Anterior Cruciate Ligament Reconstruction Basics: Quadriceps Tendon (All-Soft Tissue) Autograft Preparation-Part 2.

Anterior cruciate ligament reconstruction with quadriceps tendon autograft is a reliable graft option that has recently increased in use. Varying harvesting and graft preparation techniques available and improved technology and implant design continue to make quadricep tendon preparation more efficient and reproducible. In this Technical Note, we describe our preferred technique for all-soft tissue quadriceps tendon autograft preparation after harvest for anterior cruciate ligament reconstruction.

Anterior Cruciate Ligament Reconstruction Basics: Quadriceps Tendon (All-Soft Tissue) Autograft Harvest-Part 1.

Anterior cruciate ligament reconstruction with quadriceps tendon autograft has become increasingly popular for primary and revision anterior cruciate ligament reconstruction surgery. Although there are a variety of techniques available for performing quadriceps tendon autograft harvest for anterior cruciate ligament reconstruction, a minimally invasive, all-soft tissue harvest technique can result in a reproducible, reliable graft while minimizing donor-site morbidity. In this Technical Note, we describe our preferred technique for quadriceps tendon autograft harvest for anterior cruciate ligament reconstruction.

Aptamer-Targeted Dendrimersomes Assembled from Azido-Modified Janus Dendrimers "Clicked" to DNA.

Amphiphilic Janus dendrimers (JDs), synthetic alternatives to lipids, have the potential to expand the scope of nanocarrier delivery systems. JDs self-assemble into vesicles called dendrimersomes, encapsulate both hydrophobic cargo and nucleic acids, and demonstrate enhanced stability in comparison to lipid nanoparticles (LNPs). Here, we report the ability to enhance the cellular uptake of Janus dendrimersomes using DNA aptamers.

Physician Preferences when Selecting Candidates for Lower-Quality Kidney Offers.

Background: In the United States, more than 50% of kidneys in the lowest 15% quality range (those with Kidney Donor Profile Index >85) are discarded. Studies suggest that using more of these kidneys could benefit patients waiting for a transplant. This study assesses the trade-offs physicians make when selecting recipients for lower-quality kidneys.

Kidney organ allocation: reducing discards.

Purpose Of Review: The donation and kidney transplant system in the United States is challenged with reducing the number of kidneys that are procured for transplant but ultimately discarded. That number can reach 20% of donated kidneys each year.

Recent Findings: The reasons for these discards, in the face of overwhelming demand, are multiple.

Patient Preferences for Waiting Time and Kidney Quality.

Background And Objectives: Approximately 20% of deceased donor kidneys are discarded each year in the United States. Some of these kidneys could benefit patients who are waitlisted. Understanding patient preferences regarding accepting marginal-quality kidneys could help more of the currently discarded kidneys be transplanted.

The Role of Procurement Biopsies in Kidney Acceptance Decision Making and Kidney Discard: Perceptions of Physicians, Nurse Coordinators, and OPO Staff and Directors.

Unlabelled: Procurement biopsies suffer from challenges with quality and reproducibility and are linked to kidney discard. Nonetheless, procurement biopsies are obtained for the majority of kidneys in the United States, and biopsy findings are commonly relied upon in kidney acceptance decisions.

Methods: We conducted in-depth, semistructured interviews with 30 surgeons, nephrologists, nurse coordinators, and organ procurement organization (OPO) staff and directors to assess perceptions of factors contributing to kidney discard and strategies to reduce kidney discard, with a focus on the role of procurement biopsies.

Patient and Clinician Perceptions of Informed Consent and Decision Making About Accepting KDPI > 85 Kidneys.

Background: Although the impact of the kidney donor profile index (KDPI) on kidney discard is well researched, less is known about how patients make decisions about whether to give consent for KDPI > 85 kidney offers.

Methods: We conducted in-depth, semistructured interviews with 16 transplant recipients, 15 transplant candidates, and 23 clinicians (transplant surgeons, nephrologists, and nurse coordinators) to assess and compare perceptions of transplant education, informed consent for KDPI > 85 kidneys' and the decision-making process for accepting kidney offers. Thematic analysis was used to analyze qualitative data.

THE VALUE OF A REGIONAL 'LIVING' COVID-19 REGISTRY AND THE CHALLENGES OF KEEPING IT ALIVE.

Background: The availability of accurate, reliable, and timely clinical data is crucial for clinicians, researchers, and policymakers so that they can respond effectively to emerging public health threats. This was typified by the recent SARS-CoV-2 pandemic and the critical knowledge and data gaps associated with novel Coronavirus 2019 disease (COVID-19).We sought to create an adaptive, living data mart containing detailed clinical, epidemiologic, and outcome data from COVID-19 patients in our healthcare system.

Physician and patient acceptance of policies to reduce kidney discard.

Despite the shortage of kidneys for transplantation in the United States, approximately 18%-20% of deceased donor kidneys are discarded each year. These discarded kidneys can offer a survival benefit to suitable patients. Revisions to the current kidney allocation policy may be needed to reduce deceased donor kidney discard.

A model of supply-chain decisions for resource sharing with an application to ventilator allocation to combat COVID-19.

We present a stochastic optimization model for allocating and sharing a critical resource in the case of a pandemic. The demand for different entities peaks at different times, and an initial inventory for a central agency are to be allocated. The entities (states) may share the critical resource with a different state under a risk-averse condition.

Patient-reported outcome after stemmed versus stemless total shoulder arthroplasty for glenohumeral osteoarthritis: a patient-blinded randomized clinical trial.

Background: Stemless shoulder arthroplasty systems with uncemented metaphyseal fixation have been used for glenohumeral osteoarthritis since 2004 (Hawi, et al. BMC Musculoskelet Disord 17:376, 2016). The stemless design has several theoretical advantages compared with the stemmed shoulder arthroplasty systems: restoring patients' anatomy; preserving humeral bone stock; and few complications in component removal if the need for a revision arthroplasty arises.

Low inter-observer agreement among experienced shoulder surgeons assessing overstuffing of glenohumeral resurfacing hemiarthroplasty based on plain radiographs.

Background: In a clinical setting, a visual evaluation of post-implant radiographs is often used to assess the restoration of glenohumeral joint anatomy after resurfacing hemiarthroplasty and is a part of the decision-making process, in combination with other parameters, when evaluating patients with inferior clinical results. However, the reliability of this method of visual evaluation has not been reported. The aim of this study was to investigate the inter- and intra-observer agreement among experienced shoulder surgeons assessing overstuffing, implant positioning, and size following resurfacing hemiarthroplasty using plain standardized radiographs.

Measurement of Glenoid Bone Loss With 3-Dimensional Magnetic Resonance Imaging: A Matched Computed Tomography Analysis.

Purpose: To compare the measurement of glenoid bone surface area (GBSA) and glenoid bone loss (GBL) between 3-dimensional computed tomography (3D CT) and an autosegmentation approach for 3D magnetic resonance imaging (MRI) of patients with recurrent shoulder instability.

Methods: Eight subjects (2 women and 6 men; age range, 15-72 years [mean, 44 ± 19 years]) were consecutively enrolled who had both CT and MRI of the shoulder for clinical shoulder instability. Inclusion criteria were patients with shoulder instability or other shoulder injury who had both a CT scan and MRI performed of the same shoulder.

Osteotomy of the Tibial Tubercle for Anteromedialization.

Patellofemoral instability is a common cause of anterior knee pain, especially in younger and more active patients. Treatment of instability varies considerably depending on the patient's symptoms as well as the cause of the instability. Lateral instability has a particularly broad spectrum of treatment algorithms including patellar taping, arthroscopy, lateral release, medial patellofemoral ligament (MPFL) reconstruction, MPFL repair, and osteotomy of the tibial tubercle for realignment.

Screening for depression in Andean Latin America: Factor structure and reliability of the CES-D short form and the PHQ-8 among Bolivian public hospital patients.

Objective We assessed the validity and reliability of the Center for Epidemiologic Studies-Depression scale (CES-D) short form and the Patient Health Questionnaire-8 (PHQ-8) (two measures of depressive symptoms) among urban, low-income patients from a heavily indigenous area of Andean Latin America. This is a patient population that is in many ways culturally distinct from the populations that have been included in previous Spanish language validation studies of these instruments. Methods We administered the CES-D Yale version short form and the PHQ-8 to 107 outpatients at public hospitals in La Paz and El Alto, Bolivia.

Arthroscopic Bony Resection for Treatment of Symptomatic Bipartite Patella.

Bipartite patella is a common pathology, affecting 2% to 3% of the population. Usually these cases are bilateral and asymptomatic. However, a patient with a bipartite patella may complain of pain, which is most likely related to fragment mobility.

Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion.

The treatment of recurrent glenohumeral instability, especially with a concomitant bony lesion, remains challenging. This is especially true in the case of posterior instability given its less common incidence. Moreover, the presence of an engaging reverse Hill-Sachs lesion in combination with posterior instability will result in the need for a more aggressive treatment option.

Structured Caregiver Feedback Enhances Engagement and Impact of Mobile Health Support: A Randomized Trial in a Lower-Middle-Income Country.

Background: Patients' engagement in mobile health (m-health) interventions using interactive voice response (IVR) calls is less in low- and middle-income countries (LMICs) than in industrialized ones. We conducted a study to determine whether automated telephone feedback to informal caregivers ("CarePartners") increased engagement in m-health support among diabetes and hypertension patients in Bolivia.

Materials And Methods: Patients with diabetes and/or hypertension were identified through ambulatory clinics affiliated with four hospitals.

Successful immediate weight-bearing of internal fixated ankle fractures in a general population.

Several studies on operated ankle fractures have shown that immediate weight-bearing is recommendable. Consequently, we changed our postoperative standard regimen, from 3 weeks of non-weight-bearing followed by 3 weeks of weight-bearing, to full immediate weight-bearing in all 6 weeks. A below-knee walking cast was applied immediately after surgery.

[Aftercare of malleolar fractures in Denmark. A questionnaire study].

A questionnaire was sent out to 59 orthopaedic departments. Seventy-eight percent returned the questionnaire. Four thousand two hundred ankle fractures are treated annually.

Prognosis of fracture of the talus in children. 21 (7-34)-year follow-up of 14 cases.

14 children suffering from a fracture of the talar neck or body were examined after 21 (7-34) years. The talar neck was fractured in 10 children and the talar body in 4.3 fractures were displaced and primarily treated with reduction and immobilization.

Osteochondral lesions of the talar dome in children. A 24 (7-36) year follow-up of 13 cases.

13 patients who in childhood had had osteochondral lesions (OCL) of the talar dome participated in a long-term follow-up including physical examination, computed tomography (CT) and conventional radiographs. Most of the cases were caused by trauma. Conventional radiographs showed abnormal findings in 4 cases and CT in a further one.