A Randomized Controlled Pilot Study Using Ultrasound-Guided Percutaneous Cryoneurolysis of the Infrapatellar Branch of the Saphenous Nerve for Analgesia Following Total Knee Arthroplasty.

Introduction: Total knee arthroplasty (TKA) is frequently associated with severe, prolonged postsurgical pain, and therefore local anesthetic-based peripheral nerve blocks are commonly used for postoperative analgesia. Cryoneurolysis involves the use of freezing temperatures to provide a reversible sensory (and motor) block with a duration measured in weeks and months, more commensurate with the typical period of post-TKA pain. We therefore conducted a randomized controlled pilot study to evaluate the use of this modality for the treatment of pain following TKA to (1) determine the feasibility of and optimize the study protocol for a subsequent definitive clinical trial; and (2) estimate analgesia and opioid reduction within the first 3 postoperative weeks.

Percutaneous auricular nerve stimulation (neuromodulation) for the treatment of pain: A proof-of-concept case report using total joint arthroplasty as a surrogate for battlefield trauma.

Background: There are few effective pain treatments following trauma on the battlefield other than opioids, which are limited by respiratory depression. Ultrasound-guided percutaneous peripheral nerve stimulation ("neuromodulation") has been proposed as an analgesic, but requires physician-level skills, advanced equipment, and an hour to administer. In contrast, percutaneous auricular neuromodulation may be placed by a medic in the field under nonsterile conditions in a few minutes, theoretically provides analgesia for any anatomic location, has no side effects, and no significant risks.

EXpectation Propagation LOgistic REgRession on permissioned blockCHAIN (ExplorerChain): decentralized online healthcare/genomics predictive model learning.

Objective: Predicting patient outcomes using healthcare/genomics data is an increasingly popular/important area. However, some diseases are rare and require data from multiple institutions to construct generalizable models. To address institutional data protection policies, many distributed methods keep the data locally but rely on a central server for coordination, which introduces risks such as a single point of failure.

The Relationship Between Apical Vertebral Rotation and Truncal Rotation in Adolescent Idiopathic Scoliosis Using 3D Reconstructions.

Study Design: Retrospective review of prospective data.

Objectives: To evaluate the relationship between absolute apical vertebral rotation (AVR) evaluated with upright 3D imaging and angle of trunk rotation (ATR) before and after surgery for thoracic and lumbar curves in adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: New imaging technology allows for improved radiographic assessment of the degree of AVR pre- and postoperatively through 3D spine models created from biplanar, simultaneous spine radiographs.

Intraoperative Comparison of Measured Resection and Gap Balancing Using a Force Sensor: A Prospective, Randomized Controlled Trial.

Background: For establishing femoral component position, gap-balancing (GB) and measured resection (MR) techniques were compared using a force sensor.

Methods: Ninety-one patients were randomized to undergo primary total knee arthroplasty using either MR (n = 43) or GB (n = 48) technique using a single total knee arthroplasty design. GB was performed with an instrumented tensioner.

Impact of Femoral Stem Design on Failure After Anterior Approach Total Hip Arthroplasty.

Background: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA.

Methods: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons.

Comparison of the iAssist Handheld Guidance System to Conventional Instruments for Mechanical Axis Restoration in Total Knee Arthroplasty.

Background: Recent advances in total knee arthroplasty (TKA) include an intelligent instrument system designed to provide intraoperative guidance to reduce mechanical alignment errors. Internal position-sensing technology is integrated into microelectronic pods that attach to cutting blocks. The purpose of this prospective, randomized study was to determine whether this iAssist system enables the surgeon to make more accurate bone resections and better restore the mechanical axis compared to conventional instruments in TKA.

The 15-Year Evolution of the Thoracoscopic Anterior Release: Does It Still Have a Role?

Study Design: Retrospective.

Purpose: To determine how the indications for anterior thoracoscopic release and fusion have evolved over time.

Overview Of Literature: Anterior release was commonly performed to correct severe spinal deformities before the advent of pedicle screw fixation.

Generation of a Patient-Specific Model of Normal Sagittal Alignment of the Spine.

Study Design: Mathematical modeling of normal sagittal spinal alignment.

Objective: To create a patient specific 3-dimensional (3D) model of normal adolescent spinal shape and alignment.

Summary Of Background Data: Recreating normal sagittal balance is a key goal in spinal deformity surgery.

Avoiding Anomalous Tendon Harvest at the Pes Anserinus Insertion.

The purpose of this study was to identify the frequency and characteristics of anomalous pes anserinus tendon morphology in an adolescent population undergoing knee anterior cruciate ligament (ACL) reconstruction surgery. The records of all children who underwent ACL reconstruction surgery at our tertiary care children's hospital from June 2008 through February 2012 were reviewed. Operative reports were reviewed for any indication that an anomaly existed in the pes anserinus or that there was difficulty harvesting the required tendons.

Postoperative changes in spinal rod contour in adolescent idiopathic scoliosis: an in vivo deformation study.

Study Design: Prospective case series.

Objective: To evaluate the change in spinal rod contour from before implantation to after surgical correction of thoracic curves in patients with adolescent idiopathic scoliosis.

Summary Of Background Data: With segmental pedicle screw spinal instrumentation and vertebral derotation, many authors have reported a loss of thoracic kyphosis postoperatively.