SUPPLEMENTAL DEXTROSE IN THE INFUSION FLUID DURING DIABETIC VITRECTOMY.

Purpose: Historically, supplemental dextrose to infusion fluid has been used to reduce the need for intraoperative lensectomies to maintain visualization during diabetic vitrectomy. Valved, small-gauge vitrectomy has reduced surgical time and decreased intraoperative fluid flow. Assessment of supplemental dextrose in modern vitrectomy is presented in this study.

Dual sensory impairments in companion dogs: Prevalence and relationship to cognitive impairment.

Purpose: Many older dogs (Canis lupus familiaris) develop cognitive impairment. Dog owners often describe impairments in multiple sensory functions, yet the relationships between sensory and cognitive function in older dogs is not well understood.

Methods: We performed assessments of dog vision and hearing, both clinically (n = 91, electroretinography and brainstem auditory evoked potential) and via validated questionnaire (n = 238).

The Wisconsin silicone oil study (report #1): anatomical and functional outcomes of repair of retinal detachment with proliferative vitreoretinopathy.

Background: Silicone oil (SO) is a long-term tamponade for repair of complex retinal pathology but has limitations including late redetachment. This study describes our experience with SO tamponade for repair of retinal detachment with proliferative vitreoretinopathy (PVR), with attention to anatomic and functional outcomes.

Methods: Retrospective consecutive case series of eyes with retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR) receiving SO tamponade at the University of Wisconsin between 2013 and 2019.

Daily versus three times weekly dosing for treatment of iron deficiency nonanemia in NCAA Division 1 female athletes.

Objective: To compare the effectiveness, compliance, and side effect profile between daily or three times weekly (TIW) oral iron supplementation regimens in treating iron deficiency nonanemia (IDNA) in National Collegiate Athletic Association (NCAA) Division 1 female track and field or soccer athletes.

Design: Prospective cohort study.

Setting: Division 1 collegiate athletics.

Thrombospondin-1, BIM and CFH polymorphisms and response to anti-VEGF treatment in neovascular age- related macular degeneration patients.

Age-related macular degeneration (AMD) is a vision threatening disease in older adults. Anti-VEGF treatment is effective for the majority of neovascular AMD (nAMD) patients, although approximately 30% of nAMD patients have an incomplete response for unknown reasons. Here we assessed the contribution of single nucleotide polymorphisms (SNPs) in key angioinflammatory regulatory genes in nAMD patients with an incomplete response compared to those responsive to anti-VEGF treatment.

The Ankle Joint: Non-Operative Updates in Ankle Arthritis, Are Biologics Working?

The vast majority of ankle arthritis is post-traumatic in nature, with rates of 60% to 80%. Symptoms include pain, decreased range of motion, and joint effusion. Diagnostic imaging is helpful in determining the degree of joint degeneration, with MRI and CT scan being the most sensitive.

Utilization of machine learning to accelerate colloidal synthesis and discovery.

Machine learning techniques are seeing increased usage for predicting new materials with targeted properties. However, widespread adoption of these techniques is hindered by the relatively greater experimental efforts required to test the predictions. Furthermore, because failed synthesis pathways are rarely communicated, it is difficult to find prior datasets that are sufficient for modeling.

American College of Foot and Ankle Surgeons Clinical Consensus Statement: Appropriate Clinical Management of Adult-Acquired Flatfoot Deformity.

This clinical consensus statement of the American College of Foot and Ankle Surgeons focuses on the highly debated subject of the management of adult flatfoot (AAFD). In developing this statement, the AAFD consensus statement panel attempted to address the most relevant issues facing the foot and ankle surgeon today, using the best evidence-based literature available. The panel created and researched 16 statements and generated opinions on the appropriateness of the statements.

Union Rates and Complications of Lateral Column Lengthening Using the Interposition Plating Technique: A Radiographic and Medical Record Review.

Lateral column lengthening is a common procedure for correction of pes planovalgus. A tricortical bone graft has been a standard among foot and ankle surgeons. The purpose of the present study was to compare the union rates and complications between the 2 forms of fixation for lateral column lengthening.

Tensiomyographical responses to accelerometer loads in female collegiate basketball players.

The purpose of the present study was to characterise the relationship between relative versus absolute internal and external loads in collegiate basketball players throughout the course of a season. Five Division I basketball players wore triaxial accelerometers throughout the 2015-2016 season and were tensiomyographically assessed weekly. One-way repeated-measure analysis of variance (RM ANOVA) with least-significant-difference (LSD) pairwise comparisons was used to determine which absolute weekly loads were different across the season.

Accuracy and Reproducibility Using Patient-Specific Instrumentation in Total Ankle Arthroplasty.

Background: Implant survivorship is dependent on accuracy of implantation and successful soft tissue balancing. System instrumentation for total ankle arthroplasty implantation has a key influence on surgeon accuracy and reproducibility. The purpose of this study was to determine the accuracy and reproducibility of implant position with patient-specific guides for total ankle arthroplasty across multiple surgeons at multiple facilities.

Radiographic Assessment of a Medullary Total Ankle Prosthesis: A Test of Agreement and Reliability.

Unlabelled: Total ankle replacement (TAR) is a viable alternative to ankle fusion in certain patients with end-stage ankle arthritis. Despite the importance of understanding alignment and movement of the prosthesis, there is no standardized radiographic method for evaluating the position and movement of the INBONE 2 prosthesis. The aims of this study were to describe a radiographic measurement protocol for INBONE 2 for clinical practice and research while determining the interobserver and intraobserver reliability using standard weightbearing radiographs.

Short-Term Radiographic Results and Technique of Tibiotalocalcaneal Arthrodesis With a Posterior Anatomic Locking Plate.

Tibiotalocalcaneal arthrodesis is a salvage procedure for severe hindfoot/ankle deformities, arthritis, avascular necrosis of the talus, failed total ankle replacement, and Charcot neuroarthropathy. The methods for fixation include anterior and lateral plates, screws, retrograde intramedullary nails, and external fixation. The purpose of the present report was to describe the short-term radiographic outcomes and technique using a posterior approach with an anatomic-specific locking plate for tibiotalocalcaneal arthrodesis.

Calcaneonavicular Coalition Resection With Pes Planovalgus Reconstruction.

Calcaneonavicular coalitions can lead to a painful, rigid pes planovalgus deformity. Historical treatment of coalitions recommends resection. A newer concept in coalition treatment includes concomitant flatfoot reconstruction.

Symptomatic Hardware Removal After First Tarsometatarsal Arthrodesis.

Severe hallux valgus deformity with proximal instability creates pain and deformity in the forefoot. First tarsometatarsal joint arthrodesis is performed to reduce the intermetatarsal angle and stabilize the joint. Dorsomedial locking plate fixation with adjunctive lag screw fixation is used because of its superior construct strength and healing rate.

Failed Surgical Management of Acute Proximal Fifth Metatarsal (Jones) Fractures: A Retrospective Case Series and Literature Review.

Unlabelled: Nonunion, delayed union, and refracture after operative treatment of acute proximal fifth metatarsal fractures in athletes is uncommon. This study was a failure analysis of operatively managed acute proximal fifth metatarsal fractures in healthy athletes. We identified 149 patients who underwent operative treatment for fifth metatarsal fractures.

Osteotomies for the Flexible Adult Acquired Flatfoot Disorder.

Flexible adult acquired flatfoot disorder is commonly treated with the use of osteotomies in the calcaneus and medial column. The combination of these joint-preserving osteotomies with additional soft-tissue procedures allows realignment of the hindfoot with the goal of preventing further deformity or degenerative joint disease. A thorough understanding of each patient's condition allows the surgeon to match the correct osteotomy to the clinical indication, while also successfully executing the planned surgery.

Maintenance of reduction with suture button fixation devices for ankle syndesmosis repair.

Background: Malreduction of the syndesmosis can lead to increased peak pressures and subsequent arthritis. The purpose of this study was to evaluate the initial syndesmotic reduction and radiographic maintenance when using a knotless suture button fixation device for treatment of syndesmotic injury.

Methods: A retrospective chart and radiographic review was performed to identify patients who underwent open reduction internal fixation of ankle syndesmosis ruptures treated with a knotless, suture button fixation system.

Corrective Realignment Arthrodesis of the First Tarsometatarsal Joint Without Wedge Resection.

Unlabelled: Moderate to severe hallux valgus (HV) has traditionally been treated with a corrective osteotomy or a tarsometatarsal arthrodesis. Tarsometatarsal arthrodesis can be performed as a planar wedge resection or using a joint curettage technique. Little is known about whether adequate correction can be obtained with purely a joint curettage technique.

Posterior approach for medial column beam screw in midfoot Charcot reconstruction: technique and structures at risk.

Charcot neuroarthropathy is frequently recognized as a major cause of morbidity in patients with neuropathic diabetes mellitus. Recently, intramedullary beam screw fixation has been used for midfoot Charcot reconstructions. Ten below-the-knee cadaveric specimens were used to demonstrate an antegrade, posterior approach for placement of a medial column beam screw, with specific attention to the proximity of the anatomic structures at risk.

Surgical decision making for stage IV adult acquired flatfoot disorder.

Adult acquired flatfoot deformity is a debilitating musculoskeletal condition affecting the lower extremity. Posterior tibial tendon dysfunction (PTTD) is the primary etiology for the development of a flatfoot deformity in an adult. PTTD is classified into 4 stages (with stage IV subdivided into stage IV-A and IV-B).

Electrothermal instability mitigation by using thick dielectric coatings on magnetically imploded conductors.

Recent experiments on Sandia's Z facility have confirmed simulation predictions of dramatically reduced instability growth in solid metallic rods when thick dielectric coatings are used to mitigate density perturbations arising from an electrothermal instability. These results provide further evidence that the inherent surface roughness as a result of target fabrication is not the dominant seed for the growth of magneto-Rayleigh-Taylor instabilities in liners with carefully machined smooth surfaces, but rather electrothermal instabilities that form early in the electrical current pulse as Joule heating melts and vaporizes the liner surface. These results suggest a new technique for substantially reducing the integral magneto-Rayleigh-Taylor instability growth in magnetically driven implosions, such as cylindrical dynamic material experiments and inertial confinement fusion concepts.

Surgical considerations for the neglected or chronic Achilles tendon rupture: a combined technique for reconstruction.

The Achilles tendon is among the most commonly injured tendons in the human body. The most common reason for delayed treatment is a missed diagnosis or a deficiency in presentation. The neglected or chronically ruptured Achilles tendon presents a unique treatment challenge.

Surgical approach for combined ankle and subtalar joint chronic mechanical instability.

Combined ankle and subtalar joint instability can lead to severe disability of the lower extremity. Multiple procedures have been described for hindfoot and ankle instability, including anatomic and non-anatomic reconstructions. The authors present their technique consisting of a free autogenous split peroneus longus tendon graft combined with a modified Brostrom-Gould repair.