Robotic-assisted total knee arthroplasty reduces soft-tissue releases which improves functional outcomes: A retrospective study.

Background: There is increasing use of Robotic-Assisted (RA) and personalized alignment techniques in total knee arthroplasty (TKA). The hypothesis of this study was that RA TKA would result in fewer soft-tissue releases, and that fewer soft-tissue releases would be associated with improved clinical outcomes.

Methods: A retrospective review of an internal company registry was conducted for all primary TKAs performed from Jan 1, 2014, through a database extract date of Nov 4, 2022.

The Role of Endoscopic Assistance in Surgery for Pediatric Cholesteatoma in Reducing Residual and Recurrent Disease.

The primary aim of this study was to evaluate long-term recurrent and residual disease after surgery for acquired cholesteatoma in children according to surgical approach. A total of 71 interventions performed on 67 pediatric patients were included in the study. Canal wall-up tympanomastoidectomy (CWUT) was performed in 31 ears (13 with endoscopic assistance), a transcanal esclusive endoscopic approach (TEEA) was used in 22, and canal wall-down tympanomastoidectomy (CWDT) was performed in 18.

Osteoneogenesis at the Round Window: A Possible Cause of Cochlear Implant Failure?

Surgery for cochlear implant is a traumatic procedure, with inflammatory responses leading to immediate and delayed intracochlear changes, resulting in newly formed fibrous and bony tissue. This newly formed tissue is thought to affect speech perception with cochlear implants and can also play a role in causing device malfunctioning and soft failures. We present a case of left cochlear implant explantation and reimplantation in a 15-year-old girl, who experienced deterioration of speech perception and device failure associated with osteoneogenesis of the round window, which could represent a cause of cochlear implant failure.

Vascularized Fibular Epiphyseal Transfer for Pediatric Limb Salvage: Review of Applications and Outcomes.

Vascularized fibular epiphyseal transfer (VFET) offers a functional advantage in pediatric limb salvage due to the preservation of growth potential and an articular surface for remodeling. This review summarizes the available evidence on the clinical characteristics and outcomes of pediatric reconstruction applying VFET at different recipient sites and with varying techniques. VFET was used to reconstruct the proximal humerus, distal radius or ulna, proximal femur, distal fibula, calcaneus, and mandible.

Retained Functional Antibiotic Hip Spacers Have High Rates of Stem Loosening, Subsidence, and Reoperation.

Background: Functional antibiotic hip spacers for treatment of periprosthetic joint infection may be retained in patients deemed too sick for reimplantation, or who elect to forego additional surgery. Our aim was to characterize reoperations, modes of failure, and function outcomes in patients who have retained hip spacers.

Methods: We performed a retrospective review of 43 hips that underwent placement of an articulating hip spacer between January 1, 2014 and November 30, 2021.

Conversion Total Hip Arthroplasty in the Era of Bundled Care Payments: Impacts on Costs of Care.

Background: Conversion hip arthroplasty is defined as a patient who has had prior open or arthroscopic hip surgery with or without retained hardware that is removed and replaced with arthroplasty components. Currently, it is classified under the same diagnosis-related group as primary total hip arthroplasty (THA); however, it frequently requires a higher cost of care.

Methods: A retrospective study of 228 conversion THA procedures in an orthopaedic specialty hospital was performed.

Endoscopic transcanal tympanoplasty type I in children: Evolving experience in tragus perichondrium vs. acellular porcine small intestinal sub-mucosa grafts.

Objectives: Endoscopic trans-canal tympanoplasty type I (ETT) is gradually diffusing worldwide. It mainly allows less invasive surgery in children with respect to a microscope approach by avoiding post-auricular access. The aim of this study is to illustrate our experience in endoscopic reconstruction of tympanic membrane, using autologous tragus perichondrium (TP) and non-autologous acellular porcine small intestinal sub-mucosa (SIS) as grafts.

Long-Term Lateral Semicircular Canal Function in Children with Cochlear Implants: Results of Video Head Impulse Test.

In children with profound deafness, bilateral cochlear implant (CI) is an effective, established procedure. However, its safety on vestibular function has recently been debated. The goal of this study is to evaluate the long-term lateral semicircular canal high-frequency vestibulo-oculomotor reflex (LSC HF VOR) in children with CI by video head impulse testing (vHIT).

Cognitive improvement after cochlear implantation in deaf children with associated disabilities.

Aim: To monitor functional auditory and non-verbal cognitive skills in children with cochlear implants who had associated disabilities over a 24-month period and define how cochlear implantation may impact on non-verbal cognition by restoring functional auditory skills.

Method: Sixty-four children with cochlear implants (36 females, 28 males; mean age 4y 3mo, SD 3y 5mo, 9mo-14y 5mo) were recruited and divided into three groups: children with typical development group (TDG); children with associated disabilities not linked to non-verbal cognitive disorders group (ADG1); and children with associated disabilities linked to non-verbal cognitive disorders group (ADG2). Tests of functional auditory, communicative, and non-verbal cognitive skills were performed before cochlear implantation and at 12 and 24 months after cochlear implantation.

Opioid Use After Discharge Following Primary Unilateral Total Hip Arthroplasty: How Much Are We Overprescribing?

Background: The opioid crisis pressures orthopedic surgeons to reduce the amount of narcotics prescribed for postoperative pain management. This study sought to quantify postoperative opioid use after hospital discharge for primary unilateral total hip arthroplasty (THA) patients.

Methods: A prospective cohort of primary unilateral THA patients were enrolled at a single institution.

Use of Tetrahydrocannabinol and Cannabidiol Products in the Perioperative Period Around Primary Unilateral Total Hip and Knee Arthroplasty.

Background: Given the opioid crisis in America, patients are trying alternative medications including tetrahydrocannabinol (THC) and other cannabidiol (CBD) containing products in the perioperative period, especially in states where these products are legal. This study sought to analyze usage rates of CBD/THC products in the perioperative period for primary unilateral total hip and knee arthroplasty (THA/TKA) patients and identify a possible association with post-operative opioid use.

Methods: A prospective cohort of primary unilateral THA/TKA patients were enrolled at a single institution.

Opioid Use After Discharge Following Primary Unilateral Total Knee Arthroplasty: How Much Are We Over-Prescribing?

Background: The opioid crisis pressures orthopedic surgeons to reduce the amount of narcotics prescribed for post-operative pain management. This study sought to quantify post-operative opioid use after hospital discharge for primary unilateral total knee arthroplasty (TKA) patients.

Methods: A prospective cohort of primary unilateral TKA patients performed by one of 5 senior fellowship-trained arthroplasty surgeons were enrolled at a single institution.

Cognitive function and quality of life in older adult patients with cochlear implants.

This study aimed to evaluate the benefits of cochlear implant (CI) on speech perception, quality of life (QoL), and cognitive function in profoundly deafened older adults. Longitudinal and cross-sectional cohort study. Participants in this study were CI recipients aged 65 years or older (experimental group), CI recipients aged 50 years or younger (control group 1), and normal-hearing participants aged 65 years or older (control group 2).

Endoscopic approach to the round window through posterior tympanotomy for cochlear implantation in children: A study on feasibility.

Objective: To demonstrate the feasibility of rigid endoscopy through posterior tympanotomy, which provides both a view of the round window and direction of the scala tympani in children.

Methods: After a standard mini-invasive surgical approach with postauricular access and transmastoid posterior tympanotomy of 2 mm, a 0°, 1.9 mm diameter and 11 cm long endoscope is positioned in proximity of the upper part of the posterior tympanotomy to obtain a panoramic view of the inferior part of the medial wall of the tympanic cavity.

Intraoperative Comparison of Measured Resection and Gap Balancing Using a Force Sensor: A Prospective, Randomized Controlled Trial.

Background: For establishing femoral component position, gap-balancing (GB) and measured resection (MR) techniques were compared using a force sensor.

Methods: Ninety-one patients were randomized to undergo primary total knee arthroplasty using either MR (n = 43) or GB (n = 48) technique using a single total knee arthroplasty design. GB was performed with an instrumented tensioner.

Impact of Femoral Stem Design on Failure After Anterior Approach Total Hip Arthroplasty.

Background: An increased rate of complications related to femoral component failure has been described with less invasive total hip arthroplasty (THA). This study evaluated the incidence of femoral complications associated with the direct anterior approach for THA.

Methods: Retrospective review was performed of the initial 1120 consecutive patients who underwent direct anterior THA by 2 surgeons.

Intratympanic steroid delivery by an indwelling catheter in refractory severe sudden sensorineural hearing loss.

Objective: Many studies over the last decade showed favorable outcomes with intratympanic (IT) steroid treatment, alone as salvage treatment or in combination with conventional systemic therapy (ST). However, in severe to profound sensorineural hearing loss resistant to ST, the optimal infusion mode, the type and concentration of the solution, the preferable drug, its total amount, and the duration and fractionation of the treatment are still debated. Aim of the study was to investigate the feasibility and the outcomes of a direct and constant IT delivery of dexamethasone (DEX) by means of a new indwelling catheter.

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.

Objective: To define a minimum Standard Set of outcome measures and case-mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients.

Methods: An international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus.

Mechanical comparison of iliosacral reconstruction techniques after sarcoma resection.

Background: Reconstruction of iliosacral defects following oncologic resection is a difficult clinical problem associated with a high incidence of failure. Technical approaches to this problem are heterogeneous and evidence supporting specific techniques is sparse. Maximizing construct stability may improve union rates and functional outcomes.

Preliminary results of video Head Impulse Testing (vHIT) in children with cochlear implants.

Objective: To evaluate the lateral semicircular canal high frequency vestibulo-oculomotor reflex (LSC HF VOR) in children with cochlear implant.

Methods: 16 children (10 females and 6 males, age range = 5-17 years) receiving a unilateral (n = 12) or a bilateral (n = 4) cochlear implant were included and compared to a control group of 20 age-matched normal-hearing (NH) children. Both implanted and NH children received a vestibular function test battery, including a Vestibulo-Ocular Reflex (VOR) gain assessment by means of a video-Head Impulse Test (vHIT), which represented the main outcome measure.

Intraoperative use of fibrin glue dyed with methylene blue in surgery for branchial cleft anomalies.

Objectives/hypothesis: We present a new method of optimizing the results of surgery for branchial cleft anomalies based on the intraoperative injection of fibrin glue combined with methylene blue dye.

Study Design: Retrospective single-center cohort study.

Methods: The method was applied in 17 patients suffering from branchial anomalies.

The role of margins in extremity soft tissue sarcoma.

For extremity soft tissue sarcomas, limb salvage is now standard of care. The extent of surgical margins is balanced with functionality of the resected limb. Although negative margins are the goal, the necessary width is unclear.