Time to Total Knee Arthroplasty (TKA) Post Intra-Articular Injection.

Disease-modifying treatments are not currently developed to target the underlying causes of knee osteoarthritis (KOA). Corticosteroids (CS), hyaluronic acid (HA), and platelet-rich plasma (PRP) intra-articular (IA) injections are commonly used for patients that do not respond to non-pharmacological treatments, oral nonsteroidal anti-inflammatory, or pain medications to address solely KOA symptoms. Utilizing TKA as an endpoint in the KOA disease progression provides a basis to determine efficacy of this treatment pathway.

Local delivery of linezolid in the treatment of complex orthopedic bone and joint infections in patients with vancomycin allergy: a case series.

: Osteomyelitis is a challenging bone infection associated with ischemia, trauma, or various surgical procedures (e.g., joint reconstruction).

Functional Outcomes of Knee Arthrodesis for Infected Total Knee Arthroplasty.

Introduction: As the occurrence of total knee arthroplasties (TKAs) is forecasted to continue rising, so too will the frequency of prosthetic joint infections (PJIs) and revision TKAs. Multiple revisions can result in an unreconstructible knee. In such instances, the knee may be salvaged through arthrodesis.

Efficacy of Infection Eradication in Antibiotic Cement-Coated Intramedullary Nails for Fracture-Related Infections, Nonunions, and Fusions.

Antibiotic cement-coated intramedullary nails (ACCINs) are increasing in popularity as a viable solution for the treatment of fracture-related infections (FRIs), infected long bone nonunions, and arthrodeses without an external fixator. ACCINs effectively manage to fulfill three of the basic principles for eradicating osteomyelitis: dead space management, antibiotic delivery, and bone stability. We performed a retrospective review of 111 patients who were treated with ACCINs between January 2014 and December 2020.

A Novel Mobile App-Based Neuromuscular Electrical Stimulation Therapy for Improvement of Knee Pain, Stiffness, and Function in Knee Osteoarthritis: A Randomized Trial.

Background: Knee osteoarthritis (OA) is a widespread and debilitating disease that continues to plague patients. Over the past decade, neuromuscular electrical stimulation (NMES) therapy has shown promise in alleviating knee OA-related symptoms. This study sought to evaluate the efficacy and safety of a home-based NMES therapy for reduction of pain, stiffness, and function associated with knee OA.

Tobramycin Blood Levels after Local Antibiotic Treatment of Bone and Soft Tissue Infection.

Local antibiotic delivery using different carriers plays an important role in both infection prophylaxis and treatment. Besides dead space management, these carriers have the advantage of providing a high concentration of local antibiotics with a lower risk of systemic toxicity. Few studies have reported on systemic toxicity associated with antibiotic-impregnated carriers.

Immunological evaluation of patients with orthopedic infections: taking the Cierny-Mader classification to the next level.

: Cierny-Mader osteomyelitis classification is used to label A, B, or C hosts based on comorbidities. This study's purpose was to define the "true" host status of patients with orthopedic infection using serologic markers to quantify the competence of their immune system while actively infected. : Retrospective chart review identified patients at a single-surgeon practice who were diagnosed with orthopedic infection between September 2013 and March 2020 and had immunological laboratory results.

Simultaneous Bilateral Femoral and Tibial Lengthening in Achondroplasia.

Previous studies on lengthening for achondroplasia have reported bilateral extensive femoral lengthening followed by bilateral extensive tibial lengthening. To decrease trauma on soft tissues and joints, we propose bilateral simultaneous moderate femoral lengthening and moderate tibial lengthening followed by a similar repeat lengthening a few years later. Fifty patients with achondroplasia underwent 65 simultaneous bilateral femoral and tibial lengthening procedures.

Chronic Quadriceps Tendon Rupture Reconstruction with Sartorius Muscle Transfer: A Report of Five Cases.

Disruption of the knee extensor mechanism is an unfavorable situation because efficient mobilization requires a functioning knee extensor apparatus. The purpose of this retrospective study was to report our technique of sartorius muscle transfer for restoration of extension mechanism function and the outcomes of five patients. Patients with ruptured knee extensor mechanism secondary to trauma or knee arthroplasty-related issues were studied retrospectively.

Realignment Midfoot Osteotomy: A Preoperative Planning Method and Intraoperative Surgical Technique.

Deformities of the midfoot are often treated with midfoot osteotomies. The goal of the midfoot osteotomy is to create a plantigrade forefoot to hindfoot relationship. Many different techniques are described for performing midfoot osteotomies.

Experience with negative-pressure wound therapy with instillation in complex infected orthopaedic wounds.

Chronic exudative wounds are frequently seen in hospitalised patients, consuming hospital resources and leading to increased morbidity. Negative-pressure therapy (NPWT) with topical instillation "NPWTi" may be used to improve the wound healing process, with the unique features (removal of wound exudate, edema reduction, promotion of tissue perfusion and granulation tissue formation, as well as drawing the edges of the wound to facilitate, in addition to the cyclic cleansing mechanism). This report is a descriptive study of our experience with NPWTi on complex infected orthopaedic wounds as a potential method to decrease the need for multiple surgical debridements required for the closure of such wounds.

Ilizarov External Fixation for Correcting Complex Postpolio Foot and Ankle Deformity: A Case Study.

Given their severity and resultant loss of function, postpoliomyelitic foot and ankle deformities require a unique correction method. Correction with dynamic Ilizarov external fixation is one such modality, although it is technically demanding and requires precise preoperative planning. In our case study, a 40-year-old male with a severe postpoliomyelitic equinocavovarus right foot and ankle deformity was treated with gradual correction using dynamic, hinged Ilizarov external fixation.

Lengthening With Monolateral External Fixation Versus Magnetically Motorized Intramedullary Nail in Congenital Femoral Deficiency.

Background: Limb lengthening for congenital femoral deficiency (CFD) with or without fibular hemimelia can be performed with both external and internal devices. The purpose of this study is to compare clinical outcomes of femoral lengthening utilizing monolateral external fixation versus a magnetically motorized intramedullary nail in patients with CFD with or without fibular hemimelia.

Methods: This retrospective review included 62 patients with femoral lengthening, 32 patients had monolateral external fixation (group A), 30 patients had internal lengthening nail (group B).

Intramedullary Metatarsal Fixation for Treatment of Delayed Regenerate Bone in Lengthening of Brachymetatarsia.

Delayed regenerate healing after distraction osteogenesis can be a challenging problem for patients and surgeons alike. In the present study, we retrospectively reviewed the data from a cohort of patients with delayed regenerate healing during gradual lengthening treatment of brachymetatarsia. Additionally, we present a novel technique developed by 1 of us (B.

Trapezius Muscle Transfer for Restoration of Elbow Extension in a Traumatic Brachial Plexus Injury.

Voluntary elbow extension is essential for optimal upper limb positioning required for daily living activities, particularly above-shoulder maneuvers. The authors present a case of traumatic brachial plexus injury in which paralysis of the musculature selectively supplied by the posterior cord was based on magnetic resonance imaging and nerve conduction studies. An attempt at a radial nerve graft at another center was not effective.

Low-density lipoprotein 4: a novel predictor of coronary artery disease severity.

Background: Hyperlipidemia is a well established risk factor for coronary artery disease (CAD). Severe CAD has been observed in patients with normal levels of total and low-density lipoprotein (LDL) cholesterol. Small dense LDL particle subtypes (LDL and LDL) have been observed to be more oxidizable and atherogenic.

Trochanteric Entry for Femoral Lengthening Nails in Children: Is It Safe?

Background: Antegrade intramedullary (IM) nailing for skeletally immature femur fractures can damage the capital femoral epiphysis blood supply, leading to avascular necrosis (AVN) of the femoral head. Reported AVN rates are 2% for piriformis entry and 1.4% for trochanteric entry.

Use of internal lengthening nails in post-traumatic sequelae.

External fixators are a well-established modality for treating fractures with bone defects, leg-length discrepancy, malunion, nonunion and other post-traumatic consequences. However, use of internal lengthening rods has remarkably increased recently for post-traumatic conditions. The main advantage of internal lengthening rods is eliminating pin-site complications.

Treatment of Post-Traumatic Femoral Discrepancy With PRECICE Magnetic-Powered Intramedullary Lengthening Nails.

Objective: To evaluate the outcomes of lengthening post-traumatic femoral segments using a recently available magnetic intramedullary (IM) lengthening system.

Design: Retrospective cohort study.

Setting: Urban level II Trauma Center.

Treatment Options for Nonunion With Segmental Bone Defects: Systematic Review and Quantitative Evidence Synthesis.

Objectives: To determine which reconstruction treatment of long bones nonunion with segmental bone defects (SBDs) is effective to restore bone length and union with good function.

Data Sources: PubMed was used to identify published literature on treatment of SBD caused by fracture nonunion regardless of infection between January 1975 and December 2014.

Study Selection: We included retrospective cohort studies with a minimum sample size of 10 consecutive patients with minimum follow-up of 18 months and available data on radiographic and functional outcomes.

Comparison of PACS and Bone Ninja mobile application for assessment of lower extremity limb length discrepancy and alignment.

Purpose: There are over 500 medically related applications (apps) for mobile devices. Very few of these applications undergo testing and peer-review for accuracy. The purpose of this study is to assess the accuracy of limb deformity measurements on the Bone Ninja app compared to PACS and to determine the intra- and inter-observer variability among different orthopaedic practitioners.

Oxidized Low-Density Lipoprotein-β2-Glycoprotein I Complex But Not Free Oxidized LDL Is Associated With the Presence and Severity of Coronary Artery Disease.

Oxidized low-density lipoprotein (oxLDL) and β2-glycoprotein I (β2GPI) have been identified in human atherosclerotic lesions and when complexed have been implicated as a pro-atherothrombotic antigen. We examined the association of free oxLDL and oxLDL-β2GPI complex in patients with coronary artery disease who underwent elective cardiac catheterization. Serum was collected from patients with suspected coronary artery disease immediately before elective cardiac catheterization who were either treated (n = 385) or not treated (n = 150) with statins and from healthy volunteers (n = 134).

Normal Foot and Ankle Radiographic Angles, Measurements, and Reference Points.

The limb deformity-based principles originate from a standard set of lower extremity radiographic angles and reference points. Objective radiographic measures are the building blocks for surgical planning. Critical preoperative planning and intraoperative and postoperative evaluation of radiographs are essential for proper deformity planning and correction of all foot and ankle cases.

Statin therapy and inflammation in patients with diabetes treated with high dose aspirin.

Background: Statin and aspirin form the therapeutic cornerstone in patients with coronary artery disease (CAD) and diabetes. Little is known about relationship of statins with blood thrombogenicity and inflammation in these patients.

Methods: Two hundred nine consecutive patients with diabetes and suspected CAD undergoing elective cardiac catheterization were divided in groups based on statin treatment in the Multi-Analyte, Thrombogenic, and Genetic Markers Atherosclerosis study.

Thrombin-Induced Platelet-Fibrin Clot Strength Identified by Thrombelastography: A Novel Prothrombotic Marker of Coronary Artery Stent Restenosis.

Background And Objective: In-stent restenosis (ISR) is a limitation of percutaneous coronary intervention and has been linked to specific clinical and angiographic variables. We aimed to simultaneously assess thrombosis biomarkers and lipid levels in patients with and without ISR.

Methods: Consecutive patients (n = 170) with a history of coronary stenting undergoing elective angiography were studied.