Diabetic Deformities of the Lesser Toes.

The United States Centers for Disease Control and the National Institute of Diabetic, Digestive and Kidney Disorders now estimates that there are now over 34.2 million patients with diabetes in the United Sates, or over 10.2% of our population.

Preliminary Experience With Commercially Available Trabecular Metal Tibial Cones Combined With a Retrograde Locked Intramedullary Nail for Bony Defects in Tibiotalocalcaneal Arthrodesis.

Critical sized bone defects in the ankle are becoming increasingly more common in patients undergoing limb reconstruction with tibiotalocalcaneal arthrodesis. Bulk allografts have not fared well over time. There have been scattered preliminary reports using custom spinal cages or 3D-printed Titanium Implants to address the critical bony defect; however, the cost of these devices is prohibitive in many clinical practice settings.

Quality of Outcomes Research in Total Ankle Arthroplasty.

Total ankle arthroplasty is a topic that has recently gained increasing interest, largely due to the improved outcomes, which have been demonstrated by short- and mid-term research studies on the newer, third-generation implant designs. The purpose of this review is to provide an updated assessment of the quality of outcomes research on total ankle arthroplasty.

Cruciate-Retaining Versus Cruciate-Substituting Total Knee Arthroplasty: A Meta-Analysis.

Background: Primary total knee arthroplasty (TKA) can be performed using cruciate-retaining (CR), cruciate-substituting (CS), or posterior-stabilized (PS) total knee arthroplasty designs. While there have been many studies comparing the outcomes of CR versus PS TKA, the current literature is lacking in systematic reviews and meta-analyses that compare outcomes of CR knees versus CS TKAs.

Methods: This study is a systematic review and meta-analysis of the literature comparing CR and CS knees with regard to survivorship, functional, and patient-reported outcomes, range of motion (ROM), biomechanics, and revision rate.

Surgical smoke and the orthopedic surgeon: a non-systematic review of the hazards and strategies for mitigating risk.

Introduction: Surgical smoke generated through the use of electrical surgical devices poses a risk to the surgeon, medical personnel in the operating room, and the patient by exposing them to environmentally hazardous particulate matter. Previous investigation has shown that surgical smoke leads to an increased risk of pulmonary conditions, circulatory disorders, and irritation of the eyes, nose, and throat. Transmission of infectious disease can occur through inhalation of viral particles, and the presence of carcinogens are also of major concern.

Preoperative and Perioperative Management of Diabetics Undergoing Elective Foot and Ankle Surgery.

Diabetics are a highly comorbid population with an elevated risk profile when undergoing surgery. Proper preparation and management of modifiable risk factors can optimize outcomes in diabetics. A multidisciplinary approach to preoperative optimization, including surgeons, primary care providers, and anesthesiologists, ensures diabetic patients receive comprehensive evaluation before elective surgery.

Adductor Canal Nerve Block versus Intra-articular Anesthetic in Knee Arthroscopy: A Single-Blinded Prospective Randomized Trial.

Effective perioperative pain control following knee arthroscopy allows patients to reduce narcotic intake, avoid side effects of these medications, and recover more quickly. Adductor canal nerve blockade (ACB) and intra-articular injection of local anesthetic have been described as adjuvant treatments for postoperative pain control following surgery of the knee. This study directly compares the effect of each of these treatment modalities.

Bone cutting efficiency and heat generation using a traditional fluted Burr and a novel fluteless resurfacing tool.

Background: Powered instrumentation is often used for bone preparation and/or removal in many orthopaedic procedures but does risk thermogenesis. This study compares biomechanical properties of a fluted burr and a novel fluteless resurfacing tool.

Methods: Twenty cadaveric metatarsals were tested with four predetermined cutting forces to evaluate heat generation and cutting rate for the fluted burr and fluteless resurfacing tool over 40 s or until a depth of 4 mm was reached.

Pediatric Back Pain: A Scoring System to Guide Use of Magnetic Resonance Imaging.

Background: The prevalence of back pain in the pediatric population is increasing, and the workup of these patients presents a clinical challenge. Many cases are selflimited, but failure to diagnose a pathology that requires clinical intervention can carry severe repercussions. Magnetic resonance imaging (MRI) carries a high cost to the patient and health care system, and may even require procedural sedation in the pediatric population.

A Multivariate Analysis to Predict Total Hip Arthroplasty Dislocation With Preoperative Diagnosis, Surgical Approach, Spinal Pathology, Cup Orientation, and Head Size.

Background: There are several risk factors for dislocation after total hip arthroplasty (THA), but few studies include radiographic assessment of implants, with spine pathology and patient characteristics. This study estimates the rate of dislocation by patient gender, age, race/ethnicity, body mass index, Charlson Comorbidity Index, spine pathology, prior spine fusion, levels affected, radiographic Kellgren-Lawrence score of spine osteoarthritis, THA indication, surgical approach, and femoral head size.

Methods: Seventy-six primary THA patients between January 2007 and 2020 with a dislocation were matched on age and gender to subjects without a known history of dislocation using a 2:1 allocation.

Effect of Insurance Status on Clinical Outcomes After Shoulder Arthroplasty.

Shoulder arthroplasty is an effective treatment option for patients with symptomatic shoulder arthritis and rotator cuff arthropathy. Although there have been reports of variations in complication rates according to insurance type, few studies have examined the effect of payer status on functional outcomes. Patients who underwent elective shoulder arthroplasty performed by a single fellowship-trained surgeon and had a minimum of 1 year of follow-up were queried.

Risk of Complications With the Total Contact Cast in Diabetic Foot Disorders.

The custom-fabricated total contact cast is commonly used in the treatment of diabetic foot disorders. This resource-consuming treatment option has been associated with iatrogenic morbidity as well as the need for urgent cast removal and inspection of the underlying limb when potential problems arise. Over a 10-year period, 381 diabetic patients had 2265 total contact cast applications by certified orthopaedic technologists, in a university orthopaedic practice, under the supervision of university faculty.

Morphologic variations of the second cervical vertebra in Down syndrome compared with age-matched peers.

OBJECTIVEAtlantoaxial instability is an important cause of pain and neurological dysfunction in patients with Down syndrome (DS), frequently requiring instrumented fusion of the upper cervical spine. This study provides a quantitative analysis of C2 morphology in DS patients compared with their peers without DS to identify differences that must be considered for the safe placement of instrumentation.METHODSA retrospective chart review identified age-matched patients with and without DS with a CT scan of the cervical spine.