Prospective Evaluation of Push-up Performance and Patient-Reported Outcomes Following Open Dorsal Wrist Ganglion Excision in the Active-Duty Military Population.

 Dorsal wrist ganglia (DWG) are a common wrist pathology that affects the military population. This study prospectively evaluates push-up performance, functional measures, and patient-reported outcomes 6 months after open DWG excision in active-duty patients.  Twenty-seven active-duty patients were enrolled and 18 had complete follow-up.

Longitudinal Analysis of Circulating Markers of Bone Turnover Across Multiple Decades in Osteoporotic Women.

Purpose: The objective of this study was to analyze changes in serum markers of bone turnover across multiple decades in osteoporotic women compared with nonosteoporotic controls, to determine their utility as potential predictors for osteoporosis. Early prediction of those at risk for osteoporosis can enable early intervention before the irreversible loss of critical bone mass.

Methods: Serum samples were obtained from 20 women given the diagnosis of osteoporosis after age 46 years and 20 age-matched women with normal bone mineral density from 4 time points in their life (ages 25-31, 32-38, 39-45, and 46-60 years).

Effect of Posterior Glenoid Bone Loss and Retroversion on Arthroscopic Posterior Glenohumeral Stabilization.

Background: Posterior glenohumeral instability is an increasingly recognized cause of shoulder instability, but little is known about the incidence or effect of posterior glenoid bone loss.

Purpose: To determine the incidence, characteristics, and failure rate of posterior glenoid deficiency in shoulders undergoing isolated arthroscopic posterior shoulder stabilization.

Study Design: Cohort study; Level of evidence, 3.

Ten-year fracture risk predicted by proximal femur Hounsfield units.

Unlabelled: Colon cancer screening occurs at younger ages than osteoporosis screening. Bone density measurements using virtual colonoscopy performed for colon cancer screening can provide an early warning sign of patients at potential risk for osteoporosis-related fractures. Earlier identification may improve treatment and potentially fracture prevention.

Global Excision of Severe Heterotopic Ossification of the Shoulder: A Case Report.

Case: A 21-year-old man sustained a closed glenohumeral fracture/dislocation as a pedestrian struck by a motor vehicle. He was treated nonoperatively and developed severe post-traumatic heterotopic ossification (HO) with near-complete shoulder ankylosis. We present our technique for safe surgical excision.

Proximal Femur Hounsfield Units on CT Colonoscopy Correlate With Dual-energy X-ray Absorptiometry.

Background: Quantifying bone mineral density (BMD) on CT using commercial software demonstrates good-to-excellent correlations with dual-energy x-ray absorptiometry (DEXA) results. However, previous techniques to measure Hounsfield units (HUs) within the proximal femur demonstrate less successful correlation with DEXA results. An effective method of measuring HUs of the proximal femur from CT colonoscopy might allow for opportunistic osteoporosis screening.

Union Rates and Reported Range of Motion Are Acceptable After Open Forearm Fractures in Military Combatants.

Background: High-energy open forearm fractures are unique injuries frequently complicated by neurovascular and soft tissue injuries. Few studies have evaluated the factors associated with nonunion and loss of motion after these injuries, particularly in the setting of blast injuries.

Questions/purposes: (1) In military service members with high-energy open forearm fractures, what proportion achieved primary or secondary union? (2) What is the pronation-supination arc of motion as stratified by the presence or absence of heterotopic ossification (HO) and synostosis? (3) What are the risks of heterotopic ossification and synostosis? (4) What factors may be associated with forearm fracture nonunion?

Methods: A retrospective study of all open forearm fractures treated at a tertiary military referral center from January 2004 to December 2014 was performed.

Early outcomes of patient-specific posterior stabilized total knee arthroplasty implants.

Patient-specific implants have been linked to stiffness. The purpose of this study was to evaluate outcomes in patient-specific implants. We performed a retrospective review with a primary outcome of manipulation under anesthesia (MUA); secondary outcomes included Knee Society Scores (KSS), Knee Society Functional Scores (KSFS), range of motion (ROM), and Forgotten Joint Scores (FJS).

Effect of NSAIDs on Bone Healing Rates: A Meta-analysis.

Introduction: NSAIDs inhibit osteogenesis and may result in delayed union or nonunion. The purpose of this meta-analysis was to determine whether their use leads to delayed union or nonunion.

Methods: We systematically reviewed the literature reporting the effect of NSAIDs on bone healing.

The Use of Distal Ulnar Hounsfield Units to Predict Future Fragility Fracture Risk.

Purpose: Distal ulnar Hounsfield unit (HU) measurements obtained from computed tomography (CT) scans of the wrist can be used to accurately screen for low bone mineral density. It is unknown whether HU measurements can also predict the risk of future fragility fractures. Therefore, the purpose of this study was to determine if the HU values of the distal ulna correlate to fragility fracture risk.

Fascia iliaca blockade with the addition of liposomal bupivacaine vs. plain bupivacaine for perioperative pain management following hip arthroscopy.

Purpose: A newer formulation of bupivacaine, encapsulated within carrier molecules, has garnered attention for its role in providing extended post-operative analgesia. The purpose was to evaluate the addition of liposomal bupivacaine to fascia iliaca blockade during hip arthroscopy.

Methods: Retrospective cohort study of patients undergoing hip arthroscopy with a pre-operative fascia iliaca blockade with either liposomal bupivacaine (Group 1; 266mg + 20 cc 0.

Glenoid neck Hounsfield units on computed tomography can accurately identify patients with low bone mineral density.

Background: Osteoporosis is a costly and morbid disease with the first presentation often with a fragility fracture. The purpose of this study was to assess whether Hounsfield unit (HU) measurements on shoulder computed tomography could identify patients at risk of osteoporosis and aid in its diagnosis.

Methods: We identified patients who had both a computed tomography scan of the glenoid and a dual-energy x-ray absorptiometry scan.

What Risk Factors Predict Recurrence of Heterotopic Ossification After Excision in Combat-related Amputations?

Background: Heterotopic ossification (HO) is common after combat-related amputations and surgical excision remains the only definitive treatment for persistently symptomatic HO. There is no consensus in the literature regarding the timing of surgery, and recurrence frequency, reexcision, and complications have not been reported in large numbers of patients.

Questions/purposes: (1) What are the rates of symptomatic recurrence resulting in reexcision and other complications resulting in reoperation in patients with HO? (2) Is either radiographic or symptomatic recurrence dependent on timing and type of initial surgery, the experience of the surgeon in performing the procedure, the severity of preexcision HO, the presence of concomitant neurologic injury, or the use of postoperative HO prophylaxis?

Methods: Between March 2005 and March 2013 our institution treated 994 patients with 1377 combat-related major extremity amputations; of those, 172 amputations underwent subsequent excision of symptomatic HO.