Valgus-impacted subcapital neck of femur fractures: a systematic review, meta-analysis with cost analysis of fixation versus nonoperative management.

Background: The management of the valgus-impacted neck of femur fracture (AO/OTA 31-B1) remains contentious. The objective of this study was to determine whether operative intervention is cost-effective.

Methods: We conducted a systematic review using electronic databases (Medline, Embase, Cochrane, Ebsco, Scholar) identifying studies published in the English language concerning valgus-impacted neck of femur fractures until June 2022.

Pristine gelatin incorporation as a strategy to enhance the biofunctionality of poly(vinyl alcohol)-based hydrogels for tissue engineering applications.

Synthetic polymers, such as poly(vinyl alcohol) (PVA), are popular biomaterials for the fabrication of hydrogels for tissue engineering and regenerative medicine (TERM) applications, as they provide excellent control over the physico-chemical properties of the hydrogel. However, their bioinert nature is known to limit cell-biomaterial interactions by hindering cell infiltration, blood vessel recruitment and potentially limiting their integration with the host tissue. Efforts in the field have therefore focused on increasing the biofunctionality of synthetic hydrogels, without limiting the advantages associated with their tailorability and controlled release capacity.

Fixed coronal malalignment (CM) in the lumbar spine independently impacts disability in adult spinal deformity (ASD) patients when considering the obeid-CM (O-CM) classification.

Background: Postoperative flatback has been described in detail for sagittal plane considerations over the past 2 decades, and its correlations with disability are now accepted. Fixed Coronal Malalignment (CM) has been less described, and some authors report no significant association with the clinical outcome. The O-CM classification analyses CM and incorporates specific modifiers for each curve type.

An age and sex matched study on the effect of obesity on the functional outcomes and complication rates in patients with adult spinal deformity undergoing primary multi-level thoracolumbar spinal fusion.

Background: The objective of this study was to determine the effect of obesity on the functional outcomes and complication rates of patients with adult spinal deformity (ASD) undergoing multi-level thoracolumbar fusion.

Methods: An age and sex matched comparison of functional outcomes [Numeric Rating Scale (NRS) back and leg scores, Core Outcome Measurement Index (COMI) back scores, Scoliosis Research Society 22 (SRS22) satisfaction and total scores, Short Form 36 (SF36) general health scores, Physical Component Score (PCS), Mental Component Score (MCS), Oswestry Disability Index (ODI) (including all domains)] at 6 months, 1, 2, 3 and 4 years and the complication rates at final follow-up between obese [body mass index (BMI) >30] and normal BMI (18.5-24.

Statistical shape modelling of the thoracic spine for the development of pedicle screw insertion guides.

Spinal fixation and fusion are surgical procedures undertaken to restore stability in the spine and restrict painful or degenerative motion. Malpositioning of pedicle screws during these procedures can result in major neurological and vascular damage. Patient-specific surgical guides offer clear benefits, reducing malposition rates by up to 25%.

Surgical site infection is a major risk factor of pseudarthrosis in adult spinal deformity surgery.

Background Context: Despite the evidence in appendicular skeletal surgery, the effect of infection on spinal fusion remains unclear, particularly after Adult Spinal Deformity (ASD) surgery.

Purpose: The purpose of this study was to determine the impact of surgical site infection (SSI) in ASD surgery fusion rates and its association with other risks factors of pseudarthrosis.

Study Design: We conducted an international multicenter retrospective study on a prospective cohort of patients operated for spinal deformity.

Sacral insufficiency fractures are a risk of massive bleeding during sacrectomy: patient series.

Background: Sacrectomy carries significant risk of bleeding; however, specific risk factors, apart from medical comorbidities and tumor type, for this life-threatening complication remain unclear. This study describes two cases of massive bleeding, including one death during sacrectomy attributable to adherence of the internal iliac vein (IIV) and its neuroforaminal tributaries from sacral insufficiency fractures.

Observations: The authors presented two cases involving patients who received sacrectomy for a chordoma and experienced massive bleeding from the IIV due to adherence of the IIV and its neuroforaminal tributaries around sacral insufficiency fractures.

Is There a Nerve-free Zone in Which a Subscapularis Split Can Safely be Performed? An Anatomical Study Using Embalmed Specimens.

Background: The subscapularis muscle, which is part of the rotator cuff, is located anterior to the shoulder. In anterior approaches to the shoulder, its supplying nerves are at risk of iatrogenic injury, which may cause postoperative complications. It is unclear whether there is any nerve-free zone in which a subscapularis split can be performed without risking nerve damage.

Anatomical Topographical Investigation of the Medial Branch of the Dorsal Thoracic Branch of the Spinal Nerve in the Segments T10-T12.

Introduction: The zygapophyseal joints represent one possible cause for back pain. Therefore, many interventions are targeting the denervation of the facet joints. The aim of this study is to describe the course of the medial branch of the dorsal branch of the spinal nerve and its articular branches to the zygapophyseal joints in the segments T10-T12.

The intra-muscular course and distribution of the anterior interosseous nerve within pronator quadratus: An anatomical study.

Background: The anterior interosseous nerve (AIN) is a terminal motor branch of the median nerve innervating the following three muscles from proximal to distal: Flexor pollicis longus (FPL), the radial half of flexor digitorum profundus (FDP), and the pronator quadratus (PQ). The aim of this study was to define the course of the AIN within the PQ to aid surgeons performing distal radial procedures.

Methods: Ten embalmed cadaveric forearms were dissected to identify the path of the AIN within PQ.

The 45-year evolution of the Mathys RM monoblock cups: have the paradigm shifts been worthwhile?

Introduction: The Robert Mathys (RM) monoblock uncemented cup is a design less commonly used in primary total hip replacement. It's purported advantages over modular cemented cups are: (1) its modulus of elasticity approximating bone, thus mimicking load transmission and the biomechanical behaviour of the cup to better match stresses on the acetabulum, leading to bone-preservation; and (2) as a 1-piece cup there is absence of a mobile interface between a liner and shell, preventing backside wear. Since its inception in 1983 there have been 3 major design changes: the RM Classic, the RM Pressfit, and the RM Vitamys with the most modern polyethylene (vitamin E).

Impact of radiologic variables on item responses of ODI, SRS22 and SF-36. in adult spinal deformity patients: differential item functioning (DIF) analysis results from a multi-center database.

Purpose: To determine if responses given to each question of the Scoliosis Research Society-22 (SRS22), Oswestry disability index (ODI) and Short Form-36 (SF-36) questionnaires are influenced by the radiological parameters.

Methods: Patients enrolled in a multi-centre prospectively collected adult spinal deformity database who had complete SRS22, ODI and SF-36 data at baseline and at one-year follow-up were analysed. The presence of a differential item function of each question within each score in relation to radiological parameters was analysed using a mixed Rasch model with the radiological threshold value(s) determined.

Multiple-Rod Constructs Do Not Reduce Pseudarthrosis and Rod Fracture After Pedicle Subtraction Osteotomy for Adult Spinal Deformity Correction but Improve Quality of Life.

Objective: To compare the radiological and functional outcomes and complications of adult spinal deformity patients who underwent a pedicle subtraction osteotomy (PSO) below L2 but categorized according to their construct where either 2-rod or multiple-rod construct is applied.

Methods: Sixty-seven patients met the inclusion criteria, and were categorized into 3 groups: 2 rods (2R), multiple rods around the PSO (MRP), multiple rods around the PSO and lumbosacral junction (MRL). Demographic data, operative parameters, spinopelvic parameters, functional outcomes, and complications were collected.

A study into the viability of Synbone® as a proxy for Sus scrofa (domesticus) ribs for use with 7.62 × 51 mm Full Metal Jacket ammunition in ballistic testing.

Forensic reconstructions and ballistic testing requires the use of consistent and repeatable simulants. Synthetic bone has been developed to be mechanically similar to human bone; however, it does not have the same viscoelastic properties. Bone acts as brittle and stiff material and fails instantly under high-energy events such as ballistic impacts.

Benchmarking total knee replacement constructs using noninferiority analysis: the New Zealand joint registry study.

Background: The aim of this study was to compare the relative performance of total knee replacement constructs and discern if there is variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis.

Methods: All patients who underwent a primary total knee replacement (TKR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of total knee replacement prostheses were compared with the best performing contemporary construct.

Benchmarking total hip replacement constructs using noninferiority analysis: the New Zealand joint registry study.

Background: The aim of this study was to compare the relative performance of total hip replacement constructs and discern if there is substantial variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis.

Methods: All patients who underwent a primary total hip replacement (THR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of hip prostheses were compared with the best performing contemporary construct.

Anatomical Landmarks for Intraoperative Adductor Canal Block in Total Knee Arthroplasty: A Cadaveric Feasibility Assessment.

Background: Postoperative analgesia after knee arthroplasty forms a basis for an optimal range of motion after surgery. Femoral nerve blocks are established as a sensory nerve blockade but at the expense of quadriceps weakness delaying postoperative mobilization. The adductor canal block (ACB) similarly provides sensory blockade but preserves quadriceps function.

Strategies for inclusion of growth factors into 3D printed bone grafts.

There remains a critical need to develop new technologies and materials that can meet the demands of treating large bone defects. The advancement of 3-dimensional (3D) printing technologies has allowed the creation of personalized and customized bone grafts, with specific control in both macro- and micro-architecture, and desired mechanical properties. Nevertheless, the biomaterials used for the production of these bone grafts often possess poor biological properties.

Teleconsultation in the Management of Elective Orthopedic and Spinal Conditions During the COVID-19 Pandemic: Prospective Cohort Study of Patient Experiences.

Background: The global adoption of teleconsultation has been expedited as a result of the COVID-19 pandemic. By allowing remote communication, teleconsultation may help limit the spread of the virus while maintaining the crucial patient-provider relationship.

Objective: The aim of this study is to evaluate the value of teleconsultation compared to in-person visits in the management of elective orthopedic and spinal procedures.

The Impact of Corrective Surgery on Health-Related Quality of Life Subclasses in Adult Scoliosis: Will Degree of Correction Prognosticate Degree of Improvement?

Purpose: Objectives in scoliosis corrective surgery include restoration of normal sagittal and coronal parameters to achieve patient satisfaction. HRQLs improvements remain limited after corrective surgery. The aim of this study was to evaluate the HRQL subclass variability specific to the sagittal and coronal correction in adult scoliosis surgery.