The effect of different antibiotic combinations in calcium sulfate cement on the growth of Cutibacterium acnes and Staphylococcus periprosthetic shoulder infection isolates.

Background: Periprosthetic joint infections (PJI) of the shoulder are a devastating complication of shoulder arthroplasty and are commonly caused by Staphylococcus and Cutibacterium acnes. Absorbable calcium sulfate (CS) beads are sometimes used for delivering antibiotics in PJI. This study evaluates the in vitro effect of different combinations of gentamicin, vancomycin, and ertapenem in beads made from CS cement on the growth of C acnes and coagulase-negative Staphylococcus (CNS) strains.

Factors affecting internal rotation following total shoulder arthroplasty.

Background: Reverse shoulder arthroplasty (RSA) was developed in the late twentieth century to provide a stable arthroplasty option for patients with rotator cuff deficiency arthropathy. Since its inception, there have been changes in materials, design, and positioning. One of the persistent clinical issues has been difficulty with internal rotation (IR) and the associated difficulty with behind the back activities.

The Association Between Patient Satisfaction and Mode of Visit (Telemedicine Versus In-Person) in a Large Orthopaedic Practice During the COVID-19 Pandemic Lockdown: A Retrospective Study.

Background: During the novel coronavirus disease 2019 (COVID-19) pandemic, telemedicine was rapidly adopted to provide continued, efficient, and safe medical care. Little is known about patient satisfaction with telemedicine in orthopedics or the factors associated with selection of telemedicine versus face-to-face care. Thus, we examined (1) the association between patient satisfaction and mode of visit (telemedicine versus in-person) and (2) predictors of patient satisfaction in a large orthopedic practice during the onset of the pandemic.

Chronic glenohumeral dislocations treated with arthroplasty: a systematic review.

Background: The aim of this systematic review was to summarize the clinical outcomes and associated predictors of outcomes for chronic glenohumeral dislocations treated with arthroplasty.

Methods: A systematic literature search was performed with Embase, PubMed, CENTRAL, BIOSIS, and CINAHL databases from the inception of these databases through January 1, 2021 to identify all articles that examined outcomes or predictors of outcomes of arthroplasty in patients with chronic glenohumeral dislocations. Studies that examined outcomes for patients with a chronic glenohumeral dislocation (≥3 weeks) treated with hemiarthroplasty, anatomic total shoulder arthroplasty, or reverse total shoulder arthroplasty were included.

The Impact of Anterior Glenoid Defects on Reverse Shoulder Glenoid Fixation in a Composite Scapula Model.

Background: Achieving glenoid fixation with anterior bone loss can be challenging. Limited guidelines have been established for critical defect sizes that can be treated without supplemental bone graft when performing reverse shoulder arthroplasty.

Methods: We quantified the impact of two sizes of anterior glenoid defects on glenoid baseplate fixation in a composite scapula using the ASTM F 2028-14 reverse shoulder glenoid loosening test method.

Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine: Three Spine-Board Transfer Techniques.

Background: Numerous studies have shown that there are better alternatives to log rolling patients with unstable spinal injuries, although this method is still commonly used for placing patients onto a spine board. No previous studies have examined transfer maneuvers involving an injured football player with equipment in place onto a spine board.

Purpose: To test 3 different transfer maneuvers of an injured football player onto a spine board to determine which method most effectively minimizes spinal motion in an injured cervical spine model.

Incidence and etiology of unplanned cast changes for fractures in the pediatric population.

Background: The majority of pediatric fractures are treated in casts due to the child's ability to heal rapidly and remodel. Unplanned cast changes are a time and economic burden with potentially adverse effects on fracture management. The purpose of this study is to document the incidence, etiology, and complications related to unplanned cast changes.

Reverse shoulder glenoid baseplate fixation: a comparison of flat-back versus curved-back designs and oval versus circular designs with 2 different offset glenospheres.

Background: In this glenoid loosening study, we compared the fixation strength of multiple generic reverse shoulder glenoid baseplates that differed only in backside geometry and shape and size to optimize design from a fixation perspective.

Methods: The fixation strength of 4 generic baseplates was quantified in a low-density polyurethane substrate to isolate the contribution of baseplate profile and size (25 mm circular vs 25 × 34 mm oval) and backside geometry (flat back vs curved back) on fixation using 2 center-of-rotation glenospheres (0 mm and 10 mm lateral). The cyclic test simulated 55° of abduction as a 750 N load was continuously applied to induce a variable shear and compressive load.

Reverse shoulder glenoid loosening: an evaluation of the initial fixation associated with six different reverse shoulder designs.

Introduction: This study quantified glenoid fixation before and after cyclic loading of six reverse shoulder prosthesis designs when secured to low and high density bone substitute blocks.

Methods: A displacement test quantified fixation of six reverse shoulder designs: 38 mm Equinoxe standard offset (EQ), 38 mm Equinoxe lateral offset (EQL), 36 mm Depuy Delta III (DRS), 36 mm Zimmer (ZRS), 32 mm DJO RSP (DJO), and a 36 mm Tornier BIO-RSA (BIO), secured to 0.24 and 0.

Achieving fixation in glenoids with superior wear using reverse shoulder arthroplasty.

Background: Superior glenoid wear is a common challenge with reverse shoulder arthroplasty and, if left uncorrected, can result in superior glenoid tilt, which increases the risk of aseptic glenoid loosening. This study evaluates the impact of an E2 superior defect on reverse shoulder glenoid fixation in composite scapulae after correction of glenoid tilt by use of 2 different glenoid reaming techniques: eccentric reaming and off-axis reaming.

Materials And Methods: A superior glenoid defect was created in 14 composite scapulae.

Initial glenoid fixation using two different reverse shoulder designs with an equivalent center of rotation in a low-density and high-density bone substitute.

Background: Numerous glenoid implant designs have been introduced into the global marketplace in recent years; however, little comparative biomechanical data exist to substantiate one design consideration over another.

Materials And Methods: This study dynamically evaluated reverse shoulder glenoid baseplate fixation and compared the initial fixation associated with 2 reverse shoulder designs having an equivalent center of rotation in low-density and high-density bone substitute substrates.

Results: Significant differences in fixation were observed between implant designs, where the circular-porous reverse shoulder was associated with approximately twice the micromotion per equivalent test than the oblong-grit-blasted design.

The impact of scapular notching on reverse shoulder glenoid fixation.

Background: Scapular notching is a well-documented complication of reverse shoulder arthroplasty. The effect of scapular notching on glenoid fixation is unknown.

Materials And Methods: This study dynamically evaluated reverse shoulder glenoid baseplate fixation and assessed the effect of scapular notching on fixation in composite scapulae.

Outcomes of arthroscopic repair of panlabral tears of the glenohumeral joint.

Background: Combined lesions of the glenoid labrum involving tears of the anterior, posterior, and superior labrum have been infrequently reported in the literature.

Purpose: To evaluate the clinical outcomes of arthroscopic repair of these lesions in a general population using validated scoring instruments, presence of complications, and need for revision surgery.

Study Design: Case series; Level of evidence, 4.

Management of humeral and glenoid bone loss--associated with glenohumeral instability.

Unlabelled: Anterior glenohumeral instability complicated by bone loss is a challenging problem and, when severe, may require surgical treatment with bone grafting. We review our institution's experience with humeral head and glenoid bone grafting for large Hill-Sachs lesions and glenoid defects.

Materials And Methods: Patients who underwent intra-articular bone reconstruction for Hill-Sachs and large glenoid defects for anterior instability at our institution during 2002-2008 were retrospectively reviewed.

Cervical spine motion generated with manual versus jackson table turning methods in a cadaveric c1-c2 global instability model.

STUDY DESIGN.: Cadaveric biomechanical study. OBJECTIVE.

Comparison of the flat torso versus the elevated torso shoulder pad removal techniques in a cadaveric cervical spine instability model.

Study Design: Controlled laboratory study in a cadaveric model.

Objective: To determine if removing shoulder pads using the elevated torso technique generated less spinal segment motion than using the flat torso method.

Summary Of Background Data: Guidelines for care of the injured football player with a suspected spinal injury recommend initial immobilization with shoulder pads and helmet in place.

Survey of spine surgeons on attitudes regarding osteoporosis and osteomalacia screening and treatment for fractures, fusion surgery, and pseudoarthrosis.

Background Context: Osteoporosis and osteomalacia are significant risk factors for fracture and spine instrumentation failure. Low-energy fractures are becoming increasingly more common because of an increase in life expectancy and age of the population. Decreased bone density is an independent risk factor for instrumentation failure in spinal fusion operations.

Coracoid process fracture with acromioclavicular joint separation in an American football player: a case report and literature review.

Coracoid process fractures are rare and few cases have been reported in the orthopedic literature. In this article, we report the case of an American football player with a coracoid process fracture in the setting of acromioclavicular separation and describe incidence, mechanism of injury, and treatment. Although rare, coracoid process fracture should be considered in the differential diagnosis for shoulder pain.

Comparing cervical spine motion with different halo devices in a cadaveric cervical instability model.

Study Design: Biomechanical evaluation of conventional and noninvasive halos in cadaveric C1-C2 and C5-C6 instability models.

Objective: To compare the ability of a conventional halo and noninvasive halo (NIH) to immobilize the unstable cervical spine at the C1-C2 and C5-C6 levels.

Summary Of Background Data: Many successful outcomes have been reported in cervical spine injury treatment with the conventional halo (CH); however, complications related to pin sites have been reported.

Comparison of thoracolumbar motion produced by manual and Jackson-table-turning methods. Study of a cadaveric instability model.

Background: Patients who have sustained a spinal cord injury remain at risk for further neurologic deterioration until the spine is adequately stabilized. To our knowledge, no study has previously addressed the effects of different bed-to-operating room table transfer techniques on thoracolumbar spinal motion in an instability model. We hypothesized that the conventional logroll technique used to transfer patients from a supine position to a prone position on the operating room table has the potential to confer significantly more motion to the unstable thoracolumbar spine than the Jackson technique.

Transferring patients with thoracolumbar spinal instability: are there alternatives to the log roll maneuver?

Study Design: Using a cadaveric model, the amount of spinal motion generated during the execution of various prehospital transfer techniques was evaluated using a crossover study design.

Objective: To assess the quantity of segmental motion generated across a globally unstable thoracolumbar spine during the execution of the log roll (LR), lift-and-slide, and 6-plus-person (6+) lift.

Summary Of Background Data: The LR has been reported to be inappropriate for transferring patients with thoracolumbar injuries.

Cervical spine motion in manual versus Jackson table turning methods in a cadaveric global instability model.

Study Design: A study of spine biomechanics in a cadaver model.

Objective: To quantify motion in multiple axes created by transfer methods from stretcher to operating table in the prone position in a cervical global instability model.

Summary Of The Background Data: Patients with an unstable cervical spine remain at high risk for further secondary injury until their spine is adequately surgically stabilized.

Complex elbow instability.

This article attempts to outline the most current relevant literature regarding diagnosis, pathoanatomy, and treatment options for complex elbow instability. Specific attention is directed toward unique injury patterns, important biomechanical principles, and recent clinical outcome studies. Directions for future research are suggested.

Tendon transfers and realignment osteotomies for treatment of stage II posterior tibial tendon dysfunction.

Posterior tibial tendon dysfunction (PTTD) has been approached with a multitude of surgical techniques. This article outlines the current understanding of the flexor digitorum longus transfer and flexor hallucis longus transfer in the context of various osteotomy techniques for the correction of stage II PTTD. Pertinent clinical literature and scientific evidence will also be compared and analyzed.

Reliability of a novel classification system for thoracolumbar injuries: the Thoracolumbar Injury Severity Score.

Study Design: Prospective study of 5 spine surgeons rating 71 clinical cases of thoracolumbar spinal injuries using the Thoracolumbar Injury Severity Score (TLISS) and then re-rating the cases in a different order 1 month later.

Objective: To determine the reliability of the TLISS system.

Summary Of Background Data: The TLISS is a recently introduced classification system for thoracolumbar spinal column injures designed to simplify injury classification and facilitate treatment decision making.