The Feasibility of Blinding Intraoperative Electro-Auricular Acupuncture Under Neuraxial Anesthesia.

Demand for complementary medicine, in particular, acupuncture, has increased over the past few years but widespread acceptance has been limited, in part, by the lack of high-quality studies, including lack of blinding. Acupuncture studies traditionally have difficulty with blinding as sham acupuncture can have up to a 40%-50% analgesic effect. This study randomized patients between Acupuncture and No Acupuncture (standard of care) without using sham needles.

Synthetic PVA Osteochondral Implants for the Knee Joint: Mechanical Characteristics During Simulated Gait.

Background: Although polyvinyl alcohol (PVA) implants have been developed and used for the treatment of femoral osteochondral defects, their effect on joint contact mechanics during gait has not been assessed.

Purpose/hypothesis: The purpose was to quantify the contact mechanics during simulated gait of focal osteochondral femoral defects and synthetic PVA implants (10% and 20% by volume of PVA), with and without porous titanium (pTi) bases. It was hypothesized that PVA implants with a higher polymer content (and thus a higher modulus) combined with a pTi base would significantly improve defect-related knee joint contact mechanics.

Surgical Treatment of Iatrogenic Nerve Injury Following Arthroscopic Capsulolabral Repair.

Purpose: Case reports of nerve injuries following arthroscopic capsulolabral repair emphasize the proximity of major nerves to the glenoid. This study describes preoperative localization using nerve-sensitive magnetic resonance imaging in a small cohort of patients with iatrogenic nerve injuries following arthroscopic capsulolabral repair and the outcomes of nerve repair in these patients.

Methods: Cases of iatrogenic nerve injury following arthroscopic capsulolabral repair referred to 2 surgeons from January 2017 to December 2019 were identified.

Surgical Games: A Simulation-Based Structured Assessment of Orthopedic Surgery Resident Technical Skill.

Background: Simulation-based education and objective evaluation of surgical skill have been incorporated into many surgical training programs. We describe the development and implementation of a timed, multitask, station-based Surgical Games to evaluate orthopedic resident surgical skills.

Methods: Participants in the study were postgraduate-year 2 to 5 orthopedic surgery residents from a single institution.

Opioid Consumption After Arthroscopic Meniscal Procedures and Anterior Cruciate Ligament Reconstruction.

Background: Procedure-specific opioid-prescribing guidelines have the potential to decrease the number of unused pills in the home without compromising patient satisfaction. However, there is a paucity of data on the minimum necessary quantity to prescribe for outpatient orthopaedic surgeries.

Purpose: To prospectively record daily opioid use and pain levels after arthroscopic meniscal procedures and anterior cruciate ligament reconstruction (ACLR) at a single institution.

Lateral Meniscal Graft Transplantation: Effect of Fixation Method on Joint Contact Mechanics During Simulated Gait.

Background: Controversy exists regarding the optimal bony fixation technique for lateral meniscal allografts.

Purpose/hypothesis: The objective was to quantify knee joint contact mechanics across the lateral plateau for keyhole and bone plug meniscal allograft transplant fixation techniques throughout simulated gait. It was hypothesized that both methods of fixation would improve contact mechanics relative to the meniscectomized condition, while keyhole fixation would restore the distribution of contact stress closer to that of the intact knee.

Creating a Legion of Diabetes Patient Advocates: DPAC Policy Training Meeting and Hill Day.

The Diabetes Patient Advocacy Coalition (DPAC) held a Policy Training Meeting and Hill Day September 29-October 1, 2018, in Washington, DC. Attendees were members of DPAC's Board of Directors and Staff, Patient Advisory Board, and individuals identified through a competitive call for applicants on DPAC's website and social media. We were joined by advocates from the Association of Black Cardiologists and the Endocrine Society.

The Scaffold-Articular Cartilage Interface: A Combined In Vitro and In Silico Analysis Under Controlled Loading Conditions.

The optimal method to integrate scaffolds with articular cartilage has not yet been identified, in part because of our lack of understanding about the mechanobiological conditions at the interface. Our objective was to quantify the effect of mechanical loading on integration between a scaffold and articular cartilage. We hypothesized that increased number of loading cycles would have a detrimental effect on interface integrity.

Tracking Cumulative Radiation Exposure in Orthopaedic Surgeons and Residents: What Dose Are We Getting?

Background: The purpose of this study was to determine the amount of cumulative radiation exposure received by orthopaedic surgeons and residents in various subspecialties. We obtained dosimeter measures over 12 months on 24 residents and 16 attending surgeons.

Methods: Monthly radiation exposure was measured over a 12-month period for 24 orthopaedic residents and 16 orthopaedic attending surgeons.

Hospital for Special Surgery ACL Registry: 2-Year Outcomes Suggest Low Revision and Return to OR Rates.

Background: Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. Patient outcomes, rate of subsequent operations, and rate of subsequent ACL reconstruction following primary ACL reconstruction need to be evaluated.

Questions/purposes: This study was designed to answer the following questions: (1) What is the return to surgery (OR) rate following primary ACL reconstruction and (2) what is the revision ACL reconstruction rate?

Methods: Data was drawn from the Hospital for Special Surgery (HSS) ACL Registry.

Risk Factors for Revision Surgery After Superior Labral Anterior-Posterior Repair: A National Perspective.

Background: Data regarding risk factors for revision surgery after superior labral anterior-posterior (SLAP) repair are limited to institutional series.

Purpose: To define risk factors for revision surgery after SLAP repair among patients in a large national database.

Study Design: Case-control study; Level of evidence, 3.

Subscapularis tendon loading during activities of daily living.

Background: The purpose of this study was to determine the relative amount of load that is transmitted through the superior portion of the subscapularis during activities of daily living as compared with the load that is transmitted through the middle and inferior portions in a normal shoulder and in a shoulder with a supraspinatus tear.

Methods: By use of the Newcastle shoulder model, the subscapularis was modeled with 3 lines of action encircling the humeral head. The load was measured in the entire subscapularis, and the percentage of this load in each of the 3 tendinous bands was calculated.

Assessment of emerging biotoxins (pinnatoxin G and spirolides) at Europe's first marine reserve: Lough Hyne.

Active and passive sampling methods were employed over a four-month period, at a site off the South-West coast of Ireland, to characterise the occurrence of cyclic imines in the water column. The marine toxins 13-desmethyl-SPXC, 20-methyl SPXG toxins and pinnatoxin G were detected using active sampling from Diaion HP-20 resin. Seven water depths were sampled to determine stratification of the toxins in the water column using Solid Phase Adsorption and Toxin Tracking (SPATT).

Increased Lateral Tibial Slope Is a Risk Factor for Pediatric Anterior Cruciate Ligament Injury: An MRI-Based Case-Control Study of 152 Patients.

Background: Increased posterior tibial slope is associated with increased risk of anterior cruciate ligament (ACL) injury in adults. A similar association has not been rigorously examined in children and adolescents.

Purpose: To determine whether alterations in posterior tibial slope are associated with ACL tears in pediatric and adolescent patients and to quantify changes in tibial slope by age.

Outcomes for surgical treatment of posterolateral instability of the knee.

Injuries to the posterolateral corner (PLC) of the knee can be associated with a variety of additional ligamentous and soft-tissue injuries. The clinical outcome of a PLC injury is dependent on associated injuries, the chronicity of injury, and the method of reconstruction. This chapter discusses the current literature regarding outcomes of surgical treatment of acute and chronic injuries.

Does the marine biotoxin okadaic acid cause DNA fragmentation in the blue mussel and the pacific oyster?

Two bivalve species of global economic importance: the blue mussel, Mytilus edulis and the pacific oyster, Crassostrea gigas were exposed in vivo, to the diarrhoetic shellfish toxin okadaic acid (OA), and impacts on DNA fragmentation were measured. Shellfish were exposed using two different regimes, the first was a single (24 h) exposure of 2.5 nM OA (∼0.

Application of passive (SPATT) and active sampling methods in the profiling and monitoring of marine biotoxins.

Solid phase adsorbent and toxin tracking (SPATT) enables temporally and spatially integrated monitoring of biotoxins in aquatic environments. Monitoring using two adsorbent resins was performed over a four-month period at Lough Hyne Marine Reserve, Ireland. A range of Diarhettic Shellfish Poisoning (DSP) toxins were detected from SPATT extracts throughout the study period.

The mature athlete: aging tendon and ligament.

Context: Aging changes the biology, healing capacity, and biomechanical function of tendons and ligaments and results in common clinical pathologies that present to orthopedic surgeons, primary care physicians, physical therapists, and athletic trainers. A better understanding of the age-related changes in these connective tissues will allow better patient care.

Evidence Acquisition: The PubMed database was searched in December 2012 for English-language articles pertaining to age-related changes in tendons and ligaments.

Does the quality, accuracy, and readability of information about lateral epicondylitis on the internet vary with the search term used?

Background: Concern exists over the quality, accuracy, and accessibility of online information about health care conditions. The goal of this study is to evaluate the quality, accuracy, and readability of information available on the internet about lateral epicondylitis.

Methods: We used three different search terms ("tennis elbow," "lateral epicondylitis," and "elbow pain") in three search engines (Google, Bing, and Yahoo) to generate a list of 75 unique websites.

All-epiphyseal, all-inside anterior cruciate ligament reconstruction technique for skeletally immature patients.

Anterior cruciate ligament (ACL) injuries are an increasingly recognized problem in the juvenile population. Unfortunately, outcomes with conservative treatment are extremely poor. Adult reconstruction techniques are inappropriate to treat skeletally immature patients because of the risk of physeal complications, including limb-length discrepancy and angular deformities.

All-Inside, All-Epiphyseal Autograft Reconstruction of the Anterior Cruciate Ligament in the Skeletally Immature Athlete.

Introduction: We present an all-inside, all-epiphyseal anterior cruciate ligament (ACL) reconstruction technique with use of a hamstring autograft for skeletally immature athletes.

Step 1 Identify Subcutaneous Landmarks: Identify and mark subcutaneous landmarks to aid with anatomic orientation throughout the operation and to assist with socket placement.

Step 2 Harvest The Hamstring Graft: Harvest a hamstring autograft to create a four-strand autograft in the standard fashion or, if you prefer, perform a posterior hamstring harvest.

Contact stress and kinematic analysis of all-epiphyseal and over-the-top pediatric reconstruction techniques for the anterior cruciate ligament.

Background: Adult anterior cruciate ligament (ACL) reconstruction techniques may be inappropriate to treat skeletally immature patients because of the risk of physeal complications. "Physeal-sparing" reconstruction techniques exist, but their ability to restore knee stability and contact mechanics is not well understood.

Purpose: (1) To assess the ability of the all-epiphyseal (AE) and over-the-top (OT) reconstruction techniques to restore knee kinematics, (2) to assess whether these reconstruction techniques decrease the high posterior contact stresses seen with ACL deficiency, and (3) to determine whether the AE or OT technique produces abnormal tibiofemoral contact stresses.

Patellofemoral pain: an update on diagnostic and treatment options.

Patellofemoral pain is a frequent and often challenging clinical problem. It affects females more than males and includes many different pathologic entities that result in pain in the anterior aspect of the knee. Diagnosis of the specific cause of pain can be difficult and requires assessment of lower extremity strength, alignment, and range of motion, as well as specific patella alignment, tracking, and mobility.