Prophylaxis for preventing venous thromboembolism in knee arthroscopy and soft tissue reconstruction: consensus statements from an international panel of experts.

Purpose: There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic.

Contemporary management of subtrochanteric fractures.

Cephalomedullary interlocking nails that allow for trochanteric entry and minimally invasive fixation have revolutionized the contemporary management of subtrochanteric fractures with improved union rates and decreased incidence of fixation failure. The most successful alternative to intramedullary fixation remains the angled blade plate. Despite biomechanical superiority of contemporary intramedullary implants to previous intramedullary devices, the importance of achieving and maintaining satisfactory fracture reduction prior to and during hardware insertion cannot be overemphasized.

Fusion risk score: evaluating baseline risk in thoracic and lumbar fusion surgery.

Study Design: Retrospective cohort study.

Objective: The fusion risk score (FRS) is introduced to assess baseline risk of spine fusion surgery preoperatively. An objective method of stratifying risk allows the surgeon to control risk through tailoring intervention and explain differences in complication profile in high-complexity practice.

Results of uncemented distal locked prosthesis in revision hip arthroplasty with proximal femoral bone loss: A retrospective study.

Introduction: Management of bone loss is a challenge in revision total hip arthroplasty (THA). A retrospective review was performed to study the use of uncemented distal locked prosthesis in cases with proximal femoral bone loss.

Materials And Methods: Uncemented stems with distal interlocking were used in 65 hips during revision THAs with 38 hips having Paprosky IIIB/IV defects between January 1998 and February 2004.

Surgeon's view of pedicle screw implantation for the monitoring neurophysiologist.

Pedicle screws have become the gold standard of spinal instrumentation over the past decade owing to their biomechanical superiority. Despite their advantages, pedicle screw instrumentation is potentially dangerous, and surgeons wish to improve accuracy of screw placement to avoid complications associated with screw misplacement. The anatomy of the pedicles is variable throughout the spine, and several landmarks and trajectories have been suggested to aid safe placement of pedicle screws in the spine.

Tantalum acetabular cups provide secure fixation in THA after pelvic irradiation at minimum 5-year followup.

Background: Pelvic radiation has been commonly used to treat gastrointestinal, genitourinary, or hematopoietic malignancies. Conventional THA in these patients reportedly have high rates of fixation failure. Although secure short-term fixation reportedly occurs with trabecular metal implants following pelvic radiation, it is unclear whether the fixation is durable.

Evidence summary: systematic review of surgical treatments for geriatric hip fractures.

Background: There is a growing body of literature on surgical treatments for elderly patients with a hip fracture and the effects of various surgical procedures on complications and postoperative outcomes. No single review has previously summarized the literature on the effects of surgical procedures on outcomes after treatment across all types of hip fractures. We conducted a comprehensive systematic literature review to organize the clinical evidence for patient-centered outcomes across all types of geriatric hip fractures.

Gait analysis comparison of cruciate retaining and substituting TKA following PCL sacrifice.

The role of the posterior cruciate ligament (PCL) remains controversial in total knee arthroplasty (TKA), with some surgeons who believe in PCL sacrifice and substitution and others who believe in PCL preservation for stability. Manufacturers have developed both cruciate-substituting/posterior stabilized (PS) implants typically used when the ligament is sacrificed and cruciate retaining (CR) implants designed for ligament preservation. However, studies demonstrate excellent clinical results with CR implants despite PCL sacrifice.

Current perspectives on desmoid tumors: the mayo clinic approach.

Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation.

Management of gunshot pelvic fractures with bowel injury: is fracture debridement necessary?

Background: Low-velocity pelvic gunshot injuries occur commonly in urban trauma centers, occasionally involving concomitant intestinal viscus injury leading to potential fracture site contamination. Surgical debridement of the fractures may be necessary to prevent osteomyelitis, although not routinely performed in many centers. The purpose of this study was to determine whether fracture debridement should be done to prevent osteomyelitis in these injuries.

Treatment of common hip fractures.

Objectives: To conduct a systematic review and synthesize the evidence for the effects of surgical treatments for subcapital and intertrochanteric/subtrochanteric hip fractures on patient-focused outcomes for elderly patients.

Data Sources: MEDLINE, Cochrane databases, Scirus, and ClinicalTrials.gov, and expert consultants.

The role of locking technology in the upper extremity.

The technique of locked plating has been a major advance in Orthopaedic fracture surgery and has had an equal impact on the management of upper extremity fractures. The recognition of the role of vascularity and soft tissues in fracture healing was central to the research and development of newer plate designs that left minimal footprints on the surface of the bone. Subsequently, innovative locking technology has improved our ability to manage cases with extensive communition, inadequate bone stock, and peri-articular fractures.

Delayed onset thigh compartment syndrome secondary to contusion.

While thigh compartment syndrome is relatively uncommon, it can occur in various situations. Multiple reports document thigh contusions as a cause of acute compartment syndrome; however, compartment syndrome of the thigh presenting primarily in a delayed fashion secondary to a contusion has not been described. This article reports a case of thigh compartment syndrome.

Acute isolated lateral compartment syndrome of the leg after a noncontact sports injury.

Compartment syndrome of the leg typically affects the anterior compartment or multiple compartments and can be traumatic or exertional (chronic) in nature. Isolated lateral (peroneal) compartment syndrome of the leg is a less typical and lesser-known condition that can potentially escape diagnosis if not considered in the workup of a painful leg. This article presents a case of isolated lateral compartment syndrome of the leg without gross muscle rupture or hematoma.