The Impact of Perceived Upper Extremity Severity and Prior Surgery on Patient-Reported Outcomes.

The recently validated Hand Questionnaire (HAND-Q) is a multifaceted patient-reported outcome measure (PROM) for hand/upper extremity (UE) pathology and treatment. Here, we conduct a pilot study utilising data collected as a participating site for the Phase II HAND-Q Pilot Multicenter International Validation Study. We hypothesised that self-reported hand functionality, symptom/disease severity, hand appearance, emotional dissatisfaction and treatment satisfaction would be worse in patients who perceived their disease severity to be more severe but would not differ between patients based on prior surgical history.

Sexual Dissatisfaction after Hand Surgery.

Unlabelled: Using the hand questionnaire (HAND-Q) patient-reported outcome measure, the effects of upper extremity surgery on patients' perception of their sex life were explored. The hand is a uniquely sexual organ, and we hypothesized that self-reported measures of disease severity, quality of life, and emotional impact would correlate with sexual dissatisfaction among patients receiving treatment for hand/upper extremity conditions.

Methods: Patients were prospectively enrolled for hand questionnaire participation.

WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates.

Background: The use of minor field sterility in hand/upper extremity cases has been shown to improve workflow efficiency while maintaining patient safety. As this finding has been limited to specific procedures, we investigated the safety of performing a wide array of hand/upper extremity procedures outside the main operating room using minimal field sterility with Wide-Awake Local Anaesthesia No Tourniquet (WALANT) anaesthesia by evaluating superficial and deep infection rates across a diverse series of cases.

Methods: This study was a case series conducted between October 2017 and June 2020.

Proximal Interphalangeal Joint Congruity: A Biomechanical Study.

Background: Surgical approaches to the proximal interphalangeal (PIP) joint often require disruption of soft tissue stabilizers. Additionally, PIP joint injuries frequently result in soft tissue disruption. This study evaluates the necessity of repairing soft tissue stabilizers by assessing their role in maintaining native joint congruity.

Effect of Collagen Nerve Wrapping in a Rabbit Peripheral Neuropathy Model.

Background: Collagen nerve wraps (CNWs) theoretically allow for improved nerve gliding and decreased perineural scarring, and create a secluded environment to allow for nerve myelination and axonal healing. The goal of this study was to investigate the effect of CNWs on nerve gliding as assessed by pull-out strength and nerve changes in a rabbit model of peripheral neuropathy.

Methods: Ten New Zealand rabbits were included.

Biomechanical Comparison of 3 Thumb Ulnar Collateral Ligament Repair Methods.

Purpose: Differences in range of motion, pinch strength, biomechanical strength, or joint angulation have previously been investigated for various means of treatment of ulnar collateral ligament (UCL) tears. We sought to address a gap in the literature by comparing thumb metacarpophalangeal (MCP) joint angle measurements and biomechanical strength before complete, acute UCL tear and after repair with suture anchors (SA), suture tape (ST) anchor augmentation, or reconstruction with palmaris longus graft (PL).

Methods: Thumbs and, if present, the PL tendon were harvested from 15 fresh-frozen cadavers.

Smart Technology and Orthopaedic Surgery: Current Concepts Regarding the Impact of Smartphones and Wearable Technology on Our Patients and Practice.

Purpose Of Review: While limited to case reports or small case series, emerging evidence advocates the inclusion of smartphone-interfacing mobile platforms and wearable technologies, consisting of internet-powered mobile and wearable devices that interface with smartphones, in the orthopaedic surgery practice. The purpose of this review is to investigate the relevance and impact of this technology in orthopaedic surgery.

Recent Findings: Smartphone-interfacing mobile platforms and wearable technologies are capable of improving the patients' quality of life as well as the extent of their therapeutic engagement, while promoting the orthopaedic surgeons' abilities and level of care.

WALANT Hand Surgery: Do the AORN Guidelines Apply?

This study evaluates current guidelines for patients receiving local anesthesia, set forth by the Association of Perioperative Nurses (AORN), within the context of hand surgery. The study reviewed 217 patients and 265 operations performed under wide-awake local anesthesia no tourniquet (WALANT) technique in an outpatient procedure room with minor field sterility. Only the surgeon, one resident, and one circulating nurse were present.

WALANT Hand Surgery Does Not Require Postoperative Opioid Pain Management.

Background: Currently, opioids are the standard of care for postoperative pain management. Avoiding unnecessary opioid exposure in patients is of current interest because of widespread abuse.

Methods: This is a prospective cohort study in which wide-awake, local anesthesia, no-tourniquet (WALANT) technique was used for 94 hand/upper extremity surgical patients and compared to patient cohorts undergoing similar procedures under monitored anesthesia care.

Collagen VIα2 chain deficiency causes trabecular bone loss by potentially promoting osteoclast differentiation through enhanced TNFα signaling.

Type VI collagen is well known for its role in muscular disorders, however its function in bone is still not well understood. To examine its role in bone we analyzed femoral and vertebral bone mass by micro-computed tomography analysis, which showed lower bone volume/total volume and trabecular number in Col6α2-KO mice compared with WT. Dynamic histomorphometry showed no differences in trabecular bone formation between WT and Col6α2-KO mice based on the mineral appositional rate, bone formation rate, and mineralizing perimeter.

The gut microbiome-joint connection: implications in osteoarthritis.

Purpose Of Review: Osteoarthritis is a debilitating disease leading to joint degeneration, inflammation, pain, and disability. Despite efforts to develop a disease modifying treatment, the only accepted and available clinical approaches involve palliation. Although many factors contribute to the development of osteoarthritis, the gut microbiome has recently emerged as an important pathogenic factor in osteoarthritis initiation and progression.

Daily oral consumption of hydrolyzed type 1 collagen is chondroprotective and anti-inflammatory in murine posttraumatic osteoarthritis.

Osteoarthritis (OA) is a degenerative joint disease for which there are no disease modifying therapies. Thus, strategies that offer chondroprotective or regenerative capability represent a critical unmet need. Recently, oral consumption of a hydrolyzed type 1 collagen (hCol1) preparation has been reported to reduce pain in human OA and support a positive influence on chondrocyte function.