The past and future of peri-operative interventions to reduce arthrogenic quadriceps muscle inhibition after total knee arthroplasty: A narrative review.

Total knee arthroplasty (TKA) improves patient-reported function by alleviating joint pain, however the surgical trauma exacerbates already impaired muscle function, which leads to further muscle weakness and disability after surgery. This early postoperative strength loss indicates a massive neural inhibition and is primarily driven by a deficit in quadriceps muscle activation, a process known as arthrogenic muscle inhibition (AMI). To enhance acute recovery of quadriceps muscle function and long-term rehabilitation of individuals after TKA, AMI must be significantly reduced in the early post-operative period.

Cefazolin vs Second-line Antibiotics for Surgical Site Infection Prevention After Total Joint Arthroplasty Among Patients With a Beta-lactam Allergy.

Background: Cefazolin is a first-line agent for prevention of surgical site infections (SSIs) after total joint arthroplasty. Patients labeled allergic to beta-lactam antibiotics frequently receive clindamycin or vancomycin perioperatively due to the perceived risk of a hypersensitivity reaction after exposure to cefazolin.

Methods: This single-system retrospective review included patients labeled allergic to penicillin or cephalosporin antibiotics who underwent a primary total hip and/or knee arthroplasty between January 2020 and July 2021.

Pre-Operative Predictors for Discharge to Post-Acute Care Facilities After Total Knee Arthroplasty.

Background: Joint replacement surgery is in increasing demand and is the most common inpatient surgery for Medicare beneficiaries. The venue for post-operative rehabilitation, including early outpatient therapy after surgery, influences recovery and quality of life. As part of a comprehensive total joint program at Kaiser Permanente Colorado, we developed and validated a predictive model to anticipate and plan the disposition for rehabilitation of our patients after total knee arthroplasty (TKA).

Reliability and accuracy of digital templating for the humeral component of total shoulder arthroplasty.

Background: This experimental study evaluated the interobserver reliability and accuracy of pre-operative digital templating for humeral head size, stem size and neck angle for total shoulder arthroplasty.

Methods: Twenty-five patients underwent a total shoulder arthroplasty with a single prosthesis. Four independent, blinded surgeons (two experienced shoulder surgeons and two PGY-6 fellows) used pre-operative radiographs and templating software to generate templates of the humeral head, stem and neck for each patient.

Quadriceps tendon injuries in national football league players.

Background: Distal quadriceps tendon tears are uncommon injuries that typically occur in patients older than 40 years of age, and they have a guarded prognosis. Predisposing factors, prodromal findings, mechanisms of injury, treatment guidelines, and recovery expectations are not well described in high-level athletes.

Hypothesis: Professional American football players with an isolated tear of the quadriceps tendon treated with timely surgical repair will return to their sport.

Obesity and osteoarthritis: more than just wear and tear.

A link has been established between obesity and osteoarthritis (OA), but the precise relationship has yet to be defined. OA has a multifactorial etiology, and obesity is consistently identified as an independent and modifiable risk factor. The biomechanical relationship is intuitive: increased loads on articular cartilage cause subsequent wear and cartilage breakdown.

Biomechanical evaluation of a unicortical button versus interference screw for subpectoral biceps tenodesis.

Purpose: The purpose of this study was to evaluate and compare the biomechanical properties of a unicortical button with an interference screw used for subpectoral biceps tenodesis. We also describe the anatomic dangers of bicortical button use in the subpectoral location.

Methods: Twenty-eight fresh-frozen human cadaveric shoulders with a mean age of 52 years were studied.

Extensive heterotopic ossification after suspensory cortical fixation of acute distal biceps tendon ruptures.

Suspensory cortical fixation is commonly used for distal biceps tendon repair and reconstruction with one of several commercially available devices. The single-incision approach typically used with these devices is believed to have a lower incidence of heterotopic ossification than the dual-incision technique, but the true incidence of heterotopic ossification is unknown. The role of chemotherapeutic or radiation prophylaxis is undefined.

Are conventional reconstruction plates equivalent to precontoured locking plates for distal humerus fracture fixation? A biomechanics cadaver study.

Background: The optimal plate type and configuration for distal humerus fracture fixation has yet to be defined. Available biomechanical studies show conflicting results. No existing studies compare conventional reconstruction plates to newer precontoured distal humerus locking plates in both parallel and perpendicular configurations.