct subsidence can range from 6% for single-level procedures to 71% for multilevel procedures. In this technical note, we describe a novel technique, the bump-stop technique, for cervical corpectomy.

The Effect of Bony Parameters on the Pediatric Knee: Normal versus Anterior Cruciate Ligament Injury versus Tibial Spine Avulsion Fracture.

 Anterior cruciate ligament (ACL) injuries can present as a ligamentous disruption or avulsion fracture of the tibial spine in pediatric patients. Differences in knee morphometric parameters have been investigated between pediatric cohorts with ACL disruptions and tibial spine avulsion fractures. However, no study to date has compared morphometric parameters in patients with tibial spine avulsion fracture against a control population.

Hospital incident command system: tool for a TJC accreditation survey.

The unannounced Joint Commission (TJC) accreditation survey can prove just as unpredictable and challenging as any other incident. In this article, the authors describe a plan developed by a hospital emergency response team that has proven successful in dealing with TJC and other surveys.

Combined posterolateral corner and acute anterior cruciate ligament injuries in an adolescent cohort: a magnetic resonance imaging analysis.

Purpose: Failure of a reconstructed anterior cruciate ligament (ACL) has significant morbidity in the paediatric and adolescent patient population. Untreated concomitant posterolateral corner (PLC) injury is an identified cause of failed ACL reconstruction; however, the injury pattern has yet to be defined for the paediatric population.

Methods: Magnetic resonance imaging (MRI) studies of the knee performed between 1 January 2009 and 1 January 2013 were retrospectively reviewed.