Retrospective analysis of trends in surgery volumes between 2016 and 2019 and impact of the insurance deductible: Cross-sectional study.

Background: Understanding trends in surgical volumes can help Ambulatory Surgery Centers (ASCs) prevent clinician burnout and provide adequate staffing while maintaining the quality of patient care throughout the year. Health insurance deductibles reset in January each year and may contribute to an annual rhythm where the levee of year-end deductibles is breached in the last few months of every year, resulting in a flood of cases and several accompanying challenges. This study aims to identify and analyze monthly and yearly surgical volume patterns in ASCs and explore a relationship with the deductible reset.

Suture Button Suspensionplasty in the Treatment of Carpometacarpal Arthritis: A Retrospective Analysis of One Surgeon's Experience Over 9 Years.

Purpose: Trapeziectomy with suture button suspensionplasty (SBS) to treat thumb carpometacarpal (CMC) arthritis has been proposed as an alternative to ligament reconstruction tendon interposition. There have been limited large-scale or long-term reports regarding SBS outcomes. Single-surgeon intermediate follow-up is reported.

Comparison of NIRS, serum biomarkers, and muscle damage in a porcine balloon compression model of acute compartment syndrome.

Background: Near-infrared spectroscopy (NIRS) has been shown to aid in the diagnosis of extremity acute compartment syndrome (ACS), offering continuous real-time capability to monitor perfusion in extremities. Porcine models of ACS have been developed to attempt to aid in the understanding of the development of ACS and provide better methods of diagnosing ACS. The objective of the present study was to assess and correlate NIRS, tibial intracompartmental pressure (TICP), tibial intracompartmental perfusion pressure (TIPP), serum markers of inflammation and muscle injury in a balloon compression model of ACS.

Use of Near-Infrared Spectroscopy to Detect Sustained Hyperaemia Following Lower Extremity Trauma.

Introduction: Patients who sustain lower extremity trauma are at highest risk for acute compartment syndrome (ACS) during the first 48 hours after surgical stabilization. Near-infrared spectroscopy (NIRS) may be a useful monitoring tool for ACS during this period; however, expected normal values have yet to be established. This study sought to evaluate whether the expected hyperaemic response is present 48 hours postoperatively, using NIRS.

Cadaveric Study of Appropriate Screw Length for Distal Radius Stabilization Using Volar Plate Fixation.

We conducted a study to highlight areas of risk with distal radius fixation to prevent occurrence of extensor tendon injury without compromising the security and stability of the fixation. Twelve cadaveric forearms were used. The volar locking plate was placed to best anatomical and radiologic fit on the distal radius of each arm.

Subcutaneous depth in a traumatized lower extremity.

Background: Acute compartment syndrome is a rare but serious consequence of traumatic leg injury. Near-infrared spectroscopy (NIRS) is able to measure oxygenation to a depth of 2 cm to 3 cm below the skin, raising concerns over the ability of NIRS to accurately determine oxygenation of injured leg compartments in the presence of swelling and in the obese. The purpose of this study was to measure the thickness of the subcutaneous tissue overlying the posterior muscle compartment in subjects with tibia fractures to determine if it might compromise rSO₂ measurement in the muscle.

Correlation of near-infrared spectroscopy and direct pressure monitoring in an acute porcine compartmental syndrome model.

Objective: To correlate near-infrared spectroscopy (NIRS) and the tibial intracompartmental perfusion pressure (TIPP) in an acute limb compartmental syndrome.

Methods: Landrace swine were subdivided into 2 groups: plasma infusion (n = 16) and blunt trauma plus plasma infusion (n = 15). NIRS sensors were placed over the craniolateral muscle compartment of proximal both tibiae.

Relationship between near infrared spectroscopy and intra-compartmental pressures.

Background: Near infrared spectroscopy (NIRS) has been suggested as a possible means for detecting perfusion deficits in patients with acute compartment syndrome (ACS).

Study Objectives: To longitudinally examine NIRS in an ACS model to determine its responsiveness to decreasing perfusion pressure.

Methods: A NIRS sensor pad was placed under a tourniquet over the anterior compartment in the mid-tibia region on 20 volunteers.

What's new in acute compartment syndrome?

Acute compartment syndrome (ACS) after trauma is often the result of increased size of the damaged tissues after acute crush injury or from reperfusion of ischemic areas. It usually is not solely caused by accumulation of free blood or fluid in the compartment, although that can contribute in some cases. There is no reliable and reproducible test that confirms the diagnosis of ACS.

Ability of near infrared spectroscopy to measure oxygenation in isolated upper extremity muscle compartments.

Purpose: Near infrared spectroscopy (NIRS), a noninvasive means for monitoring muscle oxygenation, may be useful in the diagnosis of acute compartment syndrome, a condition characterized by poor tissue perfusion. This study used the decrease in muscle oxygenation caused by exercise to investigate the ability of anatomic placement of NIRS sensor pads over compartments of the forearm to isolate perfusion values of a specific compartment.

Methods: We recruited 63 uninjured volunteers from a private clinic-based setting and placed NIRS sensor pads over the dorsal, volar, and mobile wad compartments of 1 forearm.

Correlation between muscle oxygenation and compartment pressures in acute compartment syndrome of the leg.

Background: Near-infrared spectroscopy estimates soft-tissue oxygenation approximately 2 to 3 cm below the skin. The purpose of the present study was to evaluate muscle oxygenation in the setting of an acute compartment syndrome of the leg and to determine if near-infrared spectroscopy is capable of detecting perfusion deficits.

Methods: Fourteen patients with unilateral lower extremity trauma were enrolled after the diagnosis of an acute compartment syndrome was made clinically and confirmed with intracompartmental pressure measurements.

Near-infrared spectroscopy in lower extremity trauma.

Background: Near-infrared spectroscopy measures the percentage of hemoglobin oxygen saturation in the microcirculation of tissue up to 3 cm below the skin. The purpose of this study was to describe the measurable response of normal tissue oxygenation in the leg after acute trauma with use of this technique.

Methods: Twenty-six patients with acute unilateral tibial fractures and twenty-five uninjured volunteer control subjects were enrolled.

Basal joint arthritis of the thumb.

The carpometacarpal joint of the thumb is the second most common site of arthritis in the hand. Patients in whom conservative treatment fails benefit from surgical intervention, although no consensus exists as to the best method to provide maximum pain relief and functional outcomes. The pathophysiology of carpometacarpal arthritis is loss of the integrity of the palmar oblique ligament, which allows for dorsal subluxation of the metacarpal on the trapezium.

Porous tantalum implant in early osteonecrosis of the hip: preliminary report on operative, survival, and outcomes results.

Porous tantalum implants are used in early osteonecrosis of the hip. Device evaluation included surgical time, blood loss, hospitalization, patient-controlled analgesia use, transfusions, implant survival, and outcomes. Mean blood loss was 70 mL.

Tunnel convergence in combined anterior cruciate ligament and posterolateral corner reconstruction.

Purpose: To examine the geometric relationship between tunnels created in the lateral femoral condyle in reconstruction of the anterior cruciate ligament (ACL) and the posterolateral structures.

Methods: The geometric relationship between a standard ACL tunnel and 11 lateral femoral tunnel variations in synthetic femur specimens was examined. Tunnel collision frequency and tunnel separation were measured radiographically.

Risk factors for pulmonary emboli after total hip or knee arthroplasty.

Because it is difficult to predict which patients may sustain a pulmonary embolism after total hip or knee arthroplasty, we assessed multiple thrombophilic and hypofibrinolytic parameters to identify risk factors. Twenty-nine patients who survived a known pulmonary embolism after total knee or total hip arthroplasty were matched by age, gender, race, arthritic diagnosis, procedure, and surgery date with 29 patient-controls who had a total hip or knee arthroplasty but who did not have a symptomatic known pulmonary embolism or deep vein thrombosis. Twenty-one serologic measures and five genes associated with thrombophilia, hypofibrinolysis, or both were assessed without knowledge of group assignment.

Angiotensin II stimulates calcineurin activity in proximal tubule epithelia through AT-1 receptor-mediated tyrosine phosphorylation of the PLC-gamma1 isoform.

Angiotensin II (AngII) contributes to the maintenance of extracellular fluid volume by regulating sodium transport in the nephron. In nonepithelial cells, activation of phospholipase C (PLC) by AT-1 receptors stimulates the generation of 1,4,5-trisphosphate (IP(3)) and the release of intracellular calcium. Calcineurin, a serine-threonine phosphatase, is activated by calcium and calmodulin, and both PLC and calcineurin have been linked to sodium transport in the proximal tubule.