Bone Cement in Adult Hip and Knee Reconstruction: A Review of Commercially Available Options and Clinical Outcomes.

Polymethyl-methacrylate (PMMA) bone cement is used extensively in hip and knee arthroplasty. A thorough understanding of the basic chemistry underlying PMMA is important for orthopaedic surgeons because this underscores the specific way bone cement is used during surgery. Recently, clinical research has shed light on the various types of PMMA regarding the viscosity of the mixture and the effect of cement additives.

Reliability of Current Classification Systems for Periprosthetic Fractures of the Humerus.

Objective: Numerous classification systems exist to evaluate periprosthetic humerus fractures, although most are based on limited patient numbers. The Wright and Cofield system is the most widely used classification system. We sought to evaluate the interobserver and intraobserver reliabilities of this system compared with the Unified Classification System (UCS) using the largest patient sample to date.

Preoperative Activity Level an Indicator of Postoperative Functional Outcomes with a Contemporary Revision Total Knee System.

As the population requiring revision total knee arthroplasty (rTKA) grows, varying preoperative conditions may need to be considered when attempting to predict postoperative outcomes. Considering preoperative activity levels may help manage the expectations of patients. The purpose of this study was to analyze the outcomes of low- and high-activity subgroups of patients receiving a contemporary rTKA.

Exposure-Related Anxiety and Improving Patient Satisfaction with Medical Undergarments During Surgery: A Randomized Controlled Trial.

Background: The standard of care for patients undergoing a surgical procedure is to have patients remove all clothing and don a hospital-provided gown. A growing number of patients have anxiety when exposing their bodies in a medical setting, which increases stress for those patients.

Methods: This study prospectively enrolled patients at a single orthopaedic specialty hospital into 1 of 2 garment groups in a block-randomized design.

Management of Pathologic Fractures around the Knee: Part 1-Distal Femur.

Pathologic fractures secondary to metastatic disease are an increasingly prevalent problem. Such patients require multidisciplinary collaboration to optimize clinical outcomes. An established algorithm for clinical, laboratory, and radiographic work-up will ensure that each patient achieves the best outcome while avoiding catastrophic complications.

Evaluation and Management of Intra-Articular Tumors of the Knee.

Intra-articular tumors of the knee are most commonly benign. Overall, this is a relatively rare clinical presentation. The differential diagnosis includes pigmented villonodular synovitis, synovial chondromatosis, lipoma arborescens, synovial hemangioma, and very rarely primary sarcoma (synovial sarcoma being the most common).

Management of Pathologic Fractures around the Knee: Part 2-Proximal Tibia.

Metastatic disease affecting the proximal tibia is rarer than disease affecting the femur; however, it presents unique challenges that the orthopaedic surgeon must address to ensure successful outcomes and return the patient to an ambulatory status. The essential workup for evaluating and treating these patients is addressed briefly in this review as a summary of the information is provided in part 1 of this series. Part 2 of this series will focus on the surgical treatment of these lesions, which can be complex and is not as well described in the literature.

Management of Primary Aggressive Tumors of the Knee.

Primary bone sarcomas and aggressive benign bone tumors are relatively rare. It is essential to recognize features that are concerning for these aggressive tumors based on a patient's history, physical exam, and radiographs. Physicians and other health care providers should have a high suspicion for these tumors and promptly refer these patients to orthopaedic oncologists.

Management of Metastatic Disease in Long Bones.

Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.

Proximal Femur Peri-Implant Fracture After Lateral Femur Locking Plate: A Report of 2 Cases.

Case: This case report discusses 2 cases of proximal femur peri-implant fractures after the use of lateral locking plates for distal femur periprosthetic fractures.

Conclusion: The use of locking plate technology for fixation of distal femur periprosthetic fractures is a common treatment modality. Although much has been reported regarding healing and complication rates of distal femoral periprosthetic fractures, little has been reported about peri-implant fractures subsequent to treatment using locking plates.

Is Contralateral Templating Reliable for Establishing Rotational Alignment During Intramedullary Stabilization of Femoral Shaft Fractures? A Study of Individual Bilateral Differences in Femoral Version.

Objectives: To determine native individual bilateral differences (IBDs) in femoral version in a diverse population.

Methods: Computed tomography scans with complete imaging of uninjured bilateral femora were used to determine femoral version and IBDs in version. Age, sex, and ethnicity of each subject were also collected.

Use of a Defined Surgical Approach for the Debridement of Open Tibia Fractures.

Objectives: To determine whether a defined approach for debridement of open tibia fractures would result in no change in reoperation rate, but reduce the need for flap coverage.

Design: Prospective cohort study.

Setting: Academic Level 1 trauma center.

Application of Amniotic Tissue in Orthopedic Surgery.

The use of amniotic tissue in orthopedic surgery has increased in recent years. While more studies are needed to fully understand the therapeutic potential and define the appropriate applications of these tissues, basic science and clinical studies are available that indicate promising results. This review will highlight these studies as they relate to the musculoskeletal system.