Chronic Supraspinatus Tendonitis Pain: An Integrative Approach for Treatment with Cross-Fiber Massage, Electroacupuncture, Far-Infrared Heat, and Photobiomodulation.

Objective: More than 70 million Americans suffer from chronic pain; many cases are related to sports injuries. This type of injury often involves soft tissues (muscles, tendons, and ligaments). Direct-force injury (e.

The revised Approved Instructional Resources score: An improved quality evaluation tool for online educational resources.

Background: Free Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context.

Outcomes of Hip Arthroscopy in the Medicare Patient: A Growing Population.

Background: Although the results of hip arthroscopy in the elderly have been inferior to the results in younger patients, there have recently been some encouraging reports in carefully selected series of older patients. The purpose of this study was to identify the utilization of hip arthroscopy in the Medicare population and to determine the rate and timing of revision arthroscopy and/or total hip arthroplasty (THA) with the goal of identifying risk factors for secondary procedures based on patient demographics, comorbidities and the diagnosis at the time of arthroscopy.

Methods: The Medicare Standard Analytic Files were reviewed from 2005-2014 for all patients undergoing hip arthroscopy allowing for minimum 2 year follow-up (100% sample).

Ganglion Cyst as a Rare Complication of Hip Arthroscopy Resolved With THA: A Case Report.

Background: A rare complication of hip arthroscopy is the development of a ganglion cyst. These cysts can affect structures surrounding the hip joint. In some cases, the femoral artery may be involved, leading to claudication or a pulsatile mass that can resemble an aneurysm.

Preoperative Opioid Use and Its Association With Early Revision of Total Knee Arthroplasty.

Background: Few studies have evaluated the impact of preoperative opioid use on risk of subsequent revision following primary total knee arthroplasty (TKA). The purpose of this study was to determine whether preoperative opioid use is associated with an increased risk of early revision TKA.

Methods: The Humana administrative claims database was queried to identify patients who underwent unilateral TKA during the years 2007-2015.

Does Preoperative Opioid Use Increase the Risk of Early Revision Total Hip Arthroplasty?

Background: The purpose of this study is to evaluate the impact of preoperative opioid use on the risk of subsequent revison after primary total hip arthroplasty (THA).

Methods: The Humana database was queried for unilateral THA between 2007-2015. Patients were tracked for the occurrence of an ipsilateral revision THA for 2 years.

Recent Trends in Blood Utilization After Revision Hip and Knee Arthroplasty.

Background: Blood transfusion guidelines in elective surgery have been implemented over the last decade to minimize risk and cost related to transfusion without sacrificing patient outcomes. Blood utilization in primary total hip (THA) and total knee arthroplasty (TKA) has been extensively studied but there is a paucity of studies evaluating utilization in revision THA and TKA. The purpose of this study is to evaluate current trends in transfusion following revision THA and TKA.

Are Trends in Total Hip Arthroplasty Bearing Surface Continuing to Change? 2007-2015 Usage in a Large Database Cohort.

Background: Bearing surface issues related to trunnionosis or metal-on-metal (MoM) articulations have likely impacted recent trends in bearing surface choice. The purpose of this study is to evaluate trends in total hip arthroplasty (THA) bearing surface use, including 2015 data, with respect to the date of operation and patient demographics.

Methods: The Humana dataset was reviewed from 2007 through 2015 to analyze bearing surface usage in primary THA.

Recent Trends in Blood Utilization After Primary Hip and Knee Arthroplasty.

Background: Blood conservation strategies have evolved greatly over the last 5 years. There is a paucity of large blood utilization studies of total hip arthroplasty (THA) and total knee arthroplasty (TKA) that include recently performed surgery. The purpose of this study was to use a large database to evaluate trends in blood transfusion after THA and TKA, including 2015 data.

Topography of microglial activation in sensory- and affect-related brain regions in chronic pain.

Microglial activation in the spinal cord plays a central role in the development and maintenance of chronic pain after a peripheral nerve injury (PNI). There has not yet been a thorough assessment of microglial activation in brain regions associated with pain and reward. To this end, this study uses a mouse model of neuropathic pain in which the left sciatic nerve of male C57Bl/6J mice is loosely constricted (chronic constriction injury) to assess microglial activation in several brain regions 2 weeks after injury, a time point at which pain hypersensitivity is well established.

Two- to 4-Year Followup of a Short Stem THA Construct: Excellent Fixation, Thigh Pain a Concern.

Background: Short stem cementless femoral components were developed to aid insertion through smaller incisions, preserve metaphyseal bone, and potentially decrease or limit the incidence of thigh pain. Despite some clinical success, the senior author (DDG) believed a higher percentage of his patients who had received a cementless short stem design were experiencing thigh pain, which, coupled with concerns about bone ingrowth fixation, motivated the review of this case series.

Questions/purposes: (1) What is the proportion of patients treated with a short stem cementless THA femoral component that develop thigh pain and what are the hip scores of this population? (2) What are the radiographic results, specifically with respect to bone ingrowth fixation and stress shielding, of this design? (3) Are there particular patient or procedural factors that are associated with thigh pain with this short stem design?

Methods: Two hundred sixty-one primary THAs were performed in 238 patients by one surgeon between November 2010 and August 2012.

Minimum 10-Year Follow-Up of Cementless Total Hip Arthroplasty Using a Contemporary Triple-Tapered Titanium Stem.

Background: There is extensive variation in design and insertion technique of cementless tapered femoral stems. The purpose of our study was to evaluate a consecutive series of contemporary tapered cementless femoral stems inserted with a ream-and-broach technique at a minimum 10-year follow-up in patients undergoing total hip arthroplasty (THA).

Methods: One hundred consecutive THAs (88 patients) performed by a single surgeon were followed for a minimum of 10 years.

Metal-on-Metal Total Hip Arthroplasty at Five to Twelve Years Follow-Up: A Concise Follow-Up of a Previous Report.

Background: Concern has arisen regarding potential complications with modular metal-on-metal (MoM) acetabular components in total hip arthroplasty. The purpose of this study was to analyze longitudinally the longer term results of a previously reported cohort of patients utilizing a cementless modular acetabular component with a MoM bearing.

Methods: One hundred sixty-nine consecutive but selected total hip arthroplasties were performed in 148 patients at 2 institutions using a modular acetabular MoM component.

The John N. Insall Award: Do Intraarticular Injections Increase the Risk of Infection After TKA?

Background: Infection after total knee arthroplasty (TKA) can result in disastrous consequences. Previous research regarding injections and risk of TKA infection have produced conflicting results and in general have been limited by small cohort size.

Questions/purposes: The purpose of this study was to evaluate if intraarticular injection before TKA increases the risk of postoperative infection and to identify if time between injection and TKA affect the risk of TKA infection.

Risk of Acute Kidney Injury After Primary and Revision Total Hip Arthroplasty and Total Knee Arthroplasty Using a Multimodal Approach to Perioperative Pain Control Including Ketorolac and Celecoxib.

Safe and effective perioperative analgesia is instrumental to patient satisfaction and decreasing LOS after TJA. We evaluated rates of acute kidney injury (AKI) in primary and revision TJA using a multimodal pain control regimen including scheduled celecoxib and PRN ketorolac. Postoperative AKI was identified in 43/903 (4.

Fixation and Wear With Contemporary Acetabular Components and Cross-Linked Polyethylene at 10-Years in Patients Aged 50 and Under.

We evaluated the mid-term performance of a moderately cross-linked polyethylene THA bearing in younger patients. One hundred consecutive THAs performed in patients 50 years of age and under using the same cementless acetabular component and moderately cross-linked polyethylene were evaluated at minimum 10 year follow-up. At final follow-up 75 patients (89 hips) were living, 7 patients (7 hips) were deceased and 4 patients (4 hips) were lost to follow-up.