Association of Complication Rates and Severe Obesity in Patients Undergoing Ankle Arthrodesis.

Background: Tibiotalar arthrodesis (TTA) is a common operation for end-stage ankle arthritis. Elevated body mass index (BMI) is believed to contribute to complications following TTA. Previous studies involved national registries or small, underpowered cohorts.

Real-Time High-Sensitivity Reaction Monitoring of Important Nitrogen-Cycle Synthons by N Hyperpolarized Nuclear Magnetic Resonance.

Here, we show how signal amplification by reversible exchange hyperpolarization of a range of N-containing synthons can be used to enable studies of their reactivity by N nuclear magnetic resonance (NO (28% polarization), ND (3%), PhCHNH (5%), NaN (3%), and NO (0.1%)). A range of iridium-based spin-polarization transfer catalysts are used, which for NO work optimally as an amino-derived carbene-containing complex with a DMAP- coligand.

Resident Wellness During the COVID-19 Pandemic: A Nationwide Survey of Orthopaedic Residents.

Introduction: The COVID-19 pandemic has influenced the resident workforce to a particularly powerful and unexpected extent. Given the drastic changes to resident roles, expectations, and responsibilities, many valuable lessons regarding resident concerns and wellness can be garnered from this unique experience.

Methods: A voluntary survey was sent to 179 Accreditation Council for Graduate Medical Education-accredited orthopaedic surgery residency program directors to distribute to their residents.

Patient Opioid Requirements Are Often Far Less Than Their Discharge Prescription After Orthopaedic Surgery: the Results of a Prospective Multicenter Survey.

Introduction: Evidence-based, procedure-specific guidelines for opioid prescribing after orthopaedic surgery are urgently needed to standardize care and minimize excess opioids.

Methods: We developed a prospective, multicenter survey study conducted from March 2017 to January 2018 including 7 common elective orthopaedic surgical procedures (total knee arthroplasty, total hip arthroplasty, lumbar fusion, lumbar laminectomy, rotator cuff repair, arthroscopic meniscectomy, and carpal tunnel release). Phone surveys were conducted between 21 and 35 days postoperatively.

Implementation of Procedure-Specific Opioid Guidelines: A Readily Employable Strategy to Improve Consistency and Decrease Excessive Prescribing Following Orthopaedic Surgery.

Background: Evidence-based, procedure-specific guidelines for prescribing opioids are urgently needed to optimize pain relief while minimizing excessive opioid prescribing and potential opioid diversion in our communities. A multidisciplinary panel at our institution recently developed procedure-specific guidelines for discharge opioid prescriptions for common orthopaedic surgical procedures. The purpose of this study was to evaluate postoperative opioid prescription quantities, variability, and 30-day refill rates before and after implementation of the guidelines.

Operative Approach to Adult Hallux Valgus Deformity: Principles and Techniques.

Hallux valgus deformity is a progressive forefoot deformity consisting of a prominence derived from a medially deviated first metatarsal and laterally displaced great toe, with or without pronation. Although there is agreement that the deformity is likely caused by multifactorial intrinsic and extrinsic factors, the best method of operative management is debated despite the creation of basic algorithms. Our understanding of the deformity and the development of newer techniques is continuously evolving.

Use of Asynchronous Video Interviews for Selecting Obstetrics and Gynecology Residents.

Objective: To assess the effect of using of asynchronous video interviewing as a screening tool for obstetrics and gynecology residency selection.

Methods: This project was part of a quality-improvement effort to enhance the resident application process. Applications to a single obstetrics and gynecology residency program were scored using standardized criteria.

Generational Differences in Grit, Self-Control, and Conscientiousness Among Orthopaedic Surgeons: From Millennials to Baby Boomers.

Background: The training process and practice of orthopaedic surgery is demanding and arduous. Accordingly, grit, self-control, and conscientiousness are desirable qualities in orthopaedic surgeons. Some established orthopaedists have expressed concern that the future generation of surgeons may not possess the same level of grit as their predecessors.

Evaluation of Medical School Grading Variability in the United States: Are All Honors the Same?

Purpose: The medical student performance evaluation (MSPE) summarizes a residency applicant's academic performance. Despite attempts to improve standardized clerkship grading, concerns regarding grade inflation and variability at United States medical schools persist. This study's aim was to describe current patterns of clerkship grading and applicant performance data provided in the MSPE.

Outcomes Following Treatment of the Infected Achilles Tendon.

Background: Infection following Achilles tendon surgery is a devastating complication and can be difficult to treat and often leads to poor outcomes. A number of treatments have been described, but there is little information concerning outcomes of these treatments. Our purpose was to evaluate the clinical and functional outcomes of patients who have undergone treatment for an infected Achilles tendon after acute and chronic midsubstance repair.

Is Grit the New Fit?-Assessing Non-Cognitive Variables in Orthopedic Surgery Trainees.

Objective: The purpose of this study was to determine overall levels of grit, self-control, and conscientiousness among orthopedic surgery residents, to compare levels of grit across orthopedic resident training levels, and to identify common applicant variables which may correlate with these valuable noncognitive attributes.

Design: A cross-sectional study composed of a confidential electronic survey consisting of a 17-item Grit scale, 10-item Self-control scale, and 9-item Conscientiousness scale was completed by Orthopedic residents and fellows.

Setting: Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN; a tertiary medical center.

Cystic Adventitial Disease of the Tibial Vein Arising From the Subtalar Joint: A Case Report.

Soft tissue ganglion cysts are a well-known cause of tibial nerve compression in the tarsal tunnel. We describe a patient who presented with tibial nerve symptoms and was found to have an adventitial cyst of the tibial vein arising from the subtalar joint, with the joint connection confirmed both on imaging and at surgery. Surgical decompression of the cyst with transection of the vascular pedicle arising from the subtalar joint improved her symptoms at 6 months, and postoperative magnetic resonance imaging showed resolution of the cyst.

Unlocking a Diazirine Long-Lived Nuclear Singlet State via Photochemistry: NMR Detection and Lifetime of an Unstabilized Diazo-Compound.

Diazirines are important for photoaffinity labeling, and their photoisomerization is relatively well-known. This work shows how hyperpolarized NMR spectroscopy can be used to characterize an unstable diazo-compound formed via photoisomerization of a N-labeled silyl-ether-substituted diazirine. This diazirine is prepared in a nuclear spin singlet state via catalytic transfer of spin order from para-hydrogen.

Objective Predictors of Grit, Self-Control, and Conscientiousness in Orthopaedic Surgery Residency Applicants.

Introduction: The purpose of this study was to identify objective predictors of grit, self-control, and conscientiousness in orthopaedic surgery residency applicants.

Methods: The following attributes were assessed in 455 applicants: grit, self-control, conscientiousness, consistency of interest, perseverance of effort, and ambition. These measures were correlated with standard, objective demographics obtained during the application process.

An Analysis of Research Quality and Productivity at Six Academic Orthopaedic Residencies.

Objective: It remains largely unknown what factors impact the research productivity of residency programs. We hypothesized that dedicated resident research time would not affect the quantity and quality of a program's peer-reviewed publication within orthopedic residencies. These findings may help programs improve structure their residency programs to maximize core competencies.

Residents and Program Director Perspectives Often Differ on Optimal Preparation Strategies and the Value of the Orthopedic In-Training Examination.

Objectives: The purpose of this work was to compare resident and program director (PD) perspectives on the value of the Orthopaedic In-Training Examination (OITE), resident study habits, and best resources for optimal performance.

Design: A national survey of orthopedic surgery residents and PDs.

Setting: Mayo Clinic, Rochester, MN PARTICIPANTS: The survey was completed by 445 (41.

Orthopedic In-Training Examination: A Performance Review Based on Program- and Resident-Specific Characteristics.

Objectives: The orthopedic in-training examination (OITE) is the most common and objective method used to assess resident knowledge in the United States. As such, residents and programs use a number of strategies to maximize OITE performance. The purpose of this work was to better understand what strategies were being implemented and to determine which program-specific and resident-specific characteristics best correlate with improved scores.

Learning by (video) example: a randomized study of communication skills training for end-of-life and error disclosure family care conferences.

Background: Teaching residents to lead end of life (EOL) and error disclosure (ED) conferences is important.

Methods: We developed and tested an intervention using videotapes of EOL and error disclosure encounters from previous Objective Structured Clinical Exams. Residents (n = 72) from general and orthopedic surgery programs at 2 sites were enrolled.

What Factors Are Predictive of Outcome in the Treatment of Soft Tissue Sarcomas of the Foot and Ankle?

Unlabelled: Soft tissue sarcomas of the foot and ankle are common. Currently, there exist limited data on prognostic variables. The aim of this study was to review our institution's experience with soft tissue sarcomas of the foot and ankle to identify factors affecting outcomes and survivorship.

The Cost of Getting Into Orthopedic Residency: Analysis of Applicant Demographics, Expenditures, and the Value of Away Rotations.

Objectives: Little is known about the demographics and expenditures of applicants attempting to match into the competitive field of orthopedic surgery. In attempt to better inform potential applicants, the purposes of this work are to (1) better understand the demographics of successfully matched applicants, (2) determine the monetary cost of applying, and (3) assess the value of away rotations for improving chances of a successful match.

Design: Prospective comparative survey.

Orthopedic Surgery Applicants: What They Want in an Interview and How They Are Influenced by Post-Interview Contact.

Objectives: Common strategies for orthopedic residency programs to attract competitive applicants include optimizing the interview day and contacting favorably ranked applicants postinterview. The purpose of this work was to determine (1) applicants' perspectives on the ideal interview day, (2) how frequently applicants are contacted postinterview, and (3) the influence of this contact on rank order lists (ROL).

Design: Prospective Comparative Survey

Setting: Mayo Clinic Department of Orthopedic Surgery, Rochester, MN, USA PARTICIPANTS: A survey was completed by 312 successfully matched orthopedic surgery residency applicants following the 2015 match regarding their views of the ideal interview day, components they valued most, post-interview contact, and how that contact influenced their ROL.

Improving Resident Performance in Knee Arthroscopy: A Prospective Value Assessment of Simulators and Cadaveric Skills Laboratories.

Background: Cadaveric skills laboratories and virtual reality simulators are two common methods used outside of the operating room to improve residents' performance of knee arthroscopy. We are not aware of any head-to-head comparisons of the educational values of these two methodologies. The purpose of this prospective randomized trial was to assess the efficacy of these training methods, compare their rates of improvement, and provide economic value data to programs seeking to implement such technologies.

Orthopaedic Surgery Residents and Program Directors Agree on How Time Is Currently Spent in Training and Targets for Improvement.

Background: Although much attention has been paid to the role of deliberate practice as a means of achieving expert levels of performance in other medical specialties, little has been published regarding its role in maximizing orthopaedic surgery resident potential. As an initial step in this process, this study seeks to determine how residents and program directors (PDs) feel current time spent in training is allocated compared with a theoretical ideal distribution of time.

Questions/purposes: According to residents and PDs, (1) how do resident responsibilities change by level of training as perceived and idealized by residents and PDs? (2) How do resident and PD perceptions of current and ideal time distributions compare with one another? (3) Do the current training structures described by residents and PDs differ from what they feel represents an ideal time allocation construct that maximizes the educational value of residency training?

Methods: A survey was sent to orthopaedic surgery resident and PD members of the Midwest Orthopedic Surgical Skills Consortium asking how they felt residents' time spent in training was distributed across 10 domains and four operating room (OR) roles and what they felt would be an ideal distribution of that time.

Osteoid osteomas of the foot and ankle: a study of patients over a 20-year period.

Osteoid osteomas (OOs) are common benign bone tumors that seldom occur in the foot or ankle. Patients typically complain of pain that is worse at night and is relieved with use of nonsteroidal anti-inflammatory drugs. Previous studies of treating these lesions in the foot and ankle have been limited to case reports.